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DEMO-10-557Inspection Number: INSP- 147331 Permit Number: DEMO -4 -10 -557 Scheduled Inspection Date: July 01, 2010 Inspector: Bruhn, Norman Owner: BELIZAIRE, ROSE Job Address: 130 NW 102 Street Project: <NONE> Miami Shores, FL Contractor: MPR CONSTRUCTION INC Building Department Comments Passed 2-7-m5- Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 146680. CREATED AS REINSPECTION FOR INSP- 139600. Provide mechanical permit for demo of AC Provide a solid core door or metal door between garage and house. NB ,!" Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 June 30, 2010 For Inspections please call: (305)762 -4949 Permit Type: Demolition Inspection Type: Final Work Classification: Building Phone Number Parcel Number 1131010220110 Phone: (786)547 -1583 Page 18 of 26 REMOVE THE KITCHEN CABINET DISCONNECT THE WATER Passed Inspector Comments CREATED AS REINSPECTION FOR INSP- 140375. .C7 1,40 7A -- 2/ , ' PVII ' Y / (... IP dil ,172-fe Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until inspection Number: INSP - 142330 Permit Number: DEMO -4 -10 -608 Inspection Date: May 28, 2010 Inspector: Hernandez, Rafael Owner: BELIZAIRE, ROSE Job Address: 130 NW 102 Street Miami Shores, FL Project: <NONE> Contractor: HOME OWNER Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Type: Demolition Inspection Type: Final Work Classification: Plumbing Phone Number Parcel Number 1131010220110 May 28, 2010 For Inspections please call: (305)762 -4949 Page 1 of 1 Project Address 130 NW 102 Street Miami Shores, FL Owner Information Valuation: Total Sq Feet: $ 120.00 ROSE BELIZAIRE Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Type of Demo: Plumbing Additional Info: REMOVE PLUMBING FROM GARAGE Classification: Residential Fees Due CCF Education Surcharge Notary Fee Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $100.00 $3.00 $0.80 $109.60 Address 130 NW 102 ST MIAMI FL 33150 -1232 Parcel Number 1131010220110 Block: Lot: In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Pe mit 7" tem liti � cai an Plumbing Peel nit mss.' APPROVED Phone Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO - 410 -37557 04/19/2010 Check #: 1047 $ 109.60 $ 0.00 Expiration: 10/16/2010 Applicant ROSE BELIZAIRE Cell Available Inspections: April 19, 2010 Date April 19, 2010 1 Inspection Type: Final I Contractor's Company Name /l-yrra,t Contractor's Address Value of Work For this Permit $ Type of Work: ❑Addition Describe Work: Miami Shores Village INM@ma.C511 Building Department la AN ' F 2010 10050 N.E.Z',pd Avenue, Miami Shores, Florida 33138 Tel: 005) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Job Address (where the work is being done) /30 ,/ll, 443 /O2 jo• City Miami Shores Village County Miami -Dade Zip ,33/4.e7 FOLIO / PARCEL # Is Building Historically Designated YES NO Architect/Engineer's Name (if applicable) Phone # Square / Linear Footage Of Work: Alteration's New 024 744_ kli ckezn-,44.4 Phone # Flood Zone 12.0 BY : TIMSNISMOPMeineef ee8ee®® ® Permit No. iA Z 1 O 1Q Master Permit No. {11O t o r 6 — BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING "'DEMO Owner's Name (Fee Simple Titleholder) 4 � ej/� w j Q / , Phone # L ✓ "�=� -/ Owner's Address /So 4(. ,4,4) /0 'L.ir. City t 1 State /Cp(,2_ Zip .2 3/44 Tenant/Lessee Name Phone # 71170 - 2.96 _ ?S'1 tf Email r. 741 arq3 City /kr ICI -64AZ state q Zip .33/4-z: Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Contact Phone E -mail ❑ Repair/Replace ,Demolition * * * * * * * * * * * * * * *** *** * * * * ** **** * * * * * * ** F ees ** * * * * * ***** * * * * * * ** : * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ ) o0 G1s4 Pl/e— CCF $ 0 0 CO /CC $ Notary $ J OU Training/Education Fee $ - ` Technology Fee $ a Scanning $ 3- 60 Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ A 09 `(GO See Reverse side —+ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and iiia s t` . g4a,,, ca I certify that no work or installation has commenced prior to the issuance of a permit and that all work kill 11 pedrf meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature R © R' U C V /) R S Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this 12 The foregoing instrument was acknowledged before me this day of I , 20 l (by day of , 20 _, by who is personally known to me or who has produced 1 j who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: AP OP Sign: Sign: Print: Print: My Commission Expires: My Commission Expires: APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) (/ ® � Plans Examiner Zoning Z — Engineer Clerk checked M iami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: / > u� am DATE: c. D ADDRESS: /20 l I i1 &. Af Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor, I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two-family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less (The new form states 75,000), The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete. the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with- holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. Please read and Initial each paragraph. 1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner- builder permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a license. Initial I /2 2. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. Initial 4 3. I understand that, as an owner builder, I am the responsible party of record on a permit I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts. Initial /e I2 4. I understand that I may build or improve a one family or two-family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease, which violates the exemption. 5. I understand that, as the owner- builder, I must provide direct, onsite supervision of the construction. Initial /C ,8 Initial /c , /, 6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. Initial / A 7. I understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner - builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner- builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner- builder and am aware of the limits of my insurance coverage for injuries to workers on my property. ,,//�� Initial 1= /� 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for the employee. I understand that my failure to follow these may subject to serious financial risk. Initial / . 8 9. I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and requirement that govern owner - builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. Was acknowledged before me this i day of P(0 L , 20 Initial N. .� 10. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http:// www. myfloridalicense .com/dbpr /orolcilbfindex.html Initial ,. 11. I am aware of, and consent to; an owner - builder building permit applied for in my name and understands that I am the party legally and financially responsible for the proposed construction activity at the following address: Initial K - A 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that I have provided on this disclosure. Initial A A Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. By P1C .L A ?Al air-- who was personally known to me or who has Produced there License or !-Ro (RE OWNER as identification. NOTARY 0 Inspection Number: INSP- 144814 Permit Number: DEMO -4 -10 -608 Scheduled Inspection Date: June 02, 2010 Inspector: Hernandez, Rafael Owner: BELIZAIRE, ROSE Job Address: 130 NW 102 Street Project: <NONE> Miami Shores, FL Contractor: HOME OWNER Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 REMOVE THE KITCHEN CABINET DISCONNECT THE WATER Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments PLEASE CALL, HOME OWNER IS AT INSPECTION: 786.290.7574 ROGER Ai0 OME WAITING FOR THE June 01, 2010 For Inspections please call: (305)762 -4949 Phone Number \ 0 Permit Type: Demolition Inspection Type: Final Work Classification: Plumbing Parcel Number 1131010220110 Page 15 of 18 Inspection Number: INSP - 145601 Scheduled Inspection Date: June 09, 2010 Inspector: Devaney, Michael Owner: BELIZAIRE, ROSE Job Address: 130 NW 102 Street Project: <NONE> Passed 12/ Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 142328. CREATED AS REINSPECTION FOR INSP- 141666. CREATED AS REINSPECTION FOR INSP- 141201. ELECTRICAL DEMO IN PROGRESSremove all cloth & rubber insulated conductors, Add smoke & carbon monoxide detectors. Need A/C wireing permit.Replace all cloath & rubber insulatede conductors. Add smoke detecors. Pull permit to wire A/C. cyz_ f Miami Shores, FL Contractor: FELLO ELECTRIC INC Building Department Comments UPDATE ELECTRICAL WITH GARAGE June 08, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 iO551 Permit Number: EL -4 -10 -575 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1131010220110 Phone: (786)290 -7576 Page 15 of 26 Scheduled Inspection Date: April 26, 2010 Inspector: Devaney, Michael Owner: BELIZAIRE, ROSE Job Address: 130 NW 102 Street Project: <NONE> Miami Shores, FL Contractor: FELLO ELECTRIC INC Building Department Comments April 23, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 DEMO -4 ' 551 Inspection Number: INSP - 141201 Permit Number: EL -4 -10 -575 For Inspections please call: (305)762 -4949 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1131010220110 Phone: (786)290 -7576 Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments ELECTRICAL DEMO IN PROGRESS / e/1P 8 - ( /a, e at} tei 09-7 'i- /aa'/z; 9 26 Page 11 of 27 Project Address 130 NW 102 Street Miami Shores, FL 1131010220110 Block: Lot: ROSE BELIZAIRE Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Contractor(s) FELLO ELECTRIC INC Phone Cell Phone (786)290 -7576 Type of Work: UPDATE ELECTRICAL WITH GARAGE Additional Info: ELECTRICAL Classification: Residential Fees Due CCF Education Surcharge Notary Fee Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $1.20 $0.40 $5.00 $225.00 $3.00 $1.60 $236.20 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Amt Paid Amt Due Pay Date Pay Type Invoice # EL-4-10 -37505 04/19/2010 Check #: 1047 $ 236.20 $ 0.00 Applicant Expiration: 10 /16/2010 Valuation: Total Sq Feet: April 19, 2010 Date $ 1,200.00 0 Available Inspections: Inspection Type: April 19, 2010 1 BUILDING PERMIT APPLICATION FBC 20 Email Architect/Engineer's Name (if applicable) Submittal Fee $ Miami Shores Village NagEgVIS Building Department AP R 6 >O 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit Type: ELECTRICAL ,� Owner's Name (Fee Simple Titleholder) Lc, ,nix , �;; eX j, Phone # „„,16-S AS`- Z91,3 Owner's Address /$9 /4A) /0a °4 City N/ phr,, State r;(4, Zip 3.3450 Tenant/Lessee Name S 4e45 .4e Phone # Job Address (where the work is being done) /80 A/. 4J /02 vi-LLE City ' Miami Shores Village County Miami -Dade Zip ,e9/t FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone Contractor's Company Name f f . F. J,r c Phone # Contractor's Address 47V ,#y s e) City /fi a4.w State A24, Zip 33109 Qualifier Name 4yii? j ,e , fd / Phone # � u (y.6 R9 _ Pr?* State Certificate or Registration No. .. Certificate of Competency No. 6 . EGtrea 2. Contact Phone E-mail ,S ,4e,e4„. XlA Permit No. CL 10 515 Master Permit No. Demo tV ...55 Value of Work For this Permit $ 12CC .03 Square I Linear Footage Of Work: Type of Work: DAddition ['Alteration ['New Repair/Replace D Demolition Describe Work: 4014A- � � �� C 1, L u„' 1\ Phone # ' :::� 1 �/� Permit Fee $ ;G> �ls //"Y CCF $ ' gLJ CO /CC $ Notary $ ` 5 . 0 (J Training/Education Fee $ 0- Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ 9 P•JO See Reverse side —+ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFi I1)AVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a re- inspection fee will be charged. Signature Q L 1 A 0� A f\ Owner or Agent The foregoing instrument was acknowledged before me this 6 day ofkaAk_. , 20 In, by 2UU iL gE..U24 t who is personally known to me or who has produced As identification and who did take an oath. as identificOf f i 3 who did take an oath. NOTARY PUB IC: 0 Ili „ NOTARY PUB � �O 3l � / /� • Sign: � � 01,, ,,A, �� : Sign: ... Print: L C ' ®^a� ® , Z - Print: • � � ti \� � "!' My Commission Expires: ., V® �� ,�‘p °� My Commission f�p�re s':'• •••• �S ��`� ' S TAT (1... �``� APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) Engineer Signature Contractor The foregoing instrument was acknowledged before me this day of lrfrLi L , 20 , by ( 12.6C - -2-2-- (VD< who is personally known to me or who has produced F �— t - "flans Examiner Zoning Clerk checked 130 NW 102 Street Miami Shores, FL 1131010220110 Block: Lot: ROSE BELIZAIRE Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Address ROSE BELIZAIRE 130 NW 102 ST MIAMI FL 33150 -1232 Valuation: Total Sq Feet: $ 1,700.00 Contractor(s) MPR CONSTRUCTION INC Phone Cell Phone (786)547 -1583 Type of Demo: Building Additional Info: BUILDING Classification: Residential Fees Due CCF Education Surcharge Permit Fee Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $1.20 $0.40 $150.00 $6.00 $50.00 ($50.00) $1.60 $159.20 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy l��l G Type De to i on Buildl PRov Expiration: 10/16/2010 Phone Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO -4-10 -37472 04/02/2010 Cash $ 50.00 $ 109.20 04/19/2010 Check #: 1047 $ 109.20 $ 0.00 Cell Available Inspections: Inspection Type: Final April 19, 2010 Date April 19, 2010 1 BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING ROOFING Owner's Name (Fee Simple Titleholder) 656 W / 4 Phone # , 75 Owner's Address / 30 MW /0 2. 5ydree City Afami W State ,,r6 er^ic:/ Zip --;,/,5"C? Tenant/Lessee Name f A- Phone # Email Job Address (where the work is being done) /7 A(i' /0 A. se City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES Contractor's Company Name M/ /V S , O7.4 Phone # 3 /160 /L 5 l City 44 ,a st / State Qualifier Name £ecita I 'Rai ineuml Phone # 7 64, - c 7-10 State Certificate or Registration No. C &C- / 57/62 6 ( Certificate of Competency No. Contact Phone E -mail / e e-ae erm o n d °7.0 f> elZ yak s :17 r Architect/Engineer's Name (if applicable) /k//,r Phone # Contractor's Address Value of Work For this Permit $ Type of Work: Describe Work: Scanning $ Radon $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 1700 : Notary $ Training/Education Fee $ NO Master Permit No. Square / Linear Footage Of Work: Permit No. DEm0 I t -557 /awe( g44ile.ei .. 756 - 5V 7 —i5 Zip 3 3/62 Flood Zone /■/® 1-, MCMEWEE`fi' f k 0 2 2010 BY: ❑Addition ['Alteration ❑New ❑ Repair/ReplaceDemolition 7a &1ou6 P ems, eT) 7 Zy 6,414q- *************************************** ees * * * * * * * * * * * * * * * * * * ** * * * * * * * ** * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ J O CCF $ � � gA 0.40 Technology Fee $ Bond $ See Reverse side -* CO /CC $ 14(.Q DPBR $ Double Fee $ Violation date: �� y Structural Review. $ Total Fee Now Due $ 6 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) 'hl ,�- Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature •Y R © Owner or Agent The fore oing instrument was acknowledged befo e me this day of , 20 10 , by Q hiceort. who is personally known to me or who has produced figt WW t- th As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: RICHARD LAROSE EXPIRES March 10, 2013 keht, rG, { 40713 0 5 My Commission Expires: APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) FloridallotaryService.com Plans Examiner Engineer Signature / Contractor I A . foregoing instrument was acknowledged before me this I S day of k ,20 lb , by I 111d2 (tt do ( who is personally known to me or w o has produced f iN)0 roof 's IiittAit as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expir RICHARD LAROSE EXPIRES March 10, 2013 FioridalloiaryService.com Zoning Clerk checked 9 IVM-3o r r csh t v-1/4 TAf 5i(7 Y3 tO co c,-, I PIZ- (erX) SYOZ Ci M& et eti e SE / 3c) At 149 ( 0 2 /7140/4 e C - 47_5 i Clip A//t/ / /41;r4il oo, re .E._ele;25 Eri-)ove a fi p I 14 el u26 --1-0 tie Chevy e 1 3.0( Cab, A.4; a IA d azi-viie s fr lAi vk 44-44-icke Oak-2-k 4o n-7, 47- c-. e vt n 1 eeez_ t illatAi 5 A-0 fn. s hi,' 4 "icy- /42, f',/*1 715 '-' , ey n S 1 1 I 1- 1 a ts e--1 rz-e- 0ATE: 03/23/2010 T�ML: l5:40:56 `n"C[V]NT : 599121'�2 BUSINESS: MFR CONSTRUCTION INC ADD: NW 144 ST 33162 MUN: 30 ( M CORP INC / OWNER NAME: MPR CONSTRUCTION • ADDR: 30 KW 144 ST ZIP: 33168 OTHER INFORMATION: PP-FOLIC: 00 000000 RE-FOLIO: 30 2124 004 .. ............ MIAMI ......... R ECEIPT: 625 SEC TYPE 196 BLDG1 ITEMS 1 HOLD-APPLIC: LEGAL: WARNING #: PREV-YRS: YEAR: 2009 0700 STATE: CGC1511666 CC: EXEMPT-CD: VET-ID: CITY RECEIPT/ZONING PERMIT: TRANSF-FROM: TRANSF-Tb: NAICS: CAT/NAICS: 2389 FLORIDA MIAMI-DADE COUNTY, LOCA- BUSINESS TAX PUBLIC ACCOUNT INQUIRY COMM-DATE: 03/2007 DELETE-ST: ~ ^ ^ ^ ^ ^ HOL],'R[C: INSP RCT#: .00 YEAR: 2008 SUITE: AILlN8): C/O: PIMRE R RECEIPT DESCRIPTION AMOUNT-DUE D/R PD LEG . X 625U50 GENERAL BUILDING CONTRACTOR 1 93.75 ,�� MiAM 1, '� ^' ^�-:-`, ^n . SEPTEMBE��,0 14Q��F�A� �: :��H��,5W��� ��� � MiikA.i.i�,: - 130 Received on: � - F1=}�E��U CLEAR=PREV SCR F4=MORE RCT ENTER=RECEIPT ~ v COUNTY, FLORIDA �H!L: O3/23/2010 LOCAL BUSINESS TAX TI'E: 1�:40:57 RECEIPT INQUIRY . . .... . .. . . .... RENEWAL COMM-DATE: 03/2007 LAST-TRANS-DATE: 03/23/2010 DESCRIPTION GENERAL BUILDING CONTRACTOR ORIG-REC: FINANCE DEPARTMENT TAX COLLECTION DIVISION 140 W. FLAGLER STREET MIAMI, FLORIDA 3313O LDT YEAR: OO 'r!71()' ENTRY-DATE: 03/08/2�0^ ENTRY-TYPE: RAYMOND PRES . . . . . . . . . PG � '- ~ 300 NW 144 ST • .... . . . ENTRY-TYPE-DTE: W INSP-ID-DTE: PRV-YRS: CURRENT: PENALTY: HOLD: DELQPENx _ SVC-CHG: _ TRANSFR: SHERIFF: ADJUST : EXEMPT : PAID DUE THE INFORMATION HEREIN DOES NOT NECESSARILY coiri ALL PERTINENT FACTS Wmi TO REAL ESTATE CLOSINGS AND OTNER ACTIVITIES. ~ ' ' F1=MENU CLEAR=PREV SCR F2=FMHITT F3=PYMTS F4=MORE REC F5=MEMINQ F6=MUNINQ F12=PRNT F13=HELP F14=PI F15=CONTR THE kNFORMATION HEREIN DOES NOT NECESSARILY CONTAIN ALL PERTINENT FACTS WITH REGARDS TO REAL ESTATE CLOSINGS AND OTHER SIMILAR ACIWMES. rTproT FINANCE DEPARTMENT TAX COLLECTION DIVISION 140 W. FLAGLER STREET MIAMI, FLORIDA 33130 LBTR YEARg 2010 0C12 .... 03/O8/ O0/00/00 EFFECTIVE DATE: 10/23/2008 EXPIRATION DATE: 10/23/2010 PERSON: RAYMOND PIERRE R FEIN: 204519637 BUSINESS NAME AND ADDRESS: MPR CONSTRUCTION INC 300 NW 144TH STREET MIAMI FL 33168 SCOPES OF BUSINESS OR TRADE: 1- CONSULTANT 2- CERTIFIED GENERAL CONTRACTOR DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 STATE OF FLORIDA AC# DEPART; - Bff;� AN PROFEE GNAT, :, REGTJLATION CCC1511666 10 f2 08 087010112 CERTXFI L CONTRACTOR RAYMOND : IE RE RICRA j MPR CONSTR IS CRTIB`IED natter the prorria one of ch.489 Fs £xpiratt3oa hater AUG _ 31 :2010 L081021102353 10 -23 -2008 ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. IMPORTANT: Pursuant to Chapter 440 . 054141, F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05412), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05113 ►, F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the Filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -1609 Permit No: 10- 3 7 Job Name , 2010 Norman Bruhn CBO 305 - 795 -2204 Building Critique Sheet ACcite /%A, it rrietid-'7 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. ;ft . V.p,-74S:+cf -_ - F . . . . .. . r • . .. _ I - . . . , ,. . , _1„ -• - - - -) &„:;.7.S'..i.'-5 ' _-. ,., .r . : • • : • • ...• 7.1fittitbaim 7 6 - ; "en • A