RC-09-1560 (2) Miami Shores Village
� Building Department
0 U 10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING Permit No. 2
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: BUILDING ROOFING-
Owner's Name (Fee Simple Titleholder) Phone #
Owner's Address y /U, 6u1 Gib
City /&G� --( , ///" State Zip j /f
Tenant/Lessee Name Phone #
Email
Job Address (where the work is being done) Gj!/yy
City Miami Shores Villa County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO Flood Zone
Contractor's Company Name ► , Phone #
Contractor's Address
City State Zip
Qualifier Name Phone # ?
State Certificate or Registration No. Certificate of Competency No.�
-Contact Phone E -mail
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit 4 ft9,o 0 0 Square / Linear Footage Of Work: NO 41ff
Type of Work: ❑Addition ❑Alteration ❑New Re air /Re lace
p p ❑Demolition
Describe Work: J(/; �"lh 1 loepfPle
Submittal Fee $ L1 Permit Fee $ CCF coo
rani —�_
Notary $ y Training /Education Fee $ l o a Technology Fee $ 2 � p
Scanning $ Q Radon $ I DPBR $ . Bond $ �7
Double Fee $ Violation date:
Structural Review. $ Total Fee Now Due $ Z,7
�
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 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 r einspection fee will be charged..
Signature Z . Signature
Owner or Agent 6 1 Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 C , by j 9k-lb L I day of , 20 by ,
who is personally known to meor who has produced who is personally known to me or has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: �^ Sign:
Print: IV I2 ( Z Y w �� LOA) C— Print:
My Commi Ares: MARILYN R. LONG My Commission Expires:
�`.• s;
;.: MY cOMMISSION A DD 498675
t ;k. EXPIRES: January 18, 2010
..•.. Bonded ThN Notary Puts k Urdenwhers
APPROVED BY Plans Examiner
-e nL�S'f - Zoning
P54` v `�
Engineer Clerk checked
(Revised 07 /10 /07)(Revised 06/10/2009)
4. 1� understand that the building official and inspectors 'are not there to design,
alter or give advice on how to meet code - only if the structure meets the
minimum code. ,,//
Initial M
5. I understand that as an owner- builder, that any contractor disputes with sub-
contractors and myself must be handled in a civil court with the advice of 0
attorney. The department will not mitigate any contract disputes.
Initial
G. I understand that if I compensate any person or company for work performed
they are requited to have a business license in the county. If for any reason they
do not posses a business license I will be responsible and liable for any wrong
doing from this unlicensed company or person.
Initial
7. I understand that if any person gets injured on my construction projcct they are
entitled to workmen's compensation • Anil if they do not posses a workmen's
policy I could be held liable for all doctor and related cost which could include
lass of wages during recovery from injury.
Initial C_1V7 .
8. •I understand . that under state and local laws ' I can not do . any Electrical,
Plumbing, Heating, Air & Roof work on my `property with out first obtaining
the proper permits by licensed contractors..
Initial
�
Was .acknowledged before me this d day of / , 20
BY r �e who was personally known to me or who has
Produced there License or L O �) O as identification.
r: d A
OWNER u NOTARY
e: ,y
J IAeQn�c
VILLAGE OF MIAMI SRO:R.ES
OWNER BUILDER DISCLOSURE STATEMENT
NAME: DATE: g ?e
ADDRESS:
33/3 Z
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 411ows 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 redidbnce. You may
also build or improve a commercial building at a cost of $25,000.00 or less. 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 fot sale or lease, which is a violation bf this exemption. You May not hire
an unlicensed person as k contractor. It is your responsibility to make sure the people employed
by you have lloensea required by state law.arid by county or municipal licensing ordinances. Any j
person working on your building who is not licensed mast work under your supervision and must
be employed by you, which means that you must deduct F.LC.A and with- holdings tax and
provide workers' compensation for that employee, all as proscribed by law. Your construction
must comply with all applicable laws, ordinances, .buildings codes and zoning regulations.
Please rcgd and initial each paragraph.
1. 1 hold. title to the above property and I am planning on doing this construction
Myself
Initial
2. I understand that as an oviner- builder I must abide by all zoning ordinances and
building regulations in effect at the time of permit application. Inactive
permits for a period of over 180 days will become null and void (expired)
and a new permit will be required. to be Issued for reinstatement of the
permit.,
Initial
3. 1 have an understanding of the 2004 FBC & FRC and understand that this
department and its inspectors are there to help enforce and interpret the code.
There is a copy of the code in this office for review.
Initial
4. I. understand that the building official and inspectors are not there to design,
alter or give advice on how to meet code — only if the structure meets the
minimum code. l/
Initial
5. 1 understand that as an owner - builder, that any contractor disputes with sub-
contractors and myself must be handled in a civil court with the advice of W
attorney. The department will not mitigate any contractdisputes.
Initial
6. I understand that if I compensate any person or company for work performed
they are . requited ed to have a business license in the county. If for any reason they
do not posses a business license I will be responsible and liable for any wrong
doing from this unlicensed company or person.
Initial C-141
7. I undeivWnd'that if any person gets injured on my construction project they are
entitled to workmen's compensation. - ,Anil if they do not posses a workmen's
policy I could be held liable for all doctor and related cost which could include
Woo of wages during recovery from injury.
Initial
8. I understand . that under state and local laws 'I can not do . any Electrical,
Plumbing, Heating, Air & Roof work on my'property with out first obtaining
the proper permits by licensed contractors.
Initia
Was acknowledged before me this day of L4ez, , 20
By r� who w personally known to me o who has
Produced there License or as identification.
OWNER NOTARY
14UWYN R. LONG
MrcisstoN #ona M
VILLAGE OF MIAMI SjOkHS
0 WNER BUILDER DISCLOSURE ,STATEMENT
NAME: F31_17 f.Z DATE:
ADDDRESS: ��D 1/ /LftG�Yl7iri , /�D2K 3.3d.TL
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 my build or improve a one - family or two- family redidbnce. You may
also build or improve a commercial building at a cost of $25,000.00 or less. 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 fot sate or lease, which is a violation bf this exempti®tt. You may not hire
an unlicensed person as a contractor. It is your responsibility to make sure the people employed
by you havo Ilconses. required by state law•and by county or municipal licensing ordinances. Any
person working on your building who is not licensed ttutst work under your supervision and must
be employed by you, which means that you must deduct F.W 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 rogd and initial each paragraph.
1. I hold. title to the above property and I am planning on doing this construction
Myself.
Initial 40
2. I understand that as an owner- builder I must abide by all zoning ordinances and
building regulations in effect at the time of permit application. -Inactive
permits for a period of over 180 days will become null and void (expired)
and a new permit will be required. to be issued for reinstatement of the
permit.,
Initial
3. I have an understanding of the 2004 FBC & FRC and understand that this
department and its inspectors are there to help enforce and interpret the code.
There is a copy of the code in this office for review.
Initial .
013R`..73 - 73 2000 NOV 3 07
THIS INSTRUMENT PREPARED BY AND RETURN TO:
DIGNA VARGAS
United Lenders Services OOC:STPOEE 864.0 SURTX "0.00
11890 S.W. 8th Street Suite 303 HARVEY RUVINP CLERK OADE t:OUNTY4 FL
Miami Florida 33184
Property Appraisers Parcel Identification (Folio) Numbers:
Grantee SS #: 592345731 and i
SPACE ABOVE THIS LINE FOR RECORDING DATA
THIS WARRANTY DEED, made the 27th day of October, 2000 by Victor Reyna, a single man, herein called the grantor, to
Ernesto Hernandez, a single man whose post office address is 9404 North Miami Avenue, Miami Shores, Florida 33138, hereinafter
called the Grantee:
(Wherever used herein the terms "grantor" and "grantee" include all the parties to this instrument and the heirs, legal representatives and assigns of
individuals, and the successors and assigns of corporations)
W I T N E S S E T H: That the grantor, for and in consideration of the sum of TEN AND 00 /100 ($10.00) Dollars and other valuable
considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys and confirms
unto the grantee all that certain land situate in MIAMI DADE County, State of Florida, viz.:
Lots 4 and 5 in Block 167, SECTION 6 -A of MIAMI SHORES, according to the Plat thereof, as recorded in the Plat Book 12,
at Page 54, of the Public Records of Miami Dade County, Florida.
TOGETHER, with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining.
TO HAVE AND TO HOLD, the same in fee simple forever.
AND, a grantor hereby co nants with said grantee that the grantor is lawfully seized of said land in fee simple; that the grantor has
good ght and lawful authority sell and convey said land, and hereby warrants the title to said land and will defend the same against the
la claims of all persons who never; and that said land is free of all encumbrances, except taxes accruing subsequent to December
31, 999.
1
IN NESS REOF, the sai grantor has signed and sealed these presents the day and year first above written.
Sign seal and delivered in the resence of:
Witness #1 tignature ` ~`� Victor Reyna
255 Sierra Drive #303, N. Miami, Florida 33179
e '
Witness #1 ed N
Witness Si � RECORDED IN OFFICIAL RECORDS SOW
a$ OFOADE COL#M, FLORA.
Witness #2 Printed Name RECORD VER IFIED
HARVEY R UVI UVIN
CLERK CIRCUIT COURT
STATE OF FLORIDA
COUNTY OF N(IAMIDADE
The foregoing instrument was acknowledged before me this 27th day of October, 2000 by Victor Reyna who is personally known to me
or has produced d\-c v &( as identification.
SEAL u
•,PAY PU��v 10� 6 GG 6113
` MY COMMISSI Notary Si EXd'IRES: January 2 200 I Vi�
PUDIC Ut1a8lWf�teB .—
sonaea znm ao� Printed Notary Signature
My Commission Expires:
Inspection Worksheet
V Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972 0 1 - 0 q — tJ �p 1
Inspection Number: INSP 125103 Permit Number: EL -9 -09 -1561
Scheduled Inspection Date: November 05, 2009 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: HERNANDEZ, ERNESTO Work Classification: Addition /Alteration
Job Address: 9404 N MIAMI Avenue
Miami Shores, FL 33150 -
Phone Number
Parcel Number 113101034003
Project: <NONE>
Contractor:
Building Department Comments
Kitchen cabinets resurface,paint
Inspector Comments /' - Wix "� e
Passed /t i 6��
Failed
Correction -
Needed
Re- Inspection ❑ C'�
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
November 04, 2009 For Inspections please call: (305)762 -4949 Page 6 of 16
p i An�
3 tr 3 S r a¢y A
Miami Shores Village
10050 N.E. 2nd. Avenue �
Miami Shores, FL 33138-0000
Phone: (305)795 -2204
a Expiration: 03130/2018
Project Address Parcel Number Applicant
9404 MIAMI Avenue 1131010340030
Miami Shores, FL 33150- Block: Lot: ERNESTO HERNANDEZ
Owner Information Address Phone Cell
ERNESTO HERNANDEZ 9404 MIAMI Avenue
MIAMI SHORES FL 33150 -2246
Contractor(s) Phone Cell Phone Valuation: $ 4,000.00
...... _.:.: - Total Sq Feet: 190
Type of Work: For Inspections please call:
Additional Infer
(305)762 -4949
Classification: Residential Available Inspections:
Inspection Type:
Underground Rough
Final
Meter Box
Alteration
Relocation
Fire Alarm
Service Change
W. W.
Fees Due Amount Invoice # Total Amt Paid Amt Due
CCF $ EL -9-09 -35954 $ 292.73 $ 0.02 f
DBPR Surcharge $0.95
Education Surcharge $0 EL -9-09 -35954 $ 292.73 $ 242.73 $3
Penalty Fee $140.00 EL -9-09 -35954 $ 292.73 $ 292.73 $ 0.00
Permit Fee - Additions/Alterations $140.00
Radon Surcharge $0.95
Submittal Fee $50.00
Submittal Reversal Fee ($50.00)
Technology Fee $7.63
Total: $292.73
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 taws regulating
construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated.
October 01, 2009
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
October 01, 2009 1
Miami Shores Village i
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
BUILDING Permit No. E L-q - � � f
PERMIT APPLICATION muster Permit No.
FBC 20
Permit Type: ELECTRICAL
Owner's Name (Fee Simple Titleholder) 6e NfrR f2W,(U POZ- Phone # _ ?OC z?1j -
Owner's Address �-
City yl/ �`/°� State Zip
Tenant'Ussee Name Phone #
Email
Job Address where the work is being done
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO � Flood Zone oW
NJ , Contractor's Company Name ! J, Ae Phone #
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Contact Phone E -mail
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ a & Square / Linear Footage Of Work: ® 15 !711 x &Y
Type of Work: []Addition ❑Alteration FjNew Repair/Replace ❑ Demolition
Describe Work: %,oy�J°
Oa
V
Submittal Fee $ �v Permit Fee $ '��- CCF $ G6fet"
Notary $ 0 Training/Education Fee $ .�® Technology Fee $
Scanning $ Radon $ , 7,S DPBR $ : l � Bond $
Double Fee $ � , OW Violation date:
Structural Review. $ Total Fee Now Due $
See Reverse side -4
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lenders 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 re- inspection fee will be charged.
P
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this fff� The foregoing instrument was acknowledged before me this
day o=9;4h day of , 20 _, by ,
who i o has produced 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:
Sign: Sign:
Print: 14 ffi Print:
My Commission MygOWSWN#DD 675 My Commission Expires:
.: EXPIRES: Jant y 10, 2D10
APPROVED BY Wf Plans Examiner Zoning
Engineer Clerk checked
I
(Revised 07 /10 /07)(Revised 06/10/2009)
I
I
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Its
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t 3Pl�x 3 i'
Miami Shores Village r
10050 N.E. 2nd Avenue y
Miami Shores, FL 33138 -0000 N�
a 'i =�
" Phone: (305)795 -2204 3
Expiration: 0 3130/2010
Project Address Parcel Number Applicant
9404 MIAMI Avenue 1131010340030
Miami Shores, FL 33150 - Block: Lot: ERNESTO HERNANDEZ
Owner Information Address Phone Cell
ERNESTO HERNANDEZ 9404 MIAMI Avenue
MIAMI SHORES Fl- 33150 -2246
Contractor(s) Phone Cell Phone
Valuation: $ 10,000.00
Total Sq Feet: 190
Approved: In Review For Inspections please call:
Comments: (305)762.4949
Date Approved:: In Review Available Inspections:
Date Denied: Inspection Type:
Type of Construction: Occupancy: Final PE Certification
Stories: Exterior. Drywall
Front Setback: Rear Setback: Miscellaneous
Left Setback: Right Setback: Window Door Attachment
Bedrooms: Bathrooms: Tie Beam
Plans Submitted: Yes Certificate Status: Final
Certificate Date: Additional Info: Framing
Bond Return: Classification: Residential Insulation
Truss Insp
Fees Due Amount Invoice # Total Amt Paid Amt Due Columns
CCF $ RC -9-09 -35953 $ 320.40 $ 320.40 $ 0.00 Foundation
DBPR Surcharge $0.95 Window and Door Buck
Education Surcharge $2.00 Fill Cells Columns
Permit Fee - Additions/Alterations $300.00 Wire Lathe
Radon Surcharge $0.95 F. Termite Letter
Scanning Fee $3.00 F. Elevation Certificate
Technology Fee $7.50
Total: $320.40
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.
October 01, 2009
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
October 01, 2009 1