RC-07-1054Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Date: 08/27/2007
Inspector: Grande, Claudio
Owner: ROMANIK, DAVID
Job Address: 95 95 Street NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Kitchen Cabinets
Block:
Phone Number
Parcel Number 1132060130730
Lot:
Building Department Comments
kitchen remodeling
•
I r •
AUG 2 8 2007
•
Passed
Inspector Comments
E.L.01...)a-ici M.. •
Failed
Correction
Needed
Re-Inspection
Fee
($75)
No Additional Inspections can be scheduled
re-inspection fee is paid .
until
Friday, August 24, 2007
Page 2 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING 501
PERMIT APPLICATION Lef
FBC 2004
Permit Type (circle):
Permit No.
�R.
MAY 3 2 2007'
Vii)
BY:
Master Permit No.
Electrical Plumbing Mechanical
Roofing
Owner's Name (Fee Simpl Titleholder) David gorrban 1 V Phone # °7h " 30- 3440
Owner's Address 45 1.1 s+
State PL
City /h ann Shur
Tenant/Lessee Name
Zip 33135
Phone #
Job Address ('where the work is being done) 1-ne A�
City
FOLIO / PARCEL #
Is Building Historically D
Miami Shores Village
abode.
County Miami -Dade Zip
Contractor's Company Nan
Contractor's Address /3
City
Qualifier Name
State Certificate or Registrati
ignated YES NO X
e (I ®1-e e l;hone # 3-i-- ° 'qi 5
�f 2
Zip )13i
Phone #
on No.
Architect/Engineer's Name if applicable)
Certificate of Competency No.
Value of Work For this Permit $ 'Q - Old-✓
Type of Work: ❑Addition UrAlteration
Describe Work: l(+ fi
Phone #
Square / Linear Footage Of Work:
❑New Repair/ReP place CI Demolition
* * * * * * * * * * **
* * * * * * * * * * * * * * * * * * * * * * * * * ** Fees***************** * * * * * * * * * *� *) * * * * * * * * ** * * ** **
00 C422"— CCF $ (C) . 0 V CO /CC
2 CO Technology Fee $ �.
Submittal Fee $ Permit Fee $
Notary $ Training/Education Fee $
Scanning $ _ Radon $
Bond $ Code Enforcement $
Structural Review. $
DPBR $
Zoning $
Double Fee $
Total Fee Now Due $ 52,c1 .
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 riot be approved a reinspection fee will be charged
Owner or Agent
The foregoing instrument was acknowledged before me this a. /
day of Hal ,2007, by 24(/1 ?01 41.01/
who is personally known to me or who has produced i
11 As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print
My Commission Expires:
**, *,* * * ** ** * * * * *,* * * * * * * * *** * ** **
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of , 20 , by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
APPLICATION APPROVED BY:
(Revised 02/08/06)
Sign:
Print
My Commission Expires:
''/)1/(ri
Plans Examiner
Engineer
Zoning
111111111111111111111111111111111111111111111
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
N PERMIT NO. I°J7.- JO 5-1 X TAX FOLIO NO. 11 O 6013C/736
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
N 1. Legal description of property and street/address:
:FN 20a )7RIC)5 1 9979
OR Bk 25642 F's 3558; (fps)
RECORDED 05/23/2007 10:47:45
HARVEY RUVIM, CLERK OF COURT
MIAMI -GAGE COUNTYF FLORIDA
LAST FACE
°15 tW 55+
MIden , FL. 3313
2. Description of improvement: R'+ ('C.Mlxt,e. 1
3. Owner(s) name and address: ;avid trot 1.2
q5 facts 54 G. , , 1 L 33130
Interest in property: tamer
Name and address of fee simple titleholder:
Y 4. Contractor's name and address: Nome. Die,
...
IJ� • tJ ,144.44,1'
14, 4 r'Z.. 331
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, Owners designates the following person(s) to receive a copy of the•Lienor's Notice as provided
in Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
date is/ specify:;•)
/14/1/c44
*-7..___-
e of Own r r� i -t
nt Owner's Name DAv b �C'ft 1A►1'►I k ?ccepared by L.IfUd+k L. �pk-6r
Sworn to and sup gibe :fore -------; a his 1day of Mei , 20 U1..
-------; dress a JStr r3O IA.
otary Publi ` 4.)44:.4 45(3
rint Notary's Name ; i O1-1M 70 P �i,'k(I FL • 33325
y commission expires: Feb, 1 i all
.123.01 -52 PAGE 4 8/02
NOTARY PUBLIC -STATE OF FLORA;
Danielle L. Johnst ;,.
Commission #DD393787
Ex Tres: FEB. 07, 2009
Bonded Thru ?t I: nti . Bonding Co., Inc.
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24.DISHW
3" wide Filler
next to dishwasher
Must be a 36"
wide Exhaust Hood
Base cabinet will work
if the cooktop drafts less
than 3 ". Gust. is aware of
this. The drawer may not w
otherwise.
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Miami Shores Villa •e
ED BY DATE
IDEPT
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TO COMPLIANC ,WITH ALL FEDERAL.
D COUNTY RULES AND REGULATIONS
70,"
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L MAY 3 2 2007 ' �'
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homasville, Cottage Maple,
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tandard, Non - plywood construction.
tandard drawer glides.
o Mouldings chosen.
o- hardware /glass inserts chosen.
nal Design:
ate:
138"
424"
All dimensions size designations given are
subject to verification on job site and
adjustment to fit job conditions.
This is an original design and must not be
released or copied unless applicable fee has
been paid or job order placed.
•
Designed: 5/22/200
Printed: 5/22/2007
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Designed: 5/22/2007
Printed: 5/22/2007
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Printed: 5/22/2007 P-
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Designed: 5/22/2007
Printed: 5/22/2007
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interpretation of the general appearance of
the design. It is not meant to be an exact
rendition.
Designed: 5/22/2007
Printed: 5/22/2007
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NAME:
ADDRESS:
VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
aVI Cd RO ur t DATE: / /07
c r)-+
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 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 hold title to the above property and I am planning on doing this construction
Initial M.
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
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 ()-
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.
Initial �JU L
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 an
attorney. The department will not mitigate any contract disputes.
Initial De
6. I understand that if I compensate any person or company for work performed
they are required 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 project—they are
entitled to workmen's compensation. And if they do not posses a workmen's
policy I could be held liable for all doctor and related cost which could include
loss of wages during recovery from injury.
Initial DZ
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.
Was acknowledged before me this
By 'Pad K Roionic
Initial U7
30 day of nay , 20 el
who was personally known to me or who has
Produced there License or j ??' ''.I tit- 3 2,0 as identification.
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33 (38
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2604
Permit Type: El ctrical
Owner's Name (Fee Si ple Titleholder) Udklki ail
Owner's Address iJC 31-
city M iam t 31®re State
Permit No. El % )Cnq
MAY 2 5 2007 aster Permit No.RC. 07 -1C
BY:
Tenant/LeSsee Name
E -MAIL:
Job Address (where the work is being done) Same. es al-love
City Miami Shores Village County Miami -Dade
FL-.
Phone # (- -3
Zip 53139
Phone #
FOLIO / PARCEL #
Zip
Is Building Historically Designated YES NO X
Contractor's Company Name Lori ,,
Contractor's Address
City
Qualifier lame
Phone #
State Zip
Phone #
State Certificate or Regi
E -MAIL:
tration No. Certificate of Competency No.
Architect /ngineer's N. me (if applicable) Phone #
Value of Work For this Permit $ .
a•
114
Type of Work: ['A dition ['Alteration
Describe Work: Kt cher. z Ie.c„ l c-
Square / Linear Footage Of Work:
['New
Repair /Replace ❑ Demolition
**** **** - **********wwwwww* YicoY***wwww *x Feesw***** ww** w** dcx 4e*eY***w**wwwwwwww******x*****
Submittal,IFee $
Notary$
Scanning $ 5,
Bond $
Permit Fee $�'.� ' a CCF $ GO CO /CC
Training /Education Fee $ ,2U Technology Fee $j, %S
Radon $ DPBR $ Zoning $
Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $
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. l 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: 1 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.
Signatl'r
Owner or Agent
Signature
Contractor
The foregooinA instrument was ac oowlle`dggeryd before me this S , The foregoing instrument was acknowledged before me this
day of MU 20 by I✓�'oci , • day of , 20 by
, Y
who is personally k • wn to me or who has produced) • who is personally known to me or who has produced
0 — 0 As identification and who did take an oath. as identification and who did take an oath.
: .� W4 127�l Vargas P NOTARY PUBLIC:
• Y •,.Commission #DD231984
* Expt eo d 'I tr3,- 2007
p
Sign: �..' ` h47p eta \9: dfd11i:9� al �t w' . ;tic
Print:
My Comm sion Expires:
Sign:
Print:
My Commission Expires:
:xxxx xXxxxxxxxxx x xxxxx xxxxxxxxxxxxxxx xxxx x *WWX Y.xxxxxxxx x xxxxxxxx x xxxxx x xx xxx x *XY. xx xxxxx * Y.xxxxx xxx
APPLICATION APPROVED BY:
(Revised 02/08/06)
.7.5/4e)/e1,>,0Plans Examiner
Engineer
Zoning
VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
NAME: L ld crb d
DATE: 5 //Q7
ADDRESS: Ct5 tJE c5 , F*L : 3313B
Do hereby petition the Village of lyliarni Shores to•aot as my own contradtor pursuant to the laws
of the State of Florida,. F.S 489.103(7). And I have.r;ead and understood the following disclosure
statement, which entitles me to work as m' own contractor; I further understand:that I as the
owner must appear in person to coiriplete 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-fag-illy or two - family residence. You may
also build or improve a commercial building at a cost. of $25,000.00 or leas. The building must be
for yoor 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 npt licensed must work underyour 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 emplgyee, 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 hold title to the above property and I am planning on doing this construction
Initial
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
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
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.
Initial 1D12 •
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 an
attorney. The department will not mitigate any contract disputes.
Initial
6. I understand that if I compensate any person or company for work performed
they are required to have a business license in the county. Iffor any reason they
do not posses a business license I will be responsible and liable for any wrong
doing from this unlicensed eampany•or person.
Initial Ex
7. • I. understand that if any. person gets injured' on my construction project —they are
entitled to workmen's compensation. And if they do not posses a w(rkriien's
policy I could be held liable for all doctor and related cost which could include
loss 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.propert�y with out first obtaining
the proper permits by licensed contractors.
Was acknowledged before me this
25 day of
Ioitial Di
20 Cn
B
YDO U l •who was personally known to me or who has
Produced there License or
o r?, a
as identification.
1VYabei Vargas
Commission #DD23I9
- Expires: Ju113, 200"
�`��n" Afl�litli:F ondin Co.. Inc
414
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972 gC0001•1
Inspection Date: 08/24/2007
Inspector: Devaney, Michael
Owner: ROMANIK, DAVID
Job Address: 95 95 Street NE
Miami Shores, FL 33138-
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Block:
Phone Number
Parcel Number 1132060130730
Lot:
Building Department Comments
KITCHEN REMODELING ONLY
2 4 S0i
Passed
Inspector Comments
; ,/' #1‘72____
t'G %may
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Wednesday, August 22, 2007
Page 2 of 2