RC-07-1882Inspection Date: 10/17/2007
Inspector: Grande, Claudio
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Owner: TAMAYO, SAMUEL
Job Address: 160 95 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Alteration
Phone Number
Block:
Parcel Number 1132060132830
Lot:
Building Department Comments
Replace toilet replace door replace shower
head and tiles
10
10
Passed
1 1
Inspector Comments
CREATED AS REINSPECTION FOR INSP 60659. No one home
available for inspection. 10/16107 CG
cG°�f
A___ tiff
ai9A)
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Tuesday, October 16, 2007
Page 1 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
0910101
'WILDING SG,uA
PERMIT APPLICATION
1BC 2004
Permit Type (circle): Building
IMCEEVICI
� SEP 0 2001 /11.)
Permit No. R°1 1 on.
Master Permit No.
Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) S l t44L Cy -7-4,444-y O Phone It �3 69 7S e - 83 4, 7
Owner's Address - - - � qc �r. ( ) 441-3 qr7
State FL Zip 3 313?
Tenant/Lessee Name
Phone #
JOb Address (where the work is being done) /66 e sr -
City Miami Shores Village
FOLIO / PARCEL #
IS Building Historically Designhted YES NO
IIII.
County Miami -Dade
Zip 33/38>
Contractor's Company Name OCV n f 1e__ .
Contractor's Address
City
Qualifier Name
State Certificate or Registration No.
Phone #
State
Zip
Phone #
Architect/Engineer's Name (if applicable)
Value of Work For this Permit $ 'O6.6 0
Type of Work: []Addition
Describe Work:
Certificate of Competency No.
Phone #
Square / Linear Footage Of Work:
Alteration DNew:
Er Re air/Replace ❑ Demolition
4lacer rb lr 8 ocoI fie, f pod- Re
far stio eAer ead, - lace -i les -
(ace ,boot,
p(Gf fin bi cjicj ei ci cq e a %f 5uaifcel be asged
******** * * *** * * * * * * ** * **** * * * * * * * * * * * ** Fees************* * * * * * * * * ** * * * * * ** * * * * * * * * * * * ***
° Submittal Fee $
Notary $ Trai ing/Education Fee $
Scanning $3• Dv Radon $
Bond $ Code Enforcement $ Double Fee $
Permit Fee $ /57) 62
� 00
DPBR$
CCF $ 3.00 /CC
Technology FeV '�
Zo in
t'�g
bEP 1 1 2097
Structural Review. $
AlvalatA
Total Fee Now Du $
I See Reverse-side-4
D t/LII �' R(4,7 4.-C
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 reinspection fee ill be charged.
Signature U° ®' ` ]' Signature
Contractor
The foregoing instrument was acknowledged before me this
day of Sepr V4/45100 01 by APIs; C , day of , 20 , by
Owner or Agent
The foregoing instrument was acknowledged before me this 61
,`who is personally known to me or who has produced FAf2tM
1 I2. L C NS As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
P T
My Commission Expires
* * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
(Revised 02/08/06)
MARGARITA PARDO
y comm. expires t ug. 20
No. 0D458004
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
************************** ** * * ** * ***** * * * *** * ***** ** ** ***
Plans Examiner
Engineer
Zoning
VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
NAME: S A M L 4 eL c r T 4-m9 - Y D DATE: 9 - ° 7
ADDRESS: 1 6 b p1 E 69-it'[ / c-iii71zE.S 3 3!3a)
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
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.
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. If for any reason they
do not posses a business license I will be responsible and liable for any wrong
doing from this unlicensed companyor 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
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 (,71-t day of i( ih
s
2001
By CA-M TPrMA-
� . who was personally known to me or who has
Produced there License or 1L®t2 -1 l') r wIS Li' E EE as identification.
MARGARITA PARDO
Notary Public. State of Florida
My comm. expires Aug. 03, 2009
No. DD458004
PERMIT : al - I
Miami Shores Village
APPROVED
BY
DATE
ZONING DEPT
BLDG DEPT
kiliW,Illif 1
SUBJ CT TO COMPUAN /WITH ALL 5 ERA.,
STA AND COUNTY RULES AND REGULATIONS
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