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RC-08-1506*Apt )rdv- Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit Type (circle): Owner's Name (Fee Simple Titleholder) Owner's Address S S 10 City t LI li AIL State 8OO E 9fV Roofing rc�1zL° c [[ECEN ED Atu Permit No. It V `5b ter Permit No. Phone # vGS -�(bsG Zip 33 t Tenant/Lessee Name Phone # Job Address (where the work is being done) (— ,{ � ') L ! , City Miami Shores Village County Miami -Dade Zip 3 3 ( 3 4b0 FOLIO / PARCEL # Is Building Historically Designated YES NO K Contractor's Company Name Phone # Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ c2 5 Type of Work: DAddition DAlt ration Describ Work: Square / Linear Footage Of Work: ['New Repair/Replace * * * * * * * * * * * * * * ** * * **0 * * * *�x *x:+ *** *� * ** Fees: �** **�x *�x***** * *�x�x�x�x�:�x�x�xx *** * *** ** **** * *�:� * ** O( ti5 ' Submittal Fee $ Permit Fee $ G ��� �"-- CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ Code', Enforcement $ Double Fee $ Structural Review. $ (2.... (,. 6,‘)Q,K (i4,,,-,_ t„„ 0.ed, Zoning $ Total Fee Now Due $ 0-19-0 19-0 /;f1, ' Z r /2 1 14149.e.0 — �' See Reverse side -, c i c.,tc_ L(( 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. o_ 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 A1'N11)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 ill not be approved and z reinspection fee will be charged. Signature Owner or Agent Signature Contractor The foregoing instrument was acknowledged before me this � The foregoing instrument was acknowledged before me this day of -Al 14 ', 20 by , day of , 20 _, by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. , identification and who did take an oath. tonigi nd.t�ew '•> NOTARY PUBLIC: =a K v cGC�.tt;JN #oG}733 1 „ 4' • EXPtRESr`MAY 27, 2012 cgicr � +. ° ( e ONNI n Sign: � Sign: Print: Print NOTAR PUBLIC: M} Commission Expires: My Commission Expires: * * *******+x+x+ +x**** ** :* * : ******** * * ********** : **** ** ** * * * *:x * ********„x***• ** * ****:x****** * ** *** *****: * * * * * * * APPLICATION APPROVED BY: (Revised 07/10/07) 7 /o Plans Examiner Engineer Zoning • STRUCTURAL ENGINEERING • CIVIL ENGINEERING AND SURVEYING • L AND SURVEYING • CONSTRUCTION ESTIMATES PEDRO LUIS LOPEZ PROFESSIONAL ENGINEER LAND SURVEYOR AS BUILT CERTIFICATION December 1, 2009 Miami Shores Village. Building Department 10050 NE 2 Ave. Miami Shores , F133138 Re: Permit No. RC -8 -08 -1506 Job Address : 55 NE 97 ST Miami Shores Fl, 33138 Owner: David Howard Attn: Building Inspector Dear Mr. Inspector: 11249 S. W. 341 LANE MIAMI, FLORIDA 33165 PHONE: (305) 559-2487 This is to Certify that I inspected on 10 -22 -08 and through completion the framing and structure repair, interior drywall installation, tile work and painting and miscellaneous repair. Based on my observation and verification of the different elements of this job, I hereby Certify that to the of best of my knowledge, belief and professional judgment the work done is sound and built in compliance with the Florida Building Code and the approved permits drawings.. Sincerely, Pedro Luis Lopez Professional En of Florida o. 11308 VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT NAME: ¢� ADDRESS: oS 11/4-)C `ir4 " DATE: S � 11'N("MaL ctA-61A“. 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 Myself. 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. 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 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. 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. 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 (9--- day of By ►i«)AAL.► who was personally known to me or who has Produced there License or 4, '7 ra 15 L.,« j,/,0Z43D as identification. har aye'' 4�. MONICA LISSETH DIAZ :A MY COMMISSION # DD 483995 !- EXPIRES; October20, 2009 .4P, Bonded?hru Notary Public Underwriters David Howard 55 NE 97 Street Miami Shores, FL 33138 305- 968 -4656 Description of Work 1. Remove existing block wall and plaster and leaving existing 12 X 12 column and repaid drywall 2. Remove drywall from existing window opening& repair drywall 3. Remove existing saltillo tile and replace with ceramic tile. 4. Remove existing partition wall & repair drywall. Also remove one electrical outlet. 5. Remove existing saltillo tile and replace with ceramic tile. Also patch and repair damaged walls. ; `FS 10050 N.E. 2nd Avenue Miami Shores, F ..� - Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Worksheet Miami Shores Village Scheduled Inspection Date: March 09, 2009 Inspector: Devaney, Michael Owner: HOWARD, DAVID Job Address: 55 NE 97 Street Miami Shores, FL 33138- Project: <NONE> Contractor: CPS ELECTRIC, INC. Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition/Alteration Phone Number (305)968 -2445 Parcel Number 1132060130990 Phone: 305 -607 -8221 Building Department Comments wy, Passed 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-93632. CC ROUGH OK, NEEDS OUTLET INSTALLED MD 11/24/08 PLEASE MAKE INSPECTION AFTER 5:00 pm. OWNER WILL BE IN A MEETING. March 06, 2009 Page 1 of 21 to tool- Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Electrical Owner's Name (Fee Simple Titleholder) Owner's lj ddress s S /0 6 , City �a`� k'`'� . 2C-1 State Zip Tenant/Lessee Name Permit No. (-L v0 - 15/5 aster Permit No. gco 1CJO�o Phone# 20S [l9 tgo ''f E -MAIL: otg kn� Job Address (where the work is being done) City FOLIO / PARCEL # Miami Shores Village G.- 4JQ County Miami -Dade Zip Is Building Historically Designated YES NO V' Contractor's Company Name C -S" c P4 L_ Phone # 30. -C3 TS' % 0 Contractor's Address «©0 /VW 2-8 Ave__ City MI % State Qualifier Name A-17) - L. Pa me Phone # 6— C3 v., 5--570 State Certificate or Registration No. Ete00 a 0 ZC, Certificate of Competency No. 0 0 0 17 2 3 3 E -MAIL: Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Type of Work: ['Addition ['Alteration Describe Work: 3 Square / Linear Footage Of Work: ['New 7111-1-1.-e—pair/Replace ❑ Demolition ******* xxxxxxxxx* x************** xxxxxx* Feesxxxxrxxx *xrxxxxxxxxxxxxxxx* xrxxxrxxxxxxxxxxx Submittal Fee $ Permit Fee $ CCF $ CO /CC Notary $ Training /Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Structural Review. $ Code Enforcement $ Double Fee $ 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. 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 fir t inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection ill not be approved '.d a reinspection fee will be charged. Signature Owner or Agent - The foregoing instrument was acknowledged befor; me this <27 day of ill"( ,' ,20t5y,b who is sew.. x/11,. , / Qho has produced i°'Q G ' �'" R@1�3a3ubin and who did take an oath. FF1•° , `: Thw Budgetflotary Services NOTARY PUBLIC: Signature Contractor The foregoing instrument was acknowledged before me this27 day of 41. .,. ,, , 20? ,r by a° ,.•••. e ILTONRdMERO who is pp JcIPISC IMISS19It DQQIBoOhas produced 442G'' < EXPIRE P: Degather.3, 2011 ,f,e,((4`1., < ' % :, ftlitdowatrommtd who did take an oath. NOTARY PUBLIC: Sign: Sign: Print: Print: My Commission Expires: xxx xxx *x* xxxxxxxxxx *xxxxxxxxx * * * * * * * * *r. *** *xxx* APPLICATION APPROVED BY (Revised 02/08/06) My Commission Expires: xxxx * * ** * *xxxxxx * *xxxxxx * * *r. xxxxxxx xxxx *x *x * ** 7gr,,,.44-5-4 Plans Examiner Engineer Zoning