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EL-07-1492Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 09/26/2007 Inspector: Devaney, Michael Owner: CHRISTIE, GWENDOLYN Job Address: 844 98 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Block: Phone Number 305 - 757 -4852 Parcel Number 1132060142560 Lot: Building Department Comments UNDERGROUND ELECTRICAL AND UPGRADE SERVICE sEP262001 Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments OK FINAL SERVICE. MD 09/25/07 Wednesday, September 26, 2007 Page 1 of 2 Miami Shores Village 01 1 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATIO FBC 2004 Permit Type: Electrical Owner's Name (Fee Simple Titleholder) Owner's Address is /fr. City mop,/ State �,., Zip 3 Tenant/Lessee Name E- MAIL: RECEIVED JUL 1 8 2007 BY: Permit No. E 1" 141 Master Permit No. Phone# Phone # Job Address (where the work is being done) City Miami Shores Village FOLIO / PARCEL # -- Is Building Historically Designated YES Contractor's Company Name 0.0\(1)( Contractor's Address City State Zip Qualifier Name Phone # County Miami -Dade 3)32 01 Phone # State Certificate or Registration No. Certificate of Competency No. E -MAIL: Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Phone # l0 , Square / Linear Footage Of Work: Type of Work: ['Addition Alteration ['New ❑ Repair/Replace ❑Demolition Describe Work: . ( f CAC-ML, /i yc 1-1. .C.)`kq/ E'_y1��GC� 1-<4, e.-k5 c A4/4/ �al� %,� y,, ��,rr� c , L'( 11/e, CDd r✓ 7 ' ** * * * * * * * * *w c*********************** Feesxxxxxxrx***** * * * * * * * ** * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ "'et " CCF $ )• CO /CC Notary $ ''l�Q Training /Education Fee $ 0-40 Technology Fee $ '3)/5 . Scanning $ Ca °(70 Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Structural Review. $ Double Fee $ Total Fee Now Due $ 1(Q(Q _c35 At 2 3 PAID See Reverse side C'l'I 7S 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 will be charged. Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this 17 The foregoing instrument was acknowledged before me this day of erd4.,Y , 20 0 , by %44,'tL bits u • , day of , 20 , by who is personally known to me or who has produced in>/rdd who is personally known to me or who has produced bit • As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Print: My Commission Expires: Sign: Print: My Commission Expires: xrxxxxxxxxxXxxxxxxxxxxxxwvewve **** Yxxxxa w wleex* xxxxxxxxsca c* *xxeYxx***xx*xxxxxx*xxxxvrte** :xxxxxveww**?exaY****** APPLICATION APPROVED BY: (Revised 02/08/06) Plans Examiner Engineer Zoning VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT NAME: /O j � / % �, f G`"7 qe ( �J,n/ ` y • DATE: ADDRESS: £,LfL( N/ 497 '5.1'e 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 ari owner - builder I must abide by all zoning ordinances and building regulations in effect at the time of permit application 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. 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 company or person. Initial I 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 By ttkdAgj \J11 L V11441& Initial L3 day of jay ,20 D( who was personally known to me or who has Produced there License or ft. 'Driti'slit- 13 0d as identification. �QIAZ �gN1GRyQp4a399�s 'e ° °° 100 009 • MV 9 Qctoto 24, �,v9 :�• � :tl �kP1F1� �wpue�lcund L©NG -MaN (e,.5 le 61 eivcc, • • ••• • • • ••• •• •• • • • •• •• • • • • • • • • • • • • 311 i#4.2) /J��ic�•� •�� /�i'�J• i•i • �/ 3313£ • • 36'S= sas — ;7 4 •• • • • • • •• ••• •• • •• •• • •• • • • • • ••• •• me, 99/949 0 3 wi i3 e, ahAiim Iv/ 3 _a0' ))v cv - #6,91-401 bal-c- &v y ._12(.-"-- 4o a - )0°A -/ ev13 1 31ti Gold 4ctie4• -c'F -Pi, FCT TO COMPLIANCE WITH ALL FEDERAL �,!_I^JTY RULES AND REGULATIONS • .. .. .. • L. 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