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RC-09-12801FR Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 120816 Scheduled Inspection Date: December 23, 2009 Inspector: Rodriguez, Jorge Owner: WILLIAMS, STEVEN Job Address: 100 NE 99 Street Miami Shores, FL 33138 -2304 Project: <NONE> Contractor: HOME OWNER Permit Number: RC -7 -09 -1280 Permit Type: Residential Construction Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)758 -5519 Parcel Number 1132060132280 Building Department Comments STUCCO REPAIR, PREP FOR PAINTING Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. December 22, 2009 For Inspections please call: (305)762 -4949 Page 6 of 29 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 +: Building Roofing JUL 31 2Hfl B Y: —... e pv Permit NofelCri— 0(LAJ Master Permit No. Owner's Name (Fee Simple Titleholder) S' 'Z-V'l itS.. Phone )1 5� "" /�g���� Owner's Address City WI krCt r Tenant/LesseelName O 9+t- Rs State Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip 3 FOLIO / PARCEL # Zip (3 Phone # Is Building Historically Designated YES NO Contractor's Company Name - ,� ho R r Contractor's Address ter �,druf _ I i� i r Cityt 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 $ 49OO Type of Work: Describe Work: Square / Linear Footage 0 0 Work: ['Addition []Alteration ['New Repair/Replace [' Demolition ******* ***** * ***************** *** ***Fees:** * * ** *** *********** **** Submittal Fee $ Notary $ Scanning $ 3m Bond $ Structural Review. $ Total Fee Now Due See Reverse side - Permit Fee $ Joljs Training/Education Fee $ ©`t�tiO Radon $ CCF $ Technology Fee $ * * * * * * * * * * * * * * ** DPBR $ Code Enforcement $ Zoning $ Double Fee $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) C 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 wil be approved a einspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this af, The foregoing instrument was acknowledged before me this day of , 2 i?" , by tkk° R f> , day of , 20 _, by e or who has produced NC_ 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 P 1rOTAtYYUBLIC -STATE OF FLORIDA Betty A. James ''` •` Commission #DD680536 '••...,sue Expires: JULY 20, 2011 brass ATUz4TICBoxsum D,INC. e 3 NOTARY PUBLIC: Sign: Print My Com `'ssion Expires: jw.i V j Syr/ My Commission Expires: ********************* * *�x�x/***** *********** **** **** :********* ***************** * **:x********* *** ************* * ** APPLICATION APPROVED BY: f J Plans Examiner Engineer Zoning (Revised 07/10/07) VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT NAME: DATE: 1 /113 (C� / ADDRESS: (cCitt-3 I\.1 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 reaidbnce. You may also build or improve a commercial building at a cost of $25,000.00 or leas. 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.LC.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. 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. •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., 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. � �\-�" Initial Q 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 (.uJ 6. 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. 7)r 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 lass 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. Initial Was acknowledged before me this day of W BySlueAk. zL/' NActiv who was p Y ersonall known to me or who has ,20 Produced there License or ;I CU as identification. rry, OF FIA�9 ;eOVO F� .z, 1:1 108 F.';, G3, 2011 co.,Il'rC. yli::ll �� • • • • • • • • • • •_,_.1 M a, Snores Villa; 1 BJECT TO COMPLIANCE WITH ALL FEDERAL ATE AND COUNTY RULES AND REGULATIONS 'PROVED INING DEPT BLDG DEPT rt, • • • • • • • • • • 4 • • •• • • • • •• • •••• • • • • •••• • •• •• •••• • • . • •••• • • • • • •••• •• ••ri • • • • •'" •••• • • • • • • • •• • • • •• • ••• • • • • • • • • •••• • • ••••