RC-08-545Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 05/06/2008
Inspector: Grande, Claudio
Owner: MASSASSO, LUCA
Job Address: 34 101 Street NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: HOME OWNER
MY 0
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Repair
Block:
Phone Number
Parcel Number 1132060131370
Lot:
Department C
REPLACE THE WOOD STAGE ON THE SIDE OF THE
HOUSE FACING THE ALLEY. THE OLD WILL BE
PLACED BY NEW PLYWOOD COVERED BY
WATERPROOFING FILM (PAPERBAK SLIMPLED
LATH). FINALLY THE SURFACE WILL BE COVERED BY
STUCCO
Passed
Inspector Comments
CC
PLEASE IN THE MORNING
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Monday, May 5, 2008
Page 2 of 2
317110 krirtAL
wok. 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
'171‘ 71,- V ESTS3r7,711
Ei
i' MAR 2 3 2108
BY:
Permit No. . 0 5
Master Permit No.
Permit Type (circle): 'lding Roofing
Owner's Name (Fee Simple Titleholder) l CA' MAASSA SS Phone #
Owner's Address S4, h.S E. /( IST ►
City ri"t IA v1 t HoR €SState Zip 3� -1 38
g; 4S69ZE�
Tenant/Lessee Name Phone #
Job Address (where the work is being done)
City Miami Shores Village
FOLIO / PARCEL #
ww 4o/ Sr
County Miami-Dade
3706 — 0611; — 43
Is Building Historically Designated YES NO
Contractor's Company Name 1 0A1X-, %lair
Zip
Phone #
Contractor's Address
City State
Zip
Qualifier Name Phone #
State Certificate or Registration No.
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 1500_ 00
Certificate of Competency No.
Type of Work: ❑Addition
Describe Work:
Square / Linear Footage Of Work:
❑Alteration ❑New
pp d
Repair/Replace ❑ Demolition
* * * * * * **
Submittal Fee $
Notary $ 5
Scanning $ g CO
:x** ** **** Fees** ** x******1 41.44* :a1Aeg*4
$ IO °� •
CCF $ JO CO /CC
Technology Fee $ 3 '
* **
Training/Education Fee $ V' 40
Radon $ DPBR $
Bond $ Code Enforcement $
Double Fee $
Zoning $
Structural Review. $ Total Fee Now Due $
ZNS c- C
t - St .A-c lw.e44
2.- come. e. L4
3, FLAA -,,,, .
I(•
See Reverse side —�
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) em . 2r ( . pp -10o
Mortgage Lender's Address ? O. R)3>( :5'( Sb
City Le wi 1 s V LCe State 13( Zip ( - Co
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
wner or Agent
The fore oing instrument was acknowledged before me this on The foregoing instrument was acknowledged before me this
day of M&tYC A , 20(f , by (,L l ° f Gt ct Q , day of , 20 —, by
who+ is personally known to me or who has produced V,, who is personally known to me or who has produced
*irks identification and who did take an oath. as identification and who did take an oath.
NOTARY ' UBLIC: :'.'2) ''y°' : NOTARY PUBLIC:
Sign: 7 t�. 5 ' `0'. 41' 4° Sign:
Print: ry/ /.1.1./,����,� a` ''0'' I Print:
o,'
My Commission Expires: .� " "',o w4 My Commission Expires:
* **** *** ::* �x�x� :�x�x�u�x,x•x **** *** *•x�x ** �: ***7�
�o4:,
Signature
Contractor
c
Z
APPLICATION APPROVED BY:
(Revised 07/10/07)
8/6 a Plans Examiner
Engineer
Zoning
VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
NAME: LUCA HAS SA SSO DATE: ED
ADDRESS: 441Sj Sr, HIAFt S4Q Sf VLF � 3S
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 t ere 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. Iffor 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
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 al day of N' l .(1 , 20(16'
By (,jjCa MaSSQSSO who was personally known to me or who has
Produced there License or
�V GCQ -OjO2 X9-20l4°as identification.
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Job address: &t, (.0,1 ST ST. 14--i1tell-1( sfiDec&
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