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RC-08-366Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 07/15/2008 Inspector: Grande, Claudio Owner: REMY, NOEL JUL 18 R C'6 Job Address: 133 102 Street NE Miami Shores Village, FL Project: <NONE> Contractor: HOME OWNER 6 Permit Type: Residential Construction Inspection Type: Final Building Work Classification: Kitchen Cabinets Block: Phone Number Parcel Number 1132060131820 Lot: Building Department Comments REPLACING KITCHEN CABINETS EVERYTHING STAYING THE SAME WAY. REPLACING BATHTUB/TOILET, SINK AND WALL TILE. ADDING APPLIANCES IN KITCHEN. .2 Passed /if"1nsPector Comments CC Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Monday, July 14, 2008 Page 1 of 2 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 07/01/2008 Inspector: Devaney, Michael Owner: REMY, NOEL Job Address: 133 102 Street NE Miami Shores Village, FL Project: <NONE> Contractor: IDIK ELECTRIC INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration ck: Phone Number Parcel Number 1132060131820 Lot: Phone: 305 -552 -0150 Building Department Comments REPLACE EXISTING ELECTRICAL SERVICE Passed Inspector Comments CREATED AS REINSPECTION FOR INSP-85376. OUTSIDE OK. NEED TO SEE INSIDE PANEL. 06/27/08 MD 1 /� �- j z c....---64 2-- 0) /lc t if---- ‘,41) , ` P s "?� 1-4,;#42 5.-: ?71. Pfri L' Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Monday, June 30, 2008 Page 1 of 2 5 \1.0 1- (i. 8002 L 'Z AYH amA033311:11 BUILDING PERMIT APPLICATI FBC 2004 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Type: Electrical Owner's Name (Fee Simple Titleholder) N D Phone # Owner's Address 133 NI' (0 t citymiAmi State FL.. Zip 253 Tenant/Lessee Name Phone # %y�} E -MAIL: P M HAIL •COAX( Job Address (where the work is being done) (33 �� /62- c 1 Permit No. EL OR— 151 Master Permit No. o 724.- 8785 City Miami Shores Village County Miami -Dade Zip .53 138 FOLIO /PARCEL# (13Zo60(3 182-0 Is Building Historically Designated YES NO Contractor's Company Name Phone # Contractor's Address t 0 2- City ‘3.4\ State L Zip Qualifier Name Phone #��� State Certificate or Registration No. Certificate of Competency No. 99 G DO 24'1 E -MAIL: Architect /Engineer's Name (if applicable) Phone # Value of Work For this Permit $ I I e Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New Repair /Replace ❑ Demolition Describe Work: ww**%Y.YY.Averrxr ' Y. ww ww. 9[ 1f% YY. xx*xx*Y.X*Y.Y.'KY.Yet**FeesYXXx Y %Y.Y.]:YY.Y.Y.Y.XXY.Y.XY.]tY•Y. KTC iC Y. Y. Y. '�YXY. Y. Y.K %Y. Y. Y.X %Y. Y. Y. Submittal Fee $ Permit Fee $ e) CCF CCF $ � ' CO /CC Notary $ Training /Education Fee $ 0 .40 Technology Fee $ 4'00 Scanning $ C' Radon $ DPBR $ Zoning $ Bond $ Code Enforce rnient,$ Structural Review. $ p; Double Fee $ JUN O. 9 p0)-, Nil IVO u Total Fee Now Due $ 111 • 51 See Reverse side -3 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Zip 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 issue. In, bsence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this'll day of , 20 , by , day of V\ ev\ , 20 bbl , by - \ LIN � \k who is personally known to me or who has produced who is personally known to me or who has produced 9�c®i' As identification and who did take an oath. V-.z e.�or-r as identification and who did take an oath. NOTARY PUBLIC: Signature C ntractor NOTARY PUBLIC: Sign: Print: My Commission Expires: * ************ **** ** *** ****** *s *****kxntxxxxr.rxxxrxxr.. 4-& Sign: Print \..20 rs, My Commission Exp •fv• t g MY COMMISSION # DD 478771 4t. EXPIRES: Octobar 4, 2009 414-, ` Bonded Thru Notary Pubec Undenttlters LxxX* .Y.X *ay x XXx **wag Y. Y.XY. APPLICATION APPROVED BYE (Revised 02/08/06) XX *x* :xXx * *Xrxxxx *ric* * ** 9.'/4'! tans Examiner Engineer Zoning -b12-(21 t')EI toteE 1-3.61m 1\)ENN1 6ERvics 4,"PLAcE ETER- Ckni Te) mAst EctiEsocE-FL zoo At,41P5 ast 7-4-i welt KCE3-47/0P--)aNn %pita. v‘illt, PsiQD e)Aelc. (04-1) FIN154ED tA) (11+ SEILVICE CA-AvE rECIEGVED MAY NON 1 al.04\bE e P • Inspection Worksheet Miami Shores Village esc 10050 N.E. 2nd Avenue Miami Shores, FL mos Phone: (305)795 -2204 Fax: (305)756 -8972 Ins tion N ttmbe -08 _36$ Inspection Date: 04/03/2008 Inspector: Levrock, James Owner. REMY, NOEL Job Address: 133 102 Street NE Miami Shores Village, FL Project: <NONE> Contractor: KINGS PLUMBING SERVICE Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Block: Phone Number Parcel Number 1132060131820 Lot: Building Department Comments removed and install in same area all plumbing fixtures existing, kitchen sink, guest bathroom sink lavatory, tub and master bathroom nothing moved e/LI AG 10 Passed spe or • ments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Wednesday, April 2, 2008 Page 2 of 2 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 EC OVEID MARS 22 7 Permit Type: Plumbing Owner's Name (Fee Simple Titleholder) N 0 E L R-Ek t\11 Owner's Address (5''3 Ka 102_ City Wt( 4)V14. bgES State FL • Tenant/Lessee Name 1'J (A Permit No (a 8 _368 aster Permit No. Phone # 30s- 72_y- x783 Zip 33 (3 8 Phone # E -MAIL: Job Address (where the work is being done) l3J iJ E (0 2 Sr City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name t M J f LJtvvb As Vl CES Phone # J' �� o �S - `l �® Contractor's Address (`(D ED N W 6 cr City rM l µVw+il, State Ft - Zip 331 18 Qualifier Name 3b•S3E Ott Cwg z Phone # State Certificate or Registration No. Certificate of Competency No. E-MAIL: 10 / A-. Architect/Engineer's Name (if applicable) % 1ic Phone # Value of Work For this Permit $ Z ? ° Square / Linear Footage Of Work: /t1 /R Type of Work: ['Addition ['Alteration ['New 1:1 Repair /Replace ❑ Demolition Describe Work: R-01-Ace f L N [ l+ 5[14<-• AND p a/ -1 DDELV /iani 134GIVEVA 9 An(p Mt- ED ww www*** * *** * ** * ** * * ** * * * *** * * * * * * * * *** Fees* * * * ** * * * * *wwwwxxxrx W *xxxwxxwwxxxW x WW W Submittal Fee $ 0 Permit Fee $ 1,D CCF $ t•w CO /CC Notary $ 0 Training /Education Fee $ MO Technology Fee $. 4. C 1) Scanning $'1., (D Radon $ DPBR $ Zoning $_ Bond $ Code Enforcement $ _ _ Double Fee $ Structural Review. $ Total Fee Now Due $ MAR 3 1 2008 C.�C"J4lb 13tly See Reverse side -+ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Zip 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: [ 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 perm'} i ` inspection will not be approved and a reinspection fee will be charged. it is ssued In the absent o ch posted notice, there Si Signature Signature Owner or Agen Contract TI The foregoing instrument was acknowledged before me this 2O The foregoing instrument was acknowledged before me this i-0 _ daday of t-k \„ , 20 Vt., by �e.'M day of "\v wl y AN , 20 OR,, by 0v- 1�- oc6h0\Le -L 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. as identification and who did take an oath. S iprint: bA.. MIS -4S PrMy Commission Expires: MY COMMISSION # DD 478771 ., o* EXPIRES: October 4, 2009 M * *** * ** * * * *, *, * * * ** * * * ** v * *ale iteAttk4ics�P * ** **x* * * * * * * ** *** * * * * * ** * * * *x* APPLICATION APPROVED BY: (Revised 02/08/06) NOTARY PUBLIC: Sign: Print: \.v: 1 My Commission E * * * * * * * * * * * * * * * * * * * * ** f Cmmnrfn-nry Nnldo_, :r. xrxxxxxx *xrxw IA MY COMMISSION # DD 478771 Q` EXPIRES: October 4, 2009 irittVertletladslibtalk rx x xx r. xxr. rx tans Examiner Engineer Zoning 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 206 Permit No. aO t(.61 Master Permit No. CA' Y %c7 Permit Type: Electrical Owner's Name (Fee Simple Titleholder) C) EL Q_ -&' ( Phone # (30 S .) 7 2A — `e)-1 S'S Owner's Address 1 i ® 2 City `•■ h 5 State 'P Zip X31 3 B Tenant/Lessee Name k( Phone # f E -MAIL: ( �. Job Address (where the work is being done) E.. t Q 2_ City Miami Shores Village County Miami -Dade Zip l B FOLIO / PARCEL # k (— 3 2.Q Cp Zc:) Is Building Historically Designated YES NO Contractor's Company Name ■C-- Phone # C3�S SS Z - ®\ Std Contractor's Address City L.A. t State Zip (c=> Qualifier Name . Phone # (j30 j 4 (■ - O S- S-12?-S-- State Certificate or Registration No. E -MAIL: Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Certificate of Competency No. E 00C) ZA 1 170Cf7 Phone # Square / Linear Footage Of Work: Type of Work: ❑Addition gAIteration ❑New ❑ Repair /Replace ❑ Demolition Describe Work: G, jT.24JCA'A &v S xxxxxxY.Y.X%trarx xtracw*wsczw.Yxxxxw Y.Y. FeesX X %Y.Y.Y.Y.XY.XY.KXY.X]CXXx Y.Y.Y.Y.XXXY.XY.XXY. Y. Y.XY. )C Y. Y.XX Y.XX Submittal Fee $ Permit Fee $ /j'' — CCF $ 1. 0 CO /CC Notary $ Training /Education Fee $ O -40 Technology Fee $ , :7S Scanning $3': Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 153 •35 • 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 comm cement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In e 'rice of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature _AMA Owner or Agent The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 0 ) day of , 20 , by , day of 97.) e,y, 20O 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. as identification and who did take an oath. NOTARY PUBLIC: Co ractor NOTAR Sign: Sign: Print: Print: My Commission Expires: UBLIC: o1 YP�a a ice:, dro Aguado ommission #D0582703 ;F�'+ e°= Expires: AUG. 08, 2010 q,oFF1.�.• My Commission Exp7P @5''' WWW.AARONNOTA8UOM ****** *** ****W xxx x iix1Cx* xx x * xxxxx xxx x x**WWW xxx xxxx x Y. **x WY. xxx wwxx ww*xxx APPLICATION APPROVED BY: (Revised 02/08/06) Plans Examiner Engineer Zoning ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS. PLEASE CIRCLE 0 DISCIPLINE APPLIED FOR: PLUMBING ELECTRICAL PERMIT # MECHANICAL ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS 1 2. SPACE HEATERS DISHWASHER LIGHT OUTLETS % a CENTRAL HEATING DISPOSAL RECEPTACLES NC (WIND) FLOOR DRAIN SERVICE TEMPORARY A/C (CENTRAL) GREASE TRAP SERVICE SIZE IN AMPS DUCT WORK INTERCEPTOR SERVICE REPAIR/METER CHANGE REFRIGERATION LAVATORY APPLIANCE OUTLETS 7 PROCESS AND PRESS PIPING LAUNDRY TRAY RANGE TOP it UNDERGROUND TANKS CLOTHES WASHER OVEN t ABOVE GROUND TANKS SHOWER WATER HEATER U.F. PRESSURE VESSELS SINK. POT /3 COMP. MOTORS 0 -1 HP STEAM BOILERS SINK, RESIDENCE. MOTORS OVER 1 -3 HP HOT WATER BOILERS SINK, SLOP. MOTORS OVER 3 -5 HP MECHANICAL VENTILATION TEMPORARY WATER CLOSET MOTORS OVER 5 -8 HP TRANSPORTING ASSEMBLIES URINAL MOTORS OVER 8 -10 HP ELEVATORS /ESCALATORS WATER CLOSET MOTORS OVER 10 -25 HP FIRE SPRINKLER SYSTEMS INDIRECT WASTES MOTORS OVER 25 -100 HP COOLING TOWERS WATER SUPPLY TO: MOTORS OVER 100 HP VIOLATION NC UNIT NC WINDOW REINSPECTION FIRE SPRINKLER AIR CONDITIONERS HEATER -NEW INST. STRIP HEATER HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL GENERATORS TRANSFORMERS SWIMMING POOL GENERATORS TRANSFORMERS WATER SERVICE SPECIAL PURPOSE. SEWER CONNECTIONS OUTLETS COMMERCIAL UTILITY -SEWER SIGN TUBES UTILITY -WATER SIGN TRANSFORMERS SEPTIC TANK SIGN TIME CLOCK RELAY FIXTURES FAINFIELD, 4" TILE/RES. ANTENNA PUMP & ABANDON SEPTIC TANK TELEVISION OUTLETS SOAKAGE PIT CU. FT. VIOLATION CATCH BASIN REINSPECTION DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET • SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) ' GAS PIPING • "Io r Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. f-C- V U" 3 0(.0 Master Permit No. BUILDING PERMIT APPLICATION FBC 2004 Permit Type (circle) Building Roofing Owner's Name (Fee Simple Titleholder) i' O L PICT 4 Phone # Owner's Address l3b 14E L®Z City dY uon 1 54017-e State Ft. Zip Tenant/Lessee Name IJ (A Phone # 33 lD Job Address (where the work is being done) 137 E oz_ City Miami Shores Village FOLIO / PARCEL # County Miami -Dade `L— °sj0 G ,.orb — t f2:12.r) Is Building Historically Designated YES NO Onn+raetee's Company Name 001st, f l Phone # 30S 1 Z. —8'7 8 Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Architect/Engineer's Name (if applicable) Phone # Certificate of Competency No. ./PC) Value of Work For this Permit $ 2 3 6-0 Square / Linear Footage Of Work: Type of Work: r4lAolidition ['Alteration [New Describe Work: i LAC' s \ ❑ Demolition 41 1" * ** * * * *v * *>k * * *** * * * **>k * * * * ** es************* ** * * * ** ** * * ** * * * * * * * ** * **** * * ** Submittal Fee $ Permit Fee $-'°' CCF $ 1 -Z50 CO /CC Notary $ 5 00 Training/Education Fee $ O (40 Technology Fee $ • ('2, Scanning $(.0'00 Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $2.440 2 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 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 Signature Owner or Agent The fore oinggi� instrument was acknowled day o ,26 // ,by ed before me thiso Contractor The foregoing instrument was acknowledged before me this day of , 20 _, by w o is personally known to me or who has produced CJ V' 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. OTAR PUBLIC: aryl NOTARY PUBLIC: �� Z441NI'' 4,te Sign: Print: My Commission Expires: * * * * ***** **** *** * *** ** * **** * * ** APPLICATION APPROVED BY: (Revised 07/10/07) Sign: Print: My Commission Expires: *********************************** * * * * * * * * ** * ** * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT NAME: t OEL �UJ DATE: _ ADDRESS: Or5 (D2- • 3 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 etnplgyee, 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 �V 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 Iv P- 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 alter or give advice on how to meet minimum code. Initial Yv and inspectors are not there to design, code —. only if the structures meets the Initial I v 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 "a,ny contract disputes. Initial NI 12- 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 Iv)?, 7. I understand that if any person gets injured on my construetion 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 N 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 N 12— Was acknowledged before me this V day dalI 1A 2001( By 1" Q Produced there License or Ve-. bl3-0 o) -1*Ori ification. who was personally known to me or who has OWN R NOTARY PERMIT W e �ild -"11111101° Al Miami Shores Vi lag'e C I . :' APPROVED BY Y r fil Ye . PT Irr--'40,%IrA v.", 4)).-. BLDG DEPT //.7I ��617 ir r SUBJECT TO e 4i(', ' ANCE WIT!-1 ALL FEDERAL 1 `4 STATE AND COUNTY RULES ANC REGULATIONS i ar� .c i' 0 6 2000 r0 m v� ' 1 t ( ` ` ' } ' ' 1411Y J I, 1 ` I • i ,''. _H +— j • S.:44 4' ... • • ;•; • , • i• •• • •I.• Ir 0 I • //I I 1 � f w•• •• * • •1 . • 1 . g,,.. • • • . •• • • • • . r, • • • • • • • • „ , _ • • • • T • • • • • •l •: • • a3g • ••• .4' 1 i , 1 -'• • • • • • • • , ■ i • . oit!. . I. ••• • '..1 • ••• • •• i ,' • • • • •• • •• •• • • • • • • •••• • • • • • • 1. • 1 Yk Poik) ✓ _ - • • •-••Ilve- • ' - 00•••• • • • • • • • • •••• •••• • • • • • • •••• •••• • • • • •• •• • • • • • •••• • • 6-2v e>1---" xpcprzo-e/es . re ge 0,1„, oeove-P 1,40o4-41vg