RC-11-1861i
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
nspection Number: INSP - 165363
Permit Number: RC -10 -11 -1861
Inspection Date: January 26, 2012
Inspector: Bruhn, Norman
Owner: MARIA GONZALEZ, ISABELLA
DCI 17CI
Job Address: 9546 TD NW 1 1 A1 venue
Miami Shores, FL
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1131010240240
Building Department Comments
KITCHEN AND TWO BATHROOM REMODEL
Passe /..2
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
January 25, 2012
For Inspections please call: (305)762 -4949
Page 1 of 1
Miami Shores Village
Building Department
OCT 1 ' 2d 11
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING Permit Nog C) IHc0
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: BUILDING ROOFING
OWNER: Name (Fee Simple Titleholder): Sok61tq @eAI ttL ki Phone #: — "(S IA— Vick G,
Address: c S '- 6 ((V L1/4) t AV
City: 11) olr41 S( h3CCS State: T I.--
Tenant/Lessee Name: Phone #:
Email: j SQ,. 110% cU et 1i ( &DomC:0- • VA CA-
331 so
JOB ADDRESS: CIT 16 i\JQ3 J A\n_
City: Miami Shores
County:
Miami Dade Zip: 331 SO
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: O Phone #:
Address:
City: State: Zip:
Qualifier Name: Phone #:
State Certification or Registration #: Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ 4684,03 Square/Linear Footage of Work:
Type of Work: ❑Addition10-8-leek UAlteration New - ,❑Repair/Replace ❑ DDemolition
Description of Work: ik ey ovcA►vn -- CsF lry C�c1 (Perm 6A�X i C`11i
***************************************Fees****** **** ***$** ****** ********** *****
Submittal Fee $ Permit Fee $ " CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ ,
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 ,4nd a reinspection fee will be charged.
Signature
J>t
Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged be a jme this I The foregoing instrument was acknowledged before me this
day of , 201 1 , by 11� -1 t day of , 20 _, by
whcpersonally know 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: NOTARY PUBLIC:
Sign: Sign:
Print: ._! qt.--.011" _ L Print:
My Commi . on, e -.. �� = S My Commission Expires:
411`•1..;
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: 1 Sa NE
baok ` P.- - 10-)c-1e,‘‘■ DATE: '10 - (0_ - 11
ADDRESS: 6 <3.1 1 Asc 1 ;Orral f �3 tS0
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 new form states 75,000). 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 understand that state law requires construction to be done by a licensed contractor and have applied for an owner - builder
permit under an exemption from the law. The exemption specifies that 1, as the owner of the property listed, may act as my own
contractor with certain restrictions even though I do not have a license.
Initial
2. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the
construction and is not hiring a licensed contractor to assume responsibility.
Initial -A4-3.
3. I understand that, as an owner builder, I am the responsible party of record on a permit. I understand that I may protect myself
from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own
name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on
permits and contracts.
Initial Qe
4. I understand that I may build or improve a one family or two-family residence or a farm outbuilding. I may also build or improve
a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may
not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved
myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially
improved it for sale or lease, which violates the exemption.
Initial rAW
5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction.
Initial
6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or
residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or
municipal ordinance.
Initial
7. I understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner - builder permit that
erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner - builder, may be held
liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while
working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an
owner - builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
Initial `
8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to
perform the work being done. Any person working on my building who is not licensed must work under my direct supervision
and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and
social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for
the employee. I understand that my failure to follow these may subject to serious financial risk.
Initial
9. I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable
laws and requirement that govern owner - builders as well as employers. I also understand that the
Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations.
Initial
10. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the
United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the
Florida Construction Industry Licensing Board at 850.487.1395 or http : / /www.myforidalicense.com /dbpr /pro /cilbfindex.html
Initial
11. I am aware of, and consent to; an owner - builder building permit applied for in my name and understands that I am the party
legally and financially responsible for the proposed construction activity at the following address:
Initial
12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that I
have provided on this disclosure.
Initial
0
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a
license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to
assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to
understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may
be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for
verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage.
Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and
returned to the local permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the
notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when
the permit is issued.
Was acknowledged before me this a day of
By6,Poc Yektbe:h,
Produced there License or\
OWNER
20 ) Q
who was personally known to me or who has
X34 -n1 e.14-.1.01
identification.
NOTARY
O1yF+` PV (t.
CLAUDIA V. CUBILLOS
r�. Notary Public - State of Florida
r• __ My Comm. Expires Sep 23, 2015
o;= Commission 8 EE 128810
tpp�.
•,,o ,,,,,,�� Bonded Through National Notary Assn.
I IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO.Al �1,!{�Q/c TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided In this Notice of Commencement.
CFN 2011R0706532
DR Bi, 27665 Ps 4142; (1)
RECORDED 10f20/2011 10:55:43
HARVEY RLIV'Ihlr CLERK. OF COURT
MIAMI -DADE COUNTY? FLORIDA
I
LAST PAGE
Space above reserved for use of recording ofi
1. Legal description of property and street/address: ma f Pci ` - L l C h1 i(z LA-3
:ELK S14-t, }3.s71/4 t13
2. Description of improvement: Wk..Lt'n
3. Owner(s) name and address: i sfaln e tiot (la:tt W 0t16 CU W i A t S °Actr;-,`— 33 I Shy
Interest in property:
Name and address of fee simple titleholder.
4. Contractor's name, address and phone number. Fn-2,1 — 2 u i tile.!
5. Surety: (Payment bond required by owner from contractor, if any) N1< F Fn i Cc 'F r C?-74-f1'.
— e
Name, address and phone number.
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated
Section 713.13(1 )(a)7., Florida Statutes,
Name, address and phone number
d *',,
h -
by Owner upon whom Clot' a dt otnerniawyrn %5. Y b served as rovided by
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes.
Name, address and phone number.
9. Expiration date of this Notice of Commencement:
(the expiration date is 1 year from the date of recording unless a different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK
OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Signature(s) of Ov✓ er(s)
Prepared By
Print Name I sv%((a
Title/Office
�vner(s)' Authorized Officer/Director/Partner/Manager
Prepared By
Qek4 tt.tl Print Name
Title/Office
STATE OF FLORIDA
COUNTY OF MIAMI -DADE
Be fo goipg in meily
individually, or O as
acknowledged before me this 11 day of LJ2r
.colI
for
❑ Personally known, or 0 produced the following type of identification:
Signature of Notary Public:
Print Name:
(SEAL)
L 1C. •, P_ : : J. T. . r . •; D Y,.it ij
Under penalties of perjury, I declare that I have read the foregoing and
that the facts stated in ' are true, to the best of my knowledge and belief.
Signature s) of .4'er
By
or Owner(s)'s Authorized Officer/Director/Partner/Manager who signed above:
By
pck
0o %ek
tfckeiA, m-Y
t`fliomi Shodes Village
APPPPNPFD
'ZONING DEPT
DG DEPT
go i,us'-4
By DATE
efdl
t 111J[CT TO COMP! 1ANCE WITH ALL L` of (lr,l
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100.40
[3'-31/2'
293.37
[9'- 71/2'J
98.28
[3'-1 1/21
97.72
[3'-2 1/21
[4'-11 7/81
8908
12' -11 1/8']
41
FLOOR PLAN - OPTION 1
KITCHEN 1 WHITE PET
I I
II
II
II
I
33.02
96 26
[3' -1 1/21
235.23
Cr-8 6/81
369.67
[12' -1 1/21
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[2'-4 3/8"]
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[5 7/8"] -\
241.30
L�. I a te . - -_.1
30"
RANGE
4 4'..
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/
/
/
/
45.00 7620 45.00 63.50
[1' -5 3/41 [2'-6' 1' [1' -5 3/4"] " [2' -1
2.00
[3/41
ELEVATION A
KITCHEN 1 WHITE PET
5.02
[2"]
36 00
[1'- 21/81
8258
[2' -0 5/8"]
72 00
[2'-4 3/8"]
4.00
[1 5/8"]
15.00
[5 7 /8"]
110217
au:
,"a4,
3/6
3600
[1'- 21/8'
62 58
[2'-0 5/81
4.00
[1 5/8"]
72 00
[2'-4 3/81
15.00
[5 7/8"]
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[2"]
»
90.00
[2' -11 3/81
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[2' -11
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�'r[117/81T
8.18
[3 1/41
ELEVATION B
KITCHEN I WHITE PET
90.00
[2' -11 3/8"]
30.00 '
1' [113/4"] ' 1
8.20
[31/41
63.50
[2 -11
243.84
[8']
110217
and
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rafted:
a 100441 RP_
m
a
4/6
7200
[2'-4 3/8"]
47 58
[1'-8 3/4"]
4.00 -\
[15/8"]
16.00
[5 7/81
72 00
[2'-4 3/8"]
389.57
[12' -1 1/2"]
2.00 53198 47.00
[3/41 I }W] [1'-81/2"]
142.76 30.00' 45.02
[4'- 81/41 [11 3/4"] [1' -5 3/41
92.00
[3' -0 1/4"]
2.00
[3/41
45.02 ifr
[1' -5 3/41
INTE
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(2 -1"]
5.00
[2"1
81.00 50.00 � 46.02
[2'] [1' -7 5/8"] 2.00 [1'-5 3/41
[3/41
ELEVATION C- OPTION 1
KITCHEN 1 WHITE PET
389.57
[12' -4 1/21
91.98
[3'-0 1/41
45.02
• [1' -5 3/41
2.00
[3/41
243.84
[8']
110217
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OCT 2 6 2011
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