PL-07-1895Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
nspection Number: INSP -60895
Permit Number: PL -9 -07 -1895
Inspection Date: September 06, 2012
Inspector: Hernandez, Rafael
Owner: SCHAFER, MARCENE
Job Address: 381 NE 98 Street
Miami Shores, FL
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Sprinkler System
Phone Number (305)758 -2837
Parcel Number 1132060135650
Building Department Comments
SPRINKLER SYSTEM
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
For Inspections please call: (305)762 -4949
September 06, 2012
Page 1 of 1
Receipt
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit Number: PL -9 -07 -1895
Invoice Number: PL -9 -07 -29747
Applicant: MARCENE SCHAFER
Company Name:
Owner Address:
381 NE 98 ST
MIAMI SHORES, FL 33138
Job Address:
381 98 Street NE
Miami Shores Village, FL
Date
Payment Type Check Number
Amount
Tuesday, September 11, 2007
09/11/2007 Credit Card
$171.60
Change
$0.00
Total Payment: $171.60
Page 1 of 1
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795 -2204
381 NE 98 Street
Miami Shores Village, FL
Owner information
Expiration: 03/09/2008
Address
Phone
Cell
MARCENE SCHAFER
381 NE 98 ST
MIAMI SHORES FL 33138 -2409
(305)758 -2837
Contractor(s)
HOME OWNER
Phone
CeII Phone
Valuation:
Total Sq Feet
$ 2,000.00
0
Type of Work: SPRINKLERS
Type of Piping: PLUMBING
Additional Info:
Bond Retum :
Classification: Residential
II
SEP 1 12007
MIAMI SHORES VI LLA
L
Fees Due
CCF
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
01.20
$0.40
$160.00
$6.00
$4.00
$171.60
Total
Amt Paid I Amt Due
$ 0.00 $ 0.00
Payment Type:
$ 0.00
z
Available Inspections :
Inspection Type:
Final
Underground Sprinkler
In consideration of the issuance to me of this permit, 1 agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated
September 11, 2007
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
Tuesday, September 11, 2007 1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33 (38
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2004
It t
JehuiffeAt
Permit No. K. .1 - 1 895
aster Permit No.
Permit Type: Plumbing
Owner's Name (Fee Simple Titleholder) 4/Meg (lii C S'MEE n Phone # / .1 ? '
v 57
/I(. " 9.14r,57-
State ,r Zip 33/6g(
Owner's Address
City %%% s <s-f71)A�.
Tenant /Lessee Name
E -MAIL:
Phone #
Job Address (where the work is being done) 3,711zf 76(767—
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL #
Is Building Historically Designated YES NO X
Contractor's Company Name ( 1(*X
Contractor's Address
City State
Qualifier Name
Zip 33J3d"
Phone #
Zip
Phone #
State Certificate or Registration No. Certificate of Competency No.
E -MAIL:
Architect /Engineer's Name (if applicable) Phone #
Value of Work For this Perini
Square / Linear Footage Of Work:
Type of Work: ['Addition ['Alteration ❑New
❑ Repair /Replace ❑Demolition
Describe Work:
AD9 q.t.() mire .
******** * *** *** * ** **x * ** * ** ** * * ** * ** * ** Fees** * * *, **:** **** ****** * **x * *xxxrxx**x** *x ** * * *
Submittal Fee $ Permit Fee $ /, 0 CCF $ f. 20 a /C
Notary $ "// Training /Education Fee $ 0 -"IV
Scanning $ W •cX Radon $ DPBR $
Bond $ Code Enforcement $ Double Fee $
Technology
g$
SEP 1 1 2907
Structural Review. $ Total Fee Now Due $ IZ
nn�� �
thy
M1AM II .i r 9i�e 5
•
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: 1 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 /7 ALL
Owner or Agen
The foreg ing instrument was acknowledged before me this
/�% � r�) /� � �p�/C~/ The foregoing instrument was acknowledged before me this
day of ltlJ?d(1 , 20°? , by // CG t G 'SC /Pater /f / L` y of , 20 , by
who is personally known to me or who has produced CC who is personally known to me or who has produced
Ci C 45)t, As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Signature
Contractor
Sign:
Print:
My Commission xpires:
Sign:
Mffir •=4 � Q f.rPrint:
(c.) a1,
*** ** * *** ** * * ** *** ** * * * ** *** ** * ***
v j My Commission Expires:
APPLICATION APPROVED BY:
(Revised 02/08/06)
lans Examiner
Engineer
Zoning
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4v121®a
SUBJECT TO COMPEL , 1NITH ALL FEDERAL
STATE AND COUNTY RULES AND REGULATIONS
--�-� .8,b issue
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 % 2
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
Initial
day of 7 ,20 t9
By MQ1C1 .043C4f elf who was personally known to me or who has
Produced there License or
f7> `Dviri'51 !
as identification.
VILLAGE OF MIAMI SHORES
OWNER
S� 9BUILDER DISCLOSURE STATEMENT
NAME: C / DA'Z'E:
ADDRESS: 3t/44 75T
2/
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 trust 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
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 there to design,
alter or give advice on how to meet code —. only if the structure meets the
minimum code.
Initial