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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 • • ••• • • • ••• •• •• • • • •• •• • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • ••• • • t' • ••• • • • ••• • ••• • • 0 • • • • • • • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • •• • • • • N t woos 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