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RC-11-560Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 177277 Permit Number: RC -3 -11 -560 Scheduled Inspection Date: August 16, 2012 Inspector: Bruhn, Norman Owner: MONTERO, ANGELICA Job Address: 9338 NW 2 Avenue Miami Shores, FL 33150- Project: <NONE> Contractor: HOME OWNER Permit Type: Residential Construction Inspection Type: Final Building Work Classification: Alteration Phone Number Parcel Number 1131010150280 Building Department Comments DRYWALL REPAIR FROM MOLD REMEDIATION. PAINTING OF OLD KITCHEN CABINETS AND NEW COUNTER TOP. CHANGE BATHROOM TILE SHOWER AREA ONLY Inspector Comments Passed% Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. August 15, 2012 For Inspections please call: (305)762 -4949 Page 18 of 26 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 175103 Permit Number: RC -3 -11 -560 Scheduled Inspection Date: July 02, 2012 Inspector: Bruhn, Norman Owner: MONTERO, ANGELICA Job Address: 9338 NW 2 Avenue Miami Shores, FL 33150- Project: <NONE> Contractor: HOME OWNER Permit Type: Residential Construction Inspection Type: Framing Work Classification: Alteration Phone Number Parcel Number 1131010150280 Building Department Comments DRYWALL REPAIR FROM MOLD REMEDIATION. PAINTING OF OLD KITCHEN CABINETS AND NEW COUNTER TOP. CHANGE BATHROOM TILE SHOWER AREA ONLY Passe /Vy r`,j V r Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 173241. CREATED AS REINSPECTION FOR INSP- 157795. Work covered. NB 6/25/2012 - cancelled by angelica/luz June 29, 2012 For Inspections please call: (305)762 -4949 Page 25 of 38 , VARIAN ASSOCIATES, P.A. — CONSTRUCTION CONSULTING SERVICES May 15, 2012 Mr. Norman Bruhn, Building Official Village of Miami Shores 10050 N.E. 2nd Avenue Miami Shores, FL 33138 Re: Montero Residence 9338 N.W. 2nd Avenue Dear Mr. Bruhn, I am in receipt of the inspection result #157795 issued on May 7, regarding a progress inspection for permit Number RC -3 -11 -560. The reports notes a failed drywall screw inspection. The property owner has retained my firm to assist in resolving the matter to your satisfaction. I inspected the premises, and observed that most wall surfaces in question have been prematurely taped, spackled and finished, thus obscuring the fasteners. Through invasive probes and other means, I was able to locate many of the fasteners. My findings indicate that the drywall installation and attachment methods substantially comply with sections R702.5.5 and R702.3.6 of the Florida Building Code. I hereby certify same, and request that the progress inspection be passed for this element of the work. If you require additional information, please contact my office. Sincerely, Walter Syrekc #AR93992 2000 N. Dixie Hwy. • Suite 100 • Boca Raton, FL 33431 • (561) 367 -9850 • Fax (561) 367 -0393 • www.goVarian.com CERTIFIED GENERAL CONTRACTORS ENGINEERS CERTIFIED ROOFING CONTRACTORS Arlenis Silvera From: Luz Elena Lera [chokoleche @gmail.com] Sent: Friday, May 11, 2012 11:21 AM To: Norman Bruhn; Arlenis Silvera Subject: Extension for permit #RC -3 -11 -560 I'm requesting a 45 -60 day extension to complete the work on my house. I'm currently contacting professionals to certify the drywall work and getting estimates on the granite countertop. This will help me a lot!!! Please advise if you can grant my request. Thank you in advance for all your help! Angelica Montero 9338 NW 2nd Avenue (305) 575 -9555 Sent from my iPhone Miami Shores Village Building Department �� g MAR 3i2011 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BY:- BUILDING PERMIT APPLICATION FBC 20 Permit Typ ROOFING Permit No. t 1 - -:5(0 Master Permit No. Owner's Name (Fee Simple i e s older) (A CA, ft) f Owner's Address 0i5,5 ) . VJ a t o City LAI skAoe c, State v'L Zip e3? 15 0 Tenant/Lessee Name Phone # - `c) Email LLera @ . C ®,teat . Lot— Email 6 -5-11 tiotrAdthe work is being done) City Mi mi Shores Village FOLIO / PARCEL # County Miami -Dade Zip Is Building Historically Designated YES NO Flood Zone Contractor's Company Name lQ4IYk) (9j) Phone # Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Contact Phone E -mail Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ /Or We Type of Work: DAddition fi4Alteration Describe Work: Pail kA 0-4. 01 .11 Ak: YUIa � Square / Linear Footage Of Work: l f'7 DNew 0 Repair/Replace ❑ Demolition * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * ** Fees****** * * *** * * * * * * * * * * * * * * * * * * * * *** * ** * * * * ** Submittal Fee $ r 0 Permit Fee $ 0 CCF $ CO /CC $ Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ 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 k 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 approvfd and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this t The foregoing instrument was acknowledged before me this day of cS , 20tI, by PK -1,2.L ,,.t GA 1 / It 'T 121,0 day of , 20 , by , who is personally known to me or who has produced t 'L 1 C) who is personally known to me or who has produced As identification an��t � I • I l ?' fl oath. as identification and who did take an oath. `ee\`\\�\�' / /�� NOTARY PUBLIC: 4 ..••'i4.g9 NOTARY PUBLIC: # oorssrwwoo Sign: Print: My Commission Expires: APPROVED BY ',/,/ ?Plans Examiner Engineer (Revised 07 /10 /07)(Revised06 /10/2009) Sign: Print: My Commission Expires: Zoning Clerk checked M iami 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: ti- e.A 1-i3O (1.) DATE: ADDRESS: 9 c %•u° . ��� P 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 I, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a license. I nitial 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. 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 on _,...r., permits and contracts. Initial 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. 5. I understand that, as the owner- builder, I must provide direct, onsite supervision of the construction. 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 ft 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. 1, 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 r " 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. 9. I agree that, as the party legally and financially responsible for this proposed Construction activity, 1 will abide by all applicable laws and requirement that govem 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 -t- 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.myfloridalicense.com /dbpr /pro /cilb /index.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 t 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information at I have provided on this disclosure. Initial 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 retumed 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 day of By 1t 1 ,IC. 4 rt 041 rim who was personally known to me or who has Produced there Li Li or as identification. OWNER -t- Miami Shores vinage TA It • (-MINTY RULE AND REGULATIONS 25 to onem 2 LOOM Dcats9 ADD SMOKE /CARBON MONOXIDE DETECTORS. ANY AND ALL CLOTH AND RUBBER INSULATED CONDUCTORS TO BE REPLACED L -tVINQ F•60.4 tt-c! 511 G" F1.Oo R ,{� ,�y�,-, �,�}� NO POINT ALONG COUNTER TO BE MORE THAN kOkC1■ Y �"�c-t%�4 /1 2 FEET FROM G.EI PROTECTED RECEPTACLE. owtit E ?: + At\IG L Ic loco L1 - zo PUT D/W RECEPTACLE UNDER SINK. 661e ` (� ��1L -- ALL FIXED APPLIANCES ON DEDICATED CKTS.'��i�t. sS : Q3�8 �1�i 2."d V bettAMt 361E0 251. tO" n0 2- •EseNG Permit Applications Permits Applied For Between Monday, April 11, 2011 and Monday, April 11, 2011 ,2,11 lliZ.=/:. li2J 1121,;1,, , , ' ,1 1, .22' z , ,:;,,, -, ' ,.,' ''''-'11,% !UII 04/11/2011 DANIEL & GLORIA LINDE 1165 104 Street MIAMI SHORES FL 33138-2657 1165 104 Street Garage Sale $ 0.00 04/11/2011 MIAMI COUNTRY DAY SC \ 601 NE 107 ST MIAMI FL 33161-7165 106 ST AND 6 AVE STREET IMPRC Public Works $ 500,000.00 (305)759-2843 04/11/2011 MIAMI COUNTRY DAY SC 601 NE 107 ST MIAMI FL 33161-7165 106 ST AND 6 AVE STREET IMPRC FenceNVall $ 20,000.00 (305)759-2843 04/11/2011 BARRY UNIVERSITY 11300 2 Avenue MIAMI SHORES FL 33161-6628 11300 2 Avenue Mechanical - Residentia $ 25,000.00 04/11/2011 AARON & KRISTEN FEUE 78 107 Street MIAMI SHORES FL 33161- 78 107 Street k,. Paint $ 350.00 04/11/2011 AARON & KRISTEN FEUE 78 107 Street MIAMI SHORES FL 33138- 78 107 Street Paint $ 350.00 04/11/2011 KERMITH & LOUIS EUGE 285 82 Street MIAMI FL 33138- 524 113 Street Residential Constructior $ 5,500.00 04/11/2011 KERMITH & LOUIS EUGE 285 82 Street MIAMI FL 33138- )0,9 524 113 S Street Residential Constructior $ 5,500.00 04/11/2011 KERMITH & LOUIS EUGE 285 82 Street MIAMI FL 33138- 524 113 Street n _ Driveways/Sidewalks/SI $ 1,000.00 04/11/2011 KERMITH & LOUIS EUGE 285 82 Street MIAMI FL 33138- „, 524 113 Streetf Driveways/Sidewalks/SI $ 1,000.00 04/11/2011 JONATHAN GOLDBERG 9901 NE 13 AVE MIAMI SHORES FL 33138-2634 9901 13 Avenub Re-Occupancy $ 0.00 04/11/2011 ELSIE ALCIDA 18 NW 110 ST MIAMI SHORES FL 33168-4319 18 110 Street Paint $ 350.00 04/11/2011 JOHN LONGMAN 333 92 Street MIAMI SHORES FL 33138-3133 333 92 Street Windows/Shutters $ 38,000.00 0_- 04/11/2011 JOHN LONGMAN 333 92 Street J Windows/Shutters $ 38,000.00 ()_- :\ 04/11/2011 LOUISE LEE 1341 NE 103 ST MIAMI SHORES FL 33138-2623 1341 103 Street Electrical - Residential $ 967.00 Thursday, April 21, 2011 Page 1 of 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 1 � -SO Inspection Number: INSP - 172757 Permit Number: EL- 4- 11-641 Scheduled Inspection Date: April 26, 2012 Inspector: Devaney, Michael Owner: MONTERO, ANGELICA Job Address: 9338 NW 2 Avenue Miami Shores, FL 33150- Project: <NONE> Contractor: HOME OWNER Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1131010150280 Building Department Comments BATHROOM KITCHEN REMODEL ADDITION OF SMOKE DETECTORS AND CARBON MONOXIDE DETECTORS Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments (6/1�i� z ° � z April 25, 2012 For Inspections please call: (305)762 -4949 Page 22 of 27 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 11 a'©Mg7M at APR as 2utr �U BY:... �Q BUILDING Permit No. J L I H PERMIT APPLICATION Master Permit No. `j (, C FBC 20 Permit Type: ELECTRICAL Owner's Name (Fee Simple Titleholder) I C1 C%CA M5 (1 Phone # 1 CStiO " _ -C O Owner's Address ct'b ►J • W . Z ( i� City MI O , x+'1,1) r 5 State Zip Tenant/Lessee Name Phone # Email Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone Contractor's Company Name ` \1J O Y "V0 Phone # Contractor's Address City State ` Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Contact Phone E -mail Architect /Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Type of Work: QAddition Describe Work: QAlteration Square / Linear Footage Of Work: QNew 0 Repair/Replace ❑ Demolition e1UUt.O /. 14 ,4 Jul $' � ` - t&i■ ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * ** * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ /� C�. !®® CCF $ CO /CC $ Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee. Now Due $ 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 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 re- inspection fee will be charged. -+ Signature Owner or Agent Signature Contractor The foregoing instrument was acknowledged before me this _Si-The foregoing instrument was acknowledged before me this day of 2.k.A , 20 10, by Nba&CA S-t( AgC1 Z, day of , 20 _, by who is personally known to me or who has produced 1 who is personally known to me or who has produced As identification and who did take_ an on oath. as identification and who did take an oath. NOTARY PUBLIC: %res_.... ,f, o 12' Sign: c Sign: Print: _ ��aR ' S _ Print: C °In SS° •`per My Commission. Expires: %, S '••.. My Commission Expires: ,'" T4) ,'' •'- (5 `; �11irrrrrri93i+�+� +''�� * * * *** *** * * *, * * *** ** * * * * * ** *, * ** * ** * * * * * * * * * * * * ** * * *** *, tit * * * *** * * *** ** ****** * * * * * * * ** * * *** * * ** * * * * * * * * * * * ** NOTARY PUBLIC: APPROVED BY 74%°,4 %) #,.Plans Examiner Zoning Engineer Revised 07 /10'07)(Revised 06/10/2009) Clerk checked 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: DATE: ADDRESS: 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 I, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a license. 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 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 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�� 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 it/ A-7 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. myfloridalicense .com /dbpr/pro /cilb /index.html Initial 11. I am aware of, and consent to; an owner - builder building permit applied for in my name and understands that I a the party legally and financially responsible for the proposed construction activity at the following address: Initial 4 t 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 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 Lk day of 't ,20� Bya 40(0. i l c lk'-v who was personally known to me or who has Produced there License or ' as identifkcation4 ,,,,��y�i -)\-4. 1— :;°....... • "-4,5) r OWNER =NciT '4( _ sa,\ ..• / /, /l1 /IU II11 \ \ \\, Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 1 Inspection Number: INSP- 158278 Permit Number: PL -4 -11 -642 Scheduled Inspection Date: August 15, 2012 Permit Type: Plumbing - Residential Inspection Type: Final Owner: MONTERO, ANGELICA Work Classification: Addition /Alteration Inspector: Hernandez, Rafael Job Address: 9338 NW 2 Avenue Miami Shores, FL 33150- Project: <NONE> Contractor: HOME OWNER Phone Number Parcel Number 1131010150280 Building Department Comments KITCHEN AND BATH REMODEL Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 14, 2012 For Inspections please call: (305)762 -4949 Page 2 of 34 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 APR Q.$. 2011 kJ: BUILDING Permit No. 12L 1 1 ' Z PERMIT APPLICATION Master Permit No.PCl r- 5(4)(--D FBC 20 Permit Type: PLUMBING Owner's Name (Fee Simple Titleholder) A-W.1a CA yv 6 Phone # Owner's Address cl Db ' k) 1w . 2-N)( • City j.A;o0.,(; .s State Zip Tenant/Lessee Name Email r s (where the work is being done) City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated Contractor's Company Name Contractor's Address City State Zip Qualifier Name Phone # Phone # County Miami -Dade Zip YES NO avafr Phone # Flood Zone State Certificate or Registration No. Contact Phone E -mail Certificate of Competency No. Architect /Engineer's Name (if applicable) Phone # ititlue of Work For this Permit $ G—J S re / Linear Footage Of Work: Type of Work: ❑Addition ['Alteration ❑New ❑ Repair/Replace ❑Demolition Describe Work: ti(0-0111. (.1e)1/4).) �� i ►ms s e �- 1.Nr ) lr)o ►(1 i f ) ******** * * *** * * * * * * * ** *** * * * * * * ** * * * * ** Fees************* * * * * * * * * * * * * * * ** * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ J Notary $ Training /Education Fee $ Scanning $ Radon $ CCF $ CO /CC $ DPBR $ Double Fee $ Violation date: Technology Fee $ Bond $ Structural Review. $ Total Fee Now Due $ 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 Contractor The foregoing instrwt was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 ,', by heUCfr - 'kQ,4e(O , day of , 20 , by who is personally known to me or who has produced IP who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: As identification and who did take an oath. Sign: a uuuii,,� Sign: Print: !\`\'\\��c \e111s Si/ `'i�r`/ Print: Q`; �xplrti �°r j Q3/06/ ?0'? My Commission Expires: to n 443.--1,,,,,4- '.. 9. APPROVED BY /// �,�if L t `rxaminer Zoning My Commission Expires: (Revised 07 /10 /07)(Revised 06/10/2009) Engineer Clerk checked 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: DATE: ADDRESS: 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 I, 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 responsibl for the construction and is not hiring a licensed contractor to assume responsibility. Initial 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 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. 5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction. Initial 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. Initia 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. 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.mvfloridalicense.com /dbpr /pro /cilb /index.html 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 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 contractors workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and retumed 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 g `l day of , 20 1.L By 4Nikauckv ttorci (t2J who was personally known to me or who has Produced there License or as identification. 4- b,:e`; ki 'AI I'a`a b�qH ' _ `J`�eAbti�9���'0 '••. se��� • J'� �s OWNER Permit No: 11-5-CO Job Name y` LS , 2011 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Arove(e.• �/ Building Critique Sheet ( Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204