RC-10-1594Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 163928 Permit Number: RC -9 -10 -1594
Scheduled Inspection Date: December 06, 2012
Inspector: Bruhn, Norman
Owner: CANARY, JAMES
Job Address: 9835 NE 4 Avenue Road
Miami Shores, FL 33138-
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1132060170180
Building Department Comments
NEW BATHROOM AND EXISTING BATH RENOVATION
PLAYROOM RENOVATION
PERMIT RENEWED ON 12/5/12
Passed
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- 163715. Not ready, all work not
complete. Work covered without inspection. NB
December 05, 2012
For Inspections please call: (305)762 -4949
Page 3 of 31
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
BUILDING
PERMIT APPLICATION
FBC 20
Permit No, t: 10
Master Permit No.
Permit Type: BUILDING ROOFING
Owner's Name (Fee Simple Titleholder) C 4-St e. Cv b Phone # 3 o S y ct 0 ti 0 S6
Owner's Address q 3 S N c4 t-[ A-i 1-• vo .
City NI st•.(■ S 14-Cr e S State Zip 3313
Tenant/Lessee Name 4`' / p4- Phone #
Email C--G
Job Address (where the work is being done) .7g3 5 ,iJ y4?/6 /G „9-4
City Miami Shores Village County Miami -Dade Zip 3 3 ► 3 gj
FOLIO / PARCEL #
Is Building Historically Designated YES
Contractor's Company Name
Contractor's Address
NO
l'afYr Niue
Phone #
Flood Zone
City State Zip_
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Contact Phone
Architect/Engineer's Name (if applicable)
Value of Work For this Permit $
Type of Work: []Addition
Describe Work:
E -mail
Phone #
Square / Linear Footage Of Work: 42
Alteration DNew 0 Repair/Replace ❑ D:molition
******** * * ** * * * * * * * * * * * ** * * * * * * * * * * * * ** Fees************* * * * * ** * ** *** * * ** * * * * * * * * * * * * * **
Submittal Fee $ ' •�' Permit Fee $ //� CCF $ CO /CC $
PaiD
Notary $ Training /Education Fee $
Scanning $ Radon $ DPBR $
Double Fee $ Violation date: 1 qt) ��
Structural Review. $ Total Fee Now Due $ •
Technology Fee $
Bond $
See Reverse side -4
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
Owner or Agent
The foregoing instrument was acknowledged before me this 1
day of, 20 ,O,
who is personally known to me or who has produced t D
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
q, , . •C.,_ s o_
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.... r * *,v * * * *, ter * * * * * *. ** * * * * *,v * * * ** ** * * ** *fir ***,*******.******************** a ** * *.*. *** *. * ** * *.* * ** * * * * * * **
•
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of , 20 :by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
APPROVED BY
Plans Examiner.
Engineer
(Revised 07 /10 /07XRevised 06/10/2009)
Zoning
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 j
NAME: 5 DATE: /O /7/ 2ld
ADDRESS: l 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 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 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 jumbers 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 s bstantially
improved it for sale or lease, which violates the exemption. y
Initial �f
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 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 �h
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 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 thI
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 day ofSir(' , 20 1 v
By who was personally known to me or who has
Produced there License or CA(.,LO as identification.
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OWNER
ARY
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NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. 12C/0 iS 9 -/ 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.
1. Legal des pc •ption of property and street/address: 9133 5 K) A Alfe7-
41/ La / 3g-
1111111 11111 11111 11111 11111 110111111 11111111
CFN 21310R04335970
OR Bk 27426 Ps 0342; (ips)
RECORDED 09/20/2010 10:36:36
HARVEY RUVIN, CLERK OF COURT
MIAMI-DADE COUNTY? FLORIDA
LAST PAGE
ace above reserved for use of recording office
2. Description of improvement:
3. Owner(s) name and address: Cits1-/t .) rAabs q2335.- ivE Ay& (204-d 41/ 4"1(2401 33)3413
Interest in property: 1,11.44/-E'_
Name and address of fee simple titleholder: C-662 t_25 CA5701.4
4. Contractor's name, address and phone number. £4g-h'3 eitsleA, qy 3r /ye" /40
'//t*-ti 5-,44/6' g I 3 2'
5. Surety: (Payment bond required by owner from contractor, if any)
Name, address and phone ntynber. 4.//04-
Amount of bond $ A.44-
6. Lender's name and address: 74-
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)7., Florida Statutes,
Name, address and phone number: /VA-
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:
A3/4-
9. Expiration date of this Notice of Commencement: ail Z-3 /2 c7
(the expiration date Is 1 year from the date of recording unless a different date is specffied)
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 Owner(s) or Owner(s)' ia■uthorized Officer/Director/Partner/Manager
Prepared By Ct.S (..A.Act La- .*8.5SzrAY‘ 47" //vt Prepared By
Print Name rag-6c e-er5‘ear, /4-4/3 Print Name
Title/Office t04--)t-1s)-C 33/38 Title/Office
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
The for g men was ac notige
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By
ID Individually, or as
CI Personally known, or
11 day of
.QOIO
for
roduced the following type of identificat
Signature of Notary Public:
Print Name:
(SEAL)
VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES
Under penalties of perjury, I declare that I have read the foregoing and
that the facts stated in it are true, to the best of my knowledge and belief.
.
NMIP11111MILMIDIN
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NOTARY PUBLIC-STATE OF FLORIDA
•`" """""" Claudia V Cubillua
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Expires-. SEP. 23, 2011
15 tL. C BONDING CO.,11.1C.
s)'s Authorized Officer/Director/PaVnTier/M aiker who signed abov PI6
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This Document Prepared By and Return to:
KRAMER AND GOLDEN P.A.
RICHARD A. GOLDEN
1175 NE 125TH STREET SUITE 512
NORTH MIAMI FL 33181
RTSC 96 -10P
Parcel ID Number: 11-3206-017-0180
Warranty Deed
This Indenture, Made this h day of May
James M. Canary and Kathleen Canary, his
wife
111111111111 1111111111111111111111111 11111111
CFI4 20 101R103 72115
OR ek 27306 Ps 1773; (IDs)
RECORDED 06/03/2010 14 :36:29
DEED DOC TAX 2,880.00
HARVEY RUVIN, CLERY. OF COURT
MIAMI -DADE COUNTYr FLORIDA
LAST PAGE
, 2010 A.D.,
of the County of MIAMI -DADE , state of Florida
Carlos Castello and Daniella Quintero, husband and wife
Between
, grantors, and
whose address is: 9835 N.E. 4th Ave Rd, Miami Shores, FL 33138
of the County of Miami -Dade , State of Florida , grantees.
Witnesseth that the GRANTORS, for and in consideration of the sum of
TEN DOLLARS ($10) DOLLAR
and other good and valuable consideration to GRANTORS in hand paid by GRANTEES, the receipt whereof is hereby acknowledged, have
granted, bargained and sold to the said GRANTEES and GRANTEES' heirs, successors and assigns forever, the following described land, situate,
lying and being in the County of MiAm i -Dade State of Florida to wit:
Lots 1 and 2, Block 87, Amended Plat of Miami Shores Section No. 4,
according to the map or plat thereof, as recorded in Plat Book 15,
Page 14, of the Public Records of Miami -Dade County, Florida.
and the grantors do hereby fully warrant the title to said land, and will defend the same against lawful claims of all persons whomsoeer.
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P.O. Address: 47 NE 93 S , MIAMI SHORES, FL 33133
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In Witness Whereof, the grantors have hereunto set their hands and seals the day and year first above written.
Signed, sea d an delivered in our presence:
Prin
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es M. Ca Stry
P.O. Address: 47 NE 93 STREET, MIAMI SHORES, FL 33133
STATE OF Florida
COUNTY OF MIAMI -DADE
The foregoing instrument was acknowledged before me this
a�
day of May , 2010 by
James M. Canary and Kathleen Canary, his wife
who are personally known to me or who have produced their Florida driver t s
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Pri• /d Name:
Notary Public
My Commission Expires:
icense as identification.
Law Generated by C Display Systems, Inc., 2010 (363) 763 -5555 Form FLWD -I
Book27306/Page1773 CFN #20100372115 Page 1 of 1
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