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RC-06-1606Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP -19956 Permit Number: RC -6 -06 -1606 Scheduled Inspection Date: September 10, 2012 Inspector: Bruhn, Norman Owner: SCHAFER, MARCENE Job Address: 381 NE 98 Street Miami Shores, FL Project: <NONE> Contractor: HOME OWNER Permit Type: Residential Construction Inspection Type: Final Work Classification: Repair Phone Number (305)758 -2837 Parcel Number 1132060135650 Building Department Comments REPAIR GUTTERS Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. September 07, 2012 For Inspections please call: (305)762 -4949 Page 35 of 35 Miami Shores Village L- Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. aster Permit No. BUILDING PERMIT APPLICATION FBC 2004 1E E E3 Y: I(c, c 0: E---141-1 Permit Type (circle): QI—taldtirp Electrical Plumbing ,� Mechanical Roofing Owner's Name (Fee Simple Titleholder) RC,5,�, /9C P" hone # 329 " 7f.37' Owner's Address srpvs- City £i/teMZ-5 State Zip -5j %ei Tenant/Lessee Name Job Address (where the work is being done) Phone # 3,647c qs7= City Miami Shores Village County Miami -Dade FOLIO / PARCEL # Is Building Historically Designated YES Contractor's Company Name Contractor's Address City State Qualifier Name Zip :five ro e, CI r fl► NO A- Phone # State Certificate or Registration No. Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Zip Phone # Certificate of Competency No. Type of Work: ['Addition ['Alteration Describe Work: Phone # Square / Linear Footage Of Work: ['New Repair/Replace [' Demolition Submittal Fee $ Permit Fee $ Notary $ 5 , CC Training/Education Fee $ cp . 4O Scanning $ 3.00 Radon $ DPBR $ Bond $ Code Enforcement $ Double Fee $ l l • CCF $ ©. CO /CC Technology Fee $ 2 . Zoning $ Structural Review. $ Total Fee Now Due $ 1 1 1 .10 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 Owner or Agent The instrument foregoing was acknowledged before me this 1 3 day of 11 , 2 , byir" /I.Cell € 1 1 who is personally known to me or who has produced L� As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Co i is on Expires: O IPJtY .0; OF FLORIDA ► andez �'af omm` ii"'P, b ft° '4d Thru Atlantic Bonding Co., Inc. APPLICATION APPROVED BY: (Revised 02108106) '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: /5/0;0 Plans Examiner Engineer Zoning NAME: VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT DATE: CO ADDRESS: 38, Q 6i °�— 131 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 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 hold title to the above property and I am planning on doing this construction 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 __. Initial. 7z. 2 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. 4. I understand that the building official alter or give advice on how to meet minimum code. Initial /V/4 ," and inspectors are not there to design, code —. only if the structure meets the Initial 5. 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 774,1— 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 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 4_<( day of 41-C 20 �C® ICCIK1 � ( who was personally known to me or who has Produced there License or as identification. NOTARY PuLLtC- 5TAT'i OF FLORIDA Yorleny H emandez Cora mssion # DD476455 Expires: SEE 27, 2009 r1 ACi_ nr'." T ? ?. riding Co., Inc.