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RC-12-1996Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 190147 Scheduled Inspection Date: May 01, 2013 Inspector: Bruhn, Norman Owner: DI PIETRO, OLIVER & MARZIA Job Address: 336 NE 98 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Number: RC -10 -12 -1996 Permit Type: Residential Construction Inspection Type: Final Building Work Classification: Alteration Phone Number Parcel Number 1132060135700 Building Department Comments RENOVATION OF TWO EXISTING BATHROOMS Infractio Passed Comments INSPECTOR COMMENTS False 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- 190006. MISSING AC FINAL April 30, 2013 For Inspections please call: (305)762 -4949 Page 16 of 25 1 PERMIT # / 12 l cp,( CONTRACTOR: SUBMITTAL DATE: ADDRESS: NAME: )0).23 )2J 5=0 q/6s-7. qd-TO RESUBMITAL DATES: ZONING FIRE STRUCTURAL IMPACT FEES ELECTRICAL. ,,, / 2- HRS/DERM PLUMBING NOC MECHANICAL BL 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 Permit Type: BUILDING JOB ADDRESS: 336 N 6 q e Permit No. 212 _ 1 ql 1 Master Permit No. ROOFING City: Miami Shores County: Miami Dade Zip: S913 e Folio/Parcel #: Is the Building Historically Designated: Yes NO ,.> . Flood Zone: NO OWNER: Name (Fee Simple Titleholder): N.. r rR- P' IAA 14 P i P f LO Phone #: 66- "7 6 Address: 39 0 N City: . 1 t-ri eS it° State: T Tenant/Lessee-Name: 1 Email: L F{t Y✓ e Zip: 3 3136 Phone#: 1 « 2 Qo b3-:D CONTRACTOR: Company Name: B)) 0 Nee—, Phone #: Address: City: State: Zip: Qualifier Name: Phone #: State Certification or Registration #: Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ cel GatO , Square/Linear Footage of Work: Type of Work: ❑Addition ❑Alteration ❑New ,Repair/Replace Demolition Description of Work: 4RePtoot 2 bttroo . Color thru tile: oe9Z ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** eeS************* * * * * * * * * * * *** * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ / CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 112 i -Jl J 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 w 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 attac ment. Also, a ertified copy of the recorded notice of commencement must be posted at the job site for the first inspection which oc rs s en (7) ays after the building permit is issued. In the absence of such posted notice, the inspection will not be .'ppri ed a d a r. % spec en fee will be charged. Contractor The for ,oin . i ed ed before �'t.�, The foregoing instrument was acknowledged before me this da of y � � `�� _ day of , 24 _, by i personally known to me or who has produced � who is personally known to me or who has produced 11-4 'C %s identification and who did take an oath. as identification and who did take an oath. NOT , . NOTARY PUBLIC: Sign: Print: My Commission Expires: tru was a Ica led RY PUBLIC: * * * * * * * * * * * * * * * * * * ** APPROVED BY Sign: Print: My Commission Expires: ******************************************************** *+x************* ***** ** /62∎ /'-1-1 Plans Examiner Zoning Structural Review Clerk (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) 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: P A- Q l DATE: ( /a3/ ADDRESS: 14)E- cz'''eS64‘) Vekaktsca 1-C , 3 t3 Do hereby 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 regulators. 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 1, as the owner of the properly listed, may act as my own contractor with certain restrictions even though I do not have a license. 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 and cunderst understand that the contractor is required by law to be licensed in Florida and to list his or livens; numbers on 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 — 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 o 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. 7. I understand that It is frequent practices of unlicensed persons to have the property owner obtain an owner-builder 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 I « =nses 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 :II 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 may contact the Florida Construction Industry Licensing Board at 850.487.1395 or htto://www.Invfloridalicense.com/dbprioro/cilbfindex. Initial I am aware of, and consent to; an owner - builder building permit applied for in my name and understands that 1 an the party Dally and financially responsible for the proposed construction activity at the following address: . `�; u dI t 12. I agree to notify Miami Shores Village immediately of any additions, deletiions, or changes to any of the information th 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 °' day ofC , 20 12- By r61G 'i who was personally known to me or who has d th re License 11 1-0 (Q identification. BILLOS CLAUDIA •Sta'.e of Florida Notary Public Sep 23.2015 c My Comm. Expires 23810 Cmmission # ar Notary Assn. Bonded Till ou9h Naba NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. 1 `tg to TAX FOUO 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. 111111111111111111111111111111111111111111111 CF-IM 2012RO- r 8069' OR E.k 28335 Ps 45181 (1Ps ) RECORDED. 10/31 /2012 09:54 =20 HARVEY RUVINr CLERK. OF COURT MIAMI -DADE COUNTY, FLORIDA LAST F'AGE ,` Q► Space above reserved for use of recording office 1. Legal description of property d street/address: �'✓�' �� `8 `� E `_tP&( ®'' ` 3,138 =E1- S 2. Description of improvement: t 3. Owner(s) name and dd�ess: Interest in property: Vvl Name and address of fee simple titieIIeAder 4. Contractor's name, address and phone number: 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number. Amount of bond $ 6. Lender's name and address: 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. 8. In.add Lion to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provided in Section 713.13(1)(b), Ficrida Statutes. Name, address and number: 9. Expiration date of this Notice of Commb, ^•ement: (the expiration date Is 1 year from the date of recording unless a different date Is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OW i;FR AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE - ONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYI TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEivIF.NT MUST BE RECORDED AND POSTED ON THE JOB t E BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING CONSULT V!TH YOUR LE D -R • `L'� RII]A, COUNTY OF ` �"j , 1 ' CE OF COMMENCEMENT t the y or n,;?EBY CERTIFY that this is a true co Signature(s) of Owners) or Owner(s)' Authorized Officer/ Director/Partner/Managerier,cnri rn rr;a c ,ce Prepared By Prepared By Print Name Print Name Title/Office STATE OF FLORIDA COUN OF MIAMI -DAD The or s me By �❑ Individually, or ❑ as for Personally known, or Lk produced the following type of identification: Signature of Notary Public: Print Name: (SEAL) YERIFICATION PURSUANT TO SECTION 82525. FLORIDA STATUTES Under penalties of • =rjury, I dec e that I have read the foregoing and that the .c tat in it ; e to the best of my knowledge and belief. fore me this day of WIMP :SS my nand ar d fo�f D /l _Coun > 1Imuffs 3 r. ;rnvor.�� ii► ' Authorized Officer/Director/Partner/Manager who Si • nat ex(s) s B mod__ d,PY p 4� CLAUDIA V. CUBILLOS J5 UAL iii � � Notary Public - State of Florida B. �.•..� My Comm. Expires Sep 23.2015 Pa °c Commission # EE 128810 ..;;; o s :+,," Bonded Through National Notary Assn. signed g`6 1;,. ...m -e- -® IMCMEVal OCT 2 y 2611 a) /Q 24 2o'2-- rupw.u.41; QeA ST. rreA1-4-r ok.k L -{-kt_ cO\--W\A-Lc.b -1',au11- emu, 9eh. k.Gto.n- a/Z / CA ra- -1- Te\k\kA„sff re_)-c,(4,,Lop w i (t kw( ,...-- ''' ----- ::-....,- '.. ; .., A,10 .111,1, 100 *W. s. • be2 ."'-- 41/44,‘„), , ..4_,ria.-1 - • '..---- 4., , ■ i f 4!: 4' r <A,UttAt -• - Lt.'? _ -,..,:_.. .. . • -::-...k.. — I - , i 1....1 vuts.1,..k 41/4Ak-oct -2/ 6PaivNuDik-L-Al &t,QA A-0es (:)...4:4 micertou_LLo \‘':?Vt-ca4A-4,-t-.. +conks -14cuLT 6eciie4s paak&A,c)Nrc, kL oXizi 31,$.0t f_\ 030-1A& kiaLL.Q1 ci k". 1 BATHROOM NO.1 Lght window Insolation RS BATHROOM Nye.. ADD SMOKE/CARBON MONOXIDE DETECTORS. ANY AND ALL CLOTH AND RUBBER INSULATED CONDUCTORS TO BE REPLACED. BATHROOM RECEPTACLE ON 20 AMP CKT AND G.F.I PROTECTED vr Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 12- Pic? Inspection Number: INSP- 180514 Permit Number: PL -10 -12 -1998 Scheduled Inspection Date: April 24, 2013 Inspector: Hernandez, Rafael Owner: DI PIETRO, OLIVER & MARZIA Job Address: 336 NE 98 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060135700 Building Department Comments PLUMBING WORK FOR RENOVATION OF TWO EXISTING BATHROOMS NEED TO SEE LICENSED CONTRACTOR ON JOB SITE Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments April 23, 2013 For Inspections please call: (305)762 -4949 Page 1 of 43 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 Permit Type: PLUMBING JOB ADDRESS: 336 Nf 9O+1 6T li.C@MMT% OCT 2 212 FBC 20 �„� Permit No. 1 �I Master Permit No. 2-7 1 q 1Cp City: Miami Shores County: Miami Dade Zip: 33I 3F Folio/Parcel #: Flood Zone: 740 Is the Building historically Designated: Yes NO %( OWNER: Name (Fee Simple Titleholder): M` Pt LA-4\141W- tA P 1 e 1 Phone #: i 8( -%b Address: S943 1t e City: M+ A (Li \ CYZ- State: Zip: 33)38 Phone #: Tenant/Lessee Name: Email: I L F{2 € f \ Crri Pr L . ( fr( CONTRACTOR: Company Name: `©tA1 Ntere—' Phone #: Address: City: State: Zip: Qualifier Name: Phone #: State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ .=215(-1 • CC) Square/Linear Footage of Work: Type of Work: ❑Address DAlteration UNew >Repair/Replace ❑Demolition Description of Work: Pe.'Yvl ocil✓k l 1 ID °C,oc,wi, c, , ******** * * * * * * * * * * * * * * * * * * *** * * * * * * * * ** Fees************* * * * * * * * * * * * * * * ** * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ /P CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 10 67" IO 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 t attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection wh h occu ° seven (7) days after the building permit is issued. In the absence of such posted notice, the Signature ., di Owne °or gent inspection will n, appr, . a reinspection fee will be charged. The for _.o'' i oS truss -ntewas ac fledged before thi day of �l $ �' ,201 by WY1 li b% i ona y kn wn or who has produced entification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: 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. * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY * * * * * * * * * * * * * * * * * * * ** ** Plans Examiner Structural Review (Revised3 /12 /2012XRevised 07 /10 /07XRevised 06 /10 /2009XRevised 3/15/09) NOTARY PUBLIC: Sign: Print: My Commission Expires: Zoning Clerk 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: N �, i � DATE: 100 2 J 2g3 t 2_ ADDRESS: q° IQc ci e 'N` Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of, the State of Florida, FS 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 -a uilder permit under an exemption from the law. The exemption specifies that I as the owner of the property listed, may j. my own contractor with certain restrictions even though I do not have a license. Initial -41- I understand that building permits are not required to be signed by a property owner unless he or she is res ' •ble for the construction and is not hiring a licensed contractor to assume responsibility. Initial At 3. I understand that, as an owner builder, Iam the responsible party of record on a permit I understand that I may ' •tect 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 n , bers on permits and contract. Initial ri ,rte 4. I understand that l may build or improve a one family or two - family residence or a farm outbuilding. I may also b it ' 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 bstantially 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. 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 s county or municipal ordinance. I understand that it Is frequent practices of unlicensed persons to have the property owner obtain an owner-builder perms 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 - Ong as an owner- builder and am aware of the limps of my insurance coverage for injuries to workers on my property. Initial 1 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not I nses to perform the work being done. Anyperson,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 compen - ( on 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 Dally and financially responsible for this proposed Construction activity, I will abide by all a'. plicable laws and requirement that govern owner - builders as well as employers. I also understand that the Construction musf 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 1 may co ct the Florida Construction Industry Licensing Board at 850.487.1395 or htty: llwww. mvtloridaiicense .com/db ®rlpro /aibrnde ,h 1,. ) l Initial ,' ' _"` 11. 1 am aware of and consent to; an owner - builder building permit applied for in my name and understands that I am the Jelly legally and financially responsible for the proposed constructlon activity at the following address: ` '36 A2 4 "_ � Initial 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information have provided on this disclosure. Initial Ucensed 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 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 -2b day of 'a , 20 as 9nbo 0, P\400 who was personally known to me or who has ' CLAUDIA V. CUBILLOS Notary Public - State of Florida • = My Comm. Expires Sep 23, 2015 Commission # EE 128810 Bonded Through National Notary Assn. z Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL � � r I CI Phone: (305)795 -2204 Fax: (305)756 -8972 v 1 Inspection Number: INSP- 189780 Permit Number: EL -10 -12 -1997 Scheduled Inspection Date: April 24, 2013 Inspector: Devaney, Michael Owner: DI PIETRO, OLIVER & MARZIA Job Address: 336 NE 98 Street Miami Shores, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060135700 Building Department Comments ELECTRICAL WORK FOR RENOVATION OF TWO EXISTING BATHROOMS Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments 5� PA 2 April 23, 2013 For Inspections please call: (305)762 -4949 Page 28 of 43 r - 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 FBC 20 BUILDING b� , PERMIT APPLICATION Master Permit No?-�J pip/ )2 ) l p Permit No. ) / 997 Permit Type: Electrical j� JOB ADDRESS: 3'.6 N E- q8 City: Miami Shores County: Miami Dade Zip: 3)3'8 Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: %'40 OWNER: Name (Fee Simple Titleholder): M Pt- l (-d P L A4/ NIA- Di p i ko Phone#: D 6 '' ti -1‘ 3 Address: 3sq 0 NE GI 441 City: -& of Shore g Tenant/ ame - T E LkN T Email: State: tiL =1=-( z_} att A-) L . cam / . 3i38 Phone #: 2-00 7( CONTRACTOR: Company Name: v O W rJ'fG� Phone #: Address: / City: State: Zip: Qualifier Name: Phone #: State Certification or Registration #: Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ /0 SOO ! OD Square/Linear Footage of Work: Type of Work: Address DAlteration r� ONew Repair/Replace ODemolition ei Description of Work: Remo d -t� b ro ®7i-t� ******** ******* * *****w*** ****** ******** Fees************* *** *** ***** * *** ** ***** ** ******* Submittal Fee $ Permit Fee $ ..Z,-0 /43'4) ' C F $ P, CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ 1'81'5 TOTAL FEE NOW DUE $ 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 CONDmONERS, 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 inspec,:.n whic occurs sev 7 days after the building permit is issued. In the absence of such posted notice, the inspection wl no be prov and . reins #tion fee will be charged. Signature _MWr caner o Agent The fo day of is gym ipstru NOTA t was ackno ledged before 20L2y 1 ersonally kno Y PUBLIC: Llr o me or who has produced FM •r identification and who did take an oath. 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. Sign:. Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * ** ** *fit *'.:: - * * * * * ** APPROVED BY 7 NOTARY PUBLIC: Sign: Print: My Commission Expires: ***************** ** ******* ************** *******+x *s<******+x***** CT�� /z Plans Examiner Zoning Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Clerk 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 F NAME: A6- ° g i DATE' / /' )' 1 ADDRESS: -6310 IS) t - ° KA =3 31 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.CA 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 I understand that building permits are not required to be signed by a property owner unless he or she is res' °nsible for the instruction and is not hiring a licensed contractor to assume responsibility.' Initial- 3. I understand that, as an owner builder, Iam the responsible party of record on a permit I understand that I mrprotect 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 lice 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 al s 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 ubstantlaHy 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 workin r on my building or residence. It Is my responsibility to ensure that the persons whom I employ have the license required by law and b 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 pe nit 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. 8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not li -roves to perform the work being done. Any person worldng 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 con ;nation 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 ' y 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. 10. I understand that 1 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 httpa/ www. mvtloridalicense .Com/dbor{nro /alb[ndex.y+ I Initial 11. I am aware of, and consent to; an owner - builder building permit applied for in my name and understands that I the party legally and financially responsible for the proposed construction activity at the following address: 336 t4s (34114 l ; t "cv X` 49- ?,3' z' 12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the inform 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 a of have a license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation my be unable to assist you with an financial loss that you sustain as a result of contractor`may be in civil court. It is also important for you to assist any y 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 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 of (-)C-ib4ej, 20 12-- B Y N_)(A) 1 V)e who was personally known to me or who has r l ) Z D)1 ' 12- 2-01-&s identification. till ` ► UOIA V. CUBILLOS f Florida " P„ A� Notary Public - State o `P �, My Comm. Expires Sep 23.2015 3s° rFi► ``.= Commission # EE 126810 %;; ;,;,',. <, Bonded Through National Notary ASSfl.