DGT-09-190Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Scheduled Inspection Date: June 23, 2009
Inspector: Bruhn, Norman
Owner: DAVIS, WILLIAM
Job Address: 405 NE 99 Street
Miami Shores, FL
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Decks/Gazebos/Trellises
Inspection Type: Final
Work Classification: Deck - Wood
Phone Number
Parcel Number 1132060170390
Building Department Comments
'1 24,MID
Passed `04
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
• Inspector Comments
l
,Eli rX eticialsk /Aid le
tele‘
June 22, 2009
Page 1 of 17
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: January 01, 2999
Inspector: Inspector, Default
Owner: DAVIS, WILLIAM
Job Address: 405 NE 99 Street
Miami Shores, FL
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Decks/Gazebos/Trellises
Inspection Type: Foundation
Work Classification: Deck - Wood
Phone Number
Parcel Number 1132060170390
Building Department Comments
February 18, 2009
Page 1 of 1
6
Passed gerC
Inspector Comments
�r37l,8
%
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
February 18, 2009
Page 1 of 1
Inspection Date: January 01, 2999
Inspector: Inspector, Default
Owner: DAVIS, WILLIAM
Job Address: 405 NE 99 Street
Miami Shores, FL
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Decks/Gazebos/Trellises
Inspection Type: Framing in Progress
Work Classification: Deck - Wood
Phone Number
Parcel Number 1132060170390
Building Department Comments
February 18, 2009
Page 1 of 1
Passed
' 7-6-(>77,erif)
,
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
February 18, 2009
Page 1 of 1
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
405 99 Street
Miami Shores, FL
Owner Information
Parcel Number
Expiration: 08/11/2009
Applicant
Address
WILLIAM DAVIS
1132060170390
Block: Lot:
405 NE 99 ST
MIAMI SHORES FL 33138 -2461
WILLIAM DAVIS
Phone
CeII
Valuation:
Total Sq Feet:
Approved: Yes
Comments:
Date Approved: 2/9 /2009 : Yes
Date Denied:
Type Const: Wood Deck
Classification: Residential
Additional Info:
Fees Due
CCF
Education Surcharge
Permit Fee - Deck (wood)
Scanning Fee
Submittal Fee
Submittal Reversal Fee
Technology Fee
Total:
Amount
$2.40
$0.80
$100.00
$9.00
$50.00
($50.00)
$2.81
$115.01
Invoice # Total Amt Paid Amt Due
DGT -2 -09 -33893 $ 115.01 $ 50.00
DGT -2 -09 -33893 $ 115.01 $ 115.01
$ 0.00
$ 4,000.00
Available Inspections:
Inspection Type:
Final
Foundation
Framing in Progress
1
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated.
February 13, 2009
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
February 13. 2009 1
r 2.111114 A.
BUILDING
PERMIT APPLICATION F : I 2 h ` I Master Permit No.
FBC 2004 I" _, Ire'
OS
Permit Type (circle): Building Roofing
Owner's Name (Fee Simple Titleholder) + //pi M `' �y
D4vi r Phone # 0 5 ' 75"g- l 7 3s
Owner's Address 4L 0 $ o't-
City /414,7 / J 4104.e4 State Zip S -3 15%
Tenant/Lessee Name Phone #
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
RECEIVED ] Permit No.QC\ CA -R0
Job Address (where the work is being done) ...54/10 gs Jac d°`
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name to i`i //""'7 A` Phone #
Contractor's Address
City State
Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 5- Of" a 0 0
Tye , of Work: ❑Addition ['Alteration
Describe Work:
e
Square / Linear Footage Of Work:
❑New
Repair/Replace ❑ Demolition
Ltirr4
0
: x**** ************** **** * ********** * ** * *Fees******* ******** ** * ****** ** * **** : * ******* ** **
Sub itittal Fee $ Permit Fee $ /d 5 CCF $ 0 ' CO /Cc!--
Training/Education Fee $ 0 • Technology Fee $ 00
Radon $ DPBR $ Zoning $
Bond --$ Code Enforcement $ Double Fee $
Total Fee Now Due $ 15 401
Noy $
Scanning $ u.no
Structural Review. $
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 no be approved and a reinspection fee will be charged.
Signature i!
Owner or Agent
The foregoing instrument was acknowledged before me this Q4"
, by UUtilICVA iS
day of
who is ersonally known me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: etairloara Om. E
My Commission Expires: 3laql aCAO
^l D05/0504
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:
********* * ***•x**** *+x**** ** ******* x44 ** :** ** * *:x*** * *** *** * * * * *** ****** **** *** ** x******* ***** * * ** *axe *** * ***
APPLICATION APPROVED BY:
V. It 1 c /C.= =I. 7
(Revised 07/10/07)
Plans Examiner
Engineer
Zoning
• VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
NAME: .U1 ihwt �� �� i DATE: 2 - -
ADDRESS: LI +% y iil . C' et q 5 f
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 i 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.LC.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 cp struction
Myself.
Initial ,
2. I understand that as an owner - builder I must abide by all zoning ordinances and
building regulations in effect at the time of permit application. Inactive
permits for a period of over 180 days will become null and void (expired)
and a new permit will be required. to be issued for reinstateuient of the
permit.
Initial
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 and inspectors are not there to ddsj'gI, 3
alter or give advice on how to meet code - only if the structurel;in Bets the
minimum code. a 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 L°-
6. I understand that if I compensate any person or company for work performed
they are requited 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 fot any wrong
doing from this unlicensed company or person.
Initial
7. I understand that if any person gets injured on my constractioi project they are
entitled to workmen's compensation. And if they do not posses a workmen's
policy I could be held liable for all doctor and related cost which could include
loss of wages during recovery from injury.
Initial
8. I understand that under state and local laws I can not do any Electrical,
Plumbing, Heating, Air & Roof work on my property with out first obtaining
the proper permits by licensed contractors.
s)—
Was acknowledged before me this cl
Initial
day of 2009
By coitt M \ COS who w
Produced there License or
ersonally known
o me or who has
as identification.
OWNER NOTARY
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795-2204 Fax: (305)756-8972
Pennit NO. DGT-2-09-1 90
Issue Date: Not Issued
Expires:Not issued
Folio Number:1132060170390
Owners Name: WILLIAM DAVIS Owners Phone:
Job Address: 405 99 Street Total Square Feet: 45
Miami Shores, FL
Total Job Valuation: $ 4,000.00
............ ................. ............................................ .................
Contractor(s) Phone Primary Contractor
••
HOME OWNER Yes
Planning and Zoning Criteria and Comments
Approved: Yes
Comments:
Date Approved: 2/9/2009 : Yes
BOUNDARY SSURVFY
LOCATION ST{Z 1Cn
S -CALE: NTS
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SINCE 19V & ASSOC. INC.
Engineers • landStmeyors • Planters LS.d1.4789
355 NORTH SHORE O3ISE
MIAMI SUCH FL. 33$41
(305) 865 -1200 Fan _(305 865 -781
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Miami Shores Village
APPROVED
ZONING DEP JI
BLDG DEPT
SUBJECT TO COMPLIANCE F M-I ALL FEDERAL
STATE AND COUNTY RULES AND REGULATIONS