RC-13-306 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-199558 Permit Number: RC-2-13-306
Scheduled Inspection Date: September 27,2013 Permit Type: Residential Construction
Inspector: Rodriguez,Jorge
Inspection Type: Final
Owner: PIMIENTA, ERIC Work Classification: Alteration
Job Address:6 NE 106 Street
Miami Shores, FL Phone Number (786)280-3974
Parcel Number 1121360060080
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
KITCHEN REMODEL, BATHROOM REMODEL Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSPA99536. Must finishwindow
opening on outside
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
September 26,2013 For Inspections please call: (305)762-4949 Page 7 of 22
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Miami Shores Village = k'
Building Department Z01
90050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: 305 795.2204 Fax: 305 7
56.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 20
BUILDING Permit No.
PERMIT APPLICATION Master Permit No4?=Q"J-''3()(1c='
Permit Type: BUILDING ROOFING
JOB ADDRESS: (0 !y E, to(0
City: Miami Shores County: Miami Dade Zip: 1
Folio/Parcel#• t t'Z1'-3(0 —00(a 0
Is the Building Historically Designated:Yes NO Flood Zone: 0
OWNER:Name(Fee Simple Titleholder): V-fi G j?V1/k j`Q..n Phone#:1%(9®2-9 0-3cA-
Address: tO lame' tt90 S-
City: �l if}Wi�t I S Y,b re s State: EL_-
P�
Tenant/Lessee Name: phone#;
Email
( � a
CONTRACTOR:Company Name.. ®�ys"-(V- �'J t It � 1�G11,. 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 Wotk for this Permit:$ Square/Linear Footage of Work: �CS�
Type of Work: ❑Addition ��__ DAlteration ONew ` Oltepair/Replaee ODemolition
Description of Work: 1�CeY,Pe1/1 �'e�(1�®��t l ?j�'1t,�11��O m r
Color thru tile:
®a
Submittal Fee$ S •03 Permit Fee$ Q® CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
ek-7 � o
r
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 jRade 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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection w ch ccurs seven (7) d;7ese after the building permit is issued.- In the absence of such posted notice, the
inspection wi not be a rove and a reinspectio will be charged
e-
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this l� The foregoing instrument was acknowledged before me this
day of cl--�1-0-> ,20 t3,by ��1 C {�i Y71 (css`�!� day of ,20_,by ,
who is personally known to me or who has produced 1 who is personally known to me or who has produced
As identification\\a 00imldj4*e an oath. as identification and who did take an oath.
NOTARY PUBLIC: \\�eN`\ .... .. /)j ° NOTARY PUBLIC:
` p°m?e=
Sign _ �� `'o CD ' Sign:
Print: Print:
/ q
My Commission Expires: °,;�lpR�D A `\���� My Commission Expires:
° \
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skHasks$sksksIahasknk�akak=k�askH=skIa�adasksksk sIaskBasksR9kds8ssksia�sakakksks�ags#sktakskkA'akakakIaskIa$ekskskskakak=kskkkakkkakikakHs�akHsIa�askBs akHsB+skskskIssIs+kk�Iaak
skHaakdasla$sskakkskakakIak
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
.,y ° s 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: e r 1 c 6(�w`e V1 DATE:
ADDRESS: (41 tZE ® (p S'rp VK l'Gt[Nt
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-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. 1 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. 1 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. 1 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$75,000.The building or residence must be for my use or occupancy.It may
not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved
myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially
improved it for sale or lease,which violates the exemption.
Initial
5. 1 understand that,as the owner-builder,I must provide direct,onsite supervision of the construction.
I
Initial
6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or
residence.It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or
municipal ordinance. yy�'
Initial
r
7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner-builder permit th$t
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 average for those injuries. I am willfully acting as an
owner-builder and am aware of the limits of my insurance average for injuries to workers on my property.
Initial
8. 1 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 amply 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. 1 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 amply with all applicable laws,ordinances,building codes, and zoning regulations.
Initial,
10. 1 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:/hvww.myfloddalicense.com/dbor/oro/cilbrindex.html
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 party
legally and financially responsible for the proposed construction activity at the following address:
l O lrr ST M t A S)�o V-CIS
'3•3 1 3,Z Initial
12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the informatio that I
have provided on this disclosure.
Initial IE
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 maybe 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 average.
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 owners 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 0 y day of , 20
By_ �� 1 who was personally known to me or who has
Prod ther nse or
OWNER
CFN 2013RiUO12667
OR Sk 2843; Pas 170E - 1710; (3v8S)
RECORDED 01/07/2013 14:06306
DEED DOC TAX 139813.00
HARVEY RUVIH. CLERK OF COURT
p b0iri Iss MIAMI-DADS COUNTYv FLORIDA
Richard A. t9oldan Esq.
1lromer a Golden k.A.
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Book28431/Pagel 709 CFN 920130012667 Page 2 of 3
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138 4�''Fk °yam
Tel: (305) 795.2204I0 RiDA
Fax: (305) 756.8972
Permit No: RC13-306
Job Name:
Page 1 of 1
Building Critique Sheet
1. Identify all of the interior bearing walls in the area of alteration. NB.
i
Norman Bruhn
Building Official
305.762.4859
Stopped Review
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.
♦y C.I yi
•��• nInv" Miami shores Village
Building Department
10R1pA 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RECEIPT
PERMIT#: DATE:
C.
Contractor
Owner
o Architect ll
Pick �6
up se tans and othe
Address: 1c)(OCT
From the building department on this date in order to have corrections done to plans
And/or get County stamps. I understand that the plans need to be brought back to Miami
Shores Village Building De artmen continue permitting process.
Acknowledged by:
PERMIT CLERK INITIAL:
RESUBMITTED DATE:
PERMIT CLERK INITIAL:
yy pp
m C FN 2013R O 1 22764
OR 3k 28489 F's 3509i (1 p s)
RECORDED 02114/2013 11:51:442
HARVEY RUVINY CLERK OF COURT
TICS OF COMMENCEMENT MIAMI-DACE COUNTYY FLORIDA
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME AF"FIRST INSPECTION LAST F A6E
PERMIT NO. C 1 �~ `°�' TAX FOLIO NO."_Z,_5(0_ 6_0()%G
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.
Space above reserved for use of recording office
1 Legal description of property and street/address: �.V �� s d Ytr(� 5�1i56 e� (,3f3 �-
L_
2.Description of improvement � Oa...
3.Owner(s)name and address: f—vtt ` b Wt. S . QY-P—, 13 d%
Interest In property: O °
Name and address of fee simple titleholder
4.Contractor's name,address and phone number: es z; of" e C. yy\1 Woy-es-,*Ff Tck
I
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 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
9.Expiration date of this Notice of Commencement
(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 OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13.FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TIMCE 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 CW FLC§Wk OOUWY CF
Signature(s)of Owner($) Ownegs)'Authorized.Officer/Director/Partner/Managei YCOVPYVWN*isabw fw
iieONMl�d�oeuq °'
Prepared dy F—T"@ C- yet Q Prepared By d
Print Name Print Name
Title/Office - Title/Office v6pf v' ®�
STATE OF FL A — % '°"` `MUM
COUNTY OF MIAMI-DACE � C.
The fopgolng instrument was acknowledged before me this day of
By mai L. 91 Y-n I I
❑Individually,or ❑as for
❑Personally known,orALproduddd the following'type of identification: — ®®i -
Signature of Notary Public: 42
Print Name:
fSEAL)
VERIFICATION iPURSUANT TO SECTION 92525:FLORIDA STA S �`• ��`� �a;� y
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.
Signa r s)or er(s)'s rued Officer/Director/Partner/Manager who signwia��`���``
/PZ By By
723.01 /3 3110
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