RC-13-2012Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 198543
Scheduled Inspection Date: November 06, 2013
Inspector: Rodriguez, Jorge
Owner: PEAKE, FRANCES
Job Address: 9342 NE 9 Avenue
Miami Shores, FL
Project:
Contractor:
<NONE>
HOME OWNER
Building Department Comments
Permit Number: RC -9 -13 -2012
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Repair
Phone Number
Parcel Number
1132060020050
REPAIR FLOOR JOIST UNDER SW BEDROOM Infractio Passed comments
INSPECTOR COMMENTS False
November 05, 2013 For Inspections please call: (305)762 -4949 Page 13 of 34
Inspector Comments
Passed -9a
Failed
Correction
Needed ❑
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
November 05, 2013 For Inspections please call: (305)762 -4949 Page 13 of 34
BUILDING
PERMIT
Permit Type:
JOB ADDRESS:
Miami Shores Village
Building Department
10W0 N.E.2nd Avenue, Miami Shores, Florida 33 138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (3®5)'762.4949
A,PPLICA.TION
UILDIN
5 L C yt aj AV�r
FBC 20 k�
Permit No.
Master Permit No. C _ A 01 z
ROOFING
City: Miami Shores County: Miami Dade 'Lip: 3 31 3 9
Folio/Parcel#: (I- 310 � " 002 ^ o os %i
Is the Building Historically Designated: Yes NO
Zone: V0
9� Pei nr(Z5 M, PrA x i"
OWNER: Name (Fee Simple Titleholder): "1 i-�- -1 6 C lw CV eg" Phan #: ?? 0 S-
Address: q 3,4" NV-� � t 1A A, V
City:
TenanAessee Name: f1
Email:
CONTRACTOR: Company Name:
Address:
State:
'vvw OW M Or i�k rQ 3 i
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer:
Certificate of Competency #:
Value of Work for this Permit: $ I , &00 Square/Linear Footage of Work: V �
Type of Work: DAddition OAlteratio ONew I RepairJReplaee ODemolition
Description of Work: rf j A i r 4 C 10 0 r 01 ��j IA,VI �1l` �✓, li d r ner 6e -d r o o wi
Color tliru tile:
Submittal Fee $ Permit Fee $ CCF $ Cum $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training(Education Fee $ �f&echnology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 6A
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
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 slandards 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 info rmmtion is accurate and that all work will he done incompliance with all
applicable; laws regulating construction mid 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 pennit with an estimared value ewweeding 52500, the applicant must
promise in goad faith that a copy of the notice of commencement and construction lien late brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy, of the recorded notice of commencement nutst 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 he approved and a reinspection fee will be charged. �
Si nature Si nature
g g
Owner or Agent Contractor
The foregoing instrument was acknowled�ggedd before me this The foregoing instrument was acknowledged before me this
day of _, 201a. by :,(� �Wt-44<-4F day of . 20 by
who is personally known to me or who has produced who is personally kmx%m to me or who has produced
As identification and who
Sign: /
Print:
My Commission Expires:
APPROVED BY
oath.
• ....
CP
tea`
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Plans Examiner Zoning
Structural Review Clerk
'26 si eJ As k,-&A dw 9-7-1 9-
(Revised eqp� f�] �7)(R "' o61tt?f2t�i)tRavi� if]5/04i
Miami Shores Village
Building Department
90050" N.E.2nd. Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
fOWNER BUILDER DISCLdSURE STANT
NAME: —C— �`�► ��� �� K� DATE•
ADDRESS: 10)9-L
9-L
Do hereby petition the vilage of Miami Shores to act as my own contractor pursuant to the laws of the Stata of Florida, RS 489.103(7),
And I have read and understood the' following disciosuro statemen> , which entitipe ulna to work as my awn 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-loss (The new form states,75,000): The building'must be for yourown use and
occupancy: it may not be built for sale or lease.�lf you:sell or] ease'a building youf have built yourself within drityesr after the
construction is ixitnplete .tfie lawwflt presume that'you bulk for --sale of lease, which WA violation of thltdk6mption. 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 forthat employee, all`as prescrit�d bylaw. Your Construction must complywith all applicable la+vs, ordinances,
buildings codes and zoning regulations.
Please read and Initial each paragraph.
1. i understand that state law requires construction tour done by a licensed contractor and hava.applied for an owner - builder
permit under an exemption from the law. The exemption speoft 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.
. tnitial_G���
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 i1i; not hiring a lloensed corrtractDr to assume responsibility.
3. 1 understand that, as an owner builder, I am the responsible party of record on a permit. I understand that I may protct e myself
from potential financial risk by hiring a Iloensed contractor and having the permit filed In his er her name . instead of my own
name. 1, also understand that the contractor Is required by law to be licensed in Florida and to list his or license numbers on
pennils and contracts. nifh��
I
4. 1 understand that I may build or improve a one fernDy or two - family residence or a farm outbuilding. I may also build or improve
a commerolel building N the costs do not exceed $75,000. The building or residence must ire 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 win presume that I built or subsWri sally
Improved it for sale or lease, which violates the exemption. a
5. 1 understand that, as the owner - builder, I must provide direr onsite supervision of the core Wction.
Initial
6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons wodit 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 -
i understand that it is frequent practices of unlicensed persons to have the properly 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 wormer- builderr ma)!� 4e hell
Gable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees'laihlle
working on my property. My homeowner's Insurance may not provide coverage for those Injuries. I am willfully acting as an
ownet builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
Initial_ yJ
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.beirmg -done. Any person working on my building who Is not lcensed must work under my direct supervision
and must be employed by me, whidm mean§ that I must comply with laws requf(irig the withholding of federal Income tax and
social security contnbudons under the Federal Insurance Contribution Act (FICA) and must provide workers compensation for
the employee. I understand that my failure to follow these may subject to serious financial risk.
i agree that, as the party legally and financially responsible for this proposed construction activity, I well abide by all applicable
Jews and requirement that govern owner - builders as well as employers. I also understated that'the
construction must comply with all applicable laws, ordinances, building cam, , 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 hftplAvww.mvfioridellcense.com/dbprlbro/dIbAndex.html
initial`
11. 1 am aware of, end 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:
I3�7, Wr-- 14�AVG
Initial 11P&
12. 1 agree to notify Usiml Shores Village immediately of any addition, deletions, or changes to any of the information that I
have provided on this disclosure.
Licensed contractors are regulated by laws designed to protest 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. g Is also important for you to
understand that, 9 an unlicensed contractor or employee ofen 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
verirying iwhether 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 owmner's'driver license, the
notarizes 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 S day of . 20
By.
Produced there License or
e
who was personally known to me or who has
t(D
identification.
Cb