DEMO-06-2280Inspection Worksheet
Miami Shores Village
L 10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: February 03, 2009
Inspector. Bruhn, Norman
Owner: RESPONDEK, CAROL
Job Address: 1162 NE 105 Street
Miami Shores, FL
Project: <NONE>
Contractor: HOME OWNER
Buildine Deaartment Comments
Permit Type: Demolition
Inspection Type: Final
Work Classification: Building
Ckwo-00 Phone Number
Parcel Number
1122320280150
February 02, 2009
Page 1 of 1
Inspector Comments
Passed
/4 f
Failed
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
February 02, 2009
Page 1 of 1
BUILDING
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
SEP 0 6 2006 u
J_. Permit No,t�: (..°
PERMIT APPLICATION r "` Master Permit No. �',j>(� - - � � �, .
FBC 2001
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) KE rXA-ACKPhone # CS En &- (:,F,74
Owner's Address j (� r,� ilk
City -- �`,i '�►"'=- State Zip C 3y
Tenant/Lessee Name_ N Phone #
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NOS%,
Contractor's Company Name a'L+�� Phone #
Contractor's Address
City
Qualifier
State
Zip
State Certificate or Registration No. Certificate of Competency No.
�toS, s cewfl
Architect/Engineer's Name (if applicable) , Phone #
$ Value of Work For this Permit
Square Footage Of Work:
Type of Work: ❑Addition ❑Alteration EjNew El Repair/Replace Demolition
Describe Work: . . -� — _ _ -, —a _ _ ,—
Submittal Fee $
Notary S.
Permit Fee $ L5 n CC $ t CO/CC
TrainingfEducation Fee $ . `L,V Technology Fee $
Scanning $
Code Enforcement $
Total Fee Now Due $ i
(Continued on opposite side)
Radon
Zoning Bond $
Structural Plan Review. $
FEB n s aaio
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
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.
Signature
caner or Age
The foregoing instrument was as acknowledged before me this
//
Q �
Signature --
Contractor
The foregoing instrument was acknowledged before me this
day of } 20 , by 011 On -,�. IU:!:) jnAQC-�i , day of , 20 _, by
who is personally kn wn to me or who has producedg 213.010 —W o is personally known to me or who has produced '
i_ _CC- As identification and who did take an oath. as identification and who did take an oath.
NOTA Y IC-, veronica Mayorga NOTARY PUBLIC:
Sig • My Commission tm191394
w d xpi Sign:
Print:
Print:
My Commission Expires: 4- Q'J--1- OCl r apC My Commission Expires:
APPLICATION APPROVED BY: Plans Examiner
Engineer
chc 05/13/03
Zoning
` VILLAGE OF MIAMI SHORES
OWNER BUILDER I)ISCLOSURE STATEMENT
NAME:
DATE:. P . ®, a
ADDRESS: _ Ma.
Do thherebY POtiO IT
Of the 'Village. Of Miami. Shores. to act as my own contractor pursuant to the laws
e State pf Florida, F.S 48§A;03(7). And[ have read and understood the following disclosure
statement, which entitles irie to work as my own contractor; I further understand that I as the
owner must appear in person to complete: all a'pplicationg.
State Law requires construction to be done by a licensed- contractor. You have applied for a
permit under an $xception 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 comrrierctal` building at a cost of $25,000.00 or less. The building must be
fpr.yo it own use and. occupancy. It may -not be Guilt for sale or lease ...if you sell or lease a
building you have built yourself within one year after the.constructlon 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 undcr:y4ur supert+ision and must
be employed by you, which Means. that You mast deduct F.I.C.A and with - holdings tax and
Provide workers' compensation for that em'ployee,.all;as prescribed by law. Your construction
must comply with all applicable laws, drdinances, buildings codes and zbning*regulations.
Please read and--initial each paragraph.
I. I hold title to the above property and I am planning on doing this construction
Initial
2. I understand that as art owner - builder I must abide by all zoning ordinances and
building regulations in effect at the time of permit application
Initial M
.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.
Initial
4. P understand that the building official and inspectors are ndt there two design,
alter or give advice on how to meet code —% only if the structure meets the
minimum code.
Initial
r,
5. 1 understand that as an owner- builder, that any contractor disputes with sub-
contractors-.. and myself must be'haindled in a civil court with the advice of an
attorney. The department will not mitigate'any contract disputes..
Initial
6. 1 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 teason they
do not .poses a business license I wit-1 be fesponsible and liable for any wrong
doing from this unlicensed cornpany=or person.
Initial
7:: I,uliderstaf:d that-if any.persori.gets injurird on my construction project—they are
entitled to wdrkq* fi's compensation. And if they do not posses a workmen's
policy I could be hcid liable for all doctor and related cost which could include
loss cf wages duripg recovery from lnjury.'
Initial aA
8. 1. understand that under *state and local laws I* can not do -any Electrical,
Plurrtbing, Keating, Air &Roof work on my property with out first .obtaining
the proper permits by licensed contractors.
Initial
Was acknowledged before �me this day of 20 G
By 5
_2c 4ersoaally known to me or who has
Produced there License or
r
as identification.
Expi%J21-1�5, LU
F oe; BondedTbru
Atlantic Bonding Co , Inc
a
Miami Shores Village
Building Department
` 10050 NE 2 Ave, Miami Shores, FI 33138
Tel: (305)795 -2204 - Fax; (305)756 -8972
PERMIT #:
I,
❑ Contractor
XOwner
❑ Architect
Picked up 2 sets of plans and (other)
RECEIPT
DATE: IlJ 106
Address: A �0 '2- 1') E /61 i
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 Department to continue permitting process.
Acknowledged by:
PERMIT CLEARK INITIAL: /'��b
SEP o 6 2006
RESUBMITTED DATE:
BY:-v - - - - - - --
PERMIT CLEARK INITIAL:
Receipt
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit Number: DEMO -9 -06 -2280
Invoice Number: DEMO -2 -07 -27455
Applicant: CAROL RESPONDEK
Company Name:
Owner Address:
1162 NE 105 ST
MIAMI SHORES, FL 33138•
Job Address:
1162 105 Street NE
Miami Shores Village, FL
Date Payment Type Check Number Amount Change
Friday, February 9, 2007
02/09/2007 Check 4665 $106.30 $0.00
Total Payment: $106.30
Page 1 of 1
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Permit Status: APPROVED
Issue Date: 2/8/2007 Expires: 08/07/2007 Permit Number: DEMO -9-06 -2280
Owner's Name: CAROL RESPONDEK one:
Permit Type: Demolition
Work Classification: Build
Job Address: 1162 105 Street NE
Miami Shores Village, FL
Contractor(s) Phone Primary Contractor
HOME OWNER Yes
Additional Information
Type of Demo: Building Additional Info: DEMO
Classification: Residential
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.
Fees Due
Amount
CCF
$0.60
Education Surcharge
$0.20
Permit Fee
$100.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$106.30
Building Department File Copy
Applicant Signature
'Parcel #: 1122320280150
Block: Lot:
Section: PB:
Total Square Feet: 0
Total Valuation: $ 1,000.00
Invoice Number Amt Due Amt Paid
DEMO -2 -07 -27455 $106.30
Total:
o 9 PAID
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.