EL-13-1856Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-197322 Permit Number: EL -8-13-1856
Scheduled Inspection Date: September 16, 2013 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Owner: STRAUSS, MICHAEL
Job Address: 1251 NE 94 Street
Miami Shores, FL
Project <NONE>
Contractor: HOMEOWNER
comments
Inspection Type. Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number 1132050100050
ELECTRICAL WORK FOR KITCHEN REMODEL AFTER
THE FACT INSPECTOR COMMENTS False
Passed 1211�
Failed
Correction
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Inspector Comments
September 13, 2013 For Inspections please call: (305)762-4949 Page 17 of 38
Miami Shores Village ; X913
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (303) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: Electrical
FBC 20
Permit No. ) 3 — V V5�0
Master Permit No4— , ) 5 -1 Mj_5
JOB ADDRESS: r 2S 1
City; Miami Shores County: Miami Dade
Folio/Parcelk
Is the Building Historically Designated: Yes NO Flood Zone -
OWNER: Name (Fee Simple Titleholder): C t J2 ikLif� (l 9 C rl1t C L Phone#. !O J 'Kit' W, ( 2
Address: 'Z S; 9 /ll CIL-( I t •SYS'
City: �� +^� State: zip: l 3Q
Tenant/Lessee Name• _ Phone#• 3,4%`% -7c
Email: S T H I C L- l V(L 1
CONTRACTOR: Company Name: 4-10 M E: u'"i' N L� Phone#:
City. State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #.
Contact Phone#: a Email Address:
DESIGNER: Architect/Engineer: Phone#.
Value of Work for this Permit: $��1�1/p."c�' Square/Linear Footage of Work:
Type of Work: DAddress DAlteration ONew ORepair/Replace Memolition
Description of Work: EA EL (r-21 CAC WtIlk X61 VLc rf HL51U X10-10JE LrV401.
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
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 he 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 Z& Signature
Ownef or Agent Contractor
The fore oing ' t ackn ed bef The foregoing instrument was acknowledged before me this
day of 20)1 day of . 20 _, by ,
W4 -F
y known to me or who has produced o is personally known to me or who )has produced
E1 s identification and who did take an o th. as identification and who did take an oath.
NOT AR UBLIQ NOTARY PUBLIC:
Sign: s ti� PSS Sign:
Print: °�atV `� �o� #°"aPant.
My Commission Expires: _�--. �° at�`O My Commission Expires:
0
APPROVED BY �i'l°L /i'}U� Plans Examiner
Structural Review
(Revised 3/1212012)(Revised 07/10/07)(Revised 06/10)2009)(Revised 3/15/09)
Zoning
Clerk
Miami Shores Village
BuI ding Department
10050 N.E.2nd. Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNERRBUILDER DISCLOSURE 3TATEM.ENT
MME: F11 Crl,FL i -7P A L1u�9 DATE: _ I `{ 10* 1 S
ADDRESS: I Z� I /) t= 9 It "' -S/".
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the taws of the State.of Florida, F.S 489.103(7).
Aril (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 mustappear in person to complete all applications.
State taw 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
oanrpancy. it maynot be built for sale or lesser If you -sell or lease a building your have built yourself within one year after the
construction is'i othplete; this law willpINOWme that -you built for sale or lease, which We violation of thieeiter'nption. 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 FICA and with -holdings tax and provide workers'
compensation for that employeer all p*Mbed bylaw. Your construction must comply with all applicable laws, ordinances,
buildings codes and zoning regulations.
Please read and inIdal a eh paragraph.
9. 1 understand that state lair requires construction to be done by a licensed oontractor and have.applied for an owner -builder
permit under an exemption from the law. The exemption specifies that I, as the owner of the properly listed, may act as my own
contractor with certain restrictions even though I do not have a license.
2. 1 understand that building permits are not required to be signed by a property owner unless he or sire Is resporsible for the
c o strutioq and Is not hiring a iloerrsed cxmtractor to assume responsibility.
3. 1 understand that as an owner builder, I am the respo(isible party of record on a permit I understand that 1 may protect myssif
from potential finandal risk by hiring a Iioersed 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 lioensed In Fthride and to list his or noerss numbers on
permits and contracts.
IftI l
4. 1 understand that I may build or improve a one family or two-family residence or a farm outbu8cgrg. I may also b*. pr improve
a commercial bonding if the costs do not exceed $75,000. The building or residence must be for my use or oa�pency. It may
not be built or substantially improved for sale or Ise. If a building or residence that I have built or sulstantially improved
myself Is sold or [eased within 1 year ager the construction Is complete, to law win presume that I built or substsntlaily
Improved it for sale or lease, which violates to exemption.
Initial
5. 1 cn►demtarid that, as the owner -builder, I must provide dlrect, onsite supervision of the corstnuctiom
Initial L
6. 1 undenstard 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 ensue that the persons whom I employ have the lioerise required by law and by county or
municipal ordinance.
Initial ' l-
7. 1 understand that it Is frequent practices of unlicensed person to have the property owner obtain an owner -builder permit that "
error ly Implies that the property owner Is providing his or her own labor and materials. I, as an owner-buQderY;*64, hild
liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or empldseswhile
working 'on my property. Aly homeowner's insurance may not provide coverage for those Injuries. I am willfully, acting as an
ownet-builder and am aware of the limn of my insurance coverage 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 Hoenses to
perform the work done. Any person working on my building who Is not Doensed must work under my dint supervision
and must be e*oyed by me, which nheatis'that I must comply with laws '61 14 the withholding of federal Income tax and
social security contnbudons 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.
Inidal
9. 1 agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable
fews and requirement that govern owner4wilders as well as employers. I also understated that`the
mot of comply with all applicable laws, ordinances, b�dhrg cow, and zoning regulations.
10. 1 understand that 1 may obtain more Information regarding my obliged= as an employerfrom the Internet Revenue Service, the
Untled States Sm all Busbress Administration, and the Florida Department of Revenues. I also understand that -I may contest the
FWa Construction Industry licensing Board at 850.487.1395 or hbJhvwwmYW— ilari-s—e.00rd*zfar-o/cliUrKlexhW
!nidal ,.
11. 1 inn aware of, and consent to; an owner -builder building permit applied for to my name and understands that I am the party
legefly and finncialhy responsible for the proposed construction acdvity at the foliowi g addnes:
tntdal
12. 1 agree to notify Mami Shores Vilwge immediately of any addition, deletions, or charges to any of the Information that I
have provided on this demure. Initial
Licensed contradors are reguiated by laws designed to protect the public. If you contract with a person who does not have a
Dom, the Corstrolucdon Industry Ucensing 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, t an unitcarsed contractor or employee of an individual or firm Is tnju?ed" wori tg ren your property, you may
be held liable for damages. If you obtain an owner -builder permit and wish to hire a licensed tractor, you will be responsible for
veffft Whether the contractor Is properly licensed and the stators of the contractor's workers compensation coverage.
Before a building permit can be issued, this disclosure statement mist be completed and signed by the property am and
returned to the local permitting agency responsible for Muing the permit. A copy of the property t's`driver license, the
notarized signature of the properly owner, or other type of verification acceptable to the local pe WWM Wq is required when
the permit Is assured.
Was acknowledged !,More me this 1 4- day of A*L 24
By l who was personally known to me or who has