RC-09-1486 (2)Ins", ion Worksheet
Mi' 1i Sillores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (306) 7 90-2204, Fax: (305)756-8972V�
Inspection Number: INSP-128011 ' Permit Number: PL -9-09-1485
Scheduled Inspection Date: October 30, 2009 Permit Type: Plumbing - Residential
Inspector: Levrock, James Inspection Type' Rough
Owner: PHILLIPS, STAN
Work Classification: Addition/Alteration
Job Address: 210 NW 105 Street
Miami Shores, FL 33150-1143 Phone Number
Parcel Number
Project: <NONE>
Contractor: HOME OWNER
1121360161040
Building Department Comments
Replaced toilet and sink in both bathrooms. Replaced
bathtub in one bathroom. Changed tile in bathroom.
f
I
6
J
o
In ectoc Com nts
Passed
Failed
-
Correction
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
October 29, 2009 For Inspections please call: (305)762-4949
f
Page 3 of 3
08-23-'13 06:14 FROM- T-684 P000210003 F-933
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-197456 Permit Number: PL -9-09-1485
Scheduled Inspection Date: August 22, 2013 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: PHILLIPS, SEAN Work Classification: Addition/Alteration
Job Address: 210 NW 105 Street
Miami Shores, FL 33150-1143 Phone Number
Parcel Number 1121360161040
Project: <NONE>
Contractor: HOME OWNER
esuual
Comments
Replaced toilet and sink in both bathrooms. Replaced Infracbo Passed comments
bathtub in one bathroom.Changed tile in bathroom. INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-147422, CREATED AS
REINSPECTION FOR INSP-123718. No access
Failed �� l
Correction
Needed
Re -inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
August 21, 2013 For Inspections please call: (305)762-4949
Page 23 of 38
Miami Shores Village
el fl ' Building Department
p
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: Plumbing
Permit No. PL—CI—C-)q,
Master Permit No.
Owner's Name (Fee Simple Titleholder)
Phone # QS') 7&J - %6 ?6
Owner's ddress _ -.)/to /�� Ms
City Q res State ar • ��' /
Zip .X✓�/ -Si2
Tenant/Lessee Name
E-MAIL: VnAn.
Phone #
Job Address (where Jhe work is being done)
City Miami Shores Villaee County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name n De a Phone #.
Contractor's Address
City
Qualifier Name
State Certificate or Registration N
E-MAIL:
Architect/Engineer's Name (if applicable)
Value of Work For this Permit $. 4000
State
Type of Work: ❑Addition ❑Af/lteration
Describe Work: pp'llet re -d C/wi_ et.,
Zip
Phone #
_ Certificate of Competency No._
Phone #
Square / Linear Footage Of Work:
]New 0 Repair/Repla
❑ Demolition
de*xee,x �4xdzxor 9Y et oY �:x4r aY se oY 9e&x�k o:xxdc'i: otxxxxx4: oYx4r s6Fee$x&atx9e n°�k 9e*ek��YxBt��Yxr. 4exa`&xxxxxxicxxxatxdcxxxx�Y �Yxxx
Submittal Fee $ '� C� Z)ed Permit Fee $_ CCF$ (tic) CO/CC
Notary $, Training/Education Fee $ Q 2 Technology Fee $. 3
Scanning $ 0 Radon $ 0C) DPBR $ 00 Zoning $
Bond $
Structural Review. $
Code Enforcement $ Double Fee $
Total Fee Now Due
See Reverse side
I(z'Ac�)
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 infonnation 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 $2500, the applicant must
Promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not b approved and a reinspection fee will be charged
v
Signature Signature
��`Ownerr.�r Agent Contractor
The foregoing instrument was acknowledged before me thiZw d The foregoing instrument was acknowledged before me this
day of 6L? , 20t�� , by - kCi h P _ l�%7i / i/� S day of 20 _ by
who is personally known to me or who hasrd Li f
r P� �' � 1 who is personally known to me or who has produced
L)_ L Z 1_0 As identificati
iisr�take an oath. as identification and who did take an oath.
NOTARY PUBLIC: X
�,,,, , ��• 0`�` - NOTARY PUBLIC:
G' 0
Sign: "® > -e
o' Sign:
Print: �cp4�,, ( tr)
_- Print:
My Commission Expires:
x xz uxie>:x>: ae �Yxx�Ir�eY aYx&xx
APPLICATION A
(Revised 02108/06)
My Commission Expires:
'h�k,r�ae'xxxxxx9ctxxxr.�a4xicxxetixxzxdrxxa4 deu$xaY�x'lexxx'xA'xxzzaYxxac dexxxxtF aYdc'h zxacxxx
55.'V
Plans Examiner
Engineer
Zoning
VILLAGE OF MIAMI S. to ES
OWNER BUILDER DISCLOSURE ,STATEMENT
NAME: jean -
#DATE: 9 D
ADDRESS: .,)/0 A & I
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws
of the State of Florida, KS 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 41lows 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 redidbnee. 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 foe sale or lease, which is a violation hf this exemption. You may not hire
an unlicensed person as it contractor. It is your responsibility to make sure the people employed
by you hav® licenses regnhed by state law.alid by county or municipal licensing ordinances. Any
person working on your building who is not licensed ttlyst 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' Pompensation 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 cons t'
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 reinstatem t of the
permit.,
Initial
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. I, understand that the building official and inspectors 'are not there to design,
alter or give advice on how to meet code - only if the structure meets the
minimum code,
Inifial d
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 W
attorney. The department will not mitigate any contract'disputes.
Initial
6. I understand that if I compensate any person or company for work performed
they are requited to halve a business license in the county. If for any reason they
do not posses a business license I will be responsible and liable for any wrong
doing from this unlicensed company or person.
Initial
7. I undersbkd'that if any person gets injured on my construction projcct-they are
entitled to workmen's compensation: Anil 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. 1 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.
Initial X=
Was.acknowledged before me thi day of D:__ -A— , 20_
Y �4who was personally known to me or who has
Produced there License or F- C_ l P L
as identification.