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RC-14-1279Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-231021 Permit Number: RC -6-14-1279 Scheduled Inspection Date: March 30, 2015 Permit Type: Residential Construction Inspector: Rodriguez, Jorge Inspection Type: Final Building Owner: REID, LISETTE Work Classification: Alteration Job Address: 290 NE 95 Street Miami Shores, FL 33138- Phone Number (305)632-5357 Parcel Number 1132060133700 Project: <NONE> Contractor: HOME OWNER Ijuuaing uepartment comments KITCHEN RENOVATION INSPECTOR COMMENTS False March 27, 2015 For Inspections please call: (305)762-4949 Page 12 of 17 Inspector Comments Passed r Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. March 27, 2015 For Inspections please call: (305)762-4949 Page 12 of 17 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-218515 Scheduled Inspection Date: August 27, 2014 Inspector: Rodriguez, Jorge Owner: REID, LISETTE Job Address: 290 NE 95 Street Miami Shores, FL 33138 - Project: <NONE> Contractor: HOME OWNER Building Department Comments KITCHEN RENOVATION Permit Number: RC -6-14-1279 Permit Type: Residential Construction Inspection Type: Concrete Slab Work Classification: Alteration Phone Number (305)632-5357 Parcel Number 1132060133700 Intractio Passed comments INSPECTOR COMMENTS False Inspector Comments Passed ��%%�'��vGl�� Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. August 26, 2014 For Inspections please call: (305)762-4949 Page 11 of 14 NOTICE OF PREVENTATIVE TREATMENTS FOR TERMITES (AS REQUIRED BY FLORIDA BUILDING CODE (FBC 104.2.6) j SPS. SPC SERVICES LLC ADDRESS OF TREATMENT OR LOT / BLOCK OF TREATMENT j 290 NE 95 Street; Miami Shores, Florida 33138-2712 8/26/2014 Date Termidor Product Used 0.06% Percent Concentration 5:00 PM Time Fipronil Chemical Used (active ingredient) 30 Area Treated (square feet) Soil Treatment—FOLIO # 11-3206-013-3700 Compressor Sprayer Applicator 3 Number of Gallons Applied Linear Feet Treated Stage of Treatment (Horizontal, Vertical, Adjoining Slab, Retreat of Disturbed Area) As per 104.2.6—If soil chemical barrier method for termite prevention is used, final exterior treatment shall be completed prior to final building approval. The building has received a complete treatment for the protection of subterra- nean termites. Treatment is in accordance with rules and laws established by the Florida Department of Agriculture and Consumer Services. If this notice is for final exterior treatment, initial and date line below. 8/26/2014 CORPORATE SEAL Pi i State Of Florida JB223017 SPC SERVICES LLC-305-505-9113—INFORMATION@SPCSERVICESLLC.COM ft G 0-111,S C �ONSULI ING GROUP. r0RP FIELD DENSITY TEST OF COMPACTED SOH,,S ASTM D -6938-08a Date. August 21, 2014 GEOTEC No. D-140821-275 PROJECT: KITCHEN PLUMBING TRENCH 290 NE 95 ST MIAMI SHORES, FL 33138 MOISTURE DENSITY RELATIONSHIP (MODIFIED PROCTOR) ASTM D-1557-07 GAUGE SERIAL SUB -BASE MAX. DRY OPTIMUM B. PAD B. SLAB X SOIL DESCRIPTION . EXC. No. IMPORT DENSITY, MOIST. (°A) 62691 95.1 SAND WITH GRAVEL 106.1 9.2 REQUIRED COMPACTION{%) 95% 1 TEST DEPTH PENET"T,1 ON (INCITES) 12 ORGANIC % N/A MATERIAL ON SITE BACKML SUB -BASE FIELD (%) MOIST. BASE B. PAD B. SLAB X LIFT I FINAL EXC. X IMPORT SOURCE OTHER DENSITY TEST RESULTS TEST No.DENSITY LOCATIONS FIELD DRY FIELD (%) MOIST. FIELD (%) COMP. RESULTS 1 RIGHT SIDE OF TRENCH 101.6 10.9 95.8 PASS 2 LEFT' SIDE OF TRENCH 100.9 11.3 95.1 PASS 3 4 5 Sieve Size: 3" 2%" 2i' IVV' 1" % %s" 3/8" #4 II Passing Sieve Size: #10 #20 #40,'. #60 #80 #140 #200 WASHED % Passing DRY MOISTURE I DENSITY CURVE 110.00 105.00 100.00 95.00 2 W O K 90.00 0 85.00 80.00 5.11% 920% 11.88% 13.831/. MOISTURE CONTENT % GEOTEC CONSULTING GROUP CORP. No. 56712 GEOTECHNICAL, CIVIL 8 STRUCTURAL ENGINEERS -13093 SW 133 CT. MIAMI , FL 33186 - P: (786) 319.03551 P: (305) 733-14211 P: (786) 380.0734 geotec.group@yailoo.com BUILDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (30S) 762-4949 FM-JBUILDING ❑ ELECTRIC ❑ ROOFING ❑PLUMBING ❑MECHANICAL E] PUBLIC WORKS JOB ADDRESS: 290 N.E. 95 Street JUN 18 2014 FBC 201® Master Permit No. Ae / L/ r Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3206-013-3700 Is the Building Historically Designated: Yes NO x Occupancy Type: Load: Construction Type: Flood Zone: _ BFE: FFE: OWNER: Name (Fee Simple Titleholder): Stephen K. Gonzales & Lisette Reid Gonzales Phone#:305-632-5357 Address: 290 N.E. 95 Street City: Miami Shores State: FL Zip: 33138 Tenant/Lessee Name: not applicable Phone#: Email: lisettereid@aol.com CONTRACTOR: Company Name: Owner contractor Phone#: 305-632-5357 Address: same as above City: State: Zip: Qualifier Name: Phone#: State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: Arthur G. Pyle Phone#: 305-710-9016 Address: 1016 N.E. 114th Street City: Biscayne Park State: Fl- Zip: 33161 Value of Work for this Permit: $$27,000 Square/Linear Footage of Work: 200 sq. ft. Type of Work: ❑ Addition F01 Alteration ❑ New D Repair/Replace ❑ Demolition Description of Work: ldtchen renovation and exchange of existing air conditioner Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Structural Reviews $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage tender's Address Zip City 7D6d a State -re Zip Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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/ OWNER or AGENT The foregoing instrument was acknowledged before me this day of _ 20�_ by l � }�1,cf, ,, who is personally known to me or who has produced 1) . -q1A 2 6 1 y2sa as identification and who did take an oath. NOTARY PUBLIC: Notary public ,to - ) Signature COAACTOR The foregoing instrument was acknowledged before me this day of . 20 _ by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal:Vff �' E1 resOtM 212018� _ y'� %n___e xai Seal: APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revisedo2/24/2014) 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: �; Se4e DATE: & / / � 114 ADDRESS: 95 t.5 ed/`�%��i SAoret } f -L 3213t? 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. 1 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 I -M2 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 L ry► /L- 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. /- FYI � 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 LM R-- 5. 1 understand that, as the owner -builder, I must provide direct, onsite supervision of the construction. Initial /-P %t- 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. Initial �-dvt/L 7. 1 understand that it is frequent practices of unlicensed persons to have the property 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 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 coverage for those injuries. I am willfully acting as an owner -builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Initial A%m fe- 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 comply 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 Imo' 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 comply 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 htto:ltwww.myfloddalicense.com/dbpr/pro/cilbfiindex.html Initial krn2 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: o79v At,(9reet{ I-111 ,F.5/?te Initial AIX - 12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that I have provided on this disclosure. 4, '11 � Initial 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 may be 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 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 owner's 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 16 day of -e , 2011 Y- ByLi's C -V4 e 2e-1 d - who was personally known to me or who has Produced there License or12.300-5 3 61 2?2--,!(—G as identification. OWNER Y Notary Public State of Florida ' Joanna M Feliciano Myo iib" FF 082753 ,as Expire® 1N212018 STATE OF (FLORIDA) COUNTY OF (DADE) Miami Shores Village Building Department SURVEY AFFIDAVIT 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 The undersigned Affiant, /� Rt/ .c,! 9 ,does hereby attest that (Property owner) The attached survey, performed by � U n �e r ro LLe ANG' . i (Name of surveyor's company) For address:_ L�?Cl() A% Performed on 9 e !gid -/.3 (date of survey) is an accurate representation of the existing conditions and locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicabl a this or other permits. Fu er, Affiant say eth naught. -- Property Owner Signature Property Owner Print Name SWORN TO AND SUBSCRIBED before me this day of Jed e— Affiant is personally known to me, produced identification. Notary Revised on 5/22/2009/ Revised on 6/12/09 R Notary Public State of Florida Joanna M Feliciano +� My Commission FF 082753 Expires 01/1212018