PT-10-15-2690Inspection Works,heet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FIL
Phone: (305)795-2204 Fax: (305)756-8972
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
ITII =11
Parcel Number 1132060140280
INSPECTOR COMMENTS False
omments
November 03, 2015 For Inspections please call: (305)762-49491 Pecs 20 of 39
Inspector Comments
Passed
Failed
Correction
Needed
Re-inspection
Fee
No Additional Inspections can
be scheduled until
re-inspection fee is paid.
November 03, 2015 For Inspections please call: (305)762-49491 Pecs 20 of 39
Opt
Miami Shores Village
. . . . . . . 10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-000 0
Phone: (305)795-2204
Project Address
485 NE 92 Street
Miami Shores, FL 33138-3154
Owner
JORDANA HART
Permit NO,PT-1 0-16-26,90
Permit Tyiw Paint
Permit Work Classfflcafion Now
Permit Status.- APPROVSD
issue 111012212015 Expiration: PI 9 /20
Parcel Number Applicant
1132060140280
Block: Lot: JORDANA HART
Address
485 NE 92 Street
MIAMI SHORES FL 33138
Contractors) Phone Cell Phone
HOME OWNER
Type of Work: Exterior
Color NEW HOUSE WHITE
Additional Info: PAINT EXTERIOR OF PROPERTY
Classification: Residential
Color: NEW HOUSE WHITE — Approved
Color: NEW HOUSE WHITE—Api
Fees Due
Amoun t
CCF
$1,80
Education Surcharge
$0.60
Notary Fee
00
$5.00
Permit Fee
$60.00
Technology Fee
$240
Total:
$69.80
8 0
Code Comments:
Color NEW HOUSE WHITE Denied
Phone Coll
305 577-9977
Valuation: $2,400.010
Total Sq Feet: 1825
I Pay Date Pay Type Amt Paid Amt Due I
Invoice# PT-10-15-57513
10/22/2015 Check #: 1324
$69.80 $ 0.00
Available Inspectionsi.--
7
Inspection Type: [
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and reguiations
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 ak the foregoing information is accurate and that all work will be done in compliance with all applicable Taws regulating
construction and zoning. Fut rmore, I uthorize the above-named contractor to do the work stated.
October 22, 2015
Authorized 4 nall Owner / Applicant / Contractor / Agent Date
Building Depalftment Gill
October 22, 2015 1
1"V .l allll o1lulu�) 'V nlagu
Building . t ..w
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 ~-
Tel: (305) 795.2204 Fax: (305) 756 8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
City
'Tenant /Lessee Name:
Email:
JOB ADDRESS:
d� t s -�
State: ..
P, i / -Cc.)
13.1 i
Zip: 2 3 n ,
City: Miami Shores County: Miami lade Zip:
IEolio/Parcel##:
Is the Building historically Designated: Yes NO )1(f Flood Zone:
t
COIw+i"I'It .: Company Name: Phone #:
Address: -
City:
Qualifier Name:
State Certification or Registration 4: Certificate of Competency #:
Contact Phone #: Email Address: 911,111 __.
"Value-of Work for this Permit $ 2, . , S utareJl anear Footage of ..
Description of Work: - .. ', fm: ..,A. "�
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 WORD, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS,
HEATERS, TANKS and AIR CONDITIONERS, ETC......
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT ENT AY 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 COM ENC,E E T.'9
Notice to Applicant: As a condition to the issuance of a building permit with an estimated valve exceeding $2580, the applicant roust 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 penntt is issued. In the absence of
such posted notice, the inspection will not be approved and an inspection fee will be charged,
*�:��gsk'�k�� :k , L- :;e:f:.>k�:k:f:.'�'�'�k��:kak:k .e ; �of���:' �k> k* ���: k�kYel•'' 0e5' E�: k�ky�c�aY= k�k: k: Psg��o-k��� :'�:k�sk:;; ?g�%kr ^,.� * *�* f ":k��k>ksk:k����
Permit. Fee $ CCF $i Notary $ I..:, ° Training/Education Fee $
Technology Fee $ Double Fee TOTAL FEE NOW DUE $ . °"�, �d° . � �'
All elements on the site must be listed and indicate the color to be ainted
DIRECTIONS: Please circle corresponding number to a +-
Walls: 9
2
3
4
Fascia:
2
3
4
Drip edges 1 1
2
3
4
Soffits 1
2
3
4
Roofs 1
2
3
4
Flower [tins 1
2
3
4
Shutters: 1
2
3
4
Awnings: 1
2
3
4
Chimney: 1
2
3
4
]Boors & Jambs:1
2
3
4
Garage Doors: 1
2
3
4 d
Railings: 1
2
3
4
Fences: 1
2
3
4
All Pricks 1
2
3
4
Stucco Band's.: 1
2
3
4
Other Stucco
Features 1
2
3
4
Accessory Bldg: 1
2
3
4
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.
Signature:_ Signature:
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this N
clay of 0 c^� ti' , 26 1 �-, by ,
who is ersonally known to me o who has produced
As identification and who did take an oath.
■
Sign:. —,
Print: Af"N"'M N— 1 C,t
My Commission Expires:
The foregoing instrument was acknowledged before me this
day of 120 , by
who jc personally 'known to me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
>ltc - State c,, Sign:
Itxp4es May 28.71
FF OZdt)D8 Print:
ilonded Through National Notary Assn
Poly Commission Expires:
.a, e? ^.? $c 3kak��Y�k% k��* �: ��k% s��➢ r.: Y•» k�k�= k= k*% k% kek�okrk: k��a8�k�kaK�* ���k�ktkekkx: k�' c#' �# ok�sK�? k%' ��' x�H��- k������kaK�Y' ��k�k�% k�= ����k% Y• Y��> k% ��F�. �'��;�:�;�K3s�= ����k��;;�:st:.
APPROVED BY: Code Official
Preservation Board
OWNER BUILDER DISCLOSURE STATEMENT
NAME: DATE:
����
ADDRESS: | �v�
Manni Shores Village
51 ~f��,�
IL
�
nn hereby petitionthem|lageofxxiam/Sh*,e u, act a,mv own contractor pursuant to the laws "f the State of Florida, ES4oe.z03(/),4nd|have
read and understood the following disclosure statement, whichcmuiesm,»owookesmvmwncnnmcmr/furthe/undemtanathnt/astheuwner
must appear io person tu 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 voumcf. You may build or improve a one-family nrmvv4am|Iy residence. You may also build nr improve a commercial building mta
cost ^f$25.000,0Onr less (The new form states 75,n00), TheWkdimg must befor your own use and occupancy, Ut may not bebmfltfor saXear
lease. if you sell or lease a building you have bu ilt yourself within one year after the construction is complete, the law wiII presume that you buHt
for sale or lease, which isa violation *f this exemption. You may not hire anunlicensed person mma contractor, Ytis your respmmoNNitytomake
:sure the people enmpUovedby you have Ncemseorequired by state law and byumtimmVor municipal UUuemmimg ordinances. Any person working nn
your building who vs 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 bv law. Your construction must comply with all
applicable laws, ordinances, buildings codes and zoning regulations,
Please read and initial each, paragraph,
1. | understand that state law requires construction mbr done bva licensed contractor and have applied for an owner-builder permit under an
exemption from the law, The exemption specifies that 1, as the owner of the property fisted, may act esmv own contractor with certain
restrictions ever though /mo not have alicense.
mitia
z. / 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 tv assume responsibility.
mma
1 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 /` required bvlaw to be licensed in Florida and to list his or license numbers on permits and contracts,
hitia|
4. |=demmnd that | may build o, improve a one family u,two-family residence me farm outbviIding.| may also build u, improve acommercial
building i[ the costs a" not exceed $7s'nom. The building o, residence must bn for mv use o/ occupancy. |t may not hc built v,substantially
improved for sale or lease, If a building or residence that I have built or substantially improved myself is sold or leased within I year after the
construction is complete, the law will presume that I built or substantially improved it for sale or lease, whigh violates the exemption.
Initial—
s 1 understand that, as the owner-builder, I must provide direct, onsite supervision of the construction
Initial
c 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
ismy responsibility m ensure mat the persons whom | employ have the license required bv law and uy mv or municipal ordinance.
Initial
7, 1 understand that lt is frequent practices of unlicensed persons to have the property owner obtain an owner-builder permlt that erroneously
implies that the property owner is providing his m, her own labor and materials. 1, as an owner-builder, may be hem |labhanu subjected to
serious financial risk for any injuries sustained byan unlicensed person "r his nr employees while working o^mvproperty. My homeowner's
insurance may not provide coverage for those injuries. I am willfuRy acting as an owner-builder and am aware of the limits of my insurance
coverage for injuries ou workers unmvproperty.
Initial
u |understaod that r may not delegate the responsibility for supervising work to bea licensed contractor who * 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 he employed by
me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributlons under the
Federal Insurance Contributions Act (FICA) and must provide workers compensation for the empfoyee, I understand that my failure to follow
these may subject to serious financial risk.
miuvL_--��L�_
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 a, well es employers. | also understand that the
Construction must comply with all applicable laws, ordinances, building codes, and zoning regu|ai
mitie| "'vd
zo 1 understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue aemlcc the United States
sm"N Business Administration, and the Florida Department uf Revenues. /also understand that / may contact the Florida Construction Industry
Licensing Board oto5o.*a/.13es,,
Initial
zz, 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:
Iriltial
m./ agree tnnotify Miami Shores Village immediately nf any additions, deletions, vr changes of n that / have provided un
this disclosure. I
mitia
Licensed contractors are regulated uv laws designed uoprotect the public. /f you contract with a person who does not have a license, the
constp*uminn industry Licensing Board and Department of Business and Professional xcsulauoomavbeunab|ctuaaistvvvwithanynnaociu|
loss that you sustain as a result of contractor may be in civil court, It is also important for you to understand that, ifan 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 ^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. x copy of the property owner's driver license, the notarized signature nf 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 thi
PIL T'
By (VI *41 (), Ak who was perso,nally known to me or who has
Produced there License D[ |
ate-
OWNER
as identification.