ACT-15-1107 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-234433 Permit Number: ACT-5-15-1107
Scheduled Inspection Date: July 24, 2015 Permit Type: Awnings/Canopies/Tents
Inspector: Rodriguez,Jorge
Inspection Type: Final
Owner: MARTIN, RONNIE Work Classification: Miscellaneous
Job Address:9717 N MIAMI Avenue
Miami Shores, FL Phone Number
Parcel Number 1132060130960
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
CHANGE FABRIC TO AWNINGS Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
July 23,2015 For Inspections please call: (305)762-4949 Page 12 of 39
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10050 N.E.2nd Avenue N '
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Permit
Phone: (305)795-2204
Ise . 1519121 Expiration: 11/15/2015
Project Address Parcel Number Applicant
9717 N MIAMI Avenue 1132060130960
RONNIE MARTIN
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
mW. _.. _.e_.,,®....m.® ..... ...,
RONNIE MARTIN 9717 N MIAMI AVE
I MIAMI SHORES FL 33150-1744
....... w. e�
Contractor(s) Phone Cell Phone Valuation: $ 850.00
HOME OWNER
Total Sq Feet: 00
Approved: In Review Available Inspections:
Comments:
Inspection Type:
Date Approved: : In Review
Final
Date Denied: Review Building
Type of Work:CHANGE FABRIC TO AWNINGS Additional Info: Review Planning
Classification:Residential Color Approved:In Review: In Review
Code Comments: : Code Approved: : In Review
Code Denied: Scanning:3
Fees Due ]MnPay Date Pay Type Amt Paid Amt Due
CCF
Invoice# ACT-5-15-55507
DBPR Fee 05/19/2015 Check#: 1111 $69.60 $50.00
DCA Fee Education Surcharge 05/11/2015 Check#: 159 $ 50.00 $0.00
Notary Fee Permit Fee Scanning Fee Technology Fee Total:
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 AFFI VIT: I cert' at ll-the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction zoning. I or the above-named contractor to do the work stated.
May 19, 2015
Au orized Sig lure:Owner / Applicant / Contractor / Agent Date
Building Department Copy
May 19, 2015 1
Miami Shores Village
Building Department MAY J1.20,5
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax: (305)756-8972 IBY
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC�-2-0 AD
BUILDING Master Permit No./ I
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL E]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
GJ
JOB ADDRESS: 1 7 17 No-/-z t-4 r, y
City: Miami Shores County: Miami Dade Zip: f��
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): (To r\a e �/�1z , l N Phone#:
p
Address: l 7 ( -7 N d ?7# rZ Es n, / A UC
City: W j�It/I i S' rte 6 , f r State: Zip: 3/S
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: U W 4-';E Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ �� ® 4 Q Square/Linear Footage of Work:
Type of Work: [_1 Addition EE YAlteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: �v ItT�!�: o
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ D
(Revised02/24/2014)
s
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City State 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 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 Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 /S' , by day of 20 by
42
who is personally known to who is personally known to
me or who has produced r as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign Sign:
Print:
Seal: Seal:
Seal:
SMLe of Florida
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APPROVED BY Plans Examiner f�11 ) I ( l Zoning
Structural Review Clerk
(Revised02/24/2014)
,SHORES Miami Shores Village
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Eggs Building Department
10050 N.E.2nd Avenue
pfte � Miami Shores, Florida 33138
Tel: (305)795.2204
Fax: (305) 756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: csrr�-i �`� !� %F7_!na DATE:
ADDRESS: 2 7 r',9 h,s avc (- 4 t o' 3 3 i„–
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida,F.S 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 , M-
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 Z I K
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.
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-1 .
5. 1 understand that,as the owner-builder,I must provide direct,onsite supervision of the construction.
Initial F, `
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 igr A4
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
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 'M
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-23 !h>
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 http://www.myfloridalicense.com/dbpr/pro/cilb/index.htmi
Initial
11. I 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:
Initial 1Z I
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.
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 day of/7-)a y , 20 .Cs�
ByiG e nn I' c 1;4 , who was personally known to me or who has
Produced there License or as identification. ro ;
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ST
°"�►, REGISTERED ISSUED BY
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APPLICATION Glen Raven Technical Fabrics,LLC ,wnWa
CONCERN No. 1831 North Park Avenue 02/21/2014
2 Glen Raven,NC 27217-1100
�'�► Et�aa'� F 73101 Telephone(001)336-227-8211 Fax(001)336.228-8454
This is to certify that the materials described at the bottom hereof have been flame-retardant treat-
ed(or are inherently nonflammable).
FOR KEYYSTON-BURBANK . ADDRESS 6865 VINELAND AVENUE
CITY NQRTH HOLLYWOOD STATE CAUFORNIA
Certification is hereby made that: (Check "a"or"b")
❑ (a)The articles described at the bottom of this Certificate have been treated with a flame-retardant chemical approved and reg-
istered by the State Fire Marshal and that the application of said chemical was done in conformance with the laws of the
State of California and the Rules and Regulations of the State Fire Marshal.
Name of chemical used Chem.Reg.No.
Name of application
D (b)The articles described at the bottom hereof are made from a flame-resistant fabric or material registered and approved by
the State Fire Marshal for such use.
Trade name of flame-resistant fabric or material used Reg.No. F 73101
The Flame Retardant Process Used will not Be Removed By Washing
(will or will not)
GLEN:RAVIEN TECHNICAL FABRICS,I LC
Glen Raven Technical Fabrics, LLC
Name ofAppAwWr or PmdtN'on superintendent BY T GENERAL MANAGER
CONTROL No. 0528609000
CUSTOMER ORDER No.
CUSTOMER INVOICE No. 0000851306
TOTAL INVOICE YARDS 300.8
DATE PROCESSED 02121/2014
STYLE YARDS PER STYLE STYLE YARDS PER STYLE
FF 82006-0000 300.8
.. ... . . . . . ..
. .. . . . . ... .
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... . . . . ... . .
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FIRE RETARDANT COLOR RETENTION & STRENGTH
FIRESIST'S delivers a state-of-the-art combination of flame The deep,rich colors and robust durability of FIRESIST
retardant performance and UV resistance that exceeds deliver long lasting good looks to any application. Plus,
industry standards. workability improvements make cutting, sewing and welding
easier than ever.
WEATHER RESISTANCE
With over 100 years of outdoor awning experience,Glen STYLING
Raven has engineered new coatings and finishes to maximize The new FIRESIST color palette focuses on popular solids,
water repellency,sunlight resistance,and ease of cleaning. tweeds and stripes.
TECHNICAL DATA
WEIGHT 8.75 oz. per square yard
WIDTH 60"/152.4 cm
COLOR Solution dyed to resist color loss from UV exposure and weathering.
Resistant to most chemicals,including bleach.
WARRANTY 5 years against loss of color or strength.
SURFACE Plain weave- Highly water repellent and soil/stain release finish.
UNDERSIDE Urethane/acrylic coating
TRANSPARENCY LEVEL Lighter shades translucent for back-lighting applications.
ABRASION RESISTANCE Excellent
FLEXIBILITY Excellent in both hot and very cold conditions.
FLAME RESISTANCE California State Fire Marshal Title 19
(PASSES ALL,BUT NOT LIMITED TO) NFPA 701-99,test method 11
CPAI-84;Tent walls and roof
FMVSS 302
FAA 25.853(Aviation)
UFAC Upholstered Furniture,Class 1
MILDEW RESISTANCE Excellent(with proper maintenance and cleaning)
CHEMICAL RESISTANCE Excellent
WATER REPELLENCY Excellent
OIL RESISTANCE Very good
SEWABILITY Excellent
HEAT SEALING Can be heat sealed using sealing tape and heat source such as wedge,
hot air, radio frequency welding,etc.
• •• • • • • ••• •
•• ••• •• • • • ••
FIRESIPjT
•• • •
• • • FR11-817
• t • FIRESIST'IS A REGISTERED TRADEMARK OF GLEN RAVEN,INC.
0 •• ••