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RC-14-528 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-246145 Permit Number: RC-3-14-528 Scheduled Inspection Date: October 22, 2015 Permit Type: Residential Construction Inspector: Rodriguez,Jorge Inspection Type: Final Owner: LALANNE,VILBRUN Work Classification: Alteration Job Address: 190 NE 91 Street Miami Shores, FL 33138- Phone Number (305)757-8841 Parcel Number 1131010190080 Project: <NONE> Contractor: HOME OWNER Building Department Comments NEW MASTER BEDROOM AND BATHROOM 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. October 21,2015 For Inspections please call: (305)762-4949 Page 26 of 55 Inspection Worksheet Miami Shores Village I�� 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-238485 Permit Number: RC-3-14-528 Scheduled Inspection Date: July 10, 2015 Permit Type: Residential Construction Inspector: Rodriguez,Jorge Inspection Type: Framing Owner: LALANNE,VILBRUN Work Classification: Alteration Job Address: 190 NE 91 Street Miami Shores, FL 33138- Phone Number Parcel Number 1131010190080 Project: <NONE> Contractor: HOME OWNER Building Department Comments NEW MASTER BEDROOM AND BATHROOM Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed QU91L CREATED AS REINSPECTION FOR INSP-209207=penetrations Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. July 09,2015 For Inspections please call: (305)762-4949 Page 17 of 35 Miami Shores Village IVSD L. �I Building Department ��� V 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 u I 19 2014 Tel: (305)795.2204 Fax: (305)756.8972 BY.• I INSPECTION'S PHONE NUMBER: 305 762.4949 FBC 20 " BUILDING Permit No. PERMIT APPLICATION Master Permit N0' -&/! ' 'yY Permit Type: BUILDING ROOFING TOB ADDRESS: City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): �` r `�r�r12 } ��i !) _ Phone#: S� ` Address: 120 NCL City: Ct n ^ ! State: -7— L Zip: S�3 � J Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: /ri�(f�j e--�� I'` Phone#: Address: City: State: Zip: Qualifier Name: Phone#: State Certification or Registration#: Certificate of Competency#:. Contact Phone#: Email Address: DESIGNER: Ar 'ect/Engineer: Phone#: 727771 Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Addition alteration ❑New ❑Repair/peplace ❑Demolition Description of Work: Color thru tile: �*^' r� Submittal Fee$TC) Permit Fee$ 2"1� � • n CCF$ 0 • CO/CC$ S0• 0 Scanning Fee$ ��"� Radon Fee$ c /DnBPR$_1 Bond$ Notary$ Training/Education Fee$ Technology Fee$ l Double Fee$ 0 Structural Review$ •0 0 ��_� TOTAL FEE NOW DUE$ 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 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 commencemtnt must be posted at the job site for the first inspe tion w ' h occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will no he app oved nd a reinspection fee will be charged. ,Signature - �� J Signature Owner or Agent Contractor The foregoing i trument was acknowledged before me this�Y_ The foregoing instrument was acknowledged before me this day of ,20 J�,by NLS ,b( n Z-0 10IM e , day of ,20_,by , who is personally known to me or who has produced/- who is personally known to me of who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign:d- Sign: P � Notary ublic Siete of Florida Print: My Commission FF 082753 My Commission Exp aQ Expires 0 111 2/20 1 8 My Commission Expires: APPROVED BY It Plans Examier Zoning Structural Review Clerk (Revised 5/2/2012)(Revised 3/12/2012)XRevised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) 1 1 5t+,oREs Miami Shores Village Building Department "" 10050 N.E.2nd Avenue h Miami Shores, Florida 33138 �R Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: �� 1 (C,� Y1 �2E DATE: ADDRESS: /3 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 exerpption 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. c Please read and initial each paragraph. 1. I understand that state law requires construction to be done b a licensed contractor and have applied for an owner-builder q Y PP 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 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 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 hers 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 5. 1 understand that,as the owner-builder,I must provide direct,onsite supervision of the construction. Initial �- working on m building or 6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons g y g 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. t" Initial �. 4 7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obta n 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 pers n or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injur s. 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 provipe workers compensation for the employee.I understand that my failure to follow these may subject to serious financial risk. Initial 9. 1 agree that,as the party legally and financially responsible for this proposed Construction activity,it will abide by all ap licable 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 Intlemal 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://www.myfloddalicense.com/dbdr/pro/cilb/index.html Initial 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: Initial 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. f 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 Oroperty 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 rla ti's , 20���� BY �Ll' � hr as lA 1a1217 to, who was personally known to me or Who has Produced there License as identification. OWNER ig °kL Notary Publ State of Florlda F+ Joanna M Feliciano EE Commission FF 082753 O� Expirss 01/12/2018 F f'ti G- sus - s� �z gt►oRFs Miami shores Village Building Department logo 10050 N.E.2nd Avenue y�, oyd Miami Shores, Florida 33138 CITY �Nns IN® Tel: (305) 795.2204 ORIDA Fax: (305) 756.8972 3/3 o//� Py. Page 1 of 1 Permit No: A C 1 V 5 2-� Structural Critique Sheet n.¢t. ry STOPPED REVIEW Plan review is not complete,when all items above are corrected,we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re-submittal drawings. Mehdi Asraf