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RC-13-404 ° eb Miami Shores Village Buildin Departmentartment _____omm_ao._e1 if 10050 N.E.2nd Avenue,Miami Shores,Floridaa 33138 e Tel: (305)795.2204 Fax: (305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 .LDING Permit No. PERMIT APPLICATION Master Permit No. Permit Type: BUILDING ROOFING JOB ADDRESS. Iii c � -- City: Miami sShores County: Miami Dade Zip: f Folio/Parcel#: (` — -p Is the Building Historically Designated:Yes NO "�J Flood Zone: c �/ OWNER:Name(Fee Simple Titleholder): c Pho,e#:_ -0,5 �, ' i C) Address: City: State: Zip: Tenant/Lesse Name: Phone#:�� Z 2 Email: � ��oo �1 < > 1-5 CONTRACTOR: Company Name: �LJI✓���" l Phone#: Address: City: State: Zip: Qualifier Name: Phone#: State Certification or Registration#: Certificate of Competency#: Contact Phone#: Email Address: DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$_ Square/Linear Foota a of Work: -F4- . N2 sq Type of Work: ❑Addition ❑Alteration ❑Newair/Replace ❑Demolition Descripti �f Work. - (j— m 4,44 19 r ) a'4tla V� l.o �• �u LLb�.: ! C 1 ,0-cc 1°®`®'6 +i LPGs Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ r•SV t , 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 commencement must be posted at the job site for the first inspec o whit occur seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not a ppr ed and reinspection fee will be charged. Signatureg6j Signature Own or Agent Contractor The f egy��'ing instrum was ac owl dg`e/d befor a this�� The foregoing instrument was acknowledged before me this day o) J ,201 ,by V day of ,20 by , who 's personally known to me or who has produced7t) who is personally known to me or who has produced � r� • G-1 As identification and who did take an oath. as identification and who did take an oath. NOTAR LIC: - NOTARY PUBLIC: tate of F1oo15 Sign: �. ep 23. Sign: .^= u�•p�. EE 12 Print: - ° L° "° ss�p0# DWI Assn Print: j.k. a., Shtou9h My Commission Expires: '=' t,' bonded My Commission Expires: APPROVED BY I� Plans Examiner Zoning Structural Review Clerk (Revised 5/2/2012)(Reyised 3/12/2012))(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) �+ w Miami Shores Village Building Department 10050 N.E.2nd Avenue " Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNERJWUER DISCLOSIM STATEMENT -0NAME: ADDRESS: �' 15. Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida,RS 489.103(7). And I have read and understood the following disclosure statement,which entities 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. I 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 ay act as 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 resaen ' le for the construction and is not hiring a licensed contractor to assume responsibility. ' Initial 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-er' eis n 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 Tiolstanti 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 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 b law and by county or municipal ordinance. Initia t 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.1,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 40--. 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 employerfrom 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:/Avww.myfloddalicense.com/dbi)r/i)ro/cilftex.htmi. 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 �F—� 12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the inform on t 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 property licensed and the status of the contractors 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 owners 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 Cl- day of 20 By who was personally known to me or who has Produced they is nse IVU Aas identification. g1l-SOS - � a of F�otid15 a ZD C � E�p,,e`Sep�25g10 ER QTss�^a tE`Notary Assn• n •%- CommWk0la pco�9hN o�` 0 Additional detail taken from permit page previously submitted Green line:represents walls where plaster will be removed and provided in the event the building office or the insurance company wallboard will be installed loses either form in the future: Blue window/door line: represents window openings to be finished and Remove plaster, replace with wallboard, make walls continuous, cleaned up post new window installation, per previous permit finish window openings, remove ceiling piaster, replace with WS-1-13-121,currently inspected on first inspection awaiting finishing wallboard, see permit EL 2-13-405 for electrical detail Red boxes: represent location where a previous wall existed and now there are small protrusions that will be made flush as described in the text below Pale blue box: represents area where cracked plaster will be removed window and wall board will replace to make ceiling smooth Interior door 1411-hats—covered under permit EL -13-405 Interior door Interior door I MAR 0 6 2933 QJwindow Remaining separator from Exterior door = previous renovation (pre- _. current homeoner) This is to be removed to -_ I_ »_e� �°y n,ar_ r make the walls R continuous. It currently 17 a _ _ extends four inches on either side and above. tl Lk.'a-s - f f fff ff ffff f ff ff fflf ffa fff I f €R i.k 28771 Ps 431.51 (Ips) RECORDED 08/14/2013 11:10.'49 NOTICE OF COMMENCEMENT HARVEY r'UVINP CLERK OF COURT A RECORDED COPY MUST BE POSTED ON THE�IOB�(TE AT TIaE OF.F R.S WSPECTION NIAMI-DARE t CitiNT'°'•F FLORIDA LAST F'AGE PERMIT N C" ) TAX 1=060 I"'O. STATS OF FLORIDA: S1iATE*OF FLOPIIJ i NTY OF DARE COUNTY OF MIAMI-DADE: I�ES l Nod�1FY#w �e yo/� ����CO(eay� ,�. cone. C♦ THE UNDERSIGNED hereby givbs noire fh timprovernents wID A.D. of property',and In atxordaitoe with Ohdptei 7113.Florida Statutes,the ctai e. Is provided In this Notice of Com-menaement. C Coundv courts q _ oe above reserved for Ike riling office 1.Leg a]-d esori pt lo n of properly and street/address624 6 e0 ) 2.Description of improvement f a 3 CuunQ(s):name and aodress' Interest in property:_ 8 Name and'address of fee simple'titleholdde. 4 C tract r's; e,add and pato e' umber: f �° 5 Surety (Payment bond required by owner from contractor,If any) , Name,address and.phone number. AToyrlt of bond S. 6.Lender's name.and address: 7.Persons within thWe of Florida designated by Owner upo whom notices or other documents may"be sere as provided by Section 71313(1j(a) ,,Florida Statutes; Name` �. 8 In addition to himself,Owners designates the following pe (s)to receive a copy of the LiLienor's Notice as provided inSection 7131 (l�(6),Florida Statutes. 't L. �:..�, . Name,aAiitlres§'atnd phone ntrmmber �, _ . 9.izpirationiafe of this Notice of Commence►xte►tt:-. 1 ¢he expVatior "Is t year from the date of recordkV urticas a oltffMM date is spse fleoq WARalld-'M(XWNER ANY PAYMENTS MADE B_Y THE O._WNER AFTER THE E k0iMJ1ON OFTyE NOTICE OF CQMMENCEMENTARE CONSIDERED IMP,ROPI5 PAIN`- S UI1�iS�F3 CHAPTER 713,PART 1,SECTION 716"I&FL(1RIDA'S�rdfliTE9 AND CAN RESULT IN VOUi�PAYING TW!_CE FOR IMPROVEMEN fS TO YOUR P OPERTY"A NOTICE OF COMMS ICEMIaNT MUST BE RECORD b ANb°i�bSTED ON'THE JOB SITZ:gEFd'RE THE FI T JIJSPE(1TION IF YOU: ND T©'OBTA >FINANCINC3,CbNSULT),T YOUR UNDER OR AN'ATTORNEY BEFORE'COAAMENGiN(3 WORK `l�li'`RftSR INt3 Y(y R hl OF COMMS ENT,..,, . . Signets)o sr ` I 0 Pre �EY, Y;" Pr ed Print'NAme ' Print,I�ame,� fftlefOffice 425e.s� STATE OFA FLORIDA Q Obi COUf�7Y OF MIAMI DApE `Tile f regotn `in int-.vu actmowtge¢lbefo this nay oft 8y. Individually,,or ❑as ��� x, for 13 Perso�iy Isno7it,ox 'roduced,the foouyi�tg type ofafdentifflcati _,l. A I®C f 3✓ 7= $i nacre of NOtatys F?pblfm e: 4f- ryam . " ! ,nt �. A,1 ak ♦. u#u. ` WALDO LAU C10 Y I ' REN ♦ P Undel'06h"Aiti of ury,I d a4 I have read:tii+a foregoing acid +°t Noiary Public-,State of Florida that the ed ft are e,to best of... Iedge and beNef. •o My Comm.Expires Jan 25,2017 my lmpwl Commission#EE 040276 Slg )a r s o" cerl[5irector/Partnedtdlanager who sign ••• O° •` Bonded Through National Notary Assn. By By 123.01-52 PAGES 3H0 - f n ` CL. BATH c F NOT PART OF THIS PERMIT BATH I. LINEN I Nt a CL. a NOT PART OF THIS PERMIT 1 NG OF tri PE NOT PART BEDROOM OF THI5 PERMIT NO OF -— PEI BATH �L. `` `r I —v I NOT PART TERRACE OF THIS I PERMIT MAID'S RM. I 5N� NOT PART OF DRESS I THIS PERMIT I i ND OF PEF I I BEDROOM N01 42 OF Tz' (t PES 1 PORC +� DINING CL. I FIREPLACE I MONOXIDE V7ETECTORS. I ANY AND ALL CLOTH AND RUBBER I INSULATED CONDUCTORS TO BE REPLACED. I I NOT 5N2 i OF T PERK KITCHEN I :5D.H2 I I I I I I LIVING � I Q I I I I 10T-�'# 3'-3" SNIa I LOGGIA pF i --- --------------' NOT PART OF THIS n-7 F7 PERMIT NOT PART OF THIS PERMIT NOT PART OF T1415 PERMIT