RC-15-3185 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-250597 PermitNumber: RC-12-15-3185
Scheduled Inspection Date: January 11,2016 Permit Type: Residential Construction
Inspector: Rodriguez,Jorge Inspection Type: Final Building
Owner: RAYMOND, RICHARD Work Classification: Alteration
Job Address:970 NE 100 Street
Miami Shores, FL Phone Number 3051757-6572
Parcel Number 1132060340190
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
REPLACE BATHROOM TILE AND VANITY Infractio Passed comments
TO CANCEL PERMIT#RC13-1667 INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
January 08,2016 For Inspections please call: (305)762-4949 Page 30 of 35
Xt
Miami Shores Village Pt fraltt 7" Ri" ti "structlon
10050 N.E.2nd Avenue NE
w0*Gla ".0080 rw ;terstion
Miami Shores,FL 33138-0000
�N c° Phone: (305)795 2204 Pem#t Statrs.APPROVED
»ate: 12129�201Expiration: /26/2016issue
Project Address Parcel Number Applicant
970 NE 100 Street 1132060340190
RICHARD RAYMOND
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
RICHARD RAYMOND 970 NE 100 ST. 305/757-6572
MIAMI SHORES FL 33138
Contractor(s) Phone Cell Phone Valuation: $ 4,000.00
HOME OWNER r
Total Sq Feet: 40
Approved:In Review Available Inspections:
Comments:
Inspection Type:
Date Approved::In Review
Framing
Date Denied: Insulation
Type of Construction:REPLACE BATHROOM TILE AND V Occupancy: Drywall Screw
Stories: Exterior: Final PE Certification
Front Setback: Rear Setback: Window and Door Buck
Left Setback: Right Setback: Fill Cells Columns
Bedrooms: Bathrooms: Review Building
Plans Submitted: Certificate Status: Review Planning
Certificate Date: Additional Info: Review Electrical
Review Plumbing
Bond Return: Classification:Residential Review Structural
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Mechanical
CCF $2.40
Invoice# RC-12-15-58164
DBPR Fee $2.25 12/29/2015 Credit Card $ 168.90 $0.00
DCA Fee $2.25
Education Surcharge $0.80
Notary Fee $5.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $3.20
Total: $168.90
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOO ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT:_.Inert' at reg ng information is ccurate and that all work will be done in compliance with all applicable laws regulating
construction and.zonin 0' the above-nam contractor to do the work stated.
December 29,2015
Authorized Signature:Owner / Appli / Contractor / Agent Date
Building Department Copy
December 29,2015 1
i
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 1-
INSPECTION LINE PHONE NUMBER:(305)762-4949 - —�
FBC 20 P y
BUILDING Master Permit No.
PE PAIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSIONENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
q CONTRACTOR DRAWINGS
JOB ADDRESS: < Z0 /J jEF (00 ✓9?—
City: Miami Shores County: Miami Dade Zip: 3 3 &
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: D Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): A tl'CN�4�Q AV l 1F j4 VAf-10A-W,'2 Phone#: 3 en 5�7S7',b 5'ao
Address:
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email: RJ? ?S Q_D <::;;::/K m!
CONTRACTOR:Company Name: /'-4®IVi F,en,w W t--"— Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
tooValue of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: 14 " AEC p"80 V.5 -A- CM A.IPCV-.,
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ " C CCF$ 0 CO/CC$
Scanning Fee$ Radon Fee$ � DBPR$ - v Notary$
Technology Fee$ Training/Education Fee$ ?�O Double Fee$
Structural Reviews$ Bond$ 26
p,
TOTAL FEE NOW DUE$ / 0
(Revised02/24/2014)
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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
i
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
a4-C) day of �RC 20 (� by day of 20 by
who is personally known to who is personally known to
me or who has produced ty�rZ as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: \\\����` ���i, NOTARY PUBLIC:
Sign: l :m = Sign:
Print: ` �= Print:
O� ' •Q,�
Seal: . .... Seal:
////�����I�i I I l i l i NDN`\\,\•
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
A
Miami Shores Villa
_ ge
Building Department
p
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 2000
BUILDING Permit No. y
PERMIT APPLICATION Master Permit No.
Permit Type: UILDING ROOFING
JOB ADDRESS:
City: Miami Shores County: Miami Dade
Folio/Parcelk / d °3 X 6 6 0 a -7-0 l ci n
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder):_ C H1J X2 D F Phone#: 2
Address: C'�t a � �' C�=
City: 1-JC3 P,C-5 State: Zip:
Tenant/Lessee Name: Phone#:
Email: 6�Pl-/ /R PC3 C-IT4- 0 e I I
CONTRACTOR:Company Name: Phone#:
Address:
City: State zip:
Qualifier Name: hone#:
State Certification or Registration#: Certificate of Competency#.
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: OAddition OAlteration ONew UdPApairAteplace ODemolition
Description of Work: F12 to�C-/I c-8= /S�7-H ta 1141.0 ;r
T
Color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ St mctural Review$
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 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 charged.
Signature. �' Si ature
gn gn
Owner or Agent Contractor
The foreg in instrument as ac owl ged for me this The foregoing instrument was acknowledged before me this_
11�� II �j y/� i
day of U ,20 Ytd,by `�� 9 �L day of 20_,by
ho is rs nall' known to me or who has produc who is personally known to me or who has produced
As identification and,1046 did an oath. as identification and who did take an oath.
NOT Y PUBLIC: s s NOTARY PUBLIC:
Sign: c vs SeP
Print: o�# v�ota�y Print:
o
oa
My Commission Expires: ' ' e r- o dP� �uQ My Commission Expires:
************************** *********************************************************************************
APPROVED BY i Plans Examiner Zomig
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
l �+
sa° Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
�o>RN Tel: (305) 795.2204
Fax: (305) 756.8972
OWNER BUILDER DISCLOSURE STATEMENT
�A iffy-IZ)A!) DATE:
ADDRESS: �� /= /ro 5 h
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 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. 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,may act as my own
contractor with certain restrictions even though I do not have a license.
In'
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.
InitiaP �
3. 1 understand that,as an owner builder,I am the responsible party of record on a permit.I understand that I me protect myself
from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name inlobd 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.
Initiat_��r�_
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 substaptielly
improved it for sale or lease,which violates the exemption,
. IpitiaL_� ,
5. 1 understand that,as the owner-builder,I must provide direct,onsite supervision of the construction.
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 A'`
11
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. -V
Initial- I-OT_
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 odes, and zoning regulations.
Initial"'T
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 httt :/t www.myflofidalicense.com/dbi)rloro/Cilbfindex.htm,,��Ill�
Initioz_Y-
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:
/cap 5 d7"
Initial
12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the information tha41
have provided on this disclosure.
Init
tis
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 gwner 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 day of ,20 ,3
By j�kd/t' 6who was personally known to me or who has
Produced there License or11 W, 'z,/44S
' 12. ff as identification.
CO
WNER AIS `?UG SeP ado
��nta\4 \ t.�G��•- ���2a Pssp.
1NOktl
so9�NVO\-6
,MIMI®DARE MIAMI-DADE COUNTY, FLORIDA
DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES
BOARD OF RULES AND APPEALS
11805 S.W.26TH STREET(CORAL WAY)
Chairperson Room 230
Alfonso Fernandez-Fraga,P.E. MIAMI,FLORIDA 33175
TEL(786)315-2573 FAX(786)315-2570
Vice-Chairperson November 18th, 2015
Gregory Pierce
Sergeant at Arms Richard P. Raymond
Thomas Utterback 970 NE 100 Street ���
Miami Shores, Florida 33138 BY:
Members
J. Robert Barnes, R.A. Re: Appeal of Building Official
William Derrer Miami Shores Village
Rolando Diaz, P.E. 970 NE 100 Street
Mario R. Espineira,Jr.
Chief Virgil Fernandez. Installation of Smoke Detectors
Carmen T. Garcia,P.E. Florida Building Code, Existing Buildings
Jesus M. Gomez
Herbert Gopman, P.E. Dear Mr. Raymond:
Richard Horton
Juan Dalla Rizza, P.E.
Enrique Salvador This correspondence is to advise you that the above referenced item has been
Roce Simpson scheduled for the agenda of the December 17th, 2015, Board of Rules and
Deede Weithorn Appeals meeting. The meeting will be held at the Department of Regulatory
Robert Yaffe and Economic Resources, Herbert S. Saffir Permitting and Inspection Center
located at 11805 SW 26 Street (Coral Way), 2"d Floor, Conference Rooms. I
Staff and J and will begin at 1:00 P.M.
Michael Goolsby
Kathy Charles Please contact our Department if you require additional information.
Yvonne Bell
Sincerely,
Secretary of the Board
Juliana H. Salas, P.E.
*Secretnaryofe Board
in Board of Rules and Appeals
cc: Alphonso Fernandez-Fraga, Chairman
Board of Rules and Appeals
Ismael Naranjo, Building Official
Miami Shores Village
Pursuant to Section 8-4 of the Code of Miami Dade,appeals of decisions of the Board within the review
jurisdiction of the Florida Building Commission shall be to the Florida Building Commission in the
manner prescribed by law. Review of other decisions of the Board shall be to the Circuit Court of the
Eleventh Judicial Circuit in and for Miami Dade County,Florida,in accordance with the procedure and
within the time provided by the Florida Rules of Appellate Procedure for the review of rulings of any
commission or board.
I M DM:A DME
Regulatory and Economic Resources
Board Administration Section
11805 SW 26th Street Room 230
Miami Florida 33175-2474
Ismael Naranjo, Building Official
10050 NE 2 Avenue
Miami Shores, Fl- 33138
JL-bl—SSB a:a1:39