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BP-05-1173 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL BUR, Phone• 305)795-2204 Fax: (305)756-8972 nspectiainIVumb�r1�SP-� 3 Prmtt $6 be 0.05-1 r:' Bp2 'I73; 9 . Inspection Date:A 28f2M 3 OS Permit Type: Imported Permit Inspector: Grande,Claudio Inspection Type: Final Owner: RABINOVICH,SAUL Work Classification: <NONE> Job Address: 560103 Street NE Miami Shores Village, FL 33138- Phone Number Parcel Number 1132060170890 Project: <NONE> Block: Lot: Contractor: Building Department Comments I 1j V Inspector Comments Rassed Failed Correction Needed Re-Inspection Fee ($75) No Additional Inspections can be scheduled until re-inspection fee is paid. Wednesday, December 28, 2005 Page 2 of 2 Miami Shores Village REEOVED Building Department AUG 9 s 2805 • 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 BUILDING Permit No. � PERMIT APPLICATION sMaster Permit No. FBC 2001 Permit Type(circle): Building Electrical ff Plumbing Mechanical Roofing Owner's Name(Fee Simple Titleholder) b a'®v r CC4_ Phone# Z36 - '61 3 Owner's Address_5(00 Q C ® ° City State Zip '33 (36 Tenant/Lessee Name Phone# Job Address(where the work is being done) �K City Miami Shores Village County Miami-Dade Zip Is Building Historically Designated YES NO Contractor's Company Name �j U Lam, Phone# Contractor's Address Arc City State Zip Qualifier State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name(if applicable) Phone# $Value of Work For this Permit 4 Square Footage Of Work: s Type of Work: ❑Addition ❑Alteration [--]New Repair/Replace ❑Demolition Describe Work: �,� �� ( ; �rJ `® ® f S t o®2 Submittal Fee$ Permit Fee$ 1 �/ CCF$ 0•(U� CO/CC Notary$5° r0 Training/Education Fee$ o• Z® Technology Fee$ 2 ' 50 Scanning$ 3.00 Radon$ Zoning Bond$ Code Enforcement$ Structural Plan Review.$ Total Fee Now Due$ ti 1 • 30 (Continued on opposite side) Bonding Company"s Xat:e(if applicable) Bonding Company's Address A' City State Zip a� aicable) 1�rt jaje!ItMcrfeer's ' ess 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature caner or Annt Contractor The fore oing ins ent was acknowl dged�before �m,a this k The foregoing instrument was acknowledged before me this day of ,2 ,by t �IJ�ZJI �� day of .20_,by , who is perso ly kno to me or who has produced who is personally known to me or who has produced s identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLI NOTARY PUBLIC: Sign: Si Print: `D = Print: �=C' My Commission pires: Fc a;o; �,° . My Commission Expires: it k dr 9edr aY nF ek�r aY dr**eY 4e*dc is fY'e a49eeY*eF 9e de 9ee'e �e eY�9 �` 9r:C� .Y 9e*dt k eY 9e dt'ktY9:9e 4t 9t dr4r Y*oY'ie eF 4e dr ak4r 9e nk*aY 9e fie$#*de 4e9r a4 eF 9e de vkde*ir aY aY 9e 9e de dt dr�aF t F 4ck*ak aY*aF*aF !J t/Y APPLICATION APPROVED BY: JPlans Examiner Engineer Zoning chc 05/13/03 VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT OWNER BUILDER DISCLOSURE STATEMENT C L being the legal property owner, for the property Located at: ��o o L I©3 �►'<< j�0 `5 Legally described as 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). pd I have read and understand 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. DISCLOSURE STATEMENT State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that 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 or a farm out-building. `You may also build or improve a commercial building at a cost of$25,000.00 or less.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 constriction is completed, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor.It is your responsibility to make sure that 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 Iicensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A. and with-holding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances,building codes and zoning regulations. Proof of ownership provided( ) initial of reviewing clerk.Tlie foregoing instrument Was acknowledged before me this day of ,20 By who is personally known to me or who has Produced as identificationd who did take an oath. Notary Owner YPV® � Ma el Vatgas r 0=Comn sion DD231984 NA Q fires:Ju! !3,2007 '� OF FIOQO� tonded Thnl Atlantic Bonding 0). Inc. Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. — 1 V13 Job Name BUILDING CRITIQUE SHEET (ic��cQt.�2 Gc�co2d� �0 GAS �ex0 - OR L. Miami Shores Village Building Permit sell �{ 10050 NE 2nd Avenue Phone: 305-795-2204 Permit Number: BP2005-1173`` Printed:8/12/2005 Page 1 of 1 Applicant: SAUL RABINOVICH Owner: RABINOVICH SAUL JOB ADDRESS: 560 NE 103 ST Contractor Contractor's Address: Local Phone: Parcel # 1132060170890 Legal Description: 6 53 42 PB 15-14 MIAMI SHORES SEC 4 AMD PLAT LOTS 5&6 BLK Fees: Description Amount FEE2005-11070 Building Fee $100.00 Total Fees:$111.30 FEE2005-11071 CCF $0.60 FEE2005-11075 Notary Fee $5.00 Total Receipts: $0.00 FEE2005-11077 Training and Education Fee $0.20 FEE2005-11079 Technology Fee $2.50 FEE2005-11080 Scanning Fee $3.00 Total Fees: $111.30 Permit Status: APPROVED Permit Expiration: 2/4/2006 Construction Value: $500.00 Work: CHANGE VANITY AND TILE ON TOP OF EXISTING TILE CHANGE DOOR AUG 12 Pic® Signed: (INSPECTOR) 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 responisibility for all work done by either myself,my agent,servants or employes. Signed: (Contractor or Builder) BY: