RC-16-517 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-254615 Permit Number: RC-2-16-517
Scheduled Inspection Date: March 15,2016 Permit Type: Residential Construction
Inspector: Rodriguez,Jorge Inspection Type: Final Building
Owner: VILLOLDO,J PATRICK Work Classification: Alteration
Job Address:1146 NE 97 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132050170160
Project: <NONE>
Contractor: HOMEOWNER
Building Department Comments
BATHROOM RENOVATION Infractlo Passed Comments
INSPECTOR COMMENTS False
RENEWAL OF EXPIRED PERMIT RC07-1951
Inspector Comments
Passed 49-1
Failed
Correction
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
March 14,2016 For Inspections please call: (305)762-4949 Page 20 of 30
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Miami Shores Village
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000
Phone: (305)795-2204
'' � Expiration: 0911 0l2016
EZ" _I#Se X11• � � Y
Project Address Parcel Number Applicant
1146 NE 97 Street 1132050170160
Miami Shores, FL 33138- Block: Lot: J PATRICK VILLOLDO
Owner Information Address Phone Cell
J PATRICK VILLOLDO 1146 NE 97 Street
MIAMI SHORES FL 33138-2558
Contractor(s) Phone Cell Phone Valuation: $ 5,000.00
HOME OWNER
Total Sq Feet: 0
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Window Door Attachment
Date Denied: Framing
Type of Construction:BATHROOM RENOVATION Occupancy:Single Family Insulation
Stories:1 Exterior Drywall Screw
Front Setback: Rear Setback: Final PE Certification
Left Setback: Right Setback: Window and Door Buck
Bedrooms:3 Bathrooms:2 Fill Cells Columns
Plans Submitted:Yes Certificate Status: Review Building
Certificate Date: Additional Info: Review Planning
nd Retum: Classification:Residential Review Electrical
Review Plumbing
Fees Due Amount _Pay Date Pay Type Amt Paid Amt Due Review Structural
CCF $3.00 Review Mechanical
DBPR Fee $2.25 Invoice# RC-2-16-58814
DCA Fee $2.25 03/14/2016 Check#:1429 $126.50 $50.00
Education Surcharge $1.00 02/25/2016 Check#:1435 $50.00 $0.00
Notary Fee $5.00
Permit Fee $150.00
Scanning Fee $9.00
Technology Fee $4.00
Total: $176.50
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
requi for ELECTRICA PLUMBING.MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNER hat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constructi n n u re,I authorize the above-named contractor to do the work stated.
March 14,2016
A 0 Ig a Owner / Applicant / Contractor / Agent Date
Buildi Department Copy
March 14,2016 1
Miami Shores VillageZE
`
Building Department10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 ��
FBC 20 L� �"
BUILDING Master Permit No.�C I —!5(
ro (
PERMIT APPLICATION Sub Permit No.
UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION -0RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
jos An �; �T �
City:w Miami Shores County: Miami Dade CIW::2 33133
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OT"R: Fee Simple Titleholder): + "JD) nom:
Addie -�
Tenant/Lessee Name: Phone#: _s
Email:
CONTRACTOR:Company Name: Phone#:
Address:
City: State Zip:
Qualifier Name: Phone#:
State Certification or Registration M Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Square/Linear Footage of Work:
Work: ❑ Addition ❑ Alteration ❑ New _ Repair/Replace ❑ Demolition
poWak h
7
Specify color of color thru tile:
Submittal Fee$ 00 Permit Fee$ i ' CO CCF$ CO/CC$
Scanning Fee$ - Radon/�� Fee$ DBPR$Z • 2-5 Notary$ '5�•03
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ { • 12
(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 kh occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will and a reinspection fee will be charged.
9
Si nature Signature
NER or AGENT CONTRACTOR
The forego ng i rument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 JC by day of .20 .by
, a' -&TQQ 1 ,who Is ersonally known to .who is personally known to
me or who has produced as me or who has produced as
identificatiof>,and who did take an oath. identification and who did take an oath.
hfi- fARY PUBLIC: NOTARY PUBLIC:
Sign Sign:
Print: N Print:
Seal: �,�"P Notary ar,olic State of Florida Seal:
Sindia Alvarez
ppy f qM ission FF 156750
pF� Ef�ir®13t3Q10312018
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
w
i� �A
gem s Miami Shores Village
Building Department
"" ""' 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305)795.2204
Fax: (305)756.8972
O-W R BUILDER DISCLOSURE STATEMENT
NAME:V4 e k V 4� DATE: t 21`
ADDRESS: ti
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florid F.S 489.103(7).
And I have read and understood the following disclosure statement,which_entities me to work as my own contractor
iatl own�i rtlu�fs ap wrTn j%rspn c m ete ati onj..
requires con ono be done by a license`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-bullqer
permit under an exemption from the law.The exemption specifies that I,as the owner of the property listedkact own
contractor with certain restrictions even though I do not have a license. Initial2. 1 understand that building permits are not required to be signed by a property owner unless he or she ior the
construction and is not hiring a licensed contractor to assume responsibility.
Initi
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 'cense numbers on
permits and contracts.
Initial
4. I understand that I may build or improve a one family or two-family residence or a farm outbuilding.I may a build or improve
a commercial building if the costs do not exceed$75,000.The building or residence must be for my use or pancy.It may
not be built or substantially improved for sale or lease. If a building or residence that I have built or su daily improved
myself is sold or leased within 1 year after the construction is complete, the law will presume that I b It s bstentially
improved it for sale or lease,which violates the exemption.
Initia
i
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 woridn building or
residence.It is my responsibility to ensure that the persons whom I employ have the license required by I nd by county or
municipal ordinance.
Initial PV
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 homeowners 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 licenses to
perform the work being done.Any person working on my building who is not licensed must work under my,di supervision
and must be employed by me,which means that I must amply with laws requiring the withholding of federal income tax and
social security contributions under the Federal Insurance Contributions Act(FICA)and must provide works compensation for
the employee.I understand that my failure to follow these may subject to serious financial risk. V
Initial
9. I agree that,as the party legally and financially responsible for this proposed construction activity,I will abld 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.
Ind 1
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 Ucensing Board at 850.487.1395 or htto://www.mvtloddalicense.comldb r/D mIdib! d h I
Infial
F_
A 11
11. 1 am aware of,and consent to;an owner-builder building permit applied for in my name and understands that the party
legally and financially responsible for the proposed construction activity at the following address:
I '
12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the d th I
have provided on this disclosure.
Initial
Ucensed contractors are regulated by laws designed to protect the public.if you contract with a person who d of have a
license,the Constr4uction Industry licensing Board and Department of Business and Professional Regulation 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 20J_
1 �b
By t)QG� ' l who was personally known to me or who has
Prod arc License or r1-- as identification.
1
R
�aY Ptd Notary Public State of Florida
?� Sindia Aivarez
Noa My Commission FF 158750
a p- Expires 090312018
Inspection History
' Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores FL 33138-0000
Phone: (305)795-2204 Fax: (305)756-8972
131
�lz3d
Project: <NONE>
Owner: J PATRICK VILLOLDO
Phone:
Job Address: 1146 NE 97 Street Parcel: 1132050170160
Miami Shores, FL 33138- Block: Lot:
Scheduled Insp# Inspection Type Inspection Status Inspector Date Completed
01/01/2999 INSP-61290 Final NONE Claudio Grande Not Complete
10/18/2007 INSP-61289 Framing APPROVED Claudio Grande Not Complete
10/30/2007 INSP-61291 Drywall Screw APPROVED Claudio Grande 10/30/2007
MV
Thursday, February 25, 2016 Page 1 of 1
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