RC-16-414 ` Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-254232 Permit Number: RC-2-16-414
Scheduled Inspection Date: March 09,2016 Permit Type: Residential Construction
Inspector. Rodriguez,Jorge
Inspection Type: Final
Owner. MCCREADY,JAMES&LINDA Work Classification: Repair
Job Address:1399 NE 103 Street
Miami Shores,FL Phone Number
Parcel Number 1132050300190
Project <NONE>
Contractor ARCO CONSTRUCTION Phone: 305-892-6507
Building Department Comments
REPAIR OF QUAD TRUSS. Infractlo Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-252925. Not ready
Failed
Correction
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
March 08,2016 For Inspections please call: (305)762-4949 Page 39 of 43
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Miami Shores Village = "
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000
Phone: (305)795-2204
I y
Project Address Parcel Number Applicant
1399 NE 103 Street 1132050300190
Miami Shores, FL Block: Lot: JAMES S LINDA MCCREADY
Owner Information Address Phone Cell
JAMES&LINDA MCCREADY 1399 NE 103 ST
MIAMI SHORES FL 33138-2623
Contractor(s) Phone Cell Phone Valuation: $ 1,500.00
ARCO CONSTRUCTION 305-892-6507
- Total Sq Feet: 8
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied: Review Building
Type of Construction:REPAIR OF QUAD TRUSS. Occupancy:Single Family Review Structural
Stories:1 Exterior:
Front Setback: Rear Setback:
Left Setback: Right Setback:
Bedrooms:3 Bathrooms:3
Plans Submitted:Yes Certificate Status:
Certificate Date: Additional Info:
Bond Retum: Classification:Residential
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
DBPR Fee $2.00 Invoice# RC-2-16-58692
DCA Fee $2.00 02/16/2016 Check#:3272 $50.00 $191.20
Education Surcharge $0.40 02/25/2016 Check#:3277 $191.20 $0.00
Notary Fee $5.00
Permit Fee $100.00
Plan Review Fee(Engineer) $120.00
Scanning Fee $9.00
Technology Fee $1.60
Total: $241.20
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,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is a curate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-nam actor to do the work stated.
February 25,2016
Authorized Signature:Owner / Applica t / ontr or / Agent Date
Building Department Copy
February 25,2016 1
Miami Shores Village TZECEI—N7 -'�Z
. . Building Department F s 2016
l-- ' 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 1 ;,A
Tel:(305)795-2204 Fax:(305)756-8972 -1
INSPECTION UNE PHONE NUMBER:(30S)762.4949
FBC 20k'4
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No.
9!UILDING ❑ ELECTRIC [] ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: �T
City: Miami ShoresMiami Dade Zia:
Foilo/Parcel#-. I rf(:Z :3O- J !j(S js the Building Historically Designated:Yes NO
Occupancy Type:�aad: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): 3M j.LI iyD Ar 1C,1L 2-EA tp y Phone#:
Address: ?i 9!? N E l D:� '
City: L I �k 11. ,;S. State: � Z--ZL Zip: �
Tenant/Lessee Name: 1,444 Phone#:
Email:
CONTRACTOR:Company Name: r o 60WWr,L IE hI Ck)P Phone#: aC L—�7G
Z—(Q 7
Address: I'�;Q q
City: T State: Zip:
Qualifier Name: Phone#• `Z�P �?=C��
State Certification or Registration#:c I Z I en Certificate of Competency#:
DESIGNER:Architect/Engineer: „/a�'�6v� Phone#: -
Address: K. Q In y(1 „4 a(� City:�� ( i Stater Zip:
Value of Work for this Permit:$ j•F;7� c0 uare/Unear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work: ® L)
Specify color of color thru We:
Submittal Fee 60 ` M Permit Fee$ 00 -0�3 CCF$ 1 ` 2-0 CO/CC$_
Scanning Fee$ 9 ° M Radon Fee$ Z-U� DBPR$ Notary$ E5
Technology F $ 1 G o Training/Education Fee$ ®e 40
Double Fee
$
Structural Reviews i Moo Bond$
TOTAL FEE NOW DUE
(Revised02/24/2014)
Bonding Company's Name(if applicable)
R J
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$2500, the applicant must
promise In good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment Also,a certif/ed copy of the recorded notice of commencement must be posted at the job site
for the first Inspection which occurs seven (7) days after the building permit Is issued. In the absence of such posted notice, the
inspection will no be approved and a relnspecti a charged.
Signature Signature
O NZ or AG T CO TRA OR
The fo�re}goi instrumen was nowledged before me this The foregoing instrument 'UO owledged before me this
day of 20 Ito by day of 20 1( by
o&..,t ILAIL"d ,,who is rson�knn to CJS � 90� ,who Lis�p-ersonally known to
me or who has produced as me or who has produced T l.,�l ��C�
Identification and who did take an oath. identification and who did take an oath.
NOTARY PUBUC: NOTARY P UC:
Sign: Sign:
At111i11N/
Print: Print: A
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Seal: ZSeal: }o 'weti Notary aubi c State of Florida
Sindia Alvarez
7�d�:ya$ • oQ MyCommission FF 156750
�oFao@ Expires 09/03/2018
##
APPROVED Plans Examiner Zoning
"'7,p Structural Review Clerk
(Revised02/24/2014)
Arco Construction Corporation
February 16,2016
State of Florida
County of Miami Dade
Before me this day personally appeared Lester Jensen who, being duly sworn,deposes and
says:
All work to be performed by Lester Jensen or licensed and insured subcontractors.
Sworn to(or affirmed)and subscribed before me this day of 20_[42 _,by
ORNC N
Personally know
Or Produced Identification V
Type of Identification produced
Print,Type or Stamp Name of Notary
MNotary Public State of Florida
Sindia Alvarez
My Commission FF 156750
Expiras 09103/2018
General Con&actors1CGC150516311665 N.J. 1370 TerraceW.Mkm4 FL 33181
305.892-6507
Miami shoresV'ffillage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Notice to Owner - Workers' Compensation Insurance Exemption
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Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05
allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to
obtaining a building permit. Pursuant to the Florida Division of Workers'Compensation Employer Facts Brochure:
An employer in the construction industry who employs one or more part-time or full-time
employees,including the owner,must obtain workers'compensation coverage. Corporate officers
or members of a limited liability company (LLC) in the construction industry may elect to be
exempt if
1. The officer owns at least 10 percent of the stock of the corporation,or in the case of
an LLC,a statement attesting to the minimum 10 percent ownership;
2. The officer is listed as an officer of the corporation in the records of the Florida
Department of State,Division of Corporations;and
3. The corporation is registered and listed as active with the Florida Department of
State,Division of Corporations.
No more than three corporate officers per corporation or limited liability company members are
allowed to be exempt. Construction exemptions are valid for a period of two years or until a
voluntary revocation is filed or the exemption is revoked by the Division.
Your contractor is requesting a permit under this workers'compensation exemption and has acknowledge that he or she will not use
day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will
be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of
workers' compensation insurance coverage-JOom the contractor's company for day labor,part-time employees or subcontractors.
BY SIGNIN9 BELOW YOU A.9rNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS
Signature
Owner
State of F,
County of Miami-Dade
The foregoing was acknowledge before me this day of
V'q,, 20�
me or has produced
B y known
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