RC-16-2826 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone:(305)795.2204 Fax: (305)756-8972
Inspection Number: INSP-273361 PermitNumber: RC-10-16-2826
Scheduled Inspection Date: December 20,2016 Permit Type: Residential Construction
Inspector: Naranjo,Ismael Inspection Type: Final
Owner: PIERRINE LEONEL AND ALFRED Work Classification: Alteration
'WWII C0AU0%161C DICDCC 1 n111Q
Job Address:20 NE 104 Street
Miami Shores,FL Phone Number
Parcel Number 1121360130910
Project <NONE>
Contractor. JOSEPH A.MARCELIN CONSTRUCTION Phone: (305)562-7926
Building Department Comments
REPLACE KITCHEN CABINETS Infractlo Passed Comments
REPLACING RC-14-22 INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection
Fee
No Additlonai Inspedlons can be scheduled until
re-inspeclion fee Is paid
December 19,2016 For Inspections please call: (305)762-4949 Page 32 of 37
Permit q
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Miami Shores Village ��t TY *i �Mai 11 t!
10050 N.E.2nd Avenue NE ��i � � i #+�:
P A
Miami Shores,FL 33138-0000x� "A" `�
` n Phone: (305)795-2204
, p ?t31l1 Expiration: 04129/2017
Project Address Parcel Number Applicant
20 NE 104 Street 1121360130910
Miami Shores, FL Block: Lot: FRANCINE PIERRE LOUIS PIERI
Owner information Address Phone Cell
FRANCINE PIERRE LOUIS PIERRINE 20 NE 104 Street
-- - - ---- - - MIAMI SHORES FL 33138-2027
Contractor(s) Phone Cell Phone Valuation: $ 2,200.00
JOSEPH A MARCELIN CONSTRUCTI( (305)562-7926
W.. _ ._•• .. ._,..,.. w. „,.,,.....mm....m_ Total Sq Feet: 0
Approved:In Review Available Inspections:
Comments:
Inspection Type:
Date Approved::In Review
Final PE Certification
Date Denied: Window Door Attachment
Type of Construction:REPLACE KITCHEN CABINETS Occupancy:Single Family Framing
Stories: Exterior: Insulation
Front Setback: Rear Setback: Drywall Screw
Left Setback: Right Setback: Fill Cells Columns
Bedrooms: Bathrooms: Window and Door Buck
Plans Submitted:No Certificate Status: Review Planning
Certificate Date:
Additional Info: Review Electrical
Bond Return: Classification:Residential Review Plumbing
Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Structural
CCF $1 80 Review Mechanical
Invoice# RC-10-16-61693
DBPR Fee $2.00 10/18/2016 Credit Card $50.00 $61.80
DCA Fee $2.00
Education Surcharge $0.60 10/31/2016 Credit Card $61.80 $0.00
Permit Fee $100.00
Scanning Fee $3.00
Technology Fee $2.40
Total: $111.80
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 accurate and that all work will be done in compliance with all applicable laws regulating
construction andX
Futhermore,I authorize the above-named contractor to do the work stated.
el October 31,2016
Authors Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
October 31,2016 1
Miami Shores Village
� g
1 '� Buil>din Department
OCT X20'6
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 = --- -
/ Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 FB `
C 2QL(
BUILDING Master Permit No. r 1(0 - '?_&e_(0 .
PERMIT APPLICATION Sub Permit No.
�LIILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: aZo Al, Ii �G' '
City: Miami Shores County: Miami Dade Zia•
Folio/Parcel#: 021 3 4 -O . 19/0 Is the Building Historically Designated:Yes NO :✓
Occupancy Type: Load: Construction Type: Flood Zone: 112,9 BFE: FFE:
OWNER:Name(Fee Simple Titleholder): f:;K® ,n4�2� Phone#: 7814 _3eUl 8!23/ ®P,
Address: o2D /U•15- !D l4 - 7 9.6 371/ -•78.2,7
City:_ _H/ AN/ z5Aqz ES State: AL Zip:
Tenant/Lessee Name: Phone#:
Email: / 7�
CONTRACTOR:Company Name: ,,,,,, ,6t • , , ��//h �r fl�yc> Phone#:
Address: 5.6/ . FiJ G
f
City: Hloqrl` State: Zip:
A �® o
Qualifier Name: �/may % �fe � er� Phone#:/0-f I 6-,>Ace
State Certification or Registration#: /.r/ q/17!9 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ lrO" "':g Q'y d, Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New �Repair/Replace ❑ Demolition
Description of Work: 12 e e
Specify color of color thru tile:
Submittal Fee$ �C)PPrI A Permit Fee$ 00 CCF CO/CC$
Scanning Fee$ 3 Radon Fee$ 2 • DBPR$ 2 Notary$
to O
Technology Fee$ Training/Education Fee$ ' (00 Double Fee$ �®
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ 18 O
(RPvicpd07/74/70141
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
OWNER or AGENT ' T 'R
The foregoing instrument was
acknowledged before me this The foregoing instrument was acknowledged before me this
113 day of Oc� b etc- ,20 IC .by 14 day of 20 46, ,by
v AA y who is personally known to who is personally known to
me or who has produced r\ 1 _p V• �\C- as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: \ Sign:
Print: "��� J�= �e_s c�6i Print: IN/-1,1/1--
Seal: Seal:
MONDELINE F.DCBE
WfON/FF
gig f.; :r MY COMMISSION#FF 18601
oQr EXPIRES:January
,2019
fit, 0 Rrn13� °� Borded Ttw hh�myA*c 1t rs
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
f —A—An9/)A/,)ni Al
Miami Shores Village
` Bultdin' Department
10050 N.E.2nd.Avenue
Miami Shotes, Florida 33138
Tel: (305)705.2204
Fax: (305) 756.8872
OWNER BUILDER DISCLOSURE STATEME
NAME: L�fl N i' DATE: JLI
ADDRESS: oZ D N `� �T. .*twi ShtT✓ s
Do hereby petition the ViRage of Miami Shores to act as my oxo contractor pursuant to the laws of the State of Florida,F.S 489.103(7).
And I have read and under* 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 buflding'must be for your own use and
occupancy:It may not be built for sale or kese.,If you°seil or Ilse it building you have built yourself within,one-yew after the
construction is cOolefe;Maw wli pWsume#*you tatiift for sale or lege,which We violation of thieettentption.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 FICA and with-holdings tax and provide workers'
compensation for that enipioyee�all as"pn*bed by-19w.Your construction must comply with all applicable life,ordinances,
buildings codes and zoning regulations.
Please read and initial each paragraph.
1. 1 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 spedfles that I,as the owner of to property listed,may act as my own
contractor with certain restrictions even though I do not have a Dom.
lnitiat
2. 1 undenstan d that building permits are not required to be steed by a property owner unless he or she is responsible for the
construction and Is not hiring a licensed oorntrsotor to assume responsibility.
Initial_,,,OL_,
3. 1 understand that,as an owner burr,I am the respopible party of record on a permit I understand that I may protect myself
from poterdial financial risk by hirhng a licensed contractor and having fire permit fled in his,or her name Instead of my own
nacre.1,0c understand that the contractor Is required by Isar to be licensed in Florida and to int his or license numbers on
permits acid contracts.
Initial,
4. 1 understand that I may build or improve a one lonely or two-family residence or a farm outbuilding.I may also build or improve
a commercial bolding if the=is do not exceed$75,000.The building or residue must be for my use or occupancy.it may
not be built or substardially improved for sale or lee.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 substantially
improved it for sale or le,which violates the exemption.
Initial) ,
5. 1 understand that,as the owner-builder,I must provide direct,onsite supervtlon of the oomtru dton.
Initial_
6. 1 understand that I may not hire an unlicensed person to act as my contrector or to supervise person woftq on my building or
residence.it is myresponsibility to ensure that the persons whom I employ have the Dom required by law and by county or
municipal ordinance.
. Initial rev ,
7. 1 understand that it is frequent practices of unlicensed persons to have tie property owner obtain an owner-builder permit that
-error"usty implies that the property owner is providing his or her own labor and materials.I,as an owner-budder,;ina�bu3 told
liable and subjected to serious financial risk for any Injuries sustained by an unlicensed person or his or erripi(iees�wfiNe
working on my property.My homeowner's Insurance may not provide coverage for those Injuries.I am willfully acting as an
owrtet 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
r perform the work being done.Any spar,son working on my building who Is not Licensed must work under my direct supervision
and must be employed by me,which meahis'that I rhi18t comply with taws Wittiifig the withholding of federal income tax and
social security contrbudons 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
lnitial
9. 1 agree that,as the party legally and financially responsible for this proposed Construction activity,I will ablde by all applicable
laws and requirement that govern owriar-builders as well as employers.I also understand 1hat`the
Coestrudon mist comply with all applicable laws,ordinances,building codes, ,and zonbhg regulations.
Initial_.�.
10. 1 understand that I may obtain more information regard'mg 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 Ucerning Board at 850.487.1395 or h1toJAvww.mvtioridalicer�.cxmhldborloroldlbJlndex html
iNtiel,�'
11. 1 an aware of,and consent to;an owner-builder building permit applied for in my name and understands that I am the party
legally and firsndally responsible for the proposed constriction activity at the following address
'rl�ir*4 S61 33t3q
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12. 1 agree to notify Maori Shores Village immediately of arty additions,deletions,or changes to any of the infomhation that I
have provided on ft disclosure.
Initial
Llcersed 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 firfiancial loss that you sustain as a result of Contractor may be In civil court.It 182180 Iciportam for you to
understand that,If an unlicensed contractor or employee of an indhddual or firm 18 injurmi while wori ft on your property,you may
be held liable for damages.8 you obtain an mer-builder permit and wish to hire a licensed contractor,you will be responsible for
verifying Whether the contractor 18 properly licensed and the status of the contractor's workers compensation coverage
Before a building permit can be Issued,this disclosure sbdemend must be compWed and signed by the property comer and
returned to the Wd pertmi %agency responsible for Issuing the permit.A copy of the property owner's'drlver license,the
notarized signature of the property owner,or other type of verilication acceptable to the local penWq agency is required when
the permit 18 Issued.
Was acknowledged before me this day of P• 20 1{
By r c_ � g j who was personally known to me or who has
Produced thereVR
- ®` �-® �= r t as identification.
C�
T Y
JUAN J.QUESADA
* * MY COMMISSION!EE 194777
EXPIRES:May 11,2016
Battled Ttw Nor SKIM