RC-13-1445 (2) Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-194309 Permit Number: RC-6-13-1445
Scheduled Inspection Date: December 19,2013 Permit Type: Residential Construction
Inspector: Rodriguez,Jorge
Inspection Type: Final
Owner: RATA,JOSEPH Work Classification: Addition/Alteration
Job Address:452 GRAND CONCOURSE
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060170020
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
BATHROOM REMODEL. RELOCATION OF SINK AND Infractio Passed Comments
TOILET, EXTENSION OF EXISTING SHOWER. INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
December 18,2013 For Inspections please call: (305)7624949 Page 7 of 17
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I Miami Shores Village J
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Budding Department
�j 10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
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BUILDING Permit No. FBC 20 04-5.
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: 4S-Z- C AtrA D
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: ii ?��e o 0 l coto /
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): 'T ik Phone#: 1700?7s 11,3 0
Address: 4 SI, 0 LOLL 13'
City: Oki&mt s State:
Tenant/Lessee Name: Phone#:
Email: •s��`�� eaA..Ym+ v--.iqw)CONTRACTOR:Company Name: / 7r Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
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 DAlteration ONew ORepair/Replace ODemolition
Description of Work: W44. �' 1( aovy_ UUAA i. AA Q901 �( �'x ah Q
40 caw► 1044h/o0 • 74, ak&taew U.)Lp.lk . fir► yam. xr,%;�k
Color thru tile:
Submittal Fee$ Permit Fee$ J y CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
— it
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.
Initi al
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 Ming 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.
In
9. 1 agree that as the party legally and financially responsible for this proposed Construction activity,I will abide 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.
Initi al
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 htti)dhvww.mvflo4dalloonse.com/dbi)EkmMMex.htmI
Initial
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 constructlon activity at the following address:
Initial
12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the inform n that I
have provided on this disclosure.
Initial
Licensed contractors are regulated by laws designed to protect the public.If you contract with a person who does n t e a
license,the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may 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
retumed 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 miquirod when
the permit is issued.
Was acknowledged before me this day of 20
By i van who.was personally known to me or who has
n
Produced there or b� °@�) s identification.
OWN R NOTARY
CLAUDIA V. CUBILLOS
Notary PubtiC-State of Fl]2015
My rrnm Expires Sep 23,Commission#EE 12BB°i t c; Bonded Through National Notary
n° Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305)756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: L DATE: (0 ?C0 I
ADDRESS: 1{CZ CMZ"b C 0t4 C-0LkW_-Sff S
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).
And I have read and understood 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 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.CA 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.
Initial
2. 1 understand that building permits are not required to be signed by a property owner unless he or she is r s able for the
construction and is not hiring a licensed contractor to assume responsibility.
Initial
3. 1 understand that as an owner builder,I am the responsible party of record on a permit I understand that ima ro tect 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 Salsod' numbers on
permits and contracts.
Initi
4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding.I ma 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 tO or substantially
improved it for sale or lease,which violates the exemption.
• In a
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 working o 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.
Initi al
Bonding Company's Name(if applicable)
Bonding Company's Address
City State
t Zip
W
Mortgage Lender's Name(if applicable) a. s
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 goo t that a copy u notice of commencement and construction lien law brochure will be delivered to the person
whose pro rty is subjec o a c lso, a certified copy of the recorded notice of commencement must be posted at the job site
for the fi st inspection w ' h occurs seven s after the building permit is issued. In the absence of such posted notice, the
inspection ll not be ap ove reinspec nee will be charged.
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Signature Signature
Owni or Agent �� Contractor
The pi� ume t a 1 bef �pme thise� The foregoing instrument was acknowledged before me this
day ,20�!!by (A. day of 20 b y who own to me or who as produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOIC: °' NOTARY PUBLIC:
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APPROVED BY v % O� Plans Examiner Zoning
Structural Review Clerk
(Revised 3/1=012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
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RECORDED 06/26/2013 15>01232
HARVEY RUVIHP CLERK OF COURT
NOTICE OF COMMENCEMENT MIAMI-DADE COUNTYr FLORIDA
A RECORDED
,COPY M.W, BE POSTED i gGX b TH,E AS
S ITE AV PFOW ODpW LAST PAGE
PERMITNOYv ✓, 1 T
FOLIO N0.
STATE OF FLORIDA
COUNTY OF MIAMI-0ADE:
THE UNDEF000,1 Shy Om Dotlt.S Ui'i06W010its will be made to-certain real
popsy.and in accordance with Chapter 713,Ronda Ste,the foflawing
Is provided In the Notice of Comminwrieft
Spsas tabtare reserved tp►lnie of recoradbM o1Oce
1.LeaW4esulption of property and stmt/address:
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2.Description of bTiprovement �YtT°-C
3.0 wrp(s)name and address:
kttetz in property;
Name end address of-'fee Simple t4leholderr fG
4.GortbacWe name.#d*ess,and phone number.
(Payttte„t bid riequci by ot+ er,trom contractor,k any)
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idrops and phone number.
Amount of bond
6 Lena;'i tame Ord address
7 Perms withht i14 state-of Ronda designated by Owner upon whom notices or other dommun ie may be served as Provided by
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WAf1MIO OWNEF'b 1��Pi4YMEMTB MADe BY THE OWNEAAFTER THE EXPIJiATK)N OF(FIE NOTICE OF C,Qiu�NIENC�At1ENT NiE.COI IDEREp �3
IMPROPER'PAYMENTS-UNDER CHARTER 713,PART I;` -
l�ASf SECiION 713.13 FLORibA STATUTES,AND CAN RESULT TAI YbUR PAYI,N- TVWCE FOR
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Fl I CTiON.IF YOU 1 b t0 OBTAIN FINANCING,Ca�NSULT WRFC YOUR LENDER OR AN AtT01iNEY BEFORE CONIMENCWC#WORK O Qi
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Miami shores Village
Building Department ems Noll"
10050 N.E.2nd Avenue zn ►y�
Miami Shores, Florida 33138
Tel: (305) 795.2204 l0RTpA
Fax: (305) 756.8972
June 26, 2013
Permit No: RC13-1445
Building Critique Review
1. Provide plans signed and sealed from a licensed architect or engineer. The work
proposed is a level 2 alteration that requires a licensed designer. NB
Norman Bruhn CBO
305-762-4859
Plan review is not complete, when all items above are corrected, we will do a complete
plan review.
If any sheets are voided, remove them from the plans and replace with new revised
sheets and include one set of voided sheets in the re-submittal drawings.
♦SgoR�s�i
Miami shores Village 19'a
Building Department ' KENN e Bloom
10050 N.E.2nd Avenue
Miami Shores, Florida 33138 zL-Rjv ���
Tel: (305) 795.2204 lOR1U�
Fax: (305) 756.8972
June 26, 2013
Permit No: RC13-1445
Plumbing Critique
1. Need a licensed contractor
Rafael Hernandez
Chief Plumbing Inspector
Plan review is not complete, when all items above are corrected, we will do a complete
plan review.
If any sheets are voided, remove them from the plans and replace with new revised
sheets and include one set of voided sheets in the re-submittal drawings.
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ADD sM
OKEICARBON MONOXIDE DETECTORS. c
ANY AND ALL CLOTH AND RUBBER �� ��
INSULATED CONDUCTORS TO BE REPLACED.
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PERMIT#
CONTRACTOR:
SUBMITTAL DATE:
ADDRESS:
NAME:' r L
RESUBMITAL DATES:
i
PROJECT TYPE:
ZONING FIRE
STRUCTURAL IMPACT FEES
ELECTRICAL HRSIDERM
PLUMBING NOC
MECHANICAL