WS-4-09-707 PERMIT DOCUMENTSMiami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
174 106 Street
Permit No. WS-4-09-707
Permit Type Windows/Shutters
Permit
Work Classiiicab6n. Door Replacement
Permit Status APPROVED
<�' ...". •'' . .•,•issue hate: 51612049
Expiration: 11102J 9
Parcel Number
1121360080070
Applicant
Miami Shores, FL 33138- Block: Lot: LEDONIA MEDE
Owner Information Address
LEDONIA MEDE 174 NW 106 ST
MIAMI SHORES FL 33150-1248
Contractor(s) Phone Cell Phone
HOMEOWNER
Type of Work: DOOR
No of Openings: 1
Additional Info: IMPACT
Classification: Residential
Fees Due
Amount
CCF
$0 60
Education Surcharge
$0.20
Notary Fee
$5.00
Permit Fee
$110.00
Scanning Fee
$3.00
Technoloqy Fee
$2.75
Total:
$121.55
Phone
Cell
Valuation: $ 1,000.00
Total Sq Feet. 0
'r q.
Invoice # Total Amt Paid Amt Due
WS-4-09-34665 $ 121-55 $ 121.55 $ 0.00
Available Inspections:
Inspection Type:
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 and zoning. Futhermore. I authorize the above -named contractor to do the work stated.
May 06, 2009
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
May 06, 2009
Ws?Enlava �►��v � of c�fi.
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
WWW.MIAMISHORE, SVILLAGE.COM
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type (circle): Building_ Roofing
j�M, C�TIIWg
j� .PR 2 8 2009 D
Permit No. S M 7�M
Master Permit N
Owner's Name (FeeSimple Titleholder) M Phone # C-'G-- 7 L
Owner's Address !l &�'
City / I State .-- loi Zip 331
Tenant/Lessee Name Phone #
Email
Job Address (where the work is being done)
City- Miami Shores Villaze County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO '
Contractor's Company Name rUUI Phone #
Contractor's Address
City _ _ State. Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No._ _
Contact Phone E-mail
Flood Zone
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ � w Square / Linear Footage Of Work: —h ao i` 113 12IfX /
Type of Work: ❑Addition ❑Alteration ❑New �,..F emolition
Describe Work: v F
r•
***************************************Fees*********************r*,**********************
Submittal Fee $ Permit Fee $- -� CCF $ Ll ,�/ D r
Notary $_�5 0-) Training/Education Fee $ 0.Z'16 Technology Fee $
Scanning $ Radon $. DPBR $. Zoning $
Bond $ Code Enforcement $__ Double Fee $ f
Structural Review. $_ _ _ Total Fee Now Due $ ! y
See Reverse side -�
Bonding Company's Name (if applicable)
Bonding,Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage'Le'nder'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 mutt be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, FOOLS, FURNACES,130ilI.ERS, HEATERS TANKS and AIR CONDITIONERS. ETC....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is c
g $ 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 Appiiconr. As a condition to the iss" anCe oj' a building permit with an estimated value exceeding $'2500, the applieam must
promise in good faith t1wr a copy of the notice of comme?wement and construction lien lase 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 riot be approved and a reinspection fee Hill be charged;
Sig.natur .` ! 6"�r Signature
Owner or Agent
The foregoing instrument was acknowledged before me this A3.
day of 464�:,
20 N by _..�p�
l�o is personally known to me r who has produced
As identification and who did take an oath.
NOTARYAJBLIC:
Sign: Ll
Print:
My Commissio MARIE MAGDA! k.. rtLES
6lobry Public • c"^. J Florida
Mlr Coeerrseinn E ..res JW t9, 201'
Commission d DD 697039
-.-Fo@mlded Throug � Maliona1 Notary Aeon
Contractor
The foregoing instrument was acknowledged before me this
day of , 20 _, by
who is personally known to me or who has produced
_as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
APPLICATION APPROVED BY _,40ayJ J Pf Plans Examiner Zoning
Engineer
Clerk checked
(Revised 07/10/07)
VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
NAME: ■
DATE: :64
ADDRESS: I Us qs'
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 entitles 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-farbily or two-family reA'Wrice. 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 construction is complete, the law will
presume that you built for sale or lease, which is a violation of this exemptions. You cnay 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-ICA 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 hold title to the above property and I am planning on doing this construction
Myself.
r
Initial <
2. I understand that as an owner -builder I must abide by all zoning ordinances and
building regulations in. effect at the time of permit application. Inactive
a % ` peg it it oI. a period of over 180 days will become null and void (expired)
and a tsew permit will be required, to be issued for reinstatement of the
permit. ,
3. I have an understanding of the 2004, FBC & FRC and understand that this
{ .idepaArAent and --its' inspectors' art there to help enforce and interpret the code.
�Theie is a copy of the code in this office for review.
�
.w
�
rl■1'
4. I understand .that the building official and inspectors are not there to design,
alter or give advice on how to meet code - only if the structure meets the
. ,Y. minimum code.
` Initial ` W//,-
S. I understand-that"as an owner-biriideY, that any contractor disputes with sub-
contractors and myself must be handled in a civil court with the advice of an
attorney. The department will not mitigate any contract disputes.
InitialY awl
6. I understand that if I compensate any person or company for work performed
they are required to have a business license in the county. If for any reason they
do not posses a business license I will be responsible and liable for any wrong
doing from this unlicensed company or person.
Initia -- f C%•
T I understand that if any person gets injured on my construction project -they are
entitled to. workmen's compensation. And if they do not posses a workmen's
policy I could be held liable for all doctor and related cost which could include
loss of wages during recovery from injury.
L �
Initiaell��
8. I understand that under state and local laws I can not do any Electrical,
Plumbing, Heating, Air & Roof work on my property with out first obtaining
the proper permits by licensed contractors.
initial C1-
Was acknowledged before me this day of , 2
By_(XKjQ who was personally known to me or who has
Produced there License or s dentifcation.
OWNER
/7)10)/ 4
NOTARY•
NOTARY FOUC�T, �CilbillO A
fix;: rep rrrc c�,'�c.
„o,;�tiurrsxu n�'i.At+'racts��
L
BY: ------------ ------ 5}1ORIE
Isis 9MIM
'LVRin�
WINDOWS/DOORS/SHUTTERS
WIND LOAD CALCULATIONS
Please fill in the information requested:
ADDRESS OF HOME
HIGHEST POINT OF ROOF
EAVE HEIGHT OF ROOF 0
BUILDING WIDTH
BUILDING LENGTH
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(D U)
The site specific plan must show the distance of the openings from the nearest corner.
Wind Loads per RFBC 301.2(2) & 301.2(3) 150mph exposure C
Mean Roof 1-leigbt
Zone 4
Zone 4 (-)
+ 49.0
- 53.1
- 65.6
— 0'
- 56.6
20' — 25'
+ 54.7
- 59.3
- 73.2
*Zone 5 is any opening within the corner distance from any corner.
*Corner distance is .4 x mean roof height or .10 x width , but not less than 3'
rA4
,S�oRs11.
Inspection Worksheet
� el Miami Shores Village
I
10050 N.E. 2nd Avenue Miami Shores, FL
Ftnr��oP' Phone: (305)795-2204 Fax: (305)756-8972
inspection Number: INSPA 15117 Permit Number: WS-4-99-707
Scheduled Inspection Date: June 11, 2009 Permit Type: Windows/Shutters
Inspector: Bruhn, Norman
Inspection Type: Final
Owner: MERE, LEDONIA Work Classification: Door Replacement
Job Address:174 NW 106 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1121360080070
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-113936. CREATED AS
REINSPECTION FOR INSP-113430. Add tapcons per plan. NB
Minimu 1/4" tapcon are required.NB
Failed
Correction ❑
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
June 10, 2009
Inspection Worksheet
,s
n n.
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INS P-113430 Permit Number: WS-4-09-707
Scheduled Inspection Date: May 11, 2009 Permit Type: Windows/Shutters
Inspector: Bruhn, Norman
Inspection Type: Final
Owner: MERE, LEDONIA Work Classification: Door Replacement
Job Address: 174 NW 106 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1121360080070
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Inspector Comments
Passed W X/ eo``f, 40,0,E A,t UA+ ge.
Failed "O&� 4(Ac4e4(
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.