BP2005-133Miami Shores Village
10050 NE 2nd Avenue
Phone: 305-795-2204
Printed: 2/10/2005
Applicant: GUY
Owner: FORCHION
JOB ADDRESS: 160
Contractor
Local Phone:
Parcel # 1131010230200
NW 101
Building Permit
Permit Number: B P2005-133
FORCHION
GUY
ST
Contractor's Address:
Page 1 of 1
Legal Description: BONMAR PK ADD A RE -SUB PB 24-71 LOT 10 & W1/2 LOT 11 BLK 3 LOT SIZE
Fees:
Description
Amount
FEE2005-1810
Building Fee
$100.00
Total Fees: $61.30
FEE2005-1811
CCF
$0.60
FEE2005-1812
Notary Fee
$5.00
Total Receipts: $0.00
FEE2005-1813
Training and Education Fee
$0.20
FEE2005-1814
Technology Fee
$2.50
F 3 11 PAID
FEE2005-1815
Scanning Fee
$3.00
FEE2005-1816
Submittal Fee
($50.00)
Total Fees:
$61.30 ,
Permit Status: APPROVED Permit Expiration: 7/27/2005 Construction Value: $300.
Work: REPAIR WOOD IN FRONT PORCH DAMAGED BY TERMITES
Signed:
(INSPECTOR)
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
miami mores v inage
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING a°` %'v"U
PERMIT APPLICATIO W4 2 8 2005
FBC 2001
Permit Type (circle):QTifle
Build.),innElectrrrical((�� Plum-IIb+ing Mechanical Rooting
Owner's Name (Fee Simplq� 6jjz W uL(t 6�Dj Phone # 736 2Z �z SG7
Owners Address rtjO Mq C S�cQ0r ,NL c� r(n,,, e, / F41 , -13N<V
City L/\ °� - State 1= t— Zip 331 S C7
Tenard/Lessee Name Phone # 5S 7 S 8 0't� 3
xC la 11310 S-
Permit No. �*13SJ 133
Master Permit No.
Job Address (where the work is being done) 1E0 NW \U r-, l`" 0- j
City Miami Shores Village Comity Harm -Dade Zip 33 t S b
Is Building Historically Designated YES NO X
Contractor's Company Name
Contraclor's Address
City
StateCertificate or Registration
Architect/Engineer's Name (if applicable)
c A-
Phone #
Certificate of Competency
$ Value of Work For this Permit 0 • v V
Type of Work: ❑Addition ❑Alteration []New
Describe Work:
Phone #
Square Footage Of Work:
Repair/Replace ❑ Demolition
C- G ar.nsaaaee,caxa:eFeesaah,r.�ea,aar•
Submittal Fee $ 60.0 0 Permit Fee $ CCF $ � CO/CC
Notary $_ Training/Education Fee $ Technology Fee $ (DSO
Scanning S Radon $ Zoning Bond $
Code Enforcement $ Structural Phan Review. $
Total Fee Now Due $
(Continued on opposite side)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
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 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 S2500, 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, lire
inspection will not be approved and a reinspection fee will be charged.
Signahnt4 Signature
Owner or Agent qq Contractor
The foregoing instrument was ack
`no
wledges before me tlus VU The foregoing instrument was acknowledged before me this_
day o�, 20l 5 by 1 � day of 20 _, by
who is personally known to me or who has produced who is personally known to me or who has produced
14) As identification and who did take an oath. as identification and who did take an oath.
NOTARY PU IC NOTARY PUBLIC:
Sign: Sign:
Print: w .Ulppuo 8anuetuv Print:
x �x�axa��:tat�a 'Expire x My ��C�o�mxm�xi�ssi�osn�Expires: Commission Uo1 ell,
APPLICATION APPROVED BY: 1 I&V 2 920 Plans Examiner
Engineer
chc. 05/13/03
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE .STATEMENT
I
being the legal property owner, for the property
Located at: �
Legally described as .
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),;nd I have read and understand the following disclosure
Statement, which entitles me to' a ork as my own contractor, I further understand that I as the owner
must appear in person to complete all applications.
DISCLOSURE STATEMI ENT
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that 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 or a farm out -building. 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 completed, the law will presume that you built it for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure
that 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 -holding tax and
provide workers' compensation for that employee, all as prescribed by law. Your construction must comply
with all applicable laws, ordinances, building codes and zoning regulations.
Proof of ownership provided ( ) initial of reviewing clerk. Tlie foregoing instrument
Was acknowle 1ged before me this day of 20(D::�
•By G ( who is personally known to me or who has
Produced as identification and who did take an oath.'
• r'
t�
Owner
i---r•-_.,..+ul I.� QUO%
,'kaffi�' t?onded '
"'' � •� 1►�Ntic �Cndinrhrtl
Co. Inc
Inspection Worksheet
Miami Shores Village
10060 N.E. 2nd Avenue Miami Shores, FL
Fax:
Phone: (305)795-2204 (305)756$972
Job Address: 160 101 Street NW
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor:
Building Department Comments
/9 v(I Inspector Comments
Passed ((�
Failed El
Correction ❑
Needed
Re -Inspection ❑
Fee
($75)
No Additional Inspections can be scheduled until
re -inspection fee is paid .
Phone Number (786)2295250
Parcel Number 1131010230200
Block: Lot:
Tuesday, September 5, 2006 Page 1 of 2
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ELEVATION BASED ON LOC.# CBM# ELV. BOUNDARY SURVEY
SURVEYOR'S NOTES 1) ONMERSHIP IS SUBJECTTO OPINION OF TITLE. 2) EXAMINATION TO THE ABSTRACT OF
TITLE 1MLL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. 3)
NO UNDERGROUND IMPROVEMENTS WERE LOCATED. 4) ELEVATIONS ARE REFERRED TO NATIONAL GEODETIC
VERTICAL DATUM OF 1929. 5) THERE MAY BE ADDITIONAL RESTRICTIONS NOT SHOWN IN THIS SURVEY THAT MAY
BE FOUND IN PUBLIC RECORDS OF MIAMI-DADE COUNTY. 6) LEGAL DESCRIPTION PROVIDED BY CLIENT. 7p
UNLESS OTHERWISE NOTED RECORDED OR MEASURED DATA ARE IN SUBSTANTIAL AGREEMENTS. 8) BEFORE
ANY CONSTRUCTION THE SETBACKS MUST BE CHECKED. NO PROFESSIONAL LIABILITY INSURANCE
BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB_PAGE
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