9950 NE 4 Ave Rd (16)Date
Type Insp'n
Permit No.
Name
Address
Company
Phone #
Inspection Date
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMEN
305- 795 -2204
Build I spection Request
D
Date
Type Insp'n CO")
Permit No. P 04 vl
Name Orkcion
Address 55(J I NE 10'
Company l W / `g V
Phone # e
Inspection Date
Correction
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204 I ti)
Building Inspection Request
3
Re- Insp'n Fee ❑
BUILDING
PERMIT APPLICATION
FBC 2001
Miami Shores Village RECEDVIED
Building Department ' 2 0 2O'C%
10050 N.E.2nd Avenue, Miami Shores, Florida 33138.
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit No. ' 1"0
Master Permit No.
Permit Type (circle): Building l Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleho er /nl'1lliaL /I1 C b evtLA)
Owner's Address 5SO NE t d I S
Phone #
305" 313 /000
City A4! 4 Al ,S fl ,1,*% State Zip 33 / 3Y
Tenant/Lessee Name Phone #
Job Address (where the work is being done) Se! mt.- a omit— S t' 10 1 J-4-
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name 010n2 1 Phone #
Contractor's Address
City State Zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit ♦1 r r F0 � / r _ „ D p
l� (� � q �/V
Type of Work: ❑Addition , ['Alteration ['New
Describe Work: ZA/
Total Fee Now Due $ S 7, 6
(Continued on opposite side)
Repair/Re lace ❑ Demolition
y /0/( 04•5 6 /id ritkiik;)
iv d ee. rl -�c�I . f ,1 -( 1. C w /4_ Lee t — -
i ig66( - * * * * * * * * * * * * * * * * * * * * * * ** ** F ees * * * * * * * * * * * * * * * * ** * * * * * * * * * * ** �,,.... /_
Submittal Fee $ 60 .00 W Permit Fee $
a ( ic/ - CCF $ 1 1 d 0 co/CC ----
Notary $ ."--- Training/Education Fee $ a 4 0 Technology Fee $
Scanning $ 3 Radon $ Zoning -�� Bond $
Code Enforcement $ �� Structural Plan Review. $
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 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 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 att• rent. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection whic urs seve (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be appr' ed ' nd a rein ection fee will be charged.
NO
Si
Print:
Chc 05/13/03
Signature Signature
Owner or Agent Contractor
The for ` trument was ac owlledgedd before this � The foregoing instnument was acknowledged before me this
II i 20 0L b h l `�u-<' �c - k - /.. day o y y of , 20 _ , by
wh
ne or who has produced who is personally known to me or who has produced
As identification and who did take an oath.
My Commission Expires: 06
ii * COMMISSION NUMBER
* * * * * * ** * * * * * * * * * * * ** r * w� *4* * * * *i r�;***** k**************************** * * * * * ** * ** * ** ****** * ** * * * * * * * **
- OF PL, MY COMMISSION EXPIRES
AUO 22,20
******************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
JUL 2 2 2004 Plans Examiner
Engineer
Zoning
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE STATEMENT
mac. ,V, c. 6 0,-4. -n)
being the legal property owner, for the property
Located at: ' ti C I a l s - E 111 c M
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 td *cork as my own contractor, I further understand that I as the owner
must appear in person to complete all applications.
DISCLOSURE STATEMENT
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. The foregoing instr
Was acknowledged before me this 20 day of U � 2000
By Amoncin de9cugAll
Produced
1
l
Owner
Mabel
Commission
E Expires: Jul
Bonded
antic Bon
who is personally known to me or w o has
as identification and who did
Not
,?o
e an oath.
argas
D23I984
13, 2007
hru
g Co., Inc.
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 7/22/2004
Applicant: VICTOR
Owner: ORTEGON
JOB ADDRESS: 550 NE 101 ST
Contractor
Local Phone:
Parcel # 1132060171160
Signed: (INSPECTOR)
Building Permit
Permit Number: BP2004 -985
ORTEGON
VICTOR
Contractor's Address:
Page 1 of 1
Legal Description: MIAMI SHORES SEC 4 PB 15 -14 LOTS 1 -2 -3 BLK 95 LOT SIZE SITE VALUE
Fees: Description Amount
FEE2004 -7369 Building Fee $200.00
FEE2004 -7370 CCF $1.20
FEE2004 -7371 Training and Education Fee $0.40
FEE2004 -7372 Technology Fee $5.00
FEE2004 -7373 Scanning Fee $3.00
Total Fees: $209.60
Total Fees: $2n:6000 Total Receipts: 0.00
i s 1. 6 0
Permit Status: APPROVED Permit Expiration: 1/16/2005 Construction Value: $2,000.00
Work: INTERIOR RENOVATIONS REBUILD PARTITION TO ACCOMODIATE ELECTRICAL WORK BEING DONE UNDER SEPARATE
' 3th. 23 PAM
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:
EXIST. SPRINKLER EXIST. A/C
PUMP COMP.
Y
11
3'-6' 4 r -r
CLOSET
EXIST
WATER UNE
EXIST. 600 AMP
ELECT. SERVICE &
METER
ri=l
► u
EXISTING
MASTER
.BEDROOM
EXIST.
A/C
tV -S'
MASTTE
BATHROOM
111■101■
EXISTING
PANELS
EXISTING 1ST LEVEL
FLOOR _, P = L A N
IRECtIVED
MAY ?2 4 2004
,11 1 1_‘C% _
_‘C% y 10050 N.E.2nd Avenue, Miami Shores, Florida 33138
.. ! Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2001 vt
Permit Type (circle): Building / Electrical Plumbing Mechanical
Owner's Name (Fee Simple Titleholder) f� yyi aic - 4 iiit Aft ,e/ Phone # 3
Owner's Address 3 /✓I / a/ S i f 305
Zip 33/ 3 /
City 4 / 4 M / .Si (45 State l�
Tenant/Lessee Name
Miami Shores Village
Building Department
Phone #
Permit No. PLO T - - W L 1
Master Permit No.
S
s4,-, e2///e �;..
Roofing
373 fob (w1
r7 fr G,9 k" ( i )
Job Address (where the work is being done) H'm G-
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name O �i'iw Z. Phone #
Contractor's Address
City State Zip
Qualifier
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit
boo
Square Footage Of Work:
Type of Work: ['Addition *iteration a►cl � ,2,�. ['New El Repair/Replace [I Demolition
Describe Work: i 6V E 1%?CT 4) (� 614-t I ij o UQ ' Fa-drt -%
Q S 1 O C1%1t$r -
Submittal Fee $OC,K rt-I00 Permit Fee $ /76 CCF $ CO /CC
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ ` Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite side)
Bonding Comp applicable)
Bonding Company dress
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 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 good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property ' . • tachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which oc rs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be a. r • ed nd a reinspection fee will be charged
. Signature
The fore
day of
who i
personally known
�f Contractor
oing trument was acknowledged ) gedbeforeme tlni:v' ~ The foregoing instrument was acknowledged before me this
20 "v, by V I (i`1 c v Pala l p Ot+`g01(\ day of , 20 by
NOTAR P : IC:
Sign:
Print: A " 1 a (e"'e
ner or Agent
me or who has produced
As identification and who did take an oath.
NOTARY SEAL
My Colmnission Expires: o�P Rv pU e� AFMARLE NEMHELL My Conunission Expires:
n
* * * * * * * * * * * * * * * * * * * * * ** * * D 23u8A** *************************** * * * *,c * * * * * * * * * * * * * * * * * * * * * ** **
•wll�i
7
of p MrcoMMK )f Competency Holder)
AUG. 22 2005
State Certificate or Registration No. Certificate of Competency No.
Chc 12/15/03
APPLICATION APPROVED BY:
Signatur
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * *- # ** ** * *************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
2 /
Plans Examiner
Engineer
Zoning
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE STATEMENT
� it) being the legal property owner, for the property
Located at: gq J O Joe Fot✓e ak of
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),s'}nd I have read and understand the following disclosure:
Statement, which entitles me to *brk as my own contractor, I further understand that I as the owner
must appear in person to complete all applications.
DISCLOSURE STATEMENT
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 ( )
Wa . • owledged before me this c` ay 20
o is personally known to me or who has
Produced
as identification and who did take an oath.
initial of reviewing clerk. Ttie foregoing instrument
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: PL2004 -154
Printed: 5/26/2004
Applicant: VICTOR ORTEGON
Owner: ORTEGON VICTOR
JOB ADDRESS: 550 NE 101 ST
Contractor
Local Phone:
Parcel # 1132060171160
Signed: (INSPECTOR)
Plumbing Permit
Contractor's Address:
Permit Status: APPLIED Permit Expiration: 11/20/2004 Construction Value: $800.00
Work: REMOVE BATHROOM
Page 1 of 1
Legal Description: MIAMI SHORES SEC 4 PB 15 -14 LOTS 1 -2 -3 BLK 95 LOT SIZE SITE VALUE
Fees: Description Amount
FEE2004 -5292 Building Fee $170.00
FEE2004 -5293 CCF $0.60
FEE2004 -5294 Training and Education Fee $0.20
FEE2004 -5295 Technology Fee $4.25
Total Fees: $175.05
Total Fees: $17,�.0A
Total Receipts: W b
as D;
MAY 2 6 PAID
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 1 assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY: