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1184 NE 91 Terr (12)Owner's Address Architect /Engineer Bonding Company Mortgagor Square Ft. a PERMIT APPLICATION FOR MIAMI SHORES VILLAGE DateR IS I � 3 Job Address / / S V /% Q/ ) i ' 1 i 4 H ( Tax Folio /•' -���� `-� ®� ' 0 () Legal Description 14;1 °^ 2 ►=A rm RC • eA.VINI Zita ;/ / Lessee / Tenant$3Y.Z)A &I ) T1J7oV Master ermit 4k �✓ 33rghone - 11 ELf' 1 AE ,511 Contracting Co. O' /" 4-; /C Qualifier SS# - - Phone State # Municipal # Competency # Ins.Co. A) 4 N4 N i Address Address Address Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ( ROOFING PAVING FENCE WORK DESCRIPTION ) t - t � L F A ::( S')O - Estimated Cost(value) SIGN WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work s tated. Signature of owner and /or Condo President Date: a �r ---- ----r- Signature f Contractor or Owner- Builder r Date: 50/ Notary as to Owner and /or Condo President Notary o Contractor o y or Owner - Buildup -- My Commission Expires: My Commission Ex O . .I 1Zi --, "AL NOS •Lr�r.111 i NC. CC -/ ;.u7 ** * * * * * * * * * * * * A N X "t', #;�,. FEES: PERMIT I'� RADON C.C.F. NOTARY TOTAL DUE ' - APPROVED: Fire Other Zoning BuildinRYelf / Electrical Mechanical Plumbing Engineering Per 489.103(7) F.S.S. 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 outbuilding. You may also build or improve a commercial building at a cost of $25,000 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 more than one building you have built yourself within one (1) year after the construction is complete, 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. Your construction must be done according to building codes and zoning regulations. It is your responsibility to make sure that people employed by you have license required by state law and by county or municipal licensing ordinances. - q 3 Date Owner's signature Village Use Only Owner's name (print), Permit No. 3 DISCLOSURE STATEMENT sya ps %/A MIAMI SHORES VILLAGE BUILDING AND ZONING DEPARTMENT You have, this date, made application for a building permit as an owner - builder. You should be advised of the following provisions and requirements that apply to owner - builder. Proof of Ownership - Prior to a building permit being issued to you, you must submit proof of ownership of the land concerned in the application in the form of a recorded deed, showing you own the property, or a copy of mortgage or warranty deed of the land, or a Dade County tax receipt, statement to contain legal description of property and indicate property is in your name. Legal description and name on document of proof must correspond to the name and legal description on the application. Responsibility - You will be responsible for all work done by your day labor employees, and you must either employ licensed contractors or persons to be paid on an hourly or per diem basis. Any one contracting (including labor) with you, verbally or in writing, on a fixed fee basis for any work, who is not properly licensed, will be subject to a fine of $500.00 and /or imprisonment for six months. Insurance - You should be advised that if your day labor employees cause any damage to persons or property, or if any of your day labor employees are injured on the job, you are liable. Your regular home insurance policy ordinarily does not cover this type of liability. Withholding Taxes, etc. - You should be advised to investigate your responsibility for withholding Social Security, Federal and State Unemployment Insurance Taxes and Federal Income Taxes from the wages of employees working for you on the proposed construction, and for making returns thereof to the proper agencies. Work Permitted Owner - Builder - An owner - builder subject to the foregoing provisions and requirements, is limited to constructing one single family residence each year for his own use and occupancy; or maintaining, altering or repairing his own single family residence. If you do not intend to do the work involved yourself, or with day labor, please list below, the name of the individual or firm with whom you have entered (or will enter) into a contract for the work. NOTICE: SEPARATE PERMITS REQUIRED FOR ELECTRICAL, PLUMBING, ROOFING AND PIECHANICAL WORK Nam ondividual or Firm Address I, the owner of property described as Witness INSTRUCTIONS TO OWNER- BUILDER do hereby certified that I have read the foregoing instructions, and am aware of my responsibilities and liabilities under my application for a building permit for construction work on the above described property. „it Owner 2 - 6- 92 Date 0 „„-, . ,u A r r L t A y G t. c l a.c.u' T. (C• 4) -z-4 ti, •w4ttP- Wb.I tt..(( 7.' •I /,'rr . Doo i.. C.N%Mb. TC tt LoC.AT+k.o IN `O`(LR.. • "q Ai jp..oYlod. CoPOUt1 wink 3 oL'TL.t. •5 3HoWN, N�r�i } , ' ILL c potwdliss. or Du 04 clacot is 40 !'! - h— .. yt aaTga. To* txcty s aeyvNO o ?Tt,� � Mt. N t 1Zta.tT elts t... q. .. v i, !i 4j 4. i. a' II • 4.4 , ! � y, • 1 :74 15' . wa , t. 9 IN Ult.. • sl .:�t•�i , �.. P..1 a. k.t4. r.:.z. 1 7. 1 . b . O . r- a. t.lb o we A K 11401 S.W.'bi-* Arr. fr • r... r . ` 1 1 fl Q s •1 D t. tIf C ,E uc;►tsittreto 1-l4Me.S, INC. . e.G tNge., ::C.. e JAAM•F.Ib 013 N{eTItD 52 POT' ' Z S kkt1S Li- 7.E. •_ :►+t - 1 i MIAMI SHORES VILLAGE APPLICATION FOR BUILDING PERMIT BUILDING INSPECTION DEPARTMENT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address C - n -- 1 –, a X.,--, Registered Architect and /or Engineer Name and address of licensed contractor -. - .4-- I-- f . xz.r2 -r1__ 1.7 Location and legal description of lot to be built on: Lot Block Subdivision. � f Street and Number where work is to be done. ../1 /ye g / 4` -i^-.f State work to be done and purpose of building (by floors) s r .6' 1 — 1 ?---{ - I= '1-- - 2 Aea-pi. -t• t- . and for no other purpose. New Building Remodeling._ Addition Repairs £----- No. of Stories / To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ /.._y.Q 00 - Amount of Permit $ Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Date /— O No. //r y Street /V C 7/ /V q 19 Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building perinit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. � v Remarks ( Signed )_ __ _ _ _ ___ STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. / / - Permit No ? / Date (Lt E CG' Read, Sworn to and Subscribed before me. Disapproved Date _ Notary Public, State of Florida (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member __._ Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT & 1 W. A 6h�zacnn _ No str eet _L184.. N 1....7_e . Owner's Name and Address ��' • = -•- S Registered Architect and /or Engineer ..... .. ....:........ ..... 4. B. Ifia1r ire ✓2oo ,i ............._._...._. N.! P. 53 Safi�e ........_.._.._ Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision Street and Nu 1.L8 mber where work is to be done .. LYa a.___ 9t ..1.PJt/L State work to be done and purpose of building (by floors) 27 4g. of glia and for no other purpose. New Building Remodeling Addition Repairs No. of Stories It _ To be constructed of Kind of •. f �� ouunndation Roof Covering Estimated Total cost of improvements $ .LGt,lir A.00 Amount of Permit $,. ........ _...,r i Zone cubage required plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to.. . The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the 'Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as arc required by the Act. The undersigned agrees to employ only such subconpractors, on work to be performed under this permit, as are licensed by Miami Shores Village. - Retnarks (Signed)....__..___SL`� STATE OF FLORIDA, COUNTY OF DADE. j ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. l Permit � e /1" Disapproved d (Signed) Date R Ocio6e4 73 Date..._ ..._....._...... _.._ __ _..._._ �.._.... ,19..� o and Subscribed bef to me well known, Notary Public, Stag pf Florida NOTARY PUBLIC STATE OF FLOR AT I.AR ^F ore Building Inspector / _ y Commission Expires BONDED MY C THRU GENERAL INSURA ND ;977 RS PLANNI BOARD DATE Chairman Member Member Member Member ...... Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning hoard. A re fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N9 277 0 Owner of Building Architect Contractor or Builder Legal Lot Description Work to be performed under this Permit B1 - f ( DATE - 19 Contractor's License No. Subdi- vision Value of 11 Amount of Project $ - 11 Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. , f f {/ Signed./ ; 7 1 t, • BY • 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY ABBOT PRINT