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BP-05-1062Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 7/19/2005 Applicant: Owner: JOB ADDRESS: 144 NE 91 Contractor Local Phone: Parcel # 1131010190050 Signed: (INSPECTOR) Building Permit Permit Number: BP2005 -1062 ST Contractor's Address: Page 1 of 1 Legal Description: 1 53 41 EL PORTAL SEC 2 PB 9 -115 LOT 6 BLK 7 LOT SIZE 50.000 X Fees: Description Amount FEE2005 -9815 Building Fee $100.00 FEE2005 -9816 CCF $0.60 FEE2005 -9817 Technology Fee $2.50 FEE2005 -9818 Training and Education Fee $0.20 FEE2005 -9819 Notary Fee $5.00 Total Fees: $108.30 Total Fees: $108.30 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 1/15/2006 Construction Value: $250.00 Work: PLASTER CARPORT 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: BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle).. Building Electrical Plumbing @ � _ Mechanical Roofing Owner's Name (Fee Simple Titleholder) )(� *A A 1 ! d ) U v p P h o n e # 8 ©5 1 4 6 1 1 5 '' / Owner's Address ‘ r 3 6 / C G/Q Cit r i I State r �— State Certificate or Registration No. Type of Work: ['Addition Describe Work: Miami Shores Village Building Department Total Fee Now Due $ (Continued on opposite side) 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: 3 756.8972 Tenant/Lessee Name Phone # Job Address (where the work is being done))( A/6 q l 5� City Miami Shores Village County Miami -Dade Zip / �✓ e3 Is Building Historically Designated YES NO $ Value of Work For this Permit � ' ) Permit No. 1 — OC°2- Master Permit No. Zip Phone # F86 221— 5 Contractor's Company Name Contractor's Address City State Zip Qualifier Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: ['Alteration ❑New 1 Repair/Replace ['Demolition P1c61er + lfe - ****************************F Submittal Fee $ Permit Fee $ 1 b CCF $ CO /CC Notary $ ' Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable) tot s 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 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 not be approved and a reinspection fee will be charged. Signature wrier or Agent (� Contractor The foregoing, instrument was acknowledged before me this 1 Q . The foregoing instrument was acknowledged before me this_ day of C} 1 2OQ y F i ei ' v / 'O 0Li 0(i Dierei , day of , 20 by who sonally known to me or who has produced _ who is personally known to me or who has produced NOTARY P s identification and who did take an oath. as identification and who did take an oath. �' "f;�,11�li + C' .�! TARYPUBLIC: � Sign: �� / u� i r t� ,.n �" Sign: ' r'; ndect _ _ I Print: My Co ission Expires: My Commission Expires: ********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: chc 05/13/03 * Signature ******* 4**** * */ * * * * * * * * * * * * * * * * * * * * * * * * * * ** 7 /9 Plans Examiner Engineer Zoning 1I VILLAGE OF MIAMI SHORES 1S Located at: L Ij E 9. BUILDING DEPARTMENT OWNER BUILDER DISCLOSURE STATEMENT a ms , evuo' being the legal property owner, for the property 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),And I have read and understand the following disclosure Statement, which entitles me td irork 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 525,000.00 or less. The building trust 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 snake 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 Icensed 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 ( ) Was acknowledged before me this 1 day of ' 20 • By N Produced initial of reviewing clerk. Tlie foregoing instrument who is personally known to me or who has as identification who did take an oath. C p 1 Vr `/('go(( • P 57:17 ' » 2 OgIG R(Dnaed 17 AtlarticRrvl7ir?ro 9i�.