234 NE 92 St (15)Miami Shores Village
Buildin Department
e artment
10050 N.E.2nd Ave u� :Lni Sho�Ges; Flori
Tel: (305) 795 220ax: (305) 756.89
BUILDING
PERMIT APPLICATION
FBC 2001
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
Architect/Engineer's Name (if applicable)
Submiial Fee $
P ary$
Scanning $
Code Enforcement S
Total Fee Now Due $
(Continued on opposite side)
Permit Fee $
State
NO
Permit Type (circ Building lectrical Plumbing Mechanics) Roofing phone#769 9aq (',,,o5
Owner's Name
Owner's Addres`
City ' `.a .;' � ��d � u ,, to Zip
_ - 5/3•
Tenant/Les e Name
County Miami-
* * * * * * * * * * * * * * * * * * * * * * * ** *F **
Training/Education Fee $ 6j 60
Structural Plan Review. $
aster Permit No.
3138
A) e
Contractor's Company Name Phone #
Contractor's Address
City
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Phone #
ermit No. e02 5
Zip
frp
$ Value of Work For this Permit
® Square Footage Of Work:
Type of Work: ❑Addition EAlteration ❑ ew ❑ Repair/Replace I�►' Demolition
Describe Work: d ,�yZ� '7-- �
* * * * * * * * * * * * * * * * * * * * * * * **
CCF $
Radon $ Zoning
Technology Fee $
CO /CC
Bond $
•
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 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 • e < pection fee will be charged
NOTARY
Si ai •
omg strumen
ersonally mown to me
Signature
The f
day o
As identification and who did take an oath. as identification and who did take an oath.
My Commission Expires:
_�_o∎ �1 /L
,r er Agent
*** * * * * * * * * * * * * * * * * * * * * * * *Al * * * * ** F•*
o has produced who is personally known to me or who has produced
0
NOTARY PUBLIC:
APPLICATION APPROVED BY:
Chc 05/13/03
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of ,20,by
s
..;� Contif;9ibri
�; o Qac �xp;,son E xpires:
' ° P' `' � l bonding Co. 1 Inc.
* * * * ** **K * * * * * * * * * * * * * * * * * **
JAN 12 Ski
Plans Examiner
Engineer
Zoning
•
OWNER BUILDER DISCLOSURE STATEMENT
I ,4 4 t ' L Ye6c{ -({L being the legal property owner, for the property
Located at: 224- Ad 6 70 7 ` 51 - _A/4w 1 , 51 f 3. I3 A
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 1,rork 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 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. J 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 ( )
Was a
By
Owner
Owner
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
DISCLOSURE STATEMENT
initial of reviewing clerk. The foregoing. instrument
who is personally known to me or
ledged before me this ( day of
ho has
roduced as identification and who did take an oath.
Orr Notary
. Gim H. Gonell
, a Commission #DD323870
- 9 �,� ' Expires: May '26, 2008
Bonded
Atlantic
Bondliig Co.,
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2005 -51
Printed: 1/13/2005
Applicant: ALEXANDER YAHR
Owner: YAHR ALEXANDER
JOB ADDRESS: 234 NE 92 ST
Contractor
Local Phone:
Parcel # 1132060133410
Signed:
(INSPECTOR)
Building Permit
Contractor's Address:
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 8 & 9 BLK 25 LOT SIZE
Fees: Description Amount
FEE2005 -606 Building Fee $150.00
FEE2005 -607 CCF $1.80
FEE2005 -608 Training and Education Fee $0.60
FEE2005 -609 Technology Fee $3.75
FEE2005 -610 Scanning Fee $6.00
FEE2005 -611 Submittal Fee ($50.00)
Total Fees: $112.15
Total Fees: $112.15
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 7/11/2005 Construction Value: $2,400.00
Work: DEMO FOR 2 BEDROOMS
Page 1 of 1
JAN 14 PAID
3P
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: