35 NE 92 St (17)BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type (circle):
Job Address (where the work is being done)
City Miami Shores Village
FOLIO / PARCEL #
Contractor's Company Name (I,(I,(
Contractor's Address
City State
Qualifier Name
Value of Work For this Permit $
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
_ r1
Owner's Name (Fee Simple Tit eholder) �rLIR\� � � ��p�p vt,��{�Phone # RG 6o(.) 9►29
Owner's Address BS t £ , 9a, eQJ
City 1 Ptrt ∎ S\ C) ( '.Q S State �___
Tenant/Lessee Name
35 N,E qa ncA STe€F
County Miami -Dade
Is Building Historically Designated YES NO X
Master Permit No.
zip ?
Phone #
Phone #
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Square / Linear Footage Of Work:
M1 2 o 20135
Permit No.
Mechanical Roofing
A DS G? 1 5 o i
Zip 331 3
Zip
Phone #
i cy t.1-
Type of Work: ❑Addition EAlteration ❑New Repair/Replace xiDemolition
Describe Work: k�AT 4Roo71 5 'ri Lt✓3 - VAN, \ 1 t C.3
************ * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ !i`T� — ' CCF $ CO /CC
Notary $ Training /Education Fee $ Technology Fee $
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ Z CD
See Reverse side -*
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) E A M VAN 1TEj
Po isDy 30/0)
Mortgage Lender's Address
City
ftlyi 021-
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.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
(Revised 02/08/06)
I �'/
Signature / l,� C.,�l,S�11le
State
Oar or Agent Contractor
The foregoing instrument was acknowledged before me this Atial The foregoing instrument was acknowledged before me this
day of `. , 24 by &I C71( 1 , day of , 20 _ , by
who is personally known to me or who has produced f V w w,Li( , , who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
APPLICATION APPROVED BY:
Zip -3,6 3tL.
Signature
Sign:
Print:
My Commission Expires:
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
ft • •
VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
NAME: S U J A DATE: /2 020-06.
ADDRESS: � � � ; )` P/ 7/ S /1/9720 F 3 3/3
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 understood the following disclosure
statement, which entitles me to work as my own contractor; I further understand that 1 as the
owner must appear in person to complete all applications.
State Law requires construction to be done by a licensed contractor. You have applied for a
permit under an exception to the 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. 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 complete, the law will
presume that you built for sale or lease, which is a violation of this exemption. You may not hire
an unlicensed person as a contractor. It is your responsibility to make sure the 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 - holdings tax and
provide workers' compensation for that employee, all as prescribed by law. Your construction
must comply with all applicable laws, ordinances, buildings codes and zoning regulations.
Please read and initial each paragraph.
1. I hold title to the above property and I am planning on doing this construction
Initial
Initial
2. I understand that as an owner - builder I must abide by all zoning ordinances and
building regulations in effect at the time of permit application
Initial
3. I have an understanding of the 2004 FBC & FRC and understand that this
department and its inspectors are there to help enforce and interpret the code.
There is a copy of the code in this office for review.
Initial
4. I understand that the building official and inspectors are not there to design,
alter or give advice on how to meet code — only if the structure meets the
minimum code.
5. I understand that as an owner - builder, that any contractor disputes with sub-
contractors and myself must be handled in a civil court with the advice of an
attorney. The department will not mitigate contract disputes.
6. I understand that if I compensate any person or company for work performed
they are required to have a business license in the county. If for any reason they
do not posses a business license I will be responsible and liable for any wrong
doing from this unlicensed company or person.
7. I understand that if any person gets injured on my construction project —they are
entitled to workmen's compensation. And if they do not posses a workmen's
policy I could be held liable for all doctor and related cost which could include
loss of wages during recovery from injury.
8. I understand that under state and local laws I can not do any Electrical,
Plumbing, Heating, Air & Roof work on my property with out first obtaining
the proper permits by licensed contractors.
Was acknowledged before me this 2-.X day of ,X1(C1 , 20 0
By ,(6Iv1 5v15 t •
Produced there nse or 6. 2/0 5, UDO 523
OWNED
who was personally known to me or who has
ireitt MONICA USSETH DIAZ
f, MY COMMISSION # DD 483995
EXPIRES: October 20, 2009
'�' Bonded Thru Notary Pinta Undeiwdtere
Initial
Initial
Initial
Initial
i- • • 0
as identification.
/
)-( /
Passed l/ (
✓
Inspector Comments
V
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Inspection Date: 08/07/2006
Inspector: Grande, Claudio
Owner: SUISSA, ALAIN AND NICOLE
Job Address: 35 92 Street NE
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Monday, August 7, 2006
Miami Shores Village, FL 33138-
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
AUG 0 9RECD
Block:
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Alteration
Phone Number (305)975 - 0400
Parcel Number 1132060130240
Lot:
Page 2 of 2
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Issue Date: 4/3/2006 Expires: 03/28/2007
Owner's Name: ALAIN AND NICOLE SUISSA
Permit Type: Residential Construction
Work Classification: Alteration
Job Address: 35 92 Street NE
Additional Information
Miami Shores Village, FL 33138-
Contractor(s) Phone Primary Contractor
HOME OWNER
Yes
Comments:
BATHROOM TILES AND VANITIES REPLACEMENT
Type of Construction: BATHROOM RENOV. Occupancy: Single Family
Stories: NA Exterior: NA
Front Setback: NA Rear Setback: NA
Left Setback: NA Right Setback: NA
Bedrooms: NA Bathrooms: NA
Plans Submitted: Yes Certificate Status: NA
Certificate Date: 3/28/2006 Additional Info: NA
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 responsibility for all work done by either myself, my agent, servants, or
employes. I understand that separate permits are required for ELECTRICAL,
PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING
POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work
stated.
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee - Additions /Alterations
Scanning Fee
Technology Fee
Total:
Amount
$4.80
$1.60
$5.00
$240.00
$3.00
$6.00
$260.40
Building Department File Copy
Applicant Signature
Parcel #:
Block:
Section:
Permit Status: APPROVED
Permit Number: RC -3 -06 -786
Phone: (305)975 -0400
1132060130240
Lot:
PB:
Total Square Feet: 104
Total Valuation: $ 8,000.00
Required Inspections
Slab
Termite Letter
Fill Cells Columns
Tie Beam
Window and Door Buck
Window Door Attachment
Framing
Insulation
Drywall Screw
Ceiling Grid
Final PE Certification
Shutter Attachment
Shutter Final
Invoice Number
RC - 4 - 06 - 24348
Total:
APR 0 4 PAID
Amt Due
$260.40
Amt Paid
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
• •
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BY
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•
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• ••• • • • ••
• • • • • • • • • •
• • • • • • •• •. EXISTING WINDOW
• • •
••• •• • •
•• • • •• ••• ••
•
• • •
•
• ••••• • • . 60 ,
SHOWER 36° D X 60" W
DRAIN
o
GLASS PARTITION
TOILET BOWL
1 SINK VANITY
48"X22"
RGcycz, I�OT WATER PI
r pq 2 �
BATHROOMS LAYOUT
35 NE 92nd STREET
MIAMI SHORES, FL 33138
•
WATERPROOF
LIGHT FDXTURE
X
X
r
MASTER PERMIT #: 306 -786
PLUMBING PERMIT #: 306 -707
ELECTRICAL PERMIT !P.: 306 -788
EXISTING WINDOW
60"
SHOWER 36"D X 60" W
•
ORA[1N
WATERPROOF
LIGHT FIXTURE
GLASS PARTITION
COLO WATER PIPE
TOILET BOWL
1 SINK VANITY
42" X 22"
<'/z L u i'T %' 1'/2 T // '�'�/
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NC -' � °6TAX FOLIO NO.I 1 3Z D6 Di 3
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
1. Legal description of property and street /address: \ I',- S: 1 `, V\'6 t- j C)
LOTS 1 1 LOC" -
►ALE . `�I n� 5rt � = c � � k\ :5_31
2. Description of improvement:
RBT 1-F f`Oc) (> RE of F (i 1 E •c C 3;
3. Owner(s) name and address: N 1.f jN \ ( Co
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address:
N
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided
in Section 713.13(1)(b), Florida Statutes.
Name and address:
r,
9. Expiration date of this Notice of Commencement: (the expjr,atimrd
different, date specified)
Signature of Owner
Print Owner's Name j ( I )
Sworn to and subscribed before me this day of /
i
Notary Public `.
Print Notary's Name
My commission expires:
7
123.01 -52 PAGE 4 8/02
I
FATE OF FLORIDA, COUNTY OF DADE
.., TNESS my hand
lARVEY RUVI
3y
, 20L(
.rdcd I I n
nu Itrnulme('�, 111,
1 188111 ti188111111IIII I1I II iii88 !1181 II81 Ig81
Address:
4:: E.. ll., u u e o 6 IR a_ u :;:13 " ': :._
OR E?.k 243910 F'9 28 (1r11 }
RECORDED 04/04/2006 11:59.:22
HARVEY ROVINF CLERK. RK. OF COURT
URT
MIAMI COUNTY? FLORIDA
LAST PAGE
441_4 cot a,ci CL
t bei VargLts
Commission '1)1)231').