533 NE 92 St (10)Company
Phone #
Inspection Date G f is
zgz 1
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Buil ing Inspection Request
Date
Type Insp'n 4- 11' Oil UJCt4
Permit No. i,PS 441
Name — 7 OD W 1
Address 533 1E
Approved
Re- Insp'n Fee ❑
bert
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' 'MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204 CI�
Building Inspection Request ‘a
Date
Type Insp'n
Permit No.
Name
Address
Company
Phone # C O f��GJ `
E kf'
Inspection Date MI
Approved ❑
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533 NE 949 At
orrectio
Re- Insp'n Fee ❑
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Z.641
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date
Type Insp'n Dr i c1-Qw
Permit No. 6f7() 5
Name TQ" u lc L.
Fihlz►
Address 535 J6 Ca St
Company O w' . e- .
Phone #
Inspection Date ( #91Z9
Approved ❑
Correction
Re- Insp'n Fee Cl
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'MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date 1
Type Insp' n! J I 1 U.QC. O L F1 �
Permit No. I - 441
Name 9. )ic:,�
Address 15 C12.4
Company O(1jN6r
Phone #
Inspection Date 7 5
Approved
Correction
Re- Insp'n Fee
far
f
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date
Type Insp'n Pr' ( I CJ -e- C
Permit No. (3 P G — T T(
Name T
Address 3 /vf 2 T r
Company (9 GL) (� e ` ,
Phone # 365 -- / 5- ?` G Z—
Inspection Date C9 — 1 s
Re- Insp'n Fee ❑
Correction
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,#„.„.r.,,„_____
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Buijd)ng Inspection Request
Date
Type Insp'n `'�r'�" "'G��
Permit No. £ 05 -
Name C/L-4.■d6
Address 3 53 , v e 9a lei'
Company .i s
Phone# 06/76 '40
Inspection Date
Correction
Re- Insp'n Fee
Miami Shores Village
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle).
Owner's Name (Fee Simple
Owner's Address .„
City /� �[ (jm� �r�t
Tenant/l.essee Name
Contractor's Company Name
Contractor's Address
City
Qualifier
State Certificate or Registration No.
Architect /Engineer's Name (if applicable)
$ Value of Work For this Permit X
JCt
Type of Work:
Describe Work:
l �
Total Fee Now Due $
(Continued on opposite side)
❑Addi ion ['Alteration
, /a el,az
o
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
State
Electrical
frif
Master Permit No.
Plumbing
C I (6 ' Q'C Phone #
State r �-- Zip
22 ,
Phone #
Permit No. YO S ._I
Mechanical
Code Enforcement $ Structural Plan Review. $
Repair /Wlace
14
* * * * * * * * * * ** * * * * * * * * * * * * * * *, F ees * * * * * * * * * * *** * * * * * * * * * * * * * * * **
Roofing
Job Address (where the work is being done) JQ.riw czC. the)1
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO )(" +i
Phone a - Ol
(- - )luav1/(
Zip.
Certificate of Comp
Ph(
Square Footage Of Work:
❑ Demolition
4 c •�
Submittal Fee $ ' Permit Fee $ CCF $ � ad CO /CC
Notary $ Training /Education Fee $ &t T t7 Technology Fee $ �/ 5
� �
Scanning $ Radon $ ' Zoning � Bond $ �3C`�0
Bontling 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. 1 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: 1 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
COMM ENCEM ENT."
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 ins Ilion which occurs se en (7) days after the building permit is issued. In the absence of such posted notice, the
inspection wit nyi 4e approved and a r inspection fee willto charged.
S ignature
Signatu
The foreg
day of
who is personally o to me or who has produced
NOTARYPU:
Sign:
Print:
My Commis on Expires:
Owner or Agent Contractor
f
instrument was a knowledged before me thus',, TIp foregoing instrument was acknowledged before nee this___ • oC S , b ( t� C{, �y oof , 20 , by _
As identification and who did take an oath. as identification and who did take an oath.
■
* * * * * * * * * * * * * * * * * * * * * * * * * * * **** ********************************************* * * * * * * * * * * * * * * * * * * * * * * * * ** * * * **
************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 05/13/03
L ^�
who is personally known to me or who has produced
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
********************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
‘\ 30 \ C ) 3 Plans Examiner
Engineer
Zoning
X
'STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affant, 4/4-- fra4e4does hereby attest that the
(property owner)
1
attached survey, performed by
performed on Iv is an accurate representation of the existing conditions and
(dat of survey)
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the
property without first providing a survey less than six (6) months old. The Affiant, as property owner, further
agrees to remove or obtain permits for any structures which now may exist on the property which are not
permitted or which may violate zoning or building code regulations. The Affiant further understands that the
existence of any such structures may affect final inspections as applicable to this or other permits..
Further, Affiant sayeth naught.
Affiant is personally known to me, produced
(name of surveyor's company)
int/Property
/ /ti c _ e
Witness(sign and print)
GJ
T
SWORN TO AND SUBSCRIBED before me this •27( da of a 00 OS
1 '
as identification.
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE STATEMENT
7:1;a)/ c being the legal property °wrier, for the property
Located at: S J /V6 A.S
Owner
Owner
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 3irork 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. You may also build or improve a
commercial building at a cost of 525,000.00 or less. The building must be for your osvn 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 Iicensed 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 instrument
Was acknowledg d before me this 2K day of 141 rC , 20 (1r
DISCLOSURE STATEMENT
` B y a `c y one CMJ / ( IC who is personally known to me or who has
Produced • 1 ' • as identificati
)ivek
d who did take an oath.
o� "� h/A. �� e1 `! - gas
_.�' '�: Commiss!on t-DD23I9
S J ; oQ ; Expires: 3 e 3, 2007 .
'943 F F1';P,` 3onded Thru
'' • -• " Atlentic3ordingCo..:nc.
Legal Description
Owner / Lessee / Tenant Master Permit # 3 7 cw 1e
Owner's Address 'S 3 Ate 9' 2- S Phone q 6
Contracting Co. , A £ov$ CeUai / c(/ 3 0 ® S 11 1.E
L Ad d ress
Qualifier a6F/2A+ 0 (4E,AiAN Dee SS# - ' Phone SS _ 6 4 0
State # Municipal # Competency # L - 0 7 Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING �EELECTRICALL PLUMBING MEE ROOFING PAVING PENCE SIGN
WORK DESCRIPTION ,�/ • 9 l C fk 6 � ' C/ r►UC W as
Square Ft.
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
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 AFFID.yrf I certi that all the foregoing information is accurate and that all work will
be done i comjli:nce with al applicable laws regulating construct and zoning urthermore, I
author a the :••ve -n: ed con ractor to do the work stated.
S ture o •wne
Date; "
N otacy as to Owner and /or Condo,,President
My Commission Expires:
** * *
APPROVED:
Job Address ' 3 ? / V E C Tax Folio
t ! J M Commission CC419887 // { (ANNE BRAMWE
i ^ M y Comm CC419867
Expires Nov. 09, 1998
Expires Nov. 09, 1996 a :a
Zoning
an or Condo President
Estimated Cost(value)
Signature of Conga
Date. 410 111111111
l
otary as to Contracto engwner-Builder
ADRIANNE BRAMWELL My Commission Expires: ADR LL
FEES: PERMIT 1 54 1 1. RADON C.C.F. 1 c NOTARY TOTAL DUE 3'4
Fire
Buildin
Mechanical Plumbing Engineering
Other
Electrical
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