Loading...
977 NE 93 St (6)Inspection Date: 05/17/2006 Inspector: Grande, Claudio Owner: OSSMAN, LANCE Job Address: 977 93 Street NE Project: <NONE> Contractor: Miami Shores Village, FL Building Department Comments Tuesday, May 16, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 kt Block: Permit Type: Imported Permit Inspection Type: Final Work Classification: <NONE> Phone Number (786)423 -8188 Parcel Number 1132060350060 Lot: Page 2 of 2 Passed o/6/1 1 0 / Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 05/17/2006 Inspector: Grande, Claudio Owner: OSSMAN, LANCE Job Address: 977 93 Street NE Project: <NONE> Contractor: Miami Shores Village, FL Building Department Comments Tuesday, May 16, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 kt Block: Permit Type: Imported Permit Inspection Type: Final Work Classification: <NONE> Phone Number (786)423 -8188 Parcel Number 1132060350060 Lot: Page 2 of 2 Inspection Number: NSP -16 Inspection Date: 05/03/2006 Inspector: Grande, Claudio Owner: OSSMAN, LANCE Job Address: 977 93 Street NE Project: <NONE> Contractor: Miami Shores Village, FL Building Department Comments Monday, May 1, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Iurn er: Block: P2005 4 023 Permit Type: Imported Permit Inspection Type: Final Work Classification: <NONE> Phone Number (786)423 -8188 Parcel Number 1132060350060 Lot: Page 2 of 2 Passed Inspector Comments � - 1 D 0P�J A J f ,o S - Failed 4/20U4/0 f Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Number: NSP -16 Inspection Date: 05/03/2006 Inspector: Grande, Claudio Owner: OSSMAN, LANCE Job Address: 977 93 Street NE Project: <NONE> Contractor: Miami Shores Village, FL Building Department Comments Monday, May 1, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Iurn er: Block: P2005 4 023 Permit Type: Imported Permit Inspection Type: Final Work Classification: <NONE> Phone Number (786)423 -8188 Parcel Number 1132060350060 Lot: Page 2 of 2 BP2005 -1023 Inspection History Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Project: Owner: Phone: <NONE> LANCE OSSMAN (786)423 -8188 Job Address: 977 93 Street NE Parcel: 1132060350060 Miami Shores Village, FL Block: Lot: Scheduled Ins° # Inspection Type 04/19/2006 INSP -15212 Foundation Inspection Status DENIED 05/02/2006 INSP -16255 Final Pending Inspection Monday, May 1, 2006 Inspector Claudio Grande Imported Permit MR. LANCE CALLED AT 8:56 AM TO CANCEL INSPECTION. WIRE MESH NOT CONTINOUS THROUGH. WIRE MESH TO BE TIED AT 5" OF CENTER AT LAPS. REMOVE ALL ROCKS LARGER THAN 2" FROM UNDERNEATH SLAT AT GARAGE AREA. 04/24/2006 INSP -15367 Foundation APPROVED Claudio Grande Date Completed 4/19/2006 4/24/2006 Claudio Grande Not Complete Page 1 of 1 Mnspecttorl l umber: I NS P -1536 5367 Inspection Date: 04/24/2006 Inspector: Grande, Claudio Owner: OSSMAN, LANCE Job Address: 977 93 Street NE Project: <NONE> Contractor: Miami Shores Village, FL Building Department Comments Thursday, April 20, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: ( )795 -2204 Fax: (305)756 -8972 Block: eutt�er.< <B ?!2005 -1023 Permit Type: Imported Permit Inspection Type: Foundation Work Classification: <NONE> Phone Number (786)423 -8188 Parcel Number 1132060350060 Lot: Page 2 of 2 q/ZY Passed O4° Inspector Comments • Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Mnspecttorl l umber: I NS P -1536 5367 Inspection Date: 04/24/2006 Inspector: Grande, Claudio Owner: OSSMAN, LANCE Job Address: 977 93 Street NE Project: <NONE> Contractor: Miami Shores Village, FL Building Department Comments Thursday, April 20, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: ( )795 -2204 Fax: (305)756 -8972 Block: eutt�er.< <B ?!2005 -1023 Permit Type: Imported Permit Inspection Type: Foundation Work Classification: <NONE> Phone Number (786)423 -8188 Parcel Number 1132060350060 Lot: Page 2 of 2 Inspec on Num er: INSP- 15212 Inspection Date: 04/19/2006 Inspector: Grande, Claudio Owner: OSSMAN, LANCE Job Address: 977 93 Street NE Project: <NONE> Contractor: Building Department Comments Tuesday, April 18, 2006 Miami Shores Village, FL Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone 05)795 -2204 Fax: (305)756 -8972 Block: BP2005- 1023 Permit Type: Imported Permit Inspection Type: Foundation Work Classification: <NONE> Phone Number (786)423 -8188 Parcel Number 1132060350060 Lot: Page 2 of 2 Passed Inspector Comments i 5 A. go , �,,c� 7 ,, vbS 9 • `.� c,Lt • kiwi leas % C / - 2 ��� 0 G / 4.. - 5 i b tC, AT IA C S . 1-414 Z 2 t .O at 4Q? k�cx-lcg e� 6,FA�. 11 lath ok. Vide /LA-OM . 's l 4-b k-t 2 Q A/4-‘ 1 00(9. Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspec on Num er: INSP- 15212 Inspection Date: 04/19/2006 Inspector: Grande, Claudio Owner: OSSMAN, LANCE Job Address: 977 93 Street NE Project: <NONE> Contractor: Building Department Comments Tuesday, April 18, 2006 Miami Shores Village, FL Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone 05)795 -2204 Fax: (305)756 -8972 Block: BP2005- 1023 Permit Type: Imported Permit Inspection Type: Foundation Work Classification: <NONE> Phone Number (786)423 -8188 Parcel Number 1132060350060 Lot: Page 2 of 2 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Owner's Name (Fee Simple Titleholder) Owner's Address COO ME k 3' S j City ' 1^t11e�Ir 5yk State 'FL Tenant/Lessee Name Total Fee Now Due $ (Continued on opposite side) uil I ' Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Electrica � Plumbing Mechanical Roofing cm nlr CO" sT Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO N( Master Permit No. Zip 33 3 - 8 Phone # Phone # State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # UJ ( Zip 3 3f 3 '8 Permit No. IRI I v 3 Phone # 7 `3b —. C'.Z 3'3 Contractor's Company Name Contractor's Address City State Zip Qualifier $ Value of Work For this Permit -T Square Footage Of Work: q Type of Work: EAddition ❑Alteration [New VI Repair/Replace Demolition Describe Work: k C VO Ci 2)64 I P AO N bwl wnt\1 - 1 �t'QCvy1' �r17(� * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ l 2 S; r1/� . CCF $ 2 - 40 CO /CC Notary $ 5.00 Training /Education Fee $ 0 • eC Technology Fee $ 3 .Z0 96 Scanning $ 3 .00 Radon $ Zoning Bond $ O• CO 4 / - 7 Code Enforcement $ Structural Plan Review. $ 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 a reinspection fee will be charged. V Signature Owner or Agent Contractor The foregoing instrument was acknowled ed before me this �� The foregoing instrument was acknowledged before me this day of , 20 0cbyC assmor day of , 20 , by who is personall known to me or who has produced 7:0-Q _ who is personally known to me or who has produced As identification ant.1,4tpidid tage'tn oath. as identification and who did take an oath. a NOTA' Y P : IC: �O • "' 10n ; % NOTARY PUBLIC: Sin: ' ,nnc�1 Sign: ��� Sign: Print: Print: My Commission Expires: APPLICATION APPROVED BY: chc 05/13/03 ( Signature My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * ** _-- ********************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * ** * s*** j***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning • VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE .STATEMENT I �A Jv1 CC' 0551114 being the legal property owner, for the property Located at: 1 T) Gj S - Legally described as__r ( 'r Athb01,4s 6 U *IvISI?rr 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 cork as my own contractor, I further understand that I as the owner rnust 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 $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 Iicenses 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 ( ) initial of reviewing clerk. Tlie foregoing instrument Was acknowledged before me this day of 20 By who is perso ally known to me or who has Produced as identifica Owner Owner BUILDING DEPARTMENT DISCLOSURE STATEMENT do •who di take an oath. l 2l osypt, C Mabel Eg7Cds Y � , om -Ission �23I9g� 9 -' : a an Ju 3, 2 „0. No 'STATE OF FLORIDA) COUNTY OF DADE) The undersigned Affiant, /-0(V)(s2._ , does hereby attest that the (property owner) attached survey, performed by l-Ph(/! to 5 U(_yfriop -s' (name of surveyor's company) performed on , is an accurate representation of the existing conditions and (date 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/Property owner Witness(sign and print) Witness(sign and print) t piWP SWORN TO AND SUBSCRIBED before me this da at' J j = Cn1� � � g E sib!? 131984 7 P LO piro�: u Affiant is personally known tome, produced ■ �s, j� e�ti8�a 'tie nor/ding Cr) WHEREAS, 1.' p neck vp4 , hereinafter referred to as the Owner of the following described property: Legal description /folio#: lI' ?2.66 01r — dat Lot (p Block Subdivision NW2C t I4j1a11C.It,s Tax Folio #: requests permission to install: (owner) (KQ Asphalt, concrete, brick pavers (] Landscaping (] Other within the public road right of way of M iami --Ch,oreJ 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 - 2382 Telephone: (305) 795 - 2207 Fax: (305)_756- 8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY PPR o4cti (address) IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows: 1. To maintain and repair, when necessary, the above- mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligation has been canceled by an affidavit filed in the Public records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this_day of SIGNED. SEALED AND DELIVERED in the presence of: (owner) Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 7/14/2005 Applicant: LANCE OSSMAN Owner: OSSMAN LANCE JOB ADDRESS: 977 NE 93 ST Contractor Local Phone: Parcel # 1132060350060 Signed: (INSPECTOR) Building Permit Permit Number: BP2005 -1023 Contractor's Address: Permit Status: APPROVED Permit Expiration: 1/4/2006 Construction Value: $4,000.00 Work: REPLACE DRIVEWAY AND NEW DRIVEWALK TO FRONT DOOR Page 1 of 1 Legal Description: MAGEE & HAWKINS SUB PB 51 -5 LOT 6 LESS E12FT LOT SIZE 13101 SQUARE Fees: Description Amount FEE2005 -9594 Building Fee $125.00 FEE2005 -9595 CCF $2.40 FEE2005 -9596 Notary Fee $5.00 FEE2005 -9597 Training and Education Fee $0.80 FEE2005 -9598 Technology Fee $3.20 FEE2005 -9599 Scanning Fee $3.00 FEE2005 -9600 Builders Bond $300.00 Total Fees: $439.40 Total Fees: $439.40 Total Receipts: $0.00 ' JUL 15 PAID 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: REVISED: F.I.P.3/4" (NO ID) 0.25 CL 4� 8 6N A� 9 15.87' 15.49' VIZ • • • io O exit r46 Lot 3 5' C.L.F,, _ 108 00'(R8M) NOT VALID UNLESS EMBOSSED V4TI{ SURVEYOR'S SEA1 -• : •• • • • •• • Conc. 12.50' 38.65' 76.75' ONE STORY CBS RESIDENCE # 977 76.75' X1 6 C.B.S. wall.. 53. • Wood Pole Lot 4 F.I.P.3 /4* (NO ID) �O ‹. ° A � 1.50' ENC N wna14 -w 1 0 A 95.00'(R&M) o, +foot 7 'n J 00440 OftP4. cS C) Q- O z e /•~ryto • \o.. v 25. -A _ -- -- FN. U co N.E. 93rd (NO ID) STREFT S WA(= SIDEWALK( CBS = CONCRETE BLOCK STRUCTURE, CLF =CHAIN LINK FENCE, PL= PROPERTY LINE, DUE = DRAINAGE UTILITY EASEM ENT, IP =IRON PIPE. F= FOUND, NC =AIR CONDmONER PAD, P /C= PROPERTY CORNER, DM= GRILLED HOLE, WF= WOODEN FENCE, RES= RESIDENCE, CL-C LEAR. RB= REBAR, UE= UTILfY EASEMENT. CONC= CONCRETE SLAB, RAAtRIGHT OF WAY, DE= DRAINAGE EASEMENT. C/L= CENTER LINE, 0=DIAMTER. TYP= TYPICAL, •M= MFA R•RESORDED, ENCR= ENCROACHMENT, COMP = COMPUTER, ASH = ASPHALT, N/D =NAIL & DISC, S =SET, FEE = FINISH FLOOR ELEVATION, :0 /: POPE, OHP= OVERHEAD POWERLINE, WN =WATER METER •WOiODFENCE• • • •MASOIIRYwuL =I I i• 4, I I I K 1 I ELEVATION BASED ON LOC. # • CONCRETE�I•' •1r . y, , ..t : c;.: •i;.: •t;.:.�; .•t:,'.i MAINTENANCE &DRAINAGE EASEMENT= MBD.E. CBM# ELV. TYPE OF SURVEY: BOUNDARY SURVEY SURVEYOR'S NOTES: 1 OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATURE ANC? D SEAL OF FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT CQQVV��E 13Y PrOrE$$1bNAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5) LND6RGROUND•ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC VERTICAL• DATUM 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9) CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING IlF•044TIIN. 1Il) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED I STRtiMEMTS, IFANY, AFFECTING THIS PROPERTY. • F EpRi pSSrHel3 SjipiIVN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB PAGE A go, g -N, ADIS N. NUNEZ REGISTERED LAND SURVEYOR STATE OF FLORIDA #5924 LOCATION SKETCH SCALE: NTS OF MAGEE & HAWKINS SUBDIVISION i HEREBY CERTIFY That the survey represented thereon meets the minimum technical requirements adopted by the STATE OF FLORIDA Board of Land Surveyors pursuant to Section 472.027 Florida Statutes. There are no encroachments, overlaps, easements appearing on the plat or visible easements other than as shown hereon. 7 E1200' 5 N.E. 93rd STREE 8 CERTIFIED TO: CHARLES LANCE OSSMAN, 977 N.E. 93 STREET. MIAMI SHORES, FLORIDA 33138., CHRISTOPHER P. KELLEY,'P.A., ATTORNEYS' TITLE INSURANCE FUND, INC., BANKERS MORTGAGE TRUST, INC., ITS SUCCESSORS AND /OR ASSIGNS, ATIMA. LEGAL DESCRIPTION: LOT 6, LESS THE EAST 12 FEET THEREOF ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 51 OF THE PUBLIC RECORDS MIAMI -DADE COUNTY, FLORIDA SUBDIVISION AT PAGE 5 BL•.ANe© [•1R`vE`( RS S ING. Engineers • Land Surveyors • Planners • LB # 0007059 • • • • %65 NOR1 I1 SI•tQRE DRI\ • • • • • • • • • • • • • • TIAMI 40HTL•31141 (305) 865 -1200 • • • • • • • • • • Fax: (305) 865 -7810 FLOOD ZONE: SUFFIX: DATE. BASE: X ••• • • J • 7/17/95 N/A PANEL: 0093 : COMLIaI ty #: 1 : 06 12 DATE: SCALE: : Rftl: Bj :: 4.1013L415, 1 ° =20' ••• F. Blanco • • • • 734 -1076 .. • • • • • ... •• .. •.• • • • • • •• • . •• • • .. • • • • • • • • • • •. • • • •. ••• •• •• .•• •• • • • •• • • • • • • ••• • • • • • ••• • ••• • • • • • • • • • • • • • • • • • • • .. • • • • • • • • • • • • • • • • • •• •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • ••• • • • ••• ••• • • • ••• • • • 11 00 • • • • 00* ••• • • • • ••• • • • • • • • • • • • • • ••• • • • • • • ••• • • • • • • • • • • • • • • • • • • • • • • • •• •• • • • •• •• • • •• •• • • • • •• • • ••• • • • ••• ••• • • • ••• • • Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING RECEOVED Permit No.ePOL1 — I �� PERMIT APPLICATION AUG 2 T 2004 M aster Permit No. FBC 2001 4y Permit Type (circle): Building) Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) Owner's Address City VntOro) 'S i-N;,:Zlr S State L Tenant/Lessee Name c 3`° Si Job Address (where the work is being done) P)"11 IV G) fi 57 City Miami Shores Village County Is Building Historically Designated YES Contractor's Company Name Contractor's Address City Qualifier State Certificate or Registration No. Certificate of Competency No. Miami Shores Village L,p ov50,1tI J Architect/Engineer's plicable) Phone # $ Value of W t ermit ) O 3D Square Footage Of Work: k: Phone # 1�1 — 47 — I n' Zip 3313' Phone # Type d dition ❑ Alteration ENew Describe 9 7U'C DrL1 \hIDv) A10 1r./pUl'v1.� J ❑ Repair/Replace ❑ Demolition 0 i * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** QQ ") Submittal Fee $ O a.) Permit Fee $ CCF $ Notary $ Training/Education Fee $ Technology Fee $ CO /CC Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) 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 conunenced 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. Owner or Agent Contractor The foregoing instrument was acknowledged before me this j..1 The foregoing instrument was acknowledged before me this day of t ) 200q by (_ r( 1A.11 C , a s (r r. day of , 20 , by who is person. y known to me or who has produced J CJ. 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 Sign: Print: My Commis on Expires: Chc 05/13/03 Signature NOTARY PUBLIC: Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * * * ** 7 **************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Plans Examiner Engineer Zoning VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT OWNER BUILDER DISCLOSURE STATEMENT I /44)4c c <c iM.b►a being the legal property owner, for the property Located at: GI , GJ P -12 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' al ork 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 $25,000.00 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is completed, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure that people employed by you have Licenses required by state law and by county or municipal Iicensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A. and with- holding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes and zoning regulations. Proof of ownership provided ( ) initial of reviewing clerk. The foregoing instrument Produced DISCLOSURE STATEMENT Was acknowledged before me this aZZ day of , 20 QL By ` r ^ •S rinCiTh who is personally known to me or who has • as identification • - ho did take an oath.' Notary I Con] = Expire 9 OFFl � P` �� Bonded ■ Atlantic Bonding Co., Inc. Tax Folio #: (owner) COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY WHEREAS, [$)\ C- ©SS 't1 , hereinafter referred to as the Owner of the following described property: Legal description/folio #: Lot C Ltsr )2.p - Block Subdivision MAC > , ,(. 4Wl/ iti S requests permission to install: ('Asphalt, concrete, brick pavers [ ] Landscaping []Other within the public road right of way of (address) IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows: I. To maintain and repair, when necessary, the above- mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the Land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligation has been canceled by an affidavit filed in the Public records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this gi day of (,k SIGNED. SEALED AND DELIVERED in the presence ofs M iami SIiore6 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 -2382 Telephone: (305) 795 -2207 Fax: (3051.756 -8972 A PPR °rict-t ldbe ` �l mmiss►or. '..-- 9�- nO0 iaes: Ell 13, 4 BondeAl al Inc. Atlantic Booming Co., • BUILDING / ZONING DEPARTMENT SECTION BY DATE ZONING • ELECTRICAL MECHANICAL PLUMBING FIRE PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL • • JOB ADDRESS y 77 Ale ?...7 APPLICANT (ASS PHONE APPUCA ION DATE W3d/cY 1)g tve-r4A-y SHEET OF MISCELLANEOUS ZONING : CRITIQUE SHEET COMMENTS 0)4D DPIverA4y // (ZS /yea s /De S 76ekics- (io'), 9 PERMIT NO. ADDRESS: MIAMI SHORES VILLAGE 1. Subject to compliance with alt Federal, Stat County, Vllage rules !miter/tattoos. Village usual/ no responstbTitty tor accuracy oflor resutts.fra these plans. 2. This copy of plans must be axalltble building site or no Inspection will be conclude INITIALS