DRIVEWAYIssue Date: 9/12/2006
Owner's Name: ALEXANDER /GWENDOLYN ZALDIVAR
Permit Type: Driveways /Sidewalks /Slabs
Work Classification: New
Job Address: 1200 94 Street NE
Comments:
REPLACE ROCK DRIVEWAY WITH CONCRETE
Additional Information
Miami Shores Village, FL
Fees Due Amount
Bond Type - Owners Bond $300.00
CCF $3.60
Education Surcharge $1.20
Notary Fee $5.00
Permit Fee $175.00
Scanning Fee $3.00
Technology Fee $4.38
Total: $492.18
Building Department File Copy
Applicant Signature
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Expires: 03/11/2007
Contractor(s) Phone Primary Contractor
HOME OWNER
Yes
Type of Work: DRIVEWAY Additional Info:
Bond Return
Classification: Residential
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.
Invoice Number
DS - 8 - 06 - 25752
Total:
Parcel #:
Block:
Section:
Total Square Feet: 2500
Total Valuation: $ 5,800.00
Re • uired Ins • ections
Foundation
Sidewalk
Landscaping
Final
Amt Due
$492.18
Permit Status: APPROVED
Permit Number: DS -8 -06 -2051
Phone:
1132050100230
Lot:
PB:
Amt Paid
EP1
(/
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.
BUILDING
PERMIT APPLICATION
FBC 2004
Tenant/Lessee Name aViaI°
Job Address (where the work is being done)
City Miami Shores Village
FOLIO / PARCEL #
Contractor's Company Name
Contractor's Address
Is Building Historically Designated YES
City State
Qualifier Name
Architect/Engineer's Name (if applicable)
Value of Work For this Permit $
Type of Work: ['Addition
Describe Work: 1„/' �_♦ / f '(/'
6 -,_„do 3 - 7 o.D
Miami Shores Village o 3a rzk
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Type (circle): cuilding) Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) t /7 Z[.e✓// �L / emu / Phone # ?j' QS29e 97
Owner's Address /2--eV /L6 9f/ ST
City , .LLe)r S State PZ
5fv
/,2OO A J .9v sr
County Miami -Dade
NO
Zip I;
Master Permit No.
Phone #
Permit No. is 0(0 — o?
Zip 5 5S
Phone #
Zip
Phone #
State Certificate or Registration No. Certificate of Competency No.
Phone #
Square / Linear Footage Of Work:
❑Alteration ❑New Repair /Replace ❑ Demolition
e s************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ d` �� . CCF $ '6c71 CO /CC
Notary $ Training/Education Fee $ - Lk/ Technology Fee $ 4,5g
Scanning $ '(X) Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ 492 • S
See Reverse side -->
Bonding Company's Name (if applicable)
•
Bonding Company's Address
c ,
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
Sign:
Print:
(Revised 02/08/06)
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
i
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Signature
wner or gent Contractor
The foregoing instrument was ac owledged before me this / it The foregoing instrument was acknowledged before me this
, 20 _
day of T (1(r , by 6/A y 11 LAS tl /U 1 day of , 20 _ , by
who is personally known to me or who has producedZ' Z6 N-X7bho 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:
******************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
NAME:
ADDRESS:
VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
DATE: 9
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 [have read and understood the following disclosure
statement, which entitles' me to work 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 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 Tess. The building must be
for your owmuse and occupancy. It may not be built for sale or lease. If you sell dr 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,_alt 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
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
. .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. f' 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.
Initial
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'any contract disputes.
Initial
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.
Initial
7. , tunderstand that if any person.gets injured on my construction project —they are
entitled to wdrknien'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 duripg recovery from injury.
By &Ad/ ym -TS z /4/rvV
Produced there License or / !r/O%^S
Initial
8: I. understand that under state and local laws I can not do atiy Electrical,
Plumbing, I Ieatin:g, Air & Roof work on my property witeut first .obtaining
the proper permits by licensed contractors.
Was acknowledged before me this it day of � �j�T 20 OK.
who was' personally known to me or who has
XS ° as identification.
nspection Number: INSP -23789
Inspection Date: 09/25/2006
Inspector: Desharnis, George
e r g , 2 5 TM
Owner: ZALDIVAR, ALEXANDER/GWENDOLYN
Job Address: 1200 94 Street NE
Project: <NONE>
Miami Shores Village, FL
Contractor: HOME OWNER
Building Department Comments
Friday, September 22, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Number: DS -8-06 -2051
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Phone Number
Parcel Number 1132050100230
Lot:
Page 1 of 2
Passed
Inspector Comments
'1 ' L G ,
P2.--
9 2
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
nspection Number: INSP -23789
Inspection Date: 09/25/2006
Inspector: Desharnis, George
e r g , 2 5 TM
Owner: ZALDIVAR, ALEXANDER/GWENDOLYN
Job Address: 1200 94 Street NE
Project: <NONE>
Miami Shores Village, FL
Contractor: HOME OWNER
Building Department Comments
Friday, September 22, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Number: DS -8-06 -2051
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Phone Number
Parcel Number 1132050100230
Lot:
Page 1 of 2