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DRIVEWAYMIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed state„ u► isle plans and specifications herewith submitted for the build in¢ or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. / le42.21 _ _. . ,19. V) rl Owner's Name and Address ........... lam' e u' 0 ._ No.. _..... Street —L.,. k .. Registered Architect and /or Engineer Name and address of licensed contractors....... ! I /e qO tvtiesreOcrooll Location and legal description of lot to be built on: Lot Block Subdivision � Street and Number where work is to be done '92 ALE�_. State work to be done and purpose of building (by floors) /. CQte!Pe X... /./a 1/4/6cFad and for no other purpose. • New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundati� Roof Covering Estimated Total cost of improvements $ f iiC Amount of Permit S....1:) • Zone cubage required plan Cubage Distance .to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices be sent to. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obi' of labor under the Honda Workmen's Compensation Act, being Section 5 ►066, Compil and has complied with the provisions thereof, and will require similar compliance fro in the work to be performed under this permit; and will post or cause to be posted or notices as arc required by the Act. The undersigned agrees to employ only such pcnnit, as are licensed by Miami Shores Village. Remarks (Signe STATE OF FLORIDA, COUNTY OF DADE. ss' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No.._...`2 2 '.Q_..6 7 Date P - 1 i J Read, Sworn to and Subscribed before me. Disapproved :• .. Date (Signed) Building Inspector Chairman Member Member .. .. — ..._......_..._._...._....._ Council Approved Date NOTE: A charge of $1.00 will be made for the Planning Board. A rc•impeution fee of $L00 will be charged materials and/or workmanship. with reference PLANNING BOARD DATE to the building and eneral Laws of Florid contractors or sub-co ection on the ntractors, on arc its construction may as an employer ent Supplement, rs employed by hips work such public notice be performed under this to me well known, Notary Public, State of Florida My Commission Expires Member Member Member ...._ Disapproved Date making corrections or changes to this application after approval has been obtained from when such re- inspection is made necessary by improper notice for inspection or faulty 4+01/4)6 its. N E qs- '?P. pobsz Building Permit Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: BP2005 -473 Printed: 4/8/2005 Applicant: ALLISON ZELKOWITZ Owner: ZELKOWITZ ALLISON JOB ADDRESS: 420 NE 95 ST Contractor Local Phone: Parcel # 1132060140461 Contractor's Address: Legal Description: MIAMI SHORES SEC 2 PB 10 - LOTS 9 & 10 BLK 52 LOT SIZE 100.000 X Fees: Description Amount FEE2005 -4683 Building Fee $150.00 FEE2005 -4684 CCF $4.80 FEE2005 -4685 Training and Education Fee $1.60 FEE2005 -4686 Scanning Fee $3.00 FEE2005 -4687 Technology Fee $3.75 FEE2005 -4688 Builders Bond $300.00 FEE2005 -4689 Submittal Fee ($50.00) Total Fees: $413.15 Total Fees: $413.15 Total Receipts: $0.00 4579 . Permit Status: APPROVED Permit Expiration: 10/1/2005 Construction Value: $7,500.00 Work: REPLACE EXISTING ASHPHALT DRIVEWAY AND WALKWAY NEW PAVER DRIVEWAY Page 1 of 1 pv r t PAID Signed: (INSPECTOR) 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: MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request D /Gb /O Type Insp' n P i na I L7 l LICUJQ y Permit No. 1 2)RJ 433 Name Al ! 15Ur) z e_ 1 +Z Address 4}ZD r4E, 95 ST Company Phone # (3(.5 ) 458 3430 Inspection Date /CDR" /o5 Approved Correction Re- Insp'n Fee o� 0 k- 6/6443e Z 5 7 � 4 ('� MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Bu ing Inspection Request Date / Type Insp'n Permit No. Name Address Company 3OS as + - CZ 00 Phone # Inspection Date proved Correction Re- Insp'n Fee El BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) 1 / vt - 20,A I i'12 Phone # Owner's Address City M State Pt Zip '21 07 f Tenant/I,essee Name N /,a Phone # /A Job Address (where the work is being done) , iAv44c /1 ANS .D ...e City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO Contractor's Company Name Lt �ne Contractor's Address _ City Qualifier State Certificate or Registration No. Code Enforcement $ Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building D epartment 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 1 . State Structural Plan Review. $ r C c Master Permit No. Zip ur competency No. Permit No. — 4 Architect /Engineer's Name (if applicable) Phone # $ Value of Work For this Permit — 16 - 1..t.: Square Footage Of Work: (toUD c k l Type of Work: ['Addition ❑Alteration New tg. Repair /Replace ❑ Demolition Describe Work: VA L, aXth- , c't- s� A/' i vevi t.., '( t ' ` w / 1' e.AA" P ati .e -T tk i v e4"..) e U thn.S. � � 'k.e , k , t., ‘ le_ . i s urf' S t" t\ ¢)l #4.; tw.. 4c 1tl ; -' 1: Nn* c...t v`+- 1AT:!✓t . 1 6,`m * * * * * * * * * * * *** *** * * * *** * * * ** F * * * * * * * * * * * * *** * * * * * * * * * * * * ** Submittal Fee $`' .e. %r -' Permit Fee $ l S o CCF $ 50 CO /CC Notary $ Trai /Education Fee $ It 6 O Technology Fee $ Scanning $ 3 �� Radon $ — Zoning Bond $ 36V 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. 1 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 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 Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 OS, b)516 rL I ta/LQJ who is personally k _, AI • NOTARY P My Commission Exp * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 As identification and who did take an oath. n to nee or who has produced who is personally known to me or who has produced AP res: * * * * * * ** NOTARY PUBLIC: Sign: t _ ;, Mabel Vargas Sign: ' � omission 4 Print: ��� : *= Exeires: Jul 13 2007 Print: MP!xae0, :. Bonded t'hru \tlar.!!r gnvdine Co I nc * * * * * * *Ye* * * * * * ** * * * * * * * * * * * * * * * * * * # #* * * * * * Signature Contractor The foregoing instrument was acknowledged before me this . day of , 20 , by My Commission Expires: as identification and who did take an oath. ************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning • VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT OWNER BUILDER DISCLOSURE STATEMENT I. P1vx . 42_ being the legal property owner, for the property Located at: 4 Pe c4 e.A.4° e,.... 51 - Ft. 42-,‘W:), 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),gnd I have read and understand the following disclosure Statement, which entitles me td 3krbrk as my own contractor, I further understand that I as the owner must appear in person to complete all applications. Proof of ownership provided ( ) Was ac owledged before me this C4 By DIU In wt? . 77...3(LQ Produced DISCLOSURE STATEMENT 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 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 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. initial of reviewing clerk. The foregoing instrument day of 20(3S who is personally known to me or who has • as identification and who did take an oath. y reoc P�' \ I;tnti'' r t I Tax Folio #: 7//'/ iami Sh.ore 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 -2382 Telephone: (305) 795 -2207 Fax: (305)_756 -8972 f} 0 r4�� COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY WHEREAS, , hereinafter referred to as the Owner of the (owner) following described property: Legal descripttion/folio #: 4 Lot `� /0 Block 5"2- Subdivision f r t-Oc9. . P requests permission to install: Asphalt, concrete, brick pavers [ ] Landscaping []Other within the public road right of way of 4 � �1'' ' ' '4 -ee — 0.4- �,., '��lc -c , PL (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 tiie 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 owner SIGNED. SEALED AND DELIVERED in the presence of: _