386 NE 99 St (4)C
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE . ,
Date � S 9 Job Address twf+ /V F 9'9 , '$' C .. Tax Folio ) / — 3 c .C77 0 /3 -5-5-S 4C)
14eA,rl■ SW adlic S� I Ms-vp PQ co
Legal Description _ _ $[x y/ Historically Desi : Yes No
Owner/Lessee / Tenan n/; ..5 m Uv 7 CAL/ Master Permit # q5 LI 3 8
Owner's Address 9'6=2 A} E 4 1 11 44.--- _ / 1 .51. ieS 33(3? Phon f)S— 7.5 9 —3 T'�`
o \e!/1/4lE
Contracting Co.
Qualifier S / daU et./ #JGk/ i L SS# ." Phone /. .F5-4i-z>26/-7770 70
State # 4 500 / 3 — 7 Municipal # Competency # Ins. C o. S,d L n.
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOTING PAVING FENCE SIGN
� / ire - i r
WORK DESCRIPTION 2c-Ss$U� �ea �J `� (rz .. F - 2 wh AGZt�cT� X ored
Square Ft. . a .- 7c-E
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 AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will
construction and zoning. Furthermore, I authorize the above -named contractor to do the work stat
APPROVED:
Zoning
Mechanical
Building
M ° L - e V/ S ( 4
Notary as to er and/or Condo President Date
My111, SiOnklik. Ulmer
x ,., Commission # CC 733051
if Expires May 19, 2002
1, BONDED THRU
OFD ATLANTIC BONDING CO., INC.
FEES: PERMIT q 19 . - RADON
Address £ .)1(A) 1140Mu 32 169
4 s S AJ E `�'.
Address M a- Uo. )-r 'M: 8 . 33/6 7
Address A-/ a-
Address ja/o—
MArCX C.hur�h s fvf»�A /f6 vS €; t)`
3 ate, oo pet
Estimated Cost (value)
ctor or
er- Builder
ignature
Notary a=ractor or • 1 , - . - :
MyC•1 1' nE
N CO 1 ? on # CC 733
4 ires May 19, 2802
BONDED THRU
ATLANTIC BONGING CO., INC.
C.C.F. I . NOTARY
Electrical
with all applicable laws regulating
BOND
TOTAL DUE 1 -1 d 2, 3 S
c`S /99
ate
Plumbing Structural Engineer
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date) -9 17 • Job Address tie. gel ST . Tax Folio t/ _14,0 a c(9 i
Legal Description /'f ii/ /neLie //
Owner / Lessee / Tenant r� 1•A,t li S NOB � 'Jill') C Master Permit # �7�J `�
Owner's Address 9 3 9 6 . 4 L Phone 7 .7 3 4/9
Contracting Co. Address
Qualifier SS# - - Phone
State # Municipal # Ins.Co.
Architect /Engineer
Bonding Company
Mortgagor
Permit Type(circle oneUILDING ELECTRICAL PLUMBING MECHANICALL ROOFING PAVING A FENCE SIGN
WORK DESCRIPTION •1.
2%00
Square Pt. Estimated Cost(value
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 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. Furthermore, I
authorize the above -named contractor to do the work stated.
Sig'ature of owner and /or Condo President
Da ee • f - 2=�- '4
Not =ry as to Owner and /or Condo President
My Commission Expires:WARY PUBLIC STATE OF FLORIDA
MY CO/MISSION EXP JULY 22,1994
BONDED THRU GENERAL INS. UND.
** * * * * * * * *
FEES: PERMIT 37 5r RADON
APPROVED: Fire
Zoning Buildi
Mechanical Plumbing
!SS
Signaturon -car mer- wilder
Date: l -2.5-9S i 0
_.24
Not ry as to Contractor or Owner - Builder
My Commission Expires NOTARY PUBLIC STATE OF- FLORIDA
NY COMIISSION EXP JULY 22.1994
BONDED THRU GE1ERM. INS. UND.
* * * * * * * **
C.C.F. tO9 NOTARY TOTAL DUE 305d
14
0 5d
14
Other
7.1 4i Electrical
Engineering
Per 489.103(7) F.S.S.
State law requires constriction 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 youurself.,
You may build or improve a one - family or two - family residence or
a farm outbuilding. You may also build or improve a commercial
building at a cost of $25,000 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 more than one building you have
built yourself within one (1) year after the construction is
complete, 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. Your construction must
be done according to building codes and zoning regulations. It
is your responsibility to make sure that people employed by you
have license required by state law and by county or municipal
licensing ordinances.
■ - 2s -
DISCLOSURE STATEMENT
Date Owner's signature
Village Use Only
Owner's name print ), Ark SrIVEt:: CO 1'1 rC 11 Cki
Permit No.
You have, this date, made application for a building permit as an owner -
builder. You should be advised of the following provisions and reauirements
that apply to owner - builder.
Proof of Ownership - Prior to a building permit being issued to you,
you must submit proof of ownership of the land concerned in the
application in the form of a recorded deed, showing you own the property,
or a copy of mortgage or warranty deed of the land, or a Dade County tax
receipt, statement to contain legal description of property and indicate
property is in your name. Legal description and name on document of proof
must correspond to the name and legal description on the application.
Responsibility - You will be responsible for all work done by your day
labor employees, and you must either employ licensed contractors or
persons to be paid on an hourly or per diem basis. Any one contracting
(including labor) with you, verbally or in writing, on a fixed fee basis
for any work, who is not properly licensed, will be subject to a fine of
$500.00 and /or imprisonment for six months.
Insurance - You should be advised that if your day labor employees cause
any damage to persons or property, or if any of your day labor employees
are injured on the job, you are liable. Your regular home insurance
policy ordinarily does not cover this type of liability.
Withholding Taxes, etc. - You should be advised to investigate your
responsibility for withholding Social Security, Federal and State
Unemployment Insurance Taxes and Federal Income Taxes from the wages
of employees working for you on the proposed construction, and for
making returns thereof to the proper agencies.
Work Permitted Owner - Builder - An owner - builder subject to the foreaoina
provisions and requirements, is limited to constructing one single family
residence each year for his own use and occupancy; or maintaining, altering
or repairing his own single family residence.
If you do not intend to do the work involved yourself, or with day labor, please
list below, the name of the individual or firm with whom you have entered (or
will enter) into a contract for the work.
NOTICE: SEPARATE PERMITS REQUIRED FOR ELECTRICAL, PLUMBING,
ROOFING AND MECHANICAL WORK
Name of Individual or Firm Address
I, the owner of property described as 'rt t A ri l' 5.3.140
C d ri tC U 13—i fit CH1_72. --
that I have read the foregoing instructions, and am aware of my responsibilities
and liabilities under my application for a building permit for construction work
on the described property.
° ----i Witness
MIAMI SHORES VILLAGE BUILDING AND ZONING DEPARTMENT
INSTRUCTIONS TO OWNER- BUILDER
do hereby certified
e be(-
Owner
c y ® -
ae