FW-07-17 Miami Shores Village
�. 10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
� 0 Phone: (305)795 -2204 Fax: (305)756 -8972
R1 Permit
Permit Status: APPROVED
Issue Date: 1/5/2007 Expires: 07/04/2007 Permit Number: FW- 1 -07 -17
Owner's Name: WILLIAM DAVIS
Phone:
Permit Type: Fence/Wall
Parcel #: 1132060170390
Work Classification: Wire Fence
Block: Lot
Job Address: 405 99 Street NE
Section: PB:
Miami Shores Village, FL
Contractor(s) Phone Primary Contractor
Total Square Feet: 125
HOME QWNER Yes Total Valuation: $ 1,750.00
Required Inspg
Additional Information Final
Type of Construction: Wire Fence Additional Info: Foundation
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: 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. Futhermore, I authorize the above -named contractor to do the work
stated.
Fees Due Amount Invoice Number Amt Due Amt Paid
CCF $1.20 FW -1 -07 -27169 $132.72
Education Surcharge $0.40 Total:
Permit Fee - Wire & Wood $125.00 ck lim 0
Scanning Fee $3.00
Technology Fee $3.12
Total: $132.72 ))
Building Department File Copy 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.
Applicant Signature
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.22004 OJ g�Fax: (305) 756.8972
o `
BUILDING - Permit No. F IN � 1 -7 PERMIT APPLICATIO JAN ®3 2007 Master Permit No.
FBC 2004 BY -- _ --
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing J
Owner's Name (Fee Simple Titleholder) bw o 1l so 1A4 `y Phone #
Owner's Address 4os S
City_ +~° okal State Zip 3:5 { 3 8
Ten ant/I.essee Name Phone # 3 ca y < - 7 � 9 > `74.f
Job Address (where the work is being done) 4 o S tj ,++ . q �i sr
city Miami Shores Villa€ie County . Miami -Dade Zip -S t-5
FOLIO / PARCEL #
Is Building Historically Designated YES NO __ X
Contractor's Company Name 7 4 m ir A A a d'i Phone #
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
� I
Value of Work For this Permit $ 1 d °' Square / Linear Footage Of Work: 12
I
Type of Work: ❑Addition ❑Alteration �ew ❑ Repair/Replace El Demolition
Describe Work
1 4 1 l__
Submittal Fee $ Permit Fee $ 1 ®'' . ' CCF $ 1 ' an CO /CC .
Notary $ Training/Education Fee $ ° � Technology Fee $
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $ °ry
Structural Review. $ Total Fee Now Due $ )�
See Reverse side -�
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's address
V
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, BEATERS, 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 EMPROVEMENTS 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 Jbwt inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will n be approved and a reinspection fee will be charged
Si ature Si tore
Owner or Agent Contractor
The fore ing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day oKkNaAA, 200 ?, by M 1y(S day of . 20 by ,
who is personally own tome or who has produced 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 PUBLIC: NOTARY PUBLIC:
4 N Pt Notary pslbUc State of Florida
Barbara A Estep
Sign: 4 0584 Sign:
Print: Expires 03/29/2010 print:
My Commission Expires: My Commission Expires:
APPLICATION APPROVED BY: ! Plans Examiner
Engineer
/ Zoning
(Revised 02108/06}
i
VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
NAME: Dav I ' DATE: I �� lo?
ADDRESS: _ q ®S 0 Z
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 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 less. The building must be
for your 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 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, all 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 ri`"� --'
3. -1 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. I 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. I. understand that if any person gets injured on my construction project –they are
entitled to workmen'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 during recovery from injury.
Initial � w-
8. I understand that under state and local laws I can not do any Electrical,
Plumbing, Heating, Air & Roof work on my - property with out first obtaining
the proper permits by licensed contractors.
'Y
Initial
Was acknowledged before me this day of 20
BY 1>lR� S who was personally known to me or who has
Produced there License or as identification.
I .
OWNER NOTARY
"I Notary Public State of Florida
® a Barbara A Estep
My Commission ®4 ��
Expo vs 03/2912010 510584
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Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
nspection Number: INSP -36447 Permit Number: FW-1 -07 -17
Inspection Date: January 01, 2999 Permit Type: Fence/Wall
Inspector: Bruhn, Norman
Inspection Type: Final
Owner: DAVIS, WILLIAM Work Classification: Wire Fence
Job Address: 405 NE 99 Street
Miami Shores, FL Phone Number
Parcel Number 1132060170390
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Inspector Comments
Passed /
Failed El
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
For Inspections please call: (305)762 -4949
January 11, 2010 Page 1 of 1