833 NE 99 St (11)CI 3651
MIAMI SHORES VILLAGVQ)
BUILDING DEPARTMENT `9 1 �®
305- 795 -2204 3
Building Inspection Request
Date8 J22105 ��``��
Type Insp' 1 IICI I (Uc 1 k x:x<1 (aY K.J+� s
Permit No. 1 118 1
Name Adam 2'eic nCr
Address 83 a NE c lq -sr
Company a" rre r
Phone # ` 3 J 343- 6402
Inspection Date6
Approved
Correction
Re- Insp'n Fee
300
3534
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date D \NLS
Type Insp'n V ■Y\ \ W CA \ \l1JAy
Permit No. 1 LOOS " 1` 0
Name QfMM Z t Cth(UT
Address 3 Y'S Nt c c S
Company OULY1 ( ^ /
Phone # "S(, 13 l � CC �
Inspection Date I(( I105
Approved
Correction
Re- Insp'n Fee
? Gob Culled -Th a4teacJ y 774tE
So owe of "I\Noik cup, o wog
l v
&Q A T All piTiwov Iv( CM
CmltsloT ; 1/.4( 1. , 1 6 0)k. - r\ f .
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 8/12/2005
Applicant: ADAM
Owner: ZEICHNER
JOB ADDRESS: 833
Contractor
Local Phone:
Parcel # 1132060340120
Signed:
NE 99
(INSPECTOR)
Building Permit
Permit Number: BP2005 -1178
ZEICHNER
ADAM
ST
Contractor's Address:
Page 1 of 1
Permit Status: APPROVED Permit Expiration: 2/5/2006 Construction Value: $600.00
Work: REPLACE FRONT YARD WALWAY
Legal Description: MIAMI SHORES SEC 8 PB 14 - 33 E1/2 OF LOT 16 & LOT BLK 169 17 LOT SIZE
Fees:
FEE2005 -11113
FEE2005 -11114
FEE2005 -11115
FEE2005 -11116
FEE2005 -11117
FEE2005 -11118
FEE2005 -11119
Description
Building Fee
CCF
Notary Fee
Training and Education Fee
Technology Fee
Scanning Fee
Builders Bond
Total Fees:
Amount
$100.00
$0.60
$5.00
$0.20
$2.50
$3.00
$300.00
$411.30
Total Fees: $411.30
Total Receipts: $0.00
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:
BUILDING
PERMIT APPLICATI
FBC 2001
Permit Type (circle):
$ Value of Work For this Permit
Submittal Fee $
Notary $ 5 -0
Scanning $ 3.
Code Enforcement $
(Continued on opposite side)
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
Total Fee Now Due $
1
1. 30
Miami Shores Village
Building Department
100 0 v e " 5�ta ' r hores, Florida 33138
305) 756.8972
Owner's Name (Fee Simple Titleholder) Adair Ze id /in e r Phone # . O ,3 T 3 - 5 6�
Owner's Address 833 (V o r4A.ea . iL qq SZ/'eel-
City M(a S;.ot es State FL Zip t'3$
Tenant/Lessee Name Phone #
Contractor's Company Name 00 / Phone #
Contractor's Address
City State Zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Master Permit No.
Electrical Plumbing Mechanical Roofing
M/ %eaf gI 9c S-ftseeti-
County Miami -Dade Zip ? O$
NO
Square Footage Of Work:
Type of Work: EAddition ❑Alteration ❑N Er Repair/Replace 111 Demolition
Describe Work: &p/ac iMr+� yA/G� wa�,C y A,/ 4%. 6rYCkp1Ne✓fi.
* * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Permit Fee $ 6 CCF $ 0 • 0 0 CO /CC
Training/Education Fee $ 0 • 2-0 Technology Fee $ 2 50
Bond $ cO
Radon $ Zoning
Structural Plan Review. $
dft
Ali K "12 PAID
U/K 445
Permit No. 1 3RD5 — ) )7S .
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
)1 Signature
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.
Owner • /Agent Contractor
The fore •ing inst ment was acknowled ed�b this Mr c p s O The foregoing instrument was acknowledged before me this
day of :. 203, by /*P) -I or lJ� C h /� '
day of , 20 , by
who is personal wn to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY P' BL ' : NOTARY PUBLIC:
Sign: '� t,�YN�3 f S
'? 3 9R , Sign:
Print: Print:
My Co r mission Exp
APPLICATION APPROVED BY:
Chc 05/13/03
it
Atlantic Bonding Cr Inc.
Signature
who is personally known to me or who has produced
My Commission Expires:
***************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
* ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** � k* * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
By
•
Proof of ownership provided ( )
Was acknowledged before me this
Owner
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE STATEMENT
I illam 2eich,iel' being the legal property owner, for the property
Located at: 3� NE 90 S' reef fr Ia►44t S''lpe FL 3' 7323 ,
E. v t' 104 14 4'...4 a block Wi, i c -' sia., ds seetCon 8
Legally described as ; • ,'. ■ - •• , 44 .00 + • - - 0# , ' the P14 rec wys
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the m f F ig; 0 4,•+r
State of Florida, F.S. 489.103(7),And I have read and understand the following disclosure D"'� : we l l
Statement, which entitles me t6 a ork as my own contractor, I further understand that I as the owner / �t�
must appear in person to complete all applications.
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 $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 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 cl k. The foregoing instrument
day of 0
who is personally known to me or who has
Produced �� !- as identification d who did take an oath.
Ma
Commiss
Expires: J
. Ronded Thru
Atlantic Rnndina ('o
Inc
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE. FLORIDA
❑ PERMIT N?
❑
BI.
Work to be performed under this Permi
Subdi-
vision
Sq. Ft
Value of
Project $
19 g
'' � ` ^� 4 I AT Cbn #ractor
1 License No •
7 P,,
Amt. of
Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with' any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed • BY
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 responsibility for all work done,by either, myself, my agent, servant or employee.
, ' 1'T f a
CONTRACTOR OR ,BUILDER BY AUTHORITY