PERGOLAPROPERTY OWNER
New Construction
Name i
Enclosure
Address s�s___ /U. 9 rsr.
Alteration Exterior
Home Telephone -- 2J ! - 3 / 2:.3
Repair
Business Telephon( J j \ F _ 01_6
c
3
Fax Cs.) /[� Z —7 2- 6 3
Demolish
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'I Detachment
Other
I II
i II
II
INSTRUCTIONS - 'Elbe following steps must be taken to ob'ta'in a permit from the Miami Shores Village:
T ' 11 RECE VED
� E. 2 2
4! �'NrEa a � b
� 2003
\ORIDP' J�,
Step I.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
APPLICATION
Job Address:
Folio Number
Lot Block (itr i1'/ /
Subdivision PB PG Zoning Linear Feet
Current Use of Property_ Square Feet Units Floors
Proposed Use of Property (Value of Work FC `I--2- Bldg Value
Tenant Information _ Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT TYPE ( ✓
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
F
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit-
ted along with this permit application.
Address
Apt.
KY16
c33 /3y
State Zip
a 6:400 escription of Work CC l)
Master Permit No. 1 9 `2-� S
Subsidiary Permit No.
M ( AL
City
ENGINEER
Name
License No.
Address
Telephone
F
CONTRACTOR
Nam`
License No.
Address
Telephone
Qualifier Name
PERMIT APPLICATION
Page 2
INIPORTAN'I' NOTI
DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
TATE OF FLORI ,pIUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Owner Signature of Contractor / Qualifier
1
Print Name ^�
wo o and subscribed before me this c day of
N.tr
Mabel Vargas
Commission #D02321090847 Si . e of Nota bl � '" . •PP, Bgied Thru
Atlantic Bonding Co., Inc.
SEAL:
l)l2. --9 7 6 -�
Print Name
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
SEAL:
PERMIT APPLICATION
Personally known OR, Produced Identification ‘ /'‘ Personally known OR, Produced Identification
Type of Identification Produced:D \ J (13W-3 ' o 1(�A - -- C) Type of Identification Produced:
etce aooO
ELECTRICAL 11
'I'1'I'P. i 1
Minimum Fee
Q"I'1'.
9
1
TYPE !
Dryer
(jTY.
1
i 'I'YPE
Outlet, Appliance
Q I'Y.
'ivPI•:
Service Repair
) I'1'.
A/C Central 1 -3 Ton
Paint Booth
Fan
Air Handler, Tons
Outlet, Wall
Piping, Flammable Liquid
Service, Temporary
Barbecue
A/C Central 4 -7 Ton
Process/Pressure Piping
Fire Pump
Bath Fan - Vented, #
Outlet, Switch
Pressure Vessel
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16 -20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL 1 1 1
.I,yI,I'- I II QTY. TYPE, J
Minimum Fee Condensate Drain
!
QTY. "1'Yl'I:
Generator
1
op'. TYPE Q'I'V.,
Refrigeration, Tons
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Filter Replace
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Sprinkler Repair
PLUMBING f II
TYPE 1 1
A/C Condensate
QTY.
I
TYI,I.,
Drains, Roof
I
QI''.
I
' i'I:
Miscellaneous Fixture
I
QIIY
.LVpp
Soakage Pit
Q.L1•
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
1 II 1 1 JII•'''.11I'IWBi 1 111
Pagc 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
D TE
Zoning
e" )..
r'/ 3 / ) s
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
❑ CONCURRENCY
(New Construction)
O OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
Notary
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
I' RI\IIT FEES
$
(s .6. x/1000
(¢.005 / sq.ft.)
(¢.01 /sq.ft.)
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
PERMIT APPLICATION
O CONTRACTOR REGISTRATION
(On File)
TOTAL $
ISSUIN O FFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 -795 -2204 Permit Number: BP2003 -1215
Printed: 8/14/2003
Applicant: ANNE
Owner: WRIGHT
JOB ADDRESS: 825 NE 98
Contractor
Local Phone:
Parcel # 1132060142480
Fees: Description Amount
FEE2003 -5013 Building Fee $60.00
FEE2003 -5014 Notary Fee $5.00
FEE2003 -5015 CCF $0.60
Total Fees: $65.60
Total Fees: 49.
Total Receipts: _ $b0F
Permit Status: APPROVED Permit Expiration: 1/18/2004 Construction Value: $850.00
Work: BUILD A PERGOLA (WOOD)
Signed: (INSPECTOR)
Building Permit
WRIGHT
ANNE
ST
Contractor's Address:
Page 1 of 1
Legal Description: 5-6 53 42 MIAMI SHORES SEC 3 PB 10 -37 LOT 15 & E1/2 OF LOT 14 BLK 72 LOT
a
C cL.-5\n �
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:
•
FLOOD ZONE: X
1
Not valid unless embossed
with Surveyor's Seal.
Az
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7
S CAL L_ //
'I'h.i.s property described as:
Lot 15 and the East 1
of Lot 14, Block 72,
MIAMI SHORES SECTION NO. 3,
according to the Plat
thereof, as recorded in
Plat Book 10, Page 37
of the Public Records of
Dade County, Florida.
CertifiedTo: Atlantic
Coast Title, Llotne Savings of
America, F.A. and Wright,
Robert and Walsh, Anne,
Marty Patrick, P.A. and
Attorney's Title Insurance
Fund, Inc..
A BOUNDARY
Note.: Underground encroachment
and utilities, if any,
not located.
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SURVEY
I hereby certify that the survey repre-
sented hereon meets the minimum
technical standards set forth by the
Board of Land Surveyors pursuant to
Section 472. 27, Fla. Statutes. There are
no encro
app;
shq n
ments, overlaps, easements
g on the P . , other than as
hereto. -
Fla. Reg. LandJ,i rveyor No . 4 32 '7
/€ '2 V / litc
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,
4
DATE
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(
SCALE
1/
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DRAWN BY
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F L N f�l'E S and G A R C I A, INC.
ENGINEERS - LAND SURVEYORS - LAND PLANNERS
-
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PROPERTY OF: Wright, Robert & Walsh, Anne, 825 N.E. 98th Street, Miami Shores
Office address: 4080 S.W. 84th Avenue, Miami, Florida 33155
Mailing address: P.O. Box 561131, Miami, Florida 33156
DRWG. NO
189 -62.3
{
PROPERTY
LINE (TYP)
SITE FLAN
75_00'
EXISTING
CONCRETE
SLAB
EXISTING
ONE - STORY
RESIDENCE
15' -0'
Zoning
Approved
/3
MIN. 10' -0'
SETBACK
1/8' = 1' -0'
S1-1,41D
51- 1AFIE, P.E. ,
License No.
55164
1161 NE. 98th
Street
Miami Shores, FL
33
(305 914
i
Bads
Moot Ittha
®..t r,®e.r
8 5 /d, 3
NOT VA D FOR COY37W.CTION
(MESS MEI IN THIS BOX
Data
AUG. 5, 2003
SITE PLAN
AS NOTED
11
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an
1' -
I' -
I' -0'
1' -
l' -0'
15' -
- 0' , 1' -0' 1' -0' � 1' -0' , 1' -0' I' -0' , I' -0' l' -0' , 1' -0' , 1' -0' j ,
/1
v
V
/1
1/2' = I' -0'
FIRA" iINCA FLAN
2X6
BLOCKING
2X6
BLOCKING
2X6
CROSS
PURL INS
2X10
BEAMS
6 X6
POST
1
SHAD
SHAFIE, PE.,
License No.
55164
1161 N.E. 98th
Street
Miami Shores, FL
331
(305)
NOT PAW FOR1:41FRL'C D
MESS SICCED W. TM.' BOX
AUG. 5, 2003
/Moot !Ulm
PLANS, NOTES,
AND DETAILS
AS NOTED
qtr
2
1' -6'
I' - 0'
1' -0'
1' -0'
15' -0'
1' -0' / I' -0' / I' -0' I' -0' l' -0' / I' -0'
1/2' = 1' -0'
15' -0'
I' -0'
1' -
NOiRTI -I ELEVATION
I' -0'
2X6
BLOCKING
1' -0'
1' -0' , 1' -0'
-6'
2X6
CROSS
PURL INS
2XI0
BEAMS
2 -3/4' D!A.
BOLTS (TYP.)
6X6
POST
FINISH
GRADE
1' -6' DIA.
X 2' -6' FTG.
6' GRAVEL
BASE
a
1
SHAD
SNAFIE, P.E.
Bm1a
License No.
55164
IIb I NE. 98th
Street
Miami Shore*, FL
3
914
HOT VA D ;'-OR cONSTROOIDN
UIESS MED w 'MIS BOX
w
U
Z
w
co
w
H
Er
Data
AUG. 5, 2003
PLANS, NOTES,
AND DETAILS
AS NOTED
Base Razae.r
3
A} rwAVIT
STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant, WOitsfle 7 ;- 7 , does hereby attest that the
(property owner)
attached survey, performed by �,3 -�. v� S r �� ,4 ; c r 4 -
--, (name of surveyor's company)
performed on ,'i l ly 5 , is an accurate representation of the existing conditions and
(date of survey)
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the
property without first providing a survey less than six (6) months old. The Affiant, as property owner, further
agrees to remove or obtain permits for any structures which now may exist on the property which are not
permitted or which may violate zoning or building code regulations. The Affiant further understands that the
existence of any such structures may affect final inspections as applicable to this or other permits..
Further, Affiant sayeth naught.
Affiant/Property owner
Witness(sign and print) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this 2_ day o
Doi Wv
Affiant is personally kaown tome, produced UJ fOa 3'64 -248' -36$ -O as identification.
e Paccie,
Y iabe argas
;►p
:Comm ion #DD23198
aa Expires: Jul 13, 2007
v . Bonded 'Mini
,,,, " Atlantic Bonding Co., Inc.
(e) Flat roofs are permitted on additions
to existing pitched -roof structures
providing:
(1) A cement or tile roof is not
practical, and this shall be de-
termined by the planning board;
(2) The addition shall not exceed
15 percent of the ground area of
the pitched roof section of the
existing buildings, or a maxi-
mum of 300 square feet, which-
ever is greater (any existing
flat roof sections shall count
against allowable new area);
(3) The addition is not visible from
the front elevation of the build-
ing on an inside lot, or is not
visible from the front or side
streets elevations on a corner
lot;
(f) Metal or fabric roofs are permitted
to cover porches, patios and carports
in residential districts, providing:
(1) The structure is located in the
rear of the building and shall
be situated so that it is between
the prolongations of the side-
lines thereof and;
(2) The metal or fabric roof mate-
rial shall be colored by a factory
process and shall be harmoni-
ous in color with the main build -
ing; and
(3) The area covered by the metal
or fabric roof shall not exceed
15 percent of the ground area of
the main building, or, a maxi-
mum of 300 square feet, which-
ever is greater.
(g) All roofs having an incline of less
than two and one -half inches per
foot shall be constructed of build -up
roofing material and gravel modified
bitumen, or fiberglass cap. Any sub-
stantial change from existing mate-
rials in place, shall require the ap-
APPENDIX A- ZONING
CDA:49
proval of the planning board for
aesthetics and harmony with other
buildings in the proximity thereof;
(h) Trellises, arbors, and pergolas: A
heavy framework of cross timbers in
an ornamental openwork construc-
tion of woods serving as a protective
screen, not to exceed in height the
roof eave line on a single -story resi-
dence to which :it is attached, or not
to exceed ten feet in height on a
detached structure; in rear yards not
to exceed more than 20 percent of
the area of the yard; with minimum
setbacks as follows: Front yard, 25
feet, side yard, ten feet, and rear
yard, five feet, to be designed by a
registered architect and constructed
of one of the following: pressure -
treated Southern pine, cedar or red-
wood; with minimum timber sizes as
follows:
(a) Support columns —four inches
wide by four inches deep,
(b) Main support beams — nominal
cross section of 16 square inches.
This subsection shall not be con-
strued to permit the erection of
chickee huts, which are prohibited.
(5) Seamed metal and metal shingles in com-
mercial zones only.
Any change in commercial zones from existing
materials in place, shall require the approval of
the planning and zoning board.
(Ord. No. 403, §§ 1, 2, 7- 18 -78; Ord. No. 417, §§ 1,
2, 4 -1 -80; Ord. No. 433, §§ 1, 2, :10- 20 -81; Ord. No.
450, §§ 2, 4, 12- 21 -82; Ord. No. 461, § 1, 12 -6 -83;
Ord. No. 543, §§ 1 -3, 9- 25 -91; Ord. No. 553, §§ 1,
2, 12 -1 -92)
(i)
§ 524
DIVISION 8. NONCONFORMING USES
Sec. 524. [Continuation.]
Except for nonconforming signs as provided in
Section 527, a building in which a nonconforming
use is conducted may be:
(a) Continued at the extent of occupancy of
land and floor area and intensity of use at
which it existed when it became noncon-
forming;
JOB ADDRESS _E ?-5 Al 6-/S- S T.
APPLICANT Q I L b1
PHONE It
APPLICATION
DATE
1 T8T Ntl * * * * *fl
PeL' So�a
SHEET OF
MISCELLANEOUS
ZONING
7/3d/0 3 5 2 c 0 !/o)5 (L 6 7 1, l;' 1071/ / ____
1/C - " ' T) NOT /.0 cc a7 z 7
NO „T£,00 0 /T T
3WI1 3edd 39dd
300 1101 x21/xi 32301S
CRITIQUE SHEET
COMMENTS INITIALS
( - 5 T
se //6 /A/ € z2 '64-4/ 5 56>C€7
/7 C71 c - i , vG/4 1 E
(> 5 .,0 (/0 47V e 92(S')
/14(4-5 r ,'E= dti ,4 vx
89Z75L50£6
* ** 1d0d3c1 NOISSIWSNtl211
N0IId001
PERMIT (O.
ADDRESS:
MIAMI SHORES VILLAGE
BUILDING / ZONING DEPARTMENT'
SECTION BY DATE
ZONING
ELECTRICAL
MECHANICAL
PLUMBING
FIRE
PUBUC WORKS
STRUCTURAL
BUILDING OFFICIAL
1. Sublect to ocaptleece with di Federal, Slate.
Counntl; rtAds end regutatbns, Vtttags es+uates
eo re ponstblitly for coovracy ear rosette Nat
these plans.
2. Tbit copy of plans mat be %reliable ea
bu8ding Litt or co Inspect/on VII be condotled.
=39tid 21021213
XI 80 :?T 0£ /L0 ZT9
3WI1 ' °N
3QOW 121t/IS 37 13
-- • - - =213W i..L
?L6895L508: Xtl3 - -- 39ti l 1 I 11 S3c10HS I Wtl I W Q I 8(:):T £0. 0£ /LO 1411 .LN 121d
PERMIT NO.
ADDRESS:
MIAMI SHORES VILLAGE
BUILDING / ZONING DEPARTMENT'
SECTION I BY
DATE
ZONING •
ELECTRICAL
MECHANICAL
PLUMBING
FIRE
PUBLIC WORKS
STRUCTURAL
BUILDING OFFICIAL
1. Subject to oonaptiance with aft Federal, State,
County. Village rotes end regutattcns, W1*ge ess
no responsibility toe accuracy odor results (rasa
these plans.
2. This copy of plans mutt be avallible on
bufding site or no Inspection will be conducted.
CRITIQUE SHEET
JOB ADDRESS Z �' ! g S /
APPLICANT (l / I Lr f
PHONE (#
APPUCATION Pe ci a / 0.
SHEET OF
MISCELLANEOUS
DATE
ZO
COMMENTS
4(-Arkavoi
INITIALS
7/36/ D 3 05 / 2 E 7` 1 /`1 Eh/ 57 /v5 (( 16 Pi, G./ 07N
/7C /L/1 T) 42°T /RiCuet.
- T c T u X 4 - 6 - Z
STS C /11/ A2 e7) /
y c 1-(i7 2- f e /Al t: e
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MSS ( /3e dam/ AA7v5
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Located at:
Owner
Owner
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE STATEMENT
67 being the legal property owner, for the e ro
P Prh'
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),And I have read and understand the following disclosure
Statement, which entitles me to a'ork as my own contractor, I further understand that I as the owner
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 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 - 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.
Proof of ownership provided ( ) ‘4Y initial of reviewing clerk. Tlie foregoing instrument
Was acknowledged before me this l- day of y� 1 , 20 CPD
By 12-09e ()J V 1 911 r . who is personally known to me or who has
Produced O ().Q. 1.0c43- %4 -G as identification and who did take an oath.
p : Commi # 00
. - gXpi: J ul 13,2 0
B
Atlantic Bonding Co., inc.
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date 9/Z9/ 3 Time
I y , o tc(
Type Insp'n n
Permit No. 63P 2003 lZIS
Name ?o b e Q-T CR) r i 5L, i
Address $ ZS W6 98 ST'
Company
Phone # 30S- 75* 3(2.3
For Inspector: I P '? O 103 Name & Date
Approved
Correction
Re- Insp'n Fee ❑
Type Insp'n
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305-795-2204
Building Inspection Request
Date 9/14 r - Time
Permit No. 1- -- 1 ) 200 3 — 1 2 15
Name
loLeIZY (JO r 1'117,T
Address ?\ Z S JE :=
For Inspector: 1-?)I-- rill° 103 Name & Date
Approved
Correction
Re-Insp'n Fee
Company
Phone # 7'3* ( 2
ferffolg
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date
Type Insp'n�"7 G
Permit No. �1' cXIC/3
Name 1. n �
Address 52 S t E 96S4
Company
Phone # D-r,G3
For Inspector: t Ja G Name & Date
Approved
Correction
Re- Insp'n Fee
›itt
c_7 'I c 4
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date / > Ti e
Type Insp'n C1� y nu
Permit No. P � J 3 - --1)71S -
Name U�J 6 \ ` n
Address `n2 S N 1 KS-4-
Company
Phone # 96a-
For Inspector: c O
l G
Approved
Correction
Re- Insp'n Fee
❑
Name & Date
&LP
MIAMI SHORES VILLAGE, FLA. N° 5951
JOB r4- P 5 ..✓
ADDRESS k 2 6 &
INSPECTION Ag4 J
TIME READY 7' 429--
REMARKS:
INSPECTOR (.4-V%
DATE 4" �-
f �
Ci 41 .��+(°+O
� PAID BY
6-26-50
YEAR
ANNUAL TAX
PERIOD USED
AMOUNT PAID
DATE PAID
RECEIPT
NUMBER
40/%94y /i /oL! - sa
J. /le:CJer/
/9-Sf
/y S ;1-- ,/
/ c "
/05. -315/
j(- s : 2--
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4-
ero
$
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ADDRESS 825 N. E. 98th St.
LEGALLOtE214- 15,B1k.72, MSS #3 RECORD GARBAGE TAX
O"VNER;
-'-
PRESENT ADDRESS
LICENSE NO.
;, -,---;.,
PHONE NO.
RYAN, L.
JOB LOCATION (ST. OR AVE.)
825 N. E. 98th Street
LOT
15 & Ei 14
BLOCK
,72
SUBDIVISION
Miami Shores Sect. #3
GENERAL.CONTRACTOR
Dean R. Claussen
-- _ ADDRESS ...
4 N. W. 95th Street
..PHONE NO.
78- 1144
LICENSE NO.
3122
BUILDING PERMIT NO. 8 998
DATE 3/1/50
[
PERMIT FEE $ 1 5. 00
BUILDER'S BOND
NO. 9 DATE Trans.
ZONE REQUIREMENTS 20,000 CU. FT.
PLAN CUBE 20,462 CU. FT.
EST. COST $ 11,000.00
MI
DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY:
DATE
3/1/50
X
NEW CONSTRUCTION
TYPE
CBS
STORIES
1
ROOF CONSTRUCTION
Tile
INTERIOR CONSTRUCTION
Oak Floors - Plaster Walls
REPAIRS
DESCR IPTION
Liv Rm - Liv Porch - Kit - 2 Bed Rms - 2 Baths - 1 car attached garage
ALTERATION
DESCRIPTION
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE COUNCIL
REMARKS
CERTIFICATE OF OCCUPANCY NO. 916
ISSUED 6/26/50
BY MR
TO L. Ryan, 825 NE 98th St.
BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
FOUNDATION
1
.. -
FEE
TEMPORARY SERVICE
90 f
L DATE
3/6/50
BEAMS & LINTELS
Y •
3/21/50
JDH
$
SEWER
FRAMING
4/5/50
JDH
S
GAS
S
$
FINAL
6/26/50
JDH
RE- INSPECT
BY
RE- INSPECT
BY
.1-LEAN-UP
3/15/50
IMF
CONTRACTOR Jones 7th Avenue Plumbing Co.
PHONE
\ ERMIT NO. 9039 I DATE 9 9/50
FEE S 10.75
NEW BLDG. X I ALTERATION
ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
90 f
L DATE
3/6/50
S
SEPTiC TANK
$
SEWER
S
SOLAR HEATER
S
GAS
S
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
3/15/50
IMF
GAS
H. W. HEATER CONN
SEWER
RANGE CONN.
SEPTIC TANK
SOLAR HEATER.
FIXTURES & FINAL
6/26/50
JUL
FIXTURES
6/26/50
JDH
CONTRACTOR Jennings Electric
PHONE
PERMIT NO. 91 DATE 4/ /50
FEE $ 11 95
NEW BLDG. X ALTERATION
I ADDITION
REPAIRS
SPECIALfEERRMMI S
PERMIT NO.
FEE
TEMPORARY SERVICE
90 f
L DATE
3/6/50
$ 1.00
H. W. HEATER CONN.
$
RANGE CONN.
$
i
MOTORS
$
FIXTURES
S
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
TEMP. SERVICE
3 /_6/50
4/5/50
JDH
JDH
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
6/26/50
JUL
P
P
BUILDING INSPECTIONS
PLUMBING PERMITS & INSPECTIONS
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL TO POWER CO. FOR SERVICE DATE 6/27/50 BY JDH
N° 91G
")-y Tt)
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
Miar► Sho es— 'nage, Fla =
Owner, Agent or Tenant of Building
Lot/N/ �� Block 7 Subdivisio
Street Address P C. 7
Approved use by occupancy
Remarks •
This Certificate of Occupancy is issued to the above named 0
for building at above named location only u on `'the express provision that the applicant will
abide by and comply with all conditions of Ordin/es Nos. 92, 93, 9 and 97, known as he
Zoning, Electrical, Plumbing id Building Or in y es of Mi�f►�i Sh) es Villa + e rtainin to
the erection, construction, alteration or remode' in f buildi
BUILDING 131`',ISION
J
MIAMI SHORES VILLAGE. FLORIDA
ELECTRICAL ❑ DATE 195
PLUMBING ❑ P E R M I T N? 9833 Contractor s
License No
ROOFING ❑
BUILDING ❑
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
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.
CONTRACTOR - OR BUILDER
B i.
Work to be performed under this Permit
Subdi-
vision
Sq. Ft
Value of
Project $
Amt. of
Permit $
BY AUTHORITY
>»
N? 916 •
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
Miami Shores Village, Fla , -'
Owner, Agent or Tenant of Building
Lot 1 � Subdivision
Street Address /
Approved use by occupancy,,'
Remarks •
This Certificate of Occupancy is issued to the above named-
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94� and 97, known as the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shor Village pertaining l'to
the erection, construction, alteration or remodeling of buildings or structures.
BUILDING DIVISION
d