FENCE AND DRIVEWAYBUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical
Owner's Name (Fee Simple Titleholder) C 1 ., d; ^Q � t e �G 2_ Phone # �$ Z i ( — 2 2 2. Li
2 S NE 7g 5
City M.. S 17.Oe G S State
Owner's Address
Tenant/Lessee Name
Job Address (where the work is being done)
City Miami Shores Villa e
Is Building Historically Designated YES
City State
Qualifier
Architect/Engineer's Name (if applicable)
$ Value of Work For this Permit
Code Enforcement $
Total Fee Now Due $
(Continued on opposite side)
e clel. 4 10
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit NOV Z ' ' 4 3
Master Permit No.
4 12s ItiE 1g S
.2�3 Sc'
County Miami -Dade
NO
Contractor's Company Name Phone #
Contractor's Address
Structural Plan Review. $
pFtqo
.. 00T 0 7 2005
Plumbing Mechanical Roofing
State Certificate or Registration No. Certificate of Competency No.
Zip 3 3 ( 38
Phone #
Phone #
Zip 3 138
Zip
Square Footage Of Work:
Type of Work: ❑Addition ['Alteration ❑New r(
Describe Work: 1. b t z 1 n G k-1.9 o GQ tt hC.. 4E-- a z-..
wPt.1 as
�epair /Replace ❑ Demolition
14.0 DOD f-QNC C.
Submittal Fee $ Permit Fee $ /ice- ! ^ .- i CCF $
Notary $ Training /Education Fee $ O. E0 • Technology Fee $ c / . ��--0
Scanning $ 3. Cl) Radon $ Zoning Bond $ 3 C0 . 00
CV*
C O /CC
C ---04106 8't
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. 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: 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 .• . s einspection fee will be charged.
Signature Signature
Owner ornt Contractor
The foregoing instrument was acknowledged before me this 1 The foregoing instrument was acknowledged before me this
day of OC� ,20 by , day of ,20,by
who is personally known to me or whoiias roduced T CA who is personally known to me or who has produced
t/4i k.,(, As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUB • NOTARY PUBLIC:
Sign: Sign:
Print: E:� , , c✓ � / s'> Print:
My Commission
* * * * * * * * * * * * *
******************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** , + ************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 05/13/03
EMILIA SUYAPA PALMER
XPIRES: April 4, 2009
Banded Thru Notary Publio Underwriters
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
i' _ _ s'•
My Commission Expires:
�o 0)-0 /jam
,...being the legal property owner, for the property
Located at:
Was acknowledged before me this 7 day of OG
Ofner
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE STATEMENT
Owner
1 J ,.
Legally described as
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the T f>
State of Florida, F.S. 489.103(7),s'}nd I have read and understand the following disclosure
Statement, which entitles me td Cork 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 Icensed 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 ( ) initial of reviewing clerk. The foregoing instrument
20 0 5
B who is personally known to me or who has
Produced �3 (0 - • 69 - 13 ' D as identification and who did take an oath.
Notary
'STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Aff ant,L, ;.f•' -aloes hereby attest that the
(property owner)
•
attached survey, performed by --
Further, Affiant sayeth naught.
AFFIDAVIT'
(name of surveyor's company)
performed on ' c + , 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..
Affiant/Property owner
Witness(sign and print) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this 7 day of of —FJ& 4 ' O2v S .
Athant is personally known to me, produced I '% L ' /1 704 ' 1 /B) s identification.
JOB ADDRESS:
APPLICANT:
APPLICATION:
DATE
ZONING CRITIQUE SHEET
COMMENTS
\ key Li e
PERMIT #
WOW) FENCE. MUST
INSTALLED GOOD Silk OW
POOL REQUIREMENTS:
SELF-CLOSING/ SELF-LDCKING
GATES REQUIRED
FENCE: 4 IIGI I (MiN.
AND NON-CLIMBABLE
IF NEIGHBORS REMOVE FENCE:
vVITI-4 A 4' FFNr.E_ ON
OWNE H'E PPUPt T
i st eh4e
FENCt,S, WALLS, HEDGES
INSTALLED ON ALLEY MUST
ALLOW 4350. FT. FOR
TRASH CANS, TREE TRIMMINes, t IC.
INITIALS
(6 ce ti,t; -14‘ -
__) t r rke
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 10/21/2005
Applicant: CLAUDIO
Owner: RODRIGUEZ
JOB ADDRESS: 925
Contractor
Local Phone:
Parcel # 1132060143430
NE 98
Signed: (INSPECTOR)
Building Permit
Permit Number: BP2005 -1463
RODRIGUEZ
CLAUDIO
ST
Contractor's Address:
Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOTS 16 &17 BLK 80 LOT SIZE 100.000 X 103
Fees:
FEE2005 -13781
FEE2005 -13782
FEE2005 -13783
FEE2005 -13784
FEE2005 -13785
FEE2005 -13786
FEE2005 -13787
Description
Building Fee
CCF
Notary Fee
Training and Education Fee
Technology Fee
Scanning Fee
Builders Bond
Total Fees:
Amount
$380.00
$1.80
$5.00
$0.60
$9.50
$3.00
$300.00
$699.90
Total Fees: $699.90
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 4/5/2006 Construction Value: $2,350.00
Work: INSTALL NEW WOOD FENCE AND WALKWAY
Page 1 of 1
tit
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 1 assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
5'-O" MAX
2'-O"
Owner's Side
El
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4" X:t �lll�o�od po •••• ••
2" X 4" Wood Bail
I" X6" a- I" X8"
Wood Pickets
cncre'ty
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a 44 11
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- 2915 Fences
Wood Posts
2915.1 Wood fences, so located on a property
that by zoning regulations they cannot be used
as a wall of a building, shall be constructed to
meet the following minirnum specifications.
(a) Fences not exceeding 5 feet in
height shall be constructed to meet
the following minimum
requirements: from nominal 4 inch
by 4 inch by 8 feet -0 inch long
posts spaced 5 fee inches on
centers, having a fiber stress of
1200 p.s.i. in bending, and shall be
embedded 2 feet -0 inches into a
concrete footing 1 fcot -0 inches in
diameter and 3 feet -0 inches deep.
Other components shall be
designed to comply with the
provisiogs of. this Chapter and.
Chapter 23.
(b) Fences not exceeding 5 feet and 4
feet in height respectively shall be
constructed as provided in
paragraph 2915.1 (a) herein,
except that the spacing of posts
may be increased to 5 feet -0
inches and 6 feet -0 inches on
centers for these heights.
0-0544e
C1 *Y
COPY
4' -0" High or Less = 6' -0" O.C.
5' -0' High or Less = 5' -0" O.C.