BP2003-1544Type
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT, /
77 ` . D
Building Inspection Request
Date 19-)a-CI Time
Insp'n (5C YeW
Permit No. eP 2c(53-1SHLI
Name 1- IOU5f[rl
Address GO- Mt_ ) V I SS
Company 61 OYY1
Phone # 3 OS 7S) 0? OV
For Inspector: al30 • Name & Date
Approved
Correction
Re- Insp'n Fee
Acr
0
Dat
Type Insp'n
Y •
Name t k)3
Address N ( 0) 5
Permit No.
Approved
•tion
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204 . Sr?
Buildin • Inspection Request
(2
Company
Phone #
Inspection Date
BUILDING
PERMIT APPLICATIO
FBC 2001
Permit Type (circle):
Owner's Name (Fee Simple Titleholder)
Owner's Address ( .Z / J� (N
Cit carol ,q4,,,04. State
Tenant/Lessee Name
City State
C
$ Value of Work For this Permit 1 I L 0
Number of: Bays Stories
Type of Work: DAddition A ❑
3 Describe Work:
Miami Shores Village
Building Department
Electrical
RECtlVED
SEP 2003
State
�
Plumbing
Families
teration ew
Oa Kith
County Escrow Fee $ I .2 O
��--
Education/Training Fee $ a `
r t Tech $ r.7r 1 3 Scanning $
Code Enforcement $ Bond $ � Struct. $�
7,
Permit No.
Master Permit No.
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
tPaoo3 k - '-
u
Mechanical Roofing 070?
Phone # 3oS' 7S
Zip 1 ;8
Phone #
Job Address (where the work is being done) e- ( Z2 /Je (0 ( ke)2+
City Miami Shores Village County Miami -Dade Zip -2- )1;g
Is Building Historically Designated YES NO
Contractor's Company Name Phone #
Contractor's Address
Qualifier
- Phone #
Architect/Engineer's Name (if applicable)
Architect/Engineer's Address
City '~
Zip
Square Footage Of Work:
* * * * * * * * * * * * * * * * * * * * * * * * * ** *F * * * * * * * * * * * * * * * ** ** * *
Permit Fee $ (AO .00 . f Si Notary $
Minus Plans Check Fee $ Total Fee Now Due $
App Feet 30.00 ChaCh * aSad
Zip
Baths
Bedrooms
❑ Re air/Replace ❑ Demo ition
/(v5 iUAi °o-{" Ckuiviki
141
Radon $
w
(Continued on opposite side)
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. 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 n be zppJAved and a reinspection fee will be charged.
A, Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of _, 20 C by
who is person known to me or who has r c
AI As argas
As iden ' a
NOT Y � C : *1.i . Expires: Jul 13, 2007
9 ••.. dedThty
NOTARY PUBLIC:
�OF FLT ,�
Sign: " c riding Co., Inc
Print: r n►agi . d . Sign:
Print:
My Commission Expires: My Commission Expires:
APPLICATION APPROVED BY:
chc7ll /03
gnature
The foreg
day of
who is personally
Contractor
g instrument was acknowledged before me this
20 by
own to me or who has produced
a identification and who did take an oath.
*********************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * ** * * * * * * * * * * **
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
** * * * * * * * * * * ** ****************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ***ft**
Plans Examiner
Engineer
Zoning
cell is 305 - 491 -7604 please call she will be home. t' / q t
/'1
�I (/
CA- (4,1 ? I 3
-c,i...,, .,.
7
-
� G . R..
-,, / ---i-eft c. I'l- -e_ 6.-1
`
i
Passed
Inspector Comments
0
I
L
Failed
Alki ... .,
■ • 1`''
iiiiiin
F..
Correction
Needed
-
�� l/ l
Re-Inspection
- Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Number: INSP -27648
Permit Number: BP2003 -1544
Inspection Date: 09/26/2006
Inspector: Desharnis, George
Owner: . HOUSTON, KIM
Job Address: 122 101 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor:
Building De uartment Comments
Friday, September 22, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
eL
SEP 2 7
Block:
Phone Number
Permit Type: Imported Permit
Inspection Type: Final Building
Work Classification: <NONE>
Parcel Number 1132060132010
Lot:
Page 1 of 2
_- ... -... -- r - --------- -- - - - --
KITCHEN CABINETS INSPECTION.
OWNER'S PHONE NUMBER 305 - 757
8/10/06 NO ONE HOME, LEFT MESSAGE
PHONE. CG
HERE IS THE
-0708
ON CELL
Passed
Inspector Comments
Failed
1,4
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
p nspection , NumberINS P 24349`
Permit °Nurriber: BP2003`-1544
Inspection Date: 08/09/2006
Inspector: Grande, Claudio
Owner: KLINGNER, JANETTE
Job Address: 122 101 Street NE
Project: <NONE>
Contractor:
Miami Shores Village, FL 33138-
Thursday, August 10, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
ALIG 11 RECO
Block:
Permit Type: Imported Permit
Inspection Type: Final
Work Classification: <NONE>
Phone Number (305)757 -0708
Parcel Number 1132060132010
Lot:
Page 1 of 2
Date
Wednesday, August 9, 2006
08/09/2006 Check
Receipt
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit Number: BP2003 -1544
Invoice Number: imp -8 -06 -25839
Applicant: JANETTE KLINGNER
Company Name:
Owner Address:
122 NE 101 ST
MIAMI SHORES, FL 33138
Job Address:
122 101 Street NE
Miami Shores Village, FL 33138-
Payment Type Check Number
1376
Amount
$75.00
Change
$0.00
Total Payment: $75.00
Page 1 of 1
7/31/2006
To: Current Owner
122 NE 101 Street
Miami Shores Village, FL
Permit: BP2003 -1544
Address:122 NE 101 Street Miami Shores Village FL
Date Expired: 3/28/2004
Dear Sir or Madam
In order for us to serve you better, we need to keep our files up to date. Our records
indicate that the above reference Permit has expired.
The Building Department has determined that the work applied for has been completed
with out the required inspections and it has been more than 180 days since your last
approved inspection and thus your permit has expired as per Sec. 104.5.of the Florida
Building Code. You are required to renew your permit and schedule all required
inspections.
In the event you do not comply with the requirements herein, the Building Department
will file a complaint with Miami -Dade County Building Code Compliance Office for
possible disciplinary action against your licensed contractor And /or if permit was
obtained by the home owner the requirements of the Unsafe Structure Code of Miami
Dade County Sec. 8 -5. (3) will apply. "The building shall be presumed and deemed
unsafe and a permit shall be obtained to demolish the structure or bring the building in to
compliance with applicable codes as provided herein."
Please contact the Building Department, immediately upon receipt of this letter.
Sincerely,
Mabel Va
Administrative Assistant
Miami Shores Village
Building Department
10050 NE 2 Ave, Miami Shores, Fl 33138
Tel: (305)795 -2204 • Fax; (305)756 -8972
• I
i Located at:
OWNER BUILDER DISCLOSURE STATEMENT
(12— IV Ito(
Legally described as ' ` 6(4 I AAY:QA/
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),gnd I have read and understand the following disclosure
Statement, which entitles me to alrork 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 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. r 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 prescnbed by law. Your construction must comply
with all applicable laws, ordinances, building codes and zoning regulations.
Proof of ownership provided ( )
Was acknowledged before me this
By iku
Produced
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
being the legal property owner, for the property
DISCLOSURE STATEMENT
— initial of reviewing clerk. Tlid foregoing instrument
10 day of Ma, 20 0
who is personally known to me or who has
as identification and who did take an oath.
Mabel Vargas
Commission #DD231984
N;. *I Expires: Jul 13, 2007
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Miami Shores Village
Building Department
Permit No.
-. Job Name
BUILDING CRITIQUE SHEET
4A-&7t
• 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel:1305) 795.2204 ,2
Fax: (305) 756.8972,
Miami Shores Village
10050 NE 2nd Avenue
Building Permit
Phone: 305- 795 -2204 Permit Number: BP2003 -1544
Printed: 11/12/2003
Applicant: DONALD
Owner: KLINGNER
JOB ADDRESS: 122 NE 101
Contractor
Local Phone:
Parcel # 1132060132010
Permit Status: APPROVED Permit Expiratio 3/28/2004
Work: REMODEL KITCHEN CABINETS /INST
Signed: (INSPECTOR)
KLINGNER
DONALD
ST
Contractor's Address:
Page 1 of 1
Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 11 & 12 BLK 15
Fees: Description
FEE2003 -5726 CCF
FEE2003 -5727 Notary Fee
FEE2003 -7102 Building Fee
FEE2003 -7103 Scanning Fee
FEE2003 -7104 Technology Fee
FEE2003 -7105 Training and Education Fee
Total Fees:
Amount
$7.20
$5.00
$205.00
$3.00
$5.13
$2.40
$227.73
Total Fees: $227.b3 , Z
Total Receipts? 10.00
t f1%
G ov 1 & PAID
nstruction Value: $12,000.00
RS /COUNTER TOPS
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:
g ZZ