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1301 NE 101 St (4)IJ v{ I I Passed al b U Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection N amber dINSP - Inspection Date: 04110/2006 Inspector: Grande, Claudio Project: <NONE> Contractor: HOME OWNER Building Department Comments Friday, April 7, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Owner: FEILITZEN, JAN VON AND CARMEN Job Address: 1301 101 Street NE Miami Shores Village, FL 33138- Block: ermit Number ; -3 -06 -726 Permit Type: Paint Inspection Type: Final Work Classification: Miscellaneous Phone Number (305)754 -8683 Parcel Number 1132050230090 Lot: Page 1 of 2 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 2:- l 1 47m 3) 3 1 I 0 G, Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit No. ?T / " PERMIT APPLICATIO 2 B Master Permit No. FBC 2004 Owner's Name (Fee Simple - • . der Owner's Address /30/ NG /0/ cS Job Address (where the work is being done) Permit Type (circle): Building Electr' al Plumbing Mechanical Roofing cit f 1.9-m; EhoegS State P40 Li 6* Phone # Zip 33/EQ Tenant/Lessee Name Phone # /3 D/ iv /0/ S City Miami Shores Village County Miami -Dade Zip 3313k FOLIO / PARCEL # / OcA3 - ®©�'-f o Is Building Historically Designated YES NO Contractor's Company Name 41 1:=X-A- r - 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 # Value of Work For this Permit $ CO Square / Linear Footage Of Work: Type of Work: EAddition ['Alteration ❑New ❑ Repair/Replace El Demolition Describe Work: 0 ,4s- J D W PA //Y T/ /VG ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ ( �- ' CCF $ Q Co c..D CO /CC Notary $ —C—XD Training/Education Fee $ (- 2-CD Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ l - �. 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 City State 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. 1.•) CCit Signature Owner or Agent Contractor The fore oing instrument was acknowledged before me this 2-1 The foregoing instrument was acknowledged before me this Signature day o Cf+, 20D, bOINEMEk1 VOK day of , 20 _ , by who is personally known to me or who has produced `"who i l s personally known to me or who has produced 1 p As identification and who did take an oath. as identification and who did take an oath. Sign: Al ,, i, M' •.;�.:.'`.:� Print: .�� ?1►► s: a ; 2009 My Co issi g o n. e. Atlantic : .. mg Co., Inc. ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: (Revised 02/08/06) NOTARY PUBLIC: Sign: Print: My Commission Expires: 3 440 vIcYa r ". Zip Plans Examiner Engineer Zoning Signature • Miami Shores Village Paint Color Approval and Agreement Date 3 04 per .,��) Owner's Name p'r &L goo ke }3`""' Phone # F 613 Owner's Address City Mfl7/ Z1, State iLoU It Zip 33/3e Job Address (where the work is being done) /3to/ tVe /0/ s City Miami Shores Village County Miami -Dade Zip 3 3/ 3- Is Building historically Designated YES NO t Contractor's Company Name (if applicable) Phone # ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted Walls -J V0/ Zt•O /a ✓ - SW Fascia Drip Cap /drip Edge Soffit Roof Flower bins ..SIoicy ave.. 6 3 (/ eA.) Shutters Awnings Chimney Doors and door jams Garage doors Railings Fences Decorative metal 6 3 7 n / All brick (simulated or regular) SP/ C !L °? ..Sc-'_) Stucco banding Any other stucco features Accessory Buildings Other ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable lays regulating construction and zoning. APPLICATION APPROVED BY: Owner or Agent P& Z Official Date � ,3ya Cu) 6614/ at 3 11.14 ()b Date chc 6/18/03 VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT ' NAME: O /3 1 424._ l DATE: o/ . ADDRESS: /3 /a/ 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 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 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 al= 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 G ✓1 3. .I 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. 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 CV � Initial lj✓ f 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. 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. 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. 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. Was acknowledged before me this p2c2 day of /274 Q..,( J , 20 O b B VOMFEL. 2 bho was personally known to me or who has Produced there License or Initial a Initial Initial C L 1 Initial as identification. Al AO 4 q. _. ��A4 NIA 'Y � NOT. • - -STATE OF FLO' 460 Y. leny Hernandez Commission # DD476455 Expires: SEP. 27, 2009 Bonded Thru Atlantic Bonding Co., Inc. Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Issue Date: 3/30/2006 Expires: 03/21/2007 Owner's Name: JAN VON AND CARMEN FEILITZEN Permit Type: Paint Work Classification: Miscellaneous Job Address: 1301 101 Street NE Miami Shores Village, FL 33138- Contractor(s) Phone Primary Contractor HOME OWNER Yes Comments: EXTERIOR PAINTING Additional Information Type of Work: Exterior Color: IVORE ANDSPICY HUE Additional Info: 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: 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. Futhermore, I authorize the above -named contractor to do the work stated. Building Department File Copy Applicant Signature Permit Status: APPROVED Permit Number: PT -3 -06 -726 Phone: (305)754 -8683 Parcel #: 1132050230090 Block: Lot: Section: PB: Total Square Feet: 0 Total Valuation: $ 600.00 Required Inspections Final Fees Due Amount CCF $0.60 Education Surcharge $0.20 Notary Fee $5.00 Permit Fee $60.00 Technology Fee $1.50 Total: $67.30 Invoice Number PT - 3 - 06 - 24186 Total: Amt Due $67.30 Amt Paid $67.30 $67.30 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. NAME OF PERSON REQUESTING FILE: ADDRESS OF FILE REQUESTED: INFORMATION REQUESTED: Acknowledged FILE RETURNED TO: INITIAL Miami Shores Village Building Department 10050 NE 2 Ave, Miami Shores, Fl 33138 Tel: (305)795 -2204 • Fax; (305)756 -8972 PLEASE PRINT DATE: �= TIME: 3 ri PHONE #: 7)0"; iS 1 C t-{. T icYOUR ADDRESS: l 3 10 OE. (0 I 5 I understand that all documents in this file are property of Miami Shores Village and that NO documents may be removed from this file. You may get 4 complementary copies (8x11) size, additional copies will be furnished at 0.15 cents per page, not including any blue prints. If blue prints are order please be aware that we are not responsible for the quality of the printed documents. - Pm h -r Cc (,) I ! o Gee --14L ' Date / / /D/ Legal Description ..Z/7/ c,/ /9A. 2 r/2. Ad Moo' Historically Designated: Yes No .P.' -/> r' / .4'>`/ • P o t,V • ,Owner/Lessee / Tenant 444) / aYAlu• JOY! pew 4./ rt ia/ Master Permit # (9 Owner's Address /4 ,'5c / 01 . y/ c rl1i ..rd fei Phon(340 76W— JG4'i• . IT 4 4 /sc cyne 481ild•,Wfo-M/'F! Contracting Co.,' � LtL /� � ;v iz L an. 4 Corr Address 3G C COGS,? •26d4d 4 e4c4 Qualifier egg, 1 °C . Rd G 11e r__ State # CGC. DO 06 Municipal # Competency # Ins. Co. 16 4rn1 4 1l44 as • Architect/Engineer, 100/A Bonding Company Mortgagor PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address X114/ 49 6O/ Sr Tax Folio /4 f !OD q Z dGe Permit Type (circle onek BUILDIN ELECTRICAL L:fe o y . P4-r)9Tr * WORK DESCRIPTION )( Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT KJ D RADON APPROVED Zoning Mechanical 3 13/0 B Plumbing SS# Phonc(?) c 42 .' .2'99 Address Address Address sti 5 ff z� PLUMBING MECHAN)SiCAL ROOFING PAVING ENCE SIGN c /ear! /ns DDA 00/r s o ,t. 4 ( 1N 11 \ 1‘75i be do y .�® r � � Square Ft. Estimated Cost (value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I 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, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNERS 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. Furthermore, I authorize the above -named contractor to do the work stated. • gnature o No as to Contractor o My Commission Expires NOTARY BOND Electrical ontractor or Owner- Builder Date 3.2 �-// - ,1g9 -/ 3� j wner- Btild>lYS j VILLAR NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC714103 M Y C O M I O N P M L 1R, ate Structural Engineer r MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE kil,4 OWNER'S NAME:Y..1,9-.r/ ! C4r'me 10)1ni ifrrwn. PHONE: Ie3 ADDRESS; /2o/ AA') rh4orria- : : ************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE:( l2a' the CONTRACTOR & LICENSE (if applicable) y ' 2 Eoaitaued_ c.c / 'acc co/ /� COMPANY NAME: K• Cey,• emir- PHONE :4 �,�i s • * * * * * * * * * * * * * * * * ** ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls 64) AP/ re- Fascia Soffit Roof Flower Bins ,)fo. Shutters .0 IA- Awnings u`a Chimney ,.//a Doors and door jams ,o/4- Garage Doors 44.74/ .. Railings A)/s• Fences l/s. Decorative Metal 4)/4- All brick (simulated or regular) .&i*'le- Stucco Banding /4• Any other stucco features Jo Accessory Buildings v n Other mot' 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. I authorize the above -named contractor, if applicable, to do the work stated. Furthermore , the paint colors will be as per the attached samples. �121,� 3�jo/ Signature of Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 1?) der J'he 1 3-"l3 -° BuildinglOfficial Date • PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date / / //T Job Address Aga/ WORK DESCRIPTION C: s/.vT &4.77tia4 a� APPROVED: oye FEES: PERMIT .37. $ Signat� ire of Date: /. /0� /'/ , BL 'E MY COMMISSION EXP. FEB. 4,19 BONDFD TFI GENERAL 1,F S. Ut�O. Notary as to Ow an d / My Commission Expires: * pa of is erittiic R f i JO �?I:� est 0s „?- or / RADON D BIB CC C Fs:aasfi. / v Tax Foil of ` ✓ L6 (93 --D690-- Legal Description Owner / Lessee / Tenant :av7 77'Z eit, Master Permit �i &o ' 7c Owner's Address /Jo/ ///' /D/ oar. Phone .757 Contracting Co. �lv (.De.dq`,,e. Address ..1? , /7/ o �! .. Qualifier SS# ��/ - . Phone 9]% State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company. Address Mortgagor ; A ddress Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN ' vse —) ' y)a . ,6- Square Ft. Estimated Cost(value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I 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, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I auth ri the a b -naffed contractor to do the work stated. ents �p d S`S' ature of Contractor or Owner- Builder Ub Ssc,2�bebe � irq yn e +ti i SI 9 d 9 y . ?/0..f9i q UBLIC STATE' 0 >�r e l/ i " COMMISSION EXP. FEB. 1,' 996 onto P esident Notary as WiZodttehdt ALotNOwher Builder Pensunxly known to tY @ My Commiss Expires: Produ identificMt Ti * * * * * * ** NOTARY TOTAL DUE 3 g.6o Fire . . Other Zoning Buildin: j / / // Electrical Mechanical Plumbing Engineering