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DEMO-09-1733BUILDING PERMIT APPLICATION FBC 20 Notary $ Scanning $ Double Fee $ Radon $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 cj AN ®, 2010 Permit No m ` � Master Permit No. Permit Type: BUILDING ROOFING Owner's Name (Fee Simple Titleholder) o' `(War d II& Phone # 7t4 I 3 226 Owner's Address IJ( tot b'1'. City kin S State fit— Zip 3 3 Tenant/Lessee Name - / 4 Phone # Email CCZu D_ ri-t Q i s N ei Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone Contractor's Company Name 0 O'' Phone # Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Contact Phone E -mail Architect/Engineer's Name Of applicable) Phone # Value of Work For t r Square / Linear Footage Of Work: Type of Work: ► ' 'Y do ❑Alteration ONew ❑ Repair/Replace ❑ Demolition ifi� -)& %' +i & CAS W 4,l 1 a h e w( Describe Work � � ' � � � t� j f `Qe u rooct *** ******* * * * * * * * * * * *** * * * * * * * * *** * * * * * ** C' Permit Fee $ CCF $ CO /CC $ Training/Education Fee $ DPBR $ Technology Fee $ Bond $ Violation date: �� Structural Review. $ Total Fee Now Due $ 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 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 roperty is subject to attachment. so, a ertified copy of the recorded notice of commencement must be posted at the job site for the rst inspection which occu s en (7) ays after the building permit is issued. In the absence of such posted notice, the inspecti ii not be approved d inspecti n fee will be charged. day of Signa NOT PUBLIC: Sign: Print: My Commission Expires: 0 , er or Agent The fore l oing instrument was acknowledged before me this Lit I ,201 t�4v� i�w / rfr who is personally known to me or who has produced (Revised 07 /10 /07)(Revised 06/10/2009) As identification and who did take an oath. c iNfr- APPROVED BY Plans Examiner Signature Contractor The foregoing instrument was acknowledged before me this , day of , 20 , by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: ' ********************************************* * * * ****** * * * * * * * *** * * * * * * * * * * ** - ,_ * * * * * * * * * * * * * * * * * * * * * * * ** * * ** Zoning Engineer Clerk checked Y APPROVED N!INIG DEPT OF. SURVEY SCALE 1" = 28,80' • • • • w •••• E L:D z O 7 ts \qr Miami Shores Vifl��ae DG DEPT SUBJCCMPLIANC ` STATE AND Cr. UN 1Y MULES DA ALL FEDERA L 3 VINP--wiN FENCES, WALLS, HEDGES INSTALLED ON ALLEY MUST ALLOW 40 SQ. FT. FOR SH CANS, TREE TRIMMINGS, ETC. L ' • LA A...ARC DISTANCE A/C...AIR CONDMONING CBS...CONCRETE BLOCK STRUCTURE O.U.L.-OVERHEAD UTILITY LINE CL...CLEAR C/L CENIERUNE RAD..RADIAL ENC...ENCROACHMENT RfW...RIGHTOF WAY... RP...FOUND IRON PIPE 0.H.-OVER HEAD WM.—WATER METER CH—CHORD DISTANCE P/L...PROPERTY CONC ..CONCRETE F.H. FIRE HYDRANT UP...UTLITY POLE R..RADIUS U.E...UT EASEMENT ...CENTRAL ANGLE R_.RADIUS PL....PLANTER T_i 3E T C.::.._ A Ck FaS*N MH_ _MANHOLE CI F...CHAIN LINK FENCE . W.F...-WOOD FENCE bt'4 RaRt'. Os r ' PAR.. of - r e. le lei sMr -d. @S _AitA C d� 1.- 1..5 .1• _ °�s- "E)L u 'Z'Kpt.: 9gz° 253 101 Street Miami Shores, FL 33138 -2422 1132060134800 Block: Lot: TCIF REO GCM LLC CIO SMITH, Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Address Phone TCIF REO GCM LLC C/O SMITH, HIATT & PO BOX 11438 FORT LAUDERDALE FL 33339- Type of Demo: Building Additional Info: DEMOLITION Classification: Residential Fees Due CCF Education Surcharge Notary Fee Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $100.00 $3.00 $2.60 $111.40 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Valuation: Total Sq Feet: Invoice # Total Amt Paid Amt Due DEMO -10-09 -36201 $ 111.40 $ 111.40 $ 0.00 Date Expiration: 04/24/2010 Cell $ 500.00 0 For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Final 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. October 26, 2009 October 26, 2009 1 BUILDING PERMIT APPLICATION FBC 20 Job Address (where the work is being done) Ste' t sl- Contractor's Company Name Contractor's Address City Qualifier Name Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Type of Work: ❑Addition Describe Work: * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Radon $ Miami Shores Village liMOMV1ET Building D epartment OCT 212009 3 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No.OEQ Oct-- 11n Master Permit No. Permit Type: BUILDING ROOFING. p/ Z Owner's Name (Fee Simple Titleholder) MOM /a .S I - Phone # 7Ob 3 2$ ' Owner's Address LS' �r 10 t S'I-- . 1 City Pi taak SL re4 State FL Zi 3313 f Tenant/I,essee Name 11A_ Phone # Email Hoyt t e.� t t C: E fr1 kt.t .e od City Miami Shores Vil1a>:e County Miami -Dade Zip 330 d FOLIO / PARCEL # L L "3200 — (P l3 1 4V 7 0 Is Building Historically Designated YES NO. Flood Zone State ['Alteration Permit Fee $ Training/Education Fee $ 0 •20 DPBR $ Violation date: Phone # Zip Phone # State Certificate or Registration No. Certificate of Competency No. Contact Phone E -mail Phone # Square / Linear Footage Of Work: ❑New ❑ Repair/Replace EN 0 ❑ Demolition * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * ** /00 41 CCF $ CO /CC $ Technology Fee $ 2.-SO Notary $ Scanning $ Double Fee $ Structural Review. $ Total Fee Now Due $ ii - 3c Bond $ 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 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 fir inspection which occur sev ) days after the building permit is issued. In the absence of such posted notice, the inspection of be approved atjd 4 r pectton fee will be charged. Signa 0 e or Agent The for o ' ' g ' ' trument was acknow dged before me day of wh As identification and who did take an oath. NOTARY P : LIC: Sign: Print: My Commission Expires: .................................,....................................................... .... .......... APPROVED BY 4; ? j / Plans Examiner (Revised 07 /10 /07)(Revised 06/10/2009) s oz., or who has pr 1/1/1? uced 4t Signature Contractor The foregoing instrument was acknowledged before me this day of ,20 who is personally known to me or has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Comiriission Expires: /c ®' Zoning Engineer Clerk checked 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 sti ture u e s the minimum code. Initial 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 requited 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 . wig doing from this unlicensed company or person. Initial 7. I understand that if any person gets injured on my construction project—they are entitled to workmen's compensation:' Anil if they do not posses a workmen's policy I could be held liable for all doctor and related cost which could inc ude less of wages during recovery from injury. Produced there License or Initial 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. Initial Was acknowledged b e f o r e me this 2 ' 1 day of Oc - 2 r , 20 09 Byclvn© V who Sk � 11 e or who has as identification. NOTAI E 0 LO 1 y V. cellos N #'ro 7171)23 201 �COtq ggp. Z3, 1 ¢ rec B;t0G CU., tN c sn.ro�`' Booms • VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE $TATEIYIENT 'u NAME: 1‘ 1() 1 UV, ik `I— DATE: (o ° Zl — ® ADDRESS: 1 Ni to t E 3313E ( 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- fatitily 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 viol ttion bf this exemption. You may not hire an unlicensed person as k contractor. It is your responsibility to make sure the people employed by you havelicenses required by stato law.and by county or mutiielpal licensing ordinances. Any person working on your building who is not licensed roust work under your supervision and must be employed by you, which means that you must deduct F.LC.A and with - holdings tax and provide workers' compensation fbr 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 thi _ ins Myself. Initial 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. in active permits for a period of over 180 days - will become null and void (expired) and a new permit will be required. to be issued for reins a ment of the permit Initia 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. Initia q 1 ; fQM ovQ.'o.-II e >i d -°v5 t o_Ath 6 4, of S PERMIT #: SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS • • ...... .. • • •• .• (LT ••• ••••• 00000 • •. • 00000 • ...... • . . . .... • • 4v T5- NM 444 4■144=144 444 ON* 444 ONE OMM 444 144 dab 4411, OMM 444 MED 444 OM. • . • • • •• • •.••.. • •••••. •••• • • •••• ...••• • . •• •• •••••• • • • • • • • • • • •• • OlteelOQ1 • •t•• •. • • • • • • •• • 0 � 1 ••.•.• • • • • OOOOOO • • • . • • • • 1 • • ••.is • • . ••••• •••••• • • • •..••. • • 00000 • •