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FW-09-1704 r 3 s Miami Shores Village g t a 10050 N.E. 2nd Avenue 'W ` t3�d Miami Shores, FL 33138-0000 Phone: (305)795 -2204 Tr Expiration: 041 2010 Project Address Parcel Number Applicant 1700 105 Street 1122300500010 Miami Shores, FL Block: Lot: SHORES CONDOMINIUM Owner Information Address Phone Cell SHORES CONDOMINIUM 1700 NE 105 ST MIAMI SHORES FL 33138 Contractor(s) Phone Cell Phone $ 1,000.00 HOME OWNER Valuation: Total Sq Feet: 60 Approved: Yes For Inspections please call: Comments: (305)762 -4949 Date Approved: 10/16/2009: Yes Available Inspections: Date Denied: Inspection Type: Type of Construction: Wood Fence Additional Info: Final Classification: Commercial Foundation Fees Due Am ]$2.50 Invoice # Total Amt Paid Amt Due CCF FWA 0-09 -36169 $ 109.30 $ 59.30 Education Surcharge Permit Fee - Wire & Wood $FW-10 -09 -36169 $ 109.30 $ 109.30 $ 0,00 Permit Technology Fee Check * 9638 Scanning Fee Submittal Fee Submittal Reversal Fee ( Total: $10 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. November 03, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy November 03, 2009 1 Miami Shores Village OY Building Department {V 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305). 762.4949 BUILDING Permit No PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: Owner's Name (Fee Simple Titleholder) J4 S G:OW) 0 1 t5 C Phone # Owner's Address / 700 I%X . City /,GSA -1., %57, r State �� Zip Tenant/Lessee Name Phone # Email -� Job Address (where the work is being done) 17610 A/. ,9!F. City Miami Shores Villaee County Miami -Dade Zip 33« FOLIO / PARCEL # Is Building Historically Designated YES NO k Flood Zone Contractor's Company Name 49WI agile Phone # Contractor's Address _ /70o A ' AF L - City /r/C �-4-,ri! i J 1010 � S State 7 -1:::: / Zip 3.S' l3 Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Contact Phone E -mail Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace . ❑Demolition Describe Work: e��1 %J " @e OA,) eo 7A,/ Del 2 6 Fr� ,g pp� / o Submittal Fee !r V �.J Permit Fee $ ��� CCF $ `mil./ CO /CC $ Notary $ Training/Education Fee $ • Z0 Technology Fee $ 2 Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: , Structural Review. $ Total Fee Now Due $ S ci - 9 )o See Reverse side -a Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable Mortgage Lender's , Addre 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 not be approved nd a re- inspection fee will be charged. Signature Signature Owner or A ent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day o 2001 , by day of 20 _, by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Si Sign: Print: L. UGIZET tA = Print: My Commission Expires: r Na y Puboa;t J@ of P10�rI� My Commission Expires: Luwds 8 PayMn My CommIsWo DD000711 a, Expim s 07/12/2013 APPROVED BY Plans Examiner �!� Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009) Planning and Zon"ng Cifteria Miami Shores Village Permft No. FW-1 0-09-1704 10050 N. E. 2nd Avenue ................................................................................... .......... .............................. ....... ... ... .............................. ... .......... Miami Shores, FL 33138-0000 ................. .................................... ..................... ................ .. M.A. . . ....... .. .... . ... . . . ..... ................ ........................... .......... . ... ........ ............................. . .............. -22 -A Phone: (305)795 04 Fax: (305)756 8972 . ........ __ ............................. . .................. f. Issue Date: Not Issued Expires' Not Issued ................ ................ ............... ..... -1. 1 ................. .................... Folio Number: 1122300500010 Owner's Name: SHORES CONDOMINIUM Owner's Phone: Job Address: 1700 105 Street Total Square Feet: 60 Miami Shores, FL Total Job Valuation: $1,000.00 ;377. ............. I ................. ........................ ................ ............................................ .............................................. I.-I .............. . ........................................ Contractor(s) Phone Primary Contractor HOMEOWNER Yes ........... . . . .. . .... ......... Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 10/16/2009: Yes Comments: V OF MIAMI SgO:RES OWNER BUILDER DISCLOSURE STATEMENT NAME. j lil e DATE: AD 0 .tF Q (G� y�c/ 0/`�5 Do hereby petition the Village of Miami Shores to act as myown contractor pursuant fo th lawns � 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 constmotion yourself. You may build or improve a one - family or two- family retidence. 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 attd 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 fot sale or lease, which is a violation of this exemptieul. You enay not hire an unlicensed person as A contractor. It is your responsibility to make sure the people employed by you hav ®licenses required by static law -Add by county or muuiicipal licensing ordinances. Any person working on your building who is not licensed ctiget work under your sgpervision and must be employed by you, which means that you must deduct F.LC.A and with - holdings tax and provide workers' compensation for that employee, all as prescribed bylaw. Your ootruotion must comply with all applicable laws, ordinances,.buildings codes and zoning regulations. ns Please road and initial each paragraph. 1. I hold. tide to the above property and I am planning on doing this construction Myself. Initial t 2. I understand that as an ovcinnr- builder I must abide by all zoning ordinances and building regulations in effect at the time of permit application. Inactive 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 reinstatement of the permit., Initial • , 3. I have an understanding of the 2004 FBC & FR.0 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. Initiac 4. h 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 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 0 attorney. The department will not mitigate any contractdisputes. Initial — 0 � 6. I understand that if I compensate any person or company for work performed they are requited to helve 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 wroitg doing from this unlicensed company or person. Initial `Y ` ' 7. I understand that if any person gets injured on my construction project they are entitted to workmen's compensation, And Ik they do not posses a workmen's policy I could be held liable for all doctor and related cost which could include kiss of wages during recovery from injury. 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 before me this _ day of , 20 BY t rlW f Y who was p Y ersonall known to me or who has Produced there License or 1(Q9'd ' • entification. OWN NO ARY NQTP1tY pUB�1.l v oC Lrblllo `Cohn #DD71;�23 _. gam? �3, 2411 . s ,••• �p�rric gcbti�tyc co.,,xc. Bot�vEO T� .r Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: I NSP- 127209 Permit Number: FW -10 -09 -1704 Scheduled Inspection Date: January 19, 2010 Permit Type: Fence/Wall Inspector: Bruhn, Norman Inspection Type: Final Owner: CONDOMINIUM, SHORES Work Classification: Wood Fence Job Address: 1700 NE 105 Street Miami Shores, FL Phone Number Parcel Number 112230050001 Project: <NONE> Contractor: HOME OWNER Building Department Comments BUILD 5' WOOD FENCE ON BOTH SIDES OF EXISTING SHED WITH ONE GATE Inspector Comments Passe /� / �G Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. January 15, 2010 For Inspections please call: (305)762 -4949 Page 5 of 23