501 NE 102 St (5)3441
0 4 5 7 MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date b I i 6 (05
Type Insp'n 61411,1 " D l ivatutui
Permit No. r-P 2w 5 — �q
Name E3TLktii IfiCNU (i�
Address 501 at 102
Company OWW(V
Phone # �o J 1110 ` 6 " a
t t2
Inspection Date i 0
Approved
Correction
Re- Insp'n Fee
- m
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
DateQ1 t 1 105
Type Insp'n Fi flcd DrIJ Cky
Permit No. 2 1"13
Name Nlelk i na, ) tTJO !
Address 0l NE I OZ 5T
Company N (A
Phone # - N)51 q1 — G `7 Iz
Inspection Date 01 10
Approved
Correction
Re- Insp'n Fee
X6 P- 5 3A-Aid dfr-v S k
720/x.61.140Q A--ucf 5d
Pkt/u<e. 04) se e2es 7_
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( ' ' ' / 4)-(SQ Af/C
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MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Requ
t,•�s; s
Date 5
Type Insp'n
Permit No.
Name
is1gioDA P. a c)►tI e
Address 501 ME 102 5 i
Company N iA
Phone # X S) quo - 641 2 -
Inspection Date pima, (it 1 L oD5
prove
Correction
Re-Insp'n Fee
Building Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: BP2005 -793
Printed: 6/8/2005
Applicant: ESTEBAN MICHELIN
Owner: MICHELIN ESTEBAN
JOB ADDRESS: 501 NE 102 ST
Contractor
Local Phone:
Parcel # 1132060170940
Signed:
Contractor's Address:
Legal Description: MIAMI SHORES SEC 4 AMD PLAT
Page 1 of 1
PB 15 -14 LOT 13 & W1/2 LOT 14
Fees: Description Amount
FEE2005 -7691 Building Fee $100.00
FEE2005 -7702 CCF $1.20
FEE2005 -7704 Notary Fee $5.00
FEE2005 -7707 Training and Education Fee $0.40
FEE2005 -7708 Technology Fee $2.50
FEE2005 -7709 Scanning Fee $3.00
FEE2005 -7711 Builders Bond $300.00
Total Fees: $412.10
Total Fees: $412.10
Total Receipts: $0.00
i uc)
Permit Status: APPROVED Permit Expiration: 11/23/2005 Construction Value: $2,000.00
Work: DRIVEWAY BRICKS
(INSPECTOR)
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:
BUILDING
PERMIT APPLICATION
2001
Permit Type (circle):
Owner's Name (Fee Simple Titleholder)
Owner's Address 6:0/ /V g
City /4 /4 3,itoRAf State
Tenant/Lessee Name
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
Contractor's Company Name au no(
Contractor's Address
State Certificate or Registration No. Certificate of Competency No.
Architect /Engineer's Name (if applicable)
$ Value of Work For this Permit
Total Fee Now Due $ 1 0./O
(Continued on opposite side)
r.�
Miami Shores Village
Building D...e, artment
10050 $ it A epue, Miami ghores, Florida 33138
'T: (3 )'I95.2204 car Fa..;. (30 ) 756.8972
M 1
Type of Work: ['Addition []Alteration
Describe Work: V < 1 0.101 5rl('',
sr 3.4n/ /2/C gg. u/✓
/ O Z
SD/ N'e- 104 - r
❑New
Code Enforcement $ / Structural Plan Review. $ i
Permit No. " ] q3
Master Permit No.
Electrical Plumbing Mechanical Roofing
Phone #
Zip 3 3/3e
Phone #
Phone #
City State Zip
Qual ifier
Phone #
Square Footage Of Work:
❑ Repair /Replace ❑ Demolition
/ ,T /
Submittal Fee $ Permit Fee $ 1 (/ v v CCF $ J , C) CO /CC r
Notary $ `� Training /Education Fee $ , 1 40 Technology Fee $ cP'�
Scanning $ 3 a0 Radon $ / Zoning / Bond $
(3i1) 7Se Sz / 3
zip 33 3d'
360 ,60
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 • occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not . approve. . einspection fee will be charged.
Signature
NOTARY PU
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * **
Chc 05/13/03
Owner or Agent Contractor
The fore_ in instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of , 20 C by "a :5t P y I( f ( day of , 20 , by
who is personally , own to me or who has produced who is personally known to me or who has produced
* * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
/ As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Signature
My Commission Expires:
O
* * * * * * * ** * ** y �i************************************* * * * *•k * * * * * * * * * * * * * * * * * * * * * * * **
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_ ; jam e ,
G t
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* * * * * * * * * *�€ * * *,'0.5491**** * * ** * * * * * * * * * * * * * ** ** * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
,7, Zoning
I Es TC' 4, / /Y2 /rte/ - t/ being the legal property owner, for the property
Located at: <9/ Ale_ (0 Z S'er
Legally described as .
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 understand the following disclosure
Statement, which entitles me td aivork 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. ! You may also build or improve a
commercial building at a cost of 525,000.00 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 Iicenses required by state law and by county or municipal licensing
ordinances. Any person working on your building who is not Iicensed 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 ( )
• Was acknowledged before me this day of /?1► -f- , 20 oS
By
Produced
t,
OWNER BUILDER DISCLOSURE .STATEMENT
:cam --, Kl \r - r) el i n.
Owner
Owner
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
DISCLOSURE STATEMENT
initial of reviewing clerk. Ttie foregoing instrument
who is personally known to me or who has
as identification `d who did take an oath.'