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54 NE 102 St (8)MIAMI SHORES VILLAGE BUILDING 4EPARTMENT 305 -7 5 -2204 Building Inspection Request Date Type Insp'n '�- )tat Permit No. -tY Y' - Name Address Company n � / ,, Phone # 30r7_ /' / 3._ to 001 J Inspection Date ! . s.? Approved Correction Re- Insp'n Fee 5z A) BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Miami Shores Village Building Department 10050 N.E.2nd Miami Shores, Florida 33138 Tel: (305) 705:2204 F,x: (305) 913972 Electrical Plumbing Permit No. M ster Permit No. : it / V. Owner's Name (Fee Simple Titleholder) (' io... Phone # SC7S _ 1 Set - ( --j 0253 Owner's Address 54 (1 ! 10 o a r CityC`t1;- v. State �L Tenant/Lessee Name —� Zip 33 I 'A5 Phone # Mechanical Roofing Job Address (where the work is being done) 'n 4 - j IO r �� City Miami Shores Village County Miai -Dade Zip 331 3& Is Building Historically Designated YES NO > Contractor's Company Name C�p� Cap,v (7� Contractor's Address •,--1 n 1 0 a � 1no State ( - Qualifier Architect/Engineer's Name (if applicable) $ Value of Work For this Permit I 000 Type of Work: ❑Addition [V7 Alteration Describe Work: Total Fee Now Due $ (Continued on opposite side) ❑New Phone# 20 -�L q a ea Zip 331 State Certificate or Registration No. Certificate of Competency No. Phone # Square Footage Of Work: So ❑ Repair/Replace mss, .h ' 1 s i' nl<. * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ ..0. Permit Fee $ /SO — CCF $ 6r 6' 0 CO /CC Notary $ — Training/Education Fee $ (91 g n Technology Fee $ Q 1 50 Scanning $ 3 — Radon $ �' Zoning Bond $ Code Enforcement $ — Structural Plan Review. $ ❑ Demolition 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 not be approved and a reinspection fee will be charged. Signature i IP o1 ersonally PI,IBLIC: own to • n / oi : Expt a nd a d y T t v, 2008 i _, ,'" �� `' Atlantic Bonding Co., Inc. • The f. instrument was ackno day ofd/ - ...,' NOT Prm My Commission Expires: ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Cho 05/13/03 Signature Owner or Agent Contractor ged before me this or who has produced As identification an who did take an oath. NOTARY PUBLIC: Ginny H. Gonell 0 The foregoing instrument was acknowledged before me this y of , 20 by who is personally known to me or who has produced as identification and who did take an oath. Sign: Print: My Commission Expires: DE 9 Plans Examiner Engineer Zoning By OWNER BUILDER DISCLOSURE .STATEMENT I (- t"ay.< .- j N o being the legal property owner, for the property Located at: t. a i- 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),.nd I have read and understand the following disclosure Statement, which entitles me to brork 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 $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 Icensed 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 ( ) initial of reviewing clerk. Tlie foregoing instrument Was acknowledged before me this 10" day of 20 ` � o: , YP tinny H Gon - I. `�'�' Commission #DD323870 � � = Ex ires: 2 who is personally known to me or who li .. • D Bon ,' 2:08 . Atl anUe ®o ndln� Cam as identification and who did take an oath. - . Produced VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT DISCLOSURE STATEMENT 1)-)c--N--) fa -C1O(-)■ A' 11 v, (,,) �� --e,- l' ---a-_) I ...--' , >u is r - < (-)\: . Ic u s. Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2004 -1483 Printed: 1/4/2005 Applicant: JAVIER Owner: GUARDERAS JOB ADDRESS: 54 Contractor Local Phone: Parcel # 1132060131470 NE 102 Signed: (INSPECTOR) Building Permit GUARDERAS JAVIER ST Contractor's Address: Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 5 & LOT 6 BLK 11 LOT SIZE Fees: Description Amount FEE2005 -28 Building Fee $150.00 FEE2005 -29 CCF $0.60 FEE2005 -30 Notary Fee $5.00 FEE2005 -31 Training and Education Fee $0.20 FEE2005 -32 Technology Fee $2.50 FEE2005 -33 Scanning Fee $3.00 FEE2005 -34 Submittal Fee ($50.00) Total Fees: $111.30 Total Fees: $111.30 Total Receipts: $0.00 !JAN 0 4 p Permit Status: APPROVED Permit Expiration: 7/2/2005 Construction Value: $1,000.00 Work: REPLACE TILE IN BATHROOM AS WELL AS SHOWER FAUCETS, TOILET AND SINK. 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: