Loading...
WS-07-498 j W » Miami Shores Village 10050 N.E. 2nd Avenue ss 18C.itl • Miami Shores, FL 33138-0000 Y , Phone: (305)795.2204 COR i Expiration: 0911512007 Project Address Parcel Number Applicant 40 NW 102 Street 1131010180140 PAUL DOUGLAS BARKER Miami Shores Village, FL Block: Lot Owner Information Address Phone Cell PAUL DOUGLAS BARKER 40 NW 102 ST MIAMI SHORES FL 33150 -1230 Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 HOME OWNER .. ,....., Total Sq Feet: 0 Type of Work: DOOR Available Inspections: No of Openings: 1 Inspection Type: Additional Info: REPLACEMENT Classification: Residential Fees Due Amount Total Amt Paid Amt Due CCF $0.60 Education Surcharge $0.20 $ 0.00 $ 0.00 Permit Fee $1 ^ � Scanning Fee $6.00 Payment Type: J (- J ] Technology Fee $2. �' , 75 l Total: $119.55 A 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. March 19, 2007 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy Monday, March 19, 2007 1 q Miami Shores Village Building Department MAR 1 z zoos �� 10050 N.E.2nd Avenue, Miami Shores, Florida 33138` ° ^....___„_._ Tel: (305) 7 95.2204 Fax: (305) 756.8972 ©� coil BUILDING Permit No . fi` PERMIT APPLICATION Master Permit No FBC 2004 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Tit a older) ,6 4.4 Phone # V0 60 f Owner's Address �® /0.2 , Cit J kOtao State r-t- Zip 5 /ED Tenant/Lessee Name Phone # Job Address (where the work is being done) 40 MW /02. ° City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name 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 # { .t Value of Work For this Permit $ Square / Linear Footage Of Work I •� tf--� Type of Work: nAddition ❑Alteration EINew, k) kepair/Replace [] Demolition Describe Work: l (� nq Submittal Fee $ Permit Fee $ CCF $ CO /CC Notary $ Training/Education Fee $ 0 J Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ cc, See Reverse side ID F 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 ap oved q gareinspectionfee will be charged. Signature ' Signature er or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20 ®�by day of . 20 _, by 9 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: .'�o`.�PGk Marty Mock NOTARY PUBLIC: A . mWiDn # DD636884 bq+kes: FEB. 05, 2011 Sign: � W W►y oNNQTAR Sign: Print: -- Print: My Commission Expires: y�� /� My Commission Expires: APPLICATION APPROVED BY: L Plans Examiner Engineer Zoning (Revised 02/08/00 r VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT NAME: ✓ DATE: R . 2 ADDRESS: Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida,. FS 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:tbat 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 twafamily 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 Supervision and must be employed by you which means th at you trust 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 s ction 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 Initial _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 inte ret the code. There is a copy of the code in this office for review. Initial 4. 1 understand that the building official and inspectors are not there to design, alter or give advice on how to meet code —. only if the struc a meets the m minimu code. Initial r 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. Initial 6.. 1 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. Initial 7. - I- understard 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. Initial 8. I understand that under state and local laws I can not do any Electrical, Plumbing, Heating, Air & Roof work on my with out first obtaining the proper permits by licensed contractors. Initial Was acknowledged before me this day of & AVLM 20 BY 4 who was personally known to me or who has Produced there License or — as identification. R v NOTARY � y '`�''• M arcy MsCk ' _Cantu # DQ636814 ; t AEgira: FEB. 05, 2111 ° " "WV WWW.AARONNOTARY.com Miami Shores BuRding Department Product Approval Schedule / Comparison Chart Address: Permit No. , Opening Description of Window Product Acceptance Product Approval Opening Design Rough Opening Shutter Required Muliion Required Impact or Door or Mullion umber Design Pressure Pressare Size es / No yes No yes / o ( +) PSF (j PSF ( +) PSF () PSF ' O z °> C ® G 3 C r � m A a �^^ W r A O —q U) iTl i ss s•• • s • • • • s f� ._ Or • • ••• : : • • rr T •ss i s• • •s• • • i M I Am RD t MAR MIAMI -DARE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE (BCCO 140 WEST FLAGLER ST RE1s'T, SUITE I603 PRODUCT CONTROL DIVISION ��(e __��--°__ MIAMI; FLORIDA 33130-1363 NOTICE OF ACCEPTANCE (NOA) (305) 375 -2901 FAX (305) 375 -2905 Condoor, Inc. 7190 Coral Wa" Miami, FL 331 SCOPE:, This NOA is b i t rid the ' plicable rules and regulations governing the use of construction materials. The document ti b ek, as be ` reviewed by Miami -Dade County Product Control Division and accepted by the Board o� s 'peals n RA) to be used in Miami Dade County and other areas where allowed by This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Division (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material' fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ rnay. revoke, modify, or suspend the use of such product or material within their jurisdiction. BOM. reseitnves =the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Division this product or material fails to meet the requirements of the applicable building code. _ This product is approved: as described herein, and has been designed to comply` with the gigh ity Hurricane Zone oh'the•F.lbrida ¢Wding.Code. I7ESCRf ' SON: series $0•()1 Out- Sivi-ng Decoriiti°vc Glass S;inglc- Light V�aod . .F'tettCh l�obY ..... .• '• A"PPROV -AL DOCUMENT: D'rawingNo. 99 -01`i tie Series. 5091. W od Door', sheet's l through 3 of •:93 ;prepa;cd,.b Mfr .,;8&e /12i<9....9,bearing the Miami- Dade_Counij+ Product Cogtrol;Apptov. stamp with the • • • Vdtice of Ace �ptance �r*ter acid -dpproval date .b the Miami =Dade County Product Contr ol Division. • 9* nSS1 -L -r nPACt-kAbNG: None ••• •• •••• • all bear a permanent ' N D 'U • VABELING: Each unrt t label with the manufacturer's or log. , a "U IT1 •:•following slat�rnent: �Mif'adni -Dade County Product Co ntrol Approved ", unless otherwise d r M . :XANEW�►.,l(svf this WA Shall 1 e considered after a renewal application has been filed a fi be n change in tltdapplicable building code negatively affecting the performance of this produ -� TERMINATLON of this NOA will occur after the expiration date or if there has been a r i ` o cha ge i the 3 materials, use, and/or manufacture of the product or process. Misuse of this NOA as an en f y product, for sales, advertising or any other purposes shall automatically terminate this NO a r mpl o with any section of this NOA shall be cause for termination and removal of NOA. m ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, lid d low d b < , the expiration date may be displayed in advertising literature. If any portion of the NOA is W be done in its entirety. c .lt:�- INSPECTION: A copy of this entife NOA shall be provided to the user by the manufact o to OC and shall be available for inspection at the job site at.the request of the Buildin4 Official. This NOA renews NOA # 99- 0316.01 and, consists of this page i as well as approval doc ent i ed a oov The submitted documentation was reviewed by Manuel Perez, P.E. NOA No 02- 0318.07 6. n- Expiration Date: April 16, 2007 Approval Date: May 07, 2002 Page I r 2 X WOOD BUCK 1/4- MAX. 1 \Z (0 1.6875" �-- MAXIMUM 1/4 MAX. 38 1/4 BLOCK C 8 .. . -_ �� OR CONCRETE in ° r 1 7 8 INTERIOR EXTERIOR M 13a ° n" sm or 000R 4 to WAD40tsw •... MININl.I:JM MINIMUM MAX ••' E+413EYVERT o 0 EMBEDMENT HEIGHT . . .. . . t7 97 1/4" � � �•••• 0000. 0000 •„ ,► .... ITEM 4 • • • � � .: 0000 0000. � ---........- ._._.._..m.._..._....._.�.l.��� _. t_�..y.,�._.._ -- •__0000 ......... _ :.. 0000.. 0000. ••• •• •• •• •• LOCK REINFORCER BY .M.A.G. ENGo•MWIFIECI . .0 . 00 .. 0000.. 18 0000.. .. 00. 0 • •; 0000; •0000• S 0 N C — C - 0000 00000 0 0000.. .. .. 0000.. 0 • 000.. 000. 0 .. .. .. .. .0..0. • . . . . 0 0 0000.. 000 000. • • • 0. 6:4 pee 0 000 • 0000 0 00000 . 0000 • 0000 Z 1/4" MAX. 00 MAXIMUM WIDTH 75 BLOCK ONCRETE 1 3/4" M 7 8 7 8 1 3/ Drawn by: J. Hermoso t [ A Date: 12/12/99 13Q A. a ♦' * 4 e e =. Approeedascompl}'ing With the R BVISIOnS: 4 Florida Bulding Code MMWT MINIMUM - Date-- 'z"0� --- Drawing #99 -01 2 - EMBE EMBEDMENT Aliami Dadc Product Control bn' ion Drawing Title: FBMA SERIES 5001 SECTION A--A SECTION B— B WOOD DOOR Page 2 of 3 • • 20 MAX ALEX. 20 MAX. MAX. DOOR•uro••FRAME - SYSTEM (rm.) ) (TYP.) ITEM DESCRIPTION B >r STILE AND RAIL CONSTRUCTION L — t 1 DOOR MODEL 5001 - MANUFACTURERS WOOD ROGUE VALLEY OR EQUAL WITH HOA. 6" MAX. 6" MAX. 2 OJR300 T- ASTRAGAL WITH (Z) 1/8' SCHED 40x8 -1/4 LONG STL PIPE SLEEVES BORb TO CLEAR /3. WITH GLUE, ') QQ �•) 7/16 X 2' STAPLES IS' OC, 8c (16) 16 X 2' FHWS (4 EA SIDE OF SLEEVE). WEATIAERSTRIP - SCIEGEL jQ05 -650 13 C4 14 11 11 14 13 j 4 3 4 3 12 IXTENSKNt FLUSH BOLTS - QUALJTY MFG 113M - 1/2- E X 1-1/2' LANG 57E](1. W/ 3/4' THROW AT ASTRAGAL 7 7 7 AT TOP AND BOTTOM. 0.077' THICK BRASS STRIKE AT FRAME HEADER ABOVE DOOR DOOR AT UPPER CONCEALED 24' O.C. MAX. 24' O.C. MAX. MI FLUSH BOLT. THERE ARE NO STRIKES AT THE BOTTOM OF DOORS. THE LOCKS HOLES DRUM INTO THE ) ALUMINUM THRESHOLD. 4 SINGLE SURFACE DEAD BOLTS - MFR & MODEL) KWIKSET /666 SCHL 1818CH WITH A MODIFIED M.A.G. ENG. LOCK REINFORCER 120 -PB (1) O 2 -3/4 FROM TOP 8c' BOTTOM OF ACTIVE LEAF. 13 .0 O O 13 0.062' THICK BRASS SURFACE STRIKE WITH A CONCEALED 0.120" THICK STEEL PLATE tHFQRCEMEHT. 2 t 0 10 CENTER 36 - FROM BOTTOM OF .._. _.�. _._. KWIKSIT 12 00E • - --- - �..SCHU# f FYON . 0.050' THICK BRASS STRIKE AT OPPOSITE SURFACE Y7,JN r g g DESIGN PRESSURE 6 SINGLE CDER DEAD BOLT - MFR & MODEL /. a RATING (CENTERED ABM PASSAGE LOCK). KWIKSET 1660 OR SCHLAGE #B160N +48.3 PSF 0.062 - THICK BRASS SURFACE STRIKE W/A CONCEALED (14-) (5.5') A A 0.120' THICK STEEL PLATE REINFORCEMENT. 7 4' X. 4' .0,W .HINGE. WITH. SM7ETY .STUD..- HA4ER. I.1.843- 0R -P_EN OD. !!!H4� AP._. d�FR ._a -3/ brio. a4 • —58.5 PSF FROM T OF - DO - TO DOOR: (4) 19 X 3/4' FHWS. TO JAMB: (3) j9 X 3/4' 8 4 X 4 BUTT HINGE - HAGER /1841 OR PENROD /MH40AUWS. CENTER 31 -3/4' A 58" FROM TOP OF 80-0 ~"" DOOR. SCREWS - TO DOOR: (4) 19 X 3/4 FHWS. TO JAMB: (3) /9 X 3/4 FHWS k (1) 1 9 X 2 -1/2 FHWS. C 0—O C 9 THRESHOLD -MODEL IJR100 (DEPTH X NOSE HEIGHT) 2 -1/2 X 1 -1/8" 2 -1/2� X 7/8' 3' X 1 -1/8" ' WEATHERSTRIP - SCHLEGEL MODEL / /DDS -650 HERST OR /ODS 650 OR #M -928 10 FRAME - 1-1/4 X (WOOD) 4- 9/18" OR 5-1/4 - RA00ETTED AND KERFED FOR WEATHERSTRIP. EACH CORNER WAS CAl1LJCED AND ATrAcHEb WITH THESE DOORS REQUIRE (3) 3/4 X 2 LONG GUN DRIVEN STAPLES. WEATHERSTRIP - SCHLEGEL /ODS -650. 9 MIAMI DADE COONTY 11 HEAD PLATE TO MATCH FRAME - WITH 3/8' 3 PLY PLYWOOD ATTACHED WITH CLUE & 3/4' STAPLES 1 TO 1 -1/4 7 7 7 APPROVED SHUTTERS. tR$. FROM EACH EDGE .k 8 -3/4' (AVG) O.C. AND (3) STAPLES PER JAMB. 4 3 4 • 1HERSTRIP - SCHLEGEL MODEL r 10DS -650 OR OM -928 1 S � 15 15 • • • 0 • • • • • • i • 0 12 X 3 i li 0.0076 VyM ILAP GLUID TO BOTTOM OF ASTWIGN- 10 10 i • • • • • • • • •;13 FRAME+ t;cRM To • 2x w0oo eucic. , /�o. x.. � i • i • 0000 • • •00( - , 2 -1/2'. Fttyrs. Ei FROM coRirFJtS ec 24 OC (►ux). • • IRK., ABS AND O HM 6' FROM CORNERS AND 20' O.C. MAX • • • • • • • • • 130. FRAM SCREWS TO *WMNRY - 3/16' FM TAPCONS W/ 1 -1/4 MIN. ENBEDMENT 'INTO MASONRY. 16 B 12 16 16 16 12 B 16 • • • • • 0 • „SP • • 0 i � 0 004 We NG . - 0 • • • 0 75' MAX.'WIDTH 38 1/4 MAX WIDTH 0 0.14 50 WEATHERSTRIP AT OU TSIDE EDGE AT TOP OF 80TH DOORS. 0 :::: * • • • • • • 0 ••0••• • PEMKO r$S8 AT Oti7rlOG EDGE AT LOCK STILE OF ACTIVE DOOR. • • • • • • • � • • •00: 5 PtIIC 3A5AY RAINf u1+P ec SWEEP ATTACHED W 0 . • � / /6 X 5/8' RHSMS O 6' O.C. • • • • • • • • •• - . • • T8 PAO/WVERTER AT 60 • OF EACH JAMB. 1' X 2" X 3/16' 0 000• •0 • •• t •0 • • E PA�F)�Of1�iER AT 1'J ?f * OF ASTRAGAL SELF ADHESIVE PILE PAD• • • • • • 0 • • • 3/M 6` T111CK nWFtfilo %ASS IT M • 0 • • 0 • • • • 0 0 • 3/�• Tom. t 5/8' DE OVOLO WOOD MOLDING ALL A FASTENED USING 3/4 LONG X 3/16' WIDE fees •6 C M -DRIVEN WIRE STAPLES SPACED AT 3' O.C. J _ R #300 ASTRAGAL W j SLEEVES & KERFEO - FOR WEATHERSTRIP CLEAR GRADE ITE 9 DOUGLAS EQ 2.875 - E # 1.0 2.50' 1' A -B MARINE J —R #100 THRESHOLD I / 1/8. X 3 /e" 9 -PLY PLYWOOD WOOD & ALUM W /QDS WEATHERSTRIP KERF 2s OR (1) #10 X 1 FHWS 2 FROM EACH ENO 1.750' 1.0' 3' AND 10 OC (SIX TOTAL.) (1) #10 X 2 -1/2' FHWS, 4 -1/2 TO I O + Drawn by: J. Hermoso EACH SIDE OF CENTERUNE (TWO TOTAL.) L — 1- Date: 12/12/99 LUMBER 1,0' 1.75" 1.0' OR 1.250- -- (2) EACH 3/8 SCHEDULE Approved :ar�mplying with the Revisions: — 1 -3/8" 40 STEEL PIPE SLEEVES Florida A -mlina Cnde Name INACTIVE LEAF 8 - 3/4' LONG BORED TO Datc 04 ICo Drawing #99 CLEAR THE FLUSH BOLT. NOAN D7 ALUMINUM EXTRUSION — 2 A= � — 2 �,7 - (1) AT EACH END OF fNiamlDadc Product Conlrol Drawing itle: WOOD PORTION (1) /10 X 2.5' FHWS AT CENTERLINE THE ASTRAGAL Di r•'alon g (1) 12' TO EACH SIDE, AND BY FBMA SERIES 5001 BALANCE 10 OC (SEVEN TOTAL) 1.750' I WOOD DOOR MINIMUM EMBEDMENT 1.0" DOOR —1 Page I of 3 .^ � ° Illinois -_.,� Mari tza ' ~ ° GNT ENTRANCE DOORS (EXTERIOR) MODEL 5001 1 3/4 FIR MAXIMUM PANEL WIDTH 36" Minimum Dimengions - [I El Af LIU Ll Lj U1 y—q be 000 EM 0 0 0 -M.. Ij EA s a :*&a:: s et@* 0 0 1 0 0 OD sea* 0:04 0 0000 0 -_-00_�_-- 0 —���_���� �� / +=�===���_- 00*4 so °°°°= ~~~~~. °° ~ - ° °°°° ~~~~ ° _ °°°°°° ° ° - ~ °°° ° * °°°° �-' ° ° °°°°°° ° °°° ° ° ~ °:° 00 Drawn by: J. Hermosa Dote: 12/12/99 Approved as complying with the Revisions: Florida Buiding Code Drawing #99-01 �hon§�� � Ylrg�n�o / California � [��s�no U\ Mr/so Miami Do& Product Control Drawing Title: By F8MA SERIES 5001 WQOD DOOR Page 3 of 3 ?e etl Miami Sh r Sh V illage o g g D e p artment artment APR 0 7 2 010 p 10050 N.E.2nd Avenue, Miami Shores, Florida33138' Tel: (305) 795.2204 Fax: (305) 756.8972' INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit N o. - q% PERMIT APPLICATION - Master Permit No. FBC 20 Permit Type: BUILDING ROOM G Owner's Name Fee Simple Titleholder f �' UL D U �r S n # Owner's Address 7d p ho City jyP.Et 1'li State A !� ' Zip 3l Tenant/Lessee Name Phone # Email Job Address (where the work is being done) SA City Miami Shores Villa a County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Flood Zone Contractor's Company Name' 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 (if applicable) Phone Value of Work For this Permit $ Square ! Linear Footage Of Work: Type of Work: Addition ❑Alteerration // ❑New ❑ Repair/Replace ❑ Demolition Describe Work: Submittal Fee $ Permit Fee $ {_ ` IL CCF $ CO /CC $ Notary $ Training /Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Tota] Fee Now Due $ MA_ ?41 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 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 1 n roved and a reinspection fee will be charged. Signature Signature O er or Agent Contractor 2 The foregoing i trument was acknowledged before me this `� The foregoing instrument was acknowledged before me this day of &al 20 _a, by L.(� day of , 20 _, by who is personally known to me or who has CYl1tJ " who is personally known to me or who has produced A 0 � As identification A'd wbwtlig foe �v 6*h. as identification and who did take an path. NOTARY PUBLIC: ` �� - ° 's�,' r �� 0 d , = NOTARY PUBLIC: Sign: 'o O�° © 'y:' Sign: ca�� Print: / �'i: /Ua �J a _ Print: My Commission Expires: My Commission Expires: APPROVED BY Plans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009) Receipt Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Number: WS -3 -07 -498 Owner Address: Invoice Number: WS -3 -07 -27829 40 NW 102 ST Applicant: PAUL DOUGLAS BARKER MIAMI SHORES, FL 33150 Company Name: Job Address: 40 102 Street NW Miami Shores Village, FL Date Payment Type Check Number Amount Change Monday, March 19, 2007 03/19/2007 Credit Card $119.55 $0.00 Total Payment: $119.55 Page 1 of 1 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 - 140278 Permit Number: WS -3- 0 Scheduled Inspection Date: April 13 2010 Permit Type: Windows /Shutters Inspector: Bruhn, Norman Inspection Type: Final Owner: BARKER, PAUL Work Classification: Door Replacement Job Address: 40 NW 102 Street Miami Shores, FL 33150- Phone Number Parcel Number 113101018014 Project: <NONE> Contractor: HOME OWNER Building Department Comments Inspector Comments Passeds� CREATED AS REINSPECTION FOR INSP- 57798. Missing anchors NB Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 12, 2010 For Inspections please call: (305)762 -4949 Page 13 of 17