RC-05-1341"4
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 02/12/2008
Inspector: Grande, Claudio
Owner: GROSSWALD, DANIEL
Job Address: 301 98 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Patio
Block:
Phone Number
Parcel Number 1132060135610
Lot:
Building Department Comments
REPLACE WOOD WITH PATIO STONES PAVERS
•
Passed
Inspector Comments
cc
AFTER 4:00 P.M PLEASE
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Friday, February 8, 2008
Page 2 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building
Owner's Name (Fee Simple Titleholder)
Owner's Address f-3j d I rt. e
City (1 (ti M 1 .S In a c State P1 Zip 3 3/ 9
Tenant/Lessee-Name Phone #
DE
Permit No. R L341
ste " Permit No.
bing Mechanical Roofing
c J<_Phone # y6 S-2 5-7 6 14
Job Address (where the work is being done) 5'Q Mme-
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO
inoM�.
Contractor's Company Name
61,../ e —r'
Phone #
Zip
Contractor's Address
City State Zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit 4 - 00 • Square Footage Of Work: 11(0
Type of Work: (]Addition ['Alteration ONew Re air/Re lace
p p [I Demolition
Describe Work: - v ve.o ,
* * * * * * * ** ** * * * * * * * * * *** Fees * * ** * * * * * * * * * ** * * * * * * * *** * * * **
Submittal Fee $ Permit Fee $ /V CCF $ CO /CC.
Notary $E • CO Training/Education Fee $ d LC) Technology Fee $
Scanning $ 3 `" Ctp Radon $ Zoning Bond $
Code Enforcement $
Structural Plan Review. $
Total Fee Now Due $ L ( a-
(Continued on opposite 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 attach ent. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection . hich oc, rs seven (7) days after the building permit is issued In the absence of such posted notice, the
TIP
inspection will b, /pr. • and a reinspection fee will be charged
Signatwe I« S
Signature
Owner or Agent Contractor
The f oing instrument was acknowledged before me this Z°I The foregoing instrument was acknowledged before me this
day 20C:1)} -L-4 J . snemical ,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:
Sign:
Print:
My Cominiss' in Expius:
C.STATE OF FLORIDA
len H ez
NOTARY PUBLIC:
Sign:
Print:
**** ,�* , * * * * * * * * * * * * * * ** . * * * * * * *, * * * * * * *, , * * * * * * * * ** * * * * * *, * * * * * * *, * , , * * * *, *** * * * * * * * ** * * * * *** * ** ** **
My Commission Expires:
APPLICATION APPROVED BY:
chc 05/13103
'0� Plans Examiner
Engineer
a/ /6 � Zoning
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE .STATEMENT
being the legal property owner, for the property
Located at: ,JU( -nx ? 8 )71 ,,v_ 3 3 (, S %'"
Legally described as .
Do hereby petition the Village of 'anti 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 td York as my own contractor, I further understand that I as the owner
must appear in person to complete all applications.
DISCLOSURE STATEMENT
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 licensed 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 251 day old. , 20 bO--
gym 2A 111 J . ..-S ho is personally known to me or who has
Produced as identification and who did take an oath' •
•
Owner
ORIDA
S : dez
Co 27D476455 , 2009
►fires:
Bonded Thrn Atlantic Bonding Co., Inc.
i i�iaha.i SIior (/iLLCCC�e
STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant,
(property owner)
attached survey, performed by
performed on b 127
(date o survey)
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the
(name of s
does hereby attest that the
eyor's company)
is an accurate representation of the existing conditions and
property without first providing a survey less than six (6) months old. The Affiant, as property owner, further
agrees to remove or obtain permits for any structures which now may exist on the property which are not
permitted or which may violate zoning or building code regulations. The Affiant further understands thatthe
existence of any such structures may affect final inspections as applicable to this or other permits..
Further, Affiant sayeth naught.
Affiant/Property owner
Witness(sign and print) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this _ day of
Affiant is personally known to me, produced
as identification.
v r i
1A61 imnt. • 1 1 t li(;y
es: SEP 1
Atlan
Miami Shores Village
Building Department
Planning & Zoning Critique Sheet
Permit No.:
Applicant:
Job Address:
Date
Comments
1/4/6 r -r\is1 cx ► vie ft es 4e 2` 1►o
Initials
Peb lire
1-53"
v,dn P— 1e ,i, z es S('i kg. S / ,io7Ih
10050 NE 2 "d Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305)756 -8972
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