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RC-07-14Miami Shores Village °, Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING l @ MEV Permit No.0 e — li PERMIT APPLI 1 CATI j�` Master Permit No FBC 2004 JAN 03 2001, N., BYE % Permit Type (circle): Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple eholder) P41 9/ Pe Phone # ` ' = y 7 Si- J q t.i 5 Owner's Address 9 s &AT (ci d i s`-R,14.-1,1— City N (ri ( SI r ' State L_ Zip 11 3 t Tenant/Lessee Name Phone # Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name NIAtefb Phone # %',1C,L4a p Lau.cekcl Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Architect/E gineer's Name (if applicable) 14444-- t e1 el"- Value of Work For this Permit $ Phone # sc2 b- 3 037 Square / Linear Footage, Of Work: 00 r , Type of Work: DAddition DAlteration DNew ►� ;Re air/Re lace p p ❑ Demolition Describe Work: ( o T t ***************************************pees**************** ** ** * *** * * * *** * * * **** * ** Submittal Fee$ Permit Fee $ C 0 CCF $ CO /CC Notary $ Gj'00 Training/Education Fee $ ( 20 Technology Fee Scanning $ (-90 Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ (11 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 insta mdicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work w 11 fit 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 Owner or Agent The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of A/4j , 20 , by clithAf 74/fp , day of , 20 , by who is personally known to me or who has produced t' %SAS:T* who is personally known to me or who has produced as identification and who did take an oath. Signature Contractor Z.OZ9C3e1' As identification and who did take an oath. NOTARY PUBLIC: � °`f � �r� /1;r'K (4e// My Commission Expires: NOTARY PUBLIC: Sign: Print: My Commission Expires: * * * * * * * * *** * * * ** ** * ** **** *** * * ** * * * * * ** ** * * ** * *** APPLICATION APPROVED BY: (Revised 02/08 /06) Plans Examiner Engineer Zoning STATE OF FLORIDA) COUNTY OF DADE) /tom S'Arre4Vd lage et if Deftaa steect 10050 NE 2nd Ave Miami Shores, Fl 33138 Phone 305-795-2204; Fax 305-756-8972 www.miamishoresvillage.com AFFIDAVIT AR ��SAW o3 �D BY:_.! The undersigned Affiant, C: v' P Oct"-, , does hereby attest that (property owner) The attached survey, performed by t"5 -C /' ( (- (name of surveyor's company) for address: ,--)) 0 kW (c.R l S performed on 3 - 1-G t �) Li (date of survey) is an accurate representation of the existing conditions and 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 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 that the existence of any such structures may affect final inspections as applicable to this or other permits. Further, Affiant sayeth naught. Aie gr.''roperty Owner Signature Property Owner Print Name ,11) 111-1.0 P(-h c 510 c SWORN TO AND SUBSCRIBED before me this 3 day of �c,mLC(7. Affiant is /AT- ZQI personally known to me, roduced J' as identification. X95 c,c00 Notary Imcmutun I AN o s aom � VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT NAME: j44 !' P141 (3 0 DATE: 1 Z° ov. ADDRESS: Cl CV1.1- S . iZ �' 3 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 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 construction yourself. You may build or improve a one - family or two- family 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 your supervision and must be employed by you, which means that you must 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 this construction 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 3. I have an understanding of the 2004• ,FBC & :FRC 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. Initial 4. I 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 w contractors and myself must be handled in a civil court with the advic attorney. The department will not mitigate any contract disputes. Initial f 6. I understand that if I compensate any person or company for wok 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 understand that if any person gets injured on my construction ''S'ojectthey 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. 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. Was acknowledged before me this day of By who was personally known to me or who has ,20 Produced there License or as identification. OWNER NOTARY z tY N E . tA 4.4 70 ' • V 1JI©r;Wj. JAN 0 3 2007 Y-- - ® ........ This property described as: • Lots 5, 6 and 7, Block 170, SECTION "NO. 8 OF MIAMI SHORES, according to the Plat thereof, as recorded in Plat Book 14, Page 33 ' of the Public Records of Dade County, Florida. Note: Underground encroachments and utilities, if any, not located. FLOOD ZONE: X Certified To: First Financial Title Company of Ticor Title Insurance Company, Moody „Robert an Home Savings of America, F.A.. r rJ. Y—•A, Z.O'E1rS -.SUr . .• ••• • • • • • •• PROPERTY OF: Moody, Robert,. and•Kdn • 405Z•li E••100th Street Miami Shores Not valid unless embossed with Surveyor :Seal. A BOUNDARY SURVEY I hereby certify that the survey repre- sented hellion meets tore minimum tethr cal•star. ands sey froth flay �{te Boone of slam, Surveyors purs•antoto Seaton 474..020, Fla Statutes. Titre be rib encroalhments, oveelaps, eas•mehts na At the Pfaff •titer hereto. • Fla. Ne t eanssurvey: tee2rnat • DAT! • SCALE er�e►be,ii.f-ien}r� z.. _z6e o• is zo' 2 �_•.4 i ! 1 1-x.1 •e• • • 4 • ••e • • • • Iorida. 1 LANNES and GARCIA, INC. • • INGINEERS - LAND SURVEYORS - LAND PLANNERS • • • O#ice edclress: 4080 S.W. 84th Avenue, Miami, Florida 33155 •• • • 'Mailing address: P.O. Box 561131, Miami, Florida 33156 I DRAWN BY DRWG. NO bGcres e6 190 -2522 4 1T Yid k , + ., .t 1 t '. $. , q 5i.. This property described as: • Lots 5, 6 and 7, Block 170, SECTION "NO. 8 OF MIAMI SHORES, according to the Plat thereof, as recorded in Plat Book 14, Page 33 ' of the Public Records of Dade County, Florida. Note: Underground encroachments and utilities, if any, not located. FLOOD ZONE: X Certified To: First Financial Title Company of Ticor Title Insurance Company, Moody „Robert an Home Savings of America, F.A.. r rJ. Y—•A, Z.O'E1rS -.SUr . .• ••• • • • • • •• PROPERTY OF: Moody, Robert,. and•Kdn • 405Z•li E••100th Street Miami Shores Not valid unless embossed with Surveyor :Seal. A BOUNDARY SURVEY I hereby certify that the survey repre- sented hellion meets tore minimum tethr cal•star. ands sey froth flay �{te Boone of slam, Surveyors purs•antoto Seaton 474..020, Fla Statutes. Titre be rib encroalhments, oveelaps, eas•mehts na At the Pfaff •titer hereto. • Fla. Ne t eanssurvey: tee2rnat • DAT! • SCALE er�e►be,ii.f-ien}r� z.. _z6e o• is zo' 2 �_•.4 i ! 1 1-x.1 •e• • • 4 • ••e • • • • Iorida. 1 LANNES and GARCIA, INC. • • INGINEERS - LAND SURVEYORS - LAND PLANNERS • • • O#ice edclress: 4080 S.W. 84th Avenue, Miami, Florida 33155 •• • • 'Mailing address: P.O. Box 561131, Miami, Florida 33156 I DRAWN BY DRWG. NO bGcres e6 190 -2522 6a.` NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. ° TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Leg description of pro�.erty 2. D cripton f im us 3. Owner(s) name and addr ss: -� • / /4�l 94 Interest in property: cdQ /.--d7 9 b 11111111111111111111111 CFN 200-M0039588 OR Bk 25271 Ps 2907; Ups) RECORDED 01/11/2007 15 :33:16 HARVEY RUVIN: CLERK OF COURT MIAMI —DADE COUNTY? FLORIDA LAST PAGE E /0, 5 and.�tr address: Name and address of fee simple titleholder. 4. Contractor's name and address: 3 5. Surety: (Payment bondrgquired by owner from contractor, if any) Name and address: Amount of bond $ . 11/4-0444 6. Lender's name -and address: 0■0I .A. 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as Provided by Section 713.13(1)(a)7., orida Statutes, Name and address: �9""' 8. In addition to himself, Owners designates the following person(s) to receive a copy of the•Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement. (the expiration date is 1 year from the date of recording unless a different date is specified) Signa - ' o • vtner tint Owner's Name V Cl M y � Sworn to and subscrib: before me this J day of A •JLJ , 20Q7. Notary Public Print Notary's Na My commission expires: 123.01-52 PAGE 4 8/02 MYCOMMISSION# 0D214080 7Une 17, 2007 BONDEDffRUTROYFAIN INSURANCE, INC STATE OF FLORIDA, COUNTY OF DADE 1 t-1 I B Y ERT /FY that this is a tru py of the angina! n AO in this office on day of , AD 20 0,7— WI My hand and Ofhc al Seal. VIN, CLERK, of Circuit and County Courts �i D.C. Prepared by Address: 9_W 3A Y4 6 /0/ -wf /5%49 fV! 13i S-0 Inspection Date: 06/04/2007 Inspector: Rodriguez, Jorge Owner: SYDOW, JOHN Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Job Address: 950 100 Street NE Miami Shores Village, FL Project: <NONE> Contractor: HOME OWNER c� Permit Type: Residential Construction Inspection Type: Final Work Classification: Repair Block: Phone Number Parcel Number 1132060340200 Lot: Building Department Comme NEW SOFFITS ANF FACIA JUN 0 5 2007 Passed Inspector Comments �� C9‘ 0 7 Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Friday, June 1, 2007 Page 1 of 2