BP-04-1372Miami Shores Village,,�R
Building Department uu`�� --°
10050 N.E.2nd Avenue, Miami Shores, Florida 3313 OCT '.� 24
Tel: (305) 795.2204 Fag: (305) 756.8972 _
BUILDING
PERMIT APPLI TION
FBC 2001
Permit Type (circle : Building Electrical
Owner's Name (Fee Simple Titleholder) 6rlpr y e. &
Owner's Address
^44 S t,
Permit No. 610,900q -1,37 a
Master Permit No.
Plumbing Mechanical Roofing
Phone#
es.4
City f;4..y%. State Fc- Zip 33 / 3 b�
Tenant/Lessee Name
Phone #
Job Address (where the work is being done)
City Miami Shores Village
County
Miami -Dade
Zip 3 31 3
Is Building Historically Designated YES NO X
Contractor's Company Name Phone #
Contractor's Address ,.c
City
Qualifier.
Architect/Engineer's Name (if applicable)
State Zip
$ Value of Work For this PermitSDo
Phone #
Square Footage Of Work: (2 -1 L F
Type of Work: ❑Addition Alteration ❑New ❑ Repair/Replace ❑ Demolition
Describe Work: tc_ ?,t I�c.� c �'�►,i �e CA
c�
Submittal Fee $� Permit Fee $ � CCF $ �. 6 CO /CC
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ Zoning Bond $ '-
Code Enforcement $ �^ Structural Plan Review. $
Total Fee Now Due $ 4q/ q9
C.
(Continued on opposite side)
23
Bonding Company's Name (if applicable) _
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 Signature
455" or Agen Contractor
The foregoing instrument was acknowledged before me this / The foregoing instrument was acknowledged before me this
day of p C ry 20 by J (90 t� , day of , 20 _, by
who is personally known to me or )kf has produced) who is personally known to me or who has produced
yAs0identifica on and who did take an oath. as identification and who did take an oath.
NOTARY PUB_�: NOTARY PUBLIC:
Sign:
Print:
My Commissio Exp' es: ^ ' *= Expires: May 26, 2008 My Commission Expires:
k *:t *R * ** * 71+r �� *:F *lr���iP%k:Y, UBnUG[SOIK71n�•O�Y��jk 9t ie *�t 9c Ye 9t 9e 9e is �t �k 9: 9e �i �Y �t �F9c �Y:F9e *s4 *�Y �Y �e �t �Y *�c:F 9c� *fie ie �Y *�Y �t �Y �Y 9c �kkkk *�Y �F �t:Fk
H (Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
APPLICATION APPROVED BY:
Ghe 12/15/03
Plans Examiner
Engineer
Zoning
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305 - 795 -2204
Building Inspection Request
Date -Time
Type Insp'n
Permit No, #..2�_)z�c)z)
Name „ e1.c w A
Company
Phone #
For Inspector: i Z Y7 k a C Name & Date
Approved ❑ pzj I —a—,
1-24m. -2�z,
Correction
Re- Insp'n Fee ❑
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bu i ding Inspection Request
Dat ►)
Type Insp' n Permit No. No. 4"" i : � t
Name --�
Address
Company�'�
Phone #
Inspection Date oZ
Approved
Correction ❑
Re- Insp'n Fee ❑
Correction ❑
Re- Insp'n Fee ❑
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE .STATEMENT
I being the legal property owner, for the property
Located at:
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),sgnd I have read and understand the following disclosure :
Statement, which entitles me to' Vork 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 const! uction yourself. You may build or
impmve 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 FZ.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. III foregoing instrument
Was acknowledged before me this day of , 20
BY who is personally known to me or who has
as identification and who did take an oath:`
Produced
Notary
Backyard Fence Details
Godfrey Residence
1481 NE 10e Street
Miami Shores, FL 33138
(305) 586 -5092 cell
1) Install a 4 foot Aluminum Fence across the backyard (safety rail for kids)
2) The fence will be installed parallel to the existing sea wall
3) Post (2x2) to support the fence will be installed every 5 feet
4) Post holes will be dug at least 2 feet deep and 1 foot round
5) Post holes will be filled with cement
6) 3 gates ( 4x4) will be installed to provide access to cannel
0/19/0
.BOUNDARY SURVEY IVew
Ask WATEWAY VOOD
1 7.5a' N8g•50'S4'E IN WATER
•tONC.�'
EAST I/2 LOT IS - Ial
BLOCK 1 �l LINE LOT LOT 17�
BLOCK 1
LOT 18
BLOCK 1
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(140 LR)
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1 80' 2.0s' •�
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GRASS
a .ASPHALT �''� N
LIRIVEVAY-
C-9-S. ONE STURY
RESIDENCE
1481
GRASS
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�APprov_ed
GRASS
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Y ENGINE
cu
50' CBS
3RCH
RICK CQLUFIR'
STEP 6' I'• X 1.45' V.
GRASS BRICK GRASS
DRIEVAY '
GRASS
LILT I
BLOCK
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127,50' MR) N89`50'54'E OWL
0''� RSPHALT
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15.100' PARKWAY .ASP14ALT c 01
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a
/'.BASIS OF HEARING
NOT VALID UNLESS EMBOSSED WITH
SURVEYOR'S SEAL
REVISED:
to art
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&am NE 102 S TRr EE T ASPN. -PAVE. --
gym' EMFNLIP•B30NcPIPEEPK.ON
;MA
+CUrnA�CONOfTIONgR PI10,P gRiy CQRNEf1, yqj{ ".D
' $ C4CLPJ�R. RB•RESAR. Ui•LIfA.*p
p'wwGM 4IIAx E•CRAWAGH FASSMEN{, CfL•CENTpR LOVF. Q•pIAMTMp.= SLAB.
R•ASCOROED, FNCR•ENCROACipdENtc WMAL N- AWASUPZ0.
v000oa- oPPWP4P.POwERPOLZ=QMe s- ssrfee•rwsHPtooa
aoRAwAC�e�ASxr -wage ELEVATION BASED ON LOC.
SURVEYOR'S N�TFC CBM# ELV. ;
TITLE WILL HAVE TO BE MADE TO DETERM NE RECORDED INSTRUMENTS,2IFANY AFFECTING EXAMINATION TO THE ABSTRACT OF
NO UNDERGROUND IMPROVEMENTS WERE LOCATED. A) ELEVATIONS ARE REFERRED TO NATIONAL GEODETIC
ECTING THIS PROPERTY. 3),-- .
VERTICAL DATUM OF 1929. 5) THERE MAY BE ADOMONAL RESTRICTIONS NOT SHOWN IN THIS SURVEY THAT MAY
BE FOUND IN PUBLIC RECORDS OF MIAMI_DADE COUNTY. 8) LEGAL DESCRIPTION PROVIDED BY CLIENT 7}
UNLESS OTHERWISE NOTED RECORDED OR MEASURED DATA ARE INSUBSTANTIAL AGREEMENTS. 8) BEFORE
ANY CONSTRUCTION THE SET BACKS MUST BE CHECKED. 9) THIS SURVEY IS INTENDED FOR MORTGAGE OR
REFINANCE PURPOSES ONLY, EXCLUSIVELY FOR THE USE BY THOSE TO WHOM R IS CERTIFIED. THIS SURVEY IS
THIS OBE USED FOR CONSTRUCTION PERMITTING, DESIGN OR OTHER USE WITHOUTTHEWRITTEN CONSENT OF
THIS COMPANY. 10) BEARINGS WHEN SHOWNARE REFERAEO TOANASSUMED VALUE OF SAID PB ' ,PAGE CL_
Q
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oc
POOL
7.00,
'
13.4Q'
� •`�•
TERRACE
TILE
A/C
0
1
i
6' IRON F. �
ct
1 80' 2.0s' •�
• z
GRASS
a .ASPHALT �''� N
LIRIVEVAY-
C-9-S. ONE STURY
RESIDENCE
1481
GRASS
A:-I: a
ME TAI_ F.
i
C13NCr —c
a �, • • , -r
A
4 ..• a ..
CON .
ZoniAg
�APprov_ed
GRASS
o l _ PmL
Y ENGINE
cu
50' CBS
3RCH
RICK CQLUFIR'
STEP 6' I'• X 1.45' V.
GRASS BRICK GRASS
DRIEVAY '
GRASS
LILT I
BLOCK
3
•
w
P
0
•
0
0
z
n
tL
v
a
tt}
cu
f
F.I.P.
of /8'
om 14)
127,50' MR) N89`50'54'E OWL
0''� RSPHALT
• F.
15.100' PARKWAY .ASP14ALT c 01
�-+ c (NO
a
/'.BASIS OF HEARING
NOT VALID UNLESS EMBOSSED WITH
SURVEYOR'S SEAL
REVISED:
to art
�-
&am NE 102 S TRr EE T ASPN. -PAVE. --
gym' EMFNLIP•B30NcPIPEEPK.ON
;MA
+CUrnA�CONOfTIONgR PI10,P gRiy CQRNEf1, yqj{ ".D
' $ C4CLPJ�R. RB•RESAR. Ui•LIfA.*p
p'wwGM 4IIAx E•CRAWAGH FASSMEN{, CfL•CENTpR LOVF. Q•pIAMTMp.= SLAB.
R•ASCOROED, FNCR•ENCROACipdENtc WMAL N- AWASUPZ0.
v000oa- oPPWP4P.POwERPOLZ=QMe s- ssrfee•rwsHPtooa
aoRAwAC�e�ASxr -wage ELEVATION BASED ON LOC.
SURVEYOR'S N�TFC CBM# ELV. ;
TITLE WILL HAVE TO BE MADE TO DETERM NE RECORDED INSTRUMENTS,2IFANY AFFECTING EXAMINATION TO THE ABSTRACT OF
NO UNDERGROUND IMPROVEMENTS WERE LOCATED. A) ELEVATIONS ARE REFERRED TO NATIONAL GEODETIC
ECTING THIS PROPERTY. 3),-- .
VERTICAL DATUM OF 1929. 5) THERE MAY BE ADOMONAL RESTRICTIONS NOT SHOWN IN THIS SURVEY THAT MAY
BE FOUND IN PUBLIC RECORDS OF MIAMI_DADE COUNTY. 8) LEGAL DESCRIPTION PROVIDED BY CLIENT 7}
UNLESS OTHERWISE NOTED RECORDED OR MEASURED DATA ARE INSUBSTANTIAL AGREEMENTS. 8) BEFORE
ANY CONSTRUCTION THE SET BACKS MUST BE CHECKED. 9) THIS SURVEY IS INTENDED FOR MORTGAGE OR
REFINANCE PURPOSES ONLY, EXCLUSIVELY FOR THE USE BY THOSE TO WHOM R IS CERTIFIED. THIS SURVEY IS
THIS OBE USED FOR CONSTRUCTION PERMITTING, DESIGN OR OTHER USE WITHOUTTHEWRITTEN CONSENT OF
THIS COMPANY. 10) BEARINGS WHEN SHOWNARE REFERAEO TOANASSUMED VALUE OF SAID PB ' ,PAGE CL_
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 10 /26/2004
Applicant: GEORGE/KAREN
Owner: GODFREY
JOB ADDRESS: 1481 NE 102
Contractor
Local Phone:
Parcel # 1132050240130
Building Permit
Permit Number: BP2004 -1372
Page 1 of 1
GODFREY
GEORGE/KAREN
ST
Contractor's Address:
Legal Description: MIAMI SHORES BAY PK ESTS AMD PB 56-86 LOT 17 & E1/2 OF LOT 18
Fees:
Description
Amount
FEE2004 -10548
Building Fee
$127.00
FEE2004 -10554
CCF
$0.60
FEE2004 -10555
Notary Fee
$5.00
FEE2004 -10556
Training and Education Fee
$0.20
FEE2004 -10557
Technology Fee
$3.18
FEE2004 -10558
Scanning Fee
$6.00
Total Fees:
$141.98
Permit Status: APPROVED Permit Expiration:
Work: BACKYARD FENCE
Signed:
4/16/2005 Construction Value: $500.00
(INSPECTOR)
Total Fees: $141.98
Total Receipts: $0. 0
T 26MID
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 responisibiliity for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 10 /26/2004
Applicant: GEORGE/KAREN
Owner: GODFREY
JOB ADDRESS: 1481 NE 102
Contractor
Local Phone:
Parcel # 1132050240130
Building Permit
Permit Number: BP2004 -1372
Page 1 of 1
GODFREY
GEORGEIKAREN
ST
Contractor's Address:
Legal Description: MIAMI SHORES BAY PK ESTS AMD PB 56-86 LOT 17 & E1/2 OF LOT 18
Fees:
Description
Amount
FEE2004 -10548
Building Fee
$127.00
FEE2004 -10554
CCF
$0.60
FEE2004 -10555
Notary Fee
$5.00
FEE2004 -10556
Training and Education Fee
$0.20
FEE2004 -10557
Technology Fee
$3.18
FEE2004 -10558
Scanning Fee
$6.00
Total Fees:
$141.98
Permit Status: APPROVED Permit Expiration:
Work: BACKYARD FENCE
4/16/2005 Construction Value: $500.00
Signed: (INSPECTOR)
Total Fees: $141.98
Total Receipts: $0.00
5�
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: