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BP-05-903Miami Shores Village, +d Building Department ec 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305)795.2204 Fax: (305) 756.8972 BUILDING Permit No. PERMIT APPLI ofirical .5 2015. Master Permit No FBC2001 - ------ Permit Type (circl Building Plumbing Mechanical Roofing Owner's Name (Fee Simple i e older) j� ����e,$6Pt a 4 Phone f�S 7S n A o e o Owner's Address City� State,. EZ Tenant/Lessee N Job Address (where the work is being done) Zip Phone # City Miami Shores Village County Miami -Dade Zip 3 Is Building Historically Designated YES NO ?� Contractor's Company NameX © Phone # Contractor's Address City Qualifier State State Certificate or Registration No. Certitf Competency No. Architect/Engineer's Name (if applicable) Phone_# 0 $ Value of Work For this Permit Com' o Square Footage Of Work: Type of Work: ❑Addi71jjZ,71 ❑Alteration [–]New F1 Repair/Replace El Demolition Describe Work: / //� (E.. 5 FE Submittal Fee $—!I rmit Fee $ CCF $ CO/CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Code Enforcement $, Total Fee Now Due (Continued on opposite side) Radon $ Zoning Bond $. Structural Plan Review. $ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State .Of 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 �o ' Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this e foregoing instrument was acknowledged before me this_ day of , 20by i ,Icy'd of 20 _, by who Usp rsonally to me or who a i_ who is personally known to me or who has produced s identification and who did take an oath. as identification and who did take an oath. NOTARY Sign: Print: My Com APPLICATION Coniniission D NOTARY PUBLIC: 1984 r... .�..o ,007 Ilonded Theo ^olantic RordineCn �n Sign: Print: My Commission Expires: Plans Examiner Engineer Zoning Chc 05/13/03 = as �1 ES" C 151E"a VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT OWNER BUILDER DISCLOSURE .STATEMENT being the legal property owner, for the property Located at: Legally descnbed as Do hereby petition the Village of Miami Shores to act as my own contractor pursua4t to the laws of the State of Florida, F.S. 489.103(7).gnd I have read and understand the following disclosure Statement, which entitles me to' 3rork 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. 1 You may also build or improve a commercial building at a cost of $25,000.00 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is completed, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing . ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A. and with-holdin and provide workers' compensation for that employee, all as prescnbed by law. Your construction ly with all applicable laws, ordinances, building codes and zoning regulations. Proof of ownership provided ( ) initial of reviewing clerk. Tlie fordgoing instrument Was acknowledged before me this � � day of 20� �By Kn �a_ 30nctsffi who is personally known tome or who has Produced as identificatio'A who did take an oath. J 6U Owner G otaa$yfThiru - %ocet t = =: Exp IN " Owner Ada Miami Shores Village Building Department 10050 N.E. 2"d Avenue Miami Shores, F133138 Tel: 305-795-2204 Fay:: 305-756-8972 8/9/2007 Owner: 22 NW 103 Street Miami Shores Village FL 33138 RE: Process No.BP2005-903 Address: 22 NW 103 Street Miami Shores Village FL 33 L38 Dear Owner, In reviewing our files, we have found that there is an open permit submittal dated back to June 15th, 2005. The file has been inactive for over two years and 2 months (790 days) without any response from you or your representative. As per the requirements of the 2004 Florida Building Code, section 105.3.2, "An application for a permit for any proposed work shall be deemed to have been abandoned 180 days after the date of filling, unless such application has been pursued in good faith or a permit has been issued " Please be advised that if no attempt is made to this Department in writing and justifiable cause demonstrated within 15 days of receipt of this letter, the plans and related paperwork submitted for permit will be considered abandoned, and will be destroyed. Please do not hesitate to call me, if you have any questions related to the above mentioned matter or any other issues related to our Department. Sincerely, MabYeIrgas Building Department Supervisor 305-795-2204