Loading...
WS-07-1322W Miami Shores Village - �s 0 Building Department 3� - -gI b q 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 �� Tel: (305) 795.2204 Fax: 756.8972 BUILDING JUN 2 6 2007 Permit No. UUS M— 1 02.2, PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type (circle): uilding Owner's Name (Fee Simple Titleholder) Owner's Address 0 G d City_ _ State V Electrical Plumbing Mechanical Roofing SC�( Phone -� f 5-7 I 9Jn Zip 3 3 / '3-,z?> Tenant/Lessee Name Phone # Job Address (where the work is being done) Lo 45-0 0 v l --& % ° City Miami Shores Villa-ae County ,Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES O� Contractor's Company Name ® `�` '� Phone # Contractor's Address B City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of. Competency No. Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ 9 500c J Square / Linear Footage Of Work: Type of Work. ElAdditiallh ❑Alteration P19ew ❑ Repair/Replace ❑ Demolition Describe Work: 0 Submittal Fee $ Permit Fee $ !n CCF $ 0 400 CO/CC Notary $f5'00*-,Training/Education Fee $ •c V Technology Fee $ .00 Scanning $ (0 i1 Radon $ DPBR $ Bond $ Code Enforcement $ Structural Review. $ Zoning $ Double Fee $ �0 Total Fee Now Due $ : See Reverse side Bonding Company's Name (if applicable) Bonding Company's Address City State Zip AF Mortgage Lender's Name (if ap icable)V l CilCK Mortgage Lender's Address V &P 1 S-7[ City O; State (2 -pr Zip 95 — _2 ?4o o 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 ingoo faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose proper subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first ' ction which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection ill be approved and a reinspection fee will be charged. Signature. Owner or Agent Contractor The fore oing instrument was acknowledged before me this % The foregoing instrument was acknowledged before me this day ofj(o&., , 20M by S day of . 20 _, by who is personally known to me��"ap h�j u who is personally known to me or who has produced As identi�iati '&an oath. p y as identification and who did take an oath. NOTARY PUBLIC: Sign: / Print: dr1dC4rjen, My Commission Expires: APPLICATION APPROVED BY: (Revised 02/08/06) NOTARY PUBLIC: '*1N2\SS\"�obe����°"'� Si 4A :,Ma; Print: My Commission Expires: Plans Examiner Engineer Zoning W VILLAGE OF MIAMI SHORES OWNER BUILDER. DIS'GT.ngTr-DE ST. A.TEMEIVt NAME: w DATE: ADDRESS: ®bT obi ?3I3 D'o hereby petition the Village of Miami Shores to-aat as my own contractor pursuant to the laws of the gtate OfFlorida, FS 489.103(7). And I have -read and understood the following disclosure ststeritent, which entitles me to work as in own pqutractor; I further understand;th*4t 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 bu41d or improve a one•family or two-family residence. You may also build or improve. a commercial buitding at a cost -of $25,000.00 or less. The building must be for yotlr.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.constructlon is co te, the law will presume that you built for sale or lease, which is a violation of this exempti�. u may not hire an unlicensed person as a contractor. It is your responsibility to make sure th employed by you have licenses required by state law and by county or municipal licensing t es. Any person working on your building who is npt licensed must work under -your super d must be employed by you., which means that you trust deduct F.I.C.A and wlth holdings d� provide workers' compensation for that employee, all as prescribed by law. Your consct must comply with all applicable laws, ordinances, buildings codes and zoning regulattons. Please read and initial each paragraph 1. I hold title to the above property and I am planning on doin*hitruction In 2. I understand that as an owner -builder 1 must abide by all zoning inances and building regulations in effect at -the time of permit application 3.:1 have an understanding of the 2004 FBC & FRC and understand that this department and its inspectors are there to help enforce and intent the code. There is a copy of the code in this office for review. �I 11 Ini 4. I understand that the building official and inspectors are notre to design, alier or give advice on how to meet code —. only if the t e meets the minimum -code. I understand that as an owner -builder, that any contractor disp es with sub- contractors and myself must -be handled in a civil court with t vice of an attorney. The department will not mitigate any contract disputes. 6.• I 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 bi}siness license I will be responsible and liable for any wrong doing from this unlicensed ctimpany-or person. Initi 7. - I-pmderstand that if any. person gets- injured" on my constructi roject—they are entitled to workmen's compensation. And if they do not posses workmen's policy I could be held liable for all doctor and related cost oss dor include loss of wages during recovery from injury. 8. T understand that- under state and local laws I- can' not Plumbing, Heating, Air & Roof work on my -property with out the proper permits by licensed eontraators. �® Initi Was acknowledged before me this day ofJ_OKQ,, 20 By ill l�i SAD who was personally known to me or who has Produced there License or 0 ) 1M. X/O as identification.