PT-306-775 Miami Shores Village RSCEOVED
`
Building Department P72.05
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 -
Tel:(305)795.2204 Fax:(305)756.8972
BUILDING Permit No. I�`3o6 - jjj
PERMIT APPLICATION Master Permit No.
FBC 2004
Permit Type(circle) Buildin Electrical Plumbing Mechanical Roofing
Owner's Name(Fee Simple Titleholder) S1DDN A:& MH S •346S Phone# -2;0-'9 -
Owner's
0-'9 •Owner's Address
City ffi ickyA s�/ Jt& State r L Zip 33 13
TenanvLessee Name Phone#
Job Address(where the work is being done) Sam- V"�"bo�Q...•
City Miami Shores Villa
e County . Miami-Dade Zip
FOLIO/PARCEL#
Is Building Historically Designated YES NO
Contractor's Company Name 0 W I c*/- Phone# 3ys- �•
Contractor's Address eef� r
City State Zip
Qualifier Name Phone#
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name(if applicable) Phone#
�
• 0
Value of Work For this Permit$ J C70 Square/Linear Footage Of Work:
Type of Work: []Addition ❑Alteration []New C, Repair/Replace ❑Demolition
Describe Work: ' A t EARA"o-/-
Submittal
fSubmittal Fee$ Permit Fee$ 60 . 00 . CCF 0 CO/CC
Notary$ OU Training/Education Fee$ 0 .Z Technology Fee$
Scanning$ Radon$ DPBR$ Zoning$
Bond$ Code Enforcement$ Double Fee$
Structural Review.$ Total Fee Now Due$ • 30
See Reverse side
� F
Bending 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 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
r or gent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of�--,20 Q&by day of .20—'by
who is personally known to me or who has produced 1, 11[JU 13 who is personally known to me or who has produced
L(MCO 1-1 631-AAs identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: U —m a Sign:
Print: dA1ta qL .' ES: r Print:
8,,,datnN
My Commission Expires: :Rc„ My Commission Expires:
APPLICATION APPROVED BY: Plans Examiner
Engineer
L-2) (P Zoning
(Revised 02/08/06)
Miami Shores Village
Paint Color Approval and Agreement
Date 3 2 0 (c, ^^ AAt _
Owner's Name S ' CI C I/lQ/ U Phone# 3�� ' y� �5�
Owner's Address o2 - 0J C 9 ` S�— — 1
City lM(CA" S o14, State ['L- Zip
Job Address (where the work is being done) Sa -,e—
City
,e -City Miami Shores Village County Miami-Dade Zip
Is Building Historically Designated YES NO �?4_ —
Contractor's Company Name(if applicable)
Phone#
************************************************************************************************************
t_All elements on the site must be listed and indicate the color to be painted
Walls
Fascia
Drip Cap/drip Edge
Soffit
Roof
Flower bins Attach Color Samples
Shutters
Awnings I i i s t 11J i Ca R
Chimney
Doors and door jams
Garage doors
Railings
Fences
Blanco Ultra Piro 2050
Decorative metal Ultra Pure White 2050
All brick(simulated or regular)
Stucco banding
Any other stucco features
Accessory Buildings
Other
************************************************************************************************************
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.
Date
Signature
caner or Agent
Date `°I
APPLICATION APPROVED BY: Z Official dhc 6/18/03
&
VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
NAME: S; DATE: 3 . 20- •O
ADDRESS:
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 .59
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 S
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
r
5. I understand that as an owner-builder, that any contractor disputes with sub-
contractors and myself must be handled in a civil court with the advice of an
attorney. The department will not mitigate any contract disputes.
Initial
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 business license I will be responsible and liable for any wrong
doing from this unlicensed company or person.
Initial S
7. I understand that if any person gets injured on my construction project—they 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.
Initial
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.
Initial
Was acknowledged before me this L day of , 20
By sAkl�ll. 't� who was personally known to me or who has
Produced there License orI('fNU'1S LIC -" ZO lil "6_J 1U0 as identification.
OT Y
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020 �.
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Miami Shores Village
Building Department
10050 NE 2 Ave, Miami Shores, FI 33138
Tel: (305)795-2204 9 Fax; (305)756-8972
2/29/2008
To: Current Owner
1257 NE 94 Street
Miami Shores Village, FL 33138-
Permit: PT-3-06-775
Address: 1257 NE 94 Street
Miami Shores Village FL33138-
Date Expired: March 27, 2007
Type: Paint
Date of Last Inspection: It hasn't been inspected
Dear Sir or Madam,
Our records indicate that the above referenced permit has expired without obtaining the proper
final inspection. In order to serve you better, we need to keep our files up to date.
As per section 105.4.1 of the Florida Building Code, "Every permit issued shall become invalid
(expired)unless the work authorized by such permit is commenced within six months after its
issuance, or if the work authorized by such permit is suspended or abandoned for a period of six
months after the work is commenced, or completed without obtaining the final inspection of the
work performed.."
Please be advised that open permits will hinder your ability to refinance or sell this property
Please contact the Building Department, within 15 days of receipt of this letter in order to
take care of this matter.
Sincerely,
OaudioGrande CBO
Building Director
,yH 1Es Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795-2204 Fax: (305)756-8972
�LORtDp`
Permit
Permit Status: APPROVED
Issue Date: 3/28/2006 Expires: 03/27/2007 Permit Number: PT-3-06-775
Owner's Name: SIDDHARTH AND KAREN BASS one: (300)575-4085
Permit Type: Paint
Parcel#: 1132050100060
Work Classification: Repair
Block: Lot:
Job Address: 1257 94 Street NE Section: PB:
Miami Shores Village, FL 33138-
Contractor(s) Phone Primary Contractor
Total Square Feet: 0
HOME OWNER Yes Total Valuation: $ 500.00
Comments: Re uired Inspections
EXTERIOR PAINT Final
Additional Information
Type of Work:Exterior Color:ULTRA PURE WHITE 2050
Additional Info: Classification:Residential
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 responsibility for all work done by either myself, my agent, servants, or
employes. I understand that separate permits are required for ELECTRICAL,
PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING
POOL work.
OWNERS 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. Futhermore, I authorize the above-named contractor to do the work
stated.
Fees Due Amount Invoice Number Amt Due Amt Paid
CCF $0.60 PT-3-06-24245 $67.30
Education Surcharge $0.20 Total:
Notary Fee $5.00
Permit Fee $60.00
Technology Fee $1.50
Total: $67.30
Building Department File Copy NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS,STATE AGENCIES,OR FEDERAL AGENCIES.
Applicant Signature