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PF-1205-1319 Miami Shores Village y Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 BUILDING ' ��^ 7 QPermit No. E 2 7 ��` a PERMIT APPLICATIO Master Permit No. FBC zoos _ � . M... Permit Type(circle): Building Electrical Plumbing Mechanical Roofing Owner's Name(Fee Simple Titleholder) �/ZS(.f;SPS J� ;or Phone# Owner's Address W ? Ci i y�-_ ?7u • State�z Te t essee Name Phone# Job Address(where the work is being done) City Miami Shores Village County _ Miami-Dade Zip Is Building Historically Designated YES NO Contractor's Company Name 4:ZP,/2 Phone# Contractor's Address City State Zip Qualifier State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name(if applicable) */) Phone# $Value of Work For this Per it 1' Square Footage Of Work: Type of Work: QAddition ❑Alteration ONew a air/Re lace p p El Demolition Describe Work: Submittal Fee$ Permit Fee$, CCF$...0. CO/CC Notary$�` Training/Education Technology Fee$ 1 •<5�D , Scanning$ Radon$ Zoning Bond$ Code Enforcement$ Structural Plan Review.$ CX Total Fee Now Due$ 4�,_7 ,30 L P (Continued on opposite side) DEC2 8 PAID Bonding Company's Name(if applicable) Bonding Company's Address t Y 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 O r or Age c Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 2qO S ,by�/(a �/ Ole � day of 20 by who is personally known to me or who has produced �-��'1/ ✓ .L �' Yr� is personally known to me or who hasP roduced 622- .426-. C0-ks identification and who did take an oath. as identification and who did take an oath. NOTARY I --- ----rTwn PUBLIC: MONICA LINETN DIAZ Sign: n yM N t DD 4839.95 ign: Print: / �/� lIr EXPIRES:October 20,20C 9 emded N pubpoutx rint: My Commission Expires: My Commission Expires: APPLICATION APPROVED BY: 61 Plans Examiner Engineer chc 05/13/03 Zoning Miami Shores Village Paint Color Approval and Agreement Date Phone# Owner's Name ( Owner's Address j2 _ City. State /::L Zip `3 Job Address where the work is being done) City Miami Shores Village County Mamii-Dade Zip Is Building Historically Designated YES NO Cl--, *' Contractor's Company Name(if applicable) � ��r(��, Phone# All lements on the site must be listed and indicate the color to be Rainted Walls C Fascid Drip Cap/drip Edge Soffit Fv_ Roof Tl�f/ Flower bins Attach Color Samples Shutters Y41 A CI t-'( Vx1 7— � With Numbers Awnings Chimney Doors and door jams Garage doors Railings Fences Decorative metal All brick(simulated or regular) Stucco banding Any other stucco features Accessory Buildings Otber 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 Owner or Agent APPROVED BY: Date Z 61 APPLICATION chc 6/18/03 P&Z Official VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT OWNER BUILDER DISCLOSURE .STATEMENT I o �. being the legal property owner, for the property Located at: �� Vj 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)s'}nd I have read and understand the following disclosure Statement, which entitles me to:Mork 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. `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 Iicensed must work under your supervision and must be employed by you, which means that you must deduct F.I.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.Tlie foregoing instrument Was acknowledged before me this day of e( • 20 T By —r�S(X% CFGVGS who is personally known to me or who has Produced�/ T>)� � /i(��% 4Zl3 � � as identification and who did take an oath. _Notary 67 t ,•N`"' MONICA uSSM DIAZ MY COMMISSION#DD.4W5 Owner 'a, EXPIRES:October20,2009 RF h' Baled Thru Notary Pubs Un� Miami Shores Village Building Permit 10050 NE 2nd Avenue Permit Number: BP2005-1362 Phone: 305-795-2204 Printed:9/21/2005 Page 1 of 1 Applicant: YVROSE VALDES Owner: VALDES YVROSE JOB ADDRESS: 86 NW 108 ST Contractor Contractor's Address: Local Phone: Parcel # 1121360110160 Legal Description: DUNNINGS MIAMI SHORES EXT NO 7 PB 52-33 LOT 8 BLK Fees: Description Amount FEE2005-12644 Building Painting Fee $60.00 Total Fees: $67.30 FEE2005-12645 CCF $0.60 FEE2005-12646 Notary Fee $5.00 Total Receipts: $0.00 FEE2005-12647 Training and Education Fee $0.20 FEE2005-12648 Technology Fee $1.50 Total Fees: $67.30 Permit Status: APPROVED Permit Expiration: 3/18/2006 Construction Value: $1,200.00 Work: EXTERIOR PAINT SEI' 2 2, PAID C Signed: (INSPECTOR) 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 1 assume responisibility for all work done by either myself,my agent,servants or employes. Signed: (Contractor or Builder) BY: