RC-07-537 Permit NO. RC-3-07-537
Miami Shores Village Permit Type:Residential Construction
�y 10050 N.E.2nd Avenue ' Worts Classification:Alteration
Miami Shores,FL 33138-0000 Per
_�....-aa Phone: (305)795-2204 Permit Status:APPROVED
�'CONtI��
Issue Date:3/2812007 Expiration: 09/24/2007
Project Address Parcel Number Applicant
54 NE 106 Street 1121360060040
Miami Shores Village, FL Block: Lot: MARIA DEL ORTIZ
Owner Information ._..._._... Address... _. ...._..... _. Phone . __.. Cell
_... ._
MARIA DEL ORTIZ 54 N.E. 106 ST.
Contractor(s) Phone Cell Phone Valuation: $ 3,000.00
HOME OWNER
Total Sq Feet: 0
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review calling Grid
Date Denied: Final PE Certification
Type of Construction:BATHROOM REMODEL Occupancy:Single Family Window and Door Buck
Stories: Exterior: Tie Beam
Front Setback: Rear Setback: Framing
Right Setback: Fill Cells Columns
Left Setback: g Shutter Attachment
Bedrooms: Bathrooms:
Window Door Attachment
Plans Submitted: Certificate Status: Shutter Final
Certificate Date: Additional Info: Insulation
Bond Return: Classification:Residential Slab
Term de Letter
Fees Due Amount Total Amt Paid Amt Due Drywall Screw
CCF $1.80
Education Surcharge $0.60 $0.00 $0.00 $ 0.00
Notary Fee $5.00
Permit Fee-Additions/Alterations $150.00 Payment Type:
Scanning Fee $3.00 A
Technology Surcharge $3.75 ..�J
Total: $164.15 MAR PAI® 0�
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In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,1 authorize the above-named contractor to do the work stated
March 30,2007
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
Friday,March 30,2007 1
Miami Shores Villa e
_ g
Buil In MAR 19 2001,
d ,g"Department
10050Y.-__ _
N.E.2nd Av.,enue,Miami Shores,FloridaFlonda 33138 ________
Tel:(305)7951204 Fax:(305)756.8972
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
FBC 2004
Permit Type(circle): Buildin Electrical Plumbing Mechanical Roofing
Owner's Name(Fee Simple Titleholder) �• ®� �' ®e T/Z Phone# 3®S- 4-1 ff-141.3
Owner's Address .f 4/ AJ6 /06 -S T
City 6114&/ 1 .S H Q r:S State Lei to 1 0 A Zip .33/36
Tenant/Lessee Name Phone#
Job Address(where the work is being done) SW A.), 7'
City Miami Shores Villaae County Miami-Dade Zip 3/
FOLIO/PARCEL# D l2 13 d®,6E ®-04 0
Is Building Historically Designated YES NO
Contractor's Company Name Phone#
Contractor's Address
City State Zip '
Qualifier Name Phone#
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name(if applicable) Phone#
Value of Work For this Permit$ 2.606,00 Square/Linear Footage Of Work:
Type of Work: F]Addition Alteration (OTewX-%,Repair/Replace ❑Demolition
Describe Work.•
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Submittal Fee$ Permit Fee � CCF$ CJJ� CO/CC
Notary$ Training/Education Fee$ .(170 Technology Fee$ �• ' 1 S.
Scanning$ Radon$ DPBR$ Zoning$
Bond$ Code Enforcement$ Double Fee$
Structural Review.$ Total Fee Now Due$
See Reverse side—�
Bonding Company's Name(if applicable)
Bonding Company's Address.
City n State Zip
r 4,
Mortgagyl 4epder's N (ifgp licable)
i
Mortgagir' fAilcyresg ,r�>Via'
c �
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 MPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITS 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 beapprov and a reinspection fee will be charged.
Signature s Signature
er or Agent Contractor
The foregoing instrument was
�was acknowledged before me this�"- The foregoing instrument was acknowledged before me this
J�v
day of fir° 20 y ( ,by eday of .20 by ,
who is personally known to me or who has produced rt• M&J who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Ifo; G ZISSCj I Mir- uss�+Dlaz 95 Print:
My Commission Expires _ MFXpIRES:®clober2�'tigers My Commission Expires:
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gondeN°�NP°b4cUM1
4e&�4eAc4eak&&�r&4r9est&oYoY9nYY9enY4caY�eSr&4eYY �y�i � 9c4e&deY9rYt&Y4cn4YYYirY&ks13r4eY4nY�e4eYYBe&4r4rYaFsknY�YY4e&1r4rY�ea'e4etr&ataY4e9e�&9e
APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
(Revised 02J08106)
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
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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
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
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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 thisb Y of da Gr a
CGS ,20
BY LV who was personally known to me or who has
Produced there License or as identification.
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VILLAGE OF MIAMI SHORES LIAR 2 0 2007
OWNER BUILDER DISCLOSURE STATEMENT 4_'
NAME: L C!is F a
DATE:
ADDRESS: 7-
Do
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws
of the State of Florida,.FS 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$25,000.90 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
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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
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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
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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
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MAR 1 9 2007 jj
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PERMIT #: •
Miami Shores Village
APPROVED BY DATE
6 ZONING DEPT da
BLDG DEPT
y 'ev SUBJECT TO COMPU&E WITH—AlIEDE&
— /� STATE AND COUNTY RULES AND REGULATIONS