Fillable Shutter Permit Checklist

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Shutter Permit Checklist

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  • 20 check-boxes
  • 154 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Town of Cutler Bay

BROWSE TOWN OF CUTLER BAY (FL) FORMS

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UP FRONT FEE OF $130.00 IS REQUIRED TO REVIEW (non-refundable)
Town of Cutler Bay
Building Department
10720 Caribbean Blvd., Suite 110
Cutler Bay, Florida 33189
Tel:(305)234-4193 Fax (305)234-5873
PERMIT APPLICATION
Permit No.
Master Permit:
J
ob Address:
U
nit No.
1. Ow
ner In
formation 2. Contractor Information
Owner Name: Company Name:
Address: Qualifier Name:
City ST Zip Address:
Phone No. City ST Zip
Phone No.
Owner Builder Yes No License No.
3. Permit Type: (Check One Only) 4. Type of Improvement: (Check One Only)
□ BUILDING □ CHANGE CONTRACTOR
□
NEW CONSTRUCTION □ ADDITION ATTACHED
□ ELECTRICAL □ EXTENSION
□
A
DDITION DETACHED □ ALTERATION INTERIOR
□ MECHANICAL □ RENEWAL
□
A
LTERATION EXTERIOR □ REPAIR/REPLACE
□ PLUMBING/GAS □ SHOP DRAWING
□ PAVING/DRAINAGE □ SIGN
□ ROOFING □ ZONING
□ PUBLIC WORKS □ OTHER
5. Architect/Engineer: 6. Legal/Use/Work:
Name: Folio No: No. of Units:
Address: Lot: Block:
City ST Zip Subdivision: PB/PG:
License No. Current Use of Property:
Phone No. Description of Work:
Estimated Value: Work Classification:
Square Footage : Residential Multi-Family Commercial
Application is hereby made to obtain a permit to do work and installation 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, MECHANICAL,
PLUMBING, SIGNS, WELLS, POOLS, ROOFING, SHUTTERS, WINDOWS, FURNACES, BOILERS, HEATERS, TANKS, and AIR
CONDITIONERS, etc. I understand that in signing this application I am responsible for the supervision and completion of the
construction including scheduling of inspections and obtaining final inspections in accordance with the plans and
specification. WARNING TO OWNER: Your failure to record a notice of commencement may result in you paying twice for
improvements to your property. If you intend to obtain financing, consult with your attorney or lender before recording your
notice of commencement. Owner/Contractor 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.
Signature of Owner or Authorized Agent Signature of Qualifier
Print Name Print Name
State of Florida, Miami-Dade County State of Florida, Miami-Dade County
Sworn to and subscribed before me this day of Sworn to and subscribed before me this day of
20 . 20 .
By (Seal) By (Seal)
Personally known or ID Personally known or ID
NOTICE: In addition to the requirements of this permit, there may be additional deed 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.
Issuing Clerk: Date:
DISCIPLINE APPROVED DATE DISAPPROVED DATE ZONING
/
PW FEES FEES $ (√)
Zoning
Building
Fire
Structural
Electrical
Mechanical
Plumbing
Roofing
P/Works
Flood
(# )Violation
Plans out Date Clerk Check -in Date Clerk Base Permit
State Radon
Code Compliance
(% Concurrency)
Total
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Town of Cutler Bay
OWNER/BUILDER AFFIDAVIT
NAME OF OWNER/BUILDER:
LEGAL
DESCRIPTION/ADDRESS:
Congratulations and good luck with
your Owner/Builder project. Please feel free to call the Building
Department if you require assistance. This affidavit is designed to help you avoid common problems that
Owner Builders often encounter. Please read and initial each of the following items.
I do certify that, as a Owner/Builder, I understand and acknowledge the following:
1) I am personally responsible for knowledge of all applicable laws and regulations.
2) I will personally reside in the house after completion and the issuance of the Certificate of
Occupancy.
3) Neither I, nor any member of my immediate household family, have made an application for,
or have been issued either an Owner/Builder
permit or a Certificate of Occupancy based upon
an Owner/Builder permit (for a single family residence) within the past three (3) years.
4) I will be on the premises either supervising or performing the actual work at all times. I will
submit an accepted form of identification upon request by the Building De
partment’s agent.
5) I understand that if an inspection is not approved after three attempts, the Inspector may place
a Stop Work Order on the job; and require
that a licensed contractor complete the work.
6) I understand that any person whom I may wish to hire to aid me in the construction of my
home, except common laborers,
must hold a valid Miami-Dade County Certificate of
Competency or be State licensed contractor. All employees hired by me shall be covered by
Worker’s Compensation Insurance. (Typically Homeowner’s Insurance does not provide this
coverage; Please check with your insurance carrier).
7) I understand all the requirements and responsibilities involved in obtaining an Owner/Builder
permit. I have read and understood the foregoing disclosure, and am aware of my
responsibilities and liabilities under my application for building construction work on the
above-described property. I further understand that failure to comply with all the required
regulations may cause the revocation and/or denial of the permit and /or certificates of
occupancy/completion.
X
Signature of Owner
Print
Name
STATE OF FLORIDA COUNTY OF MIAMI-DADE
Sworn to and subscribed before me this
day of 20 .
By
(SEAL)
Personally know
or I.D.
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Shutter Permit Checklist

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Completed 12 July 2020

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