BP2002-1079 s �
ed° PERMU APPLICATION
"" Master Permit No.
Subsidiary Permit No. Ct'
INSTRUCTIONS The followino steps intist be (aken (o obtain a permit from the 'N'tian)i Shores Viflaoe:
Step 1. Complete the attached permit application which must be signed by the owner andqualifm Both sigaat=must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done,a roofing application must be submit-
ted
ubmitted along with this permit application.
Step Z Submit the completed application with all necessary documents to the Building,Planning aAd Zoning Department for processing. During the
processing of your application,you may be asked to submit additional information.
Job Address: 'a co n a Los 3+ 1"l iam i 111 ]ICS EL 3 LS og,
0
Address Apt. City rr�� ' e State L Zip
Folio Number. - 32®(D 70_':W_ `® q� Description of Work 29 W X a'11 O h C I't S4=d
Lot 71 lock I SCQ
1 n- M C e, tib ah C Q c-losr-S
Subdivision�` itO PB PGy� Zoning Linear Feet a CP o
Current Use of Property Square Feet Units Floors
Proposed Use of Property &Miaef%A;121 Value of Work L9. (}Q- Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT TYPE (./) PERMIT CHANGE (°/) TYPE OF MANAGEMENT (Of)
Buil .Contractor New Construction Enclosure
Electrical Renewal Alteration Exterior i/ ReAmir
Mechanical Revision Alteration Interior Demolish
Plumbing Extension Relocation of Structure Shell Onl
LPG% Supplement Foundation Only Add°l Attachment
Rooft Reinspection Other Add°1 Detachment
Fence Other
Other
ARCHITECT ENGINEER
Name Name
License No. License No.
Address Address
Telephone Telephone
Fax Fax
PROPERTY OWNER CONTRACTOR
Name Nam
Address,^o® T Address . 1\ G w__ u -I ~
, ®� `C7b�e
HomeTelet►ho - - �-1�Q� �(_% t F's_ ig�® 0
.MGBuses Telephone Telephone F
Fax Qualifter Name �'�,
Page 2 , A
PER UT APPLICATION
IkIPOIZI-ANT NOTICE'S
I. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Apelying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 and.to 6:00 p.m.,and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN,NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES,AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the streeUsidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMII.Y RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building,Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services(HRS)approval is required for applications involving septic tanks. Department of Environmental Resources
Management(DERM)and/or Miami-Dade Water and Sewer Department(MDWASD)approval is required for applications involving sewers.
Application is hereby made to obtain a permit to do work and installation as indicated. I,the OWNER of the property,certify that all
work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits
are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building.Official. Further,I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent(50%) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent(50%) of the replacement cost of the structure,then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than$2,500 or intend to obtain financing,you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1°Floor,(305)679-1078. Once recorded,the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713-35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
w
ST 00
A, OF MIAbII-DADE STATE O A, MIAMI-DADE
Si of � Si of Contractor/Qualifier
Okeir; Ar-1 LovePrid
Name Print Name !�
Swan to and subscribed before me this�_day of�i► P`, Sw subscribed before me this day of S.Ln_
C�fY� g&��t CP� rCAJJ!C- r'0,1w
r�of N ARY Siguatcreg ffi of Notary Public-State of Florida
OFMCULK&MARTHA CORERO CIAL NOrAR SEAL
SEAL: NOTARY PUBLIC STATE OF FLORIDA SEAL: MARTHA COREA
NOTARY PUBLIC STATE OF R DPMA
MAMMON NO.CC9 I01 COMMMON NO.CCpWM
MYCO ON EXP. 13 MY COMMISSION EXV,RIM13
Personally known OR,Produced Identification Personally known OR,Produced
Type of Identification Produced: Type of Identification Produced:
Page 3 i
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies)in the space provided below.
I
dTum Fee Dryer Outlet,Appliance Service Repair
Central l-3 Ton Fan Outlet,Wall Service,Temporary
Central 4-7 Ton Fhe Pump Outlet,Switch Central S.
Ton Future-Fluorescent Oven Space Heater(kw)
AIC Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs
A/C Central 20+Ton Flood Lights Plugmold/Strip Subfeeds,No.of Amps
A/C Window FPL-Load Central Posts Swim Pool,Commercial
Air Conditioners Garbage Disposal Rangeatange Top Swim Pool,Residential
Chiller Generators,etc. Receptacles Switchboards
Clear Violations Heat Recovery Refrigerator,Comm.(p/PH) Hemp Serv.,Construction
Compactor Low-volt,Burglar Refrigerator,Domestic Temp for Test-30 days
Deep Freezer Low-volt,Fire Renew-Temp Service
Demolition Low-volt,Intercom/Teleph. Repair Circuits
Dishwasher Low-volt,Television Service,Number of Amps
bndmum Fee Condensate Drain Generator Reffigeration,Tons
A/C Central,Tons Cooling Tower Heating Strips,each Vent Hood,Cost
A/C Wall/WhL Tons Dryer Vents,Number of Paint Booth Ventilation,Cost
Air Handler,Tons Ductwork,Cost of Piping,Flammable Liquid Periodic Inspections
Barbecue Fire Sprinkler System Procesaftessure Piping
Bath Fan-Vented,# Fireplaces,Number of Pressure Vessel
A/C Condensate Drains,Roof Miscellaneous Fixture Soakage Pit
Bath Tbb Drinking Fountain Miscellaneous Repairs Solar Water Heater
Bidet Fllter Replace Pool Piping Sprinkler Repair
Cap-nxdure Fountain Punkp and Abandon S er System
Ca -Water Gas-Appliance Pomp,Domestic Supply,AC Well
Ca -Sewer Gas-Natural Ptunp,Fire Stand Temporary Tollet
Catch Basin Gas-Propane Pump,Re-circulate Temporary Water Closet
Clothes Washer Gas Piping Pump,Replace-Pool Urinal
Dental Chair Grease Trap Punip,Sprinkler Utility-Sewer
Discharge Well Ice Maker Pump,Sunp U -Water
Dishwasher Indirect Wastes Relay Vacuum Pum
Disposal Interceptor Roof Inlet Water Closet
Domestic Well Laundry Tray Septic Connection Water Heater
Drainfield,4"Tile/Res. Lavatory Septic Tank Water Heater New
Drains,Area Meter Set(Gas) Sewer Connection Water Re- l
Drains,Floor Minimum Fee Shower Water Service
Drains,French Miscellaneous Equipment Sink Well,Su l
RECEIVED AND REVIEWED BY: DATE:
Page 4
PERMIT APPLICATION
OFFICE USE ONLY
❑ OWNER-BUILDER FORM ❑ PROOF OF OWNERSHIP ❑ CONDO ASSOCIATION APPROVAL
(Attach) (Attach) (Attach)
❑ FIRE DEPARTMENT ❑ HRS/DERM APPROVAL ❑ BPR APPROVAL(Restaurants)
APPROVAL(Commercial/ (Septic/Sewer)
multi-family)
❑ CONCURRENCY ❑ IMPACT FEE ❑ CONTRACTOR REGISTRATION
(New Construction) (New Construction) (On File)
❑ OTHER ❑ OTHER
(Specify&Attach) (Specify&Attach)
$3.00 per page(Scanning Fee) $
Miami Shores Village $
Bond $
Metropolitan Dade County (C.C.F.) $ (sxq.ft 0=) x/1000
¢.6
Inspector State Educational Fund $ (¢.005/sq.ft)
State DCA(Radon) $ (¢.01/sgA)
Code Enforcement Fine $
Zoning Review $
Notary $ /
TOTAL $
REVIEWED AND PREPARED BY DATE:
SECTION BY DTE
Zoning Ay
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural ge Ole
Building Official
Revised July 2001
10050 N.E. 2-AVE.,MIAMI SHORES,FL• (305) 795-2207 •FAX(305)756-8972 •http://www.miamishoresvillage.com
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Page 1 of 2
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This property described as:
Lot 7, Block 166
SECTION NO. 8 OF MIAMI SHORES,
according-to the Plat
thereof, as recorded in
Plat Book 14 , Page 33
of the Public Records of
Dade County, Florida
and
Tract 186 A,
REVISED PLAT OF SECTION 140. 8
OF MIAMI SHORES,
according to the Plat
thereof, as recorded in
Plat Rook 31 , Page 41
of the Public Records of
Dade County, Florida . �Qo� � /96,., .�� 14 X33
it off Andrew and
PROPERTY OF: Itkoff, Valerie, 1200 N.E. 103rd Street, Miami Shores, Florida
MrrV.41joWit NUtrr"it StGXAruer A ��ARY SURVEY LANNES ANG ::ARCIA, INC.
aMo nlrIMU;t.`EAL1t INEDWALOF ! hereby cervi(!' that the wary 'apple
"AMI lAl.lCr!R:r1►3"VENtlK rented h*fmm mean the lmt--m LH.n_(t9tl
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shown hereto. (3tlSt 666.79" t944)323.86b3
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69
Miami Shores Village Building Permit
10050 NE 2nd Avenue
Phone: 305-795-2204 Permit Number: BP2002-1079
Printed:6/11/2002 Page 1 of 1
Applicant: ANDREW ITKOFF
Owner: ITKOFF ANDREW
JOB ADDRESS: 1200 NE 103 ST
Contractor ISLAND FENCE OF FLORIDA INC Contractor's Address: 711 E OKEECHOBEE RD
Local Phone:
Parcel# 1132060340290 Legal Description: MIAMI SHORES SEC 8 PB 14-33 LOT 7 BL 186&TR 186-A OF PB 31-41 LOT SIZE
Fees: Description Amount
FEE2002-3314 Building Fee $100.00 Total Fees:$103.60
FEE2002-3315 CCF $3.60
Total Receipts: $0.00
Total Fees: $103.60
Permit Status: Permit Expiration: 12/8/2002 Construction Value: $6,000.00
Work: 299:X 4'HIGH GALVANIZED STEEL FENCE WITH 2 GATES
If there is no permit package accessible on the job-site for inspectors to verify,there will be no inspections. Re-inspection
fee is$50.00,which must be paid In advance before calling for another inspection.
This Permit is,granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all
ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,drawings,statements or specifications that may have been submitted to
and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without
authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the
ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done
Is agents,servants or employees.
� A
ed: ECTOR) BY:
i
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 spechIcations submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility,for all work done by either
myself,my agent, employes.
Sig (Con_hactor or Builder) BY:
ISLAND FEHonCi E3eee RIDA INCA
711 E OKEECHOBEE ROAD BAH
HIALEAH,FL 33010 / /7 ,0 2—
D D (�
PAYv D� LQ YYI j/0 O M s�
TO THE _ �I V °°""•°°
ORDER OF /
®,UNION RAWE1S gANK
FOR ---
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305-795-2204
Building Inspection Request
Date Time
Type Insp'n j2LXi74-�
r� 9
Permit No. ,���C 0022- /V
Name
-
Address
CompanyS
Phone# 3 0
For Inspector:7-3,®) Name to
Approved A c �
Correction ❑
Re-Insp'n Fee ❑
MIAMI SHORES VILLAGE
BUR DING DEPARTMENT
305-795-2204
Building Inspection Request
Date 9- ;Z-&V Time
Type Insp'n A,9-,
Permit No.
Name -`
Address ;
Company T
Phone# P- a
For Inspector: 2,3-OZ Name&Date
Approved ❑
Correcti �..
A41e!-
Re-Insp'n Fee ❑
o-.-
NIIAMI SHORES i
BUILDING I
04
BwildingRequest
Date) L-9)0 .1--) Time
PermitType Insp'Z-990�,,�- 9 1 a,
ar0 ,
Name
Address
Phone
Date
Approved _
Correction
Re-Ins
pi Fee
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