CC-16-1762 (2)MIAMI•DiADE
COUNTY
MIAMI-DADE COUNTY
DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES
Building_Representative/Specialist Name: '� C nCk
Process Number(s):
Date: / 1 S / (4
*MUNICIPAL APPLICATIONS WITH A DERM REVIEW REQUIRES DERM STAMP AFTER PAYMENT IS MADE.
PLANS ARE APPROVED AND READY FOR PERMIT
Yes (Please proceed to the Cashier Section) ZJ No (Please check below for pending and/or disapproved reviews.
Please note: Disapproval comments are attached to the office
copy of the plans)
PLANS ARE NOT READY FOR PERMIT FOR THE FOLLOWING REASON(S):
❑ Impact Fees (Please proceed to Windows 9, 10, or 11 near the Cashier Section)
Owner's Quiz required (Please proceed to the 2"d Information Counter)
n Permit By Affidavit/Short Term Event—CCHK
CQUA (Please proceed to the 2"d Information Counter)
DBLB (Please proceed to the Building Code Violations and Unsafe Structures Office located on the 2"d floor, Room 230)
Contractor Licensing Section - Located on the 2nd floor, Room 207
❑ Zoning Services Section, Room 106
PLANS A'
LL•W NG ' IEW(S) AG IES:
Plumbing
❑ Structural
Fire
n EFUS / ENFC (Please proceed to the Building Code Violations and Unsafe Structures Office located on the 2nd floor, Room 230)
U DRY RUN / PERM (Please proceed to the Permit Records Section — Windows 9-20)
n Electrical
Zoning
Public Works
Mechanical
Planning
Public Works Concurrency
n Building
D.E.R.M.
HRS
n W.A.S.D.
7 P. W.I . F.
PLANS\HAVE BEEN;DISAPPROVED BY THE FOLLOWING BUILDING DEPARTMENT DISCIPLINES AND/OR AGENCIES:
Disapproval comments for the following disciplines can be add essed at the 2"d Information Counter Tuesday through Friday
during the hours of 7:30 a.m. through 12:00 p.m.
Plumbing
❑ Structural
n Electrical
❑ Roofing
II
Mechanical
Planning
Building
Zoning
Disapproval comments for the following Agencies can be addressed at their respective counters located behind the 151
Information Counter on the 1st floor.
❑ Public Works Concurrency
123 01-149 6/16
Fire
❑ Public Works HRS
W.A.S.D. (located on the 15' floor —Room 140)
P.W.I.r
Regulatory and Economic Resources
Herbert S. Saffir Permitting and Inspection Center
11805 S.W. 26th Street
Miami, FL 33175-2474
786-315-2100
miamidade.aovlaermits
CONTACT INFORMATION FOR PERMIT APPLICATION
Dear Applicant:
Please complete the following information. Your email address is required so you can be notified on the status of your plans.
First Name: (PRINT CLEARLY) P G' i-4"e- t Last Name: (PRINT CLEARLY) 4 "-O- Lt e
Cellular Number:
- EMAIL Address:
Comments:
Office/Home Number:
(2. r A, vc ?A-o L c o w
If you are submitting a municipal plan, please provide the municipal process number(s) and ensure the municipal
application is in the office set of plans
PLEASE INDICATE IF PLANS ARE
GOV'T PROJECT/ DEPT n GREEN BLDG (NEWCONSTRUCTIONONLY)*
AFFORDABLE/ WORKFORCE HOUSING* ❑ ECONOMIC SIGNIFICANCE*
(*Pursuant to Ordinance 99-140; Ordinance 05-115; and Ordinance 08-51. Project may have additional requirements.)
REQUESTED REVIEWS
ALL ❑ BLDG n DERM n ELEC n ENRG y FIRE
HCAP ❑ LANDSCAPING _ MECH I 1 PLUM n PWKS n PWCC
ROOF ❑ SIGN _ STRU 1 1 ZNPR ❑ WASD ❑ PWIF
n PERMIT BY AFFIDAVIT CHECK ❑ SHORT TERM EVENT AFFIDAVIT CHECK ❑ OPTIONAL PLAN REVIEW
❑BLDG ❑ELEC MECH ['PLUM ESTRU
-FOR OFFICE USE ONLY -
TO BE COMPLETED BY BUILDING AND OCCUPANCY REPRESENTATIVE OR PLANS PROCESSING SPECIALIST:
'11
Application Date: 9. I) , / )(� Clerk Name: 9
Arrival Time: : V0)--
Process No(s): I e51 Co °I N3 / /
/ /
123_01-117 1/16
❑ Re -Issue
❑ Rework
❑ Plan Revision
❑ Shop Drawing
L
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Departr v.nt of Regulatory and Economic Resources
Miami -Dade County
Plan Review Summary
Process Number: M2016013432
FINAL CORE REVIEW DATE: 6/30/2016 OVERALL STATUS: Overall Disapproval
PROJECT DETAILS: CONTACT DETAILS:
FOLIO: 11-2136-000-0050 NAME: RAFAEL HUGUET
ADDRESS: 11300 NE 2 AVE, , FL EMAIL:
PERMIT TYPE DESC.: HANDICAP RAILS PHONE #: 7862511331
DISAPPROVAL CODES:
Disapproval Code 01: 0301 - Tree permit required. See application at
Miamidade.gov/derm/I ibrary/permits/tree_removal_pack
TASK
REVIEWED BY STATUS DATE STATUS
Initial Core Review Cynthia Palermo 06/28/2016 Reviewed
Comments: EXT. ALT. TO REMOVE AND REPLACE EXISTING RAMPS AND WALKWAYS AT MONIGNOR
WILLIAM BARRY MEMORIAL LIBRAY, ADRIAN HALL, AND DUNSPAUGH HALL AT EXISTING BARRY
UNIVERSITY. NO CHANGE IN USE/NNI. AS PER PLANS, TREES TO BE RELOCATED ON ALL JOB AREAS.
TREES Review Hilcia De la Cruz 06/29/2016 Disapproved
Comments: Trees to be removed/relocated. Tree Removal Permit required. Tree Removal Permit Application
attached to plans.
Please do not hesitate to email me with any question(s) you may have regarding the review comments for this
project. While I may not respond immediately to your email, because I may be assisting another customer at the time
I receive your email, I will reply within 24 hours of receiving your email unless I am out of the office. My email
address and that of my direct supervisor are as follows: My Email: cruzh@miamidade.gov My Supervisors Email:
AbrahR@miamidade.gov.
Final Core Review
Cynthia Palermo 06/30/2016 Overall Disapproval
Comments: ***SEE TREES REVIEW DISAPPROVAL COMMENTS***
2016-WDU-PR-10919: NO SEWER CAPACITY CERTIFICATION LETTER REQUIRED. PROJECT RE5iL'7S1N A
NO -NET INCREASE (NNI) FOR SEWER FLOW. •• • .• • •
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PLAN CONDITIONS: •
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NO CONDITIONS
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PLAN REVIEW FEES (FEES ARE SUBJECT TO CHANGE PENDING FINAL APPROVAL):
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FEE CODE DESCRIPTION
USER
DATE
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UNIT
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TOTAL
D034
D034R
Total
FastTrack Fee
FastTrack Fee
ADMIN
ADMIN
06/29/2016 1
06/29/2016 --1
FOR MORE INFORMATION PLEASE CONTACT:
YOUR DERM CORE REVIEWER: palerc@miamidade.gov
$80.00
($80.00)
$0.00
JCS
Juan C. Salinas, Architect
August 26, 2016
Miami -Dade County
Building Department
11865 Southwest 26th Street
Miami, Florida 33175-2400
RE: RESPONSES TO FIRE REVIEW COMMENTS FOR THE
BARRY UNIVERSITY ACCESSIBILITY RAMPS
11300 NORTHEAST 2ND AVENUE
MIAMI SHORES, FLORIDA 33160
PROCESS NUMBER: M2016013432
To whom it may concern:
This is to inform you that I, Juan C. Salinas, R.A., have reviewed the "Fire" comments, dated July 1,4,
2016, issued by Mr. Ricardo Gonzalez, of the Miami -Dade County Building and Zoning Department'$ Fire
Division, and have made all the necessary revisions to the construction drawings. In an effort to.satisfyeeVeer
review comments, to obtain final approval for a building permit, please see the following resposise9: • • •
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9. Stair Tread dimensions have been indicated on the following sheets A-8, A-9, A-10, A-12,
A-15 & A-16.
10. Stair Treads have been revised in compliance with Section 7.1.7.2.2.
11. Sheet A-16: See Detail #4 for Guardrail details. There are no Intermediate Guardrails.
12. Acknowledged.
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1. Note has been indicated on Cover Page.•
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2. Note has been indicated on Cover Page. • • •• •• •• •
3. Sheets A-4 & A-6: Minimum Ramp Landings have been revised to 60". • • • • •
4. Sheet A-7: indicates stairs to be demolished. Sheets A-8, A-9 and A-10 show the:vitt stairs. • • • • '
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5. Sheets A-11, A-12 and A-15: The existing railings for the existing stairs at the Msting T%rrace
have been indicated. No new work is to be performed in this area. • • • • •'
6. Sheet A-13 shows a New Ramp. See Note #1 same sheet and Detail #1 on sheet A-16. •
7. Sheet A-16: Handrail clearances have been revised accordingly. Also, see tUe fptlpwing•sheets • •
A-4 A-5 & A-6. •• ' • • • • • •
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8. Stair Handrails are indicated incompliance with Section 7.2.2.4.4.10.
Revised drawings are being re -submitted along with these written responses and clarifications in an
effort of being in full compliance with all review comments, the Florida Building Code, the NFPA and all
applicable codes. Should you have any questions or require additional information, do not hesitate to contact
me immediately.
Sincere
cc: Ramiro Gamez
BARRY UNIVERSITY B&Z FIRE RESPONSES. •
P.O. Box 442066 • Miami, Florida 33144-2066 • (305) 265-3737 • Fax: (305) 265-3773
jcsarchitect@bellsouth.net
AR 0015010
FIRE ENGINEERING & WATER SUPPLY BUREAU
11805 SW 26 STREET, SUITE 150, MIAMI, FL. 33175
TELEPHONE (786) 315-2771 EMAIL:
www.miamidade.gov/mdfr
0
rtf
FIRE REVIEW DISAPPROVAL COMMENTS
DATE: 7/14/16 FD TRACKING NUMBER: M2016013432 REVIEWED BY: RICK GONZAIEZ
NAME OF PROJECT: BARRY UNIVERSITY ADDRESS: 11300 NE 2 AVE MIAMI, FL.
PROVIDE RESPONSE SHEET ADDRESSING EACH OF THE COMMENTS AND INDICATE THE SHEET
IN WHICH CORRECTION IS FOUND — IF NOT PROVIDED ORIGINAL FULL REVIEW FEE WILL BE
ASSESSED AGAIN
1. INDICATE ON PLANS THE FIRE PREVENTION CODE 2013 EDITION FIFTH EDITION AS THE
GOVERNING FIRE CODE
2. INDICATE ON PLANS THE CLASS OF REHABILITATION AS PER NFPA 101 CHAPTER 43
MONSIGNOR WILLIAM BARRY MEMORIAL LIBRARY: •
3. SHEET A-4 AND A-6: — MINIMUM RAMP LANDING IS 60" IN THE DIRECTION OF TRAEL ;'SCT. •
7.2.5.3.2(4) - (THEY ARE SHOWN ON THE PLANS AS 4' 3" AND 4' 5") •• ' •• • • ' •
ADRIAN HALL: • • . .
4. SHEET A-7 — SHOWS EXISTING STAIR RISER DIMENSIONS AT 6", BUT SHEETS A-8, A-'-10 SHOV7
THE SAME STAIR RISERS NOW AT 7.125, NOW WITH NEW HANDRAILS — ARE STAIRSREPI-940E9
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DUNSPAUGH HALL: • ' •
5. SHEET A-12 & A-15 - SHOWS EXISTING STAIRS NEXT TO EXISTING TERRACE WITHOV T.IWIDRAILS-
?'? • • •
6. SHEET A-13 — SHOWS A PARTIAL RAMP, MORE INFORMATION TO BE PROVIDED •
7. SHEET A-16: - NEW HANDRAILS SHALL BE INSTALLED TO PROVIDE A CLEARANCE OF.N TI:LESS 'FR:VN
2 1/a" BETWEEN THE HANDRAIL AND THE WALL — SCT. 7.2.2.4.4.5 •. '
8. STAIR HANDRAILS SHALL EXTEND HORIZONTALLY, AT THE REQUIRED HEIGHT, NOT LESS THAN 12"
BEYOND THE TOP RISER AND CONTINUE TO SLOPE FOR A DEPTH OF 1 TREAD BEYOND THE BOTTOM
RISER — SCT. 7.2.2.4.4.10
9. PROVIDE DIMENSION OF ALL STAIR TREADS — SCT. 7.2.2
10. WHEN A STAIRS IS USED IN CHANGES IN MEANS OF EGRESS OF 21" OR LESS, THE TREADS SHALL BE A
MINIMUM OF 13" — SCT. 7.1.7.2.2
11. SHEET A-16: - PROVIDE COMPLETE DETAILS OF ALL GUARDRAILS 0 SCT. 7.2.2.4.5.3 — INTERMEDIATE
RAILS.
12. ADDITIONAL COMMENTS MAY FOLLOW ONCE ALL INFORMATION IS PROVIDED
* ALL CODE REFERENCES MENTIONED IN THESE COMMENTS ARE FROM FFPC/NFPA, FLORIDA FIRE
PREVENTION CODE AND NFPA 101 LIFE SAFETY CODE, UNLESS OTHERWISE NOTED..
• PROVIDE NEW SHEETS WITH ALL CORRECTIONS AND CHANGES HIGHLIGHTED OR CLOUDED.
• RETURN VOIDED SHEETS WITH FIRE DEPT. STAMPS FOR COMPARISON, OR FULL REVIEW FEE WILL BE
ASSESSED
• COORDINATE ALL CORRECTIONS & CHANGES THROUGHOUT THE ENTIRE SET OF PLANS.
* PROVIDE ALL INFORMATION ON THE PLANS
* DROP OFF FOR REWORK
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Miami Shores Village
Building Department
10050 NE 2nd Ave.
Miami Shores, FL 33138
305-795-2204 / Fax 305-756-8972
NOTICE TO MIAMI SHORES BUILDING DEPARTMENT OF EMPLOYMENT AS SPECIAL
INSPECTOR UNDER THE FLORIDA BUILDING CODE.
I (We) have been retained by to perform special inspector services under the Florida
Building Code 5th Edition (2014) and Miami Dade County Administrative Code at the
project on the below listed structure as of (date). I am a registered
architect/professional engineer licensed in the State of Florida.
Proces Number: W i ' (r) (e l'
pecial Inspector for Reinforced Masonry, Section 2122.4 of the FBC 5th Edition (2014
Miami Dade County Administrative Code, Article II Section 8-22 Special Inspector for
Trusses > 35 ft. long or 6 ft. high
St9e1 Framing and Connections welded or bolted
'-'Soil Compaction
_ Precast Attachments
Roofing Applications, Lt. Weight. Insul.Conc.
Other
Note: Only the marked boxes apply.
The following individual(s) employed by this firm or me is authorized representative to TAM;
inspec ion'" • • • •
1. E 2. • • •
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"Special inspectors utilizing authorized representatives shall insure the authorized representative is qualified by
education or licensure to perform the duties assign by Special Inspector. The qualifications shall include licensure as a
professional engineer or architect: graduation from an engineering education program in civil or structural engineering;
graduation from an architectural education program; successful completion of the NCEES Fundamentals Examination;
or registration as building inspector or general contractor.
I (we) will notify the Miami Shores Building Department of any changes regarding authorized personnel
performing inspection services.
I (we), understand that a Special Inspector inspection log for each building must be displayed in a
convenient location on the site for reference by the Miami Shores Building Department Inspector. All
mandatory inspections, as required by the Florida Building Code, must be performed by the Miami Shores
Building Department .Inspections performed by the Special Inspector hired by the owner are in addition to
Me mandatory inspections performed by the department. Further, upon completion of work under each
Building Permit, I will submit to the Building Inspector at the time of the final inspection the completed
inspection wed statement indicating that, to the best of my knowledge, belief and
profess' r�A, dtfltfCr� ., p �`";ons of the project outlined above meet the intent of the Florida Building
Codee with the approval plans.
Name
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Engineer/Architect
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Print
Address fib, %mac 441494:62
'l pt11 - -3144.20t�CQ
UssI
U.S.. Structures. inc.
Structural Plans Processor January 11, 2017
Miami Shores Building and Zoning Department
RE: Response to Review Comments for the Barry University Ramps
PERMIT #:CC16-1762
11300 North East 2nd Ave., Miami Shores, FL
Mr. Orlando Blanco:
The following is a summary of our response to your recent review comments regarding the
project referenced above, per critique sheet dated 12/15/16.
2. A) Please note that all footings are continuous. WF-1 6 footing capacity is well over
2000 plf. Actual loading conditions less than 500 plf. Therefore by inspection footing
provided is adequate.
B) Please note that the walls alongside the ramps are braced at the top by the
concrete slab over compacted fill and a maximum span of 4'-0". By inspection, there is
no significant overturning moment to account for.
C) Please note that there 4 steps which are to be formed over compacted soil with a
minimum bearing capacity of 2000 psf. Calculations are not needed.
D) Please note that all railings will be delegated to a specialty engineer under a
separate permit. Calculations will be provided at that time.
3. Agree.
7. Please note that this information was originally provided. All slabs are 4" thick. Please
refer to note [2S] of the structural drawing notes.
8. Special Inspector forms will be provided by the owner.
Sincerely,
U.S. STRUCTURES, INC.
Jose A. Toledo, P.E.
President
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12855 SW 132"`' Street
Suite 204
Miami, Florida 33186
CA 8439
T: 305.665.4555
Email: info@usstructuresinc.com
Website: www.usstructuresinc.com
TREE COMMENTS
CHANGES NEEDED FOR NATURAL RESOURCES APPROVAL
(All changes must be ` echanically reproduced)
DATE OF NOTICE: ( ��
Our aerial historic records indicate the presence (currently or in the past) of tree resources.
Please clarify the information as follows:
IF YOU DO NOT NEED TO REMOVE TREES:
1. On SITE PLAN, show trees within twenty feet (20') of ANY type of
construction, including driveways, septic tanks, fences, pipes, buildings,
construction roads, structures to be demolished, etc.
2. Show distance from these trees to construction.
3. Label the trees as existing to remain.
4. On SITE PLAN show 6-8' barriers around trees less than 18 inches in
diameter at breast height* (DBH) and show 10-12' barriers around trees 18 inches in
diameter at breast height or greater.
[If trees are too close to construction for proper sized barriers, please contact
our office—(786) 315-2800.]
*18 inches in diameter at breast height is the same as 56.5 inches in circumference.
5. We MAY need to see pictures of the site or the downtown office may have to
do an inspection to be sure that no trees will be damaged by the construction.
IF YOU NEED TO REMOVE OR RELOCATE TREES:
Permit applications are processed by the Tree Program. The following
items must be submitted to apply for a permit:
1. Filled out TREE REMOVAL/RELOCATION application form.
2. Application fee (check or credit card). Please-segfee schedule--_
3. Two copies of site plan showing all trees. Please mark the trees to be
removed/relocated. If there are more than 10 trees on -site, you need to
provide two copies of a tree survey.
TREE PROGRAM:
701 NW 1st COURT, 6th floor. (305) 372-6574
WALK-THRU FROM 8:00 a.m. TO 12:00 p.m.
EVENING HOURS BY APPOINTMENT ONLY
REVIEWER:
PHONE: (786) 315-2800
Tree Permit Application
Tree Permitting Program
701 N.W. 1 Court, 6th floor
Miami, Florida 33136
T (305) 372-6574 F (305) 372-6479
FOR DEPARTMENTAL USE ONLY Updated 10/12
Date Received:
Received By:
Application Number:
Application Fee (other fees may be applicable):
Application Type: ❑ Removal 0 Relocation ❑ Removal & Relocation DModification 0 Extension
After -the -Fact: ❑Yes ❑No
Application must be filled out in its entirety. Please indicate N/A for non -applicable fields.
1. Applicant Information:
Name:
Address:
Phone #:
Email:
Zip Code:
Fax #:
' This should be the applicant/owner's information for contact purposes.
2. Applicant's Authorized Permit Agent:
The name and contact nrormatlon `or the Agent ;That Is authorized oy the ow:er to process :ne
appJca:on, furnish supplements[ Informa'oon relating to the apcl.caoor and tlntl the applicant
to all regu,reme nts of tre a pp, ca:Ion/permit document.
Name:
Address:
Phone #:
Email:
Zip Code:
Fax #:
3. Site Location and Description where the proposed activity exists or will occur:
Folio #(s):
Site Address:
Does intended use of the property require re -zoning or plat? ❑Yes 0 No
City or Town:
4. Current Use/Location of Trees (check all that apply):
❑ Single Family ❑Multi -Family :Commercial :Business ❑Agricultural :Swale/Right-of-Way ❑Other
5. Work Description:
Building permit process number (If Applicable):
Number and type of tree(s) to be removed, or relocated. Include trees affected by improper trimming or removed without a permit:
Location of the tree(s) stated above:
Reason for permit request:
Attachments (check all that apply): (e.g. site sketch, plans etc.):
❑ Site Sketch ❑ Plans 0 Photographs ❑ Arborist Assessment
❑ Tree Survey
0 Other
1
6. IMPORTANT NOTICE TO APPLICANT:
The written consent of the Property Owner is required for all applications to be considered complete. Your application
WILL NOT BE PROCESSED unless the Property Owner consent portion of the application is completed below. You have the
obligation to notify the Department in writing of any changes to information provided in this application.
Application is hereby made for a Miami -Dade County tree permit to authorize the activities described herein. I agree to or affirm the
following:
• I possess the authority to authorize the proposed activities at the subject property, and
• I am familiar with the information, data and plans contained in this application, and
• To the best of my knowledge and belief, the information, data and plans submitted are true, complete and accurate, and
• I am authorizing the permit agent listed in Section 2 of this application to process the application, furnish supplemental
information, and bind the property owner(s) to all requirements of this application/permit document, and
• I agree to provide access and allow entry to the project site to inspectors and authorized representatives of Miami -Dade
County for the purpose of making the preliminary analyses of the site and to monitor permitted activities and adherence to all
permit conditions.
A. IF THE APPLICANT IS AN INDIVIDUAL
Signature of Applicant Print Property Applicant's Name Date
B. IF THE APPLICANT 15 OTHER THAN AN INDIVIDUAL OR NATURAL PERSON
(Examples: Corporation, Partnership, Trust, LLC, LLP, etc.)
Print Name of Applicant (Enter the complete name as registered) Type (Corp, LLC, LLP, etc.) State of Registration/incorporation
Under the penalty of perjury, I certify that I have the authority to sign this application/permit document on behalf of the Property
Owner, to bind the Property Owner, and if so required to authorize the issuance of a bond on behalf of the Property Owner. (If
asked, you must provide proof of such authority to the Department). ***Please Note: If additional signatures are required,
pursuant to your governing documents, operating agreements, or other applicable agreements or laws, you must attach additional
signature pages. ***
Signature of Authorized Representative Print Authorized Representative's Name Title Date
C. IF THE APPLICANT IS A JOINT VENTURE Each party must sign below (If more than two members, list on attached
page)
Print Name of Applicant (Enter the complete name as registered) Type (Corp, LLC, LLP, etc.) State of Registration/Incorporation
Print Name of Applicant (Enter the complete name as registered) Type (Corp, LLC, LLP, etc.) State of Registration/Incorporation
Under the penalty of perjury, I certify that I have the authority to sign this application/permit document on behalf of the Property
Owner, to bind the Property Owner, and if so required to authorize the issuance of a bond on behalf of the Property Owner. (If
asked, you must provide proof of such authority to the Department). ***Please Note: If additional signatures are required,
pursuant to your governing documents, operating agreements, or other applicable agreements or laws, you must attach additional
signature pages. ***
Signature of Authorized Representative Print Authorized Representative's Name Title Date
Signature of Authorized Representative Print Authorized Representative's Name Title Date
2
7. WRITTEN CONSENT OF THE PROPERTY OWNER FOR THE PROPOSED WORK LOCATION
I/We are the fee simple owner(s) of the real property located at
Miami -Dade County, Florida, otherwise identified in the public records of Miami -Dade County as Folio
No(s). I/we am/are aware and familiar with the contents of this application for a Miami -
Dade County tree permit to perform the work on the subject property, as described in this application. I/we hereby consent to the work
described in this tree permit application.
A. IF THE PROPERTY OWNER 15 AN INDIVIDUAL
Signature of Property Owner Print Property Owner's Name Date
Signature of Property Owner Print Property Owner's Name Date
B. IF THE PROPERTY OWNER IS OTHER THAN AN INDIVIDUAL OR NATURAL PERSON
(Examples: Corporation, Partnership, Joint Venture, Trust, LLC, LLP, etc.)
Pr;nt Name of Property Owner (Enter the complete name as registered) Type (Corp, LLC, LLP, etc.) State of Registration/Incorporation
Address of Property Owner
Under the penalty of perjury, I certify that I have the authority to sign this application/permit document on behalf of the Property
Owner, to bind the Property Owner, and if so required to authorize the issuance of a bond on behalf of the Property Owner. (If
asked, you must provide proof of such authority to the Department). ***Please Note: If additional signatures are required,
pursuant to your governing documents, operating agreements, or other applicable agreements or laws, you must attach additional
signature pages. ***
Signature of Authorized Representative Print Authorized Representat!ve's Name -ite Date
Signature of Authorized Representative Print Authorized Representative's Name Title Date
Please Review Above
'Cx 5: , B or C
AND
Box 7. etetPer A or B
d
A F'1 Da n.t
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7. WRITTEN CONSENT OF THE PROPERTY OWNER FOR THE PROPOSED WORK LOCATION
I/We are the fee simple owner(s) of the real property located at
Miami -Dade County, Florida, otherwise identified in the public records of Miami -Dade County as Folio
No(s). I/we am/are aware and familiar with the contents of this application for a Miami -
Dade County tree permit to perform the work on the subject property, as described in this application. I/we hereby consent to the work
described in this tree permit application.
A. IF THE PROPERTY OWNER IS AN INDIVIDUAL
Signature of Property Owner Print Property Owner's Name Date
Signature of Property Owner Print Property Owner's Name Date
B. IF THE PROPERTY OWNER IS OTHER THAN AN INDIVIDUAL OR NATURAL PERSON
(Examples: Corporation, Partnership, Joint Venture, Trust, LLC, LLP, etc.)
Print Name of Property Owner (Enter the complete name as registered) Type (Corp, LLC, LLP, etc.) State of Registration/Incorporation
Address of Property Owner
Under the penalty of perjury, I certify that I have the authority to sign this application/permit document on behalf of the Property
Owner, to bind the Property Owner, and if so required to authorize the issuance of a bond on behalf of the Property Owner. (If
asked, you must provide proof of such authority to the Department). ***Please Note: If additional signatures are required,
pursuant to your governing documents, operating agreements, or other applicable agreements or laws, you must attach additional
signature pages. ***
Signature of Authorized Representative Print Authorized Representative's Name Title Date
Signature of Authorized Representative Print Authorized Representative's Name Title Date
P)e
Ap_ atesg
Box 5:
AND
itr
deg iro
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3