Loading...
REV-19-135 (2)BUILDING PERMIT APPLICATION f Y�1 BUILDING ❑PLUMBING ❑ ELECTRIC Miami Shores Village lo Building Department '�o �6 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel• (305) 795-2204 Fax• (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 i� FBc Zon Master Permit No. __�If _/�7 �16.4 Sub Permit No. ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS Inn nnnRFcc• City: Miami Shores County: Miami Dade Zip: �5ITf > X Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: W av�i�7 0/ OWNER: Name (Fee Simple Titleholder): Aft 1� Phone#: Address: q3 2 9_IOW co 9 S /- 6fk-4— , 41-410 City: f\-4fow1 State: Zip: 'v 2 Tenant/Lessee Name: Phone#: Email: 0 CONTRACTOR: Company Name: �tIC Phone#: Z O� Yd2;3`� Address: J� Z .--5 Z 0 5' f City: State: G`�� Zip: �3 �Q/ 3 Z ' Qualifier Name: 0?�2 A Phone#: 7 y 6 / 45Z 3 3l f/ State Certification or Registration #: Certificate of Competency #: _ DESIGNER: Architect/Engineer: Phone#: - Address: City: State Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Description of Work: ILV 5 /csij �o4e10!_1�f ^j Zip: ❑ Demolition Specify color of color thru tile: Submittal Fee $ PernritFee•$ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ ! (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage. Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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 ocruc 7 days after the building permit is issued. In the absence of such posted notice, the inspection will no approved and a reinspection a will be charged. Signatu or AGENT The foregoing instrument was acknowledged before me this 0 day of 20 11 ' by y NPV whys personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign:_ Print: Signature CONTRACTO The foregoing instrument was acknowledged before me this day of: N4 20 by 1/yZRr;.- I61ov1 , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Print: l rt,C��ZVc7 S o l� 14 L) =w :z— • — `. - — Seal: �'-7s °yap : .Q�z Seal: , :'j''r.. PEDRO P SORQkNQ s••s��;dv00 0.••' �N� MY COMMISSION N FF2439S4 *'i �,bb••• ��'`� •...., EXPIRES June24.2019 APPROVED BY 1 / Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT qq'�jj APPLICATION FOR PLUMBING PERMIT Permit No._.. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submits for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shares Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work:-n n —a _ A Owners Name and Registered Architect and/or En Employing Plumber's Name--_ _:11 -� Location and Legal Description Lot Street and Number where work is tD be performed —No - State work to be performeS and purpose of building (By Floors) Subdivision__--_ Street.__.------------- _-------- New Building____—__ Addition....___._... Repairs.__.._................ No. of Stories_ CLOSETS BATH Tuns SNOWER5 LA". TORTES SINKS SLOP SINKS LAUNDRY Tuns URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NB TOTAL FIETUREs COMra. LIST CHEOK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE' TRAP SOLAR HEATER DEEP SPRKLR. WELL SYSTEM SWIM'G POOL COMM.- LIST CHECK "OfSize SepticTanis-.Feet of Drain Tile_ Tank or Drain Field from Well._.____ ----___-_---_--_------- ------------ - Nature of Water Supply: City —Well — Size of Soakage Pit __.__.__--_--......... __.-__....... Amount of Permit ; The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 59N8, Compiled General Laws of Florida Permanent Supplement, and has corn - plied with the provisions thereof, and will require similar compliance from all contractors or sub -contractors employed by him in the work to be performed under this permit, and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the AcL The undersigned agrees to employ only such sub-contractom on work to be perfo under this permit, as are lieensed by Miami Shores Village. (Signed) s�L err 1Smber. t STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority. a notary public, duly authorized to administer oaths and take admowiedgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath depose and says that he is the_ _ _._ ---------__.._.�_............... ....... of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A minspection fee of $1.00 will be made when such minspection is made -necessary by improper notice for inspection, or faulty materials and/or worlammship. MIAM IHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted fore build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether hZ ' specified or not. A copy of approved plans and specifications must be kept a' building during progress of the work. Date.----. ........_:_..... .19 T Owner's Name and Address._...--_.�.---..._ .---_-- No.....................Registered Architect and/or Engineer..- -• ---- ..._. ..-_--•.---••-•-----...----------.....a -- Name and address of licensed contractor ............ .- r. Location and legal description of lot to be built . Lot------ ------ -_------------------------- Block ............................ Street and Number where work is to be done ___--.-_-- State work to be one _ d, p mpse ofQ�by ... _........ .. D. =.c�rstr* _% 0.------ ...--_r.--. _--: --'-'•----�` *sj��'rA�_'_.. _ .. G -[A .Q..............and for no other purpose. New Building...._ ........................ Remodeling.... ... ----_-----.- Addition..._._ --------- Repairs .......................... No. of Stories.......................... To be constructed of ................... _.__... Kind of foundation....•. -.--..---.----*_--..--.--- Roof Covering - vim_..._...--••--- - • - --- 8................................... ............ Estimated Total cost of improvements $........... ®_._��...__Amount of Permit a ........ Zone cubage required ............... -............. ...................._.............-•••----......Plat► Cubage............... ..... --......... _...................................... ......_...._......... Distance to next nearest building........ ........................... -.....__.....-._._....Size of Building Maximum live load to be borne by each floor-----. -------- ------ ---------- ---------------------- -....... _........ -_............................................ I hereby su79'edap a pl s and pecifications for said building. All ices _with reference to the building and its construction may be sent to - ------------ ----••... -•-• - �..tiu .........._..----- -- ------ The underscant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under tWorkmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance contractors or sub -contractors employed by him in the work to be performed under this permit; and will post or cause to be poste or in on on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such a ors, onyworkto,. rmed under this permit, as are licensed by Miami Shores Village.Remarks.—..-r_ �__ _____ __�----•.----------- r__.__ (Signed)_ _.__ . STATE OF FLORIDA, t COUNTY OF DADE. ( ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared--- ---- -- -----•--------_-•---- - -- - - - - _ _ __......... _._..---- ------ ----------------------------------- ----------------------- -------- ---- — --- - ------ to me well known, and who, bein by me first duly sworn, upon oath deposes and says that he is the- .................................. ................................................... of the above escribed construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him siytI e. Permit Date__ ---•--___.... 5 55 z, � ... Read, Sworn to and Subscribed before me. No..---------•---- -------- - —..-. . Disapproved_ ... ...............................................................-•-•-•-----......•......---••--........ Notary Public, State of Florida (Signed) ................... -...... ._ ..._........ --------•-----•-• _..- ...... ............... Building In for My Commission Expires _-----------.................. ..................................... LANNING BOARD ....... .... -------- --•----•------------ ------- ...DATE Chairman............ .... •---•-------•-•- -----•----------------------------------_-_--- Member ....... -•................ ................. ----------------- Member... -....................... -_ •-•-•----- —--- --- ------- — --- Member - Member ...._. ___--------- _-___.-_------_. Member CouncilApproved —---- -------- ----- ----------------------------- ------------------ .-Date Disapproved -- ------------------ ......... .................... --....... ..Date NOTE: A charge of $1.00 will be made for mak' g corrections or changes to this application after approval has been obtained from the Planning Board. A re -inspection fee of $1.00 will be charged whe such re -inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 32r?- _ v Permit No... _ ._- Application Is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, an ces of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be cSmplw wi J�treia specified or not. A copy of approved plans and specifications must be kept at building during progress of work r5. - p—K�t Owners Name and Address.___ L.�� �__. No. Street..__. - ....._... Registered Architect and/or En ' _ — ��-- _-------_--._.._......_. zi�ih " Employing Plumber's Name_-- �� _ Po�- Street -— Location and Legal Description Lot_ B _ . Subdivision Street and Number where work is to be performed—No.-7 ze Street--- _qj_ _...—__--__.------ State work to be performeil and purpose of building (By Flom) -----__-_-- --.. . New Building._.___-_.-...._-_. _.__ Remodeling _--.-_ Addition-_____ _.__.._ Repairs_ ____..__.._---_. No. of Stories_ _ .._.._..._.:....... CLOSETS BATH TUO@ SHOWERS LAVA • TORIES SINKS SLOP SINK@ LAUNDRY Tue6 URINALS CATCH SA@IN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURes Cowm. UsT CHECK SEPTIC TANK CiONN. DRAIN FIELD SOAKAGE PIT GREASC TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL COMM. LIST CHECK &,__ e__ 3- m.ar, n q Y Feet of Drain Tile_ _-.-___._-_--Dist. Feet of Tank or Drain Field from ...... --_-----_....... _..... Nature of Water Supply: ity Well __�_ —_ — �_-Size of Soakage 17 Amount of Permit i — _ — ( Signed )- f Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts hi-*igations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub -contractors "toyed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by fire Act The undersigned agrees to employ only such sub -contractors, on work to be performed under this permit, as are licensed by Miami Shares Village. O (Signed)- _�t .. Plumber. STATE OF FLORIDA, COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administeik oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon'oathdep ores and ays that he is the _..._._--_-.-.-.-_-.__----....._------_.__ _-. _--•. of the above described construction, that he has carefully read theregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida — NOTE: A re -motion fee of $1.00 will be mado when such re -inspection is made -necessary by improper notice for inspection, or faulty materials and/or wadananship. , % I L 1- V/ IYFR