BP-02-1435PROPERTY OWNER
Name :? P 1 Ur \re c t 1
Address i 13Ob 14,. e . azi isoiene.
mic r•-► i shoes, L fe l
Home Telephone
moZ° ■_D 1t abiP
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Business Telephone — tC
Fax .e _ 421)7 . p
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ARCHITECT
Name i-k at.1 r '''sr4- kATS M1C._ 0
License No. 1
Address Qlo1 Pr1 mIprC.t C_ i rcle.
C.T rc41 C- r 53 54
Telephone s _ 42.1t..0 _ 10 2
Fax �. — A'1 LD — M
ENGINEER
New Construction
Name
i ` ,,,
( e
Y . I c
?c1'( -VYP . ±IC
License No.
Repair
Address
Alteration Interior
0101 MAGrJ fc, C1 roe
CJO\ Q e3 L 3 - 5134
Telephone
Relocation of Structure
Fax
Shell Only
TYPE OF MANAGEMENT (✓ )
New Construction
-
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'1 Attachment
Other
Add'l Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
8P -01 - 111v
Subsidiary Permit No. 'DP'c3coca •
Master Permit No.
PERMIT APPLICATION
Complete the attached permit application which be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate proceing_of your application. If roofing work will be done, a roofing application must be submit-
ted along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
A PPLICATION
Job Address:
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
v
100 I\3,. tk5. 11 '55 ST.
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
Lankii :
Zip
n Address Apt.
Folio Number 1 i — (. Q - QOO -oo40 Description of Work
Lot Block
Subdivision PB PG
Current Use of Property ( 1110 (Sell TOrn4. Square Feet Units 1 1 k Floors 4
Proposed Use of Property LI 61 WSt rim, X. Value of Work 0 a, Bldg Value
Tenant Information Tax Assessed/Appraised Value - rikfiji C e.
Flood Zone Base Floor Elev.
City
Zoning
State
A
-
f L1(i -1�ritilt�
Linear Feet ` ()Cr)
O
CONTRACTOR
Name l IC f Y ] YY1� C r-e - f lr t' on CC)
License No. LC—k e . 0 4 2 _ n
Address a („1 I- norcC, \ve ua
tr& C a 'FL 33134
Telephone - � A 5* -44-1-0441
Qualifier Name `i `'
Page 2
UMPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. 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 street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY 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.
AFFIDAVIT - Please read carefully.
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 F1.RCTRICAL, 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.
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Owner rgnature of Contractor / Qualifier
Print Name
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
SEAL:
Personally known OR, Produced Identification
STA. OF n •' •
Y1crt.A L Cr e.
Sworn to and subscribed before me this 2-Q day of SU N
Print Name
Signature of Notary Public - State of Flori
PERMIT APPLICATION
A, CO OF MIAMI-DADE
Type of Identification Produced: Type of Identification Produced:
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TYPE:
Service Repair
Q I'Y.
A/C Central 1 -3 Ton
Fan
Outlet, Wall
Service, Temporary
A/C Central 4-7 Ton
Fire Pump
Outlet, Switch
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater • (kw)
A/C Central 16-20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Thbs
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
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm.. (p/PH)
Temp Sery , Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL
TYPE
Minimum Fee
Q "I Y.
TYPE
Condensate Drain
QTY.
TYPE
Generator
QTY.
"II PE
Refrigeration, Tons
QTI.
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C WaWWin. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Supply, AC Well
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Temporary Toilet
PLUMBING
TYPE
A/C Condensate
QTY.
'I YPI;
Drains, Roof
QT Y.
TYPE
Miscellaneous Fixture
QTY.
'IYP!?
Soakage Pit
QTI.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
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 -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
Page 4
OFFICE USE ONLY
CIIECKLIST
Cl OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
Notary
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
LI OTHER
(Specify & Attach)
PERMIT FEES
$3.00 per page (Scanning Fee) $
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine $
Zoning Review
SECTION
Electrical
Mechanical
Plumbing
Public Works
Building Official
ilufro
(sq.ft. ) x/1000
x 0.60
(¢.005 /sq.ft.)
(C.01/sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $
f ISSUING OFFICIAL {{�_
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 8/15/2002
Applicant: BARRY UNIVERSITY
Owner: UNIVERSITY BARRY
JOB ADDRESS: 11300 NE 2 AVE
Parcel # 1121360000050
Building Permit
Permit Number: BP2002-1435
Contractor BEAUCHAMP CONSTRUCTION CO INC Contractor's Address: 247 MINORCA AVE
Local Phone: 305 -445 -0819
Page 1 of 1
Legal Description: 36 52 41 40 AC SE1 /4 OF NE1 /4 LESS E35FT & LESS W4OFT LOT SIZE 1740400
Fees: Description Amount
FEE2002 -4575 Building Permit Application Fee $60.00
FEE2002 -4576 CCF $1.80
Total Fees: $61.80
Total Fees: $61.80
Total Receipts: $0.00
Permit Status: Approved Permit Expiration: 2/11 /2003 Construction Value:
Work: MINOR ASPHALT ALTERATION PER MASTER PERMIT
$2,500.00
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
by his agents, servants or employees
Signed
(INSPECTOR) BY:
In consideration of the issuance to me of th' 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 sp e ications 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, se�ants or employes
REG CO1 082002 1244 CO1 000483 CHARGE
(Contractor or Builder) BY:
$61.80
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