Loading...
9950 NE 4 Ave Rd (7)l 50- MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 BB Inspection Request Date,U ( 7 Type Insp'n WO 11 Jini— Permit No. 6160- Name Ore Uy7 Address SSC) N E 101 SI Company Phone # 3 3 10(x) Inspection Date .2., f Approved ❑ Correction Re- Insp'n Fee beau 'Fr41 s ,� l.v Or k_ ph cal LA.Pr AS, . MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Build g Inspection Request Date Type Insp'n Permit No. Name Address Company Phone # Inspection Date Approved Correction Re- Insp'n Fee (97/ /0 s- MIAMI SHORES VILLAGE BUILDING DEPARTME 305- 795 -2204 Building Inspection Reque Date Type Insp'nfi in I UGI hC� _ Permit No. E 1 ,� Z _ Name V COCA( 61 l Address ) �p Sc� V kJ mi (O 3 Company U () 1 t rn) 1 L d a ea, Phone # ' T s - 3 L19- 3) . Inspection Date 1 Approved Correction Re- Insp'n Fee • 41e1 e- / 1A �v / V74)-K/› l a OOP Owner's Name (Fee Simple Titleholder) Owner's Address 53 City ,e,t' A- Q Tenant/Lessee Name $ Value of Work For this Permit 2 V$ Type of Work: ❑Addition iteration spa/ /1/e L.< Describe Work: Submittal Fee $ Notary $5 ° Training/Education Fee $ 0 Code Enforcement $ Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION Master Permit No. FBC 2001 Permit Type (circle): Building CElectrical Plumbing Mechanical Roofing err Phone # 4/ /Dm State �t— Permit Fee $'' /d ` C' Scanning $ Radon $ 017- ct 1421 Permit Zip 2_< 18 Phone# 3o5 3g - )y5'S Job Address (where the work is being done) P7' 1 (- / City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO ` ( 1 7(1- 996 6 Contractor's Company Name �c/` A-; i f C�'''c �. .��< Phone # Contractor's AdcIress 20 0 / 5 W 2 J f� 5 l3 - /L / City , �'Vd State Zip Qualifier�iitv G09 � ,y1 /s Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: yNew ❑ Repair/Replace ❑ Demolition rd S ur c * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** CCF$ I•5d Technology Fee $ a ...S n Bond $ Structural Plan Review. $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zi 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 subjec o 'ttachment. •: lso, a certified copy of the recorded notice of commencement must ' • posted at the job site for the first inspection wh' h occurs s• n (7) days after the building permit is issued In t absence . i pasted notice, the inspection will not , e ap. oved and a r: pection fee will be charged. My Commission Expires: Chc 10/14/03 Th= ' oregoing instrument was ac Cb • owled ed before me this_ f day of er, 20a by d � 14c__ OL M • 600 who ' ersonally known o me or who has produced As ide Contractor The foregoing instrument was acknowledged before this day of vlk ( Signature who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUB I Sign: - q MY COM LLa•• • ,� OF . 0 AUG. 22,2005 Print: zdo5 , 20Q, by Mabel Vargas 1 may • '_ - mon #DD231984 J �•• 107 My Commission Expires: (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Plans Examiner Engineer Zoning nc 200 AMP MAIN 8 CIRCUIT PANEL FOR FUTURE POOL EQUIPMENT L . McGOVERN Residence 600A- SINGLE PHASE 120/240V SERVICE • CWP 5/IrX IT GROUND RODS CONNECTEDVNTH 2/0 VNRE CUSTOMER APPROVAL: GUTTER 8AX8' X3' •--- • J OUTSIDE (2) 2° PVC CONDUIT WITH (3) 250 MCM IN EACH . mm/11 ;•y! 600 AMP FPL FEEDER 550 NE 101ST ST MIAMI SHORES, FL 33138 200 AMP MAIN 30 CIRCUIT €ST IN � ,PREPARED BY Q ontiF'►1 �. )e,cty' , IY4L'. 954 -768 -9966 EC0002115 PAGE 1 200 AMP MAIN 30 CIRCUIT ED ZON*G STRUCTURAi ELECTRICAL • PLJMBt MEDRAMDAL ROCi:ND BLDG. OFFICIAL - MIAMI SHORES VILLAGE DATE SUBJECT TO CCMPt_io,:i:: STATE AND COUNTY PECOWiCiiS. 14. SUOTI: vILLACE KeS tO aSPOAitillES FOR ACCURACY a ori iitsaTs nog TH:cm: FLANS. COKJP.NCE Wi To. ?HE. SOUTH FIONA Otrit.U10%•CODE AS ADOPTED V MIAMI SHOI;ES v1 .., RMUITIED. rriE ARCUITECI, SUiLDER g SUB 1 CONTRACTORS ieaE. c4:,1.0 Willi THE KNOwil.:):11. OF ALL fitiii.V F.:F.LaiLgos WHI:NER 1;R HOT SPF.CiFtCALLY INCUIED iTEREIN. Fl E COPY Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10 /30/2003 Applicant: VICTOR Owner: ORTEGON JOB ADDRESS: 550 NE 101 Contractor UNLIMITED ELECTRIC, INC. Local Phone: 954 - 768 -9966 Parcel # 1132060171160 Signed: (INSPECTOR) Electrical Permit Permit Number: EL2003 -322 ORTEGON VICTOR ST Contractor's Address: 2001 S. W. 20 ST. b -121 Legal Description: MIAMI SHORES SEC 4 PB 15 -14 LOTS 1 -2 -3 Permit Status: APPROVED Permit Expiration: 4/24/2004 Construction Value: $2,450.00 Work: INSTALL NEW UNDERGROUND SERVICE Page 1 of 1 BLK 95 LOT SIZE SITE VALUE Fees: FEE2003 -6675 FEE2003 -6676 FEE2003 -6678 FEE2003 -6679 FEE2003 -6680 Description Notary Fee CCF Building Fee Training and Education Fee Technology Fee Total Fees: Amount $5.00 $1.80 $100.00 $0.60 $2.50 $109.90 Total Fees: $109.90 Total Receipts: $0.00 \ OCT 31 PAID 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 specifications 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, servants or employes. Signed: (Contractor or Builder) BY: ELECTRICAL TYPE: Minimum Fee Qi'1'. Tl'1'E Dryer QT1'. 'I'YI'I Outlet, Appliance QTY. 'I'1'I'1: Service Repair QTV. 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 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 Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., 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 TYPP. Minimum Fee QTY. TV'PE Condensate Drain QTY. '11TE Generator QTY. "I'YI'E Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. 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. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit Q'I'Y. 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: SECTION BY TE IOD Idl Zoning Z /L Electrical Mechanical Plumbing Fire Public Works Structural Building Official �- rl _ l/'e Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ 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 Notary ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ $ $ C o (sq.ft. = x/1000 x0.60) $ (¢.005 / sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ g S d. ,4 ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2"° AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Page 2 INIPORTANT NOTICES 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. 1. 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 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 accoo • 'th Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Con actor. STATE Sworn to and subscribed before me this � � -S ta gnatur:(.f Notary blic of SEAL: Name RIDA, COUNTY OF MIAMI -DADE at 00 � --' Fl orida STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: PERMIT APPLICATION O� D,RY P O ?.-ICIAL t^O • � � ANGELA RA la_G ' :.i }l (,, Co:.'^,....:O I..; -A c., ,_,t,k. Q CC73G.:7 II Personally known' r . ; '� r OR itr Personally known OR, Produced Identification ' Type of Identification Produced: J 4. 04 (M3 ' 53-- L) . 0 Type of Identification Produced: PROPERTY OWNER Name oG ? ;/L it o/1 le o d Address , • �J/ / 1 6 , : 70` 4 — ,r / j% 5 ? p,44, 4 — i "3 C i 13 Home Telephone Business Telephone Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other •1 INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures 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 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. APPLICATION Job Address: •55° /J r /0/1/i/ Address Apt. Folio Number Lot - Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No., City State PERMIT APPLICATION Zip Description of Work (C) t l �� O fkO 0 Y2 ifrtn , Zoning Linear Feet Square Feet Units Floors Value of Work Tax Assessed/Appraised Value Flood Zone Base Floor Elev. Bldg Value ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: i D OWNER'S ADDRESS: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * ** * * * * * * * * * * * * ** All Elements on the site must be -- ed,and indicate the color to be painted. Walls Fascia Drip Cap/Drip Edge Soffit Roof Flower Bins Shutters ; f) zi Awnings M_I! Chimney y Doors and door jams Garage Doors • c Railings Fences n Decorative Metal _ - 3 All brick (simulated or regular) / IM/ / -(/fd4 ud-e.'i Stucco Banding \S t r) /2a./0 & ; • Any other stucco features Accessory At-- Other • OWNER'S AFFIDAVIT: I certify t at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I authorize the above -named contractor, if applicable, to do the work stated. Furthermore , the paint colors will be as per the attached samples. Signature of Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION L' /0/)--94, Building Offic al Date 4/23/01 es The Sunshine State — UCENSE*&mER 0632476 -53 -425-0 VICTOR RAUL ORTEGON 550 NE 101 ST MIAMI, FL 331384000 BIRTH DATE SEX HOT. REST. ENDORSE. 11-2543 M 5-10 ISSUED EXPIRES 07.0902 11 -26-08 DUPUCATE 00-00-00 SAFE DRYER TOT02770110007 . Operation of • nictor vehicle constitutes consent to any sobriety teat required by law. Miami Shores Village 10050 NE 2nd Avenue if Phone: 305-795-2204 )PS Printed:194.12Q02 P /GIS /03 Applicant: VICTOR Owner: ORTEGON JOB ADDRESS: 550 NE 101 Contractor Local Phone: Parcel # 1132060171160 Permit Status: Approved This Permit is granted to the contractor or builder named above to construct t ordinances pertaining thereto and with the understanding that the work will be p and approved by the proper municipal authorities. Thi - ermit may be revoked authorization. A further condition upon which • .ermi is granted is the unders ordinances and regulation pertaining to - work co •red hereby whether show by his agents, servants • e �•Ioyee Signed: y Signed: (INSPECTOR) In consideration of the issuance to me of this permit, I agree to perform the w with the plans, drawl gs, statement or specifications submitted to the proper a myself, my agent, servants or : pl. es. Building Permit Permit Number: BP2002 -1867 (Contractor ORTEGON VICTOR ST Contractor's Address: Legal Description: MIAMI SHORES SEC 4 PB 15 -14 LOTS 1 -2 -3 Fees: FEE2002 -6182 FEE2002 -6183 FEE2002 -6184 Description Building Permit Application Fee CCF Notary Fee Total Fees: Amount $60.00 $0.60 $5.00 $65.60 Total Fees: $65.60 Total Receipts: $0.00 Permit Expiration: /29/2003 Copstruction Value: Work: EXTERIOR PAINTING AS EPR AGREEMENT f 1 If there is no permit package accessible q the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advan a before calling for another inspection. VICTOR R. ORTEGON AMANDA M. MCGOVERN 550 NE 101ST STREET MIAMI, FL 33138 G /,� �, s 6 . .. Order of Pay to the J $ S Dollars W 11 11 A L T A R For 2P, ?ngnt. • $300.00 Page 1 of 1 nn 4n '7 a 1. c� 1 BLK 95 LOT SIZE SITE VALUE li -nce with all Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2002 -1867 Printed: 3/7/2003 Applicant: VICTOR ORTEGON Owner: ORTEGON VICTOR JOB ADDRESS: 550 NE 101 ST Contractor Local Phone: Parcel # 1132060171160 Building Permit Contractor's Address: Page 1 of 1 Legal Description: MIAMI SHORES SEC 4 PB 15 -14 LOTS 1 -2 -3 BLK 95 LOT SIZE SITE VALUE Fees: Description Amount FEE2002 -6182 Building Permit Application Fee $60.00 FEE2002 -6183 CCF $0.60 FEE2002 -6184 Notary Fee $5.00 Total Fees: $65.60 Total Fees: $65.60 Total Receipts: $65.60 Permit Status: Approved Permit Expiration: 9/29/2003 Construction Value: $300.00 Work: EXTERIOR PAINTING AS PER AGREEMENT & PATCH (DECORATIVE STUCO AROUND WALL & COLUNMS WITH DECORATIVE 5 j,--2 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 - .ndition upon which t . - •• it is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and reg .tior . ertaining • e w.. cov- ed 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, see ant • "mploy l Si fled' •ECTOR) BY: In consideration of the suance 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 specifications 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, servants or employes. Signed: (Contractor or Builder) BY: Miami Shores Villa 17- Paint g �� Color Approval and Agreement ,. Date J i UGC-e/1 00-e19)C■K-) Phone # �CO Owner's Name Owner's Address City State Zip Job Address (where the work is being done) SSC Ii\-) ( 0 1 S City Miami Shores Village County Miami-Dade Zip Is Building Historically Designated YES NO Contractor's Company Name (if applicable) Phone # ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted Walls scia D ' p Cap /drip Edge Sof t Roo Flowe bins Shutte s Awnings Chimney Doors and door jams Garage doors Railings 0C F ices Deco ative metal All bri (simulated or regular) Stucco b . i ding Any other s ' cco features Accessory Bui dings Other * * * * * * * * * * * * * ** ************************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 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 co and zoning. Signature APPLICATION APPROVED BY: P& Z Official Date Date chc 6/18/03 PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY � (OWNER TO RETAIN COPY) t Job Address 5:50 /(f � /a /SjZ' Tax Folio // 3386 /7 / /it a Legal Description lit07 Jl Z 94'7 _ (: J 9fl. Master Permit # Lessee / Tenant t i M7rr°�/ 4,6/it o Owners Address /7( / J // phone ;R5 Contracting Co. / Address Qualifier State# Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle Ave., one)) ELECTRICAL PLUMBING MECHANICAL PAVING FENCE / SIGN WORK DESCRIPTION e% -1f j �l/'��.� L � 'I ZV C d2 Square Ft. Estimated Cost WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated. I 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, SIGNS, POOLS, ROOFING, and MECHANICAL work. OWNER'S AFFIDAVIT: I certify that all the foregoing informationAs accurate and that all work will be done in compliance with all applicable laws regulating '-construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signa a of Owner and /or Condo President Date: Competency IF SS# - - phone Ins. Co. Signature of Contractor or Owner - Builder Date: l No ry ap(to Owner and /or Condo Pr Notary as to Contractor or Owner - Builder My bb Commission Expires: NOTARY PUBLIC. SI ORIDA My Commission Expires: * * * Sity COMMISftION EXPII S APRIL 1E. 1992 P * * * * * * * l3ONUED TNRU STEMBLE -ADAMS & ST PERMIT FEE: Ntr4.5 /4( 1 APPROVED: Zoning Mechanical Fire Building Other Electrical Plumbing Engineering t Permit No. i Gl__� Date ' " Application is hereby mad d 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, all ordinances of Miami Shores 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. ( Owner's Name and Address ..... — No.- `��O Street_ -- / ©l s Registered Architect and /or Engineer ..... ____— _-______________________ Employing Plumber's Name Am, s Got s' S' - s . L er_&t Street_-_- ,t(l_Z- ______ Location and Legal Description Lot_ ______ Block Subdivision Street and Number where work is to be performed —No „"cS'O Street /.6 "'co" State work to be performed and purpose of building (By Floors)._ _____ New Building ___ Remodeling__-__ _____ Addition__ Size Septic Tank MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Repairs Type of Tank Capacity Gals Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well. -_ - -- _- ...... ______-------- .... - ______ _ ____Size of Soakage Pit Amount of Permit $ (Signed)- P umbin _ s .ctor. 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 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 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 t1ie Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. A/ if / 1/ 0 4/s 7 No. of Stories. _ Master Plumber. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes 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 re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA TORIES SINKS SLOP SINKS LAUNDRY TUBS URINAL CATCH BASIN FLOOR DRAIN DRINKING FOUNT' H6 y /_ 3 7 lY X10 A el 4 TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK t Permit No. i Gl__� Date ' " Application is hereby mad d 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, all ordinances of Miami Shores 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. ( Owner's Name and Address ..... — No.- `��O Street_ -- / ©l s Registered Architect and /or Engineer ..... ____— _-______________________ Employing Plumber's Name Am, s Got s' S' - s . L er_&t Street_-_- ,t(l_Z- ______ Location and Legal Description Lot_ ______ Block Subdivision Street and Number where work is to be performed —No „"cS'O Street /.6 "'co" State work to be performed and purpose of building (By Floors)._ _____ New Building ___ Remodeling__-__ _____ Addition__ Size Septic Tank MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Repairs Type of Tank Capacity Gals Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well. -_ - -- _- ...... ______-------- .... - ______ _ ____Size of Soakage Pit Amount of Permit $ (Signed)- P umbin _ s .ctor. 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 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 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 t1ie Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. A/ if / 1/ 0 4/s 7 No. of Stories. _ Master Plumber. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes 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 re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. 1 BUILDIN INSPECTION DEPA'RTMEN' APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the det, iled statement of the plans and specifications herewith submitted for the build- ing or o h, : �`ructure her i described. This t-t licatic is made in compliance and con•o'm ty w.th the Building Ordinance of Mia v Shores Village, r ,or'da, and all pro. isions of the Laws cf the State of I•krid. all o d nances ,,f Mi au Shores Village and all rules and regu'•auion: of the Building Div.:. i of lam Shot ' illage 1 '1 ,e o. ipl.ed with, whether herein specified or not. A copy of approved plans and specificati .n must be kep: at building durin, progress of tl.e work. • ■ Owner': Name and Address /Y • 4 /A/ Registered Architect and /or Engineer Name .nd address of licensed contractor. '1/NE ft/ a . 39/0 %/k/ 7 a-as. 4.- cet.oul 3 7 - -- - - -- -- - - - -- - Location and legal description of lot to be built on: Lot_ Block___ ___.. __ Subdivision Street and Number where work is to be done �S_ S` -_�/ _ /D / sr. At i /anti 5 /5 o State work to be done and purpose of building (by floors) and for no other purpose. New Building_ �.. _ _ _ Remodeling__ ____ _ ... Addition__._ _. -_ -_ ..... __ _ Repairs_ - No. of Stories_ To be constructed of - _ Kind of foundation Roof Cov sing__ Estimated " ;tal cost of improvements $__. 3 00 " Zone -ubage required_ __ Plan Cubage_____ Distance to next nearest building__ _ _ _ Size of Building Lot Maximum live load to be borne by each floor_ hereby submit all the plans and speciiications for said building. All notices with reference to the building and its construction may be sent to The unde signed appli ant for this budding permit does hereby certify tat he understands and accepts his obligations as an employer of 1• bor under he Florida Workmen's Compensation Act bung S—tion 5966 Col p led Gen al Laws of Florida P r anon. SApplc nent, and h , s compl ed wqh the prov':ions thereof, and will require s :milar compliance from all contractors or sub - contractors emplo-ed by him in the wo-k to be p<rf r-med under this pern it. and ill post or cause to be posted for inspection on the site of the work su :h public noti' e or •otires as are requir d by the Act. The u.,d•.r- ign.•d agrees to employ only such .abcontr. ctors, on work to be perform . der this permit as are licensed by M Shores I il:: ge. Remarks (Signed) - -- (A �J /!� ►� C#"uC� STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ep- peared _. .to me well known, and who, being by me first d:.ly sworn, upon oath deposes and sa s that he is the of tli abov. de.cribed ••istruction ti • h: has carefully read th foregoing application, and that he did sign the same, and that all facts therein by him stated arre e. �, �� Permit No ._ Date__ I . . Read, Sworn to and Subscribed before me. Disapproved Date__ _ Notary Public State of Florida (Signed) Building Inspector My Com :nission Expires_ Chairman Member Member ._ Council Approved. MIAMI SHORES VILLAGE lR Co y_p 17 0 A/I N 6 Y. 6 , ,✓6 Date Amount c.` Permit $._ PLANNING BOARD DATE Member Member Member Date Disapproved /— /S -3 ,I9 No._ /YE• Street_. /_Q /_ T At, 'oat 51 4E5 Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application tfter approval 11.1s been obtained from the Planting Board. A re- inspection fee of $1.00 will be charged when such re- inspection is ma:ie necessary by improper notice for inspe:•t•or or fa tty materials yid /or workmanship.