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1140 NE 91 Terr (11)ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. 'TYPE Outlet, Appliance Q'TY. TYPE Service Repair QTY. A/C Central 1 -3 Ton Heating Strips, each Fan Outlet, Wall Service, Temporary Paint Booth A/C Central 4 -7 Ton Fire Pump Outlet, Switch Piping, Flammable Liquid Signs A/C Central 8 -15 Ton Fixture - Fluorescent Process/Pressure Piping Oven Space Heater (kw) A/C Central 16-20 Ton Pressure Vessel 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 TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons QTY. 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 Pump and Abandon Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Gas - Appliance PLUMBING . TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. 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 2 INIPORTANT 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 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. STATE OF FLORIDA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature o o c WILL IAM L. w^ LSH Print Name Sworn to and subscribed before me this 1 S day of tJ 0 V Z-0 0 1 . LORI DAY My Comm Fxp. 2/1 No. CO 0021 Personally Known 11 ether 1.0. 41 WM. b./ Signature of SEAL: 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 Personally known x OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND E V :EWE) = /Y: DATE: SECTION BY DATE Zoning ae /gp— ////6 lam/ Electrical Repair Mechanical Fax Qualifier Name Plumbing Relocation of Structure Fire Shell Only Public Works Add'l Attachment Structural Other Building Official �� it (it CONTRACTOR ' Name W i l l i P) VY1 W A I S II Name Home Telephone 30 6 -_ 757 _ 7 3 License No. Fax Address Repair Telephone Fax Qualifier Name Demolish PROPERTY OWNER ' Name W i l l i P) VY1 W A I S II Address , j - o NE c7/ Terr & CC Ng M A vn i Shores : FL 3 313 g Home Telephone 30 6 -_ 757 _ 7 3 Business Telephone 9s-,, 3 4 a. -- qo 5 g 3 C g a. — q o c�} g Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $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 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) f‘ 0 (sq.ft. = x/1000 x (t.60) $ (¢.005 /sq.ft.) (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL G b 0 ISSUING OFFICIAL 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 K Job Address: Step 1. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other J bP-o) /1DQ3 Folio Number 11 3 a.Q VD 1 • pa) p 7 Lot 1 a qu &h4Lf© Z Subdivision biafer5 eI: ;c_ PB q PG ! q/ Current Use of Property No Vi ? Proposed Use of Property }4(7 W) P Tenant Information PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Master Permit No. Subsidiary Permit No. SO s7 0 PERMIT APPLICATION INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: 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 submitted 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 // q AlSt I si hl E M I A vv) i 5110 yes FL 3 3138 Address Apt. City State �� ZZi Description of Work 1 r e A r - /U C WOW(' (�.' Zoning ReS . Linear Feet 76 feet Square Feet Units / Floors 1 p( Value of Work 41 gCOO ,CCD Bldg Value X /63, 000• CO Tax Assessed/Appraised Value ii /3$,000/# /63 J- Flood Zone A L Base Floor Elev. 8 - eet ENGINEER Name License No. Address Telephone Fax z GO! 1 COMM flON SERVICES IC, PAY TO THE OR D ER 1 0F . /X FOR North Miami Office 1 255 N.B. 16 Ave e, North Miami, Florida 33161 S i tA0 ci Ac e, (1 r e .1" gi o te ■• I . I. I k or de 1979 N.E. 147TH TER. N. MIAMI, FL 33181 PH. 305-944-0000 c 0.:P. ez_cogu_Sigy_es, to is p.c1.7 fop *COMMERCIAL BANK OF FLORIDA "O 20 2" 1:0660 103? ?I: 11 4 11000 II LH' DATE dAl / 141.11111.C.OS0,121.G.1101.1/te ■111[0111 ITS Atataaramenummr 1 12012 Owner's Side 5'-0' MAX 2' -0" T"1 I O A I I I - III -I - I II - II - I I I - 1 ' -0 I I_- 4" X4" Wood post I "X6 " orI " X8" Wand p ickets Wood Posts 211 X 4 Wood pad 4' -0" High or Less = 6' -0" O.C. 5' -0" High or Less = 5' -0" O.C. Concrete WOOD FENCES 3' -0" Concurred 2915 Fences 2915.1 Wood fences, so located on a property that by zoning regulations they cannot be used as a wall of a building, shall be constructed to meet the following minirnum specifications. (a) Fences not exceeding 5 feet in height shall be constructed to meet the following minimum requirements: from nominal 4 inch by 4 inch by 8 feet -0 inch long posts spiced 5 fee -0 inches on centers, having a fiber stress of 1200 p.s.i. in bending, and shall be embedded 2 feet -0 inches into a concrete footing 1 fcot -0 inches in diameter and 3 feet -0 inches deep. Other components shall be designed to comply with the provisions of this Chapter and Chapter 23. (b) Fences not exceeding 5 feet and 4 feet in height respectively shall be constructed as provided in paragraph 2915.1 (a) herein, except that the spacing of posts may be increased to 5 feet -0 inches and 6 feet -0 inches on centers for these heights. I COMMUNITY NUMBER 120652 ODERAL NOTES' 2: PANEL NUMBER 93 3: SUFFIX J LOS 19 BLK 2 DATE OF FIRM INDEX 7/17/95 FNO I /2' IP NO ID Lf) ALUM. SHED ON CONE SLAB 0.05' 5: FIRM ZONE AE 7.5' 0.2' 11 Mint OF EARING' NOSUMIED MERIDIAN 2) ELEVATIONSS SHOWN HEREON ARE RELATIVE TO NATIOAL EOETIC VERTICAL DATIMUN.O.V.D.) 9) LOCATION AND IDENTIFICATION OF UITILITIES ON AND/OR ADJACENT TO THE PROPERTY WERE NOT SECURE AS SUCH INFORMATION WAS NOT REQUESTED. k) NOT VALID WITHOUT THE SICMATUME AN) THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR NIO MAPPER. 51 DDROADIE NTS AND VIOLATIONS ON SUAVEYC IF ANY)' BOUNDARY SURVE ••• • 75.0' PRI VAO FEki'G. _L .0 14.5' 18.6' 6:BASE FLOOD ELEVATION 8.00 6. LOT 18 8LK 2 3 4. 6 5' 45.6 1 STORY RES • 1140 CBS LOWEST FLOOR ELEVATION • 8.05' GARAGE FLOOR ELEVATION - 6.31' 13.5' PLANTER 6.08' 11111 CB - CATCH BASIN LEGAL DESCRIPTION LOT 18 & EAST 1/2 OF LOT 17 IN BLOCK 2 OF WATERSEDGE, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 9 AT PAGE 141 OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY. FLORIDA. • � v 0) 7.75' 75.0' SKETCH OF SURVEY SCALE' 1' - 20' LECREIOI FND - FOUND CM - CONCRETE MONUMENT IR - IRON ROO IP - IRON PIPE R/V - RIGHT OF WAY P08 - POINT OF BEDINNINO POC - POINT OF COMMENCEMENT PC - POINT OF CURVE POC - POINT ON A CURVE -� -- CHAIN LINK FENCE �/ -- VOCD FENCE PB - PLAT BOOK P - PAGE M - MEASURED 0 - EED R - RADIUS A - ARC A - CENTRAL ANOLE C - DICRO X.XX - ELEVATION --I--I- NON - VEHICULAR ACCESS LINE - CONCRETE to P -u- - ovemEro LINE 0 - HANDLE )o - 7IREE • • . :• : . • • • • • 410 • • • • • , • • • ■•• • • • • • • • • • ••• ••• ■ • • ••• • • • • : • • • • • • • •• ND I /2''IP • . : ••• : : ••;10 'di •• • EAST 1/2 LOT 17 BLK 2 20.25' ANTERI. v ✓ V • , 9.5' ASP 5.09' — c. NE 91 TERRACE(24' PAVEMENT) — --- 50' TOTAL R/W • • : • • • .• • •• • ■•• • • 0.35' K 1 -- ON It .. • • • ••• A a, FND 1/2' IP // // 0 NO ID S, of WEST 1/2 LOT 17 BLK 2 B25' CERTIFICATION OF BOUNDRY SURVEY. I HEREBY CERTIFY THAT THIS SURVEY WAS MADE UNDER MY RESPONSIBLE CHARGE AND TO THE BEST OF MY KNOWLEDGE AND BELIEF; THI SURVEY MEETS THE MINIMUM TECHNICAL ' STANDARDS AS 5 FORTH BY THE BOARD'OF. PROFESSIONAL 1' LAND SURVEY() N CHAPTER GIGI7 -6 FLORIGA.A6MINISTRATIVE CODE PUR 0 SECTION 472.027., FLORPA,ST/$TUTES. JU Ir` . PITA, P.L.S. PROFESSIONAL LAND SURVEYOR LAC' SE NO. PSM 5789 STATE OF FLORIDA 1/2' IP 0 BLK COR JULIO S. PITA, P.L.S. LAND SURVEYORS 7805 CORAL WAY. SUITE 100 MIAMI. FLORIDA 33155 PHONE. (305) 262-2404 SECTION 5 - 53 - 42 I COUNTY: DADE CERTIFIED TO: WILLIAM L. WALSH 1140 rE 91 TERRACE. MIAMI SHORES. FLA 33138 DATE: 9/22/98 I ' A t$': 98 - 09 - 34 DWG: GL1141 / • • • • • • • • • • • • • •• • • • • •• • • • • • • • • • • • • •••• • • • •. •• ••• • • • • • • • •• •• •• • • • • •••• • • • • •••• • • • • • • • • •• 1