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1225 NE 91 TerrMIAMI SHORES VILLAGE BUILDING DEPARTMEN 305- 795 -2204 Building Inspection Reque D JP...3 Time Type Insp'n ��� _/.//,\ Permit No. r ? () ' 6 Name Q Address \ 4 t l I d� t - Compan Phone #30-c- ' -©s l (7 For Inspector :3/ 03 a e (Si Date g 2 3 , 161 c) Approved Correction Re- Insp'n Fee ELECTRICAL TYPE Minimum Fee QTY. 'I'1'1'E Dryer t )r -. TvnE. •Outlet, Appliance Q'I'V. 'I'1'PI': Service Repair Q•I'1'. 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 I'IECHANICAL TYPE Minimum Fee QTY. TVI'I. Condensate Drain QTY. "1'YI'li Generator QTY. 'FVI'I: Refrigeration, Tons Q A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C WalWVin. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of /200 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 PLUNIBING TYPE A/C Condensate QTY. TV'PI: Drains, Roof QT'V. TYPE Miscellaneous Fixture QTY. TvI'I: 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 2 • • • • • • • • .•. • • • • • • • • • • • • • ••• • • • • .... • PERMIT APPLICATION IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECE$VBD i ViLIF)ATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: ¶4on'day'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 vi A CaitN, UATt1ND SINI.'A RY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEli FR)�1� FitOl 4 DIRE' M.D DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGE) BY EQP1IPMBN'POR \ 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 govemmental 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, C S ignature of Owner Signature of Notary Public - State of Florida NTY OF MIAMI -DADE Print Name Sworn to and subscribed before me this day of SEAL: SEAL: STATE OF FLOR , - ' MIAMI -DADE Signa Print Name Personally known OR, Produced Identification Personally known / Qualifier Syor�� �ubscribed before me this Signature of No t - 1 - C '�NcD day of / a/e a //- Ci.te■af la inriiv 1 „' 4 j , ”, , ROBERTO F. RODRIGUEZ SAW' f E My C p n'rnOelon Expires Jun 14, 2008 Commll<9Ion 0 00 103178 Ilan** Py Netlanal Notary Ilan. s Type of Identification Produced: Type of Identification Produced: Page 3 • • • • • • • . • • • • • ••• • • • • • • • • • • ••• • • • • • • Z•• • ••• • • • ••• • •• • • • • • PERMIT APPLICATION INSTRUCTIONS: Please indicate the type Qf work Derfo n d,aOd quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning License No. . . a Electrical a-4 4R -R Telephone �j70 CI f'ZJ 0 Fax Mechanical 1 46, l/ 3. Z (• o Plumbing Relocation of Structure Fire Foundation Only Public Works Add'I Attachment Structural Add'l Detachment Building Official Other CONTRACTOR New Construction \ Name e67/ ,,, � C P _ e / � ,p Cl License No. . . a Address ca( zd e 0 a-4 4R -R Telephone �j70 CI f'ZJ 0 Fax Alteration Interior Qualifier Name )/( ... e ice... i, _ PROPERTY OWNER New Construction Enclosure Address . . a Home Telephone Repair Business Telephone Alteration Interior Fax Demolish TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'l Detachment Other Page 4 OFFICE USE ONLY ❑ 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.) 1 Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review Notary ••• • • •. ❑ IMPACT FEE (New Construction) • • ••• • • • • • • • • • ••• • • • • • • • • • • • • •• ..••••• • • • • • •• ❑ PROOF OF OWNERSHIP (Attach) ❑ OTHER (Specify & Attach) • •• .•• •• • • • • • • • • • • • ❑ HRS / DERM . •. (Septic•/•Setiser) • • • • • (s . x/1000 x ((t.005 /sq.ft.) ((t.01 /sq.ft.) ••• PERMIT APPLICATION CHECKLIST • ❑ CONDO ASSOCIATION APPROVAL (Attach) • 9 BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF APPRO\AL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com , , r� INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application wn ich:oat he signed by 1 property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate place: sing 0g yyur application. tf •roofing work will be done, a roofing application must be submit- with this permit application. . • • ' •• • • • • ted along P PP •• • • • • • ••• •• 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 /'Z Z J Address PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other • • • • • • • • ••• • • • • • • • • • • • • • • • • • • • • • • • • • ... Mastar•Permit No. • •• • • • • • • • • • Sutistdidgy Permit No. • • • • • • • • • • ••• • • • Apt. City Folio Number escription of Work Lot Block Subdivision PB Current Use of Property Proposed Use of Property Tenant Information ARCHITECT Name License No. Address Telephone Fax PERMIT APPLICATION BP © o2- za State //�� ip f ?E 0 l� AC PG Zoning Linear Feet S uare Feet Value of Work / 4R.0 U Bldg Value ax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection Units Floors ENGINEER Name License No. Address Telephone Fax f Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/21/2003 Applicant: ELLIOT Owner: PILSHAW JOB ADDRESS: 1225 NE 91 Contractor COMFORTEMP A/C INC. Local Phone: Parcel # 1132050010240 COMFORTEMP AIR CONDITIONING, INC. W 2120 MIAMI, FL 33155 PAY TO THE ORDER OF If there is no nermif n Ori. 111�� ern National Bank j 2495 NW. 82nd Avenue Miami, Florida 33122 FOR e0023060-40670025334 6900 L79006 Mechanical Permit Permit Number: ME2003 -36 PILSHAW ELLIOT TERR Contractor's Address: Legal Description: WATERSEDGE Total Fees: $0 Co Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 9/17/2003 Construction Value: $1,200.00 Work: RELOCATED & PERFORM DUCT WORK PB 9 -141 LOT 28 & LOT 29 LESS E15FT BLK 1 Re- inspection Iication herefor in strict compliance with all :ifications that may have been submitted to >s or if the plans are changed without ponsibility for a thorough knowledge of the that he assumes responsibility for work done .ns pertaining thereto and in strict conformity •esponisibility for all work done by either