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BUILDING PERMITType Insp n Permit No. Name MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ime Address J Company Phone # For Inspector: Approve ❑ Correction Re- Insp'n Fee ❑ Name & Date 001 )1 1 MIAMI SHORES VILLAGE uds 5 BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Type Insp'n i Permit No. Nam, A`/--) J -61 Address ( / �i ot < Name & Company Phone # For Ins s. ctor; Time / 027-4r, e A - off a APP 111 41 r r A o Alt. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date /` - 2 Time Type Insp'n r.0 LE Permit No. 7 0202,- /D5 Name Address /35 f l< b Company �� 7 Phone # Approved Correction Re-Insp'n Fee 9/1/ fy For Inspector: 2 _Q 2 Name & Date MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 7-if — 'a 2 Time Type Insp'n G2� Permit No. 3 7 gee),-/ � Name �, �a ��/ gip �r✓ loNs a Address 1. 3 IP 9/ Si Company �i� r 7_, Phone # L lQL / i / 66 For Inspector: 20 o Z Name ate Approved Correction Re- Insp'n Fee Date Type Insp'n Permit No. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Name CT ie/e Address 1 3 ,mot l S Company Phone # aS Y Qj •� For Inspector: ^I 0 Name & 't" / Approved ' Correction ❑ Re- Insp'n Fee ❑ Time _DDc7)- • (Q MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buiding Inspection Request Date 0 Time ro _ )4r5 TypeInsp' n, a,� \s�_ � � ? o O �- 1 Permit . Nae Address 13—) Y t( " Company Phone # For Inspector: Approved Correction Re- Insp'n Fee C) Name & Date /Oil • ..a MIAMI SHORES VILLAGE PERMIT r Jr Office of Electrical Inspector CERTIFICATE OF INSPECTION No. . THIS CERTIFIES THAT the wiring and apparatus installed at by Address for -- - owner, and occupied as has been inspected and current is authorized to be turned on, until otherwise notified, for: Size of Service Number of Lighting Circuits Range watts. Water Heater watts Power: Connected load H P. Space Heaters Other Apparatus watts ELECTRICAL INSPECTOR. • N9 80 CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Miami Shores Village, Fla., Owner, Agent or Tenant of Building Lot Block Subdivision Street Address Approved use by occupancy Remarks: This Certificate of Occupancy is issued to the above named for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildings or structures. BUILDING DIVISION Subdivision wn e Bldg: - Pre rmi No. Near - 'Cor8truct 2 � eral ' f/ Contractor Zone Req. Cu. Ft.: 2. ( Checked by • To _Coax ejI • • • .. .2 -lamb ng� Permi t No . .- .S- eptic• Tank . Sewer • Miscel._ New Const.._ Number Street 31 /2 .17 c(/ / No Address or Phone / %i -- /‘,-2.47f. Lie. No. Address or Phone Ct.b. Cont. 22 93 '7 By Plat- Restriction' By- To Planning - Board - d - oved t , Re- Submitted t r''P.Bd•. Approved Approved Stories . Alteratio - ? ' zee) Rej`ect • • Rejected • Date•- Re ' ected cost.? R o of • Date! /-26 - I, Q - Pee P it l � . 14 J/ ! ' .. 8 .g of ,�� i -moo Alteration - � '0 Repairs -/ Electrical Permit No. Fixtures Heater. - _-- Motors • Misce1 New Const.' • Bldg. • F oundat. o Beams & L Final"`� Final Qlean - U Sewer .Septic Tank Solar. Heater' Final Cer - t. ;Vat e Plumbing . Insp.' j ' Dat Roughing �- o Fixtures - /•:=� — L,'i Electrical - Insp.'~ „Late Rough Fixtures Final !� Service 0. K. to Power Co 1z- n Alteration x_e- Insp,.. Date 1/ - 2 = c�Fee _ -.4 i t � .... t .. Rep1irs steins "P. Re-Insp. By Reinsp B Re- Insp. By Reinsp. By 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, all ordinances of Miami Shores Village and all rules and regula- tions 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 the work. O wner's Name and Address , _ __ ,� " ,. 4 .--....:_-_...L. _, S „ _- i. �_- --- -_- - - - -_ No,.a Registered Architect and /or Engineer _.,a_ 4' U_�'F iv r. / �a w. d Name and address of^ contractor � " _ , ' : ,,f, Location and legal description of lot to be built on: , , Lot__-___ Block_ _2- _ —__ Subdivision ° 2„ - Street and Number where work is to be done A E ; 9 2 ' ' 1 State work to be done and purpose of building (by floors) and for no other purpose. - New Building______ __: _ ___ Remodeling /dcption_ y - Repairs No. of Stori _y..0 To be construct d of__ -1- Kind of foundations Roof Covering__ �. __s:' 1 ° : r +...„. Y # Amount of Permit $ 44 �- Estimated Total cost of improvements Zone cubage required -- =/ Distance to next nearest building Maximum live load to be borne by each floor be sent to I hereby submit all the plans and ,specifications for said building. All notices with reference to the building and its c nstructio may The un ;signed 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 complied 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 Act. The undersigned agrees to employ only such sbcontractors, on work to be pe ormed under this permit, as are licensed by Miami Shores Village. y Remarks (Signed) 7/ r _4. -.#- ' STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized appeared 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. � Date/ Permit No Disapproved ________________ Date (Signed) ______— Chairman Member Men er- Council Approved______ APPLICATION FOR BUILDING PERMIT MIAMI SHORES Building Inspector BUILDING INSPECTION DEPARTMENT —Plan Cubage /2/ • ( PLANNING BOAR,D___ __Date » 7 - VILLAGE A Size of Building Lot ___� '� ' ____ — Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires DATE Member Member Member Disapproved 19 L =- Street__'i % r y,> ( to administer oaths and take acknowledgments, personally to me well known, _______Date NOTE: A charge of $1.00 will be made for making 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 when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 1; General- :Building Contractor. • 2. ' Pluinliing, Heating; Ventilating, Air Conditioning and'Gas `Fitting. 3. • Electrical. , . 4. Architects, Engineer, Surveyors, Landscape Architects and Interior Decorators. 5. Excavating, grading,.filling and Landscaping \\ 6. Moving or wrecking. LIST OF CONTRACTORS, SUB - CONTRACTORS, ETC. REQUIRING OCCUPATIONAL LICENSES MIAMI SHORES VILLAGE 7. Septic Tank and Drain Field. r 8 Brick, Stone, Tile, . Cement Block, Concrete and Gypsum. 9. Carpentry, Millwork, Awning and Shutters: • 10. Cem,eiit, •Lilne, Plastering, Stucco, Lathing and Cast Stone. • • 13. Ornamental Iron, Bronze and Steel, Steel Sash, Over -head Doors. 11; Decorating (interior and exterior) , Painting, Waterproofing, Damp- Proofing and Paper- hanging. • j 2. Flooring, sanding. or finishing vyooii,,, rubber,: composition; Anoleum and .other • flooring' otherwise specified. 14. Roofing, Sheetinetal and Skylights." 15. Solar Systems: ` 16. Well drillers. 17. Sprinkler Systems of all kinds, including those for Buildings`, Lawns, etc. 18. ,. Structural and Reinforcing Iron and Steel. 19. Tile, Terrazzo, Marble; Granite and Cut Stone. 20. Electric Fixtures. 21.. Illuminated Signs. • 4 22. Bridge, Bulk - heading, Drainage Sewer, Water and Gas excavation and Construction, Dredging, Irriga- tion System, Pile Driving, Sea Wall, Paving, Sidewalks, Curb and Gutter or similar work. 23`•, Every person, firm, co- partnership, Corporation, .Association or other organization engaged in the bus- iness of supplying, furnishing or delivering:building materials for any construction project within the Village Limits and not having a regularly established and licensed place of business in the Village. JOB: PLUMBING • • BUILDING • • • • WORK • DONE BY • ELECTRICAL • The following is ready for Inspection: Inspector's Report: - REQ,UESTED AD: ♦ • • • • • . WILL BE READY • JOB. AD: BUILDING ELECTRICAL PLUMBING inspector's Report: - MIL • WORK • • DONE BY • • REQUESTED • • The following is ready for WILL BE READY lv BUILDING ELECTRICAL PLUMBING • • • • Inspector's Report: - JOB: AD: • • WORK DONE BY The following is ready for Inspccti on: REQUESTED • • • • WILL BE READY JOB: Al): BUILDING • • • WORK • DONE BY ELECTRICAL : - L.-_ PLUMBING • • • The following is ready for Inspection: Inspector's Report: - • • REQUESTED • REVUES ED • • WILL BE READY J 4 BUILDING ELECTRICAL PLUEBING • • • • Inspector's Report: JOB: AD: WORK DONE BY REQUES ?ED The following is ready for Inspection • • • • WILL BE READY JOB: AD: BUILDING ELECTRICAL PLUMBING Inspector's Report: - • WORK • DONE BY • The following is ready for Inspection: • • REQUESTED • • WILL BE READY • • PAID BY YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT NUMBER 1940 7/.."' o ) 1941 ~O /D © A - 0 , -/3 "�/ J' r/ /-e2. 4 - ld gL 3 .0 � A' ,/ / %,7.A, �' / 3. 2/ 1 i 4 /jyy ///o5/ / /G 1 1 O ', l /36 1 /S" / 4 o - ��" .e.- ,(sf_10 1942 .-. . .4 . . .r. • L � •- (x) iyjJ 1943 1944 L O . Q U //% • i i A.: / c. 0L) aG - //i7 / 1- . //._ e-- 3 /i - Se 6 / -Y -t- . i - '4' 6 /3o /44E( / - '�' --k� f / -y '-v y 'S/- - 0 is / f,�. . , os,,.„s 1945 1946 1947 • / % W . .vti a,s I t i (1 11 1948 / �• 0l) /, ' y/ / /.2 - .,;/ /0 ' 5 1 / 3. o.- / ; ; - ; t ' ) ,3. b0 .3. 0 0 ' i, 1949 3. �-0 i,r, 4-I, (/' ,, 1950 i3- 0 0 LOCATION 133 N. E. 9lst. Street GARBAGE TAX CORD •3. o - o •9 D a'L A 7'7 ,.V C44 9T SE .eY�CE or $. E. 91st St. By 1 Year Annual Tax Period Used Amount Pd. Date Pd Receipt # 04 - I. M. Weinstein - rsy_i15 _ tiL2k.i51 stlf -S1 SCV -"- D70/I BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description Lot X PERMIT N° 1452 Work to be performed under this Permit BUILDER MIAMI SHORES VILLAGE, FLORIDA f DATE '/ - / 194,a. Contractor's License No. B1.V d• �., - �. t,. r" Subdi- vision Address of a ) i. * ,,, Value of �y J Building ) t.. o - ` Project i _ .. i 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 ott the plans or lraa vines of in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. ; --j if Signed �� , 1 f 'INSPECTOR Amt. of > Permit E / In consideration of the issuance to me of this permit I agree to perform the Fork covered hereunder in compliance with all ordinances and regula- ti• s . rtaining thereto and i trict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores V la . Ina scepti his • . it I assume responsibility for all work done by either myself, my agent, servant or employee. BY AUTHORITY CONTRACTOR Ectig Pools, Inc. Name 1800 NE 151st Street License No. �� O •1 (• tt. 21 J-01 North Miami, Fl 33162 Address 30 949 -0000 ' 954-438-6251 Fax: 305-949-9171 Telephone Fax Qualifier Name \ fl w' o A c r`/ PROPERTY OWNER Name 0 Name zi Nix) 0 / 'L- Address s /3 Nt 9 5i " Home Telephone ,30 r� q —4 - cPY6 0 Business Telephone 3 o -' 9 p,2 -- / 3 f / 7 6 to Fax Demolish ENGINEER Ityvt4 C I Name 0 License No. Address 5 . ---- ,S / 1L Telephone ?O i 'v. y V 9 — 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'l Detachment Other N Step 1. Jab 'TEB �N b ORl 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 propert y owner and qualifier Both signatures must be notarized Please print or type to allow for a more accurate processing of your application. If rooting 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 Job Address: / 33 / ✓g 9/ s 4 Address Apt. Master Permit No. Subsidiary Permit No. __ F T City State PERMIT APPLICATION Folio&.Number Description of Work Boo/— 1 u L� L y4i 0 ,cor)r Block / / q -4 44 or SOT /9 Subdivision PB / t9 PG '26 Zoning Linear Feet Current Use of Property ' Square Feet Units Floors Proposed Use of Property Value of Work / �V / i d 0 0 Bldg Value Tenant Information Building Electrical Mechanical Plumbing LPGX Roofing Fence Other TYPE ( ✓) ' ERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT License No. Name Address Telephone Fax 3 241, Zip Tax Assessed/Appraised Value Flood Zone Base Floor Elev. Page 2 IMPORTANT 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-Dad 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 permiits 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 Comm ... - - t must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the broch �� j flag Hall . on Construction Lien Law and Choosing a Contractor. " — IDA, COUNTY OF STATE OF FL Signature o : •• or g2) /0 N Print Name Sworn to and subscribed b fore me this l I day of i • D igna � f ' ,ir. :ir - $4 -..... , i d i No ary Public, State of Florida My coms$oitoy4, 2003 CI TM IG 1 1 I , t; SEAL' satcsp Personallr.k ownn ' ; Type of Identilication;Prodt ed:. AMI -DADS OR, Produced. Identification ame m to and subscribed before me this / 7 da Iblic-4i.toofl' , RRES y CA 1 * COMMISSION NUMBER •' 0840452 6',.., 9�R O MY COMMISSION EXPIRES F ft.� c MAY 26 2003 Prin Sw Signature of Not SEAL: PERMIT APPLICATION , COUNTY OF MIAMI -DADE Ae-)/6e_ E.S'S l 6- Personally known /e OR, Produced Identification Type of Identification Produced: PAY TO THE ORDER OF ESSIG POOLS, INC. 1800 NE 151ST STREET NORTH MIAMI, FL 33162 0 5-7852 : 7.7=Magot.-- ,, .) _51102z/ c‘vr ® Mellon United National Bank Miami, Florida FOFf Ce „gt, a4,4 . _et cuip_ 00E167E1611' 1:0670096461: 002i L330200 DATE 62— 6 ) . • ,Nr...p 86786 63-9642 670 $ 57s7, ey DOLLARS NP Miami Shores Village 10050 NE 2nd Avenue Building Permit Phone: 305 - 795 -2204 Permit Number: BP2002 -1090 Printed:6 /13/2002 • Applicant: CHARLES MORGANSTERN Owner: MORGANSTERN CHARLES JOB ADDRESS: 133 NE 91 ST Contractor ESSIG POOLS Contractor's Address: Local Phone: Parcel # 1132060133320 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 E1/2 OF LOT 18 & LOT 19 BLK 24 LOT SIZE Fees: Description Amount FEE2002 -3359 Budding Fee $240.00 FEE2002 -3360 Buildier's Bond $300.00 FEE2002 -3361 CCF $9.60 FEE2002 -3362 CCF $9.24 Total Fees: $558.84 Permit Status: Approved Permit Expiration: 12/10/2002 Construction Value: $16,000.00 Work: POOL & DECK 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 regulati.ns . ertaining 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, servan . a r p loye= Signed: — (INSPECTOR) BY: � � Page 1 of 1 Total Fees: $558.84 Total Receipts: $0.00 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 pr 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, se nth or empl 1 (Contractor or Builder) BY: Signed: TO 33 REQUISITION BY f 1/ i >. . QTY ORDERED ESSIG POOLS INC. 1800 N.E. 151 Street NORTH MIAMI, FLORIDA 33162 (305) 949 -0000 '- f n WHEN SHIP QTY. RECEIVED STOCK NC) / QESc 1. Please send copies of your invoice. 2. Order is to be entered in accordance with prices, delivery and specifications shown above. 3. Notify us immediately if you are unable to ship as specified. F.O.B. POINT Show this Purchase Order Number on all correspondence, invoices, shipping papers and packages. DATE 1/) •) j REQUISITION NO. SHIP TO I TERMS UNIT PRIC AUTHORIZED BY TOTAL TO REQMISITIONED BY QTY ORDERED ESSIG POOLS INC. 1800 N.E. 151 Street NORTH MIAMI, FLORIDA 33162 (305) 949 -0000 WHEN SHIP QTY. RECEIVED SHIP VIA 1. Please send copies of your invoice. 2. Order is to be entered in accordance with prices, delivery and specifications shown above. 3. Notify us immediately if you are unable to ship as specified. 1 F.O.B. POINT STOCK NO. / DESCRIPTION Show this Purchase Order Number on all correspondence, invoices, shipping papers and packages. f DATE REQUISITION NO. SHIP TO TERMS UNIT PRICE AUTHORIZED BY TOTAL PERMIT NO. ADDRESS: MIAMI SHORES VILLAGE BUILDING 1 ZONING DEPARTMENT • SECTION BY DATE ZONING' ELECTRICAL MECHANICAL PLUMBING FIRE PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL 1. Subject to compliance with eft Federal. State. Garay. Village rules end regulations. Waage ensues no responsibility for accuracy oflor results fro or m plant 2. This copy of plans mutt be available on lidding cite or no Inspection wtil be conducted. JOB ADDRESS /37 Ai 7( 5 rite r APPLICANT �� 14/I f/k3 LOP` �'� PHONE # POO APPUCA11ON SHEET OF • MISCELLANEOUS DATE ZONING • ( /s - 4 cd / / /iA ,ao /_ c 7w7 c4 7i4 ,v — ifriet6N117 Alz-Z7 D CRITIQUE SHEET COMMENTS INITIALS DATE: 6 TO: FROM MESSAGE: a 91114-0Si S(wicea, 'IiilCaye 10050 N.E. 2` Ave Mliarni Shores 33138-2382 305 -795 -2209 FAX TRANSMITTAL FAX (iac) Z J FAX: (305)756 -8972 Number of Pages Including Cover � - 1 33'x. C. 1 V s Villgefe (date of survey) AFFIDAVIT STATE OF FLORIDA) COUNTY OF DADE) The undersigned Affiant, , does hereby attest that the (property owner) attached survey, performed by (name of surveyor's company) performed on , is an accurate representation of the existing conditions and locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than six (6) months old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits.. Further, Affiant sayeth naught. Affiant/Property owner Witness(sign and print) Witness(sign and print) SWORN TO AND SUBSCRIBED before me this day of Affiant is personally known to me, produced as identification. Notary ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. 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 Cle•ir 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 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 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 1 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 r Page 3 h 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 DA Zonin: if ' -_ _•e, (,I 0�- Electrical �� � _ 3�� 2 Mechanical Plumbin: NAM MI' Fire ..r...., Public Works Structural / !o O Building Official IIMUYa MIdiPr02 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 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ REVIEWED AND PREPARED BY: ( sq.ft. = x/1000 x 0.60) (¢.005 / sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com . 4 DATE: 'CONDITION OF APPROVAL' PP,oAtn j SL of Revised July 2001 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date `,r �C 9 `e/ Job Address / 3 iv o 7/".> f Tax Folio , °t'— 0 —CZ - Le Description 12. hi / tt ) 9 &'JK z4 Historicall Desi Yes No if Owner/Lessee / Tenant C:✓ i-,4. krtfi Owners Address ■ Contracting Co. ,� ,�y �u � G�G%�z> �i e Address Qualifier State # Municipal # Competency # Address Address Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle on6 ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION , 12: .e740" Square Ft. APPROVED: 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 above, and on the attached addendum (if applicable). 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 information is accurate and that all work will be done in compliance with all applicable laws regulating construction aqd zoning. Furthermore, I authorize the above -named contractor to do the work stated. FEES: PERMIT r 1, Maria V. '3utcher OMM SSION; CC749756 EXPIRES September 12, 2C a2 ,,t Rw BONUE9 THRU TROY FAIN INS' TRANCE INC RADON nical Plumbing �iP/ kOtl ,tg 0,7 a " �' e: f ,�'�s�F tea Estimated Cost (value) 9?/: Zoning Building c�-- Master Permit # 1 7 1. 8 9 D SS# ; - - - 7; 7Ly n e (3t ) i73// Contract or Owner Vi/ 5 J % 9 « ���� Ins. Co. Maria V. 3utcher :A. MY COMMISSION # CC749756 EXPIRES September 12, 2002 ROND, 1 NMI Trny FAIN INCI IDAR''CF, IYC ( C.C.F. • ) 0 NOTARY BOND ,J TOTAL DUE 34102.-0 Electrical Structural Engineer PERMIT NO. . ADDRESS: . MIAMI SHORES VILLAGE BUILDING / ZONING DEPARTMENT' SECTION BY DATE ZONING ELECTRICAL MECHANICAL PLUMBING FIRE PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL I. Subf ect to =glance with ett Federal, State. Cocnty.Wage Miss Ind regc.4at:ons. Wtage essu no responsibility for acacrecy offor resits from ttiese plans. 2. This copy of plans must be imallabte cc bacling cite or no Inspection will be condoled. JOB ADDRESS J 3, /-R/ 11 n- APPLICANT PHONE It APPUCATION # SHEET OF MISCELLANEOUS J k :I/ I....[/% oit,eixS DATE COMMENTS .)/(405 CRITIQUE SHEET itoc c. 1,0a INITIALS I, (Cv E AA'or to re- occupy the single family residence known as : (address) , Miami Shores, Florida. Legal Description: APPLICATION FOR CERTIFICATE OF RE OCCUPANCY Lot: Block PB & PG: I hereby certify that I understand that the zoning of the property is for single - family residential use and that it is unlawful for more than one family to reside therein. I also understand that any Certificate of Re- Occupancy that may be issued by Miami Shores Village, certifies only that the referenced property is being used for single - family purposes and that such Certificate does not constitute any representation, warranty or certification as to the condition of the dwelling or other structures on such property. Applicant izj 7 Date O 3// 3 /6 Print Name /1 C& v'_Q 012 0` 64fr"' t 2k For purposes of conducting the inspection required by Section 902 of the Miami Shores Land Development and Zoning Code, please contact: Contact Name: (,k r A 2 r pie r n f��lephone: 365 56 o� 3 I� v Buyer filler Realtor I/ Company Name Fi/t_.>�� Application Fee ($50) paid: Cash Check No. Inspected by: Comments: Approved v PAGE 1 OF 2 , hereby apply for a certificate Denied Dated - 2-3- 0 ) CERTIFICATE OF RE- OCCUPANCY On behalf of Miami Shores Village, Florida, the undersigned certifies that the property described in the above application has been inspected for purposes of re- occupancy pursuant to Sections 901 and 902 of the Miami Shores Land Development and Zoning Code and that; such property may be re- occupied by the above applicant for single - family residential purposes. THIS CERTIFICATE VERIFIES THAT THE REFERENCED PROPERTY HAS BEEN INSPECTED BY MIAMI SHORES VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE MIAMI SHORES LAND AND DEVELOPMENT CODE PERTAINING SOLELY TO THE REQUIREMENT THAT EACH ONE - FAMILY DWELLING IS USED AND INTENDED TO BE USED FOR A ONE - FAMILY DWELLING PURPOSE ONLY HOWEVER, THIS CERTIFICATE DOES NOT CONSTITUTE ANY REPRESENTATION OR WARRANTY AS TO THE CONDITION OF THE DWELLING OR OTHER STRUCTURES ON THE PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH CONDITION, AND INTERESTED PERSONS ARE ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE PREMISES IN ORDER TO DETERMINE THE CONDITION, THEREOF. PAGE 2 OF 2 MIAMI SHORES ijr, , FLORIDA By: •� i Date of Certification: Fez) Date .4- Legal Description 6 ) if /5 / thk. 2/ Lessee / Tenant HC PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Owner's Address Q Contracting Co. a��v Square Ft. �� Job Address 133 �►. DCLA 1\I OX Master Permit # Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: Mechanical Address Qualifier SS# - - State # Municipal # Competency # ** * * * * * * * * * * * FEES: PERMIT 97/5 °//5 a RADON C .0 . F. ', (-0 NOTARY APPROVED: Fire Tax Folio // 3 'en' /3 33 '®c7 Da te: Vl 4'tary s to C y Commission 4, S'. �� / .�md ,6 /9 Ins.Co. /-- Phone 2 - Phone Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING AVIN FENCE SIGN WORK DESCRIPTION / Y /Fig 69 -7 �%z/� A A9 5 �i G�f/t� /y %7 C / JAS e CO Estimated Cost(value) C� �� 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 above, and on the attached addendum (if applicable). 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 information is 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. 4 gnature o / - er- Build fv �.'il'Ir ..�� . xp .• NaCC197545 ** L/ - DO TOTAL DUE Ai 3 -% Other Electrical Plumbing Engineering • . Owner's Name and Address Registered Architect and /or Engineer Zone cubage required MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby rnnde for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 the work. Date..._..._ . �.fL �r ..0 1 . _._ ,19 :e Name and address of licensed contractor 1f . . Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done ,t .L q1, State work to be done and purpose of buildin (by floors) '......e 1 Clf fltIff f .ffITIITT.frflf. VftrittleffIfi.. and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation - Roof Covering Estimated Total cost of improvements $ S. '--" Amount of Permit $. plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the pfn s and spec' 'cations f said uilding. All notices with reference the building a ,it may be sent to .- ........f - ?- t-- �.•(l' ,.t- The undersigned applicant of r 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 5066, Compiled General Laws of Florida, Pennxnent Supplement, and has complied 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 Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks..._ (Signed) STATE OF FLORIDA, 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, 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 Permit No._ _I' L � / /3 Date Disapproved (Signed)� : sass - .,sass.. Building ector // ` Commission Expires Read, Sworn to and Subscribed before me. Notary Public, State of Florida PLANNING BOARD _.._ DATE Chairman Member Member Member Member sass.. __.____.__._..._ _._.__._.._ Member .-- -_ Council Approved _.. Date Disapproved Date NOTE: A charge of $1.00 will be made for making 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 when such re- inspection is made necessary by improper notice for inspection at faulty materials anti /or workmanship. ./ APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building rdinance 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 Mans and specifications must be kept at building during progress of the work. Owner's Name and Address.... 0I/4/ -5 2 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Date ..._.id ° 1 ` ,19e (� No Street Registered Architect and /or Engineer Name and address of licensed contractor .. /ore .2Q. Location and le a desc of lot to be built on: Lot! ..1 s / Block ._ 2 4 Subdivision .. l'et T. _ S b � sS ' Street and Number where work is to be done JJ /_.1� 2../ - Jr, p ding (by floors )..._ ....... � ��`l / . e d' State work to be done and urpose,of bui! Remodeling Additio Kind of foundation Estimated Total cost of improvements $ Zone cubage required Distance to neat nearest building New Building To be constructed of Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to 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 complied 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 h the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by by Shores Village. Remarks (Signed). STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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 Date....l.l.. 7- d Permit No Disapproved • �_.. ys ,. Date (Signed) ... _ ng Inspector and for no other purpose. n Repairs de----- No. of Stories _ Rif Coring e12-r3 —°' Amount of Permit $ t _Plan Cubage Size of Building Lot to me well known, Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of 81.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. PLUMBING .•••••••••• JOB: :WORK : DONE BY: BUILDING : ELECTRICAL : ' REQUEST FOR • INSPECTION • Inspector's Report: - ' WAS MADE The following is ready for Inspection: - • ADD: ( ' • • • • • •• • • : WILL BE READY NOTE: REQUESTS FOR INSPECTIONS MUST BE MADE BY THE CONTRACTOR PERFORMING THE WORK. • • • ) 1 - e • G 0 JOB: BUILDING ELECTRICAL PLUMBING Inspector's Report: - The following is ready for Inspection: • WORK AD: • DONE BY • REQUESTED • WILL BE READY n I