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KITCHEN REMODELDate • 4 9 8(° P ' Job Address ` 1 ( Er Legal Description Owner /Lessee/Tenet Owner's Address Contracting Co. WORK DESCRIPTION: Cvl° rJ urZ 15( ME qi Q ualifier 'JLi n . OC1sai rd o � State # CP5-3516 Municipal # Competency # IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING ELECTRICAL 6 Square Ft. Estimated Cost value G I q ( ) 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 ANY 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 all disciplines. OWNERS AFFIDAVIT: 1 certify that all the foregoing information is accurate and t all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above named contra • . to .. the work stated. S i ature of o ner and/or Condo President Date - 2r - , ` � � - -� .?P /092 Notary as to Owner afi i/or Condo l rreside t. at� My Commission Expires +jog a. Mara T. Garcia -Finale . •�, Commission k DD 021530 _ r .•� ui i <e Expires June 10, 2005 �'• \`•ri0 Thru %9j •..,,,,,.• Q.; Bonded �' %iiivO�� Atlantic Bonding Go., Inc, FEES: PERMIT ' /(/_/ RADON C.C. APPROVED: Zoning Building Mechanical Plumbing PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138.305- 795 -2204 SS# My Commission Expires Historically Designated: Yes / ' '4 : 9 000 1 6 l / No / f Master Permit # // NOTARY Tax Folio Phone C-- - Address Contractor or Owner Builder / Notary as to Contractor 6 Owner Builder Phone (50 .-7 7 Ins. Co. 1 b + (yd Insure:ir MECHANICAL ROOFING �, 30A Date 011V?,;, :i is i . Garc Fi 2a�. ,p '�n %Conalll.0 ult 1):)02153 -..�: Expires June 10, 2005 l P thkC Bonding Go., ND ate TOTAL DUE Electrical Structural Engineer +ED , THE OS+ti-R' S NOTARIZED SIGNATURE NEED NOT • 'LU MOTORS OVER 10- 25 FP MOTORS OVER 25-100 FP 40TCRS OVER 1C0 FP AIR CaDITI0lERS STRIP NEATER GENRERATORS TRAtSFCRWERS GENERATORS TRA?SFCASERS GENERATORS IRA :FORMERS SPECIAL FLP. E is • CUTLETS CCERCIAL SIGN MBES SIGN TRAXSFCi.4ERS SIGN TI1rE CLCCX FIX LRES AXTEh2A TELEVISION CURETS MIME r INII1111111: 101111111 111111111 VIOLATION VIOLATION RE INSPECTION IO RE INSPECT ION ELEVATCRS/ESCALATCRS FIRE SrRINKLER SYSTEMS.. 1_ 11111111 sla 1•111 111110 a SLFPLY T0: UNIT 1E SPRINXLER ITY -SEKM IVY -WATER I C TANG( 31 BASIN INLET AR WATER HEATER RaHGE WELL Ih'ST 4' TILE/RES. (GAS) A/c WI?iOW FR 3 FOUNTAIN RAIN TAP ?TOR tY t TRAY 3 WASHER POT /3 COMP. RESIOENCE SLC;P LtRY WATER CLOSET ECT WASTES ;TER -NEW ;TER - REPLACE .i1 S(RINXLER -4iElL !WING PC%L TER SERVICE C0.'+2ICT IONS ti 1E10. ' & ASANCON SEPTIC TAXA CALE PIT CU. FT. ARGE WELL ESTIC A IRA(N E STANDPIPE :L PIPIM 4 SPRINKLER SYSTEM 'ER SET 3 PIPING ELECTRICAL UNIT FEE ITEM S"A I TC`l CUTLETS 1 LIGHT CUTLETS 1 RECEPTACLES . SERVICE TBRRARY SERVICE SIZE IN ASPS SERVICE REPAMRMTE Cu»r£ ( APPLIANCE OUTLETS I RNA TCP OVEN WATER HEATER MOTORS 0- 1 FP MOTORS OVER 1- 3 FP MOrCPS OVER 3- .5 FP MOTORS OVER 5- 8 FP MOTORS OVER 8- 10 FP BE P2. Ski ON SUBSEQUINi UNIT FEE ITN . SPACE HEATEPS '. CENTRAL FEATIAG MECHANICAL A/C (WttO) A/C (CENTRAL) GMT T+CRX REFRIGERATION PROCESS A N 3 PRESS P I P I F O UhtERGROUN3 TAMS ABOVE Man TAMS U.F. FRESSLRE VESSELS STEM BAILERS HOT WATER BOILERS MECHANICAL VENTILATION TR,+„CRTING ASS&.ELIES UNIT FEE I • PAY TO THE ORDER OF P-L-U-M-B-E-R Inc. Phone (305) 758-6237 7579 West 31st Avenue Hialeah, 5L 33018 MAW( k-1-4-‘6 First Union National Bank Hialeah, Florida R/T 047006432 FOR ne 00 2 7lis 1:0 6 700 4 3 21: 20 900 1 2!.O 2 '. 2" DATE 4 DOLLARS 63-643/670 BRANCH 00531 Sncunty features incioand Dela liS on bad., Miami Shores Village 10050 NE 2nd Avenue Plumbing Permit Phone: 305- 795 -2204 Permit Number: PL2002 -108 Printed: 4/29/2002 Applicant: CARLOS Owner: NUNEZ JOB ADDRESS: 156 NE 91 Contractor CASCARDO JUAN H Local Phone: 305 - 758 -6237 Parcel # 1131010190060 Work: REMODEL KITCHEN NUNEZ CARLOS ST Contractor's Address: 7892 NW 170 TERR Legal Description: EL PORTAL SEC 2 PB 9 -115 LOT 7 & W1/2 OF 8.. BLK 7 LOT SIZE 75.000 X PeA p_Q 9 0 .aa Total Fees: $0.00 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 10/26/2002 Construction Value: $500.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. his 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 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 ther sh on the plans or drawings or In the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. i Sig -. �. /it `. s/ INSPECTOR) BY: FirF 6111#' In considgr +T° o e -uance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and reputations pertaining thereto and in strict conformity with the plans, dra gs, 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 Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 4/29/2002 Applicant: CARLOS Owner: NUNEZ JOB ADDRESS: 156 NE 91 Contractor CASCARDO JUAN H Local Phone: 305 -758 -6237 Parcel # 1131010190060 Permit Status: Approved Permit Expiration: Work: REMODEL KITCHEN This Permit is granted to the contractor or builder pertaining thereto and with the understanding that tl proper municipal authorfties. his Permit may be re which this permit is granted the understanding tt} covered hereby wh - ther sh • on the plans or dray Sig li ft' In consid :'' O e - ance to me of this pep plans, dra gs, statements or specifications subrr servants or employes. Signed: Plumbing Permit Permit Number: PL2002 -108 NUNEZ CARLOS ST Contractor's Address: 7892 NW 170 TERR Legal Description: EL PORTAL SEC 2 PB 9 -115 LOT 7 & W1/2 OF 8.. BLK 7 LOT SIZE 75.000 X Total Fees: $0.00 Total Receipts: $0.00 10/26/2002 Construction Value: $500.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in PAY 3 TO THE ORDER OF Alt P- L- Z1- 5I/f -13-E -fi Inc. Phone (305) 758 -6237 7579 West 31st Avenue Hialeah, TL 33018 , First Union National Bank Hialeah, Florida R/T 0470 06 43 2 :067006 21: 20900 ■ L 2 :0 24 2n• Page 1 of 1 PATE 2167 63- 643/670 g70 BRANCH 00531 DOLLARS Secure,' lectures Demur ar back. NP i4i Permit No. 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 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. i Owner's Name and Address Q /�� f "� g No ` Street h- ell • Registered Architect and /or Engirt eer__ Employing Plumber's Name ( � I ° %i'' ! Location and Legal ,Description Lot 7 7 R Street and Number where work is to be performed —No STATE OF FLORIDA, 1 COUNTY OF DADE. Amount of Permit $ ss. MIAMI SHORES VILLAGE - PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT N 3 �- 5 Block (Signe (Signed) 7_ Street • Date Street Subdivision e 1 G� State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories 0 Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Nature of Water Supp Dist. Feet of Tank or Drain Field from Well ell Size of Soakage Pit 6 -10 0 Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that 119u : erstands and accepts his obligate' as an employer of labor under the Florida' Workmen's,Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent upplement, 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 the 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. 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 Master Plumber. 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 URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS ` / �A ,14), n C' " TOTAL FIXTURES CONTR. LIST I A / / / A A / / CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER • DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST • CHECK Permit No. 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 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. i Owner's Name and Address Q /�� f "� g No ` Street h- ell • Registered Architect and /or Engirt eer__ Employing Plumber's Name ( � I ° %i'' ! Location and Legal ,Description Lot 7 7 R Street and Number where work is to be performed —No STATE OF FLORIDA, 1 COUNTY OF DADE. Amount of Permit $ ss. MIAMI SHORES VILLAGE - PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT N 3 �- 5 Block (Signe (Signed) 7_ Street • Date Street Subdivision e 1 G� State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories 0 Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Nature of Water Supp Dist. Feet of Tank or Drain Field from Well ell Size of Soakage Pit 6 -10 0 Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that 119u : erstands and accepts his obligate' as an employer of labor under the Florida' Workmen's,Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent upplement, 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 the 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. 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 Master Plumber. 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. • Location and Legal Description Lot ! Y. 21} Nature of Water Supply: City —Well STATE OF FLORIDA, 1 COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No / 2' 0 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 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. �j Owner's Name and Address l� !liZ�____V y ?4 e / # t • No. r AA. _ __ �___________, Street Registered Architect and /or Engine / Employing Plumber's Name l li/ e_ s2_�._t� �l _ _� '� 6 No._ �G__! _ 1 1 __ Street Subdivision_ - - _p, Street and Number where work is to be performed —No AC .4 9 / • Street State work to be performed and purpose of building (By Floors 0 _ _ ___�_ New Building 'Remodeling * Addition Repairs No. of Stories 1 Size Septic Tank 3 X___h Type of Tank 4'2 Feet of Drain Tile 7Lf Dist. Feet of Tank or Drain Field from Well Block 7 0 Amount of Permit $ ( Signed ) k 6 c Date___ ' 11 ° ' 7 Capacity Gals 0 Size of Soa e Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he u ders ands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General aws of Florida Permanent Supplement, and has corn- plied with the provisions thereof, and will require similar compliance from all contra4r3 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 ite of the work such public notice or notices as are required by the 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. ( Signed) L%T 42 i% 2 e ' _--_! 0-�a Master Plumber. 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 URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK • Location and Legal Description Lot ! Y. 21} Nature of Water Supply: City —Well STATE OF FLORIDA, 1 COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No / 2' 0 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 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. �j Owner's Name and Address l� !liZ�____V y ?4 e / # t • No. r AA. _ __ �___________, Street Registered Architect and /or Engine / Employing Plumber's Name l li/ e_ s2_�._t� �l _ _� '� 6 No._ �G__! _ 1 1 __ Street Subdivision_ - - _p, Street and Number where work is to be performed —No AC .4 9 / • Street State work to be performed and purpose of building (By Floors 0 _ _ ___�_ New Building 'Remodeling * Addition Repairs No. of Stories 1 Size Septic Tank 3 X___h Type of Tank 4'2 Feet of Drain Tile 7Lf Dist. Feet of Tank or Drain Field from Well Block 7 0 Amount of Permit $ ( Signed ) k 6 c Date___ ' 11 ° ' 7 Capacity Gals 0 Size of Soa e Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he u ders ands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General aws of Florida Permanent Supplement, and has corn- plied with the provisions thereof, and will require similar compliance from all contra4r3 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 ite of the work such public notice or notices as are required by the 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. ( Signed) L%T 42 i% 2 e ' _--_! 0-�a Master Plumber. 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. 7/, a-ec 7 t-- I AA . T e „,a4 Ji 4. 3 if -r. 4 OWNER ADDRESS WORK ORDER MECHANIC DATE JOB COMPLETED JOB SLIP DATE MATERIAL TIME DATE BUILDING ELECTRICAL PLUMBING Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 10152 Work to be performed under this Permit Owner of Building Bl. Subdi- vision Value of Project $ DATE 195 Contractor's License No. Amt. of .» Permit $ J This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. d` Signed • BY INSPECTOR 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 responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY BUILDING ELECTRICAL PLUMBING Architect Contractor or Builder Legal Description. Address of Building Lot CONTRACTdR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 10220 Work to be performed under this Permit Owner of Building Bl. Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed • BY INSPECTOR 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 responsibility for all work done by either, myself, my agent, servant or employee. + e J c*,.. � . s BY AUTHORITY i A tr (r r r 4 - -s - 77 Cf' rr 0 - • r ■ • , • ' •• •t� •••• •• •, - .• - • • • •• • 4r / 1I f '`= • • • • � • • s • • • • • •• i• ii - • •• •• • • • • •••• • - •• • • •• • • • • • _ _ -- • - - .. ••/•• 1 • •s••• o l• • . •I.•• • • •• • • •• • •• • • • -•- - __V • • • • • • • • • 3 e ______ • • •• •v• • •• -1 • • • •.• • • • •: - 144 • • • • _ • •• • •1•••• S ._ -,,,_44-.41- _ --- • • •• • •• • • • • -- -- M4- •.•J_- _-__W _ • • • -'_` _ ••• • 3y 1&4 ' /'c T -- ; - - -_ 7 -T- 1" I - ,A 0 PROPERTY OWNER 1 Name fea. kP t 4(2.103 IJV nll— Address 156 13 t 91 ' ,IPY11Ad, Shona, FL 3313s Enclosure Home Telephone 305- '161 -1 612— Alteration Exterior Business Telephone 305. 666 - �q 3i 0,7r ist20 Fax Alteration Interior 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 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 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 Folio Number PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Lot Block Subdivision PB Current Use of Property Proposed Use of Property Tenant Information PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax escription of Work Square Feet PERMIT APPLICATION Master Permit No. Subsidiary Permit No. P ' c-oo a • ye::.2 Y (A e . li-4-c n r Ine,('s PG Zoning Linear Feet Units Floors 1K Value of Work 1 400.0D Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name 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 -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 S1'I'E in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. e of Owner -e Print Name Sworn to and subscribed before me this ; I •7 . c S gnatur f Notary ST SEAL: > : O ORIDA, COUN • • AMI -DADE Personally known OR, Produced Identification Type of Identification Produced: F 'A rvoi ' -, r � T. A• cow, A BECG'ER ° " '4' H NUMBEa P OF f l -�Yg VISS'S , �? cS CC78 6697 day of PERMIT APPLICATION STATE OF FLORIDA, COUNTY OF MIAMI -DADE 1 K Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Personally known OR, Produced Identification Type of Identification Produced: 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) 1 $ 3 - O v (sq.ft. = x/1000 x ¢.60) $ (¢.005 /sq.ft.) $ (¢.0I /sq.ft.) 5. Oo REVIEWED AND PREPARED BY: SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ e 0 0 aw- 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 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 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 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 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: