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PAINT PERMIT
Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/28/2003 Applicant: `CARD Owner: -M4NEZ - --.JOB ADDRESS: M Contractor Local Phone: Parcel # 1131010190060 156 NE 91 Fees: FEE2003 -1847 FEE2003 -1848 FEE2003 -1850 Description Amount Building Permit Application Fee $60.00 Building Fee $1.20 Notary Fee $5.00 $66.20 Total Fees: Total Fees: $66.20 Total Receipts: $0.00 Permit Status: Permit Expiration: 9/23/2003 Construction Value: $1,200.00 Work: EXTERIOR PAINTING ASPER AGREEMENT 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. n.G ;; _ v }3 ;amformity y, r t" 9 ® 'Wither Bank dvanta This Permit is granted to the contractor or builder named at ordinances pertaining thereto and with the understanding that and approved by the proper municipal authorities. This Permit authorization. A further condition upon which this permit is gra - ordinances and regulations pertaining to the work covered her by his agents, servants or em.loyees. Signed: In consideration of the issuance to me of this permit, I agree with the plans, drawings, statements or specifications submitte_ myself, my agent, servants or employes. Signed: ( l For Building Permit Permit Number: BP2003 -500 Contractor's Address: Legal Description: EL PORTAL SEC 2 NUNEZ - _ Q ' 1 emotes ST PB 9 -115 LOT 7 & W1/2 OF 8 BLK 7 LOT SIZE 75.000 X Page 1 of 1 MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: /c) OWNER'S NAME: ADDRESS: / cep /--)E **************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * ** CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ADDRESS OF SITE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 11 Elements on the site must be listed and indicate the color to be painted. Walls \v \.C-0 Fascia 4 Drip Cap/Drip Edge Soffit L , Roof Flower Bins Shutters Awnings Chimney Doors and door jams , Garage Doors i Railings Fences --� Decorative Metal All brick (simulated or regular) Stucco Banding Any other stucco features ---� Accessory'Buildings Other OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I authorize the above -named contractor, if applicable, to do the work stated. Furthermore , the paint colors will be as per the attached sample, APPROVED: � 3/d0 Building Offic Date Signature of Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION PHONE: - 9L cn 4/23/01 State •-----. The Sunsh•Wg ------ u ct OTEit arAD ,►a ass s+ o N0 Pt. 3g.� EN�RgE M 51W' T fi g(. ,tE sM A o_w.ntME a 00�'�� TM, ����'' g alai �O^'— � 03'0 ,4,4 ,.10 • tNm" -tr B y te¢ ��pR toen'� ,,,,,art d`�Y' caP' • a • • • • • •• ••• • • • • •• • • • ••• • • • • • • • • • • ••• • • • •. • • • • • ••• • • • • • • • ••• ••• • • • • ••• • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • •• •• • • • •• •• ••• • • • ••• • • PROPERT N ER / /� / Name t Ater ? / >i Address 11/1011111 SA/ 011115 S G/ SS /3 e Ti Home Telephone o .) i - - 3 Business Telephone. O ?S- — 11(-? - 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'I Detachment Other Step I. .. • o • • •.i • • • • • • • •• • • • •• ••• Master Perulit 4 11 9 . • • • • t •• • • • . • :1! _ l lsidi u Pesmit•No. •• • •s :•t • • ••• •••• • .t. • • INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: t Complete the attached permit application whrnOt lfe sgr:4d ¥ the�olgpe fp�'3 zty bdv$eraas qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate' /09104 liCati ni jrroaAng w8rjc will be done, a roofing application must be submit- ted along with this permit a lication.• • • • • • • •• S S. • • • g P PP .. . .So", . ... .. 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 2<j b Address: / S 9 5 //`' ✓vr S 'l l /aeS Address Apt. City _ State Zip Folio Number Description of Work Lot Block Subdivision PB PG Current Use of Property Square Feet �,, �Units Floors Proposed Use of Property Value of Work r t?'C7 - C� y Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax • .1. • i •! • • • • • • • •.• PERMIT APPLICATION Zoning Linear Feet ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Page 2 STATE & O'.IDA, COUNTY OF SEAL: • • • • • • .• • Notary Pub 'c tate of orida Angela M Becker My Commission 0D150048 Expires November 15, 2006 .•• • • • • • • • • • • •• • • • • • • • • • • • • • • • • : 1 _.. I • I ••• • • 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 IMPORTANT NOTIC 1. DO NOT BEGIN ANY WORK WITHOUT H41 G EIV 1S%' VALIIATEc RMItt1�ID PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION lint 8 to: Mdhday 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 I CLE NE4T AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES Sit A LL II KEPI F O A�ICCI BRIAS �V C 4. SWALES MUST BE PROTECTED FROM BEINGbAMX E5. ' �iQCII at V't}QCCE$ 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 hav; 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 -DAD:E cif e• Personally known OR, Produced Identification e tioon P Personally known OR, Produced Identification Type of Identification Produced: )) Identification Produced: ELECTRICAL 'I.YPE Minimum Fee QTY. TYI,I7 Dryer • • • • • Q *' • • TVI'): o cott J : %pine : ()Ty. TN I,I,, Service Repair QTY. A/C Central 1 -3 Ton Fan Ou et, 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 AJC Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps AJC 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 TY'I'E Minimum Fee QT1'. TYPE Condensate Drain QTY. 'I'1'1'E Generator QTY. '11 IT 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 Q TYPE Drains, Roof QTY. 'fl'I'I? Miscellaneous Fixture ()Ty. TYPE Soakage Pit ( T1'. 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 • • ••• • • • • • • • • • • • • • • • • •• • • .•• . •.t t• • • • • • • ••• PERMIT APPLICATION ••• • INSTRUCTIONS: Please indicate the typ .of wort bejn pei Aurnpt7(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: Page 4 OFFICE USE ONLY ... • :°t • ••; . °. :•• ❑ OWNER - BUILDER FORM • ❑ PROOI' OF bWNERgITIP ❑ CONDO ASSOCIATION APPROVAL (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 Notary • • • • • • • ••• • (Attach) (Attach) •• ••• •I° •••• 1,°••. ° • • •• �1 • • HRS I • s Q • P• • • • • ❑ IMPACT FEE (New Construction) ••• • • • • • • • • •• • • ❑ OTHER (Specify & Attach) 6 0 $ I , a 0 (sq.ft. = x/1000 x 0.60) $ (0.005 / sq.ft.) $ (0.01 /sq.ft.) s S,0 0 • • TOTAL $ 6‘ PERMIT APPLICATION • • • • •; CI BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES ISSUING OFFICIAL REVIEWED AND RZEPARED BY: DATE: SECTION Zoning Electrical BY Fire Mechanical Plumbing Public Works Structural Building Official DA , E � r 3 CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL o (305) 795 -2207 o FAX (305) 756 -8972 o http : / /www.miamishoresvillage.com PERMIT APPLIC ' )N FOR MIAMI SHORES VILLAGE Date 1 _ - N Job Address 156 V? < �� Srecc Tax Folio /) '3) - U1 006 o Legal Description -0- Roan L S GT Z C © 1 / Lessee / Tenant 7 /7Te tC c? 1 Pe c G L w 61c-- 8 Master Permit # 7/7eP" Owner's Address /56 N 6 / l 5r 5 r eCC T Phone Contracting Co. C w/V6' e / Qualifier SS# - _ State # Municipal # Competency 0 / / cv ` l c _ Architect /Engineer "' 3 /e� s3a 3/C ; 29� Bonding Company A_�____ -- Mortgagor Address Address yf 'C Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN :ORK DESCRIPTION Pei ) Ir r IN 6 EX ice) a i'z Square Pt. Estimated Cost(value) J C C d o 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 conduction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and /or Condo President Date: Date: J, - J 2 -c Signature of Contractor or Owner- Builder Notary as to Owner and /or Condo President Notary as to Contr ctf p ;'�*-' - .11.1%.... a e L SEAL My Commission Expires: My Commission Expi * -' t COMMISSION AN N N FUOAZZ • .01' a CC360191 � F " Q` BAY COMMISSION P ** * * * * * * * * * * * * d5 FCC * PA MAR. 29 19 FEES: PERMIT ��J/' RADON C.C.P. •r- NOTARY , %F;i 7 o TOTAL DUE APPROVED: Fire Zoning Buildi Electrical Mechanical Plumbing Engineering Other