BP03-268Date 0 i
Type Insp' n t9_ , - 0 ti d
Permit No. LV # •
N • e eL;. J
Addres�,C n 1_,ft
Company Z nACl•4
Phone # 3 VD C " 31
For Inspector: 1 G J /3 Name & Date
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
B ildin_ Inspection Req
PROPERTY OWNER
New Construction
pp9
I�'�ea/�tt ?j,/,c
cJ�
� 430
Home Telephone .....,73
1-7/
Business Telephone 3f3 a
/ `
Fax 36.c-3%2-- 6 / O /
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
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
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:
Complete the attached permit applicatioq diIlicQ nlist,t1b.sigtEcjbltht p&dikrty owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurategjoc3 !AtgbfyoOr. /pppeation• Lf roofing work will be done, a roofing application must be submit-
ted along with this permit application. • • • • • • • • • • • • •
•• • ••• ••
Address
Folio Number
Lot Block
Subdivision PB
Current Use of Property
Proposed Use of Property
Tenant Information
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
• • • • • • •Stitb'sidiary Permit No.
• • • • • • • • •
• • • • • • •
••• •••
S�
S-1-red am, S J) e 33/3
Apt.
A scription of Work
PG Zoning Linear Feet
Square Feet Units Floors
Value of Work It 7ST0 , 00 Bldg Value
ax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT APPLICATION
Masta,Permit No. / '5 ' K
City
State Zip ' '
� uT Poof /4ur ��(
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
Q
License No.
Address
Telephone
Fax
Qualifier Name
Page 2
IMPORTANT NOTICES
DO NOT BEGIN ANY WORK WITHOUT HAVING RECEITE9 nxtR VAC1E TED PERMItAND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION%re linsted to: Monds}*t rougW rtday 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 KEPI' FRET' rKQUDIer.4 ' D 6EfIk1S.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED$N EQtarv T bR;VI ICLe, 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.
1.
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.
F FLOR ! OUNT OF 1
,e,,
d 7 illem,Wd
tur 0
I -DADE
Print Name Print Name
S • to d subscribed before me this day of � � A•
.., 4......, ture of Nu.,ry Ptbhc .tare o orida
, „ �^ ngela Becker
My Commission D0150048
1 1 , 01 Expires November 15, 2006
SEAL:
• ...•.. • .•.
• • • • • • • • • •
• • • ..• • • •
• • • • • • • •
... • • • • ..... •
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Contractor / Qualifier
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
SEAL:
PERMIT APPLICATION
Personally known OR, Produced Identification V Personally known OR, Produced Identification
Type of Identification Produced: of Identification Produced:
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPI?
Dryer • . . •
QTY.
.
TYPE
gutlet, Appliance
QTY.
"I'YPE
Service Repair
QI'N.
A/C Central 1 -3 Ton
Heating Strips, each
Fan •• • • •
• '
OAAet! Wall
Service, Temporary
Paint Booth
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
Piping, Flammable Liquid
Signs
A/C Central 8-15 Ton
Fixture - Fluorescent
Process/Pressure Piping
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Pressure Vessel
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
1 \1ECHANICAL
TYPE
Minimum Fee
QTY.
TYPE
Condensate Drain
QTV. TYPE
Generator
QTY. 'I'YPI?
Refrigeration, Tons
QTY.
A/C Central, Tons
QTY.
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Pump and Abandon
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Gas - Appliance
PLUIIBING
TYPE
A/C Condensate
QTV.
TYPE
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTY.
'HYPE':
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
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• • • ••• • • • • • • ••
• • • • •••
INSTRUCTIONS: Please indicate the type of workbeiagrerf&rmed'and quantity(ies) in the space provided below.
••• ••• •
•
•
PERMIT APPLICATION
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
DA
c2lpS
Zoning
r-6"
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
_
Building Official
/���
_/
Page 4
OFFICE USE ONLY
❑ OWNER - BUILDER FORM
(Attach)
LI FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
State DCA (Radon)
Code Enforcement Fine
Zoning Review
Notary
$
6
b
.••
• • . •• • • • •• ••
• • • • • • • • • •
• • • •• • • • •
• • • . . . • • • •
•••• • .••••••• •
•
•
•
CHECKLIST
• • • • • • •
❑ PROOI' OF OWNE12SH1r
(Attach)
•• ••• • • • •
• • • • • • •
❑ HRS / DWM A;PRijV4L.
(Septic' /.Sevaj . . '.'
❑ IMPACT FEE
(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 $ (¢.005 /sq.ft.)
( x .60 1000
)
$ (¢.01 /sq.ft.)
$
.
PERMIT APPLICATION
•
"' ❑ CONDO ASSOCIATION APPROVAL
(Attach)
• U BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $ - 4
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: 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
MIAMI VILLAGE
Paint Coldr•kppfroiral•and Agreement
DATE:
• oN •,:. •: • • • • •: •
OWNER'S NAME: 1.� ' '! ..4.1.../. /> PHONE:3QS-'2�. V2'2 L&)4
ADDRESS: •
* * * * * * * * * * * * * * * * * * **t *V and*;*+ r *0 * * * * * * * * * * * * * * * * * * * * * * * * * * **
' 1 ,;
ADD RESS OF SITE: 3 dab : RI :II
CONTRACTOR & LICENSE if applicable)
(� PP ) I�l ��SI,R� I? avt
COMPANY NAME: SA- PHONE: — 9 --'3T 7
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the ) 7 to must be listed and indicate the color to be painted.
Walls.
Ifr
Fascia
Drip Cap/Drip Ed e
Soffit G ?.�
Roof
Flower Bins
Shutters
Awnings
Chimney
Doors and door jams
Garage Doors
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 work stated. Furthermore , the paint colors will be as per the attached
APPROVED:
wig Official
(WI OM
Signature ol%bwner Date Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
ate 4/23/01
OC)
J ivy IN OOJ
O C)
y ,
i„ i,a r■
li i10 �i /IL LO
01/00
/00
z,1,0A 3
ct-a 1 °L e
71)4Q)\6( AA4311/-
ao0 q S
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 2/19/2003
Applicant: RONA
Owner: cFREDERISK
JOB ADDRESS: 360 NE 91
Contractor
Local Phone:
Parcel # 1132060190210
This Permit is granted to the contractor or builder named
ordinances pertaining thereto and with the understanding thi
and approved by the proper municipal authorities. This Perr
authorization. A further condition upon which this permit is
ordinances and regul. '.ns pertaining ty,ri. &work covered h
by his agents, sery or employe
Signed*
In consideration of the issuance to me of this permit, I ac
with the plans, drawings, statements or specifications subr
myself, my agent, servants or employes.
PAY TO THE
ORDER OF
FOR
F
Building Permit
Permit Number: BP2003 -268
RICHARD J. MEINHOLD
Ph 305- 538 -6783
1775 Washington Ave, Apt 4g
Miami Beach, Fl 33139
FREDERICK
onninl n �'y/ „q
ST
Contractor's Address:
Legal Description: 6 53 42 EL PORTAL
Fees:
FEE2003 -1042
FEE2003 -1043
FEE2003 -1044
Description
Building Permit Application Fee
CCF
Notary Fee
Total Fees:
Amount
$60.00
$0.60
$5.00
$65.60
Total Fees: $65.60
Total Receipts: $0.00
! /Q_A-L/ .��_O�1Se
Ni o First Un/on National Bank
firstunion.com
Org. 003 R/T 067006432
$750.00
Permit Status: APPROVED Permit Expiration: 8/18/2003 Construction Value:
Work: EXTERIOR PAINTING AS PER AGREEMENT
If there is no permit package accessibln the job -site for inspectors to verify, there will be no inspections.
fee is $50.00, which must be paid in advance before calling for another inspection.
1:06 70064 3 21: Loc nn c o,
PB 9 -101 LOT 4 & E1/2 LOT 5 BLK 2 LOT SIZE 75.000
Page 1 of 1
Re- inspection
,frit4 compliance with all
bmitted to
iout
dge of the
or work done
1 254
2 '/ l 63- 643/670
DATE eA!i¢t,�.� 2 7 r)'O 03BRANCH 00901
$ 6 QA
RS f gig:..
Express Checking
i tee017/9
ict conformity
by either
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•
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PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Q ?
Date V,8 Job Address -j (U N • I g1- , Tax Folio
Legal Description 5) r-1 � 2 p , , u h � _ Historically Designated: Yes No
/ Tenant 1�LV N A 1_ Z CC Master Permit #
Owner's Address 3 69 G . c" Phone
Contracting Co. Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Address
Architect/Engineer
Bonding Company
Mortgagor Address
Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Cam `71 C t – t E- �Z x/1/1&, C4
I W 11 2- or /
Square Ft Estimated Cost (value)
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.
Signa an, l/or Condo President D ( ' Signature of Contractor or Owner- Builder Date
otary as to Oder fd/or Condo President Date Notary as to Contractor or Owner - Builder Date
My Commission Expires: My Commission Expires:
FEES: PERMIT L RADON C.C.F. r l 0 NOTARY 5 0 0 BOND
TOTAL DUE
APPROVED: f
Zoning Building I Z9 ' Electrical
Mechanical Plumbing Engineering