PAINT PERMITDate
Type Insp'n
Permit No.
N
Phone #
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Buildi : Inspection Request
AddresO�
Company 5�(
C)s S P-3977
For Inspector: l l l "f / lame & Date
Date / / Time
Type Insp'n
Permit No.
Name
Address
Company
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Buildin: Inspection Request
Phone # 3o' • '7S 2. 3(-1
For Inspect?) )N' ) �j Name & Date
Approved
Correction
Re- Insp'n Fee
j . :: : : .1•1,1•■•••■■■
MIAMI SHORES VILL.
• 1 • ' Paint Color Approval and Agreen
DATE: 51110
Y
OWNER'S NAME: ii"r M. WOlSTQn hOI PHONE:_
ADDRESS: 3R0
********************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *:
ADDRESS OF SITE:
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:
All Elements on the site must be listed and indicate the color to be painted.
Walls 120 bv2.y Oa 9- -661/1 j C BQMs in w1— He -4 Z )
Fascia W 1-,
Drip Cap/Drip Edge lJ 1 )9,
Soffit X44,
Roof
Flower Bins
Shutters wl A
Awnings &
Chimney NA Ik
Doors and door jams v3 I -JXL
Garage Doors \ ,A A
Railings QI
Fences N) A
51/ /6 3
Building OfficYal Date
o�rwne�(,�IC -�4a n'1
iu
S ot iu
z
w
tzi
re Cvtili- ,
Decorative Metal N�
All brick (simulated or regular)
Stucco Banding A
Any other stucco features i\ A
Accessory Buildings 0\ a �aL ��?
Other D � J e Wei Cw ,c r ,� �/� -nt UAtk
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. Fu . ermore , the paint colors will be as per the attached
sampl -
5 1 0�
Si • ature of Owner Date Signature of Contractor Date
** ***************************************************************
APP OVED: WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01
HC -42
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2003 -723
Printed: 5/5/2003
C ` \ Applicant: BRIAN WOLSTENHOLME
Owner: WOLSTENHOLME BRIAN
t l 1 JOB ADDRESS: 380 NE 91 ST
_
Contractor
Local Phone:
Parcel # 1132060190200
Fees: Description Amount
FEE2003 -2698 Building Permit Application Fee $60.00
FEE2003 -2699 CCF $1.20
FEE2003 -2700 Notary Fee $5.00
Total Fees: $66.20
Total Fees: $66.20
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 11/1/2003 Construction Value:
Work: EXTERIOR PAINTING AS PER AGREEMENT
Signed:
Signed:
Legal Description: EL PORTAL PB 9 -101 LOT 3 & W1/2 LOT 2 BLK 2 LOT SIZE IRREGULAR
(INSPECTOR)
In consideration of the issuance to me of this permit, 1 agree to perform the work
conformity with the plans, drawings, statements or specifications submitted to the p;
done by either myself, my agent, servants or employes.
Building Permit
(Contractor o
Contractor's Address:
BRIAN D. WOLSTENHOLME x-04 s3 - 8z3in of
ANA MARIA WOLSTENHOLME
380 NE 91ST ST.
MIAMI SHORES, FL 33138•
Pay to the
Order of
PIS' . LAS COUNTY TEACHERS
. CREDIT UNION.
P.O. Ho, 2650 • Largo, Florida 35779.2650
24 ItomAcmo (22715 w
6Oglaw
Fors l i'r''I
Page 1 of 1
Date •
I: 26 18 23 L 21:00000 L4 506? 2910 L374
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
. 1 i003a N.E. 2nd Avenue • Miami Shores, Florida 33138 • Phone: 305- 795 -2204 • Fax: 305 756 - 8972
Date � I ` Job Ael'd - So ILA E "I ( 'S l ' 0 Tax Folio
Legal Description Historically Designated: Yes No
✓ Owner /Lessee/Tenet 1.1 t1 ' WO I5Tt ■ lilOL W4 • aster Permit # 1 690 . i
owner's Address 8c ti re, A 1 St' P e T e- 3 (r
ontracting Co. Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING
` )XWORK DESCRIPTION: PG1 1 N t '
500 ° gOeD
Squa-e Ft. Estirrd Cost (value)
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN
YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR ANY ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Appl cation is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that
all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required
for all disciplines.
OWNERS AFFIDAVIT: 1 certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Furthermore, I authorize the above named contractor to do the work stated.
Signature of owner and/or Condo Preside • Date Signature of Contractor or Owner Builder Date
No as to S er and/or on'o President
y Commission Expikqeia M Becker
f
My Commission D0150048
/ ? / Exppiirres November 15, 2008
FEES: PERMIT / v RADON
APPROVED:
Zoning �' 4-2, ,3 Building
Mechanical Plumbing
Notary as to Contractor or Owner Builder Date
My Commission Expires
C.C.F Z NOTARY ^— • oe BOND
TOTAL DUE -, 2 0
Electrical
Structural Engineer
CONTRACTOR
BY
Name
Zoning
License No.
0 - - ✓$
Address
Home Telephone j i g /„ J 0 . 5 - V f7
Telephone
Fax
Qualifier Name
Demolish
SECTION
BY
DATE
Zoning
.
0 - - ✓$
Electrical
Home Telephone j i g /„ J 0 . 5 - V f7
Business Telephone
Mechanical
Fax , D �/ J
/'DJ )!l C) (- --/ f// Y
Demolish
Plumbing
Relocation of Structure
Fire
Foundation Only
Public Works
Add'l Attachment
Structural
Add'l Detachment
Building Official
Other
K6PW
PROPERTY OWNER
New Construction
Name 7/ ' Y „4, 1
0 C
Address
3T0 N
23(..
/ 5 ' 6 -
Home Telephone j i g /„ J 0 . 5 - V f7
Business Telephone
Alteration Interior
Fax , D �/ J
/'DJ )!l C) (- --/ f// Y
Demolish
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'l Attachment
Other
Add'l Detachment
Other
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ 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 $
State DCA (Radon) $
Code Enforcement Fine $
Zoning Review
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)
TOTAL $ � (^ - 0
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
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
Address
Folio Number / / 3 0 (a (.7 /q OD Description of Work
Lot Block
Subdivision
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
Apt.
City
PB PG Zoning
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
PERMIT APPLICATION
Master Permit No.
t ,
Subsidiary Permit No. j P D 0)-- • 2 53
State
Zip
r - ,/
Linear Feet
Current Use of Property Square Feet Units Floors
Proposed Use of Property p< Value of Work 4 2 occ> .' Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
ELECTRICAL
TYPI.
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYl'1:
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
A/C Central 1 -3 Ton
Fan
Dryer Vents, Number of
Outlet, Wall
Ventilation, Cost
Service, Temporary
Air Handler, Tons
A/C Central 4 -7 Ton
Piping, Flammable Liquid
Fire Pump
Outlet, Switch
Fire Sprinkler System
Signs
-
A/C Central 8 -15 Ton
Bath Fan - Vented, #
Fixture - Fluorescent
Pressure Vessel
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/1'eleph.
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
Solar Water Heater
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Cap - Fixture
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Pump and Abandon
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 2
INIPORTANT NOTICES
1. 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 $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1° Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
STATE OF FLORIDA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signat . e ova er Signature of Contractor / Qualifier
Print Name
Sworn to and su
ore me this / / day of Z G o
41 ,00 Carla Daiorre
#9 6xplres April 14, 2002
SEAL: SEAL:
Signature of
29
Type of Identification Produced: A --.5 0
I2Q /vee$-
PERMIT APPLICATION
Print Name
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
Personally known t/ OR, Produced Identification Personally known OR, Produced Identification
Type of Identification Produced:
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:
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 3/18/2002
Applicant: MICHAEL
Owner: FRAZIER
Contractor
Local Phone:
Address:
Cellular:
Fees:
FEE2002 -1577
FEE2002 -1578
FRAZIER
MICHAEL
Parcel # 1132060190230 Legal Description: EL PORTAL PB 9 -101 LOT 7 & E1/2 OF LOT 8 BLK 2 LOT SIZE 75.000 X
Job Address: 348 NE 91 ST
Description Amount
Building Permit Application Fe$60.00
CCF $1.20
Total Fees: $61.20
Building Permit
Permit Number: BP2002 -559
Permit Status: Approved Permit Expiration: 9/14/2002 Construction Value:
Work: EXTERIOR PAINTING AS PER AGREEMENT (OWNER BUILDER PERMIT)
$2,000.00
Page 1 of 1
Total Fees: $61.20
Total Receipts: $0.00
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. 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: (INSPECTOR) BY:
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 responisibility for all work done by either
myself, my agent, servants or employes.
Signed: • (Contractor or Builder) BY:
MIAMI SHORES VILLAGE'
Paint Color Approval and Agreement
DATE: /////&2
OWNER'S NAM /mil /e ,ggei /), PHONE: 7 - 07/ -2 z i 2_
ADDRESS: 3 rv.• 9/" - 7:2, 4 ) 8
xxxxxxxxx.cxxxxxxx ;cx xxxxxx
X
xxxxxxxxxxxxx
ADDRESS OF SITE:
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:
e listed and indicate the color to be painted.
All Elements on the site
Walls
Fascia c o i^-
Drip Cap/Drip Edge c,J
Soffit w ■•••:A. {-e
Roof w
Flower Bins
Shutters
Awnings
Chimney
Doors and door jams w i
Garage Doors 1.0h, fie. Ax-. s
Railings C - 1
Fences — 6
Decorative Metal
All brick (simulated or regular) 12-
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
samples.
Sig ature of Owne r� ate Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED: WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
3 / d12.
Building Officia Date
x> XX** C*xxxxxxxx
xxx 4 >(>C
4/23/01
BUILDING
ELECTRICAL
PLUMBING
ROOFING
MIAMI SHORES VILLAGE. FLORIDA
❑
PERMIT N° 5679
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Descripticn � Bl.
Address of
Building
CONTRACTOR OR BUILD46
f
DATE 195
Contractor's
License No.
Work to be performed under this Permit
Subdi-
vision
Value of
Project $
Amount 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 furthar 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 cr in the statemAts or specifications and that he assumes responsibility for work
done by his agents, servants or employees. ,,
Signed. r
-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 regulation::
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac•
ceptinng this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY