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PAINTBUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Lot MIAMI SHORES VILLAGE. FLORIDA PERMIT N? . 7050 a , 4- CONTRACTOR OR BUILDER ; 4 Address of Building 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 cr in the statements�or speci ations and that he assumes responsibility for work done by his agents, servants or employees. f /f " Signed BY: INSPECTOR B1 Work to be performed under this Permit / " Value of Project DATE Contractor's License No. t*' Amount of Permit $ BY AUTHORITY 195_ Subdi- vision 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. Owner's Name and Address 7 / 1 ), Registered Architect and /or Engineer MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT y made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein BASE 1 ion is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the P.'ORANA PAllr )Pslit of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with. whether £ISCAYNE (MCA copy of approved plans and specifications must be kept at building during progress of the work. ii AAIMI, FL 33181 C 6f/ 7?wZ Name and address of licensed contractor Location and legal description of lot to be built on: _ Lot /PO47Z Block r'rr/ Subdivision e. { Street and Number where work is to be done /° ° / `. 9 3 State work to pur�s� of building rel, state exterior colors (submit samples) b C� ,tt„,c New Building Remodeling Addition Estimated Total cost of improvements $ Zone cubage required Plan Cubage Date /CA T 19 0 p a, ,rte No./.0r,1 / Street /1/ ` ���� .7 612.94,6 To be constructed of Kind of foundation Roof Covering 1 4 00 ' Amount of Permit S J7- S o // /<_" "Ddr 7o 7 P .t� -f 0 cc Ale 0 SeE. and for no other purpose. Repairs No of Stories Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all 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 obligatons 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 subcontractors 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 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. Date /42/2 7 fr 7 Read. Sworn to and Subscribed before me. Permit No Disapproved �! Date (Signed) !\ Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of 525.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Notary Public, State of Florida PROPERTY OWNER Name �e A-A "I- eNie ST7nE Roorzi&u Address /oaf AIE 13 S. m1/9-m l Al - 3.? 1.?k' Home Telepphone 3oS-7S7c 3 3... Business Telephone 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'1 Detachment Other Step 1. PERMIT APPLICATION Master Permit No. Subsidiary Permit No. )� 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 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 submit- ted 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: Folio Number /Nescription of Work ,FY 7 t'/ D Pe.- /ti)-ESC / 14 /77, �r Lot Block Subdivision PB PG Zoning Linear Feet Current Use of Property Square Feet Units Floors Proposed Use of Property alue of Work 0 5 . 0 0 Bldg Value Tenant Information ax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other lc / ,v€ q.3 St Address A PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax rnIA City State 32, 3e Zip ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Page 2 IMPORTANT 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 PROTEC:I'ED 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 v i ..4 ignature of Owner Print Name worn to and subscribed before me this v :. AL 7.-Ia Signature of SEAL: day of a c 1 , 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 Personally known OR, Produced Identification Personally known OR, Produced Identification Type of Identification Producer` J` J 4 ol I t ` J �' S y, /hype of Identification Produced: ELECTRICAL TYPE Minimum Fee QTY. TYPI•. Dryer (1"1'1'. TYPE: Outlet, Appliance QTY. "I I PE: Service Repair Q 1'. 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/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New NIECHANICAL TYI'E Minimum Fee QTY. 4-17YPE Condensate Drain QTY. •I'YI'E Generator QTY TYPE Refrigeration, Tons (_) I V 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 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: Page 4 OFFICE USE ONLY CIIECKLIST U OWNER - BUILDER FORM (Attach) U FIRE DEPARTMENT APPROVAL (Commercial / multi - family) • CONCURRENCY (New Construction) U OTHER (Specify & Attach) U PROOF OF OWNERSHIP (Attach) • HRS / DERM APPROVAL (Septic / Sewer) U IMPACT FEE (New Construction) U 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 Notary $C0 $ / 1 6 V ( sq.ft. = x/1000 x ¢.60) $ (¢.005 /sq.ft.) $ (¢.01 /sq.ft.) $ _5; REVIEWED AND PREPARED BY: SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE l�v des/ d /a• PERMIT APPLICATION U CONDO ASSOCIATION APPROVAL (Attach) BPR APPROVAL (Restaurants) U CONTRACTOR REGISTRATION (On File) TOTAL $ 4,FD ISSUING OFFICIAL DATE: CONDITION OF APPROVAL 10050 N.E. 2ND AVE., MIAMI SHORES, FL o (305) 795 -2207 o FAX (305) 756 -8972 0 http:/ /www.miamishoresvillage.com Revised July 2001 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 -795 -2204 Printed: 10 /29/2002 Applicant: CHRISTINE Owner: RODRIGUEZ JOB ADDRESS: 1021 Contractor `"jq.Local Phone: `'J.J Parcel # 1132050150070 NE 93 Building Permit Permit Number: BP2002 -1844 RODRIGUEZ CHRISTINE ST Contractor's Address: Legal Description: 5 53 42 BELVIDERE PARK Fees: FEE2002 -6087 FEE2002 -6089 FEE2002 -6090 Description Building Permit Application Fee CCF Notary Fee Total Fees: Amount $60.00 $1.80 $5.00 $66.80 Total Fees: $66.80 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 4/27/2003 Construction Value: $2,580.00 Work: EXTERIOR PAINTING AS PER 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. Page 1 of 1 Signed: (INSPECTOR) BY: PB 16 -71 LOT 11 & 12 BLK 2 LOT SIZE 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. 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 1 assume responisibility for all work done by either myself, my ag - • - - ants or employes. (Contract or /iilder) BY: - e mem q't ewS,y� e orde BANK 0 AME 02992 FL $ ACH R/T 063100277 904 datj _. I $ Pernendo Rodriguez 4-00 1021 N.E. 98 St. Miami, FL 33138 IOW Alart At , ,,,, 7 7 .. M '.` :'a..s .Y47.∎ 4063 L00 2771: 00 3666 3 28 7 5 1 1 63 -27 6 31L 0904 IYNV RNA. POAD • OZOW P0. M IWw fbaaW rat l r MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: / 6/4-4 OWNER'SN CAni <T /we /co0/2 /6-uEZ PHONE: 3os 7o �S a ADDRESS: /or; ,/C 93 Si tilt/0711 .m,-es PZ - 3 3/3 -- ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: //) / 3 S� ��,, � . CONTRACTOR & LICENSE (if applicable) i v ei si ff -R,vodo d o 5oo3 off; COMPANY NAME: PHONE:. ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls / 0 4S / /io 3 Fascia X14 - Drip Cap/Drip Edge He - / ( Soffit Roof /1/A Flower Bins /v 4 S Shutters 4/.4 Awnings 0 4s Chimney i 0 9 ,Sr Doors and door jams //C. /j_? Garage Doors i o 9.c Railings Fences it/ Decorative Metal All brick (simulated or regular) Stucco Banding • A cototf Any other stucco features Accessory °— Other OLQ APPROVED: Building Offi ial Date ivi 2/D 4/E Iouisburg green 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 sam • les. / /t0 <9 Signature of Owner Date Signature of Contractor Date ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED CALL FOR FINAL INSPECTION 4/23/01 The Sunshine State UCENSE NUMBER R362 -108 -53 -524 -0 CHRISTINE HELEN RODRIGUEZ 1021 NE 93ST MIAMI SHORES, FL 33138 38 BIRTH DATE SEX MGT. REST. ENDORSE. 01-24-53 F 503 ISSUED EXPIRES 11.1401 01 -24.08 DUPLICATE 00'00 SAFE DRNER X060111145700 Operation of a motor Vehicle oonstk tes Consent to Sty sobriety test required by kw.