1050 NE 93 St (11)PROPERTY OWNER
/
\Name Pi- Q lam• ` ke.Cce,c A,75:
Address
1 05 0 ►.D - - a . 93T-S) •V.
A\vs,w;, 5ko -,e,s. L.,a„ 3' \39
Home Telephone c-s O s) 7 E 1_ 2.4 7 3
Business Telephone
C3 0 9 3 8 3 C.
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
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Complete the attached permit application which •nust igiie4 blj tl pigperty owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing ofsoQr tppDe io:t. If roofing work will be done, a roofing application must be submit-
ted along with this permit application. • • • • • • • ••• • • •
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: ` 0 So �.
Address
Folio Number
Lot
Subdivision
Current Use of Property
Proposed Use of Property
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
PB
3c5. a311 30
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• •. . •.: •Master Per iiit No. (P 'O3 '
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• • • • • • •Sub §idia Permit No
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cc
Block
Apt City
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
PERMIT APPLICATION
'rl.. `33\3y
State Zip
escription of Work 94 L as t`S ,
PG Zoning Linear Feet
Square Feet Units Floors
alue of Work S 2,L jbC, 00 Bldg Value
x 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
SEAL:
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S A Y' • : FLORIDA, O Y OF MIAMI -
lot 41-4.4-4 AIP
Print Name .
Sworn to and subscribed before me thi
day of, e' ` ,
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SEAL:
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PERMIT APPLICATION
IMPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING IVEIVWD YO11% 'AL1J TED•ASRMIT 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 MAINTAIUD 1i11 ACLEA#I, N €AT7AN33 SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL B4itEP%CR>aE LR9M•DIfiq'41NpDEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAM4GED BY.EQMPIV;E? T 4R0VBIKLES, 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
Signature of Contractor / Qualifier
Print Name
Sworn to and subscribed before me this day of
Signature •' otary Pub io - State of Florida Signature of Notary Public - State of Florida
� Angela M Becker
My Commission DD150048
f o Expires November 15, 2006
Personally (mown / /OR, Produced Identification Personally known OR, Produced Identification
Type of Identification Produced: Type of Identification Produced:
ELECTRICAL
'rv'Pi:
Minimum Fee
QTR'.
TYPE,
Dryer . • • :
;)Tv.
II • •
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T1
IP au 1et
QTV.
T)1
Service Repair
Q n'.
A/C Central 1 -3 Ton
Heating Strips, each
Fan
Outret,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
NIECHANICAL
TYPE
Minimum Fee
QTY.
TYPE
Condensate Drain
QTY. TYPE
Generator
(1'x'1', 'I'VI'F
Refrigeration, Tons
Q I'V.
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
PLUNIBING
T1'm
A/C Condensate
QTY.
TYPE
Drains, Roof
QT1'.
TYPE
Miscellaneous Fixture
QTY.
T YPE
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
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PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being�perfotmeddand qusntity(ies) in the space provided below. •
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RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
DATE
7(d_3
`!
Zoning
.P/7
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
'(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
Notary
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❑ 1tROO . F OF OW • •
OWNERSHIP
(Attach)
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❑ HI;S / D)•)IV1'PR(�V1L;
(Soptiof ;ewvet) • • • •
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
$ (Q.Oo
/ - SO
$
$ 5 .
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ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
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(sq.ft. = x/1000
x ¢.60)
(¢.005 / sq.ft.)
(¢.01 /sq.ft.)
°PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $ `4) "' • Ub
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 Shores Village Building Permit
\, 10050 NE 2nd Avenue
cQ Phone: 305 -795 -2204 Permit Number: BP2003 -327
L) Printed: 2/27/2003 Page 1 of 1
Applicant: )
Owner:
l Jb , ,- b
JOB ADDRESS: 1 50 NE 93 - ST
Contractor
Local Phone:
`.� Parcel # 1132050150120
This Permit is granted to the contractor or builder named above to col
ordinances pertaining thereto and with the understanding that the work v
and approved by the proper municipal authorities. This Permit may be r
authorization. A further condition upon which this permit is granted is th.
ordinances and regulations pertaining to the work covered hereby wheth
by his agents, servants or employees.
(INSPECT 1.
In consideration of the issuance to me of this permit, I agree to perfori g
with the plans, drawings, statements or specifications submitted to the F g
myself, my agent, serv.. - . , r employes.
O p
Signed:
4 s
Contractor's Address:
Legal Description: 5 53 42 BELVIDERE PARK PB 16 - 71 LOT 4 & LOT 5 LESS W12.5FT BLK 3 LOT
Fees: Description Amount
FEE2003 -1219 Building Permit Application Fee $60.00
FEE2003 -1220 CCF $1.80
FEE2003 -1221 Notary Fee $5.00
$66.80
Total Fees:
Total Fees: $66.80
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 8/26/2003 Construction Value: $2,400.00
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.
P,
For
Y[o the
order of
PROSPERO G. HERRERA, 11
JULIE F. HERRERA
1050 N.E. 93RD STREET
MIAMI SHORES, FL 33138
fns, :S'A
tilig SOUTH FLORIDA EDUCATIONAL FCU
7800 S.W. 117TH AVENUE
MIAMI, FLORIDA 33183
5 -91
Date
V . ( (r> -r
3 1
),1.-c>t< �
ci
eL
2548
63- 7782/2670
I
$ 77
Dollars 8
APPROVED:
MIAMI SUORES:VILLAGE • •
Paint Color App'rw a
••, :•• ••...:
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DATE: .
OWNER'S NAME: 3•os .3c,6 Ae AC.2- k :Cr o0 PHONE: (3 os) 7C7-1-113
ADDRESS: kfls .. `$3.c .S2 .E,‘ c.,. Stk\vim S �. 33131
* * * * * * * * * * * * * * * * * * * * * * * * *. *C *c4 *9c*3*, **a; * * * * * * * * * * * * * * * * * * * * . * * **
ADDRESS OF SITE: \ 0 SV vs q. oi- &.A••• ..',: \ 1 A,:,",..,; S1,„R..� 3313y
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls 1
Fascia o�
Drip Cap/Drip Edge
Soffit l o 3
Roof
Flower Bins
Shutters 104
Awnings
Chimney t 03
Doors and door jams 0 C t
Garage Doors 0 3
Railings '$ \wck.
Fences
Decorative Metal
All brick (simulated or regular)
Stucco Banding
Any other stucco features
Accessory Buildings
Other
LA/ '1,115
3/B 102
D
0
3/D
103
OWNER'S AFFIDAVIT: I certify that all the foregoi elp 5 P e
L
and that all work will be done in compliance with all ai T we LA'
construction and zoning. I authorize the above -named ■ ti`' ( - a -d :o
)do the work stated. Furthermore , the paint colors will b t In
pr iel,.4,.._ f Se.,
g nature df owner Date Signature of Co. l oof' 1 . g I ,
************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ( � ,, e ln•0
� t
WHEN PAINTI to— I _
CALL FOR FIr 3A^ 0c-
2 / [ 1-7103 #i(p r r
Building Official O Date "''� 4/23/01
OC -91