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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 • • • • •• ••• •• 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 • • •• • • • • ••• • • • • • • • ••• • • • • • • • • • • • .•• • •. . •.: •Master Per iiit No. (P 'O3 ' • • • • • • • •Sub §idia Permit No ••• •••• •.• • • 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: • • • • • • • •• • 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' ` , • • •• • • • ••• • • • • • • • ••••••• •• • SEAL: • • • 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 • • • _ 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 • Page 3 • • • • • • • ••• • • • • • • • • ••••••• • • ••• • • • • • • .•• • ••• PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being�perfotmeddand qusntity(ies) in the space provided below. • • 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 ••• • • • • • ••• • • • • ❑ 1tROO . F OF OW • • OWNERSHIP (Attach) • ❑ HI;S / D)•)IV1'PR(�V1L; (Soptiof ;ewvet) • • • • ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ (Q.Oo / - SO $ $ 5 . • ••• • • • • ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: • • • •• • • • • • • • • • • • • ••• • • • .. • • • •• • (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 ••, :•• ••...: • •• • ••• • 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