PAINT PERMITDate
Type Insp
Permit No.
Nam
Address
Company
Phone #
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
For Inspector: 0 \Name Date
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o
Time
A
9'
i
Date T pw
Type Insp'n
Permit No
Name u)- (Likto
Address I
Company
Phone #
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
3 .0& 75'g59)
For Inspector: TIA Name & Date
CONTRACTOR\
&Ara.kit - e
,
5
Name ) , 'p
�° li.t1 1
v C
�'`t
License No.
Repair
Business Telephone 3 ) I s- _ 9 91 L
1
Alteration Interior
Fax
Demolish
` j
Shell Only
Teleph
Foundation Only
J
Qualifier
:,
Add'I Detachment
Other
PROPERTY OWNER
New Construction
Name
, � ')C�. vA
Enclosure
Address
0 P CA z.„ ?1 tl 1, ( 6t,AA i
�'`t
Home Telephone ' bs, 7 _ , i
Repair
Business Telephone 3 ) I s- _ 9 91 L
1
Alteration Interior
Fax
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'I Detachment
Other
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
ic ob Address:
kL1
Address
Apt.
Lot Block ra C St a .I -.P
Subdivision PB PG Zoning
Current Use of Property Square Feet
Proposed Use of Property /Value of Work 1 1 � Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
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
Master Permit No.
Subsidiary Permit No.
City
State
Linear Feet
PERMIT APPLICATION
Units Floors
Zip
ENGINEER
Name
License No.
Address
Telephone
Fax
Page 2
I A'IPORTANT NOTI CES
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.
TATE OF FLORIDA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE
ature of Owner
Print Name
worn to and subscribed before me this
lf�i►r �_ `
II •
/ 1 , 3%. •>R ra'i1 I�Li
ature o
COMMISSION NUMBER
¢ CC786697
MY COMMISSION EXPIRES
SEAL: a
OF Fk.° NOV. 15,2 002
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 / �
•
or 4■
he
Miami h cs
10050 NE 2nd Avenue
c
Liiiding Permit
Phone: 305- 795 -2204 Permit Number: BP2002 -1235
Printed: 7 /15/2002
Applicant: ANN .SWANER
Owner: SWANER ANN
JOB ADDRESS: 1145 NE 92 ST
Contractor's Address:
r, Contractor
Local Phone:
Parcel # 1132050270360
Fees: Description Amount
FEE2002 -3871 Building Permit Application Fee $60.00
FEE2002 -3872 Notary Fee $5.00
FEE2002 -3873 CCF $2.40
(c) Total Fees: $67.40
Legal Description: BAY LURE PB 44 -63 LOT 24
Page 1 of 1
BLK 2 LOT SIZE 75.000 X 125 OR
Total Fees: $67.40
Total Receipts: $0.00
Permit Status: Approved Permit Expiration: 1/11/2003 Construction Value:
Work: EXTERIOR. PAINTING AS PER AGREEMENT (OWNER BUILDER PERMIT)
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:
PECTOR)
Signed es�- L��i�l (Contractor or Builder) B ':
BY:
$4,000.00
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.
i
PAT TO THE
i P ORDER 01'
JAMES C. SWAIVER
1145 NE 92ND ST-
MIAMI SHORES, FL 33138 -2934
•r
1 ,u44 S�res I lip e
y 5
Washington Mutual
Wasttlngton Mutual Bank, FA
Miami Stores Financial Center 1722
9640 NE. 2nd Avenue 1.800 - 7e8 - 7000
'Miami Shores. FL 33138 24 hour Customer service
(V)
MEMO
I:267084L3 0538
63-8413/267
8314623063
DATE
i $ 7
DOLLARS
8
5.38
11P
MIAMI SHORES VILLAGE
Paint Color Approval and Agreemen
(DATE: - 1 o
OWNER'S NAME: � PHONE
ADDRESS: i 1 Lir � '� 9
Y Y Y Y Y X X X X X X X >(X X X x x X
xx *.xxxxvv***.$v k >,c *xxxx * x xaxx>
i
ADDRESS OF SITE: 1 5 1
CONTRACTOR & LICENSE (if applicable) p,tarc,r c
COMPANY NAME: \Fa_VJotAr c PHON
hex
** c)<
xxxx xxxxxxxxxx
All Elements on the site must be listed and indicate the color t
Walls )L SA-'& G re _,v
Fascia S0--k �■ G
Drip Cap/Drip Edge)( Sc j
Soffit
Roof ( N
Flower Bins —
Shutters P
Awnings �' r r�_�� �.� $te p �.
Chimney 0,0
Doors and door jams Ack_ 5 ocu v i5k
Garage Doors S -( <9•4 ( krei2-v\
Railings
Fences 0 P ,
X XXX
0
/a-4.;_
Building Of - tal Date
N
Decorative Metal Z$
All brick (simulated or regular) o.,
Stucco Banding
Any other stucco features
Accessory Buildings C BOA CAWS 5CLAA c3 Lacg
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.
\ �i, ���v 1 - O
• ignature of Owner Date Signature of Contractor Date
APPROVED: fi r %ems( WHEN PAINTING IS FINISHED,
/ CALL FOR FINAL INSPECTION
4/23/01
C
'00
N
0
0
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein
described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the
State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether
herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work.
Owner's Name and Address flit, • Mogi J 6 €fl EA-
Date /9 , / 7/ 19 C
No. / / ¢. �' Ng Street 9 Z J re
Registered Architect and /or Engineer
/v¢2B1w - r7jrdt. Goth— et- ei>rre. 33328
Name and address of licensed contractor �F 6 /9• /1 -Ca—el d K/
Location and legal description of lot to be built on: Zukje,./ p J o / Lot Block Subdivisio6 ! 1 d c 1—S 7 LJw e p�
•
Street and Number where work is to be done // g f N • L • . J la
State work to be done and purpose of building (by floors), state exterior colors (submit samples) P0 c ua E C 6 cieZ/h E
0 /iv (ZJ 7 Coo 7J , /71.7- PG•9 7 r/t-6 Oz-c. 1.4.49 Tom al 9 Arierled
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ /90 O Amount of Permit S 'N5®'eis e
Zone cubage required Plan Cubage
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 sub - contractors 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) /
Disapproved Date
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.
Permit No. 'A N Date Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
(Signed) t WVV w s`r
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $25.00 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.