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PLUMBING PERMITMIAMI SHORES VILLAGE, FLORIDA BUILDING DATE,, ELECTRICAL PERMIT N? 11615 PLUMBING ROOFING 11 Work to be performed under this Permit Owner of `" • • Building 1: • I ljI Architect Contractor or Builder Legal Lot Description Address of Building / Bl. 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 plane, 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 -pr in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. 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 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 responsibility for all work done by either, myself, my agent, servant or employee. Ire CONTRACTOR OR BUILDER BY Subdi- vision ,fit '' ' /4 r. Value of Project $ Signed • BY / 195 Contractor's License No Amt. of j Permit $ ' T AUTHORITY Permit No. ._ Date .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 a'1 rules .uld 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 work. Owner's Name and Address No. . Street Registered Architect and /or Engineer Employing Plumber's Name _.. No.__ Street . Location and Legal Description Lot Block - Subdivision Street and Number where work is to be performed —No. _ Street State work to be performed and purpose of building (By Floors) New Building _ Remodeling Addition Repairs No. of Stories CLOSETS CONTR. LIST CHECK CONTR. LIST CHECK SEPTIC TANK BATH TUBS SHOWERS SEWER DRAIN CONN. FIELD Size Septic Tank - - - - -- - - Feet of Drain Tile Nature of Water Supply: City —Well. Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. LAVA- TORIES SOAKAGE PIT MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT SINKS GREASE TRAP SLOP SINKS SOLAR HEATER Type of Tank .. Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit LAUNDRY' CATCH TUBS URINALS BASIN DEEP WELL (Signed) (Signed) _. __ SPRKLR. I SWIM•G SYSTEM POOL FLOOR DRINKING, DRAIN I FOUNT'NS I II Capacity Cals. My Commission Expires Notary Public, State of Florida Master Plumber. TOTAL FIXTURES Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5960, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-cont. cInpluyed by him in the work to be performed under this permit; and will post or cause to he 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 sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and tnkc 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. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or foul materials and /or workmanship. Application is hereby mach 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 work. Owner's Name and Address Registered Architect and /or Engineer____- ......... _ Employing Plumber's Name A.B.C. Septic Tank Service No._ 711 i_. I;. Street' " Location and Legal Description Lot.____ _ ._____.__ _ _ —._ Blork Subdivision- _ ____. Street and Number where work is to be performed -No State work to be performed and purpose of building (By Floors) New Building ....... ______. Remodeling -____ _________ Addition Repairs No. of Stories_ Size Septic Tank ____ -- -- - -_ - -- Type of Tank Feet of D r a i n Tile -____- - "- . ' `' _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City-Well. __.____ ____._Size of Soakage Pit Amo MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No._ 1120 11.E. Street Capacity Gals._ D ate 10- 1 Street My Commission Expires Notary Public, State of Florida 92St /. unt of Permit $ .. ( Signed)--------- - -__ -_ . Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Peru anent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors a in cloyed by him in the work to be performeA 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 requered by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perforned under this permit, as are licensed by Mimi Shores Village. ( Signed) -- - - Master Plumber. STATE OF FLORIDA, I COUNTY OF DADE. 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. NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS !SHOWERS LAVA- TORIES KINKS SLOP SINKS LAUNDRY TUBE U URINALS CATCH BASIN FLOOR DRAIN DRINK' NO FOU NT' NS TOTAL FIKTUREB CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE' TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM•0 POOL COMTE. LIST - CHECK Application is hereby mach 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 work. Owner's Name and Address Registered Architect and /or Engineer____- ......... _ Employing Plumber's Name A.B.C. Septic Tank Service No._ 711 i_. I;. Street' " Location and Legal Description Lot.____ _ ._____.__ _ _ —._ Blork Subdivision- _ ____. Street and Number where work is to be performed -No State work to be performed and purpose of building (By Floors) New Building ....... ______. Remodeling -____ _________ Addition Repairs No. of Stories_ Size Septic Tank ____ -- -- - -_ - -- Type of Tank Feet of D r a i n Tile -____- - "- . ' `' _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City-Well. __.____ ____._Size of Soakage Pit Amo MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No._ 1120 11.E. Street Capacity Gals._ D ate 10- 1 Street My Commission Expires Notary Public, State of Florida 92St /. unt of Permit $ .. ( Signed)--------- - -__ -_ . Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Peru anent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors a in cloyed by him in the work to be performeA 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 requered by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perforned under this permit, as are licensed by Mimi Shores Village. ( Signed) -- - - Master Plumber. STATE OF FLORIDA, I COUNTY OF DADE. 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. NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Datel /3/ )OJ —Time r t ` [ Permit No. Name Address Company PtIone # For Inspector: 1 1 1 Approved Correction Re- Insp'n Fee 00 Name & Date i/ • Date Type Insp'n Permit No. Name Address Company Phone # For Inspector: / Approved b Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request o o 4 Time 1 Y i & Date Type Insp'n Permit No. Na Address Company MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buil Inspection Request 6D 1d Date i —/ ! 0 ime 0 Phone# Of cpti % y For Inspector:' )5 /v Name & Date Approved Correction ❑ Re- Insp'n Fee ❑ 3°\ Type Insp Permit No. MIAMI SHORES VILLAGE BUILDING DEPARTMENT Building Inspection Request \ 305- 795 -2204 C. ►^ Dat- -' r Time Nay l\. 6,4 Address l 144 Compan Phone # ForInspec3 Approved Correction Re- Insp'n Fee PROPERTY OWNER' Name {NilIi License No. ■ Address Name Svc � \ _ J 5 Fax Fax Demolish Relocation of Structure Address 1` \ ., Ali° q ` t � s\.b,t )11- . t lG.. 33 \ 3 8 Home Telephone Add'l Detachment Other Business Telephone Fax ]ENGINEER Name {NilIi License No. ■ Address Telephone % S 1 5e , 0` 33 \toL Fax Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure License No. ] — Alteration Exterior Repair % S 1 5e , 0` 33 \toL Alteration Interior Fax Demolish Relocation of Structure 6-55 Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other CONTRACTOR w -� ;C) \ Name C 55\ l� License No. ] — Address J i C0 f■ e t 'AA• O. % S 1 5e , 0` 33 \toL Telephone Fax Qualifier Name 1 6-55 Step 1. Job Address: INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Vi lage: 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 Folio Number Lot Block 3 Subdivision Zi°.y , u rt. PB_`_ PG b3 Zoning Linear Feet Current Use of Property Square Feet Q Units Floors Proposed Use of Property Value of Work - ( O� Bldg Value Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other ‘\o\6 �C 9z_ S \- . Address Apt. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection A��CmTECT Name License No. Address Telephone Fax Master Permit No. _ Subsidiary Permit No. Description of Work City State a,\ p Tax Assessed/Appraised Value PERMIT APPLICATION ( y Zip Flood Zone Base Floor Elev. 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 CONDITION1free 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. 1 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 mit be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the br'ochu - . Villag- Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLO,/ NTY OF MIAMI -DADE Signature oer ///cir-k !i Print Name Print Name grn to and subscribed .efore me this day of c:V7 , Sworn to and subscribed b Gi �� ig) . i+* ' I Not ary ' ' Pit o ary �' .. , ry ' ublic, State of Florida / comm. exp. May 24, 2003 Cnmm. No. CCRl9725 SEA : Personally known OR, Produced Identification PERMIT APPLICATION [DA, COUNTY\ OF MIAMI -DADE me this ZIP day of 57Y Si• .�� of Nota ublic - State of Floridad KENNETH SHERMAN S AL: Notary Public, State of Florida My co ezp. May 24, 2003 • tlmm. NO CC819 Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton Cooling Tower Fan Heating Strips, each Outlet, Wall Vent Hood, Cost Service, Temporary A/C Wall/Win. Tons A/C Central 4 -7 Ton Dryer Vents, Number of Fire Pump Paint Booth Outlet, Switch Ventilation, Cost Signs Air Handler, Tons A/C Central 8 -15 Ton Ductwork, Cost of Fixture - Fluorescent Piping, Flammable Liquid Oven Periodic Inspections Space Heater (kw) Barbecue A/C Central 16 -20 Ton Fire Sprinkler System Fixture Light Process/Pressure Piping Parking Lot Lights Spas/Hot Tubs Bath Fan - Vented, # A/C Central 20+ Ton Fireplaces, Number of Flood Lights Pressure Vessel 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 Ileater Dishwasher Low -volt, Television Service, Number of Amps Water Ileater New MECHANICAL TYPE' Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE ,QTY. Generator TYPE Refrigeration, Tons QTY. A/C Central, Tons "lath Tub Cooling Tower Drinking Fountain Heating Strips, each Miscellaneous Repairs Vent Hood, Cost olar Water Heater A/C Wall/Win. Tons 73idf.tt Dryer Vents, Number of Filter Replace Paint Booth Pool Piping Ventilation, Cost prinkler Repair Air Handler, Tons Cap - u Ductwork, Cost of Fountain Piping, Flammable Liquid Pump and Abandon Periodic Inspections Sprinkler System Barbecue Cap - Water Fire Sprinkler System Gas - Appliance Process/Pressure Piping Pump, Domestic Supply, AC Well Bath Fan - Vented, # Cap - Sewer Fireplaces, Number of Gas - Natural Pressure Vessel Pump, Fire Stand Temporary Toilet _ PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. "lath Tub Drinking Fountain Miscellaneous Repairs olar Water Heater 73idf.tt Filter Replace Pool Piping prinkler Repair Cap - u 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 Ileater Drainfield, 4" 'file/Res. Lavatory Septic Tank Water Ileater 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: SECTION BY DATE Zoning Electrical Mechanical - / Plumbin • / -oi Fire — IF 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) ❑ 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 $ X24 " (¢.005 /sq.ft.) (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: DATE: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ [ ko_n ISSUING OFFICIAL 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 FOR Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10 /25/2002 Applicant: DAVID MARKUS Owner: MARKUS DAVID JOB ADDRESS: 1190 NE 92 ST Contractor ESSIG POOLS Local Phone: Parcel # 1132050270460 Permit Status: Approved Work: POOL PIPING Miami, Florida ESSIG POOLS, INC. 1800 NE 151ST STREET NORTH MIAMI, FL 33162 Mellon United National Bank a v087 L 261I' 40670096464 00 2 L L330 20v Plumbing Permit Permit Number: PL2002 -288 Contractor's Address: Legal Description: BAY LURE PB 44 -63 LOT 8 Fees: Description Amount FEE2002 -6072 Building Fee $120.00 Total Fees: $120.00 Total Fees: $120.00 Total Receipts: $0.00 Permit Expiration: 4/23/2003 Construction Value: $900.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection DATE I lr Op a� PAY TO THE gAg 63 -42 1 670 96 87126 ORDER 0 DOLLARS Page 1 of 1 BLK 3 LOT SIZE 75.000 X 125 OR nation herefor in strict compliance with all ifications that may have been submitted to s or if the plans are changed without )onsibility for a thorough knowledge of the that he assumes responsibility for work done .ns pertaining thereto and in strict conformity •esponisibility for all work done by either Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) Cl OTHER (Specify & Attach) $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 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) ( x .6 x/1000 0) $ (¢.005 / sq.ft.) $ (¢.01 /sq.ft.) SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2"° AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com ELECTRICAL TYPE Minimum Fee QTY. 'I YI'I; Dryer QTY. TYI'L Outlet, Appliance Q'I'V. TN P1.; Service Repair (,)'I'Y. A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Signs A/C Central 8 -15 Ton Fixture - Fluorescent 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 MECHANICAL TYPE Minimum Fee QTY. TYPE 'Condensate Drain QTY. TYPE Generator Q'I'V'. 'I'YI'E 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 Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping 1 Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUM BING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. 'fYI'I: Soakage Pit Q'I'Y. 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 1#Y: DATE: Page 2 IMPORTANT NOTICES 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. 1. 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, 1g 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 C•ntractor. Print Name Sworn to and subscribed before me this t �;': ?l 1 / . 01 My comm. m exp. jLv 5 Coa �„ ��� STATE 0 Signature Signature of Notary Public - State of Flo DA, COUNTY OF MIAMI -DADE N Iorida , 2003 Print Name SEAL: SEAL: Personally known OR, Produced Identification STA 0 ORIpA, CO Y OF MIAMI -DADE r ature of Contractor / Qualifier , C.c Sworn to and sub Signature of Notary Public - S PERMIT APPLICATION Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: CONTRACTOR Name / (.O r),,,// License No. J� o f/ 6 1 L (� `7 Address Telephone 6 c.y 3 t 9 Fa Qualifier Name /9-Lt Gid 60(1' (.e 1 PROPERTY OWNER New Construction Name /j 1 2' 1/ "� /�� yvc Alteration Exterior Address r /(9 O C ' 1 (� V Home Telephone j `71 4 ( t Business Telephone Fax Shell Only TYPE OF MANAGEMENT ( )i New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Addi 1 Attachment Other Add, l Detachment Other 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: / 1 4'O J C S 2- .07/4 4.1 Folio Number Lot Subdivision Current Use of Property Proposed Use of Property Tenant Information 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. Address Apt. Block PB PG Zoning Linear Feet Square Feet Units Floors Value of Work 7 0 0 Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev PERMIT TYPE (✓ ) Building Electrical ec amcal Plumbing Roofing Fence Other 7 PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax PERMIT APPLICATION Master Permit No. Subsidiary Permit No. /4 J V6 0 v 4 - 1 City Description of Work State /4 r7 q— // Zip ENGINEER Name License No. Address Telephone Fax 0 cD Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10 /29/2002 Applicant: DAVID Owner: MARKUS JOB ADDRESS: Contractor Local Phone: Parcel # 1132050270460 Permit Status: APPROVED Permit Expiration: Work: INSTALL 3" WELL Signe Signed: 1190 NE 92 r V ) 2,0 Plumbing Permit Permit Number: PL2002 -290 MARKUS DAVID ST Contractor's Address: Legal Description: BAY LURE PB 44 -63 LOT 8 Page 1 of 1 Fees: FEE2002 - 6086 Description Amount Building Permit Application Fee $60.00 Total Fees: $60.00 Total Fees: $60.00 Total Receipts: $0.00 4/27/2003 Construction Value: $700.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection BLK 3 LOT SIZE 75.000 X 125 OR ...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 .roper 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 furth-r 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 regul -tions 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 - agent — se ant.-or- employees. - — (INSPECTOR) BY: In considerati• n ;j 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 age t, servant or employes. (Contractor or Builder) BY: • • ■1•• • •VA • (.1•:" ,••••■cv _..—.■•••••■•••••.•14011 • ,Isnrogto senevnonarf "nzum volvint ,,,,, ESSIG POOLS, INC. 1 144. -71 /A 1800 NE 151ST STREET TO THE ORDER OFI &/1/( ) NORTH MIAMI, FL 33162 -69 $13 6 0 63-964 DATE 670 1 PAY Azat ( (.° Mellon United National Bank Miami. Florida FOR seQ-; ils087Ls?us 1:0670096461: 002L L33020" DOLLARS 44 87157 BUILDING ELECTRICAL PLUMBThIG ROOFING Owner of Building` n Work to be performed under this Permit PERMIT N? 11340 Architect ontractor or Builder , ' Legal Description Address of Building Lot/ MIAMI SHORES VILLAGE, FLORIDA �l. Subdi- vision DATE ° r ■ 195_1 Contractor's License No Value of Amt, of r s Project $ Permit $ i 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: .' , BY INSPECTOIV In consideration of the issuance to me of this permit I agree to rform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, ments or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibili' ' f all work done 10r. either, myself, my 'gent, servant„or employee. Permit No. =-- Size Septic Tank Feet of Drain Tile___ Nature of Water Supply: City— Well. STATE OF FLORIDA, 1 ss. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING 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 work. Owner's Name and Address No. ___ -_ ______.__.___.. _ .___ Street - Registered Architect and /or Engineer Employing Plumber's Name :_ No. ___ - Street Location and Legal Description Lot . ____ - Subdivision Street and Number where work is to be performed —No. _______________ ____._._. - Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Amount of Perrnit $ . -/ - (Signed) ( Signed)._ Repairs Type of Tank Dist: Feet of Tank or Drain Field from Well Size of Soakage Pit Date Capa:ity Gals.. No. of Stories Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accents his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Floridl I.crnuu:cut Supplement, and has com- plied with the provisions thereof, and will r9quire similar compliance from all contractors or sub - contractors c mployed by him in the work to be performed under this permit; and w1. 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 sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned aufr'gritY, 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. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by iciproper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOCR DRAIN DRINKING FOUNT'Ns I } 7t / 7 .- ? I i t TOTAL FIXTURES XTTURES CONTR. LIST f e.....1 .. CHECK -, �� SEPTIC TANK SEWER CONN. DRAIN --FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST 7 - CHECK Permit No. =-- Size Septic Tank Feet of Drain Tile___ Nature of Water Supply: City— Well. STATE OF FLORIDA, 1 ss. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING 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 work. Owner's Name and Address No. ___ -_ ______.__.___.. _ .___ Street - Registered Architect and /or Engineer Employing Plumber's Name :_ No. ___ - Street Location and Legal Description Lot . ____ - Subdivision Street and Number where work is to be performed —No. _______________ ____._._. - Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Amount of Perrnit $ . -/ - (Signed) ( Signed)._ Repairs Type of Tank Dist: Feet of Tank or Drain Field from Well Size of Soakage Pit Date Capa:ity Gals.. No. of Stories Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accents his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Floridl I.crnuu:cut Supplement, and has com- plied with the provisions thereof, and will r9quire similar compliance from all contractors or sub - contractors c mployed by him in the work to be performed under this permit; and w1. 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 sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned aufr'gritY, 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. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by iciproper notice for inspection, or faulty materials and /or workmanship. C. fi'' def Miami Shores Village Florida Gentlemen: Plumbing Inspection Department .Please send us a supply of the attached form. Thank you. DAD.E GAS COMPANY 6940 1117 27 Ave. Permit No Size Septic Tank Feet of Drain Tile /9 2 92.00 Nature of Water Supply: City—Well Amount of Permit $ 2.00 STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING 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 w°ric./ — Cippes Owner's Name and Address 9 990 .VE 92 St No. Street Registered Architect and/or Engineer 6940 27 Ave Employing Plumber's Name DADS GAS 01_1(pARY N Location and Legal Description Lot_ ___ Block Subdivision F Street and Number where work is to be perfon 1190 AT 92 St ned—No Street State work to be performed and purpose of building (By Floors)_ New Building Remodeling. Addition Repairs Type of Tank _Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed)_ // Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has ccnn- plied 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 sub-contractors, on work to perfornj under this penult, as are licensed by Miami Shores Village. ( Signed) Date November 19 1963 No. of Stories. Capacity Gals 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. My Commission Expires Notary Public, State of Florida Master Plumber. NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made by improper notice for inspection, or faulty materials and/or worlananship. CLOSE" BATH TUBS SH LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS a TOTAL FIXTURES cotera. LIST . - X CHECK ,---- 4 - SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWING POOL CONTR. LIST CHECK Permit No Size Septic Tank Feet of Drain Tile /9 2 92.00 Nature of Water Supply: City—Well Amount of Permit $ 2.00 STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING 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 w°ric./ — Cippes Owner's Name and Address 9 990 .VE 92 St No. Street Registered Architect and/or Engineer 6940 27 Ave Employing Plumber's Name DADS GAS 01_1(pARY N Location and Legal Description Lot_ ___ Block Subdivision F Street and Number where work is to be perfon 1190 AT 92 St ned—No Street State work to be performed and purpose of building (By Floors)_ New Building Remodeling. Addition Repairs Type of Tank _Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed)_ // Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has ccnn- plied 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 sub-contractors, on work to perfornj under this penult, as are licensed by Miami Shores Village. ( Signed) Date November 19 1963 No. of Stories. Capacity Gals 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. My Commission Expires Notary Public, State of Florida Master Plumber. NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made by improper notice for inspection, or faulty materials and/or worlananship.