1260 NE 93 St (6)MIAMI SHORES VILLAGE
APPLICATION FOR BUILDING PERMIT
Application is herby made for the approval of the detailed statement ul toe mans and specifications herewith submitted for the build
inc or other structure herein described This application Is made in compliance and conforrnity with the Building Ordinance of Istiami
Shores Village, Finrida. and n11 provisions nf the Laws of the Stale of Flurida, all ordinances of Miami Shores Village and all rules and
regulations of thc iituktilig Division of Miami Shores Village shall be complied with, whether herein specified or aot. A copy of approved
plans and specifications must be kept at building during progress of the work.
STATE OF FLOEIDA,
COUNTY OF DADE. ss.
pealed
New Building
Owner's Name and Address t I ( 47.4 S
Registered Architect andlor Engineer f\I
Name and address of licensed contractor F
Location and lc al description of lot to be built n
Lot 7 Block Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
BUILDING INSPECTION DEPARTMENT
••• ry ft T •••• .ttl•trI,,••• IITIVVVIC .
g4 -
v\)00
for no other purpose.
Date.—...--
N0.122 0 .
Building Inspector My Commission Expires
L ,19.X
/e2)
er 227/ /
04i .f „2,
Remodeling Addition Repairs No. of Stories . _
To be constructed of Kind o foundation col Covering ...._
.telli
Estimated Total cast of improvements $ I) 0 ...Amount of Permit L.
Zone cubage reqred — ....Plan Cubage —
Distance to next nearest building Size of Building Lot
Maximun-i live load to be borne by each floor _____..... ........... _. ....... ....... ..... ..... .. .. ..... ....
1 hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to ... .. . . . ......
Tr.e orwirrsicr.ccl appliumt for this building permit does hereby certify that he understands and accepts his obligation% a% an employer
of lAhor undrr the ,Hord. Workmen's Compel's:ow!, Act, being Section 5966, Compiled General Laws of Florida. PermAnent Sopp1■41ient,
ar,,i has com;,lird %%ill, the provision¼ thereof, and will require similar compliance from all contractors or sub-contractors emplo b bi
in t!A: work to bc 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 arc required by the Act. The undersigned agrees to employ only such subcontractors, on vvpit to be performed under this
pcnnit, as axe licensed by Miami Shores Village. . ,,,, i
Rein.uks.. , ___ (Signeti)A.---..e.-‘
•
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgmenu, personally ap-
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 suted.aze true.
Permit No.._ Date )i./ r Read, Sworn to and Subscribed before me.
Disapproved Date.
Notary Public, State of Florida
(Signed)
PLANNING BOARD - - DATE
Ch airman — Member ., --.......... ....... ---..........
Nfernber . - , Member - - — ,
Member . Member — - —
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained fotto
the Nation...4 ltu.ird.
A re fee of $1.00 will be charged when such re-inspection is nude necessary by improper notice for inspettion or faulty
materials anti/or workmanship.
SKETCH OF SURVEY
egc TH U
•
ALL NAILS AND C
TO BE . GALVANIZED (
X 2 ?.T WpAt a1L )
0 "
OOP ' 3/4' :is-
.:
8 I
ti.
. t t
1
THESE PLANS ARE APPROVED FOR
ISSUANCE OF A BUILDING PERMIT
VARIANCE(S) LISTED IN "REMARKS"
M: °..':1i S`l'1RES BUILDING AND ZONING
U';I.E:;;: SPECIFICALLY LISTED BELOW.
ArD COU:IIY LAWS MUST BE COMPLIED
.Mv+' n *el S'gn Date
■ WITH NO VARIANCES ❑ WITH
NO OTHER DEVIAT!O 'S FROM T'-IE
ORDINANCES WILL BE F'EF
ALL OTHER APP!.ICMQ' E STATE
WITH BY ALL PARTIES.
FIRE DEPARTMENT
PII5LIC V;OR;■S
POLICE CEPARTLIE:'.
BUILDING DIRFCTO;t
PLAWNG & ZO.:I,.G ..
VILLAGE COUi!I'.
APPROVAL
PRELIMINARY: FINAL:
REMARKS:
COMPLIANCE WITH THE SOUTH FLORIDA BUILDING CODE AS ADOPTED
BY MIAMI SHORES PILLAGE IS REQUIRED. THE ARCHITECT, BUILDER &
SUB CONTRACTORS P; :E ` " . ''' "''`' '''' K Ot'LENE OF All BUILD-
ING REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED HEREIN. j
PROPERTY OWNER
New Construction
Name t/ A .,,•o
Enclosure
Address 110 q5 SefiNgt
Alteration Exterior
Home Telephone ..)0 S"" .. 1' S y ,; 4
- /
Business Telephone G>ti S.,(— Y Y 7 — o ` a / /
rq, 3d s- -- 3 °) a -1.3 9a-
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I 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
Job Address: / 6o 1i q 3
Address Apt. City
Folio Number
Lot Block
Subdivision PB PG
Current Use of Property
Proposed Use of Property
Tenant Information
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
#escription of Work
Master Permit No.
Subsidiary Permit No. 3r. . t7a
Zoning Linear Feet
Square Feet
Value of Work
Tax Assessed/Appraised Value
PERMIT APPLICATION
Units Floors
9'8 Bldg Value
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
a
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone Fax
Qualifier Name
Page 2
1MPORTANT 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.
AFFIDA\'1T - Please read carel'u1Iv.
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, 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.
V 4 i
• ( � I
Si
Pnnt Name
of Owner
worn to and subscribed before me this
y
SEAL:
F FLORIDA, C
TY OF MIAMI -DADE
n
'amons
0
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Contractor / Qualifier
Print Name
Sworn to and subscribed before me this day of
PERMIT APPLICATION
0 l :,_,._1_,. '.� .....
,l ure of N i . ry Public ) -P . te'0I _ s ' s . : .. + Signature of Notary Public - State of Florida
1 P U & Ai'�':l-A M B. L...
�. ''" �(', CO LS" & . ,G,•,_ 1
t t . cc -3it:y7 IN
Personally known OR, Produced Identification `-- Personally known OR, Produced Identification
Type of Identification Produced:(
SEAL:
5 o ape of Identification Produced:
5'-O" MAX
2'-O"
Owner's Side
:111
I 4
4 m'
I II =III
a ° . 11 1- - -
-
I=II III
4" X 4" Wood post
/ 2" X 4" Woad Pail
1 "X6 "orI "X8"
Wood P Ickets
Concrete
WOOD FENCES
3u-0"
2915 Fences
Wood Posts
2915.1 Wood fences, so located on a property
that by zoning regulations they cannot be used
as a wall of a building, shall be constructed to
meet the following minirnum specifications.
(a) Fences not exceeding 5 feet in
height shall be constructed to meet
the following minimum
requirements: from nominal 4 inch
by 4 inch by 8 feet -0 inch long
posts spaced 5 fee -0 inches on
centers, having a fiber stress of
1200 p.s.i. in bending, and shall be
embedded 2 feet -0 inches into a
concrete footing 1 fcot -0 inches in
diameter and 3 feet -0 inches deep.
Other components shall be
designed to comply with the
provisions of this Chapter and
Chapter 23.
(b) Fences not exceeding 5 feet and 4
feet in height respectively shall be
constructed as provided in
paragraph 2915.1 (a) herein,
except that the spacing of posts
may be increased to 5 feet -0
inches and 6 feet -0 inches on
centers for these heights.
4' -0" High or Less = 6' -0" O.C.
5' -0" High or Less = 5' -0" O.C.
performed on
STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant,
attached survey, performed by
to of survey)
AFFIDAVIT
• / VA 4iL
SWORN TO AND SUBSCRIBED before me this day of
Notary
does hereby attest that the
(property own
6a€,13 0R4:1).
(name of surveyor's company)
■ ! Is an accurate representation of the existing conditions and
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the
property without first providing a survey less than six (6) months old. The Affiant, as property owner, further
agrees to remove or obtain permits for any structures which now may exist on the property which are not
permitted or which may violate zoning or building code regulations. The Affiant further understands that the
existence of any such structures may affect final inspections as applicable to this or other permits..
Further, Affiant sayeth naught.
Witness(sign and print) Witness(sign and print)
Affiant is personally known to me, produced as identification.
• 3-11 -2000 2 :28PM FROM JOSEPH R. COLLETTI 3055761756
LOT 10
BLOCK 2
SCALEu 1* ■20'
Ap
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L
I A
on P1. • •
0.75'CL �+ ``
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31I
2
•
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FP •
�+a • ..r ..o NNW Mt 1 III
110100110 .. • ... • •
■n IMP 7111 MIN Iasi. •
• •
• • • • •
• • • JOB 110,
naM[(ap 4111-31 i�P� • •
13.10'
LOT 17
BLOCK 2
N89 W 75.00'(R &M
24,75
POOL
ONE STORY
RESIDENCE
N. um
£0.75'
N89 °22'45" W 75.0C
13.00'
PK/VY
• ••• • • • •••
•• •• • • • •• •• •
• ,. • • • • • • • •
• • •• • • •
• ••• • • • • •••
•• • • • •• ••• ••
•
• • • •
• • •
•
•• • • • • • ••• ••
NE93ST
(80.60' TUTA Ivy)
WOuu
PIP
as
8
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°CRISIS°
LOT
BLOCK 2
P.2,
Miami Shores Village
10050 NE 2nd Avenue
hone: 305 - 795 -22
' Printed:4 /15 /2002
Applicant: JEAN
Owner: GAGNE
JOB ADDRESS: 1260 NE 93
Contractor
Local Phone:
Parcel # 1132050270210
Permit Status: Approved
Work: FENCE 5' HIGH
Signed:
Sign
Building Permit
Permit Number:.;: BP2002 -761
GAGNE
JEAN
ST
Contractor's Address:
Legal Description: 5 53 42 BAY LURE PB 44 -63 LOT 9
Page 1 of 1
BLK 2 LOT SIZE 75.000 X
Fees: Description Amount
FEE2002 -2185 Building Permit Application Fee $60.00
FEE2002 -2186 CCF $0.60
FEE2002 -2187 Notary Fee $5.00
Total Fees: $65.60
Total Fees: $65.60
Total Receipts: $0.00
Permit Expiration: 10/12/2002 Construction Value:
$200.00
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.
(INSPECTOR) BY:
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 ands 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 emp I / tom/
(Contractor or Builder) BY:
ELECTRICAL
TYPI?
Minimum Fee
QTY.
'TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
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
MECI-IANICAL
TYPi.:
Minimum Fee
()Ty.
TYPI?
Condensate Drain
QTY.
TN IT
Generator
QTY.
TN PE
Refrigeration, Tons
Q'I'1'.
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C WaWWin. 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
Supply, AC Well
,
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Temporary Toilet
PLUIIBING
.TYPE
A/C Condensate
Q TY.
TYpI:,
Drains, Roof
Q'T'Y.
TYPP:
Miscellaneous Fixture
QTY.
i 'i'i:
Soakage Pit
()Ty.
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:
SECTION
BY
D TE
Zoning
ate / �j
� / � bp
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
-�
�� 6 i
Page 4
OFFICE USE ONLY
C1IIIECi L1ST
1' 1i 2:_
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
Metropolitan Dade County (C.C.F.) $
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL ❑ BPR APPROVAL (Restaurants)
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
, P PERMIT FEES
$3.00 per page (Scanning Fee) $
Miami Shores Village
Bond
Inspector State Educational Fund $ (0.005 /sq.ft.)
State DCA (Radon) $ (0.01 /sq.ft.)
Code Enforcement Fine $
Zoning Review
(sq.ft. = x/I000
x 0.60)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $
ISSUING OFFICIAL
1 A
REVIEWED AND PREPARED BY: DATE:
CONDITIONjOF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL o (305) 795 -2207 o FAX (305) 756 -8972 o http : / /www.miamishoresvillage.com