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FENCE PERMITType Insp'n Permit No. Name Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reque Date tc � 2 Time Approved Correction Re- Insp'n Fee PLA40 -3 Pt)/ The- tag A/g 3.95 l- For Inspector /b ® Name & Date a 9 igC 1 1 1 ION BY D • T Zonin: f/ 03 Electrical OF Mechanical Plumbing Fire Public Works Building Official Building %� 4% 7\ LJ Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ 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 (Attacbl • • • • • ❑ HRS / DORM A?PRtXV,IL. (Septic /•gewerl • • • • • ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERNIIT FEES o 0 • • • • ••. • • • • • • $ $_5 0 • • ••• • • • •• • • • • • • • ••••••• •• • • •• • • • • ( x .60) x/1000 (¢.005 /sq.ft.) (¢.0I /sq.ft.) .• • • • • PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL • • (Attach) • ❑ BPR APPROVAL (Restaurants) •• ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ •• • • • • • • •• • • • •• •• • • • •. • • • ••. • •• • • • • • • • • • • • •••• • • •••• • •• •• • • • • • •••• • • •••• • • •••• • • • • • • • • • • • • ISSUING OFFICIAL RVIE)VD1? AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 20W 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 0 FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com • • • ELECTRICAL , rvn; Minimum Fee QTy i ' Y i i, Dryer • • • • • QTY • • ,.. Millet! Appliance Q ' I ' Tyt Service Repair Q . r v A/C Central 1 -3 Ton Dryer Vents, Number of Fan Ventilation, Cost Outlet, Wall • •Ductwork, Cost of Service, Temporary Periodic Inspections A/C Central 4 -7 Ton Fire Sprinkler System Fire Pump - Outlet, Switch Fireplaces, Number of 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 Freezes • • • , •, Low -volt, Fire Renew - Temp Service Water Closet ■••• • Demolition • • • • 1 . 4 ;Low -volt, Intercom/Teleph. Repair Circuits Water Heater • 3YI tMasher •••• • • _ •Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL 't'1'tl: (j.7. TYPE Condensate Drain QTY. TYPE Generator QTV. 'iVPE QTY. Refrigeration, Tons i entral, Tons Itili Cooling Tower Heating Strips, each Vent Hood, Cost Bath Tub Dryer Vents, Number of Paint Booth Ventilation, Cost •Airliandler, Tons • •Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. 'I'1't'E: Miscellaneous Fixture QTY. TYPE 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 woriZeing perfocme'dAnd quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: Page 2 Signature of Ow . nt Name Sworn 01 : , • • fr .Lb and subscribed before me this I ' day of Di w . Pu11e i da STATE Signa 4 my Com salon DD150048 SEAL: g Expires November 15, 2006 AMI -DADE ••• • 0 • ••• • • • • ••• • • • • • • • • • • • • • • • • • • • • ••• • •• • • Print Name SEAL: • • • • IMPORTANT NOTICES • DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIWEED'FOUR VA+.IDI 1 D PEIeMPF 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'I1 4 CL'cA SINTI CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KJ T FRE; Ftzp vt PIKE' 4l Dk$RIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY mJIPMI{NT TEI3ICt , 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 progeoy, s ertify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. L ynderstanetaat sejaraterermits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FEh105, DRIV €WAY 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 tha prioryveeye months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my:home or busim%under t14.1and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, tflg strttjurj rneet theu present federal flood criteria for finished floor elevation. I -am also fully aware that if the total cost • • • • • p y t p� Wyk to my home or b rvsines9 under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, Man the ar►tire structurt'i1m r 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 • • Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida PERMIT APPLICATION Personally known OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produced: F.A ) L of Identification Produced: PROPERTY OWNER 1 p0 \iame • ii f 44 if-- 11'64 • • • • Address 1 Llectrical Home Telephon N S' ) 7 s--/--/.1 / / Business Telephon ., S1 Q 5 _ s -_ 3 2 f J f Fax Relocation of Structure Shell Only TYPE OF MANAGEMENT (✓ ) New Construction • • • • Enclosure 1 Llectrical Alteration Exterior Repair Alteration Interior Plumbing Demolish Relocation of Structure Shell Only Roofing Foundation Only Add'l Attachment Other Other Add'I Detachment Other 'rE'RMIT TYPE 4 ✓) ••: $6ilding • • • • 1 Llectrical Mechanical Plumbing LPGX Roofing Fence Other v s Job Address: Folio Number Lot Subdivision • • • •• • • • • •••• •■ •••• • Citgrent Use of Property 1)-ef 1y Address Block • •• 143 • • •. • • •• • • PG t • • ••• • • • P?dpbb8d Usepf relaerty •• • • Tg'alai jnformapQp • • • • • • • • ••• • • • • • • • • • • ••••••• • •• • • • • . PERMIT CHANGE (✓ ) Chg. Contractor • Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax • • • • • •• • • Mastef•Permit No. • • • :•• Substdiaty Permit No. •• •••• • • • • INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: •• • • • •• ••• •• Step I. Complete the attached permit application *tich St b sign :d property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate prc a tsiri of y :ur• ration. If: oofing work will be done, a roofing application must be submit- ted 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. A PPLICATION N,uu4l City Apt D cription of Work PERMIT APPLICATION P(a State Ihri t Fewee Bldg Value ”/)8 Zip Zoning Linear Feet quare Feet Units Floors Value of Work n • 00 Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Applicant: ARLEEN Owner: POITIER JOB ADDRESS: 1284 NE 92 Contractor Lc) Local Phone: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 4/7/2003 Parcel # 1132050270520 Fees: Description Amount FEE2003 -2000 Building Permit Application Fee $60.00 FEE2003 -2001 CCF $0.60 FEE2003 -2002 Notary Fee $5.00 Total Fees: $65.60 Total Fees: $65.60 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 9/30/2003 Construction Value: $1,000.00 Work: INSTALL FENCE 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 al ordinances pertaining thereto and with the understanding that and approved by the proper municipal authorities. This Permi authorization. A further condition upon which this permit is gn ordinances and regulations pertaining to the work covered hei by his agents, servants or employees. In consideration of the issuance to me of this permit, I agree with the plans, drawings, statements or specifications submit+ myself, my agent, servants or employes. Signed: Building Permit Permit Number: BP2003 -539 POITIER ARLEEN ST Contractor's Address: Legal Description: BAY LURE PB 44-63 LOT 15 BLK 3 LOT SIZE 75.000 X 125 OR 15967 -2718 0693 2 (2) JOSEPH W. POTTIER 3 ARLEEN POITIER 1284 NE 92ND STREET MIAMI SHORES, FL 33138 Pay to the Order of SunTru Bank ,( t4 s j ?17 // C.) c SU SJTRUST - • - . , .. .. with all 1_flC. flflflCfll_r•f1 m o annr nrr , r7 1,,. , r,I , Page 1 of 1 Date 5942 63- 60/660 1 $ (g e Socurity Dollars bitted to ut e of the work done conformity either _1l Pl �� ^ oR11)P• • • STATE OF FLORIDA) •..•. COUNTY OF DADE) The undersimed Afnant,_ attached survey, performed by performed a•• Witness(sign and print) 1 I 1 LGLITLL V LttC B .. AFFID,�YIT (prop'rtG4rner) r , does hereby attest that the (name of surveyor's company) is an accurate repres.- station of the existing conditions and • locations of all structures on the property as of this date. • • TI rpetgose of this Affidavit is to induce Miami Stores Village to issue a building permit for the . • __ • • • • p Ky first p �ovidirip a survey less than six (6) months old. The A • fnant, as property owner, further Q t e.s to r ...P..: Sfi?o Yi or obta •r -.�,; .. . . iit.paanits for any structures which now property which are not • may exist on the • " • fitted or.w•hkh may i viat zoning or building code regulations. The Afnant further understands that the • . .A . •••• •••• ...•. . • existence of ally such st ldtttfes may affect final inspections • • • • p as applicable to this or other permits.. • Fuct�tcr, Afi'iart;saygth naught. SWORN TO AND SUBSCRIBED before me this day of Alnant is personally Iaiown to me, produced • Witness as identification. • • • • • • • • • • • • .. • • • • • .. • • • • • •••• • . • ••••0 • • • •• •S.I.P. = F.I.P. = P.C.P. _ TRes. _ CL.. _ :114 _ •� • _ A.. • = �•• = •T •• •••• • ee.ee • Set 1/2 iron pipe LB761, Found 1/2 iron pipe Permanent Control Point Concrete Block Stucco ResidFnce dear Conditioner Pre DeItz• Radii :i::4 ilium c'ciitt ZONING, ZONED SIR -E7 LINES, SEA - BACKS, UNDERGROUND EASEMENTS AND RIGHT OF NAYS, ETC.. \� OR ABSTRACT TO BE VERIFIED AND/ O3TAINE.D . BY OyyNER, ARCHITECT OR BUILDER BEFORE DESIGN OR CONSTRUCT pit 3y2?' -d= 9O °ad 25,0 x ., • MIAMI/ SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby.upadc for the approval of the detailed statement of the plans and specifications herewith submitted for the build' ing 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 ° A/Af 1 Registered Architect and /or Engineer , y Name and address of licensed contactor A-- �� - lC� �� l.1j 1/ `'0...•.�! 9 Ll Date. /t/ NYj Ott.. ,tt ". 1.. •'tt'tt!!••tt •- '•Stitt Stt C!t . Location and legal ascription of lot to be built on: �� E 6.3 Lot AS Block ' Subdivision � _�.. -. Street and Number where work is to be done 12 ' 4 1 4 Af-E State work to be done and purpose of building (b floors) C NA /6" 0 ,tit& y Na t (9A HA m of labor under the Florida Workmen s Compensation Act, being Section 5966, Co..p. and .has complied with the provisions thereof, and will require similar compliance frog in the work to be performed under this permit; and will post or cause to be posted fo or notices as arc required by the Act. The undersigned agrees to employ only such s pcnnit, as axe licensed by Miami Shores Village Remarks STATE OF FLORIDA, t ss. COUNTY OF DADE. f .,..Before me, peared Disapproved V Date Building Inspector Chairman Member Member (Signed).. My and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of - 7 5. y� fou tion ` Roi Covering Estimated Total cost of improvements $4 Amount of Permit ... • Zone cubage required .Plan Cuhage Distance to next nearest building. Size of Building Lot /AS ti t /6 o I Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the buildin be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts hi ed General Laws of Flo all contractors or su inspection on the si ntractors, orn to and Sub Commission Expires g s and its construction may ligations in employer Sul,plement, loycd by him ch public notice rmed under this , Penman • ntractois the wor to be 4 e undersigned auth a notary public, duly uth ,zed to minister oaths and take acknowledgments, p . to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No 5 Date... ..._t Notary Public, State..ol Flo ootary narlta, State of Florida at Large ` dlq C- tnission• xpires -. :-- gr -}S$}- Bonded By Amorican Firo & Casualty Company PLANNING BOARD DATE Member Member Member Disapproved Date Council Approved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from die Planning l;o.rrd. A re inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection at faulty materials and /or workmanship. architect '. ontractor Builder egal Tescription A ddress of wilding Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA t3UILDING ❑ F. L ECTRICAL ❑ PERMIT N' 8151 PLUMBING ❑ HOOFING ❑ ❑ Work to be performed under this Permit Dwner of wilding Bi. Subdi- vision Sq. Ft Value of Project $ DATF 195 Contractor's License No Amt. of Permit $ 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 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. BY AUTHORITY Application is hereby made for the approyal of the detailed statement of the plans and specifications herewith submitted for the build- ing 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. Date P.le, //) J 19 , 1 9 Ns Owner's Name and Address.. 0 U,d i.,s._.__..M .a S CtfiE IQ F 1VieA No../ ?..$ Street. Al, E, 9-1n - ST Registered Architect and /or Engineer / / Name and address of licensed contractor._.. 1 A A. Y to % Q /� A 7 S C lam, 4✓ . 7_4 -S r Location and legal description of lot to be built on: Lot Block Subdivision io ubdiv T Street and Number where work is to be done /; 8 O! • 9 . --.-- -s State work to be done and purpose of e' 0 da Disapproved (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT uilding (by floors) * Chi A / / .(, / /viz . /C.4 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 $ l S Amount of Permit $ 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 p suubmit all the plans and specifications for said building. All notices with reference to the building and its construction may / be sent to.._'camt C■?.t- A".' � Sr /V. L-✓. 2 6 ¢ S T 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 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) 0 a r STATE OF FLORIDA, COUNTY OF DADE. J ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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 CI I / Date / — d Read, Sworn to and Subscribed before me. ate l�/ Notary Public, State of Florida Building I , ector My Commission Expires PLANNING BOARD DATE Chainnan Member Member 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 from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. / 1 0 A 8 1 N 1 `'s e et,