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PAINTPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Bate 0 2 • I J oWddress `LO rJC 4') S 7. Tax Folio Historically Designated: Yes No O�c.oE� bE(LA -(_ hick-13k_ cjo ' � Master Perm t # � i p (2..LrtY3 3 3 hone Legal Description 1/ Owner/Lessee / Tenant 1 4er's Address Contracting Co. Qualifier State # Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle o ' : B i ILDIN 3oS- Lu• 1351 C 2 C:)c C e v cetizelityess o 6 • d' ( cs.,2 2) SS# - - Phone Municipal # Competency # Ins. Co. Address Address WORK DESCRIPTIOI $ EXTE 1 O a__ e iA , n7 ^C-, o3 ( ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN Square Ft. Estimated Cost (value) o� Zoo . WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I 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, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President My Commission Expires: -e FEES: PE RADON APPROVED: Zoning Mechanical Plumbing Date L P My Commission Expir C.C.F. (� NOTARY as t . ' ontracto .,'CEO d �! uilding / 902(2e- ( Electrical er- Builder Si ::,i ture of Contractor c3wner- Builder Date 6i o lc g i - S eh- i� c=Yt a, a, 11 - A l S - S/2 9 /o Date 1 Li o FF11Clp! i aL �Tnv p��e _cttEa • Ni : 15F.!V.: aa: i iF.ZS - AY CO' :... F OF f� ARO V . 5 , ?3G I3OND O 2 TOTAL DUE 2 to Structural Engineer JIC MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: 11 Cf�l OWNER'S NAME: OC,ioco.) Ceb,E( rt- Q7•,,)L PHONE: ( - S�s� ADDRESS: 12(.0 OQL.A a. J Ft. ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: NO N)S q3 S P- T M i A,4 s11 -o2c.s, (2. CONTRACTOR & LICENSE (if applicable) fly COMPANY NAME: ,v /4 PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls ATTA`1A& S0c-1••■ t3eL,.,e Fascia iD) Pr . Drip Cap/Drip Edge rO /In Soffit �( Roof ,.9 /- Flower Bins nJ / Shutters J ) Awnings ,J IA- Chimney Door's and door jams Al A- Garage Doors Railings Fences Decorative Metal 'VP All brick (simulated or regular) o v/,1 Stucco Banding /v/ /4 Any other stucco features n/ /4- Accessory Buildings n/ Ji7 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 Signature o.4 - Aty€a Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION at" /z ; Building Official Date 4/23/01 BUILDING ELECTRICAL PLUMBING ROOFING f Owner of Building Architect Contractor or Builder ! • Legal Lot Description Address of Building PERMIT N° _ 3640 0 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA B1 Work to be performed under this Permit Value of Project $. DATE 195_1:— Contractor's License No. Amount of Permit $ Subdi- vision 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 Vlage. In ac- cepting this permit I assume responsibility for all work done by either," myself, my agent, servant or employee. r BY AUTHORITY 6.- ELECTRICAL TYPE. Minimum Fee QTY. TYI'P, Drytat • • • • • • • QT1'. • • • TYPE Outlet, Appliance Q'I'Y. 'I'yI'I 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-i- 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 Disposal Demolition Low -volt, Intercom/Teleph. Repair Circuits Domestic Well Dishwasher Low -volt, Television Service, Number of Amps Drainfield, 4" Tile/Res. MECHANICAL TYPE Minimum Fee QT't'. TYPE Condensate Drain QTY. TYPE Generator QTY. 'fYI'I: 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 In3pections Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Water Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Cap - Sewer PLUMBING TYPE QTY. TYPE QTY. TYPE QTY. TYPE QTY. A/C Condensate Drains, Roof Miscellaneous Fixture Soakage Pit 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 4 • • ••• • • • ••• • • • .•• • • • • • • • • • ••• • • • • • • • • ••• • • • •• • • •• •• • • • • • • • • • • • • • PERMIT APPLICATION INSTRUCTIONS: Please indiaate:the type:of fork Meg $exformed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning ne jE / ;it • Electrical Mechanical Plumbing Fire Public Works Structural Building Official 1 - 4 17 z' Page 4 OFFICE USE ONLY ❑ 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.) $ 1 Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine $ Zoning Review Notary ,46o 7 $ _5; z c • • • • • • .• • • • • ••• CI PROOF OF OWNERSHIP (Attach) - .. ••• •• • ❑ HRS / DERM APVROVAt ••; (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) ( x . f t. x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) • • • • • • • .• • • • • • • • • • •• • • • • • •. •• • • • • CHECKLIST • ❑ CONDO ASSOCIATION APPROVAL (Attach) • • 31:R7IPPROVAL (Restaurants) • • • •• PERMIT APPLICATION ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ g S.,. Z. ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: 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 Page 2 IMPORTANT NOTICES • • • • • 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALINATED•P@RM11''AND PERM11 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 CLEAT, jVE'A1''AN)1 QAp1}'I'MR.4' dr0t16ITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM flII2T' D DE$RtS : • 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQU?PMEr pR 114Y NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1°' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF y • • DA, CO TY SF MIAMI -DADE Signature of Owner om to and subscribed before me this 1 1 day Print Name , SEAL: =ot ►r",t Angela M Becker My Commission DD150048 Expires November 15, 2008 Personally known OR, Produced Identification ... • • • ... • • • • • • • • • • ... • • • • ... • • • • STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Personally known OR, Produced Identification ot Type of Identification Produced: / ^) > B ) 0 0 p e o Identification Produced: PERMIT APPLICATION PROPERTY 0 NER Wit( P Name / / d Address I'?v N E 9 J'd S7 /(AM +w; fk it 3 3 /YS Home Telephone (3 9 7 S8" -7fe4 Business Telephone t.704 3S /- Coe o x" 6/8 Fax - C3051 S 11 c c g5 TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other Step 1. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other • • • • • • • • • • ••• • • • • • • • • • • • • • • • • • • • • • • • ••• • ••• INSTRUCTIONS - The following steps must be taken to obtain a per •■ • • • •• ••• •• Complete the attached permit a4vlicaM wpicp n s:be: igned by the nrotlerty owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more otIraR prct ssl►cg of:(our application. If roofing work will be done, a roofing application must be submit- ted along with this permit applicetione • • • • • • • • • 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: Lt 0 E 3" 51. M i "►� i - S 4 v e S 1 y 3/ j$ Address Apt. ••• ••• • ••• Folio Number Description of Work P G ; v‘ Lot Block Subdivision PB PG Zoning PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax • • • • • • • •Mas Permit No. • • • • • • • • •• • • ' ' ' Stibsidiary Permit No. • • • • • • PERMIT APPLICATION it from the Miami Shores Village: City State Zip Linear Feet Current Use of Property Square Feet Units Floors Proposed Use of Property Value of Work h SO 0. 0 o Bldg Value Tenant Information 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 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12 /16/2002 Applicant: FELIX BOBE Owner: JOB ADDRESS: 140 NE 93 ST Contractor Local Phone: Parcel # 1132060133110 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 10 & W25FT OF LOT 9 BLK 23 LOT SIZE Fees: FEE2002 -7207 FEE2002 -7208 FEE2002 -7209 Signed: Building Permit Permit Number: BP2002 -2174 Contractor's Address: Description Amount Building Permit Application Fee $60.00 CCF $0.60 Notary Fee $5.00 Total Fees: $65.60 it St us: APPROVED Permit Expiration: 6/14/2003 Wor EXTERIOR PAINTING AS PER AGREEMENT Construction Value: $500.00 Page 1 of 1 Total Fees: $65.60 Total Receipts: $0.00 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. Signed: — (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 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. REG X01 121902 0901 I±C401 003502 CHARGE $65.60 (Contractor or Builder) BY: DATE: 1 ;Jo �'. .: .: _ .'..'. OWNER'S NAME ), x . � 13 l e :.. PHONE: 3os- 7r3 -7 ADDRESS: l i 0 E q ,7 tid S A4 1 WW1; S>^ o de s /'4- � 3 /J * * * * * * * * * * * * * * * * ** ******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE:'. F4 :T t 3 t.• - 3 ` .5 M;o; Stw 37138 CONTRACTOR & rTCEIiNSE (i'f ip lllcWble) / A COMPANY NAME: N / A PHONE: ******************************** * * * * * * * * * * * * * * * * *° * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted.. Walls Fascia Drip Cap/Drip Edge .6 Soffit 13 Roof W ∎,', re. Flower Bins Shutters Awnings Chimney Doors and door jams Garage Doors Railings Fences Decorative Metal All brick (simulated or regular) Stucco Banding Any other stucco features Accessory Other (4 Jr wt- rneag. w (rtdow - 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 Signatur6of Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: Building MIAMI SHORES VILLAGE PaintiqIpr+iipro?val and Agreement / ,2111 /oz /0'-/ ficial Date WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 •• • • • • • • • • • •. • •• • • • • • r• • • •••• • • • • •••• • • • • • • • • • • • • •••• • • • • • •••• • •• • • •• • • • • • •• 1