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151 NE 93 St (6)Type Insp'n Permit No. Name- Address Company Phone # For Inspector: Approv Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time e Lae-41 1 / (Ntr.,2 � o 9)g Q l/ Nam P a e rrs ::: • ,..g• Roof Flower Bins Shutters Awnings MIAMI SHORES VILLAGE Paint Color Apptoval and Agreement g‘tf re ** Building Offici DATE: /b /0 7 OWNER'S N ADDRESS: /c7 E * * * * * * * * * * * * * * * * * * * * * * * ** ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements o the site must be listed and indicate the color to be painted. Walls (�C T v Fascia - ' Drip Cap/Drip Edge Soffit Chimney Doors and door jams Garage Doors Railings Fences Decorative Metal All brick (simulated or regular Stucco Banding Any other stucco features Accessory Buildings Other PHONE:zi 2 92d OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all appli,eable laws regulating const • , tion and zoning. I authorize the above -named contractor, if applicable, to do the . rk state «1Furthermore , the paint colors will be as per the. attached wner Date Signature of Contractor Date ************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** VED: WHEN PAINTING IS FINISHED, 4 k -"" CALL FOR FINAL INSPECTION Date 4/23/01 fi 157 7 Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Printed: 7/18/2002 Applicant: JUDY Owner: SALVADOR` JOB ADDRESS: .151 Contractor Local Phone: Parcel # 1132060133040 NE 93 Building Permit Permit Number: BP2002 -1267 SALVADOR JUDY ST Contractor's Address: Page 1 of 1 Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 E1/2 LOT 22 & LOT 23 BLK 22 Fees: FEE2002 -3977 FEE2002 -3978 FEE2002- 3979 Description Building Permit Application Fee CCF Notary Fee Total Fees: Amount $60.00 $0.60 $5.00 $65.60 Total Fees: $65.60 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 1/14/2003 Construction Value: $500.00 ; Work: EXTERIOR PAINTING AS PER AGREEMENT (OWNER BIULDER PERMIT) If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. Signed: _ !' SPECTOR) BY: This Permit is granted tothe 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. 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, dra • gs, 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, se ants or employes. Sig (Contractor or Builder) BY: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE ,/ ^ Si Date L Job Address /V WC 96 Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant ` ,'4 C9 07)4 Master Permit # 4/5 0 Owner's Address /J7 NC '/3 Sl / l 7/Z,�• Phone 5ar 7.1 ^ 990 Contracting Co. (rn #J " Address Qualifier SS# © 6hone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILD G ELECT ' CAL PLUMBING MECHANICA L ROOFING PAVING FENCE SIGN WORK DESCRIPTION l Square Ft. 3 , 620-0 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 cons : . n and zoning. F g. ermore, I authorize the above -named contractor to do the work stated. Si er and/or Condo President Notary as to Owner and/or Condo President My Commission ExNiP iRY PUBLIC - STATE OF FLORIDA LOIS E. LINDLEY COMMISSION # CC601852 EXPIRES 12.15.2000 BONDED THRU ASA 1- 888- NOTARYI FEES: PERMIT APPROVED: Zoning Mechanical cD ✓ RADON Date I� �a 1q5 Date Building *Noll, Estimated Cost (value) Z 5 B-0 e of ontractor or Owner - Builder r " -zL g Date Notary as to Contractor or Owner - Builder Date My Commissio UBLIC - STATE OF FLORIDA LOIS E. LINDLEY COMMISSION # CC601852 EXPIRES 12.15.2000 BONDED THRU ASA 1- 888- NOTARY1 C.C.F. / • " NOTARY BOND Electrical TOTAL DUE Plumbing Structural Engineer 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: Mcnday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. ST' OF FLORID • , COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE / . ii :" / . gn.1 of 0 /� Signature of Contractor / Qualifier ci f.) /. S v!) Print Name Sworn to and subscribed before me this 6 day of 41; e A o Vi' otary 2 Print Name Sworn to and subscribed before me this day of PERMIT APPLICATION Y gnature of Ofi lm- 'oTA. "' - Signature of Notary Public - State of Florida .\ e ANGELA XI paC,.r. SEAL: /I IN .. CC7$6697 \ ,'/i," .y MV co:..`.aSE'O:J 'x ?i:r'i Personally known .O Produced Identification ?ersonally known OR, Produced Identification Type of Identification Produced),_ 1) 2.„S 1 )3 m J j —,Type of Identification Produced: 6 SEAL: PROPERTY OWNER New Construction Name T `J � Alteration Exterior Address q 33 135' Home Telephone .O S -- 99 p 0 7 7 Business Telephone Shell Only Fax Add'l Attachment TYPE OF MANAGEMENT ( ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be 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. APPLICATION Job Address: /57 ,C/ 9 3 Address Folio Number Lot Block Subdivision Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PB PG Zoning Square Feet Chg. Contractor Renewal Revision Extension Supplement Reinspection PERMIT CHANGE (✓ ) ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No. &N-i'ii' Apt. City >escription of Work ©O TS D State Zip 1 A.1 T I(\ CD c S E Units Floors Value of Work .50C • " Bldg Value Tax Assessed/Appraised Value PERMIT APPLICATION FOOD, p60 Linear Feet Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name ELECTRICAL 'Il "1'E. Minimum Fee QTY. TYPE Dryer O'I'1'. '1'1'1'1•: Outlet, Appliance Q'I'1'. TYPE Service Repair Q I'1. 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 .vi. central, ions QTY. coonng rower QTY. Heating strips, each (1'1'1'. vent noon, cost QT\. A/C Wall/Win. Tons Dryer Vents, Number oT Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Sprinkler System Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Supply, AC Well PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. T l'PE Miscellaneous Fixture (1'1'1'. 'I'YPI: Soakage Pit QT\. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Primp 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 Pimp, 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 Pu`np, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Seplic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Sep ^rc 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. MECHANICAL "I'YPE Minimum Fee QTY. TYPE - Condensate Drain ()T1'. TYPE Generator (1'1'1'. '11'1'1: - Refrigeration, Tons RECEIVED AND REVIEWED BY: DATE: Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) O FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Code Enforcement Fine Zoning Review Notary ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) Metropolitan Dade County (C.C.F.) $ • 6 0 (sq.ft. = x/1000 x 4.60) Inspector State Educational Fund $ (4.005 /sq.ft.) State DCA (Radon) $ (4.01 /sq.ft.) $ 5,00 SECTION Zonin Electrical Mechanical Plumbing Fire Public Works Structural Building Official D 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. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com