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SIDEWALK3 MIAN:* SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date �` 2 Time �-- Type Insp'n Permit No. SP o .1 J ` ) - 2 z * (rtefl Name Address O2 • ! F_ "1a 5+ Company 1 C O ! & a XJ Phone# For Inspector: 4P 1 3 Approved Re- Insp'n Fee CONTRACTOR L J p A Name `-Q O F� a ,4 3L « License No. CGtC� ; CZ/ — oo �' Home Telephone 6,3Z:81 <' + ^ Sy a 10 ! Address 9o( S,., , A. ks„,Q 0 40.Q A cj -3_ cc Pc-re N .L 3S4-2,/ Telephon( 6- c.3 2G - 45 41 Fax Qualifier N e €4 C- VA 432 x ; 0 i• PROPERTY OWNER New Construction Name a P--5 . e0. (S eTTQ._ G C k Address 02 �V „ 1 ` z-, C� 2 s + asi _ A ∎ _0.; S� f '1. Home Telephone 6,3Z:81 <' + ^ Sy a 10 ! Business Telephone Fax 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 Step I. Job Address: o2 Address PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other MAY 11 . 4 2003 PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. City Folio Number Lot Block Subdivision PB PG Zoning Current Use of Property Square Feet Proposed Use of Property Value of Work Tenant Information Description f.,,IVorlt Units PERMIT APPLICATION Subsidiary Permit No. INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: 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. State Linear Feet Bldg Value Zip cam` IZS • tz) t`t C. Floors Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Page 2 IMPORTANT NOTICES I. 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. 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. OR, Produced Identification Type of Identification Produced: Type of Identification Produce Personally known PERMIT APPLICATION SEAL: Personally known OR, Produced Identification ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. 'I'1'1'1: Outlet, Appliance QTY. TYI'I: Service Repair QT1'. 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 11'IECHANICAL TYPE Minimum Fee QTY. TYPE. Condensate Drain QTY. TYPE Generator Q"I'1'. 11 PE Refrigeration, Tons Q'I'Y. 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 Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. Ill'1. Miscellaneous Fixture QIl. IlPi: Soakage Pit QTY. 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: 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 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) CI OTHER (Specify & Attach) PERMIT FEES $ (60% 00 Metropolitan Dade County (C.C.F.) $ Q/ t (9 0 $ SECTION Zonin Electrical Mechanical Plumbing Public Works Structural Building Official (s .6. x/1000 x (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) Cl CONTRACTOR REGISTRATION (On File) TOTAL $ ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2"° AVE., MIAMI SHORES, FL c (305) 795 -2207 0 FAX (305) 756 -8972 0 http:/ /www.miamishoresvillage.com 6 MST - - - ) 5.7 I a y4. A , 6 \ ><,,, • • 6 0F) V /4 ° nt 1464 7 'iorift 41" • v ow, lett. IC 641a; WZ!tir: e• c.,69, ismaggaiEssmaisimgowsigiaiiI3EP A / /A 1 7 ( 7 ' ; • 4es Q !', 4 A,,m,v ' > tb_O � �! c_> >�?��;� a� Y ?;�`'1! (6 JET 'n fir^. whir h c L 1, T o� 0er ,z,_„:1,,,,„ � , -2 f±,../.?..) 0 .4(4'.fr j' . �9e Y ' %) ♦.- - - 4 ,rya - '� P � Nr ! .�'�;��v4�9�."y � � � Cr �� �-v C'J Lam, tom X: =: - �- . I i 4" _ �"= /�,� ` or rv�v, ,> G,— ter' Cf -c C' G� � (�'. d;, U-(` {. `. ' - x - 'a. -�YL, e - � I` �� —=LLr • i • ' i v l ° I I ' — ; I I —I -I I I- �I P= ATI ®N FDP BUILDING PERMIT 8 E MI SHORES TILLAGE BUILDING INSPECTION DEPARTMENT �.`. ss Application is hereby made for the apjproyal 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 - . °� f f _ Registered Architect and /or r = gineer // Name and address of licensed contra or_ Location and legal description of lot to be • uilt Block . Subdivision....... Shat and Number w h e r e w o r k is to ba done.... .. a .. State work to be done and purpose of building (by floors) Remarksfj.. STATE OF FLORIDA, COUNTY OF DADE. ss. Disapproved �(� , Date._ (Signed) �9( _3 Building Inspec Addition ANNING BOARD DATE ....... ....... _.................. ........ and for no other purpocsa. Repairs No. of Stories New Building Remodeling To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ 71® 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 submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to - 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 5968, 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 der this permit, a 'censed y rrl} Shores Villa v - - ... l -------------- --- -- igned ) Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ac,' aowledgments, personally ap- peared --- - - - - -- - 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 / ( 4S - cc Date _ Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires to me well known, Chainnan __._ _ Member Member Member Member _, _- Member - Council Approved. _? ... _ Date Disapproved Date NOTE: A charge of k1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. t� A re- inspection fee of $1.00�lwill be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING / Vy. ELECTRICAL PLUMBING Owner of Building Architect Contractor a ._ . - .} or Builder Legal Lot Bl. / Description Address of D ; Building 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 appli- cation 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 plane chan without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above es 44 _re ibilityliot horough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans- awin s!or in tstatements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. i� ' - /i:9 f /, !?P Signed. In coj ideration of the i "su ice to me of this ermit I agree to perform the work covered hereunder in compliance with - I1 Ordinances andiregulatkons pertainin eretAan . strict tOnformniW,w th ' plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accept4n Hermit �- ass uixf responsibility nfork done by either myself, my agent, servant or employee. 1, << Work,to be performed under CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE ' /, / PERMIT N? 4864 this Permit Subdi- vision Value of Project j Contractor's License No Amt. of ' Permit - d. 2' 194 'INSP By AUTHORITY lUILDING LECTRICAL 'LUMBING MIAMI SHORES VILLAGE, FLORIDA DATE 194= PERMIT N2 4 8 6 4 Contractor's License No. Work to be performed under this Permit Owner of Building Architect Contractor Dr Builder Legal Lot Bl. I )escription Address of Building 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 appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work wil 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 respon- sibility for work done by his agents, servants or employees. Subdi- vision Value of Project Amt. of j Permit CONTRACTOR OR BUILDER BY AUTHORITY 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. Miami Shores Village 10050 NE 2nd Avenue Building Permit Phone: 305 - 795 -2204 Permit Number: BP2003 -800 Printed: 5/16/2003 Applicant: Owner: JOB ADDRESS: 302 NE 92 Contractor ICOA CONSTRUCTION Local Phone: 786 - 326 -4041 Parcel # 1132060136480 ST Permit Status: APPROVED Permit Expiration: 11/12/2003 Construction Value: Work: SIDEWALKS REPAIR (CONCRETE) $700.00 Page 1 of 1 Contractor's Address: 901 S. W. 4th Avenue, Apt. B1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 11 & 12 BLK 48 LOT SIZE Fees: Description FEE2003 -2963 Building Permit Application Fee FEE2003 -2964 CCF Total Fees: Amount $60.00 $0.60 $60.60 Total Fees: $60.60 Total Receipts: $0.00 compliance with all ordinances and regulations pertaining thereto and in strict ami Shores Village. In accepting this permit I assume responisibility for all work uer) BY: 'STATE OF FLORIDA) COUNTY OF DADE) attached survey, performed by Mew . Q N a c N-12 0(IL G. The undersigned Affiant, , does hereby attest that the (property owner) (name of surveyor's company) performed on , is an accurate representation of the existing conditions and (date of survey) 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. Wi si`' and print)' SWORN TO AND SUBSCRIBED before me this /3 day of Witness(sign and print) Affiant is personally known to me, produced 2N -0o ' • Cs identification. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 B uilding Inspection Request Dat‘/ / j v3 Time Type Insp'n lV Permit No. P 7 °C 0 0 Name ddd Address _3 O *k o� . Company \ /r." Phone # ? U ` 3 17-L-)191) For Inspector: W / b 3 me & Date Approv orrection Re -Ins i'