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PAINTApplication is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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. O wner's Name and Address Registered Architect and or Engineer Name and address of : icensed contractor_ (1 fl� _/� I Location and legal description of lot to be built on: Lot het and Number where work is to be done '.1 te work to be do e and purpose of building (by floors), state exterior colors (submit samples) Y New Building To be constructed of STATE OF FLORIDA COUNTY OF DADE. Block I SS. Remodeling Building Inspector Disapproved (Signed) APPLICATION FOR BUILDING PERMIT MIAMI SHORES VILLAGE TIDING INSPECTION DEPARTMENT Subdivision L'J •i � Nr � /j ( rg6l I / n/r F'� l �.✓ Addition Repairs :1 , Kind of foundation Roof Covering L. =st mawd Total cost of improvements S ._ V Amount of ?ermit S Zone cubage required Distance to next nearest building Maximum live load to be borne by each floor I hereby submit all 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 obligators as an employer cf 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 wort such public notice or notices as are required by the Act. The undersigned a is to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. to Remarks (Signed) Before me. the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally eppeared to me well tnown. 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 app 'cation, and that he did sign the same, and that all facts therein by him stated are ':rue. C Permit No. ‘-) r r%'a! Date / � `� Read. Sworn to and Subscribed before me. Plan Cubage 6fF No _ Street e • 3 Size of Building Lot Notary Public. State of Florida D No. of Stories My Commission Expires PLANNING BOARD DATE Chairman ___ _ _ Member Member Member Member Member Council Approved slate Disapproved and for no ether purpose Date NOTE: A charge of S23.00 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 S25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and or workmanship. APPLICATION FOR BUJILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 tl•e 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. w:iether 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 Z Registered Architect and or Engineer Name and address of licensed contractor 4 Location and le al description of lot to be built on: Lot _____ { / y I7 Block_ Subdivision s I / P /1 ge,zp / e i ` .— Street and Number where work is to be done � ` State work to be done and purpose of building (by floors), state exterior colors (submit samples) f i t a 9 'iCr/ MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Date 3P 7 / ' 19 6 f No. LV 6A Street c / and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof C yering_ Estimated Total cost of improvements S 6. Amount of Permit S 7 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 plans and specifications for said building. All notices with reference to the building and its construction may he sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons 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 subcontr: ctors. on,,work to Le perfor med under this permit, as are licensed by Miami Shores Village. r i Remarks (Signed) STATE OF FLORIDA COUNTY OF DADE. } ss. Before me, the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared__ _ . ._ 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 t rue. Permit No. Date � 61) I Read, Sworn to and Subscribed before me. Disapproved (Signed) Date Notary Public. State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member - Member Member Member Member Council Approved Date Disapproved _ Date NOTE: A charge of 525.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building ArC '.'.. t Ct Contractor or Hui:der Icgtl Lot Desorietien Li Li MIAMI SHORES VILLAGE FLORIDA BI PERMIT N? 5223 1 dc re,3s of Building CONrRACTCR O:? ° Jl'.` .R Work to be performed under this Permit_— Subdi- vision Value of Project $ DATE 195 Coniractc;r's License No. Amount cf Permit $ This pe:-mit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appaeatior. Lerefor in strict compliance with all ordinances pertaining thereto and with the understanding the: the work will bo performed in compliance with any pla is c.a:Ti -1s, statements or specifications that may have been submitted to and approved by the proper municipal authorities. Th s Permit may k : revoked at o ay ticre it tee work is net done is compliance with such ordinances or if the plans are changed without authorization. A further condition upon w - dch this permit is craned is the understanding that the contractor or buileer named above assumes the responsibility for a thorough knowledge of the ordinances and regulations rc to he work covered hereby whether shown on the plans or drawings or in the statemens or spocificatior.s and that ie assumes resT:onsi'eiltty fcr wail: c.e .c by 1_iu agents, servants or employees. Signed: -- – -- B?: — INSPECTOR Ir consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinance ; and regulation - r g thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miam. She co Village. In as- c::raiug this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY a PROPERTY OWNIEi't N 7-14)-#4,,e; e ''�9, 4�. 'l Address (/710 u "Iv r ✓I Oc' s�' 3©bp Nue 1fi6/, frii.4 / FL C-Lloaae Telephone e3 r-i lc_ I& siness Telephone ,... 5 ,_ q - s— g°a0 0 Alteration Exterior TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish ? +'elocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachmen', Other �[ c -_ -L _s_- 1- r. asas,e'� ;'stns ROCTIO IS °= the f4Ifilcclng s be taken to obtain, a peril t f'Wna the Miami1Slr re age: Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be ro'arized. ?lease print or type to allow for a more accurate processing of your application. If roofing work will be done, a rcofing application mus^ 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 processirg. During the processing of your application, you may be asked to submit additional information. Sob Address: 9 2 , 4G 7, ` ;LL - Apt. ' City Subdivision Current Use of Property Proposed 'Use of Property Tenant Information Address Folio Number Description of Work E x ' el `f / ° Lo: Block uil Electrical Mechanical Plumbing L?GX Roofing Fence MIT TYPE ( ✓ ) tling VC PB PG PERMIT CHANGE ( ) Chug. Contractor Renewal evisicrn EFSCens'cn Sgmplernean¢ einspection OOP ARC ' TECT Nr License No. Address 'Telephone Fan 111101111=11111111111.1111 11111111111111111111111 PEWIT APPLICATION Master Permit No. S:d3si iary Permit No. Zoning Linear Feet Square Feet Units Floors slue of Work 0 R ( C ) Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENOIINEE Name License Na. Address Telephone Fax CONTIRACTO Name License No. Address Qualifier Name State Telephone Fax ZI7 Page 2 In'IPORTANT 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, la' 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 0d! IDA, C2 UNTY OF MIAMI -DADE o 3 Signature Print Name Sworn t.• and subscribed before me this 0 day , SEAL: PERMIT APPLICATION STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of gnature f Notary ' . blic - State , of Flgti, :: : ;. Signature of Notary Public - State of Florida !I R C 1'b A ' - .. , ;C. i �, „i • r n _' n (Z:'.... -: C......n....... . . 1 C ' 1 .. .... c (•• • .. a Personally known OR, Produced Identification v Personally known OR, Produced Identification Type of Identification Produced: ) �,' (Y )3S7- - 003- b Type of Identification Produced: SEAL: Bidet IFilter Replace Pool Piping Outlet, Wail Sprinkler Repair Senice, Temporary Cap - Pinturre A/C Central 4-7 'Ton Fountain Pump and Abandon Cooling Tower Sprinkler System Heating Strips, each Cap - Water Gas - Appliance Pump, Domestic Yinture - Fluorescent Supply, AC Well Oven I Cap - Sewer Space Heater (kw) Gas - Natural Pump, Fire Stand Facture Light Temporary Toilet Parking Lot lights j Catch Basta Spas/Hot 'It las Gas a Propane Pump, Re-circulate Flood Lights 'Temporary Water Closet Piugmald/Strip Clothes Washer Subfeeds, Na. of Amps Gas Piping Pump, Replace - Pool 7:1 - Load Central Urinal Posts Dental Chair Swim Pool, Commercial Grease Trap Pump, Sprinkler Garage Disposal Utility a Sewer Range/Range Top I Discharge Well Swim Pool, Residential Ice Maker Pump, Sump Generators, etc. Utility - Water Vacuum Pump Receptacles Dishwasher Switchboards Indirect Wastes lclay Repair Disposal Interceptor Roof Nutlet Term Serv., Constr.,: ction Water Closet Compactor Domestic Weil Low-volt, IV.urglar Laundry 'Tray Septic Connection Water Heater Drzinfield, 4" Tile/Res. Lavatory Septic Tank ' - Temp Service Water Heater New Drair.s, Area Meter Set (Gas) Sewer Connection Repair Circuits Water Re-pipe Drains, :Floor Mum Fee Shower Service, Number of Amps Water Service Drains, French Miscellaneous 'Equipment Sink We:2, Supply i A/C Central 1.-3 on I Fan TYPE Condensate Drain Outlet, Wail TYPE Generator Senice, Temporary !, Refrigeration, Tons A/C Central 4-7 'Ton A/C Central, Tors Fire anup Cooling Tower Cutlet, Switch I Heating Strips, each Signs A/C Central 0-ilS 'Ton Yinture - Fluorescent Oven I Ventilation, Cost Space Heater (kw) A/C Central :6 'Ton Facture Light Parking Lot lights j Periodic Inspection Spas/Hot 'It las A/C Central 2:- Lon Flood Lights Piugmald/Strip Subfeeds, Na. of Amps A/C Window 7:1 - Load Central Posts Swim Pool, Commercial Air Conditioners Garage Disposal Range/Range Top I Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear VEG]af..crs . Recovery Refrigerator, Comm. (p/PH) Term Serv., Constr.,: ction Compactor Low-volt, IV.urglar efrigerator, Domestic Temp for Test - 30 days Dcep Freecer Low-volt, Fire ' - Temp Service Demolition Low-volt, lIntercomiTeleph. Repair Circuits Dishwasher Low-volt, Television Service, Number of Amps TYPE IVr_lnknum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. !, Refrigeration, Tons A/C Central, Tors Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. l'ons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of , ping, Flammable Liquid i Periodic Inspection 13Erhecue Fire Sprinkler System Process/Pressure Piping I 1 3ath Fan-Vented, # Fireplaces, Number of Pressure Vessel ,.., A83A801 - 88 , ,r , 38M:A04- , 411 , 144 , 11:',':":'''VW:r , t6r,t,43:) ,, ..:1- . • . r , Page 3 :INSTRUCT:CM: Pease indicate the type of work being performed and quantity(ies) in the space provided be:ow. 7.1/2 74 'QtY. TYPE QTY. TYPE Outlet, Appliance 7 I QTY. .1146 QTY. TYPE QTY. TYPE "I 7 QTY. 'YP A/C Condensate I3atb 'afo RECEIVE Dryer Drains, Roof Drimddmm Fountain , " 7 " -7,7 1 7-7 =irj1171121E13-1111 , I. Miscellaneous Fixture Miscellaneous Repairs 11MAMIND11111011101111111111111111141. PERMIT APPLICAT:ON Service Repair Soakage Pit Solar Water Heater AND REVIEWED BY: DATE: SECTION BY DA )CE / /.Z /4 Zoning Z' /' Electrical Mechanical Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY CIl -IECKLIST ❑ 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 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ Go9 0() $ .60 ( sq.ft. = x/1000 x ¢.60) $ (¢.005 /sq.ft.) $ (¢•O1 /sq.ft.) REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ V ° 6 ISSUING OFFICIAL I 1 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 MIAMI SHORES VILLAGE' Paint Color Approval and Agreement DATE: 0 0 - OWNER'S NAME: ih1 o r i 'e , Ni PHONE: 30 3-9 G3-2o a - 3 ADDRESS: c NE_ '73 S'i riik✓4 *,=**** *,4 * skyc** *,—, * * 4 ADDRESS OF SITE: O NE cr3 S`% 10/,474 / !� a'- CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ** ** **d es:c>;as: ** ******z. " . * **acs' . All Elements on the site must be listed and indicate the color to be painted. Walls Fascia vtJk . Drip Cap/Drip Edge ;v/,, Soffit Roof r/0,�.4 Flower Bins ei Shutters Awnings tAihd Chimney NV, Doors and door jams 4/ Garage Doors n/ ft Railings N� Fences RAM, Decorative Metal i/ //4 All brick (simulated or regular) /\//' % Stucco Banding i\144 Any other stucco features oki/as Accessory Buildings i'4 /A Other ry (J� 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 sam • .•*. . a I. . ' 0 A o 0 1 S u o Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: //4/6/ Building Of icial Date WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 PROPERTY OWNE New Construction Name 'rj�,� /.( . e f ;y4-:(k ✓ Alteration Exterior f' '"(5d%, Repair 31 1-Home Telephone 3 , )c . _ - 0 Demolish Business Tele2hoaz ca Relocation of Structure )ax a0 c° '' / - 0 S Foundation Only TYPE OF MANAGEMENT (J ) 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 1. Step 2. Submit the completed application with all necessary documents to the Buildirg, Planning and Zoning Department for process During the processing of your application, you may be asked to submit additional information. ° , CI ih Job Address: Tenant Information Complete the attached permit application which must be si ng ed by the pro pert owner and qualifier. Both sigiatures must he rotarize Please prict or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application tr ust be submitted along with this permit application. Proposed Use of Property PERMIT TYPE (E/ ) uildin Electrical Mechanical Plumbing LPGX Roofing Fence 0 er N E 9 < 2 "4,0 f ) L. Address Apt. City Folio Number CL: ,6 FE Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address 'fl'elephuae Fax Description of Work Master Permit No. Subsidiary Permit loo. ° ' / ' '1 ") Lot , Block r Subdivision PB 1 PG e Zoning Linear Feet Current Use of Property Square Feet Units Floors Value of Work b 6 a 0 Bldg Value Name Address 'Telephone 'Fan Name Address Tax Assessed/Appraised Value Flood Zone MIT CHANGE (I ) ENGINEER License No. CONTRACTOR License No. Qualifier Name State t 4 /) C) Telephone !Fan PE '1' KIT A P :K.:CA'II" ION Zip Ai Base Floor Elev. 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: 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. ST#" iip FFL%ti• ..1111 ate'' +e o fe ,er SEAL: IDA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE zee: i a 1 U .,/ai O , 1 P�2V Pi4 BARBARA ANN RJCs li? le' / n ca''s' , snoN tuuaea I � �P�,n 1 ' �O V/ c! :^ a:ss :O EniFIE.S Personally known - - - 01 Pradiiceii talon' Print Name \' Sworn to and subscribed before me this day of i� Q � Signature of Notary , ; . Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: PERMIT i1PPLICATION Personally known OR, Produced Identification •s r , A Type of Identification Produced: 8n 0 1gi S ll. C�� Type of Identification Produced: 'LSE ! RIC U TYPE Minimum Fee QTY. TYPE Dryer QTY. TY PE Outlet, Appliance TYPE Generator Q'rY. TYPE Service Repair Q'l'Y. A/C Central 1 -3 Tom Fan Cooling Tower Outlet, Wall Heating Strips, each Service, Temporary Bath Tub A/C Central 4 -7 Ton I rinking Fountain Fire Pump Miscellaneous Repairs Outlet, Switch Ventilation, Cost Signs Air Handler, Tons A/C Central 8 -I5 Ton I, actwork, Cost of Fixture - Fluorescent Piping, Flammable Liquid Oven Sprinkler Repair Space Heater (kw) Cap - Fixture A/C Central 16-20 Ton Fountain Fixture Light Pump and Abandon Parking Lot Lights Bath Fan- Vented, Spas/Hot Tubs Fireplaces, Number of A/C Central 20+ Ton Pressure Vessel Food Lights Pump, Domestic Plugmold/Strip Supply, AC Weil Sul feeds, No. of Amps Cap - Sewer A/C Window Gas - Natural FPL - Load Centr. Pump, Fire Stand Posts Temporary Toilet Swim Pool, Commercial Catch Basin Air Conditioners Gas - Propane Garbage Disposal Pump, Re- circulate Range/Range Top Temporary Water Closet Swim Pool, Residential Clothes Washer Chiller Gas Piping Generators, etc. Pump, Replace - Poul Receptacles Urinal Switchboards Dental Chair Clear Violations Grease 'Tap Eieat Recovery Pump, Sprinkler Refrigerator, Comm. (p/PH) Utility - Sewe Temp Serv., Construction Discharge We: Compactor ice Mauer Low -volt, Burglar Pump, Sump Refrigerator, Domestic Utility - Water Temp for Test - 3C days Dishwasher Deep Freezer 11rrarezt Wastes a w -volt, Fire Relay Repair Renew - Temp Service Vrcuunuo Pump Disposal Demolition IInterceptur Low -volt, Intercom/Teleph. Repair Circuits :Domestic estic We Dishwasher Septic �C Septic llanllt Low -volt, Television Water Heat Water Heater 1 \ue.✓ Service, Number of Amps ..LLan 22'..s], 4" LLe/Res. 1 TECHANI TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons Drains, Roof Cooling Tower Miscellaneous Fixture Heating Strips, each Vent Hood, Cost Bath Tub A/C Wall/Win. Tons I rinking Fountain 'i r yer Vents, Number of Miscellaneous Repairs Paint Booth Ventilation, Cost Air Handler, Tons I, actwork, Cost of Piping, Flammable Liquid Periodic Inspections Sprinkler Repair Barbecue Cap - Fixture Fire Sprinkler System Fountain Process/IPressure Piping Pump and Abandon Bath Fan- Vented, Fireplaces, Number of Pressure Vessel Pump, Domestic P LUMBIN G TYPE QTY. TYI'E QTY. TYPE QTY. TYPE QTY. A/C Condensate Drains, Roof Miscellaneous Fixture Soakage Pit Bath Tub I rinking 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 Weil 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 - Poul Urinal Dental Chair Grease 'Tap Pump, Sprinkler Utility - Sewe Discharge We: ice Mauer Pump, Sump Utility - Water Dishwasher 11rrarezt Wastes Relay Repair Vrcuunuo Pump Disposal IInterceptur Roof Inlet Water Closet :Domestic estic We Launc.ry 'Tray Septic �C Septic llanllt Water Heat Water Heater 1 \ue.✓ ..LLan 22'..s], 4" LLe/Res. Lavatory Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Water Service Drains, Floor Minimum Fee Shower Drains, French Miscellaneous Equipment Sink Well, Supply 7 - • Page 3 PERMIT APPLICA':i JON ENSTRUC'I EONS: 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) LI 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 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES s 6a Metropolitan Dade County (C.C.F.) $ r 47 h (sq.ft. = x/1000 x 0.60) (¢.005 / sq.ft.) ISSUING OFFICIAL Q d REVIEWED AND PREPARED BY: g B SECTION Zonin Electrical Mechanical Plumbing Fire Public Works Structural Building Official ffa- 2 r / /7 o7 DA 2 (¢.01 /sq.ft.) PERMIT APW,LICATION • U CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ 4s C) 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 Miami Shores Village 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305 - 795 -2204 Printed: 12/19/01 Applicant: TIi (? n.►i Owner: Contractor Local Phone: Permit Status: Approved Permit Expiration: Work: PAINT ROOF WHITE TO WHITE This Permit is granted to the contractor or builder named above to construct the ordinances pertaining thereto and with the understanding that the work will be perfo and approved by the proper municipal authorities. This Permit may be revoked at authorization. A further condition upon which this permit is granted is the understar ordinances and regulations pertaining to the work covered hereby whether shown of by his agents, servants or employees. Fees: FEE2001 -514 FEE2001 -515 FEE2001 -516 Signed: (INSPECTOR) Address: Cellular: IR consideration of the issuance to me of this permit, I agree to perform the work c with the plans, drawings, statements or specifications submitted to the proper author myself, my agent, servants or employes. Signed. (Contractor of B Pay to the order of e '� Parcel # 1132060130180 Legal Description: OR 12714 -1102 1185 4 LOT 6 BLK 2 LOT SIZE 50.000 X 128 OR 19407- 0454 -0455 12 Job Address: 50 93 ST NE Description Amount Building Permit Application Fe$60.00 Notary Fee $5.00 CCF $0.60 Total Fees: $65.60 6/17/02 Construction Value: If there is no permit package accessible on the job -site for insnPrtnr ••w._ $.• fee is $50.00, which must be paid in advance before calling fot THOMSON M. THOMAS Bank of America. ACH Ft/r 083100277 For /%thl4 iLi'c �IL�' 0 J% � �( fl 1' L�� Li �J u 6 $800.00 Page 1 of 1 $ 7, •r►'t*i4, f '4 Total Fees: $65.60 Total Receipts: $0.00 e :06 300004 ?m: 00 LLI 644 ?ll° s09 Date 1 f iliqk I $ 6s Bank of America Advantage 2509 63 -4/630 FL 994 Dollars 8 ,�„�. do the wo samp MIAD'iI SHORES VILLAGE Paint Color Approval and Agreement 1ER'S NAME: 6 l/6)17 PHONE: 3oc -9 6 :DDRESS: 5 - 0 l E cr:3 S� W/4i 7/, ice x xxxx ADDRESS OF SITE: r6 6 7 3 5 7 ! , v>, ft- CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: exxx;aXXXXX:S4* kxx xxxxxxx x xJ; exxx xxr :xxx 3IC )(e Asxx?r All Elements on the site must be listed and indicate the color to be painted. Walls Fascia Drip Cap/Drip Edge Soffit Roof 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 Buildings Other i �_ r 7 /c// Building icial Date J x xxxxxxxxx * xx.�xx >� 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 stated. Furthermore , the paint colors wi1l.be as yth. attached • • • • • • • • • • • • • • • • • • • • • • • •• ••• •• • • • •• Sign�" • Owner Date Signature of Contractor. ••• Date APPROVED: • • • • • • • • • • WH1N•P•AIIN''G ICS ISHED, CALL FOR F• • INAL ••• INSPECTION 00 • • • • o • • • • • • • • • • • • • • • • • • • •• •• • • • •• •• ••• • • • ••• • • 4/23/01