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477 NE 92 St (10)/PROPERTY OWNER New Construction Name l fG—i G� g) l- 7 at� ( fJ Address , rT 1 ? �--t ( Sbi qZ t Z3, 36' Home Telephone ( 3..s Relocation of Structure -758, - 7 r b Business Telephone C -cas 9 75 - /- 0 Fax Add'l Detachment Other TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'1 Attachment Other Add'l 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 t t t l J obAddress: �i 2 S� Address Apt. Folio Number Lot Subdivision Current Use of Property Proposed Use of Property Tenant Information PB PG Zoning Square Feet Block PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax t--k IA-14( Sticr2CS L_ City State scription of Work Master Permit No. PERMIT APPLICATION Subsidiary Permit No. , Z)Ice --*'' Linear Feet HoLE Cas Ebs Units Floors 331 Tg' Zip )xalue of Work APPP_oX Ic. no Bldg Value 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 Page 2 PERMIT APPLICATION IMPORTANT NOTICES 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 $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLOWUNTY OF FLOW MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI-DADE ignature of Owner Signature of Contractor / Qualifier I IJ Print Name Print Name Sworn to and subscribed before me this day of worn to and subscribed before me this day of Si • :tore of .tars Public - �t to of Florida Angelo M Becker Personally known ! ` IaylY l$ $�nTiTica _ Personally known OR, Produced Identification r , Q1 s NOVe of Identification Produced: Signature of Notary Public - State of Florida SEAL: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2003 -550 Printed: 4/8/2003 Applicant: DIETER RUDIN Owner: RUDIN DIETER JOB ADDRESS: 477 NE 92 ST Contractor Local Phone: Parcel # 1132060140270 Legal Description: MIAMI SHORES SEC 2 PB 10 - 37 LOTS 21 & 22 & W15FT OF LOT 23 Fees: Description Amount FEE2003 -2054 Building Permit Application Fee $60.00 FEE2003 -2055 CCF $1.20 FEE2003 -2056 Notary Fee $5.00 Total Fees: $66.20 ermit Status: APPROVED Permit Expi ork: PAINTING AS PER AGREMENT If there is no permit package accessibh fee is $50.00, which must be paid in advai This Permit is granted to the contractor or builder nar ordinances pertaining thereto and with the understandin and approved by the proper municipal authorities. This authorization. A further condition upon which this perm ordinances and regulations pertaining to the work cover by his agents, servants or employees. Signed: In consideration of the issuance to me of this permit, with the plans, drawings, statements or specifications s myself, my agent, servants or employes. Building Permit Contractor's Address: Page 1 of 1 Total Fees: $66.20 Total Receipts: $0.00 Paint Color Approval and Agreement DATE: t G OWNER'S NAME: I 1 i Q. PHONE: cS 7 75 - I6 ADDRESS: 47 7 72 ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * ** * * ** ADDRESS OF SITE: (fl 7 — 2 CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted.: Walls 4 44 - Lt Fascia Drip Cap/Drip Edge Soffit Wub 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 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•les. WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION Building icial ate 4/23/01 ■ Signature of Owner Da e Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: 2 J © 3 OWNER'S AME: ' \ e co PHONE: (300 1 5-43 ADDRESS: Irrf 1.. 92 C Te. ( --n S t* �S r--?( g --? (g *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: 117 q2 eT12._ 4-4-44 : S c es 1 a CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls c Vt o .t L US Fascia Drip Cap/Drip Edge ) +(\ Soffit I � CA/ Roof Flower Bins Shutters Awnings Chimney Doors and door jams Garage Doors Railings .S Fences Decorative Metal APPROVED: All brick (simulated or regular) Stucco Banding Any other stucco features / / Accessory' Buildings t- f Other d that all w ork compliance all ` P applicable laws ® t rn OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate G 7 � and will be done in com liance with 1 re ulatin g � °'"� g g construction and zoning. I authorize the above -named contractor, if applicable, to ©1» e do the work stated. Furthermore , the paint colors will be as per the attached sa � r Signature of Owner Date Signature of Contractor Date e�'�� *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** � WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION Building Official Date 4/23/01 ELECTRICAL TYPE Minimum Fee QTY. 'I'V'1'E Dryer QTY. TYPE Outlet, Appliance QTY. Tv P1•: Service Repair Q'I'V'. 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 MECHANICAL TYPE Minimum Fee QTY. TYI'E Condensate Drain QTY. "I'YPE Generator QTY. '1'YI'E 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. "'vi'P: Miscellaneous Fixture QTV'. 'I'YI'F. 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 Metropolitan Dade County (C.C.F.) $ 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) ❑ OTHER (Specify & Attach) $ $ S. ob. SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE 0/ 3 (s .6. x/1000 x (¢.005 /sq.ft.) (¢.01 /sq.ft.) 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 4 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE t'' I E, St — c Tax Folio / ( — j o Z d O ":1 Dal Legal Description !'6!5 a L - ?3 mC P 3 7 Historically Designated: Yes No Owner/Lessee / Tenant <F. a no, / Master Permit # 3 7 7o Owner's Address ` 1 A)! 9 a Phone ! S 6 q05‘ 70 IQI • 130 ss# ), 66 (" 79 a Y a - Date ,;Job Address Contracting Co. gvk e tr g f i/ l i Qualifier L � t.0 L t C F 6 ®Lb s tate # e t ' i' Municipal # I -A-) Address Architect/Engineer Bonding Company Mortgagor Permit Type (circle one) BUILDING LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION ?( �� C511Z. - �- rn L- .� �A / - - 1 Competency # Address Address Address Square Ft. Estimated Cost (value) X 2/C 136 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 accr ate and at al ork ill 1(e, done in co_npliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above - ed co � 4Alket5 R e e x - y ge) R5 Signature of owner and/or Condo President Date z t � ) e )3 •� `�� / ! , �f ' Notary as to Owner and/or Condo President Date My Co 1111 FClMrP 4pooSICIAL NOTARY SEAL O e, SANDRA M MONTIEL * w * C NUMBER ::h,• < CC401261 o 7 ',„ q' MY COMMISSION .EXP. ``'oF F. AUG. 17,1996 FEES: PERMIT RADON C.C.F. My Co NOTARY ,) stated. Signature of Contractor or Owner- Builder Notaryy a ,. s ontractor or Owner - Builder IBI$FICIAL NOTARY SEAL Y- SANDRA M MONTIEL * COMMISSION NUMBER CC401261 T � ( c QN MY COMMISSION •EXP. OF AUG. 17 1998 APPROVED: Zoning Building Electrical °) V4P Mechanical Plumbing Engineering Date ■ TOTAL DUE ' / Date