61 NE 93 St (4)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 the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regula-
tions of the Building Division of Miami Shores Village shall be complied with, whether herein specified or n. t. A copy of approved plans
and specifications must be kept at building during progress of the work.
MIAMI SHORES VI LLAaE ,
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Subdiv' io
Street and Number where work is to be done
State wo k to be d, ne and purpose of building (by floors) et,./..)a 1 —A 4
New Building_ _____ ____ —_ _ Remodeling_______________ Addition__ Repairs
Distance to next nearest building
Maximum live load to be borne by each floor
STATE OF FLORIDA,
COUNTY OF DADE.
appeared
Disapproved —_ — __ Date
(Signed) —_ -- — --
Building Inspector
mod- pm, ,9®/ ,e 4 0/q -- 9
To be constructed of_____— ____________ Kind of foundation ______________ Roof Covering
Estimated Total cost of improvements $_— _ of Permit $
Zone cubage required__ Plan Cubage
Size of Building Lot
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 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 subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks
(Signed)
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
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 be did sign the same, and that all facts
therein by him stated are true.
Permit No.__ I 7-3 Date G - i g Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD- DATE
Chairman Member
Member Member
Member Member
Council Approved_ - - Date Disapproved
and for no other purpose.
No. of Stories____—
_Date
NOTE: A charge of $1.00 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
,a ■ 11141
itsa
C 079
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pkv,a approved su bject zr ' e,.: ;9 t t r '= c; o-�nt .0 > it
.•ir: r era , 're 1? cc,W;*JD ®SY f4i�c;, ?8
, a
Jlr: s it:Age. l lar Ari::s.tz -- i .., ,; :.,:,r F4r'.^Cjd:iB; kvi
ea knowlet;ge of ail builder,{ regu :: vriiethdcr
o indics:red herein. Ali r.:Uaadarc -sl ftcol otettcQitiF;TA
6n”ning, electrical wiring; and roof fiask/lin c t ai
not be co nceale
UltE
[ANI Ge: G 1Rt
/COX /4" / 0 .7 ,t m
C-- S
W
•
be ore inspection.
# PERMIT NO. _ l o oeeveo.
1
4
T /L �az�
1
id . , 974/4 fl 7,70 glq,"
4 ,e4e, /6./59 Z -
/e4 / 1/94e/' AdAexavi
e//if
CHAIRMAN PLANNING QOAR1
3. —�
i
f
• MAYOR
OSCAR E. DOOLY, M.
iami Jhores
L O R ID A
ATTORNEY
ROY E. SAPPENFIELD
VILLAGE MANAGER
C. LAWTON McCALL
COUNCILMEN
M. B. ARNOLD
WALTER C. EARNEST
M. E. REYNOLDS
JOHN G. THOMPSON
ELECTRICAL
TYPI'.
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
'1'1'1'1{
Service Repair
)1 1.
A/C Central 1 -3 Ton
Dryer Vents, Number of
Fan
Ventilation, Cost
Outlet, Wall
Ductwork, Cost of
Service, Temporary
Periodic Inspections
A/C Central 4 -7 Ton
Fire Sprinkler System
Fire Pump
Outlet, Switch
Fireplaces, Number of
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. TYPF.
Condensate Drain
QTY. TYPE QTY.
Generator
TYPE Qyl'Y.
Refrigeration, Tons
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C WaWWin. 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
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
PLUMBING
TYPE
A/C Condensate
QTY.
TYPF.
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTY.
TYPE
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 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 govemmental 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 FLORIDA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE
d steLlyw
c? ,C4m
Print Nkfie
Sworn to and su► t'bed before me this �6\ day of
,� to El- .
Signature of Contractor / Qualifier
Print Name
Sworn to and subscribed before me this day of
Signature of Notary 'P ublic - State of Florida Signature of Notary Public - State of Florida
PERMIT APPLICATION
4 ,10 4 Lina Castel SEAL: SEAL:
* ' * My Commission CC902784
II Expires Expires January 17 2004
Personally known OR, Produced Identification Personally known OR, Produced Identification
Type of Identification Produced: Type of Identification Produced:
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:
SECTION
B
D E
Zoning
)fl/�
/
Electrical
Repair
,42
Mechanical
Fax
Demolish
Plumbing
Relocation of Structure
Fire
Foundation Only
Public Works
Add'l Attachment
Structural
-
/0 `( 2-2-
Building Official
Other
PROPERTY OWNER
New Construction
\Name
Enclosure
Address /- ' N - 9 , /
� rd. �:T
M(R -Nt) '34oRE5 -- 3( . g
Home Telephone 3 6 5 7 5 .., 9 9 0 49
Repair
Business Telephone
Alteration Interior
Fax
Demolish
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
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)
-- PERMIT FEES
$
(s .6. x/1000
$ (¢.005 /sq.ft.)
(q.01 /sq.ft.)
REVIEWED AND PREPARED BY:
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $ b 9 a
ISSUING OFFICIAL
DATE:
CONDITION OF A PPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL o (305) 795 -2207 o FAX (305) 756 -8972 a http : / /www.miamishoresvillage.com
APPLICATION
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step I.
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.
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.
1•
Address
Folio Number
Lot Block
Subdivision PB PG
Current Use of Property
Proposed Use of Property
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other ? j
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Zoning
Square Feet
Ydl of Work
Master Permit No.
Subsidiary Permit No.
Apt. City State
a scription of Work
PERMIT APPLICATION
• WOL'INIffirki
Zip
t o /- e) lE ay— al house
Linear Feet
Units Floors
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
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
'VbATE: . r ,2 4 020 D P-
Any other stucco features
Accessory
Other
APPROVED:
k N ME: .h in,) n 909
RESS:
�D 6//I/ E 93 (1. res
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
"DDRESS OF SITE: e &-t a /'e
CONTRACTOR & LICENSE (if applicable) 4 /
COMPANY NAME: --� PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls k) hi 7
Fascia ( 7"P
Drip Cap/Drip Edge 1.c>Ii 7/(0
Soffit Gv`j, 74
Roof k e eels . C 1.eotA i v - 16nratt
Flower Bins
Shutters
Awnings
Chimney
Doors and door jams
Garage Doors t
Railings
Fences
Decorative Metal
All brick (simulated or regular
Stucco Banding
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 to
do the work stated. Furthermore , the paint colors will be as per the attached
samples.
r ignature of Owner Date Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
i
Building Offi a Date
cn
b
. . .
•
-H
1-3 .
• C
b7 tl
cn
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01
Miami Shores Village
9
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
dmodb
Printed: 10 /3/2002 Page 1 of 1
Applicant: JUNON
Owner: SALOMON
JOB ADDRESS: 61
Contractor
Local Phone:
ees:
FEE2002 -5519
FEE2002 -5520
Signed:
NE 93
Building Permit
Permit Number: BP2002 -1678
SALOMON
JUNON
ST
Contractor's Address:
060130410 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 20 & E1/2 LOT 19 BLK 3 LOT SIZE
Description Amount
Building Permit Application Fee $60.00
CCF $0.60
Total Fees: $60.60
Permit Status: Approved Permit Expiration: 4/1/2003 Construction Value: $400.00
Work: EXTERIOR PAINTING AS PER AGREEMENT
Total Fees: $60.60
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.
SPECTOR) 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 C01 100702 1259 MC401 001774 CASH $60
`; _�-- Signed: (Contractor or Builder) BY:
Date
Type Insp'u.
Permit No.
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Name
Address
Company
Phone # )))
For Inspector:) / / '2 / °. name &