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670 NE 93 St (2)BUILDING ELECTRICAL PLUMBING Owner of Building Architect t. MIAMI SHORES VILLAGE, FLORJDA PERMIT N° 7496 Work to be performed under this Permit i c - Contractor or Builder Legal , Lo Description,. CO Of BUILDER F X Subdi- vision Value of Project BY DAT 4 .0 INSPECTOR tractor's License No Address of Building This permit is granted to the contractor or .wilder named above to construct the bu ding 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 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. r Signed:' ide Any of Permit , By , a ration of the issu ce to me of this permit I agree to perform,th work covered hereunder in compliance with„all ordinar e�a n r8 l lions o and in strict nfo pity with the plans, drawings, statement r specifications submitted to the proper authorities of Mian#Sh res Village permi as responsibility for a work done beither myself, my agent, servant or employee. AUTHORITY 1947 OWNER'S NAME H. L. GLAR% PRESENT ADDRESS , 9080 Biscayne Blvd. LICENSE NO. PHONE NO. JOB LOCATION (ST. OR AVE.) 670 N. E. 93rd Street LOT E Fe 11 BLOCK 63— SUBDIVISION Miami Sh GENERAL CONTRACTOR Paul Kinney & L. M. Griffin ADDRESS 108 N. E. 101st St. PHONE NU. LICENSE NO. 3068 BUILDING PERMIT NO. 7496 DATE 1 / 6 /49 M PERMIT FEE $ 15.00 BUILDER'S BOND NO. ( DATE ZONE REQUIREMENTS 17 ,5 00 • CU. FT. PLAN CUBE 1 CU. FT. EST. COST $ 11,000.00 DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: JDH DATE X NEW CONSTRUCTION TYPE CBS STORIES 1 Gravel CONSTRUCTION G+ avel INTERIOR CONSTRUCTION Plaster - Oak Floors REPAIRS DESCR IPTION Living Room, Jalousied Porch, Kitchen, 2 Bedrooms, Bath ALTERATION DESCRIPTION 1 car attached garage, ldy ADDITION SUBMITTED TO PLANNING BOARD APPROVED REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD SUBMITTED TO VILLAGE COUNCIL REMARKS CERTIFICATE OF OCCUPANCY NO. 7 I ISSUED _5/9/49 BY JDA TO H.L. . Clark 9080 Biscayne B1v BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE • INSPECTIONS DATE PHONE RE- INSPECT BY RE- INSPECT BY FOUNDATION 1/12/49 ��BBYY��JJ!!!jj��^ FEE TE ` aiden FEE TEMPORARY SERVICE ry 75 BEAMS& LINTELS SEPTIC TANK I� 7652 3/2/49 $ 1000 SEWER RANGE CONN. FRAMING SOLAR HEATER t' 5 GAS FIXTURES $ $ % $ INSPECTIONS DATE BY FINAL UNSPECT BY BY BY ROUGHING 1 / 1 9/49 JDH CLAN -UP , GAS ROUGHING PERMIT NO. 754 DATE PHONE FEE $ 6.25 y19/49 NEW BLDG. X l ALTERATION AC DITION REPAIRS SPECIAL PERMITS PERMIT NO. REPAIRS DATE FEE TE ` aiden FEE TEMPORARY SERVICE ry 75 1 / 1 4/49 SEPTIC TANK I� 7652 3/2/49 $ 1000 SEWER RANGE CONN. $ SOLAR HEATER MOTORS 5 GAS FIXTURES $ $ % $ INSPECTIONS DATE BY RE- UNSPECT BY BY BY ROUGHING 1 / 1 9/49 JDH ZDH GAS ROUGHING . i; . SEWER H. W. HEATER CONN SEPTIC TANK 3/3/1 H SOLAR HEATER FIXTURES C —M14 IVI � 1 p"1�� CONTRACTOR & 11 Electric PHONE [ H PERMIT NO. 7624 DATE 2121 49 FEE $ 7. NEW BLDG. X ALTERATION I ADD TION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE ry 75 1 / 1 4/49 $ 1.00 - H. W. HEATER CONN. $ RANGE CONN. $ MOTORS $ FIXTURES $ % $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE 2/22/49 ZDH ROUGHING . i; . H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL —M14 IVI � 1 p"1�� BUILDING N PECTIONS PLUMBING PERMITS & INSPECTIONS CONTRACTOR Seventh Avenue P1 bin ELECTRICAL PERMITS I& INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE BY be sent to A-9 Y MIAMI SHORES VILLAGE f Owner's Name and Address Registered Architect and /or Engineer Name and address of licensed contractor Location,and legal description of lot to be on: Lot w' Block Street and Number where work is to be done iBuilding Inspector Chairman Member Member Council Approved Date NOTE: A charge of $1.00 will be made for the Planning Board. A re- inspection fee of $1.00 will be charged materials and /or workmanship. BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval 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 heI•ein specified or not A copy of approved plans and specifications must be kept•at building during progress of the work. Date S U �� / .� �� No._ 4 'Z Street P ' f /,( --s and for no other purpose. New Building � RRemodeling Add •tiioo� �j Rep No. o Stories To be constructed of e • � ` e Kind of foundation ��' _`_=` _r d a _ Roof Covering__- Estimated Total cost of improvements $1L�r_,"_a___ Amount of Permit $___1 ` ' Zone cubage required _, - 7 _ ___________________________plan Cubage_ / 'Z f d - Distance to next nearest building 7 Size of Building Lot ' ' - / > Maximum live load to be borne by each floor �!� f�(rn!�✓��/S! f 1* I=AA . �rC� Subdivision 6' 2 � ' 5 State work to be done and purpose of building (by floors ) ____ ere: ' Y _ c' I hereby sub 11 the Tans jncd specifications for said building. All notices tth reference to the building and its construction may 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 s bt n ctors, on wo to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) PLANNING BOARD DATE ■ (6 W / STATE OF FLORIDA, COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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 carefull read the foregoing application, and that he did sign the same, and that all facts L therein by him stated are true: Permit No 6 Date ___/_ Read, Sworn to and Subscribed before me. Disapproved Date (Signed) e_ Notary Public, State of Florida "My Commission Expires Member Member Member Disapproved Date making corrections or changes to this application after approval has been obtained from when such re- inspection is made necessary by improper notice for inspection or faulty 4 - 17;7°FiLk C L.L) DC 1 1) fl 0_ C ;,J1 S I , 1:&----4011. CD Z1 I " 2t in 0 zi:s" x ix:* c-i 2.4 i1 .P\ zli-i Z, -x. 14 t" '-'- 3 1 4.4 T. "5 ff) IQ 40. 4 •, .ZLEVA 02_1'9" k" A-12e g 9 88 .1 s ' cr. 11 X 0 711 . ...._. ck . ......." 4■1%1 11,11DE -5 c-- vz IL-=. 2 6. -Lcom 10 — tai Ti- t_. ii,t J.(-: ...1 ‘ l 1,, v t k e ' . C,6 t C1 ":1: I e / 1 ..} aC , 1 0 0 .44- (5) Ao cie) do 6 = I 4.4 - -, 1 (c" {,-- , ,-, (,. 0 . ,,,,_., ) 7, 4 48 ..---.. iA' 8 1 t_ L.. ci, ,---4 t . -- roT,F1:, .‘„,t,,N.D1c zs: %T.,N---c.1.- = 18 2 4 8 0 C° (e" t - 11 Oat APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval 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 erein .4gecified or not. A copy of approved plans and specifications must be kept at building during progress of the work. \T 1 Date J CST r- ii ir r� f Street _ __ No 0 S v/ 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: Lot Block Street and Number where work is to be done New Building To be constructed of Estimated Total cost of improvements $ Zone cubage required Distance to next nearest building STATE OF FLORIDA, COUNTY OF DADE. ss. Permit No Disapproved (Signed) Building Ins NOTE: A charge of $1.00 will be the Planning Board. A re- inspection fee of $1 materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT work to bpine and purpose o uilding (by floor ) Chairman Member Member Council Approved PLANNING BOARD DATE and for no other purpose. Remodeling Ad Repairs No. of Stories Kind of fou ndation _ Roof Covering Amount of Permit $ e50 plan Cubage 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 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 • section on .: ite of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only su .r ntrac s, a .�., d permit, as are licensed by Miami Shores Village. Remarks ( Signed)_ rl Sit Read, Sworn to and Subscribed before me. its construction may k to be performe under this Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, on oath deposes and says that he is the of the above des ibed construction, that e has c efully read the foregoing application, and that he did sign the same, and that all facts therein by him st ted are true. 4 f Notary Public, State of Florida My Commission Expires Member Member • Member Date Disapproved Date made for making corrections or changes to this application after approval has been obtained from .00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty T 0 4 Street and Number where work is to be done APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval 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. // Date , 19 e/i/ T sG CJ. ee1Cf" No.. 670 Street /" ° 9 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: Lot /1 ' - / > Block 6-.3 Subdivision. e f O A/ o j ZY/I9/_?1/.__. r e S G7C I/ 7 3 57'. State works to be done and purpose of building (by floors) ........... ..% ,�1 ,°.._1�Qf/ --- rer7` f H�� /_ � h l- and for no other purpose. New Building Remodeling Addition Repairs ✓ No. of Stories / To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ le-5-0 aA Zone cubage required DIstance to next nearest building Maximum live load to be borne by each floor I hereby submit all the plans ar specifications for said building. be sent to_IZE/2C4 C5 QN rr2 0er/ow �o 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 Su1plement, 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, work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA, COUNTY OF DADE. j ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, 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 true. Permit No Disapproved (Signed) Building Inspector MIAMI SHORES VILLAGE Date BUILDING INSPECTION DEPARTMENT /o - Z; Chairman Member Member Council Approved Date r UCT /9 A/ Amount of Permit $ -Plan Cubage Size of Building Lot All notices with reference to the building and its construction may 5' /' u. r /V..¢4.7 to me well known, Read, Sworn to and Subscribed before me. 0 r.5'4d B Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Member Member Member Disapproved 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. rote 670 N, E' 93 S a' / iee®ars Ilk ace/Les C ®rosr, C . Job # 3b11i-} • MIAMI SHORES VILLAGE ' BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING 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 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 MR, 'Tom C C) r N Py No 670 Street NE 93 S/ Registered Architect and/or Engineer /1 Name and address of licensed contractor .T. m . m O I1T C O m € Y y - R00-4f03 l .O . � N c . Location andle� description of lot to be built on: Lot / / 4 12 / A Block 1 3 Subdivision Street and Number where work is to be done ( 70 u E 9 3 S T State work to be done and purpose of building (by floors), state exterior colors (submit samples) 1 -y- W D V r a 1 VS 40 Yes 1d enr 1 L 6) 03 (3 p r)(0,1 ¢ qCuvc O f pS � ' V Bowl .bid36pc10 / and for no other purpose. New Building Remodeling Addition Repairs V No. of Stories ( j � ' 1 V To be constructed of Kind of foundation Roof Covering U e ` 1) 6 Estimated Total cost of improvements S / 5O4 '30 Amount of Permit $ 30 00 Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor 1 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 obligatons as an employe of Labo Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement. and :s co •• , lied with the pr. isions compliance from all contractors or sub - contractors employed by him in the work to be performed u t cid will .. st or on the site of the work such public notice or notices as are required by the Act. The undersigned • • s p y on such ubco under this permit, as are licensed by Miami Shores Village. 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 "fRPN. Ciervkl'NS and who, being by me first duly sworn, upon oath deposes and says that he is the 1)CUAIe(a- of the above described construction, that he has carefully read the foregoin • application, and that he did sign the same. and that all facts therein'by him stated are true. Permit No. 7 65 Date Disapproved (Signed) Building Inspector Date Read, Swor and Subs ed jP_rW - 1(7 My Commission Expires PLANNING BOARD DATE Date /0Z U 19 g7 // 1024 / 1./ me. der the Florida Workmen's of. and will require similar to be posted for inspection rs. on work to be performed er us rac 'cam- b 10510 to me well known. III7 { (t tilArp�• e"STATE OF F'LORI)A KY COIINISSIO6l"CXP JUNE'2',199)- HUN*D TNRJ GE- NE1141.411$4-1M1"`- Chairman Member Member Member Member Member 'Council Approved Date Disapproved Date NOTE: A charge of $25.00 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 525.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING Architect Contractor or Builder Legal Description Address of Building MIAMI SHORES VILLAGE, FLORI 'A DATE Contractor' License No i PERMIT N° 9973 111111111111111111 , r k to be performed under this Permi I S L Owner of Building t 90 la This permit is granted to the contractor or builder timed above to herefor in strict compliance with all ordinances pertaining thereto and wit drawings, statements or specifications that may have been submitted to and time if the work is not done in compliance with such ordinances or if the plans granted is the understanding that the contractor or builder named a ove assum pertaining to the work covered hereby whether shown on the plans •r drawings done by his agents, servants or employees. CONTRACTOR OR BUILDER ro L SjE'nF Bl. In consideration of the issuance to me o pertaining thereto and in strict conformity with the p In accepting this permit I assume responsibility for all wo Sign Subdi vision �� $ at� nstruct the building or to install the equipment or device described in the app' the understanding that the work will be performed in compliance with any pla roved by the proper municipal authorities. This Permit may be revoked at any e changed without authorization. A further condition upon which this permit is the responsibility for a thorough knowledge of the ordinances and regulations r in the st. , ents • cifications and that he assumes responsibility for work Value of Project Amt. of Permit $ INSPECTOR ermit I agr to perform the work covered hereunder in complian with all ordi rawi _ , stanrs or ecifications submitted to the •roper authorities of nays < m • • ee. BY AUTHORITY 195_0 nces and regulations iami Shore, Village. N° 717 CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Miami Shores Village, Fla , Owner, Agent or Tenant of Building Lot Block_ Subdivision Street Address Approved use by occupancy Remarks This Certificate of Occupancy is issued to the above named for building at above named location only upo i the exppyess provision that the abide by and comply with all conditions of Ord" ances 92, 93/94 and 97, Zoning, Electrical, Plumbing and Building Ordin nces of Miami Shores Vi the erection, construction, alteration or remodelin. of Puildi o its BUILDIN applicant will known as the Village to VISION C OCC G.. PAID BY YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT NUMBER _ .24 ,,� �e f .,t �, J' 7 1949 x a_ 31- 5/9 �`� o o f-0. 19 g.� / /9 /I /1 -1 /-5 /.? - 3i -1/ a - a / - -3' / /z', o .y. . o-O / - /75--a - .1 - 5 - el -s 1 Ns-if /'3e5? ? 4 s 4 , , i i $ 8 . - -. /c5t7 �. vU V °- " ( / Al ADDRESS 670 N. E. 93rd St. LEGAL 1; 12 -11, Mk. 63, II S RECORD GARBAGE TAX Owner's Address Contracting Co. My Commission Expires: APPROVED: Zoning Mechanical PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date > S Job Address 676, Ai `s' Tax Folio Legal Description Historically Designated: Yes No / Tenant 7 A* S 614? o� , - 1 Master Permit # Li5 -,�� & 'lc 1,..), 6' is r— L Phone 7 S Z (6 / wV 51 - 53 S8 SL F_ Address 6:70 ) c. 6 ST _ Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one : BUILDIN a ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION r` n O v c e LD SST G. c70 S. S 7 I L cfc— / c2 - Ono C Square Ft. Estimated Cost (value) d / 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 construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. d?/L j �/ ' Signature of owner and/or Condo President Date Signature of Contractor or Owner- Builder Date Notary as to Owner and/or Condo President Date FEES: PERMIT 4 /0, RADON C.C.F. % • o v NOT otary as to Contractor' or Owner- Builder My Commission Expires: FL �, srn 3 'x_ R-• U— OMISSION NUM$ 4,u' Q CC797277 @ MY CO * 88fO EXPIfEA OF F1.S DEC ; E� •, r 002 TOTAL DUE 7"- ef Date Building +1+ C( lr ( 'r/ Electrical Plumbing Structural Engineer ti A uttai, c-CitztaTilia BUILDING AND ZONING DEPARTMENT 10050 N.E. SECOND AVENUE MIAMI SHORES. FLORIDA 33138 -2382 TELEPHONE (305) 795 -2204 FAX (305) 756 -8972 ROOF RAFTERS TOP PLATE HEADER /BEAM r -�a FLOOR — FT - STUDS '-i T i . - JwteT2' 12(� � BUILDING AND ZONING DE= ARTMENT 10050 N.E. SECOND A \'E••UE MIAMI SHORES. FLOFIDA 33.2S-2382 TELE ?HONE 13.0 ) 795.22J4 FAX 1305) '55-8972 ROOF RAFTERS 1 1] TOP PLATE HEADER /BEAM FLOOR ALL Gc. ..l' \fl r-- S�?:�r :'(40∎:; ?.5.,50 xw mrUs tWW4.NH_'i I i.µ ,1 Y r 64y ..� o t> t� -.-:.y. �'%tr C Lt:., i' \`Ioti • I ) 0. C J• ;. _ G. r' -4 ' 14 P , 1 ., MIAMI SHORES VILLAGE BUILDING DEPARTMENT �. 305- 795 -2204 Bu lding Inspection Request I Dat TypeInsp'n Permit NoZ? . 1� I Name QQ ( O Address (0 g35 Compan l Phone # Inspection Date Approved Correction a Re- Insp'n Fee ❑ to)-- plogs 411e,5 W011avoAA ro ifu-af)- Too--ea ouo Type Insp'n Permit No. Name ` bY Imo' Address ((n v ,N€ cr35- Company JL V Phone # Inspection Date Approved Correction Re- Insp'n Fee r) MIAM -I SHORES VILLAGE &' BUILDING DEPARTMENT '305- 795 -2204 Bukling Inspection Request Datd I t L05_ p/(5 loss 1/Ii ( )0I1a,ucii � Q-eul Los �ta lo-ecJi Pay to e Ord r of BankofA ACH R/T 083100277 Miami Shores Village 10050 NE 2nd Avenue Printed: 2/12/2003 Applicant: LANA & TOM CARNEY Owner: CARNEY LANA & TOM JOB ADDRESS: 670 NE 93 ST Contractor Local Phone: Parcel # 1132060141510 Permit Status: Approved Permit Expiration: 7/13/2003 Work: REPAIR WALKWAY TILES LANA R. CARNEY THOMAS M. CARNEY 670 N.E. 93RD ST: MIAMI SHORES, FL ,33138 — 10-6 erica. For I:06 300004 ?I: 00 L L96 ?4 25 7811' 6680 Date /iL / °3 ■ Building Permit Phone: 305 - 795 -2204 Permit Number: BP2002 -1381 Contractor's Address: Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOT 11 & E1/2 OF LOT 12 Fees: Description Amount FEE2002 -4402 Building Permit Application Fee $60.00 FEE2002 -4404 CCF $0.60 $60.60 Total Fees: Total Fees: $60.60 Total Receipts: $0.00 Construction Value: 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. 6680 83-4/630 FL 1348 ° $ GO j 6 Dollars Bank of America Advantage e equipment or device described in the application herefor in strict compliance with all ith any plans, drawings, statements or specifications that may have been submitted to not done in compliance with such ordinances or if the plans are changed without or or builder named above assumes the responsibility for a thorough knowledge of the is or in the statements or specifications and that he assumes responsibility for work done ompliance with all ordinances and regulations pertaining thereto and in strict conformity Village. In accepting this permit I assume responisibility for all work done by either BY: BY: Page 1 of 1 BLK 63 alamoftrawm. 1 6. 1.5 4.11 ,.\ 4. 1 ijreeeleiar • igrrfr 41 ? el -I / 8. ZS • ........ . . t‹) /p,/ // -_, 57: / a 78 • a • IL Ve • /..s. e P/0 4 , va -- ,..'tqrfti Z..4, • 12 ::\ / 4 .51 17 : YT A A Ar01111r4 1111Milt CY/ DESCRIPTION: ��MIAMI SHORES SECTION N0. 3 Lot 11,. and the East of Lot 12, Block 63, according to the plat thereof as recorded in Plat Book 10 at Page 37 of the Public Records of Dade County, Florida. ALL OF THE FOREGOING SUBJECT TO any dedications; limitations, restrictions, reservations or easements of record. ORDERED BY Buyer: Town & Country Brandon Loan #78 -249M PREPARED BY CHARLES D. WEBB, INC. 4712 South Le Jeune Rd. Coral Gables, Florida 33146 T11.: , '6! -795 I HEREBY CERTIFY: That the attached "SKETCH OF SURVEY" of the above described property is true and correct to the best of my knowledge and belief as recently surveyed and platted under my direction; also that there are no visible encroachments . unless shown thereon. Examination of the abstract of title will have to be made to determine • recorded instruients, if any, affecting the property, location and identification of utilities, pumps, wells and septic tanks on and /or `adjacent to the property were not secured. NOT VALID UNL BY S SEALED WITH AN EMBOSSED SURVEYOR'S SEAL til f ,y� ��/ /iii _ - . febb; Jr. d Surveyor OF'. FLORIDA ar es Reg. .L STATE Trox/ . 9/(6-r6v--/ _ 7k• / "�ZDD 187 Dec. 2, 1978 F.B. #Q -12 -50 Job #780476 ORDERED BY, Town & Country Loan #78-249M.' BY PREPARED BY CHARLES D. WEBB, INC. 4712 South Le Jeune Rd. Coral Gables, Florida 33146 T 6 itV DESCRIPTION: according rd and toohtheaplat 12, recordedin Book10Satrr NO. 3", Page 37 of according plat Public Records of Dade County, Florida. ALL OF THE FOREGOING SUBJECT TO any dedications, limitations, restrictions, reservations or easements of record. Buyer: Brandon Dec. 2, 1978 F.B. #Q -12 -50 Job #780476 I HEREBY CERTIFY: That the attached "SKETCH OF SURVEY" of the above described property is true and correct to the best of my knowledge and belief as recently surveyed and platted under my direction; also that there are no visible encroachments unless shown thereon. Examination of the abstract of title will have to be made to determine recorded instruments, if any, affecting the property, location and identification of utilities, pumps, wells and septic tanks on and /or adjacent to the property were not secured. NOT VALID UNL. ►S SEALED WITH AN EMBOSSED SURVEYOR'S SEAL Miami Shores Village 10050 NE 2nd Avenue (Phone: 305 - 795 -2204 rinted: 8/7/2002 .cas Applicant: i-- v \ Owner: - iG JOB ADDRESS: 670 NE 93 Contractor Local Phone: Parcel # 1132060141510 Permit Status: Approved Work: REPAIR WALKWAY TILES Building Permit Permit Number: BP2002 -1381 Contractor's Address: Page 1 of 1 Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOT 11 & E1/2 OF LOT 12 Permit Expiration: 2/3 /2003 Construction Value: H 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. Fees: Description Amount FEE2002 -4402 Building Permit Application I'ee $60.00 FEE2002 -4403 Buildier's Bond $300.00 FEE2002 -4404 CCF $0.60 Total Fees: $360.60 Total Fees: $360.60 Total Receipts: $0.00 kOKJ— 5c. f`?. BLK 63 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. Signed: (INSPECTOR) 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. Signed: (Contractor or Builder) BY: Miami Shores Village 10050 NE 2nd Avenue Printed: 8/7/2002 Applicant: ANDREW OLIS Owner: OLIS ANDREW JOB ADDRESS: 670 NE 93 ST Contractor Local Phone: Parcel # 1132060141510 Signed: Building Permit Phone: 305- 795 -2204 Permit Number: BP2002 -1381 Contractor's Address: Page 1 of 1 Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOT 11 & E1/2 OF LOT 12 Fees: Description Amount FEE2002 -4402 Building Permit Application Fee $60.00 FEE2002 -4403 Buildier's Bond $300.00 FEE2002 -4404 CCF $0.60 Total Fees: $360.60 Total Fees: $360.60 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 2/3 /2003 Construction Value: Work: REPAIR WALKWAY TILES 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. -(INSPECTOR) BY: BLK 63 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. Signed: (Contractor or Builder) BY: Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: BP2002 -1381 Printed: 8/7/2002 Applicant: ANDREW OLIS Owner: OLIS ANDREW JOB ADDRESS: 670 NE 93 ST Contractor Local Phone: Parcel # 1132060141510 Permit Status: Approved Permit Expiration: 2/3/2003 Work: REPAIR WALKWAY TILES Signed: Building Permit Contractor's Address: Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOT 11 & E1/2 OF LOT 12 Fees: Description Amount FEE2002 -4402 Building Permit Application Fee $60.00 FEE2002 -4403 Buildier's Bond $300.00 FEE2002 -4404 CCF $0.60 Total Fees: $360.60 Total Fees: $360.60 Total Receipts: $0.00 Construction Value: Page 1 of 1 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. BLK 63 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. (INSPECTOR) 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. Signed: (Contractor or Builder) BY: STATE OF FLORIDA) COUNTY OF DADE) yai _ Cliore Vi��uc�e AFFIDAVIT The undersigned Affiant/\ Lana_ cta-V,4oes hereby attest that the (property owner) C/ —= attached survey, performed by (Y L!) � ej��_�� (name of surveyor's company) performed orj t 2 , 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. Witness(sign and print) Witness(sign and print) SWORN TO AND SUBSCRIBED before me this 5 day of Affiant is personally known to me, roduced Z V cation. Ill' PG OFFICIAL NOTARY S " !. .I _ ' ANGELA M BEC1:Ey �I CO mnentzon NUMBEr4 r ^ • IOP•" ¢ CC786697 c ct` MY CO? ISf ON XPIR:!S OF P,O NOV. COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY WHEREAS, L a-f(1•CL. R. Catzinexl, hereinafter referred to as the Owner of the (owner) following described property: Legal description /folio #: Lot Block Subdivision Tax Folio #: requests permission to install: [4 sphalt, concrete, brick pavers [ ] Landscaping [ ] Other within the public road right of way of m arni SJorcrj DRWeiufrV f� Pfe oic -t 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 - 2382 Telephone: (305) 795 -2207 Fax: (3051756 -8972 SIGNED, SEALED, EXECUTED AND ACKNOWLED E on this • ay of SIGNED, SEALED AND DELIVERED in the presence CO 0 X13 Chca m∎n.cv (address) IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows: 1. To maintain and repair, when necessary, the above- mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. ?. The owner does hereby agree to indemnify and hold Miami Shores Village or dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligation has been canceled by an affidavit filed in the Public records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). The Sunshine State LICENSE NUMBER C650-536-44468-0 LANA ROPES CARt4EY 570 NE 13 ST MIAMI SHORES, FL, 331384000 BIRTH CATE SE( IT. REST. EtCORSE. 10-0844 F 5-04 A ISSUED EXPIRES 044340 1041144 Operation of a motor vehicle constitutes consent to eny sobriety test required by law. DUPLICATE 00-0040 WE DRIVER ✓J i o /4 G .Sick - at" cx° .9eizv -y ea • o -x ,,., /5 ' Z7 l' .91✓er/c /3.443 " o. /2.5.4. to . N Zo.;• f 1- s y . c a.s. Fes. z. f i 01 Mi i M /5.88' _ Z 1. I Pio'4r • Porc /8. 1J • • Y . 7 ;7 4 9."ale • jTz;�. ;^ ; (: Jai {�w:4.1� y ,c1L6 '7L•7 PROPERTY OWNER New Construction Name LTA 6 r TOtit Ci\N•+� ` ` Alteration Exterior Address (1 t O q3 t - NA. m l ∎ Skor-es, IRA • 3 (7)g Home Telephone 305 , C -- 1 _ / _ 2 (. _ Business Telephone-5 . ✓l1 - 4 s Fax Shell Only TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'l Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Job Address: 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 C10 RE 93 Bute) . Ftt a,livNi 3V.voN,5 , �'(/� 3� [3g Address A Folio Number t' `Description of Work DQ,I r wAl, u l + Lot Block Subdivision PB PG Zoning Current Use of Property quare Feet Units Floors Proposed Use of Property Value of Work 25o " Bldg Value Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Tax Assessed/Appraised Value Master Permit No. Subsidiary Permit No. PERMIT APPLICATION City State Zip Linear Feet Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name IMPORTANT NOTICES AFFIDAVIT - Please read carefully. Page 2 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YO the right to begin construction. HOURS OF CONSTRUCTION are li 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 C 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT 4. SWALES MUST BE PROTEC I ED FROM BEING DAMAGED BY required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FA 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 STO 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 fee 9. Department of Health and Rehabilitative Services (HRS) approval is re Management (DERM) and/or Miami -Dade Water and Sewer Departmen Application is hereby made to obtain a permit to do work and work will be performed to meet the standards of all laws regul . are required for ELECTRICAL, PLUMBING, POOL, EXT ROOFING and SIGNS and there may be additional permits re I, the OWNER of the property, have disclosed all informati months to the Building Official. Further, I am fully aware tha any other permit equals or exceeds fifty percent (50 %) of th present federal flood criteria for finished floor elevation. I am under this and any other permit exceeds fifty percent (50 %) conform to the current code requirements of the Building Cod WARNING TO OWNER: Your failure to record a NO improvements to your property. If you are spending more th your attorney or lender before recording your Notice of Co 22 N.W. 1st Street, 1°' Floor, (305) 679 -1078. Once recorded, t accordance with Section 713 -35 of Florida Statutes. Rev Choosing a Contractor. S'I[ATE OF FLORI�IA, C /ignature of Owne r • a /\ Print Name to and subscribed before me this .416 ure o Nota Public - S is of ' orida SEAL: Ci■ P 1P' e <i Personally known J ` Type of Identification Produced: UNTY OF MI % -DADE CRY CGK.:.:!.: ':?i . 7 QR,} `oduced lde`ntification -' � ,�. C CD 5 L/ PERMIT APPLICATION R VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant ed to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. EAN, NEAT AND SANITARY CONDITION free from construction debris. E FROM DIRT AND DEBRIS. • UIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is ILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer M DRAINS without approval from the Building, Planning and Zoning Department. from the edge of pavement. wired for applications involving septic tanks. Department of Environmental Resources (MDWASD) approval is required for applications involving sewers. nstallation as indicated. I, the OWNER of the property, certify that all ting construction in this jurisdiction. I understand that separate permits RIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, uired from other governmental agencies. n related to any work at the property performed in the prior twelve if the cumulative cost of work to my home or business under this and fair market value of the structure, the entire structure must meet the also fully aware that if the total cost of work to my home or business f the replacement cost of the structure, then the entire structure must CE OF COMMENCEMENT may result in you paying twice for $2,500 or intend to obtain financing, you may wish to consult with mencement. The Notice of Commencement must be recorded at: e Notice of Commencement must be POSTED AT THE JOB SITE in ew the brochure at Village Hall on Construction Lien Law and STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Personally known OR, Produced Identification Type of Identification Produced: ELECTRICAL 'I Minimum Fee Q'FY. 'I'YI'E Dryer QT1'. TYPE Outlet, Appliance Q'I Y. TY I'I: Service Repair QTY. 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. TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE 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 TYPE Miscellaneous Fixture QTY -,-,p,. 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 SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Constt uction) ❑ OTHER (Specify & Attach) $ Do $ o- 6 0 (sq.ft. = x/1000 x ¢.60) $ (¢.005 /sq.ft.) $ (¢.01 /sq.ft.) $ 0 O D T 10050 N.E. 2ND AVE., MIAMI SHORES, FL o (305) 795 -2 PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ . S b () ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 2001 07 c FAX (305) 756 -8972 a http : / /www.miamishoresvillage.com