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711 NE 93 St (8)1 (1 Atiomem The Sunshine State LICENSE NUMBER • V152-106-65-224.4 CARLOS F VIVANCO 711 NE 93ST — MIAMI SNORES, FL 331313;2906 BIRTH DATE • SEX HOT. REST. ENDORSE. 06-2445 M 643 ISSUED EXPIRES DUPLICATE 05-11-00 062404 00-0040 X080006111792 Operation of a motor velvets constituters consent to rely sobriety test mitered bylaw. MIAMI SHORES VILLAGE Paint Color ApprsvalandAtrieement DATE: 1- - OZ. • ••• • OWNER'S NAME: P11 B:1st, R Jo Li ADDRESS: 'III PE 93 Si-. ••• ..• ••• : '.• :.. ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: ••• •• • •• "' ••• . • • . • . • CONTRACTOR & LICENSE if a lic bl • • • •' • • COMPANY NAME: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls Fascia Drip Cap/Drip Edge Soffit j Roof Flower Bins Shutters Awnings mil. Chimney 3 Doors and door jams 2 Garage Doors Railings Fences Decorative Metal Si * * APPROVED: a; Building Offt6ial Date • • • • • ••• 61YY 89/135 Amarillo Lunar Sol Lunaire PHONE: Moonscape All brick (simulated or regular) Stucco Banding Any other stucco features Accessory --- Other 5A A--- 6 L/ 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 same 7 •ture of Own r Date Signature of Contractor Date ***************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *: WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 CANYON CLAY PROPERTY OWNER New Construction Name b 4., a, Ni \ G.S, co Enclosure Address 1 ` pJ e. q t 3 S -A- n Urv - ,SCvoreS C%t- ' Home Telephone ; s _- S (o g v �.r Repair , p Business Telephone 30 1 aL 3 a Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other K Job Address: 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. A PPLICATION Folio Number JXDescription of Work Lot Block Subdivision PB Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other ARCHITECT Name License No. Address Telephone Fax 1I o 5-1-. Address PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection Master Permit No. Subsidiary Permit No. M1 ClC`A S'oN - es Apt. City State e e oc cakes r9 PERMIT APPLICATION u PG Zoning Linear Feet Square Feet Units Floors lue of Work 3 Z1700 Bldg Value Tax Assessed/Appraised Value Zip 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 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. STAT gn'ue of Owner gnature of No SEAL: DA tJ UNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE C/-1:7-uu 1 (H- /JC Print Name o and subscribed before me thi C 8669 comiaSc. xryR _S O MY 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 Personally known OR, Produced Identification / / Type of Identification Produced: -L. l L_ J) . - 1 Q4 " 4�5� Ty ke of Identification Produced: ELECTRICAL "I"1'I'E Minimum Fee QTY. TYPE Dryer Q"I'1'. T1'1'1: Outlet, Appliance Q " I'1 . "PI'L'L: Service Repair Q I' 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. QTY. Minimum Fee TYPE Condensate Drain QTY. TYI'I: Generator QTY. TYPE Q"I'1'. Refrigeration, Tons 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 Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel PLUMBING TYI'li A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE: Soakage Pit QT1. 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: SECTION BY DATE Zonin : di FA `y Z) Electrical ' Mechanical Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) Cl FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) Cl 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 $ (io Z) �7b t a (sq.ft. = x/1000 x 0.60) $ (¢.005 / sq.ft.) $ (¢.01/sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ CP (0 ' 6 ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL o (305) 795 -2207 o FAX (305) 756 -8972 o http : / /www.miamishoresvillage.com