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75 NE 92 St (3)Owner of Building r.1 ti Lt-9 Architect Contractor or Builder Legal Description Address of Building CONTRACTOR or BUILDER MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ Date r rt `� ELECTRICAL ❑ PLUMBING ❑ PERMIT N? 10621 ROOFING ❑ ❑ Work to be performed under this Permit Lct 11 1 BI Contractor's _ a License No. w BY AUTHORITY 19 Subdi- vision Sq. Ft. e; Value of � 1 Amount of o. Project $ c °` t 11 Permit $ This permit is grrnted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict corpliance 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 :.s 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 tmderstanding 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. Signed •" `' l (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 responsibility for all work done by either, myself, my agent, servant or employee. PROPERTY OWNER New Construction Ili \ \ - ,c \Q \ Q-, fk-1 tsi\ Alteration Exterior Address Repair Home Telephone Demolish Business Telephone 3 0 5 .- S b GI 2 ... I c Fax Fax Add'I Attachment 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 / ' _0111 Lvi,mr Eissm Step 1. PERMIT TYPE ( Building Electrical Mechanical Plumbing LPGX Roofing Fence Other ARCHITECT Name License No. Address Telephone Fax PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection Master Permit No. Subsidiary Permi ■No. PERMIT APPLICATION TIONS - The following steps must he taken to obtain a permit from the Miami Shores Village: 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. Job Address: S A �( Z—� �l i , \ L. 3 1 7 3 6' Address Apt. City State Zip Folio Number escription of Work 7 k Al_,L ki• 1 i 1 LE (iJ Lot Block Subdivision PB PG Zoning Linear Feet Current Use of Property Square Feet A Units Floors Proposed Use A Property Value of Work 1---- b 0 r Bldg Value Tenant Informsttion ax 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 11IPOR'I'AN'f 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. AFFIDAV1 T - 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 accord. nce }with Section 7 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choo n a ontractor ST J , js OF MIAMI -DADE Signature of Owner Signature of Contractor / Qualifier Print Name S6 o o and subscribed before me this-7 ( day of VV • ature of ' .Ii State of Florida ((Pk l Personally known 8(?,, I?rdauced Ideht ihccation Personally known OR, Produced Identification Type of Identification Produced: 722.D4 of Identification Produced: SEAL: STATE OF FLORIDA, COUNTY OF MIAMI - DADE Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: PERMIT APPLICATION LLECTRI `AL 'Fyn: Minimum Fee Q.Ly. .L\,I,I:: Dryer O TYPE Outlet, Appliance `t.l.V TYPE Service Repair Q•I.l. A/C Central 1. -3 Ton Fan Outlet, Wall Service, Temporary A/C Central zt -7 Ton Fire Pump Outlet, Switch Signs A/C Central E : -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 Violatio:is 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 MECHANI AL TYPE Minimum Fee QTY.. T Condensate Drain QTY. TYPE Generator Q'I'1'. TYPE: Refrigeration, Tons O'I'V. A/C Central, Tuns 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 PLUMB1N TYPE: A/C Condensate: QTY. TYPE. Drains, Roof QTV. TYPE: 1 Miscellaneous Fixture Oi'V. TYPE Soakage Pit Q'I'1'. 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 /c)r7 Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official � l� to �� 2. Page 4 OFFICE USE ONLY CIII:CK ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $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) $ (71 ( x .60 x/1000 ) (¢.005 /sq.ft.) ($.01 /sq.ft.) ❑ CONDO ASSOCIATION APPROVAL (Attach) O BPR APPROVAL (Restaurants) O CONTRACTOR REGISTRATION (On File) TOTAL PERMIT APPLICATION t �� ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com ctibank® CITIBANK. F.S.B. BR. #50 396 ALHAMBRA CIRCLE RAL GABLES, FL33t y ank,e , 7o AtS tfAore, ,97 aa/,9�9,W/ 1:2660a6S5to: Ne. 31071,296450 63-865550 2660 31071297 LO?? 1077 I, of ,11 ;IV WANCI Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 6/10/2002 ^ n Applicant: Div ` '` `�—' -L NFS+�Y PP Owner: - I c��rtN�KY MA6rBA- JOB ADDRESS: 75 • NE 92 ST Contractor Local Phone: Permit Status: Work: FRONT WALWAY TILE WORK Approved Permit Expiration: 12/7/2002 Building Permit Permit Niimher: Contractor's Address: Fees: Description Amount FEE2002 -3250 CCF $0.60 FEE2002 -3251 Building Permit Application Fee $60.00 FEE2002 -3252 Notary Fee $5.00 Total Fees: $65.60 QI uvL Construction Value: $400.00 Page 1 of 1 Parcel # 1132060130270 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 21 & E 1/2 LOT 20 BLK 2 LOT SIZE Total Fees: $65.60 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 9 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, sery ,2sr�j s or emplo (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 t 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 mysfif, my agent, servants cx employes. L Signe (Contractor or Builder) BY: • property described as: Lot 21 and the East 1/2 "Yot 20, Block 2, AN AMENDED PLAT OF MIAMI SHORES TION NO. 1, according to the Plat thereof, as ecorded in Plat Book 10, Pdge 70 of the Public,Record of Dade County, Florida. FLOOD ZONE: X N f VgILL HoLE ., • 0 h u 4' 2. d /6: f A e el C I. ' it. C ll ) .. e" 0 • Do' • 9.99' r 0 L • wit(497 A.646v) 7 . ( - ,v 41 4 ,0;1 1 C , 9 ts, Lor z 2.16 :57 4?,e5/1:16Ake - • • 1 - . • i . to ' 27,49 73.4o ' c/. 'L) FL 0 qrke • -,I. \-tv I, WE '),7. 5 0' 4 : • Z H 00' Li FOufJp 1(2.00 pr 4;4.. .,- 1--(E.4.4,*“7 • wrE Li GOO& GC:We-Fe:re I 1 1,f 71 6i 140d NOTE: Underground encroach- ments, if any, not located. • bo4,. A. - " r ik? ig fir t LO 'C-&L E_ I" ZOO .r. 6 r; e' Nol valid unless embossed with Survey Seal. Meets min. Lech. Standards set forth by the Bd. of Land Surveyors' pursuant to. Sec. 472.027, Fla. Statutes. eplILT t 20 • A5p4 1 4Cr,A6VEIJE J PROPER fY OF:Blankenshi pr 7 5 N.E. 92nd Street, A BOUNDARY I hereby rertify Olaf the curver SURV sentecl hereon nu•ets the minunoon technical standards set forth hs• the• Board o(, I end S rveyors pursuant i Section 47 r a. Statutps. There are noencro • ments,bve .fn.easemenIs appe g on the • other than as sh. •n hereto. Fla. Reg. la d Surveyor N. � 1'5.231.Z.— revised. - es . it 7.7 1 m �F w � 3 r jd-7 Up u - 1f41 - Certified To: Gulj.sLr Title Company and R.L. Schmidt Mortyaye, inc., its successors and /or assigns. Miami Shores, Florida. CANNES and GARCIA, INC. ENGINEERS - LAND SURVEYORS - LAND PLANNERS Office address: 4080 S.W. 841h Avenue, Miami, Florida 33155 Mailing• address: P.O. Box 561131, Miami, Florida 33156 359 Alcaz.r ►venue, Coral Gables; -F.l.. Phone: (305)666-7909 J333134 DATE SCALE "Recertified rr /1oQd Zone added and Certified To DRAWN BY , 614 . and hai,te DRWG. NO 1.87 -68 1 91 State work to be don e and purpose of building (by floors) Zone cubage required Distance to next nearest building_ _.. Maximum liv; load to be borne by each floor.._ I hereby submit all the plans and specifications for said building. be sent to___ - MIAMI SHORES VILLAGE APPLICATION FOR BUILDING PERMIT Applical ion 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 Villace, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations cf 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_ _z / 7 IY 9 Owner's Name and Address._. 1 . /._ e 4 _ / 9 No._ _.7 /+/ _ Street- -- _ -- r _ -_ : -- RegiStered Architect and /or Engineer.._ _ . Name and address of licensed contractor. ' ( c /// o -I ! c C__ 1 6/�� ■ ,yam 2 F Location and legal description of lot to be built on: Lot.. Block - Subdivision Street and Nirrrber where work is to be done •7✓ /V• ,6: 9' 2-- C Date / (-- i • — BUILDING INSPECTION DEPARTMENT Date. New Buildin„ i" / Remodeling .__ Addition . ___ __ Repairs No. of Stories To be constricted of __d - l i e % • Kind of foundation__. _4.. 6 / • Roof Covering _ ... _... Estimated Tctal cost of improvements $ -1 . �_ Amount of Permit $ plan Cubage .. Size of Building Lot __.. All notices with reference to the building and its construction may The undersigned applicant for this building permit dot 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 subcontractoy onwor)C to be performed under this permit, as arc 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 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 carefully read the foregoing application, and that he did sign the same, and that all facts therein by hint stated are true. Permit No 1 2 Read, Sworn to and Subscribed before me. Disapproved .. , (Signed) PLANNING BOARD__ __ -- -- -- -- - DATE Chairman - Member Member Member Member . _ _ __ _ . Member Council Approved ..... .__ _Date Disapproved Date NOTE: \ charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning I';oard. 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. Notary Public, State of Florida Building Spector My Commission Expires__ A 00 , . . _ - - and for no other purpose. 9 ? 11 5 \