849 NE 92 St (4)Type Insp'n
Permit No.
Name
Approved
Correction
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date g ik ® Time
7 & P -/5`9
I
Address
Company
Phone # i ®S 96 ° 3 �.�
For Inspector: `�i'i� -® t l Name ate
7/4)2.6%
Re-Insp'n Fee ❑
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date Time
Type Insp'n <' -"?; �; " ?'
Permit No. i o�e��
Name �1
Address 1 % c2 sr
Company Zt€
Phone # CO L_W ° 5 d
For Inspector: 90 ®� Name & Date
Approved �w
Correction ❑
Re- Insp'n Fee ❑
SECTION
BY
Di TE
1 A
Zoning
(2P f1
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
4
Building Official
/ f
e � e
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
O 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)
$
$ D
$ ��
to
$
( x .60 x/1000
)
(0.005 /sq.ft.)
(0.01 /sq.ft.)
PERMIT APPLICATION
0 CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
0 CONTRACTOR REGISTRATION
(On File)
TOTAL $
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL ° (305) 795 -2207 ° FAX (305) 756-8972 ° http : / /www.miamishoresvillage.com
ELECTRICAL
.
Minimum Fee
Q ' I ' V
TYPE
Dryer
QTY
TYPE
Outlet, Appliance
Q . Q . Y .
' FVI , E
Service Repair
Q . Q . Y .
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/PII)
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. ; T TE
Condensate Drain
QTY. TYPE
Generator
QTY. TYPE QTY.
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
TYPE
A/C Condensate
QTY.,
TYPE
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 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:
CONTRACTOR
Name )44-1_04-3 Csut _f t ¢ 140cA -e f
License No. v...Zp / o r
Address Ao G n w sa.a 7 ST
Telephone 3or 796 viz 1 Fax 4 (y'3 7773
Qualifier Name
�T_ aQC --R...‘ i OS
PROPERTY OWNER
New Construction
Name / c, .1l % U ciQ '
Enclosure
Address a_ - 2,17-3:› , 4-
l
r.A A.M % S kbuele S mac-- 3'a t Is
Home Telephone 3 -7s---i �-3de
,/
Business Telephone_ u ,5.- 11'4 0 C
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'l Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit-
ted along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
APPLICATION
Job Address: 1 1 A I Z
Address Apt.
Folio Number
Lot Block
Subdivision PB
Current Use of Property
Proposed Use of Property
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
City
(Description of Work
Master Permit No.
Subsidiary Permit No.
PERMIT APPLICATION
LIMMIUDINC
State Zip
PG Zoning Linear Feet
Square Feet m Units Floors
,Value of Worg p oa. Bldg Value
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
Page 2
IMPORTANT NOTICES
I. 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.
STATTI RI Gy OAMI -DADS
St ature of Owner
l S V ver
Print Name
and subscribed before me this 2 '" day of ,) "l VI ,
SEAL: RV PV
0-0 0 0 3' 's 11 C. � ��
,)• '
• ,,
Personally known :QR' Predated Identification Personallyknown, OR, Produced Identification •
Type of Identification Identification Produced: '
Signature of Contractor / ualif
?r4Stv.: oS
Print Name
Sworn to and subscribed before me this
Signature of Notary Public - State of Florida
SEAL:
PERMIT APPLICATION
RID COUNTY OF MIAMI -DADE
day of
G Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: BP2002 -1519
Printed: 8/29/2002
n
Applicant: TINA .VASQUEZ
Owner: VASQUEZ TINA
JOB ADDRESS: 849 NE 92 • ST '
- Contractor ATLAS CONCRETE & PAVEMENT Contractor's Address: 10657 NW 7 ST
Local Phone: 305 - 796 - 5421
Parcel # 1132060050050
Fees: Description Amount
FEE2002 -4854 Building Permit Application Fee ., $60.00
FEE2002 -4855 CCF $0.60
FEE2002 -4856 Buildier's Bond $300.00
FEE2002 -4857 Notary Fee $5.00
Total Fees: $365.60
Total Fees: $365.60
Total Receipts: $0.00
Permit Status: Approved
Work: REPAIR DRIVEWAY
Signed:
Signed:
Permit Expiration: 2/24/203
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, servant mployees.
(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, se rya'ttr s or employes.
Building Permit
Legal Description: GOLDEN GATE PARK ADD PB 6 -130 LOT 6 & W1/2 LOT 5 BLK 1 LOT SIZE
Construction Value:
$850.00
Page 1 of 1
(Contractor or Builder) BY:
PAY TO THE
ORDER OF
INTRASTATE CONSTRUCTION COJMIAMI •
6520 SW 16TH TERRACE
MIAMI, FL 33155
—.."
MEMO yam'" -<' , ' !% `" / / ' i ) y
II ■00 L8 5611' I: 26 7080 5 201: / OQ046 50 3 5911'
PAN -AM HORIZONS
FEDERAL CREDIT UNION
MIAMI, FL 33126
. 63- 8952/2670
% -r
$ �'
1856
DOLLARS
n t Security features
induded.
Details on back.
' rI ::Rti8 It 1
05/04/2001 03:04 305598
MJIJRGE ARECEE
•• •• • • • • •• •• •
• • • • • • • • • •
• •, • ••• • • •
• • • • • • • •
• • ••• • • • • •••
• Sheet 2 of 2 Boundary' S rvey
qa►e• a • PI 't• ••• •'• •••
•
1/2 F.I.P. • : • • ' • • • • 34 �.1 . •
SS'0'00'00 "E • • 7t' 81 • • • - • • • •
0
0
0
CL
cr4 P'
1
O
0
to
10.61
1
12.10'
A ;PQCH.I
1.95'
9
W.L.P•
[Job i Bil -362 1
5-- t8 -199B
iof
r
a
Not a
9uraemore Notes: /t tootle Shown hereon were not
abstracted rot. eaaeaent bwd /or Rill' of records
/L Survey le incomplete ilthout She 1l I of Z
91 Beaehreark : Mule County Public Rorke Cry.
e/•
/4 Swinge as ehown hereon are (lewd upon
S.E. Cor. 61f1/4,HB1//.91:I/4,See.e - -42
/5 PIev,! See Abbreviation and Le/end on the
Beck Pete of Short 1 of 2
45 stele of Drawln6: t w 20' .
/> Drewn D7 : A. Abram Dote: b- IB -1005
�e Dlecktttes No. 101
19 Reviled:
5' HIGH CLF A 1.4_• ifs Ft ►lgNp.
• ••. • •
• • • • • • •
• • • • •
••••
ONE STORY
CBS HOUSE
RES /j 849
18.60
15.110
— 735 11
1 779
'2.
', ttA I -
N l I In
3' 3/4" 1..r. 1/
/ 18.30 PRWY O.E.13) I
1
590'00'OC' "E 7o.F.lt
�l
AFA
Company, Inc.
I
I l
•
• •
• •
•
• •
• •
•• ••
•
• •
•
• ••
0
O
w
o'
0
15.3' ASPHALT PAV.
f\lo 2 n d Street
50.00 right -of Tway
op
OI
0
0
0
J �
Z0 i
This aerty't. that thAr survey of Mt roperty
deeertbad 1 rnon was meth under my evper-
visien •' it >1 the v1et?rvy meets the mintn,ym
tecMnteat :. •.ndarde vet forth by tk, riaMda
Board t .. ja 8 Land 6 of F
j �� 't O v, Cod& ;n et ! to Scotto,.
• flat eke :iketc) hereon u a true and
accurate 'e .resentatton thrreef to Ile bast
eJ my tnr ledge and *Me V. euptect to noise
Professionn al o none. ,s N.0Wn . oR
Surveyors & Mappers '/
13050 S.ii. 133rd Court'' ,' ,'
Miami Florida, 33188
11h. tY 305) 234-0508
Fax / {305) 234 -0423
'r' t . • F. Alvarez
Prone • eior & Moppet / 5326
• hate of florid,
not V*lId on • '. e16e,e0 k !Impel alai antenna 31011
PAGE 01/03
Lot Block Subdivision
Tax Folio #:
requests permission to install:
SIGNED. SEALED AND DELIVERED in the presence
M iami Shore6
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 -2382
Telephone: (305) 795 - 2207
Fax: (305)-756 -8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, 2"i Vi t -'7,__ , hereinafter referred to as the Owner of the
(owner)
following described property:
Legal description /folio #:
pRtuEiufFV
APPec'ticki
[ ] Asphalt, concrete, brick pavers
[ ] Landscaping
[]Other R
within the public road right of way of '0'1"1 Jfe-. Z (%A. # l d:: S kbo S I �
(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.
2. 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).
SIGNED, SEALED, EXECUTED AND ACKNOW . AGE o is ay of_ "i j
STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant, (ova s \ P v _= —, does hereby attest that the
(property
attached survey, performed by
Further, Affiant sayeth naught.
Witness(sign and print)
'Miami 6' /iurni _ 9zoreJ Vi��ac�e
AFFIDAVIT
(name of surveyor's company)
performed on S • Q , 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..
Affiant/Property owner
Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this day of � - ZOO
3 3 -∎
Affiant is personally known to me, �oduced - 0 / - as identification.