930 NE 92 St (11)MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: % )6 0
OWNER'S NAME: eq/4/264 , 125 2 i;7 PHONE: gq -- 7S 67 3
ADDRESS: Al E q,2 ¢ ayi4evti Sim �o ?
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: 93'0 >7c= 94‘,..C:7 /%AM: 5 10 ?i, 3
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: — PHONE:
•
********************************* * * * * * * * * * * * * * * * * * * * * * *4 * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls 61 4-' a s 4p f2 5) ,gt1
Fascia N„ ! ) . Q --t
Drip Cap/Drip Edge W / ). . H. . ,
' if
Soffit \N
1,\ qfi /
Roof 1, l PS
Flower Bins 1
Shutters
Awnings / P
Chimney /3ridse , tc rn a k
Doors and door ja s °xc ,s,04 g
Garage Doors
Railings
Fences Ni1heq
Decorative Metal
All brick (simulated or regula P PI
Stucco Banding
Any other stucco features tukLci"t - 51 /11N5 ! _ r 0 ) p,/ (Owe o)t n aor0's --vii 7',
Accessory Ft )r
Other --1 >7) 20o d'" t+ /4r ( d (1
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
samples_
Zdd
X . 7 I 1 7 P li c7/4( fi'''''
Signature of Contractor Date
** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
7/ 2 CALL FOR FINAL INSPECTION
1/
Building Of icial Date 4/23/01
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 9/26/2002
Contractor
Local Phone:
Signed:
Applicant"
Owner: c#-11&L
JOB ADDRESS: 930 NE 92
Parcel # 1132060060090
Building Permit
Permit Number: BP2002 -1662
- 14tEt
i
�i
ST
Contractor's Address:
Permit Status: APPROVED Permit Expiration: 3/25/2003 Construction Value: $200.00
Work: EXTERIOR PAINTING AS PER AGREEMENT
Page 1 of 1
(INSPECTOR) BY:
Legal Description: AMD PL GOLDEN GATE PK PB 7 -54 LOT 11 LOT SIZE 50.000 X 140 OR
Fees:
FEE2002 -5408
FEE2002 -5409
FEE2002 -5410
Description
Building Permit Application Fee
CCF
Notary Fee
Total Fees:
Amount
$60.00
$0.60
$5.00
$65.60
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 $50.00, which must be paid in advance before calling for another inspection.
This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all
ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to
and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without
authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the
ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done
by his agents, servants or employees.
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity
with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either
myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Wush 1e°nma o tM O
190 0. SUeet
tAtan,1,p.. 9199
•
e: 26
•
vat . l���
1 6
_
• a
2 12$
PROPERTY OWNER
New Construction
Name A/� /kn/,4 b. We9 r7
"
Alteration Exterior
Address
W e e ril I — CAA ✓�_. i)
3/'
P
Home Telephone 3 0 g , 7. {
ct i
Demolish
Business Telephone
Relocation of Structure
Fax
Foundation 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'I Detachment
Other
INSTRUCTIONS - The following steps trust be taken to obtain a permit from the Miami Shores Vijlage:
Step 1.
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:
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!
Address
Apt. City State Zip
Folio Number escription of Work 6i l' 6 A i .. Vi I
Lot Block
Subdivision PB PG Zoning Linear Feet
Current Use of Property Square Feet Units Floors
Proposed Use of Property Value of Work O O. 00 Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
' o AJ. '-/ i 1 / ; cf Fe:
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No.
Subsidiary Permit No.
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone
Qualifier Name
PERMIT APPLICATION
Fax
Page 2
)ignatur
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.
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
r f
t - "-' ?
Print Name r
Sworn to and subscribed before me this° ( O day of
f No
O
Signature
SEAL:
weer
OR, Produced Identification / Personally known OR, Produced Identification
Type of Identification Produced: F &D1� of Identification Produced:
Personally known
.
e LH M 6 ^G • •.r
K,tMEL.1
UI' -•. � i CC786697
v. NC'
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:
PERMIT APPLICATION
ELECTRICAL
T1TE QTY. TYPI?
QTY. TYPE
QTY.
'I'vPI: Q'I'
Minimum Fee
Generator
Dryer
Refrigeration, Tons
Outlet, Appliance
A/C Central, Tons
Service Repair
Cooling Tower
A/C Central 1 -3 Ton
Heating Strips, each
Fan
Vent Hood, Cost
Outlet, Wall
A/C Wa1WVin. Tons
Service, Temporary
Dryer Vents, Number of
A/C Central 4 -7 Ton
Paint Booth
Fire Pump
Ventilation, Cost
Outlet, Switch
Air Handler, Tons
Signs
Ductwork, Cost of
A/C Central 8 -15 Ton
Piping, Flammable Liquid
Fixture - Fluorescent
Periodic Inspections
Oven
Barbecue
Space Heater (kw)
Fire Sprinkler System
A/C Central 16-20 Ton
Process/Pressure Piping
Fixture Light
Parking Lot Lights
Bath Fan - Vented, #
Spas/Hot Tubs
Fireplaces, Number of
A/C Central 20+ Ton
Pressure Vessel
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
Laundry Tray
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Lavatory
Dishwasher
Low -volt, Television
Service, Number of Amps
Meter Set (Gas)
NIECHANICAL
TvPI: QTY. TYPE QTY. TYPE Q'I'1'. 'rviI: QYI'Y.
Minimum Fee
TVPE
Drains, Roof
Condensate Drain
T vII.:
Miscellaneous Fixture
Generator
'I'1'PI':
Soakage Pit
Refrigeration, Tons
Bath Tub
A/C Central, Tons
Drinking Fountain
Cooling Tower
Miscellaneous Repairs
Heating Strips, each
Solar Water Heater
Vent Hood, Cost
Bidet
A/C Wa1WVin. Tons
Filter Replace
Dryer Vents, Number of
Pool Piping
Paint Booth
Sprinkler Repair
Ventilation, Cost
Cap - Fixture
Air Handler, Tons
Fountain
Ductwork, Cost of
Pump and Abandon
Piping, Flammable Liquid
Sprinkler System
Periodic Inspections
Cap - Water
Barbecue
Gas - Appliance
Fire Sprinkler System
Pump, Domestic
Process/Pressure Piping
Supply, AC Well
Cap - Sewer
Bath Fan - Vented, #
Gas - Natural
Fireplaces, Number of
Pump, Fire Stand
Pressure Vessel
Temporary Toilet
Catch Basin
PLUMBING
TYPE
A/C Condensate
Q'I'1'.
TVPE
Drains, Roof
QTY.
T vII.:
Miscellaneous Fixture
Q'I'1'.
'I'1'PI':
Soakage Pit
)T1'.
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
r Y
D • TE
Zonin:
- V,X�
®j
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
L
7
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
Cl CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $
Notary
O PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
$ 6
(s ¢ . x/1000
x
Inspector State Educational Fund $ (¢.005 /sq.ft.)
State DCA (Radon) $
Code Enforcement Fine $
Zoning Review
Z
(¢.01 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $
ISSUING, OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2N AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
1049-60 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date II � > ob Address ? 3O NE q2 d v - �D Tax Folio (( -32OL -° 0O(p °° 009
Legal Description Ot M Dp1 &M (f Pk Pe) - 1- s 4 Historicall y Designated: Yes No X
Owner/Lessee / Tenant -Debra_ A . k
Owner's Address 930 i\; .4 S-r
Contractin Co. OU)1 L J . `rc
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
or
WORK DESCRIPTION EX+Q rl 0C ( %Y +1P) ' l a &
C est ctipprcA..3611 4br c a
f
O ccer -1- Col or OP of Loctli on kous -t° , (7372a) u) Coral 1402 - Flex p+">
Square Ft. 1(c6 -P4- Estimated Cost (value)
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
vv
construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of owner and/or Condo President Date gnature ontractor or • er- Builder
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT ,V RADON C.C.F. o (/ NOTARY
doo APPR9VED: \ i (, d. r �e at
f
z o . K- ��� ti }r �"
zoning Qe C t P
) $ Burldmg
Address
as to Contractor or
My Commission Expires:
Electrical
Mechanical Plumbing Structural Engineer
Master Permit #
BOND
79
Phone 3 - KS-- 1 -1
q54 - "13 3 - (57(o I)) o¢.
",own Bui)3btkI l % IA,. r
■ F.Z.T�ir, rt Iri BL 5i i-a n ? : Of. Fi.. ∎ In D to
COMMISSION N6• cc /viol . 9
TOTAL DUE
•
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: I D J 3 - 00
OWNER'S NAME: Debra. H-i 1 1 PHONE: c, - 9 S4- -1 33 - (o7(0
ADDRESS: 930 NE. ciana sr pt Sf-togzeS 3313 8
*********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: 930 Me cl' r •4 Sr
CONTRACTOR & LICENSE (if applicable) J/A
COMPANY NAME: J O /A PHONE: ,3 /fl
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls i Ski 82101 W Tr-caliiapas0 Tc
Fascia
Soffit
Roof
Flower Bins
Shutters
Awnings
Chimney t
Doors and door jams v
Garage Doors T 826/vv
Railings
aCihonat Tan
Fences
Decorative Metal
All brick (simulated or regular)
Stucco Banding
Any other stucco features
Accessory Buildings 7372W
Other �1 S► cie / ccerot -- u U 73720 ( a--uze Cord is
0.e.„144 sb eft
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
the work stated. Furthermore , the paint colors will be as per the attached
alis
►/� x 00,4 ' //
,ate 4 r. . /
nature of Owner
Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED:
Building Official Date
V ad
Signature of Contractor Date
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
Date
Type Insp'n
Permit No.
Address
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Time
Name
-
Company (,1 °
Phone .3 0 &
.ector: Na & Date
Approver
I/ u '
orrection ❑
Re- Insp'n Fee ❑
00852 Sheriff's Star
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 . j S fl? t / d, in a r
Registered Architect and:or Engineer
Name and address of licensed contractor
STATE OF FLORIDA
COUNTY OF DADE.
Permit No.
Disapproved
(Signed(
} SS.
Nti‘
IRES VILLAGE
CTION DEPARTMENT
wa4M� r BUILDING PERMIT
Date
I5 1 Date qd Read. Sworn to and Subscribed before me.
Date � f IJC.r 19 q
/ �Y f J
No. 9 ✓,/v Street ?a_,At. /'• _
Location and legal description of lot to be built on:
Lot / / Block Subdivision Y7 /�� Z 1� � //U��7/ � oy/
Street and Number where work is to be done _! q 3 q a S'
State work to be done and purpose of building (by floors), state exterior colors (submit samples(i /rE ` ` / �" YZ.ct-e_
and for no other purpose
New Building Remodeling Addition Repairs Y No of Stories____ —_
To be constructed of Kind of foundation !�j Roof Covering
Estimated Total cost of improvements 5 _ l P QC) , d 0 Amount of Permit $ V 1 i
Zone cubage required _ Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I 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 employer of Labor under the Florida Nbrkmen's
Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement. and has complied with the provisions thereof. and will require similar
compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit: and will post or cause to be posted for inspection
on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors. on work to be performed
under this permit, as are licensed by Miami Shores Village.
Remarks (Signed) / AA/ I 0
Before me, the undersigned authority. a notary public. duly authorized to administer oaths and take acknowledgments, personally appeared
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 him stated are true.
Notary Public, State of Florida
Building Inspector My Commission Expires
PLANNING BOARD DATE
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.