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930 NE 92 St (8)MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Type Insp'n Permit No. Name Address f i, Company (C, Phone For Inspecto Approved! Correction U ❑ Re- Insp'n Fee ❑ Type Insp'n Permit No. • P 0 op— 1.17V-Is Name CaA Address 9 b . E 1 f Company Phone # 86- 36-- For Inspector )3o/ B Name & to Approved Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date�L2- // O ? Time Re- Insp'n Fee ❑ 2 OD 13_ ___47 )7-) Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 9/25/2002 Applicant: —BEBAA Owner: Mitt- Ct • DEBRA- JOB ADDRESS: 930 NE 92 Contractor ICOA CONSTRUCTION Local Phone: 305 - 970 -0531 Parcel # 1132060060090 Fees: Description Amount FEE2002 -5358 Buildier's Bond $300.00 FEE2002 - 5359 CCF $1.40 FEE2002 - 5361 Building Permit Application Fee $60.00 Total Fees: $361.40 Total Fees: $361.40 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 3/24/2003 Construction Value: $3,100.00 Work: CIRCULAR DRIVEWAY 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 callit This Permit is granted to the contractor or builder named above to constn ordinances pertaining thereto and with the understanding that the work will I and approved by the proper municipal authorities. This Permit may be revo authorization. A further condition upon which this permit is granted is the ui ordinances and regulations pertaining to the work covered hereby whether by his agents, servants or employees. Signed: (INSPECTOF In consideration of the issuan . - to me of this permit, I agree to perform 1 with the plans, drawings, . tate nts or specifications submitted to the prc myself, my agent, serv. A. pIn (Con Building Permit Permit Number: BP2002 -1646 ST Ce.ob Page 1 of 1 Contractor's Address: 901 S. W. 4th Avenue, Apt. B1 Legal Description: AMD PL GOLDEN GATE PK PB 7 -54 LOT 11 LOT SIZE 50.000 X 140 OR W b NUN 11:J1 Hf1 • 0 N 0 / 1.._ D C_„/T / c)N te /� �,�/ T. 5� i',•;F•/ /r1Lr /.= :UAC). 7j • c . 1) u 1, /tl .02.90c) s 7 /. ,/ =uh'ti M1 i � • U 1 /a It /d IV 6 ./9' Cto iS b 1 ' - 4jd ,e- evoea. /7 11 C»? d hAX NU, oo' c L. This property described as:' Lot 11, AMENDED PLAT OF GOLDEN GATE PARK, according to the Plat thereof, as recorded in Plat Book 7, Page 54 of the Public Records o Dade County, Florida. .17447 w ZvYs/x? 0 S� r �n; N� 1-SCI 's .Lb �Jh� qf peAoJddV BuluclZ r, ue/ ui I'u c of JOB ADDRESS 13z N. e-", ?R APPLICANT d O ( -v PHONE ft APPUCATlON 6 -9 SHEET OF MISCELLANEOUS DATE ZI T%JI.NG CRITIQUE SHEET PERMIT NO. SECTION N ZONING ELECTRICAL MECHANICAL PLUMBING FIRE PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL BY ADDRESS: MIAMI SHORES VILI. BUILDING / ZONING DEPART 1. SubJed to cocapilance with aft Federal, Coczlty.Yd age rules vd regcRations. Village ass no responsibility for accuracy of/or results these plans. 2. This copy of plans owtt be available buffdtng site or no Inspection will be condvc COMMENTS j% /s JO' oxi Sr�F nusr g , u INITIALS STATE OF FLORIDA) COUNTY OF DADE) The undersigned Affiant, attached survey, performed by Witness(sign andrint) Affiant is personally known to me, TARA LAVENDER 1�Dtry Pu51ia - Stri 2 of Flof& Comm a on� D • ��l d ' / / iu,ni S ' U I � P age AFFIDAVIT @G%\ (property owner) does hereby attest that the 6 (name of surveyor's company) performed ort ' 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. SWORN TO AND SUBSCRIBED before me this d ' day of Seri G� Produced FL- D Y i kiLe < S (C el l eiclentification. WHEREAS, &WpiANT OF CONSTRUCTION WITHIN RIGHT OF WAY A.91 Oa_tvro (owner) Tax Folio #: following described property: Legal description/folior: Lot AA Block Subdivision � em requests permission to install: pU Aspha f J Landsca [ j Other brick pavers q i_3® DoE• 4 ; A 0 (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 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 representativ ). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this aft\ day of within the public road right of way of SIGNED, SEALED AND DELIVERED in the presence of: M iami , CA,oNeJ 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 -2382 Telephone: (305) 795 -2207 • Fax: (305) -756 -8972 , hereinafter referred to as the Owner of the JR1LCwIcy f� PP o/rCt -f U( Qi —0 //GO6 eo - 1 - 0 664/26 /ed CONTRACTOR New Construction Name ,, d,,° /3- e? e/ ��, ---— Name %_'"` -n d I 8 —� p .s � CT1Gj License No. Home Telephone . J.–.7;)-349..- . ,7`�3 Alteration Interior Business Telephone , ` Address 50 r . ss. , fU o ° J - - - do c2ti y.4�� 13. _ 4 7 , 3^'.. 3Z i / Telephone " i /� Foundation Only Qua lifier NameL rl Add'I Attachment Other PROPERTY OWNER New Construction Name ,, d,,° /3- e? e/ ��, Enclosure Address /26,4: rtli2, „4.,,w--- �7 -. J7 /Z . 3,--.? 0 Home Telephone . J.–.7;)-349..- . ,7`�3 Alteration Interior Business Telephone r � ; » 7".,,,_:";q:-;' 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 Step 1. Step 2. Submit the completed application with all necessary documents to the Building, Pla processing of your application, you may be asked to submit additional information. APPLICATION a Zip Folio Number Description of Work C /ree' ' a -f ire b 2,4 _, - Lot ii Block ., cur � P G...4: Job Address: Subdivi 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 applica i ust be submit- ted along with this permit application. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Address Apt. City Current Use-df Property� Proposed Use of Property Tenant Information PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No. Zonin Square Feet Units Floors Value of Work ' 1 O © Bldg Value --7 Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax State Linear Feet PERMIT APPLICATION Village: and Zoning Department for processing. During the < Page 2 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 o, Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE ature o ` �y" , 14 4 RUTH A. GUE \ Notary Public - : to of Florida pay Commiasian Eies Mar 25, 2006 Commission 8 DO 102892 ,,° „;;,'t°' Bonded By National Notary Assn. Personal y known Si Print Name Sworn to and subscribed before me this r day of Signatur SEAL: _ caner Type of Identification Produced: y _ Signature__o : (#. i� + ' L1C STATE 02 ' P4 SEAL` JOSE WPM fir _::I ?15ON N * f SONNIESION ,'x'. FEI3. 19 )u' PERMIT APPLICATION Personally known OR, Produced Identification Type of Identification Produced: ELECTRICAL TYPE Minimum Fee QT} TypE Dryer QTY TYPE Outlet, Appliance QTY. TYPE Service Repair Q . Q . Y . A/C Central 1 -3 Ton Cooling Tower Fan Heating Strips, each Outlet, Wall Vent Hood, Cost ill Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Air Handler, Tons Signs Ductwork, Cost of A/C Central 8-15 Ton Piping, Flammable Liquid Fixture - Fluorescent Periodic Inspections Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Bath Fan - Vented, # Parking Lot Lights Fireplaces, Number of Spas/Hot Tubs Pressure Vessel 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 VVater Heater New MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. 'I'Vi'E Q'f Refrigeration, Tons A/C Central, Tons Bath Tub Cooling Tower Drinking Fountain Heating Strips, each Miscellaneous Repairs Vent Hood, Cost ill A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Sprinkler Repair Ductwork, Cost of Cap - Fixture Piping, Flammable Liquid Fountain Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Gas - Appliance Bath Fan - Vented, # Pump, Domestic Fireplaces, Number of Supply, AC Well Pressure Vessel Cap - Sewer PLUMBING TYPE. A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. "I'YPE Soakage Pit )'I'Y. 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 VVater Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower VVater 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) ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (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 $ 60 $ Re,© $ .y0 SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY , DATE lrvrX0it ' Airm 7 26-- 02 ( z .6. x/1000 (¢.005 / sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $. fib, [ 0 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