PAINTMIAMI SHORES VILLAGE
BUILDING DEPARTME T
305- 795 -2204
Building Inspection Reques
Date Time
Type Insp'n
Permit No. A/ALA Name l i� 1/0!/a
Address 4 _ '44V-
`' - I
Company LC•f -e
Phone #
For Inspector: 1 �, n Name & Date
Approve ' It
Correction ❑
Re- Insp'n Fee ❑
PROPE ' ' WNER
Name he ( 6./ a e ((.____
t
Address
'qg E q a»'� ( r 1
Home Telephone /3 -6---_, - a
Business Telephone '' 5-( .- n Ce
l/
Fax
Gr
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
Step 1.
X Job Address:
Address
Folio Number
Lot Block
Subdivision PB PG
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
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
&(L 305- 5021-G ge
• •
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• • ••• •
• • • • • •
• • • • • • • • •
410
Apt. City
>escription of Work
• • •
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone
Qualifier Name
• .••
• •
• •
• •.•
Mlstei; P r lit
Su'bbsi$iar Iietmit q. •
• • •••• •--•
INSTRUCTIONS - The 'following steps must be taken to obtain a permit from the Miami Sho
State
PERMIT APPLICATION
C.Y3
es Village:
•• • • • •• ••• ••
Complete the attached permit application which must be signed b9 ate ptcart2 ° 'n& apd qualifies Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your appliciil. jf rpol2nVgrk will be drone, 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.
Fax
Zip
Zoning Linear Feet
Square Feet Units Floors
Value of Worlc b b'° per i YI+' Bldg Value
'
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
Page 2
STATE OF RIDA, C
Sign o
5 ))42A- e
Print Name
to . • d subscribed be ore me this
41,10
la
Signature of Notary Pt
SEAL:
Personally known
...
...
• •
• •
••• •
•
MIAMI-
•••
blic - Statt4fl i • ZEEMAN
NOTARY PUB ' STATE OF FLORIDA
COMMISSION NO. CC994036
MY COMMISSION EXP. FEB. 15;2005
Identification
(.cam
•
• .• •
• • •
• ••• • •
• • • • •
•••••••
day of Hp'J ,
Type of Identification Produced:
•
•
•
•
PERMIT APPLICATION
1 ? IPOR'1'ANT NOTICES
1. DO NOT BEGIN ANY WORK WITI4OUT J CtVED YOjJR 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 Ml!in BEMAIN IN1iD IK ACLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIB6:6F�4LL ME EEO'S NEU NOM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING.131,M1GrD EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sid'ewai • • • • • • • • •
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
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
Type of Identification Produced:
S
BAY
Miami Shores Village
10050 NE 2nd Avenue
Printed: 3/12/2003
Applicant: SHERYL
Owner: CUCCHIELLA
JOB ADDRESS: 948 NE 92
Contractor
Local Phone:
Parcel # 1132060060100
Permit Status:
Work:
APPROVED Permit Expiration:
EXTERIOR PAINTING AS PER AGREEMENT
there is no permit package accessible on the job-site for insner_t
fe4 is $50.00, which must '�
948 N ST. i 30 759 33326 LA
MIAMI S ES, FL 33138 -291
I :26 7084 1 3 10: 133146
63- 8413/
83146534
Building Permit
Phone: 305 -795 -2204 Permit Number: BP2003 -381
9/2/2003
CUCCHIELLA
SHERYL
ST
Contractor's Address:
„wr ashin : • utual
Washington Mutual Bank, FA
Miami Shores Financial Center 1722 1 Bpp 7aa•7d00
9640 NE. 2nd Avenue 2. huur Customer
Miami Shores, Fl. 33138
Legal Description: AMD PL GOLDEN GATE PK PB 7 -54 LOT 12 & W1/2 LOT 13 LOT SIZE 75.000 X
Fees:
FEE2003 -1504
FEE2003 -1505
Description
Building Permit Application Fee
CCF
Total Fees:
Amount
$60.00
$0.60
$60.60
Total Fees: $60.60
Total Receipts: $0.00
Construction Value: $300.00
1417
»
6.
NP
Page 1 of 1
rify, there will be no inspections. Re- inspection
.tion.
he equipment or device described in the application herefor in strict compliance with all
with any plans, drawings, statements or specifications that may have been submitted to
not done in compliance with such ordinances or if the plans are changed without
tor or builder named above assumes the responsibility for a thorough knowledge of the
gs or in the statements or specifications and that he assumes responsibility for work done
BY:
; ompliance with all ordinances and regulations pertaining thereto and in strict conformity
Village. In accepting this permit I assume responisibility for all work done by either
•
MIAMI SHORFJS .ILLAGE
Paint Calm Apprbv9l•iidd iAgrEement
DATE: 3 0
OWNER'S 1 . a,.,,, « f ' ' PHONE: 305
ADDRESS: qyg /V' 9,1 tib r _ .. ... ..
* * * * * * * * * * * * * * * * * * * ** * * * * * * ** ** * n *c *Iec * * * * * * * * * * * * * * * * **
•
ADDRESS OF SITE:
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME:
********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
s on the site must be listed and indicat
e 11) L..Y► ; ®1 pi 0 (e.._
berg L.,i ,,► Monce- I ))a7U L J
(
All Elemen
Walls
Fascia
I Drip Cap/D
Soffit
Roof
Flower Bins
Shutters
Awnings
Chimney
Doors and door jams
Garage Doors
Railings
Fences
r Decorative Metal
All brick (simulated or regu
Stucco Banding
Any other stucco features
Accessory Buildings
ther
Building Offic
te)
Date
... . ... • ...
• . . . .. •
• ..... • •
•
.. • .. •
• • • .. •
.. .. • • ..
•
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 t e work stated. Furthermore , the paint colors will be - . per the attached
tat
Signature of Owner Date Signature of contractor Date
************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * **
APPROVED: WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01
5' n J
1- 7
ELECTRICAL
TvPi•:
Minimum Fee
QTY'.
Yuri
Dryer
QTY.
T
9 fief 4)04llco" • ... ..
Outlet, Wall
on; ;;
'1 I'm
Service Repair
Service, Temporary
(yT1'.
A/C Central 1 -3 Ton
Dryer Vents, Number of
Fan
A/C Central 4 -7 Ton
Air Handler, Tons
Fire Pump
Piping, Flammable Liquid
Outlet, Switch
Barbecue
Signs
Process/Pressure Piping
A/C Central 8 -15 Ton
Bath Fan - Vented, #
Fixture - Fluorescent
Pressure Vessel
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
Indirect Wastes
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Interceptor
Dishwasher
Low -volt, Television
Service, Number of Amps
Laundry Tray
NIECHANICAL
TYPE: QTY.
Minimum Fee
TYPE
Condensate Drain
QTV. TV QTY.
Generator
TYPE QT\.
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
Miscellaneous Repairs
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Bidet
PLUMBING
.l.VI,l,,
QTY
.l.VPE
QTY.
TYPE
QTR
i VpI ,, Q . I ' \ '
A/C Condensate
Drains, Roof
Miscellaneous Fixture
Soakage Pit
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 Pum •
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
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PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being perks ned;Tel gyantity(idS)'ipthe 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)
$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
••1
• •
• •
••• •
••• • ••• •
• •• •.•
• • • •
•
•
•
• ••
• • ••• ■ •
• • •
• ••• • • •
• • • • • •
• • • • • • • • •
•••
•
❑ PROOF OF OWNERSHIP
• • • • . (Attach) • • •
• • • • • • • •
•• • • • • ••• •
Q RS /:DrRZVI;APPROVAL
••• • • •
(Septic $ewers
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
$� O
$ t (sq.ft. = x/1000
x 0.60)
$ (¢.005 / sq.ft.)
$ (¢.01 /sq.ft.)
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
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
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 5 a✓Job Address e'i'a q9 stx. Folio
Legal Description ` Historically Designated: Yes No
Owner/Lessee / Tenant r 6 P d ( i f Master Permit # Y 7,
Owner's Address cii el - Phone ___— 1 7 4 */ —2). (C)
Contracting Co. (C eJo e r Address
a
a)
Qualifier SS# >'
a)
b`
State # Municipal # Competency # _a
Architect/Engineer
Bonding Company Address
Mortgagor Address
Signature of owner and/or Condo President Date
construction and zoning. Furthermore, I authorize the above -named contractor to do
APPROVED:
Zoning
Building f4A
Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE
WORK DESCRIPTION . �- h& - V i 5 G& €_ /6r
�� (M teA / 7 2 : 1 (9 !vA hOxaq u✓acC
Square Ft. 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.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that al
e of Contractor or Owner- Builder Date
Notary as to Owner and/or Condo President Date Notary as to Contractor 'o L)wner- Buiider,� Date
My Commission Expires: My Commission �Ezpires: ` • ` .., , all 7- 8- o
S . ,4ic.- _,; . &.rr Cvctj i e(t 9
Electrical
Mechanical Plumbing Structural Engineer
1'
will be done in compliance with all applicable laws regulating
tated. /
FEES: PERMIT — 0 RADON C.C.F. ^ NOTARY ,5
/ BOND
TOTAL DUE
2048 -70
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
t/// 1 6 l
ate �z /gf3 Job Address 9 218 N E 9 S f• Tax Fol .5a 0 D (9/ 0 /
Legal Description / 4G' /4 /■ 9 Ad irl 2 � .
�wner / Lessee / Tenant �/ £V E (1d,(rTI) dig / 1 J rN) 1 Master Permit # 3_57/30
✓Owner's Address 1 8 N 92" S Ph on e iS 7 - A 6 1
Contracting Co. ea//WAV Address
Qualifier SS# - - Phone
State # Municipal # Competency # Ins.Co.
Architect /Engineer
Bonding Company
Mortgagor
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
CORK DESCRIPTION Ek 7 J- O R Pip IN) /A/cLUO1n/G /2-.00 F
Square Ft. Estimated Cost( value) t 13 0 0 0
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 construction and zoning. Furthermore, I
authorize the above -named contractor to do the work stated.
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
Zoning Buildin
Mechanical Plumbing
Address
Address
Address
7l
Notary/ as to C
My Commission
Signature of Contractor or Owner- Builder
Date: ) 21/4 /9 3
JOSEPHINE CHURCH
% :Ilcfzry `.lic. Stato of PinoA.
Kbi°nOtiiii0LE+43bat+l leYli
No.CC197545
ININIM
** * * � j * * * * * * * * * * * * / * **
FEES: PERMIT 3 / J` RADON C.C.F. f` 10 NOTARY S f)D TOTAL DUE 7 -qi 5
APPROVED: Fire
Other
Electrical
Engineering
unr. t4' •
t I .11
,UE INA
dk1C..:,! owl
4
;UILDING
:LECTRICAL
'LUMBING
1OOFING
)caner of
luilding
-egal
)escription
sddress of
uilding
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
DAT]? - . z z- 1954
PERMIT N° 4503 Li e act r'
Work to be performed under this Permit
srchitect
ontractor
r Builder •
Lot
j
•
Bl.
Signed.
Subdi-
vision
Value of
Project $
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
erefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
rawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked. at any
me 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
ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
ertaining 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
one by his agents, servants or employees. J�
,AY r `
INSPECTOR
Amount of
Permit $
In consideration of the issuance to me of this permit I agree to perform the work covered he nder in compliance with all ordinances and regulations
ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submit � to the proper authorities of Miami Shores Village. In ac-
-, ptfng this permit I assume responsibility for all work done by either, myself, my agent, servant olemployee.
BY AUTHORITY