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PAINT PERMITPERMIT APPLICATION FOR MIAMI SHOR Date 4 1ob Address 97f gZ Legal Description nn Historically Designated: Y■ Owner/Lessee / Tenant 0077 �� I , �" Master Owner's Address 9 7 - A 92 vl Phone _— - — _ cam' / 77,a Address fq * Sail Cloth 77 Contracting Co. �►'3M c L �%' " " "� � - — - Qualifier 74 (-Z. •� SS# Phone State # Municipal # Competency # D W-V Architect/Engineer Bonding Company Mortgagor Tax Folio Address Address Address r Square Ft. Estimated Cost (value) 2;300 Ins. Co. rr � Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICA RO OFING PAVING FENCE SIGN / WORK DESCRIPTION r 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 LEINTF4 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a pemlit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be perforated 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 all work will be done in compliance with all applicable laws regifl>ttjng construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. crn v4 44, Signature of owner and/or Condo President Date Notary as to Owner My Commission E MI AEL IWASKEWYCZ MY COMMISSION 9 CC 721000 d > P _ EXPIRES: April 10, 2002 Trim Notary Public Undenvdters /0 /DL — d)0 C,n FEES: PE RMI RADON C.C.F. b v NOTARY S� APPROVED: Zoning Mechanical Building M Po 7 0 Signa of Co No as to Contractor or My Commission Expires: Electrical . ° o/ _21:00 r.,MS] VILLAI1 D: NOTARY PUBLIC SATE OF FLOILDA 1 COol:,MESION NO. ccn' COMMOS O � 4 BOND to TOTAL DUE 'i D 1' Plumbing Structural Engineer Owner / Lessee / Tenant PERMIT APPLICATION FOR MIAMI SHORES VILLAGE o Date / ? Job Address9 75 i� �". 9� � _ Tax Folio // � 6 C�(a ge 306 Legal Description Z-07 Master Permit # 33i/, Owner's Address //�� Phone Contracting Co. t 4 , .;„Qd Per, Address Qualifier SS# - - Phone State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one BUILDING) ELECTRI L PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESS.R IPTION Square Ft. / Estimated Cost(value) `?`e/, 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: APPROVED: Fire Zoning Building Signature of •Gontree ec=e - Owner- Builder D�yt S / F / 9 0 1 - !/C' 'cam A. 69-// - Notary as to Owner and /or Condo President Veeo,'c Afit otary as to Contractor or Owner- Builder My Commission Expires: Print type or stamp name of NoMyiyission Expires Personally known d6R Produced I.D.0 Ty ?e and number of I.D. produced: NOTARY PUBLIC STATE OF FLORIDA ** * * * * * * t A A * * MY CiMMISSIN4 EXPIRE 5/09/94* 0 DID take an oath, or Bonded thru Stembler- -Adams & Sweet FEES: PERMIT 37570 RADON C C F e an oat NOTARY , TOTAL DUE T- G D p. Other 7)rn ✓ Electrical Mechanical Plumbing Engineering 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 Registered Architect andior Engineer Name and address of licensed contractor 0' 61) /� E /� - Location and legal description of lot to be built on: Lot Block Subdivision � aoAttP itif.a 11 • State work to b done and purpose of building by floors), state ex rior colors (su• itamples) Street and Number where work is to be done and for no other purpose. New Building_ imodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Coverin Estimated Total cost of improvements S --17--).--4—, Amount of Permit S 3 Zone cubage required Plan Cubage�j� /� Distance to next nearest building Size of Building Lot .-.0 K / �/ v Maximum live load to be borne by each floor 1 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 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 e ermit: 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 er ploy only such 9nbcontr rs. on wo,l e performed under this permit, as are licensed by Miami Shores Village. /T 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 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. Permit No. Disapproved (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT r I \� U Building Inspector Date Date Read. Sworn to and Subscribed before me. Notary Public. State of Florida No Street --4/ 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 rc- inspection fee of S25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and or workmanship. SECTION BY DATE Zoning a A-4 `? (V6 Electrical Mechanical Plumbing Fire Public Works Structural Building Official 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 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ o-, (sq.ft. = x/I000 x 0.60) (¢.005 /sq.ft.) (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ bs - ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2 AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. 'I'IPE Outlet, Appliance QTY. TYPE. Service Repair QTY. 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/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 MECHANICAL TYPE: Minimum Fee QTY. TYPE Condensate Drain ()Ty. Tvi Generator QTY. mg.:: QTV. 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 TvPI.; A/C Condensate ()Ty. TYI : Drains, Roof Q'I'V. TYI,IP, Miscellaneous Fixture ()Ty. 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: Page 2 IMPORTANT NOTICES 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. 1. 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 "Ootaf41 6t)167,41. Signature of Owner 4N644 tO%e Print Name Sworn to and subscribed before me this 9 day of Zoo Z-. Signature of Notary SEAL: Personally known is - gate ‘t'rpYPGi� 1I I r 7 IWaskewyaz °. :Commission. # DD098211 A �a � Expires April 10. 2006 ,n%% Atlantic Bonding Co.,Inc. OR, Produced Identification Type of Identification Produced: gnature SEAL: to and subscribed before me this) day of ry Public - . to of on s . PERMIT APPLICATION STATE OF FLORIDA, C • Y OF MIAMI -DADE Signature of Con • actor / Qualifier f teG .Zwsxceo v f c— Print Name II Odra,. ^( /Bi Q:'r,`�L.G� �, I.:, �•.1 a I� " ?' -�ti. Q 7 c - Personallyknown _ C ft;` 4dduced Identification Type of Identification Produced: PROPERTY OWNER Name erle / /a 42 Addres 975' u.e 9 c f /b IZCf Home Telephone Business Telephone Fax CONTRACTOR . /J� /f Name /� ___rkt / er .' / A 61 License No. O/y/a/ / � \�.Jy �/ Address 76 e /.3D .Sr / y N /'7/ ariii, /q 533/67 Telephone301_ C. /J Q. Fax G,' �, y poo pot Qualifier Name /' / 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 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 submitted 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: 97.s N6 Address Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Chg. Contractor Renewal Revision Extension Supplement Reinspection PERMIT CHANGE (✓ ) ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No. P7ip 41/U i7e City State Folio Number Description of Work / 2 ) et.CI C'.R?'`l / Lot Block f) - 4 S /44 60 Q4.& Zoning V Square Feet Value of Work Linear Feet Units Floors Tax Assessed/Appraised Value Bldg Value PERMIT APPLICATION S-3 /Y Zip Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 9/16/2002 Applicant: DONALD Owner: WHEELER JOB ADDRESS: 975 Contractor Local Phone: 305 - 895 -1368 Parcel # 1132060060030 Work: PRESSURE CL I This Permit is granted to the contractor or builder named above to construct the buil ordinances pertaining thereto and with the understanding that the work will be perform and approved by the proper municipal authorities. This Permit may be revoked at any authorization. A further condition upon which this permit is granted is the understandii ordinances and regulations pertaining to the work covered hereby whether shown on I by his agents, servants or employees. Signed: .� (INSPECTOR) In consideration of the issuance to me of this permit, I agree to perform the work o with the plans, drawings, statements or specifications submitted to the proper author myself, my agent, servants or employes. Signed: NE 92 Building Permit Permit Number: BP2002 -1592 (Contractor or WHEELER • • DONALD ST Contractor's Address: 1476 NE 130 STREET Legal Description: GOLDEN GATE PARK AMD PB 7 -54 LOT 2 LOT SIZE 50.000 X 140 OR 12420 -769 Fees: FEE2002 -5155 FEE2002 -5156 FEE2002 -5157 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 Permit Status: Approve - �} Permit Expiration: 3/15/2003 Construction Value: N & PAINT ROOF & SIDE WALL WHITE If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. fee is $50.00, which must be paid in advance before calling for another inspection. COMPLETE HOME PAINTING BY MICHAEL MICHAEL IWASKEWYCZ 1476 NE 130TH ST. PH. 305- 895 -1368 NORTH MIAMI, FL 33161 PAY TOME "..27,4,,,W/ ORDER OF MEMO I : 26 ?0 i �► 0 ' Was1 , I tual W N 900 NE. orth ggMl[tam 125th S utual Bank, FA V125ttrh ct S treet Financial Center 1728 North Miami FI. 33181 1-801 3•799 -7000 $850.00 24 hour Customer S4rnro Page 1 of 1 Re- inspection L3 L i s 83/4835 14 835 1i3o ;5p2 ^.I .. hcrafnr in strict compliance with all a 7 DATE 63 -84 13 -2670 3527 $ DOLLARS LJ ..., MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: OWNER'S . ,Dgi c PHONE: ADDRESS: ?IT /t/, 93 -V ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: ?7r SY CONTRACTOR &LICENSE (if applicable) COMPANY NAME: PHONE: Fascia Drip Cap/Drip Edge Soffit Roof Flower Bins Shutters iv//f Awnings //17 Chimney ,, /sr Doors and door jams fr /or Garage Doors ti It Other ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls Railings affl Fences ivfil Decorative Metal Aft All brick (simulated or regular) fr Stucco Banding A 11 Any other stucco features Accessory`Buildings tif` %rt _Af ea 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. , � t 9A Signature of Owner Date Si natu e of Cont for Date g ignatu APPROVED: WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION Building Of � cial Date 4/23/01