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1044 NE 94 St (5)- MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: / OWNER'S NAM ADDRESS: /pct — Flower Bins Shutters - Awnings Chimney Doors and door jams Garage Doors . Railings Fences s ADDRESS OF SITE: CONTRACTOR & LICENS (if applicable) COMPANY NAME: PHONE: Nl 7 AJ2 ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elemen n the site must Walls Fascia CO / _ � L 1 � G �- I , Drip Cap/Drip Edge Soffit t?2 Roof 7/../41,(1' 7 Decorative Metal /-("4 All brick (simulated or regular) • S tucco B an di ng Any other stucco features 1\. Accessory'Buildings Other A , LA- Sec OWNER'S AFFIDAVIT: certi 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. Signature of Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: WHEN PAINTING IS FINISHED, Building Official Date 0 PHONE : 306 9 sus • 3 t a e listed and indicate the color to be painted. `)2Bn H, H CALL FOR FINAL INSPECTION 4/23/01 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 8/20/2002 Applicant: RONALD Owner: V JOB ADDRESS: 1044 Contractor Local Phone: Parcel # 1132050150020 Signe NE. 94 Building Permit Permit Number: BP2002 -1458 MARROCCO ST Contractor's Address: Legal Description: 5 53 42 BELVIDERE PARK Page 1 of 1 Permit Status: Approved Permit Expiration: 2/16/2003 Construction Value: $2,165.00 Work: EXTERIOR PAINTING AS PER AGREEEMENT (OWNER BUILDER PERMIT) PB 16 -71 LOTS 1 -2 & 3 Fees: FEE2002 -4644 FEE2002 -4645 FEE2002 -4646 Description Building Permit Application Fee CCF Notary Fee Total Fees: Amount $60.00 $1.80 $5.00 $66.80 Total Fees: $66.80 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 woi. - ered 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 a ployees (INSPECTOR) BY: BLK 2 LOT SIZE 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, sery y or employes. (Contractor or Builder) BY: THIS CHECK IS DELIVERED IN CONNECTION WITH THE FOLLOWING ACCOUNTISI OATE AMOUNT FORE 2444.it JOMAC OF MIAMI INC. PAINTING CONTRACTOR 1160 N.E. 169th TERRACE NORTH MIAMI BEACH, FL 33162 PAY TO THE ORDER F 0 . WAS G TON MUTUAL BANK, FA us00 39 S? II' 1 :26 ?084 L3 LI: 8 3 0 3 90 LOw 311° � /[ts 20 6- 3957 $I 6Z', 9 63-8413/2670 OLLARS 8 :" ELECTRICAL TVI,l,. Minimum Fee QTY. .i'YP1,. Dryer ()Ty. TYPE Outlet, Appliance QTY ' rvpi. . Service Repair `I rl A/C Central 1 -3 Ton Cooling Tower Fan Outlet, Wall Service, Temporary 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 Fixture - Fluorescent Oven Space Heater (kw) Process/Pressure Piping A/C Central 16-20 Ton Fixture Light Bath Fan - Vented, # Parking Lot Lights Fireplaces, Number of 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 vv. TYPE Condensate Drain QTY. TYPE Generator Q I y. rVrr. Refrigeration, Tons (yrY. A/C Central, Tons Bath Tub Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Filter Replace Ventilation, Cost Pool Piping Air Handler, Tons Sprinkler Repair Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Water Gas - Appliance Bath Fan - Vented, # Pump, Domestic Fireplaces, Number of Pressure Vessel Cap - Sewer PLUMBING •TYPE. A/C Condensate OTy. TY Drains, Roof QTY. TA . l , l ,. Miscellaneous Fixture Q ' I ' V . Soakage Pit OTT 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 BY D TE Zoning /. /Li -i Electrical Mechanical Plumbing Fire Public Works Structural Building Official - .011 �I6 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 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES i ( 0 ( x .6 x/1000 ) (0.005 /sq.ft.) (Q.01 /sq.ft.) ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ C _ Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com PERMIT APPLICATION ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OFAPPRO\'AL 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 on Construction Lien Law and Choosing a Contractor. FLORIDA, COUNTY OF MIAMI -DADE 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 PERMIT APPLICATION OFFICIAL t4OT4 ' ; } SEAL: . P1' PU eei ANGELA AA Dub.: N SEAL: -, ---(1. - (.2, .0.eissioN wotit 4 O '# ° CC786(4 T " 'Al' -a O I ` I nnY co' =1:.0N �wti 40F Fv o NOV. ' :_ Personally known OR, Produced Identification 1"'"/ � 0 Personally known OR, Produced Identification Type of Identification Produced: F "V) f VI4 �y' /3 6 � -, V Type of Identification Produced: PROPERTY OWNER ' A Name D l ( fZ. i Address 0 q 9 Nc5i-- Home Telephone c 5/; !J ;7 . -25 , 3 ) c p Business Telephone 7 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'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 submit- ted along with this permit application. Step 2. Submit the completed applicatioq 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. X Job Address: Address /lE State Description of Work'e Folio Number Lot Block Subdivision Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Apt. City PB PG Zoning Linear Feet Square Feet Units Floors Value of Work / (.2 S Bldg Value Tax Assessed/Appraised Value Flood Zone PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No. PERMIT APPLICATION Zip Base Floor Elev. ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name