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1065 NE 94 St (3)Date a' / %6 Job Address 111 ature of o d/or Co President Date `- ti/cc 1 -o . FEES: PERMIT APPROVED: Zoning ondo President x'MANN GILL My Comm Exp. 11 -13-97 Bonded By Service Ins No. CC326705 Ipemmu limbo La ya. PERMIT APPLICATION FOR MIAMI SHORES VILLAG Mechanical Plumbing /"5—,1--- 9 �J 2 Tax Folio Legal Description Historically Designated: Yes Owner/Lessee / Tenant ! 7 /c / a / �C2/i 57X/2 4v Master Permit # tc>f Owner's Address /e'6.. / 7P S,' Phone Contracting Co. C� of �ps� �� ia �y ®4e�. Address 3623 Qualifier 1Lin7 / SS# Phone fCf' /#21f-5 .�ysLl State # Municipal # Competency # 7 n..500.320 — Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION /, Ar,�, r -D /5 , ,00 1.7 7 to wf�,t Square Ft. Estimated Cost (value) "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. OWNERS 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. ank .Gniv`/ - JO- q (o RADON C.C.F. Bu„., :q* u'}ab Signature of Contractor or Owner- Builder Notary as to Contractor or Owner - Builder Date My Commission Expires: - - - • - • it 1 • ' �,�� l ' - I( NOTARY p, ' BOND Electrical TOTAL DUE 2 oP6 Date y6_ Engineering Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 1 /17/2003 Applicant: ALICIA MANGHAM Owner: MANGHAM ALICIA JOB ADDRESS: 1065 NE 94 ST Contractor Local Phone: Parcel # 1132050120100 Signed: Building Permit Permit Number: BP2003 -79 Contractor's Address: Legal Description: KIRBYS ADD TO MIAMI SHORES Page 1 of 1 PB 41-44 LOT 10 LOT SIZE 75.000 Fees: Description Amount FEE2003 -323 Building Permit Application Fee $60.00 FEE2003 -324 CCF $0.60 FEE2003 -325 Notary Fee $5.00 Total Fees: $65.60 Total Fees: $65.60 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 7/16/2003 Construction Value: $200.00 Work: EXTERIOR PAINTING AS PER AGREEMENT 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. (INSPECTOR) BY: 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. (Contractor or Builder) BY: alls ascia APPROVED: MIAMI SH(1RES•VILLAGE Decorative Metal- • • .. • Paint Coldr Afp'rbVat aid Agreement . . ••• • ..• •• •• .. • ATE: 0 — 5— 0 3 • • • • LWNER' S NAME: 11 • n h a i�' PHONE: 30S a Q Cr, 01 — DRESS: (0(05 IJ E `i - .. s : fi ** * � ** * * * * * * * * * * * * * * * * * * * ** * * * ** * ** * * * * * * * * * * * * * * * * * * * * * * * * ** . 1DRESS OF SITE: 10(0.W' :14 R':: CONTRACTOR & LICENSE (if applicable) ! / /1. COMPANY NAME: PHONE:' ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 11 Elements on the site must be listed and indicate the color to be painted. }/& LO (A) S a m e P ? #1 Drip Cap/Drip Edge Soffit Roof Flower Bins Shutters Awnings Chimney Doors and door jams Garage Doors Railings Fences Fr or, s a r LC) i o r Building Official Date All brick (simulated or regular , Stucco Banding Gre e 1e - no& Pet WI 4 -r4-q Any other stucco features Accessory Buildings Other Lr t r'A 5 4i'vu 01) tivity y -DH 0 0 WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION � M31n38dao -100 DH ®31100W NIWVIN38 c r pr veil ` l r n -e 41*re � - fi1 - 10A ca ° of bou 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. Of - Ls - 03 Signature of Own Date Signature of Contractor Date * ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 4/23/01 0 1 ELECTRICAL 'F1'1'E Minimum Fee QTY. TYPE Dryer •• • • • ;1TY. • TY:'E. • Opjlgt, \ppliance QTY. 'FvI'I: Service Repair QTY. A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch 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 QTY. TYPE Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/VVin. 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 Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. 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 6eing - niedk a$d quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY D TE Zoning P - -erAW Electrical / Mechanical Plumbing Fire Public Works Structural Building Official sv Page 4 OFFICE USE ONLY ❑ 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.) $ • • • • • • • • ••. • • • • • • • • • • • • •.• • • • • • • ••• • • .•. • ... • CHECKLIST • • • • • • • Inspector State Educational Fund $ (¢.005 /sq.ft.) State DCA (Radon) $ (0.01 /sq.ft.) Code Enforcement Fine $ Zoning Review Notary • ❑ PRO0 OfOWN)#2SII •�' ❑ CONDO ASSOCIATION APPROVAL (Attach) PERMIT APPLICATION (Attach) •• ••• •• • • • •• • • • . . . . • • ❑ HRS / 1DERMIPP141M: ••❑ BPR APPROVAL (Restaurants) (SepticISe er) • • • • • • • ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ .OD (X .ft. = x/1000 ❑ CONTRACTOR REGISTRATION (On File) TOTAL $‘__C , b - 1) 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 Page 2 IMPORTANT NOTICES DO NOT BEGIN ANY WORK WITHOUT HAVING R4E1VE3) tOURyA3..IDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited ta: MbRday thr&fglk 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 PT E2M DiRliAND DBBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAC1 BYMIAATIE►1TIJR: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 atn 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 $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE > ('rnkL '� gnature of Owner F m • nt Name w.m to • nd subscribed before me this day or Ole i &A ignature oflotary Pub1i• • ' _ SEAL: . ... 2J _ f 4 o•-i Becker My Commission DD150048 a n dP Expires November 15, 2006 • .. .. • • • • • • • • • • • • • .•. • • • • • • • • • • • .•.. ...•••• • v PERMIT APPLICATION STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Personally known OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produced: F. J > y 0- pe of Identification Produced: PROPERTY OWNER Name fr i K E I t p40314 iii_ '') Address J 106S OE clq Home Telephone 305 -7 E ti Q (poi Business Telephone so s 322 5 - 1 'F v Fax SOS - 7- 5 8 f3 TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Step 2. Complete the attached permit application whiebmustbe signed.lay the prpperjy owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate phesst 1p$f jlott aaplcaOgn. 1'froofing work will be done, a roofing application must be submit- ted along with this permit application. • • • • • • • • • • •• • • • • • ••• •• 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 Mta.M1 Stkot2ES PL 3313`i3 rr City State Zip Folio Number ( /Description of Work 1�F + 1& T OUT' s kde W 4.LL S Job Address: MS OE 6 14 s Address Lot Block •• •• • • • •• •• • • • • • • • • • • • • • • • • • 000 • • • • • • • • • • • • • • • ... • • • • ... Master Permit No. A? ' a OD.--3 , g---2 • •; • • •• ;•s l:b1i Y:P arrermit No. 1 • • • • Apt. • .• • •• •••• PERMIT APPLICATION Subdivision PB PG Zoning Linear Feet Current Use of Property Square Feet Units Floors Proposed Use of Property /Value of Work 17 ' ® Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other-re M 7� L/ PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name