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PAINTPage 2 IMPORTANT NOTICES K 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. S iA OF FLORIDA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE SEAL: Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: PERMIT APPLICATION Personally known OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produced , (I3 Jti ' ei-xs • elg („00 ype of Identification Produced: PROPERTY OWNER New Construction NameJ ( ik. `l e T e 1. Enclosure Address I s U ' `I E kS /a Home Telephone —30S r1s (: in Business Telephone 31 % ss �s Fax '3 � DS 54 11 7 3- TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'1 Attachment Other Add'l Detachment Other Step 1. K Job Address: Address PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: 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. A PPLICATION ioso N 9S Folio Number Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Apt. City Description of Work '\am'∎ . 3hofes State -e•icA-e or PERMIT APPLICATION Master Permit No. Subsidiary Permit No. Zip Zoning Linear Feet Square Feet p � Units Floors K Value of Wolf ij,vv Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name MIAMI SHORES VILLAGE' Paint Color Approval anrd',Agreeppent DATE: la • • OWNER' S'` N M : CJ c,� 11 bra_ • • ; • � • • : R OI •. DS' `1 O (Pk, ADDRESS: i 0 e O NC, qS ••• ••• ;cxxxxxxxxxx.cxx Building Offi al 4cxxxxxx �C* ADDRESS OF SITE: Its s b N e • Roof Flower Bins Shutters Awnings Chimney Doors and door jams Garage Doors Railings Fences Decorative Metal • All brick (simulated or regular) Stucco Banding Any other stucco features Accessory Buildings • 4 x it wie xe�: • ••. • • • • •,• • • • .. • • • ••• -- *xxxxxx CONTRACTOR & LICENSE (if applicable)•• COMPANY NAME: PHONE: *x* x xxxxx xx exx9e xxxx xx3exxxxxxxxxxxxx3e*Ae>,exx>,c All Elements on the site must be listed and indicate the color to be painted. Walls G'l c \0 ?Fascia ? ti o r Drip Cap/Drip Edge r 0 Soffit 5 gin) h cn H )3 � r1a e (0 004 ti Other 1A-r i 'De co ak v,ve co e- _, / - $-r h') (j, yyt ' Ali � ".�., , I'lh t 1 �- T qjv0.l_ , i OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate pod- Joe 7 and that all work will be done in compliance with all applicable laws regulating („aulge L°iC ' construction and zoning. I authorize the above -named contractor, if applicable, to 0e 6rlct leri the work stated. Furthermore , the paint colors will be as per the attached fo be. P sa ales. wed s ;nature of Own. � a e Signature of Contractor Date ******************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: P g"4 �,�� - S . WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION . -coeN Yelioco 4/23/01 Architect Contractor or Builder -it -- � Legal Lot II Description II Bl. Address of ti Building 0 0 r�I 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 applica- tion 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 be assumes respon- sibility for work done by his agents, servants or employees. Signed:. f . �� -2 'e - '' (INSPECTOR) BY In consideration of the issuance to me of this it I agree to perform the work covered hereunder in compliance with all ordinances and regulations - pertaining thereto and in strict conformity with the p ans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. � 1 In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. DANIEL T. BRADY JULIE ANN BRADY 1080 NE 95th Street Miami Shores, FL 33138 Pay to the Order of For SunTrust Bank Miami Miami, FL (30S) 591,6000 BUILDING El ELECTRICAL ❑ PLUMBING ❑ ROOFING ❑ MECH ❑ Owner of .' �� Building ( CONTRACTOR or BUILDER 1 :066000604 1 .036001 L 3L), 7637 MIAMI SHORES VILLAGE, FLORIDA Date /cY/ / PERMIT 50 4 1 0 PERMIT CARD MUST BE AVAILABLE FOR ALL INSPECTIONS n Work to be performed under this Permit a tiC Y X n • l � ( -0' 1 c_ 305 - 795 -2204 7637 2 - , Date 11/1M-R-d /O - CeC % C $ (0SX ,76 y •4 Dollars 63- 60/660 M' k Contractor's License No. Subdi- 1.- t:'t(_') - - (( ({ C i-'1 5 vision ► ) c3 (. Li ) 'y Sq. Ft. Value of Project $ (2 `- CQ )149A/ C' ;) Permit: CCF: Notary: Bond: Radon: Amount of Permit: BY AUTHORITY 20 ! QD nC� . O C . Co Q ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton Fan Dryer Vents, Number of Outlet, Wall Ventilation, Cost Service, Temporary Air Handler, Tons A/C Central 4-7 Ton Piping, Flammable Liquid Fire Pump Outlet, Switch Fire Sprinkler System Signs A/C Central 8 -15 Ton Bath Fan - Vented, # Fixture - Fluorescent Pressure Vessel Oven Pump, Domestic Space Heater (kw) Supply, AC Well A/C Central 16-20 Ton Cap - Sewer Fixture Light Gas - Natural Parking Lot Lights Pump, Fire Stand Spas/Hot Tubs Temporary Toilet A/C Central 20+ Ton Catch Basin Flood Lights Gas - Propane Plugmold/Strip Pump, Re circulate Subfeeds, No. of Amps Temporary Water Closet A/C Window Clothes Washer FPL - Load Central Gas Piping Posts Pump, Peplace - Pool Swim Pool, Commercial Urinal Air Conditioners Dental Chair Garbage Disposal Grease Trap Range/Range Top Pump, Sprinkler Swim Pool, Residential Utility - Sewer Chiller (Discharge Well Generators, etc. Ice Maker Receptacles Pump, Sump Switchboards Utility - Water Clear Violations (Dishwasher Heat Recovery Indirect Wastes Refrigerator, Comm. (p/PH) Relay Repair Temp Serv., Construction Vacuum ' mp Compactor Disposal Low -volt, Burglar Interceptor Refrigerator, Domestic Roe Inlet Temp for Test - 30 days Water Closet Deep Freezer Domestic Weal Low -volt, Fire Laundry Tray Renew - Temp Service Septic Connection Wate eater Demolition IlDrainGeld, 4" Tile/Res. Low -volt, Intercom/Teleph. Lavatory Repair Circuits Septic Tank Water Heater New Dishwasher it rains, Area Low -volt, Television eter Set (Gas) Service, Number of Amps Sewer Connection Water Re -pipe 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/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Solar Water Heater Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Fixture Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Pump, Domestic PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE_ Miscellaneous Fixture QTY. TYPE Soakage Pit QT Y . 1 Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Fountain Pool Piping Pump and Abandon Sprinkler Repair Sprinkler System Cap - Fixture 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, Peplace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer (Discharge Well Ice Maker Pump, Sump Utility - Water (Dishwasher Indirect Wastes Relay Repair Vacuum ' mp Disposal Interceptor Roe Inlet Water Closet Domestic Weal Laundry Tray Septic Connection Wate eater IlDrainGeld, 4" Tile/Res. Lavatory Septic Tank Water Heater New it rains, Area eter 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 DATE Zoning 'Z /1 / -Q! Electrical Mechanical J Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY CHICKLIST ❑ 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 $ ( sq.ft. = x/1000 x ¢.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 $ ISSUING OFFICIAL 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