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MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 - 795,2204 Building Inspection Request Date r r Time Type Insp'n Permit No. Name'i� -�'� � 9 c 1 Address 1 c k( (>) �.-9 Ci , r 7t Company Phone # OS-" 5 1 ) 9 For Inspector: I I / Z/ Name & Date Approved / Correction Re- Insp'n Fee PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY ) d 2 Date3 - i/ Job Address / 2 ' 1) L ' l' Tax Folio/304H olio /f t Legal Description. g f /j � � s � � Permit # Owner / Lessee / Tenant 13 / ?f-`/ SWag Owner's Address /AO g A)E° 5 Phone / 257 . 7v 2 A/ /• Contracting Co. Qualifier S4/b'/E State# Architect /Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION ,49 //- 8001. y ./ 5"E s4'2 e'ra.c4 Square Ft. 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. / y e'rA' Signature of Owner and or Condo P Date: 3- ta6 - 9i , Notary as to Owner a a = /or Condo President My Commission Expires: g- / 9/ * . * * * * * PERMIT FEE: APPROVED: Zoning Mechanical Bo pM :l ,/t) ( R,97 SS # Phone 93- CQQ0 Estimated Cost Other * Engineering or Owner- Builder 7)ilYhr Electrical PERMIT APPLICATION FOR MIAMI SHORES VILLAGE D a t e i i ` g ) ' 16 J o b Address /c / E FS 3r Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant /0) $k'O 7E Master Permit # Owner's A d d r e s s /, n /1, 7,475 Phone Contracting Co. l ? v, / v (0/3 8 r Address Qualifier Phone State # AZ. Municipal # Mt' Competency # Ins. Co. l'PRJk75 Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION fff.�5i1 RE - hN #0 use l V ocx / P/P//ir ( &# ,TO 7 (? ( lug 00 Square Ft. 00 Estimated Cost (value) 5 ' 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 : lrTor Condo Preside ' , Date otary as to Owner and/or Condo President Date My Commission Expires: fir. , s � �✓ Al /' A Fo , FEES: PERMIT k / DCv RADON APPROVED: Zoning Building Mechanical /9 5 gdal Signature of Contractor or Owner - Builder Date otary as to Contractor or Owner - Builder Date My Commission Expires: - _3S =©62 FO li •1/40 o ©iAL P-05 4.4 C.C.F, 6 0 NOTAR -- IgOND L)1q Electrical TOTAL DUE Plumbing Engineering PROPERTY OWNER New Construction Enclosure Alteration Exterior Address /a `f e7=-�� Alteration Interior Home Telephone 3 6 � 77_ d d / 9 Business Telephone Shell Only Fax Foundation Only TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'l Detachment Other PERMIT APPLICATION Master Permit No. Subsidiary Permit No. INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step I. 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 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: /R e A% g'-7- s't s of M 33f '& Address Apt. City Sta Zip 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_ — ARCHITECT Name License No. Address Telephone Fax PB PG PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection Description of Wor Zoning Linear Feet Square Feet Units Floors ue of Work /' CI 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 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. STATE OF FLORIDA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature sI(Notary SEAL: f F rwigula M Becker • My Commission /001500 Expires November 15, 2006 Signature of Contractor / Qualifier PERMIT APPLICATION 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: F1 S /00••c26° d Type of Identification Produced: ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TAPE Outlet, Appliance Q'I'V. TYPE Service Repair Qi'V. 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. TVPE Generator QTY. TYPE Refrigeration, Tons QT Y. 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 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 QTV. "1'VPE 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: SECTION BY D T Zoning 71J / &( 0 tc ad.- 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 Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review Notary 4 Metropolitan Dade County (C.C.F.) $ 0 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ (sq.ft. = X/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL '& D 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 is Shores Village ocest ME ens Avern Phone: 305 - 795 -2204 Printed: 11 /7/2002 Applicant: LORETTA Owner: SWOPE JOB ADDRESS: 1208 Contractor Local Phone: Parcel # 1132060144100 Fees: FEE2002 -6303 FEE2002 -6304 FEE2002 -6305 Permit Status: (?)— APPROVED Permit Expiration: Work: ROOF PAINTING WHITE TO WHITE ' s)76 / — LORETTA J. SWOPE 1208 N. E. 95 ST. MIAMI SHORES, FL 33138 Pay to the order f "/-4 Bank ofAme'frica, �� ACH R/T 063100277 Memo �G x:063 L00 2771: 0040 L 30 25 28 ill' NE 95 Description Building Fee CCF Notary Fee Total Fees: Legal Description: 8 205 Building Permit Permit Number: BP2002 -1907 5/6/2003 Date /1 4.4 .Z) SWOPE LORETTA ST Contractor's Address: MIAMI SHORES SEC 3 PB 10 -37 LOT 15 - 16 BLK 85 LOT SIZE IRREGULAR 8205 63- 27/631 FL - 988 Dollars' 8 �" - - Amount $60.00 $1.20 $5.00 $66.20 Construction Value: Bank ofAnterica Advantage'' BY: BY: $1,500.00 Page 1 of 1 Total Fees: $66.20 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. 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 s not done in compliance with such ordinances or if the plans are changed without ctor or builder named above assumes the responsibility for a thorough knowledge of the ngs or in the statements or specifications and that he assumes responsibility for work done in compliance with all ordinances and regulations pertaining thereto and in strict conformity res Village. In accepting this permit I assume responisibility for all work done by either /DATE: O 4- IOWNER' S NAME: „G c' & 17 37- S'1 flc PHONE: 0 d�-),7,6ls ,7,Z / 9 (-ADDRESS: /q c �; '' _ �• �-� 1V1��'l.1V11 0.111 , V ilLEAUE Paint Color Approval and Agreement FF ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** LADDRESS OF SITE: �5 e- CONTRACTOR & LICENSE (if applicable) a' 1 n COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * ** * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls • Fascia ' Drip Cap/Drip Edge ri. Soffit Roof L -- 4 ) ,t-e, ` ° ey aia : Flower Bins ro Shutters - c Awnings - Chimney y Doors and door jams Garage Doors Railings Fences cn APPROVED: Building Offici if 6 0% Date Decorative Metal All brick (simulated or regular) Stucco Banding Any other stucco features Accessory'Buildings Other WNER'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 sa ,.les. Signature o'Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01