PAINTVillage of Miami Shores
10050 NE 2nd Avenue
Miami Shores, FL 33138
Phone: 305 - 795 -2204
Printed: 1/30/2002
Applicant: ROBERT & CHRISTINE
Owner: ODWAZNY
wilding Permit
Permit Number: BP2002 -180
MOSHEIM
ERIN
Contractor COMPLETE HOME PAINTING Address: 1476 NE 130 STREET
Local Phone: 305 - 895 - 1368 Cellular:
Page 1 of 1
Parcel # 1132050100100 Legal Description: MIAMI SHORES BAY VIEW PB 40 -16 LOT 11 LOT SIZE 75.0
Job Address: 1285 NE 94 ST
Fees:
FEE2002 -543
FEE2002 -544
Permit Status:
Description Amount
Building Permit Application *60.00
Notary Fee $5.00
Total Fees: $65.00
Permit Expiration: 7/29/2002
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.
fee is $50.00, which must be paid in advance before calling fe
This Permit is granted to the contractor or builder named above to construct tht
ordinances pertaining thereto and with the understanding that the work will be per
and approved by the proper municipal authorities. This Permit may be revoked at
authorization. A further condition upon which this permit is granted is the underst
ordinances and regulations pertaining to the work covered hereby whether shown
by his agents, servants or employees.
Signed: (INSPECTOR)
In consideration of the issuance to me of this permit, I agree to perform the woi
with the plans, drawings, statements or specifications submitted to the proper au
myself, my agent, servants or employes.
Signed: (Contractor
Construction Value:
06 ,
Total Fees: $65.0
Total Receipts:3 $0.0
r lA
m
D -0 0
x = A
O m z
z to .
0
U r to
O O m
v D f)
— o 0
v D z D
Re- irtt&otkon
0
N
0
c
1
0
z
0
0
P1
v
PAY TO THE
a ORDER OF
MEMO
X >A '
Washington utual
Washington Mutual Bank, FA
North Miami/125th Street Financial Center 1728
900 NE. 125th Street 1- 800.788.7000
' rth Miami, FL 33181 /t 2�ur Customer Ser.
7
COMPLETE HOME PAINTING
BY MICHAEL
1476 NE 130TH ST. PH. 305 - 895 -1368
NORTH MIAMI, FL 33161
/r
sl
4
I: 26 70E4 L 3 LI:a 310141335 L L111311' 3303
63- 8413/2670 3 3 0 3
8314835113
DATE ( /cg-
v2
8 `—.ow
DOLLARS '
IbP
MIAMI SHORES VILLAGU
Paint Color Approval and Agreement
/a te
OWNER'S N ME: / e/
ADDRESS: /2 /��
X >4 >6 K K K K
ADDRESS OF SITE:
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:
* *
Garage Doors
Railings
Fences
ac )14 at >c >4
All Elements on the site must be lis ed and 'ndicate the color to be painted.
Walls
Fascia
Drip Cap/Drip Edge //-
Soffit 14.414{
Roof AVG/
Flower Bins Au /!9
Shutters Ai//1
Awnings ov /
/Ai
Chimney
Doors and door jams J4
fr /
Decorative Metal
ee y
r7 Pt
All brick (simulated or regular) A/r-
�
Stucco Banding.
)ccxxxa< >Yc
Any other stucco features
Accessory Buildings
Other
PHONE:
DESERT CACTUS
i(o
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.
Signature of Owner Date Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED: WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
Building Official Date 4/23/01
311 -3(MT)
ELECTRICAL
TYI'E
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYI'F;
Outlet, Appliance
QTY.
TYPF,
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 'Ribs
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.
'I'YI'F:
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
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
Q:TY.
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
DATE 7
(
Zoning
7
-
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
)
i
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
❑ PROOF OF OWNERSHIP
(Attach)
❑ FIRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
$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
$ tee) . nO
$
'DLL
(sq.ft. = x/1000
x0.60)
(¢.005 /sq.ft.)
(¢.0I /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
PROPERTY OWNER
Name (L %f' Gn - -f rr
t4 - h in e∎ Y110dtt✓t
Addres
o- _ 0 f: 9,1 oyt,e4-
fml 4,0'e t%l. 3i13f
Home Telephone
305 434
Business Telephone
Fax
` QU /J
CONTRACTORC,v)/e7 J
p/Asi
Name . / 1. h eff
License No. 4py /3 /
Address
Telephone cf✓7S/34:64451-
Fax
Qualifier Name 7
v
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'l Attachment
Other
Add'l 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.
A PPLICATION
Job Address: ft 16 N 6 1.4 91
Address Apt.
Folio Number )I 0 5 1 2 1 ( ' ) v O
Lot 1I Block
Subdivision PB 1 40 PG /
Current Use of Property
Proposed Use of Property
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Ch► 4n1t 4110re
City
Linear Feet
Description of Work
A
Master Permit No.
Subsidiary Permit No.
PERMIT APPLICATION
YtO() 01.0
State
Zoning
Square Feet
Value of Workc9j i oD Bldg Value
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
Units Floors
3313 2'
Zip
ENGINEER
Name
License No.
Address
Telephone
Fax
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 F FLORIDA, COUNTY OF MIAMI -DADE
Signatur of Owner
SEAL:
Print Name
Sworn tt and subscribed before me this 2 7 day of 10 N
/
14I411Yi ei m o ki61 r 1
Personally known ✓ OR, Produced Identification
Type of Identification Produced:
PERMIT APPLICATION
STATE OF FLORIDA, C
Si
SEAL:
Y OF MIAMI -DADE
Signature of Contra tor / Qualifier
7 /# FL _rw11A' y e
Print Name
. o ELA BECKER
* ' n COM143610* NUMBER
CC786697
(,` fl� MY COMMISSION EXPIRES
NOV. 15,2002
worn to and subscribed before me thi day of
Personally known Produced Identification
Type of Identification Produced: