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285 NE 95 St (4)ER PROPF�R�Y A L--E, ,� ec / N ame a _,, A Enclosure Alteration Exterior Address W / I / 14 ? , & Home Telephone 3 7s'7 ? 7 7 - -- e Business Telephone 3,51s-__ &c::, 0 s 7 ( x Fax Fax Foundation Only 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 • • • • • • • • •.• • • • . • • • • ••• • • • • • • • • • • • • • • ••• • • • •• • •• • • • • • • • • •• • • • • • • • • • •.• ••• Master Permit No. Subsidiary Permit No. PERMIT APPLICATION ti'24) INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: •• • • • Step 1. CompltF th4ytacti'ed peimie aphlicatidh which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type V:114v �pra more accuva eprocessing of your application. If roofing work will be done, a roofing application must be submit- ted along with tlfis 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: Address ,4}E s; (2 /#/#3o7 Sirs• Apt. City State g � Zip Folio Number scription of Work /'7ti ` / /C / Lot Block Subdivision PB PG Zoning Linear Feet Current Use of Property Square Feet Units Floors Proposed Use of Property Value of Work / Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. 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 ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Page 2 I/ /► . ILL ignature of • ; m .rich • • M mission DD150048 or ctI Expires November 15, 2008 SEAL: SEAL: ••. • • , •. .. • ... • s . • • •... Signature of Contractor / Qualifier ee• • • s • • • • PERMIT APPLICATION •• • • • Signature of Notary Public - State of Florida • IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CXRD, e Applyint•fer 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. • • o••• 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY tON TIVN•free f n coistru &tjpn debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBI:IS. : • •. • : : •; • • 4. SWALES MUST BE PROTEL I hD FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AAI[?M14Y•NOT 5riUStECFOfi 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 Print Name Sworn to and subscribed before me this day of Personally known OR, Produced Identification � Personally known OR, Produced Identification Type of Identification Produced: 77--DL c3 S o " - LIC 4 63-0 Type of Identification Produced: ELECTRICAL TvPF. Minimum Fee • • • • rl','. ' ' fYP';. Dryer QTY. TYPE Outlet, Appliance 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 QTV. TYPE Generator QTY. 'FIT'E 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 QTV'. TYPE Soakage Pit Q'I'Y. 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 INSTRUCa'JOE1• Please irftlicate the We of work being performed and quantity(ies) in the space provided below. .• • • RECEIVED AND REVIEWED BY: DATE: 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) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $3.00 per page (Scanning Fee) $ Miami Shores Village Bond $ Cz. D . 00 Metropolitan Dade County (C.C.F.) $ " L D (sq.ft. = x/1000 • x ¢.60) Inspector State Educational Fund $ (¢.005 / sq.ft.) State DCA (Radon) $ (¢.01 /sq.ft.) Code Enforcement Fine $ Zoning Review Notary $ .D 00 ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: SECTION Zonin Electrical Mechanical Plumbing Fire Public Works Structural Building Official DA r ••• • • •• • ••• • • • • • • • 00. • • PILI IFI; APPLICATION • • • • ••. • • • • • • •• • ••• ❑ CONDO ASSOCIATION APPROVAL ° ° jAttaeh) •• •• • • • • • ••• •• ❑ HRS / DERM APPROVAL 0'114 L (l1eslat - ants) (Septic / Sewer) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ • ••• • • • • • •• OS LLD Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Miami Shores Village 10050 NE 2nd Avenue Phone: 305 -795 -2204 Permit Number: BP2002 -2181 Printed: 12 /16/2002 Page 1 of 1 Applicant: JAMES KEEGAN Owner: KEEGAN JAMES JOB ADDRESS: 285 NE 95 ST Contractor Local Phone: Parcel # 1132060133960 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 - 70 LOT 22 & E1/2 OF LOT 21 BLK 29 LOT SIZE Fees: Description Amount FEE2002 -7232 Building Permit Application Fee $60.00 - 7::::::::::"?-7233 CCF $0.60 FEE200: '7234 Notary Fee $5.00 Total Fees: $65.60 Permit Status: APPROVED Permit Expiration: 6/14/2003 Construction Value: $1,000.00 Work: EXTERIOR PAINTING AS PER AGREEMENT If there is no permit package accessible on the job -site for ins fee is $50.00, which must be paid in advance before calling for a This Permit is granted to the contractor or builder named above to construct the bui ordinances pertaining thereto and with the understanding that the work will be perform and approved by the proper municipal authorities. This Permit may be revoked at any authorization. A further condition upon which this permit is granted is the understandi ordinances and regulations pertaining to the work covered hereby whether shown on by his agents, servants or employees. Signed: (INSPECTOR) In consideration of the issuance to me of this permit, I agree to perform the work co with the plans, drawings, statements or specifications submitted to the proper authori myself, my agent an or employes. Building Permit Contractor's Address: Total Fees: $65.60 Total Receipts: $0.00 JAMES D. KEEGAN 285 N.E 95TH ST. MIAMI SHORES, FL 33138 -2711 Pay to the Order of •:0660 10 3? 7u: 11'90 20006 3 1 4u' 63- 1037/660 2 • Dollars 8 OLDEN PLUS ACCOUNT •• • • • • • • • •• • •• •. • • •. • •••• • • • • •••• • • • •• • • • •••• • • • • • •••• • • • • • •• • • • ••• • •• • • • • • • • •• • • • • • •• •• • • • • •v • •• • • • •.•. FLLO - 'NEVE at The Sunshine State JAMES DAVID KEEGAN 285 NE 95 ST . MIAMI SH, FL•33138 -2711 . I..n. . .n m b! Jix, hM•ucf Vl Nt$ 08 -03 -46 14 5 -10 k °.lwr� b1 -12 -1993 . K250- 444 -46- 283 -0•-4 8 -03 -1998 .CLASS: E SAFE DRfyER 00 -0000 . 4. iv11.Ex.i.v1L.OrivU1 LJ V kLLA(rL Paint . 4 o3or Approval and Agreement DATI •: ;;�� :/` 0 OWNIR:S N 'ti•' PHONE: ADDRESS � * * * * ** **,”* 4**.******:************ *** * * * * * * * * * * * * * * * * * * * * * * * * * * ** • ° ADDRESS; ;S 3 • • �r �� . CONTIRAC.''l & LICENSE (if applicable) tea/ COMPANY NAME: PHONE:. ********************************* * * * * * * * * * * * * * * * ** * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted.... Walls Z/% /U/4 /,A / Fascia • • Drip Cap/Drip Edge Soffit f Roof Flower Bins Shutters Awnings Chimney Doors and door jams &U/ /7 Garage Doors Railings Fences Decorative Metal All brick (simulated or regul r) Stucco Banding Any other stucco features ,5 / Accessory'Buildings �( ther APPROVED: 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 rk stated. Furthermore , the paint colors will be as per the attached /J- /2 Building Offic .1 b ate . o • 0 cn cn ro /g/ V— / • !fan &a Hint is ature of Owner Date Signature of Contractor Date * * * * * * * * * * * ** ******************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01