PAINTMiami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2002 -2084
Printed: 12 /4/2002
Applicant: BRUCE BROWN
Owner: BROWN BRUCE
JOB ADDRESS: 402 NE 95 ST
Contractor
Local Phone:
Parcel # 1132060140470
Fees: Description Amount
FEE2002 -6894 Building Permit Application Fee $60.00
FEE2002 -6895 CCF $0.60
FEE2002 -6896. Notary Fee $5.00
Total Fees: $65.60
Total Fees: $65.60
Total Receipts: $0.00
Permit Status: Approved Permit Expiration:
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
r�f� fee is $50.00, which must be paid in advance before calling for another I.,�.,o...r,...
N 1 ` 1 This Permit is granted to the contractor or builder named above to construct the b
ordinances pertaining thereto and with the understanding that the work will be perfor
( >Q and approved by the proper municipal authorities. This Permit may be revoked at ar
authorization. A further condition upon which this permit is granted is the understanc
rdinances and regulations pertaining to the work covered hereby whether shown on
by his agents, servar}i or employees.
Signed: .2 (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 authoril
myself, my agent, servants or employes.
Signed'
Building Permit
Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOTS 11 & 12 BLK 52 LOT SIZE 100.000 X
5/25/2003 Construction Value: $1,000.00
(Contractor or Bu
Contractor's Address:
BRUCE L. BROWN
402 NE 95TH ST. 305 - 758 -130
MIAMI SHORES, FL 33138 -2730
PAY TO THE
ORDER OF
W Was sngton Mutual
NOTE
Washington Mutual Bank, FA
Miami Snores Einanciai center 1.722
9640 NE. 2nd Avenue 1-800-760.7000
8h -s FL33138 2a
I: 26 7084 L 3 LI:B 3 Liv46 24?
Page 1 of 1
63- 8413/2670
8314624706
DATE
2183
$ , 5 7 GO
ARS
8
ypny
a �
DATE: iclov •Uo�
OWNER'S NAME: ,Q�cP. ;P ';�,� • : �'t bNE:��,5 5a5
ADDRESS: YOB .JAS �It5;: 614 /•iPl/ • • r ~s �. 9
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: WA Aix...
CONTRACTOR & LICENSE (if ap 1iEabk.; • :__ • .:
COMPANY NAME: PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * ** * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls
Fascia
Drip Cap/Drip Edge
Soffit
Roof
Flower B ns
Shutters
Awnings
Chimney
Doors and door jams
Garage Doors
Railings
Fences
Decorative Metal
natur
* * * **
MIAMI SHORES VILLAGE
Paint Color Ai3pOd�aa�aindAigreement •
• •
*
APPROVED:
All brick (simulated or regular)
Stucco Banding
Any other stucco features
Accessory
Other
Building Offic i Da e
• • • --
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
r , P ate Signature of Contractor Date
********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
o-
0
4/23/01
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The Sunshine State —
UCEME NUABER
B650 -072- 54 -041 -0
BRUCE LEO BROWN
402 NE 96 STREET
MIAMI SHORES, FL 33138 -2730
BIRTH DATE SEX Nr3T. REST. ENDORSE.
02 -01-64 M 602
ISSUED EXPIRES DUPLICATE
11 -12-08 0241-06 000000
SAFE DRIVER
ORGAN DONOR MOTORCYCLE ALSO
11120227
Operation of a motor vehicle constitutes consent to any sobriety test required by law.
ELECTRICAL
TYI'E
Minimum Fee
QTY.
TYPE
Dryer ;
(n,.
• ;
ri PE
p4 4,'4p4liance ;
QTY.
Tvi
Service Repair
QT v.
A/C Central 1 -3 Ton
Fan ••
• •
dutlet, Waft' ••
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.
TYI'E
Generator
QTY.
TYPE,
Refrigeration, Tons
QTV'.
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
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
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PERMIT APPLICATION
• • • ••• • •
., .• • • •• ••
INSTRUCTIONS: Please indicate the type of w be p a n d g u�x t ity( i es) in the space provided below.
••• •••
VI WW1/
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)
• •• •• • • • •• ••
• • • • • • • • • •
• • • ••• • • •
• • • • • • • • • • • • •
• ••• • • •••••• •
• • ••• •
• 9 PROOF OF OWNERSHIP• • •
(Attach)
•• ••• •• • • • ••
❑ •1'IRsiDtRM:AAP124VAI✓•
•. • (Vail leNtSr : • • • •
❑ 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
Notary
$ 6O
$ 1< C' (sq.ft. = x/1000
x t.60)
$ (¢.005 / sq.ft.)
$ (¢.01 /sq.ft.)
g
BY
/9 P .G,
SECTION
Zonin
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
DATE
/
7 ,
•
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $ 1jS�
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
PROPERTY OWNER
New Construction
Name /f
/
, , L��
AddresoL. e.
/i 473i°'
i � " Rq d
44 4 / '
Home Telephone G
✓ �� 2
—
F '.� �
lit'' • . ,�,':
$f d/'//'
F •
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'I 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 lio•signed by the prapertyownernand qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing yob Zf Qapfing 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:
9,5 5
Address A
Folio Number
Lot Block
Subdivision PB 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
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•
• • • • • • • • • • • • • • •
Master Permit No.
• • 1 : �;tbs; t�iary lr4rltit No.
•
• • • • • • • • •
• • • • • • • •
PERMIT APPLICATION
/,c/e t - 0/5?
City State Zip
Description of Work �/�'`Z (745 3 � �i�-
Zoning
Li ear Feet
Square Feet Units Floors
)aIue of Work /GaG; ' 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
• • • • • • •
DO NOT BEGIN ANY WORK WITHOUT HAVING 1tECEIVEp /Op : ALIDAT,ED CERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Meedtty tlteugh 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 g1~:(0,R4E.FIi24 Dilt%AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING.DAMA E?ur EDLCIPI2IE:1TOR 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.
STAT . • IDA, C ► Y OF IAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Print ame // `' /r Print Name
to a d subscribed before me this 4f4 day of N4 1 / , Sworn to and subscribed before me this day of
''e of Notary
SEAL:
Type of Identification Produced:
onda
Angela M Berkey
•
• •• .. • • • .. •.
• • • • • • • • • •
• • • .•. • • •
• • • • • • • • • •
.... • ...•.. •
Signature of Contractor / Qualifier
ignature of Notary Public - State of Florida
SEAL:
PERMIT APPLICATION
1+� MMyCariftrtM 001/0049
Personally Imown °°F". ' p OR, ProdaceAcin ication Personally known OR, Produced Identification
pe of Identification Produced:
PERMIT APPLICATION FOR MIAMI SHORES V
Date X'' Job Address , -1(' .c1 9 —' Tax Folio / / — ,3 2.0 6. •-
Legal Description Le %//‘/# c2((
Owner/I.essee / Tenant
Owner's Address 1��� .. ,(J/ �� .
Contracting Co. 0 W L( iG/Ci
Qualifier SS#
Competency #
Address
State #
Architect/Engineer
Bonding Company Address
Municipal #
Address
T
Historically Designated: Yes No
Master Permit #
;t /0 Phone
Phone
Ins. Co.
v t /
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICA : PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION /9 //u �< <� �� t�o �J „ ,� Vd 4��Fri
Square Ft. Estimated Cost (value) DSO a
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 zonir�gl Furthermore, I authorize the above -named contractor to do the work stated.
Notary as to Owner and/or Condo President
My Commission Expires:
}'(, OFFICIAL NOTARY SEAL
0 e �- SCOTT W DAVIS
`' 1)` :i �* COMMISSION NUMBER
� " (. CC255237
7 ! 45$ Q MY COMMISSION EXP.
F C F C JAN. 26 1997
resident Date Signature of Contractor or Owner- Builder Date
Date
Notary as to Contractor or Owner- Builder Date
My Commission Expires:
FEES: PE RMIT RADON C.C.F. . SO NOTARY �O C TOTAL DUE A,lf..",r®
APPROVED:
Zoning Building 1CIP
Electrical
Mechanical Plumbing Engineering
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date Time / , ,
Type Insp'n - ' _ ?;Ai / "' y,
Permit No. ' fI
Name /tom, l ' /-fc- '��.* , Address (2 `� f L 1
�
�_j �
Company . ( *6 :. t _
rl
Phone # 7 o ' G I G.
For Inspector:,
Approved
Correction
Re- Insp'n Fee
Nam Date