340 NE 94 St (3)MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work. f .
1 Date a , 19C e
i
Owner's Name and Address ' E./..4) 00-0.41.6 .T / i &) No. AS 1 / Street G / 3 o 5r Z
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done i '� e '
State work to he done and purpose of building (by floors) .27A5 re9I.bA C# / 6 / .i. i") t.-
44118 ( 1?� )Ti k!L'/ d l/A�/i -9 1_l �G'" -a .CY z oik 7u s— L° .e_r5?.c/aa d�r� p ct ,�.vG )
' T6i hoot. ) v
/(�� °i /N ,F1.�.+�f�.�J.;. - f.t1�5'�/tTL - ../> I �clCT - � �L�,� � � 07 %G G A� 6 - i %i/ and'for no other purpose.
'`lew Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
aeo G G
Estimated Total cost of improvements $_al. ! e—
Zone cubage required
Distance to next nearest building
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to -- N /3;45 .5 efr 4 _ 1��. •�
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such sukcon)aactors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
f
Remarks
Permit No / 'r ! Date
Disapproved
(Signed) l�
Building In ctor
e� .tJi G1' /46;0"..../,' !
Amount of Permit $
_Plan Cubage
Size of Building Lot
(Signed)
Read, Sworn to and Subscribed before me.
STATE OF FLORIDA,
COUNTY OF DADE. J ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the_
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him statedprpiie.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
it 3 -6 /3 6*/)
a L 4 APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement or toe plans and specifications herewith submitted for the build •
in or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
r � y �� -.- � ,11
Owner's Name and Address 1 � _" te..No .: .
Street_.... —
` —
Registered Architect and /or Engineer �J
` ' 'L 2 . ::. ,<.••• ,.., - .,.
Name and address of licensed, contrpcto1�. _ . Z „s
Location and legal description of lot to be built on: - GV 0 i in / — 3,3d /
Lot Block Subdivis�ion
Street and Number where work is to be done Q V�.[.. L�.�. 2.
State •r to be done and purpo c of buildin (by floors)..
STATE OF FLORIDA,
COUNTY OF DADE. s$ •
Permit No.
Disapproved
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Date 1Mi&5
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Inspector My Commission Expires
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Co Bring
Estimated Total cost of improvements S•... . Amount of Permit S. t i .
Zone cubage required .Plan Cubage
Distance .to next nearest building. Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
•
be sent to..
The unclersigr,cd applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of Libor under the Florida Workmen's Compensation Act, being Section 5906, Compiled General Laws of Florida, Permanent Supplement.
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only s , • •ntractors, on work to performed under this
pennit, as are licensed by Miami Shores Village.
Remarks (Signed)
Before me, the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all fads
therein by him stated are true.
PLANNING BOARD DATE
Chairman Member
\Icrr:bcr Member
Member .. .. Member —.._.....
Council Approved Date Disapproved Date
NOTE: A charge of 51.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
CONTRACTOR
Name C .+ R. A ; r Co rn c1 . Go.
License No. c A c, rl 0 v w 1 4
Address ss
Q„0. boy 66i 330/1imrnn P. 3S16a
Telephone 30 664 Fax je �o' ^ , S '
Qualifier Name is t _ e rT ` C sn rr
1�1 1
PROPERTY OWNER
New Construction
Naive to i I l t 0 vvI
c r ir y
Address
Repair
Home Telephone 30S" . 7E6..
7 1
Business Telephone
1 1
®J / Sxl
r c l 7 - )
'T
Fax
Shell 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 C)tct c f cap (ct c Q vv vtiT
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
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: 3 0 , E J l
PERMIT TYPE ( ✓
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
ARCHITECT
Name
License No.
Address
Telephone
Fax
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.
Address
Apt.
Folio Number Description of Work
Lot Block
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
/1/( tr (SIA0tea
City
Tax Assessed/Appraised Value
fI -
State
PERMIT APPLICATION
Master Permit No.
Subsidiary Permit No. -e220(f
Zip
Subdivision PB PG Zoning V Linear Feet
Current Use of Property Square Feet Units Floors
®o
Proposed Use of Property Value of Work y 6 S • Bldg Value
Tenant Information
Flood Zone Base Floor Elev.
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.
Signa
RIDA, COUNTY OF MIAMI -DADE
Print Name
Sworn to and subscribed before me this AP day of
Signatu
SEAL:
is - State of Florida
Joyce Kran
ld; COMMISSION # CC808 PIRES
February 14, 2003
SOWED THRU TROY FAIN INSURANCE, INC
etc
Personally known OR, Produced Identification
Type of Identification Produced:
Sig4ia(ure of Con 'Ti •ua
o 3 .
Print Name
[s (Joy ern b ri -
Sworn to and subscribed before me this le day of
SEAL:
Signature of Not
Personally known
PERMIT APPLICATION
OF MIAMI -DADE
c - State of Flori
Joy a Kranz
M" COMMISSION,# CC808950 E 'IRES
Februa' 14, 2003
BONDED TAU TROY F . • CE, INC
OR, Produced Identification
Type of Identification Produced:
ELECTRICAL
TYPE
Minimum Fee
I TY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
A/C Central 1 -3 Ton
A/C Central, Tons 1 =j'
Fan
'Cooling Tower
Outlet, Wall
Heating Strips, each I: MpKt.j
Paint Booth
Service, Temporary
Vent Hood, Cost
Ventilation, Cost
A/C Central 4 -7 Ton
A/C Wall/Win. Tons
Fire Pump
Dryer Vents, Number of
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
TI'PE )'T Y. TYPE QTY. TYPE QTY. TYPE QTY.
Minimum Fee
TYPE
Drains, Roof
i Condensate Drain
TYPE
Miscellaneous Fixture
Generator
'rYl'li
Soakage Pit
Refrigeration, Tons
Bath Tub
A/C Central, Tons 1 =j'
C '
'Cooling Tower
Miscellaneous Repairs
Heating Strips, each I: MpKt.j
Paint Booth
Solar Water Heater
Vent Hood, Cost
Ventilation, Cost
Bidet
A/C Wall/Win. Tons
Filter Replace
Dryer Vents, Number of
Air Handler, Tons 1_ --Tp,,
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Gas - Appliance
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Gas - Natural
PLUMBING
TYPE
A/C Condensate
'I'1'.
TYPE
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTY.
'rYl'li
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
DATE
Zoning
Electrical
Mechanical
rIZis l y
(l, 2/, c, Z.
Plumbing
Fire
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
GI E CKLI
CI OWNER - BUILDER FORM
(Attach)
CI FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
CONCURRENCY
(New Construction)
LI OTHER
(Specify & Attach)
CI PROOF OF OWNERSHIP
(Attach)
HRS / DERM APPROVAL
(Septic / Sewer)
IMPACT FEE
(New Construction)
OTHER
(Specify & Attach)
PERMIT APPLICATION
CI CONDO ASSOCIATION APPROVAL
(Attach)
BPR APPROVAL (Restaurants)
LI CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
$3.00 per page (Scanning Fee) $
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $ 3 -r 0
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine $
Zoning Review
$ 75
( sq.ft. = x/1000
x ¢.60)
(¢.005 /sq.ft.)
(¢.01 / sq.ft.)
REVIEWED AND PREPARED BY:
TOTAL $
ISSUING OFFICIAL
DATE:
jCONDITI N OF APPROVAL
Revised July 2001
10050 N.E. 2N AVE., MIAMI SHORES, FL o (305) 795 -2207 o FAX (305) 756 -8972 o http : / /www.miamishoresvillage.com
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 11 /21 /2002
Applicant: DYNISE
Owner: PERRY
JOB ADDRESS: 340 NE 94
Contractor C & AIR SERV ICE
Local Phone: 305 - 888 -6560
Parcel # 1132060136160
e2 4
�e �s o 0
C� p— 3,o°
Permit Status: APPROVED Permit Expiration: 5/7/2003
Work: EXACT REPLACEMENT OF 5 TON SPLIT SYSTEM
If there is no permit package accessible on the job -site for inspettoi
fee is $50.00, which must be paid in advance before calling forranothsr&
This Permit is granted to the contractor or builder named above to oany2rucn Qhre di ill Ii ,� tin rt lith
ordinances pertaining thereto and with the understanding that the work will tie peirtrirreit rm • n Ilia
and approved by the proper municipal authorities. This Permit may be revo ed an awry th ie fl rrm ark
authorization. A further condition upon which this permit is granted is !No underrs+sardan rt"un rest lea
ordinances arid regulations pertaining to the worts covered hereby whether siha.m crn n'M clua.n ¢n 4►rni�
by his agents, servants or employees.
Signed: GU < <' (INSPECTOR)
Signed:
Mechanical Permit
Permit Number: ME2002 -162
PERRY
DYNISE
ST
Contractor's Address: 2400 W 2 AND AVE
Construction Value:
In consideration of the issuance to me of this permit. I agree to perform the .rcrrt 2 wr*ua narawnllm f ltr
with the plans, drawings, statements or specifications submitted to the propel? wP
ar¢Mltan. 1Wwnl 3tnss 1
myself, my age,t, servants or employe .
tGcmnracncn •cn illraUort1 qr�
Page 1 of 1
e
Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 W15FT OF LOT 6 & ALL LOTS
- W. 00
"l Fees: $O8
eipts: $0.00
d 4172
m
0 .
b oo 52
—�� DOLLARS 8
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