353 NE 94 St (4)Date Y /F 7 Job Address 35'3 g V 5-7L,
Legal Description ko't' l2 q 1 We i. 4 ,f Ld ( � 4„Jr_ 5
Owner/Lessee / Tenant , 'Cdd n J Th V / -
Owner's Address 3 53 Iv E-
Contracting Co. Address
Qualifier f if /4 SS# - Phone
State # AJ /14 Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company /V /,D Address
Mortgagor AY A �l , Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL
WORK DESCRIPTION ,Q ► /l �C � r i d (aR eeAl frc
"AM ti FE- TP H : St(e Cr T . g 3
Square Ft. Estimated Cost (value) J
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.
/2_44:J.A.J e t /
Signature of owner and/or Condo President
Notary as to Owner and/or Condo President
My Commission Expires:
ENID KHAN
Notary Public, State of Florida
My Commission Exp. DEC. 13, 1998
No. CC 614891
FEES: PERMIT
PERMIT APPLICATION FOP ItAni A 1e'irT cLW D IT" .lI , AGE
RADON
7
(9 Lt ( 87 7
Date l Notary as to Contractor or Owner- Builder
My Commission Expires:
APPROVED:
Zoning Building
Mechanical Plumbing
PhoneL56SJ 57'` 6 3 ako q -e/9B 9
Signature of Contractor or Owner- Builder
C.C.F. C NOTARY BOND
Electrical
No l/
ROOFING PAVING FENCE SIGN
I (( 6ON
Date
Date
TOTAL DUE yC ' 60
Engineering
L
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
89212 Silver Lining or the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein
,de 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.
q5q - 3D
Owner's Name and Addres C� El�.f= �Z \ •\10A , �WU�k�rJ
Registered Architect and/or Engineer ()
Date I
No ��53
Street 1V . e -
Name and address of licensed contractor
Location and
�d �� Block be legal description of lot to built on: Q �J �,�/
Lot / /3 / .2 &&//9/A1) t7°C(L v
V Subdivision ��,l )
Street and Number where work is to be done
State work to be done and purpose of building (by floors). state exterior colors (submit samples)
3 c "' ` z c
R \ fv"T \O U S and for no other purpose.
New Building Remodeling \ Addition_ Repairs No. of Stories
To be constructed of �y Kind of foundation Roof Covering
Estimated Total cost of improvements s Boo . G®
�
Amount of Permit 8 r
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 plans and specifications for said building. All notices with reference to the building and its construction may be sent to
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons 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 empl. . • v such subcontractors. on work to be performed
under this permit. as are licensed by Miami Shores Village.
Remarks I Signe
STATE OF FLORIDA
COUNTY OF DADE.
}SS.
Before me. the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments. personally appeared
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 forego g application. and that he did sign the same. and that all facts therein by him stated are true.
Permit No.
Disapproved
(Signed)
q
Date 1
Date
Read. Sworn to and Subscribed before me.
Notary Public, State of Florida
to me well known.
Building Inspector My Commission Expires -
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and or workmanship.
3543
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date g 1'91 Time
Type Insp'n Ft- nn 1 Riff*
Permit No. @PaOO?) • 10?)
Name Chris line, Mercho.th
Address 353 N E Q 4'6+
Company
Phone # 305.333. 15q6
For Inspector: g lag Name & Date
Approved
Correction ❑
Re- Insp'n Fee ❑
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
VDATE: ( 03
''6WNER'S NAME: ('.lv; fitutiG,1 HONE: 3 3-.SY 3)¢l
LAIDDRESS: 3S3 NE 9% Sf
i c********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: 352 S
CONTRACTOR & LICENSE (if applicable) / /}
COMPANY NAME: PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be liste and indicate the color to be painted.
alls ydoov ( tee 0
F. scia
Dr • Cap/Drip Edge u h, e
So it AAA
Ro If JulA
Fl 'ewer Bins / v/jei
utters ,U7/4-
Awnings rJ�a
Chimney ° �la v 6;€
Doors and door jams wLl i P, t_ek
Garage Doors to h,`
Railings
4 /7,
Decorative Metal Ai//q
All brick (simulated or regular) ,f)/4
Stucco Banding A/74--
Any other stucco features ye Cxe
Accessory Buildings k)7,
Other A)//4
APPROVED:
Building Official
/ 3
Date
2B
honeywheat
0
0
Pc'
A / , / `--
C1 C.-Lc
y o i'beil-
k,J -
fir r 0A
179
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 zoni g. I authorize the above -named contractor, if applicable, to
do the for ")s : to • 4rthermore , the paint colors will be as per the attached
sam • =s.
Mr LI
Sig ru e • Owner Date Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01
ELECTRICAL
TYPE
QTY TY'PI?
QTY 'I'VI'li
Q•I'1'
T1 pi Q•I'1'
Minimum Fee
• 1'Y1'I.,
Refrigeration, Tons
Dryer
A/C Central, Tons
Outlet, Appliance
Cooling Tower
Service Repair
Heating Strips, each
A/C Central 1 -3 Ton
Vent Hood, Cost
Fan
A/C Wall/Win. Tons
Outlet, Wall
Dryer Vents, Number of
Service, Temporary
Paint Booth
A/C Central 4 -7 Ton
Ventilation, Cost
Fire Pump
Air Handler, Tons
Outlet, Switch
Ductwork, Cost of
Signs
Piping, Flammable Liquid
A/C Central 8 -15 Ton
Periodic Inspections
Fixture - Fluorescent
Barbecue
Oven
Fire Sprinkler System
Space Heater (kw)
Process/Pressure Piping
A/C Central 16-20 Ton
Supply, AC Well
Fixture Light
Bath Fan - Vented, #
Parking Lot Lights
Fireplaces, Number of
Spas/Hot Tubs
Pressure Vessel
A/C Central 20+ Ton
Temporary Toilet
Flood Lights
Catch Basin
Plugmold/Strip
Gas - Propane
Subfeeds, No. of Amps
Pump, Re- circulate
A/C Window
Temporary Water Closet
FPL - Load Central
Clothes Washer
Posts
Gas Piping
Swim Pool, Commercial
Pump, Replace - Pool
Air Conditioners
Urinal
Garbage Disposal
Dental Chair
Range/Range Top
Grease Trap
Swim Pool, Residential
Pump, Sprinkler
Chiller
Utility - Sewer
Generators, etc.
Discharge Well
Receptacles
Ice Maker
Switchboards
Pump, Sump
Clear Violations
Utility - Water
Heat Recovery
Dishwasher
Refrigerator, Comm. (p/PH)
Indirect Wastes
Temp Serv., Construction
Relay Repair
Compactor
Vacuum Pump
Low -volt, Burglar
Disposal
Refrigerator, Domestic
Interceptor
Temp for Test - 30 days
Roof Inlet
Deep Freezer
Water Closet
Low -volt, Fire
Domestic Well
Renew - Temp Service
Laundry Tray
Septic Connection
Demolition
Water Heater
Low -volt, Intercom/Teleph.
Drainfield, 4" Tile/Res.
Repair Circuits
Lavatory
Septic Tank
Dishwasher
Water Heater New
Low -volt, Television
Drains, Area
Service, Number of Amps
Meter Set (Gas)
Sewer Connection
MECHANICAL
TYPE
Minimum Fee
QT1'.
Tl'I'1%
Condensate Drain
Q•I'1'.
Tl'I'I:
Generator
QTY.
• 1'Y1'I.,
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.
Tl'I'1?
Miscellaneous Fixture
QTI
•11'1'1?
Soakage Pit
Q'1'1
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
B /
D YS
Zonin;
Ir —� �, �� 5.474
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
Building
UL 1 4 ZlI
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
Metropolitan Dade County (C.C.F.) $ (sq.ft. = x/1000
x0.60)
Inspector State Educational Fund $ (¢.005 / sq.ft.)
State DCA (Radon) $ (¢.O1 /sq.ft.)
Code Enforcement Fine $
Zoning Review
Notary
s$ D
3
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
4 30. 0 0 otztA-Jc
TOTAL $
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
Q
Name (1,;,,,\ l ,t& L -f
Address 3&3 74 54
AL, < J1 ' e s, , � L 3 . 3 / 3
Home Telephone
Business Telephone 30 J` 3.33. , (k.STC
Fax
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
Step I.
Job Address:
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other/41vivy'
ECEOVE
JUL 0 3 2014
!�1
INSTRUCTIONS - The following steps must be taken t� obtqin a permit from the NIiamifShores Village:
Complete the attached permit application which must be signed by theproperty 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.
PGiU C� C $ 0o
3‹3 Aic• 94 s a ;
Address Apt. City
Folio Number - 0/3— (et/0
Lot /Z Block
Subdivision PB PG
Current Use of Property
Proposed Use of Property
Tenant Information
Zoning
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Description of Work
A t a t e v el)
PERMIT APPLICATION
Master Permit No.
Subsidiary Permit No. 2. V03— ) a
¶ 'Sl3
State Zip
l a ;/rk � t &Jf /r2:"t.
Linear Feet
Square Feet Units Floors
Value of Work " S T> t, J t) 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 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.
Al 11DAVIT - 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 o f Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a ontractor.
Print Name - / Print Name
Sworn to and subscribed before me t13_,_ day
ignature • Notary ' is - State o onda
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Contractor / Qualifier
Swom to and subscribed before me this day of
Signature of Notary Public - State of Florida
PERMIT APPLICATION
SEAL: SEAL:
om,i0` Angela M Becker
ye , My Commi 150048
"da Expi ovember 15, 2006
Personally known OR, Produced Identification Personally known OR, Produced Identification
Type of Identification Produced: Type of Identification Produced: