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500 NE 95 St (4)Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Printed: 2/13 /2003 Applicant: DOUGLAS Owner: BONHAM JOB ADDRESS: 500 Contractor Local Phone: Parcel # 1132060140840 Fees: FEE2003 -958 FEE2003 -959 FEE2003 -960 Description Building Permit Application Fee Notary Fee CCF Total Fees: Amount $60.00 $5.00 $0.60 $65.60 Total Fees: $65.60 Total Receipts: $0.00 Permit Status: JOYCE W BONHAM DOUGLAS C BONHAM 1010 N.E. 105TH ST. MIAMI SHORES, FL 33138 jlje�he der of /W WACHOVIA SECURITIES Wachovia Bank, N.A. . ACH RT 063000021 For 406 30000 2 1I: 9 9837 27 4 NE 95 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 fee is $50.00, which must be paid in advance before calling for another inspection. CAP Asset Management Account Date 9 LL6 CODE Building Permit rei Ilia. I 1 l.11 i I I J W arhuu.3 L ++ 8/12/2003 1 1 9-7 BONHAM DOUGLAS ST Contractor's Address: Legal Description: 6 53 42 MIAMI SHORES SEC 2 PB 10 -37 LOT 12 Construction Value: 63 -2/630 BRANCH 00666 LJ , lars (Mono on 9116 ' equipment or device described in the application herefor in strict compliance with all ith any plans, drawings, statements or specifications that may have been submitted to lot done in compliance with such ordinances or if the plans are changed without )r or builder named above assumes the responsibility for a thorough knowledge of the s or in the statements or specifications and that he assumes responsibility for work done ompliance with all ordinances and regulations pertaining thereto and in strict conformity Village. In accepting this permit I assume responisibility for all work done by either BY: BY: $100.00 Page 1 of 1 BLK 55 LOT SIZE DATE: 1 � 4 OWNER'S NAME: 4 PHONE: T- 's G 41 ADDRESS: fD /o ,u � " ./e■ - tgr . 174, ,5,,.e /: r= c * * * * * * * * * * * * * * * * * * * * * * * ********* * * ** * * * * * * * * ** * ** * * * * * * * * * * * * ** • • ADDRESS OF SITE• CONTRACTOR & COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on tlJ a s'te must be listed and indicate the color to be painted. Walls Fascia Drip Cap/Drip Edge Soffit oof lower Bins Shutters Awnings Chimney Doors and door jams Garage Doors Railings Fences Decorative Metal All brick (simulated or regular Stucco Banding Any other stucco features Accessory Buildings Other APPROVED: MIAMI SHORES VILLAGE Building Offici Paint Co �dX .�rpV�l�and Agreement • Al /A 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 o the work stated. Furthermore , the paint colors will be as per the attached samples. P1 Date ignatur-'of Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 ELECTRICAL TYPE Q'I'V. TYPE 'QTY. ''1'PI QTY. 'I'1'1'i; QTY. Minimum Fee Generator Dryer . - • • • • • • Outlet &ppliance A/C Central, Tons Service Repair Cooling Tower A/C Central 1 -3 Ton Heating Strips, each Fan Vent Hood, Cost Outlet, Wall A/C Wall/Win. Tons Service, Temporary Dryer Vents, Number of A/C Central 4 -7 Ton Paint Booth Fire Pump Ventilation, Cost Outlet, Switch Air Handler, Tons Signs Ductwork, Cost of A/C Central 8 -15 Ton Piping, Flammable Liquid Fixture - Fluorescent Periodic Inspections Oven Barbecue Space Heater (kw) Fire Sprinkler System A/C Central 16-20 Ton Process/Pressure Piping Fixture Light Pump, Domestic Parking Lot Lights Bath Fan- Vented, # Spas/Hot Tubs Fireplaces, Number of A/C Central 20+ Ton Pressure Vessel Flood Lights Pump, Fire Stand Plugmold/Strip Temporary Toilet Subfeeds, No. of Amps Catch ]Basin A/C Window Gas - Propane FPL - Load Central Pump, Re- circulate Posts Temporary Water Closet Swim Pool, Commercial Clothes Washer Air Conditioners Gas Piping Garbage Disposal Pump, Replace - Pool Range/Range Top Urinal Swim Pool, Residential Dental Chair Chiller Grease Trap Generators, etc. Pump, Sprinkler Receptacles Utility - Sewer Switchboards Discharge Well Clear Violations Ice Maker Heat Recovery Pump, Sump Refrigerator, Comm. (p/PH) Utility - Water Temp Serv., Construction Dishwasher Compactor Indirect Wastes Low -volt, Burglar Relay Repair Refrigerator, Domestic Vacuum Pump Temp for Test - 30 days Disposal Deep Freezer Interceptor Low -volt, Fire Roof Inlet Renew - Temp Service Water Closet Domestic Well Demolition Laundry Tray Low -volt, Intercom/Teleph. Septic Connection Repair Circuits Water Heater Drainfield, 4" Tile/Res. Dishwasher Lavatory Low -volt, Television Septic Tank Service, Number of Amps Water Heater New Drains, Area MECHANICAL TYPE QTY. TYPE QTY. TYPE QTY. TYPE QTY. Minimum Fee QTY. TYPE Q "1'1'. Condensate Drain Generator Refrigeration, Tons 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 Pump, Domestic Bath Fan- Vented, # Fireplaces, Number of Pressure Vessel Pump, Fire Stand PLU IBING TYPE QTY. TYPE QTY. TYPE QTY. TYPE Q "1'1'. A/C Condensate Drains, Roof Miscellaneous Fixture Soakage Pit Bath TO 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 • • • • • • • 000.0 t • • • • • • • • • • • • ... • • • • ••• PERMIT APPLICATION • •.• • • •. • • • • • • • • INSTRUCTIONS: Please indicate the type of work Wing pe;f tnzed 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) $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 • •• •• • • • •• •• • , -• • • • • • • • • i ^•.•••• • • • • • • • • • • • • • • • •• • • • .• • • • • •• • • •. • • ••• • • • • • ❑ PROOF OF OWNERSII1P (Attach) $ ,o 1 SECTION Zonin: Electrical Mechanical Fire Plumbing Public Works Structural Building Official • ••• • • • • • • • • • ❑ HRS / DEW APPRO (Septic /Server): ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ ( x .ft. 1000 $ (¢.005 /sq.ft.) $ (¢.01 /sq.ft.) • • • PERMIT APPLICATION • ••d CONDO ASSOCIATION APPROVAL (Attach) • • •• • • • •; r BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ C$ 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 Page 2 IMPORT,- NT NOTICES 1. DO NOT 3EGIN ANY WORK WITHOUT HAVING RECEI'EI Yt)LQt VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are lin>3ted to: Mdhday through 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 constniction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEIfhR E�)rROM. REBRI6. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED 4:11( EQI.1d'I3r (SRi/Ej3IGL1ssS AND MAY NOT BE USED FOR STORAGE. A bond is required fcr 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. AFFII)AVI I' - 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 $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORID., COUNTY OF MIAMI -D DE /:;,(;..4/ ,-'!" day of ignature of Own Print Name Sworn to anndd subscribed before me this SEAL: SEAL: Personally known OR, Produced Identification ker Angela M 8e' Go F_xpires Novel Type of Identification Produced: ga • •• • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • •••• ••••S•• • PERMIT APPLICATION STAT%OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida Personally known OR, Produced Identification Type of Identification Produced: PROPERTY OW R i 1 Address - - Ho Te}�7 ( 4 1 7'- 4 Business l E OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration I terior Demolish Relocation Structure Shell Only Foundation my Add'I Attachment Other Add'l Detachment Other •• •• • • • •• •• • • • • • • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • • • • • • • •••••• • •••• � Master Permit No. 13 P ' a 4 • • • • .• • • SuIsidlary Permit No. • • • • • • •••• PERMIT APPLICATION INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application awhioh must lie signed byllle privity owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accura!o,pro$esting' of yq it $plipatidty If roofing work will be done, a roofing application must be submit- ted along with this permit application • • • • • • • • •• • • • • • ••• •• Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION J Address: Se o4 S Folio Number Lot Subdivision Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other l.� Apt. Block PB PG PERM Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax /?( 5' /-7,9 D &,_,_ A_ is 'L City State Zip / D ription of Work (5) a y� ! d A- � /�OCi S� Zoning Linear Feet S uare Feet Units Floors Value of Worker /O d Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name •• •• • • • •• •• • • • • • • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • • • • • • • •••••• • •••• � Master Permit No. 13 P ' a 4 • • • • .• • • SuIsidlary Permit No. • • • • • • •••• PERMIT APPLICATION INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application awhioh must lie signed byllle privity owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accura!o,pro$esting' of yq it $plipatidty 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. APPLICATION J Address: Se o4 S Folio Number Lot Subdivision Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other l.� Apt. Block PB PG PERM Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax /?( 5' /-7,9 D &,_,_ A_ is 'L City State Zip / D ription of Work (5) a y� ! d A- � /�OCi S� Zoning Linear Feet S uare Feet Units Floors Value of Worker /O d 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 PERMIT APPLICATION FOR MIAMI SIB( ~ E Date / -C' � � 67/ Folio WORK DESCRIP'T'ION 43) Legal Description Historically Designated! Yes No L/ 00n /Lessee / Tenant 1)0 GQ / 1.95 e. Boic.///,46-7 / / D /D i ll E /0 5 67' /1i 6L9/ 64/ E'S 75 (o G 4 Owner's Address f� Phone .- Master Permit # Contracting Co. Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN z t4& f /1.0 Square Ft. Estimated Cost (value) <SDO 3q 027 Toll Go' Gray (90) 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. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT RADON Sign (ure of Contractor or Owner- Builder 1 Date Notary as to Contractor or Owner- Builder My Commission Expires: Date C.C.F. - NOTARY TOTAL DUE \ r APPROVED: p, 4 1 f / (_� Zoning Building Electrical Mechanical Plumbing Engineering