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431 NE 94 St (8)Date Type Insp' n Permit No. r3 o7.-_ Name Co r K.f_ I Address 43 1 L IS - I -- Company L./ Vl/ VL ( Phone # Inspection Date Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Re- Insp'n Fee ❑ 61)01 'ELECTRICAL 'TYPE Minimum Fee QTY. TYPE Dryer Q1 TYPI'. Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton Drinking Fountain Fan 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 Cap - Fixture Signs Fountain A/C Central 8 -15 Ton Fixture - Fluorescent Barbecue Oven Fire Sprinkler System Space Heater (kw) Process/Pressure Piping A/C Central 16-20 Ton Supply, AC Well Fixture Light Cap - Sewer Parking Lot Lights Gas - Natural Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip - Pump, Re- circulate Subfeeds, No. of Amps Temporary Water Closet A/C Window Clothes Washer FPL - Load Central Gas Piping Posts Swim Pool, Commercial Air Conditioners Garbage Disposal - Pum I, S s rinkler Range/Range Top Utility - Sewer Swim Pool, Residential Discharge Well Chiller Ice Maker Generators, etc. Receptacles Switchboards S Clear Violations - Relay Re' air Heat Recovery Vacuum Pum s Refrigerator, Comm. (p/PH) Dis i osal Temp Serv., Construction Interce I for Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days - Se • tic Connection Deep Freezer Water Heater Low -volt, Fire Drainfield, 4" Tile/Res. Renew - Temp Service Lavatory - Se s tic Tank Demolition Low -volt, Intercom/Teleph. Repair Circuits - Sewer Connection Water Re- s i s e Dishwasher Drains, Floor Low -volt, Television Minimum Fee Service, Number of Amps Water Service Nt'E C HANI t�C AL 1 1 ' I �.. .:. :art . -, Minimum Fee a s; . > :- O I Y. 1'1 PG - u Condensate Drain QTY. TYPE Generator QTY. TYPE M Refrigeration, Tons A/C Central, Tons Bath Tub Cooling Tower Drinking Fountain Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Bidet Dryer Vents, Number of Filter Replace Paint Booth Ventilation, Cost Air Handler, Tons Cap - Fixture Ductwork, Cost of Fountain Piping, Flammable Liquid Periodic Inspections Barbecue Cap - Water Fire Sprinkler System Gas - Appliance Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Cap - Sewer Fireplaces, Number of Gas - Natural Pressure Vessel Temporary Toilet Pl IBING 1 11 A/C Condensate QTY. - TYPE Drains, Roof QTY. TYPE - Miscellaneous Fixture QTY. TYPE Soakage Pit Q:= 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 Tra r - Pum I, S s rinkler Utility - Sewer Discharge Well Ice Maker Pum •, Stun' Utility - Water Dishwasher S Indirect Wastes - Relay Re' air Vacuum Pum s Dis i osal Interce I for Roof Inlet Water Closet Domestic Well Laundry Tray - Se • tic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory - Se s tic Tank Water Heater New Drains, Area Meter Set (Gas) - Sewer Connection Water Re- s i s e Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equi , ment - Sink Well, Su .sly Page 2 ItMpOR FANiT NOTIG 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. i iF FID T 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. \TATEO # " IbA,CIt !/ • Tor nt Name Sworn to and s : ribed before me this ' day of /ny ft ra�tate of FNIAMAR PEREZ COMMISSION ?% CC 997478 • . a EXPIRES: January 29, 2005 ty � Bonded Thru Notary Public Underwriters St. of Nota SEAL: ature Personally known OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: F MIAMI -DADE PERMIT APPLICATION STATE 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 SEAL: 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: $CTION BY DATE s / -2 y/d1 Zoning 0-e 4- Electrical Home Telephone gcy.7 Mechanical Business Telepho Alteration Interior Plumbing Demolish Fire Shell Only Public Works Foundation Only Structural Other Building Official ;����fM .�.� .� Other SLZ,P p&I A -r // PROPERTY OWNER New Construction Name )t _ Z `' Enclosure 41 ` N (2...— 7 M 1 prl4 9�-- P- - Home Telephone gcy.7 S4 . 4 g,Q, Business Telepho Alteration Interior Fax Demolish TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'1 Detachment Other SLZ,P p&I A -r // 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 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) LI OTHER (Specify & Attach) $ (¢.005 / sq.ft.) $ (¢.01 /sq.ft.) (sq.ft. = x/1000 x ¢.60) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ o a V ISSUING OFFICIAL VIEWED 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 INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Step 2. Job Address: 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. 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 Address Apt. 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 SP1 PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement einspection ARCHITECT Name License No. Address Telephone Fax j Va1ue of Work Subsidiary Permit No. PERMIT APPLICATION Master Permit No. Nil/ 1 / Eu2salS City State l escription of Work Zip 9Q Zoning Linear Feet Square Feet Units Floors O � e Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. Coo CE:t013 - L ` ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name BOARD DECISION: A PPROVED DENIED SIGNATURE & TITLE DATE: inly 0)1 010N CERTIFICATE OF APPROPRIATENESS ADDRESS OF PROPERTY: 431 N.E. 94 Street NAME(S) OF APPLICANT(S): Jerry & Suzanne Cornell APPLICATION DATE: (Date Application Received by Village Clerk) Mav 21, 2002 CERTIFICATE OF APPROPRIATENESS REQUEST FOR: Paint exterior of home using the following colors: Base Wall Color = Benjamin Moore Clarksville Grey (HC -201) Trim Highlights = Benjamin Moore Crownsville Grey (HC -106) Decorative Trim above arched windows = Benjamin Moore Providence Olive (HC -98) Restore & Stain as many wood casement windows as feasible using the following stain: Benjamin Moore Medieval Brown Stain Remove jalousie windows and replace with casements. APPROVED WITH CONDITIONS / 40 / /.�•; MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: OWNER'S NAME: ADDRESS: vl ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: ZPs As €A � CONTRACTOR & LICENSE (if applicable) pig COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted Walls (;(4.,- Fascia 0 W '! ,.r.� SA,on Drip Cap/Drip Edge P - - Soffit � '1 Roof 11 s Flower Bins ({(2-6.1 Shutters P Awnings per `f Chimney Doors and door jams Garage Doors Al f 10 Railings fr Fences Decorative Metal All brick (simulated or regular) () Stucco Banding 42 Any other stucco features Accessory Buildings Other 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 t , • stated. rthermore , the paint colors will be as per the attached r e of Owner * * * * * * * * * * * * * * * * ** LPHONE: a t , K= L5 S co ►c- �--- �24 � M 4"t` e ,24. , C 4) Date Signature of Contractor Date ************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION .75 3- 4-07 4/23/01