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575 NE 95 St (3)p. BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle) Owner's Name (Fee Simple Owner's Address 7 S City N� ca w I S i d►e s Contractor's Company Name Code Enforcement $ Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Electrical Plumbing Mechanical Roofing ea1Q Zip X3(3' Tenant/Lessee Name Phone # jQ5 �, - $ �� State F( Permit No. ���� "� 3 Master Permit No. Phone# cea 7kV //e Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip is Building Historically Designated YES NO l� Phone # Contractor's Address City State Zip Qualifier State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # rt7 $ Value of Work For this Permit ,3 00 Type of Work: ['Addition ❑ -Alter tion ['New i Describe Work: ?�� Submittal Fee $ Permit Fee $ ®s Notary $ Training/Education Fee $ GO Scanning $ ti-- Radon $ -- Zoning Structural Plan Review. $ Square Footage Of Work: --8 ' lace * * * * * * * * * * * * * * * * * * * * * *** * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** CCF $ 0. 60 CO/ Technology Fee $ f. S 1 Bond $ 0 ❑ Demolition Bonding Company's Name (if applicable) Bonding Coinparti's A City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith That a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature wner or Agent Contractor The foregoing instrument was acknowledged before me this /2' he foregoing instrument was acknowledged before me this day of 200 5 by �.o,p e� , day of , 20 _, by who is personally known to me or who has produced who is personally known to me or who has produced Z-4 ? ^( s i d e ]fication and who did take an oath. NOTARY . 1 Sign: My Y' "'; t I ton #DD 38 + OCT 1 2 2004 %."46 R0C Bonded Thru _ Atlantic Bonding Co., Incr — APPLICATION APPROVED BY: Chc 05/13/03 as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: / My Commission Expires: *************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * *3° **************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** e\/ Plans Examiner Engineer Zoning BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building MIAMI SHORES VILLAGE. FLORIDA PERMIT N? 9850 Work to be performed under this Permit BI. Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed • BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY •UILDING fECTRICAL 'IMBING )weer of .u;lding rchitect : ontractor r Builder .ega1 )escription MIAMI SHORES VILLAGE, FLORIDA PERMIT N2 7211 Work to be performed under this Permit I r Lot ..,; it ddress of - - J ' ,- Value of ..,.... Amt. of uilding +.wrt Project Permit ..' "+,,.._.,. This permit i granted to the contractor or builder "famed above to co truct the building or to install the equipment or device described in the appli- ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any lans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked t any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this ermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and gulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and tha3,l ..issumes respon- bility for work done by his agents, servants or employees. Subdi- vision DATE Contractor's License No. Signed: INsI R ( By • In considerai the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations ertaining theret nd in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. accepting rmit I assume responsibility for all work done by either myself, my agent, servant or employee. �t CO RACTOR OR BUILDER BY AUTHORITY j 3 194 _.,x N? 694 CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Miami Shores Village, Fla , Owner, Agent or Tenant of Building Lot Block Subdivision Street Address Approved use by occupancy Remarks- This Certificate of Occupancy is issued to the above named for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, kno4r as the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildings or structures. BUILDING DIVISION u i kalaml i maiZttul i min t`f Mill o `ui� IMIM ii iMiWWWWW WWW,Mircv 4 r 0, 2 1 KNOW ALL MEN BY THESE PRESENTS, that I Cjf Address _ca, WHEN CLEARED AND REPAIRED BY THE VILLAGE $ SO $ �v Amount of Bond Cost of clearing and repairs done by Village Balance due Builder eiami chores FL OA ID A. BUILDER'S BOND in consideration of the issuance to me by Miami Shores Village, Florida, of a permit or permits to construftt buildings? t the followin addresses: re p airs ut of the aforesai said2 hall be returned to me. • WITNESS MY HAND and Seal at Miami Shores Village, Florida, this l • day'of N? 758 (2,--e) Pi 9f, ■ $g i f ____) .t A , - -...7 i arm �� c � � � , 1 r do hereby d:' .sit with Miami Shores Vi . ge, Florida, the sum of c and I agree with said • "T 1711) n such construction shall have 1 been completed by me within the meaning of the ordinances of s d Village, I will clear all premises and rep. Village property damaged by me, �~ used for the deposit of material or equipment in the construction or repair and that, if I do not so clear and repair such premises immediately upon the ;: completion of such constructi � ,u within the meaning of such ordinances, the Village may clear. and repair the same and pay the costs of such clearance and 's �' O �° K � Q � 6 �j r..1:.= . rep it a building or an d return the remainder to me; an d that, i f I shall clear an d repair said property imme d i ately as aforesaid, then (Seal) INSTRUCTIONS TO BUILDER —When above mentioned construction is completed ruiLthe premises ar cleared and repaired take t his bond to the Village Building Inspector and obtain his approval, after which Miami Shores Village will refund your rr /ney in accordance with the above agreement. VILLAGE BUILDING INSPECTOR'S APPROVAL I hereby certify that the construction contemplated under this Bond, has been completed and that the builder thereof has caused the surrounding premises to be cleared and repaired in as good condition as they were before commencing said construction. Village Bui ding Inspector = y s"t es Village Cancelled 19 By . 4 t r r. rt n rt r !�"�7!! !!cm`�l! rt r t r: em`A�l / r!�^a7!! !! rt n n i� •'•1r`• °'•i �t`.°'ii`•°O°'•ii:° .i •'•ii•.` �► :ar �r• cy .iek, 'Mi` ;i:n'•ii• .:••�r`• '•; �, • P.r:•� •'•ii °•' ee. F .) • DATE: 9 L5 TIME: NAME OF PERSON RECUEST INC FILE: YCUR ADDRESS: 32 e ADDRESS OF FILE RECUESTED: 3 INPCRMATION RECUESTED: I UNDERSTAND THAT ALL DOOMENTS IN THIS FILE ARE PRO;iTui SHORES VILLAGE AND THAT /0 =MEWS MAY BE REMOVED Mn.J.al, FILE. YW MAY GET UP 10 POUR (4)(OMPLIMEIMRY COPIES. /);nwf. COPIES WILL BE FURNISHED AT 15 CENTS PER PAGE, NCT BLUEPRINTS. ACKNOWLEDGED BY (Signature): FILE RETURNED - DATE: *** PLEASE PRINT *** COMMUNITY AFFAIRS AND CODE ENFORCEMENT I)IVI,Ints;': 10050 N.E. SECOND AVENUE MIAMI SHORES. FLORIDA 33138-2.38, TELEPHONE (305) 795-2204 FAX (305) 756-8972 TIME: RETURNED TO: BUILDING ELECTRICAL PLUMBING In consider pertaining ther In acceptin r Architect Contractor /j or Builder , . , Legal 1,ot Description of Building This permit pew MIAMI SHORES VILLAGE, FLORIDA DATE / d 6 194;2 PERMIT N? 7211 Work to be performed under this Permit. k ;Q Owner of � � , f Building TRACTOR OR BUILDER Subdi- vision Value of Projec '2 granted to the c: retractor or builde `' amed above t s c ' struct th building or cation herefor in strict compliance with all ordinances p `'rtaining thereto and with the understandin plans, drawings, statements or specifications that may have been submitted to and approved by the at any time if the work is not done in compliance with such ordinances or if the plans are changed permit is granted is the understanding that the contractor or builder named above a sumes the res regulations pertaining to the work covered hereby whether shown on the plans r wjtf k or sibility for work done by his agents, servants or employees. Signed. BY Contractor's nc ense No Is ? i r Ci 4o install the equipment of ev ce escribed in the appli- g that the work will be performed in compliance with any proper municipal authorities. This Permit may be revoked without authorization. A further condition upon which this p ility for a thorough knowled • - : ordinances and it statements or p ications`. ` 4 . assumes respon- E of :the issuance to me of this permit I agree to perf. • ' the work covered hereunder in compliance with all ordinances and regulations and in strict, conformity with the plans, drawings, stag S ents or specifications submitted to the proper authorities of Miami Shores Village. ¢emit I assure a responsibility for all work done by eith myself, my agent, servant or employee. AUTHORITY ■ Owner's Name and Address Registered Architect and /or Engineer Name and address of licensed contractor r Location and legal description of lot to be built on: �' `� '� Bl ock �__ Lots= �,_. _ ' 1— lam Subdivision Street and Number where work is to be done �_ —_ - ''_ State work to be done and purpose of building (by floors) Permi) Disapproved Council Approved__ To be constructed of Kind of foundation Estimated Total cost of improvements $ r ' Zone cubage required �`� Distance to next nearest building _________. Maximum live load to be borne by each floor STATE OF FLORIDA, COUNTY OF DADE. ss. Plan Cubage ga X 17 MIAMI 6)1 RES 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 building 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 regula- tions 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. New Building_ ! Remodeling Addition Repairs Size of Building Lot _ Y v • A 1 y / 2 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 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 r--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 a site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on ork to be performed under this permit, as are licensed by Miami Shores Village. '?�j Remarks (Signed).- f' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared and who, being me first duly sworn, upon oath depo s and sa s that -he :'the__ of the above des ibed construction, that he has caret y read oregoi :: application, and that he did sign the same, and that all facts therein by him s • ted are , rue. Read, Sworn to and Subscribed before me. Notary Public, State of Florida uilding Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Date - L // � ; � - - 19g. No Street__. ______________ _ __and for no other purpose. No. of Stories C �Roof Covering Amount of Permit $_ Ci to me well known, 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- i is made necessary by improper notice for inspection or faulty materials and /or workmanship. F�< r : (C 7 O�(- -t, nf 1 OWNER'S NAME GEORGE DUVALL PRESENT ADDRESS 355 NW 54th St a LICENSE NO. PHONE NO. JOB LOCATION (ST. OR AVE.) 575 N E 95th Street LOT 22; i4 23 BLOCK 54 SUBDIVISION NI s V GENERAL CONTRACTOR George Duvall ADDRESS Same PHONE NO. 7 -7042 LICENSE NO. 1820 BUILDING PERMIT NO. 7211 DATE 1 PERMIT FEE $ 14.00 BUILDER•S BOND NO. 578 DATE 10/26/41 ZONE PEQUIREMENTS 17,500 CU. FT. PLAN CUBE 19,298 CU. FT. EST. COST $ 10,000.00 JDH DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY JDH DATE 10/20/48 X NEW CONSTRUCTION TYPE �r CBS STORIES 1 ROOF CONSTRUCTION m Tile ram • INTERIOR CONSTRUCTION oak f irs; porch — tile fir. REPAIRS DESCR IPTION Liv Rm — Din Rm — Kit — Screen Porch 3 BedRms 1 Bath ALTERATION DESCRIPTION 1 —car attached Garage ADDITION Bldg Inspector / / SUBMITTED TO N �OKPoD/ /// APPROVED 10/20/48 REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD SUBMITTED TO VILLAGE COUNCIL EMMA F � �� c' CERTIFICATE OF OCCUPANCY NO. 694 ISSUED 4/ B Y TD�i I TO Geor Duvall 355 mt 54th st. BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION 1 PERMIT NO. JDH FEE TEMPORARY SERVICE 10/27/48 $ 1.00 BEAMS & LINTELS SEPTIC TANK No Dade Septic 7254 11/6/48 $ 1.00 No Dade Septic 7370 FRAMING s 1.00 i t $ $ GAS $ 'u S S FINAL DATE RE- INSPECT RE- INSPECT BY RE- INSPECT BY rLEAN -UP 11/1/48 JD JDH H ROUGHING CONTRACTOR i 1cCormlck— DVyett PHONE Q F$iRMIT NO. 7280 DATE 11/15/48 FEES 9.50 NEW BLDG. I ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE 10/27/48 $ 1.00 $ SEPTIC TANK No Dade Septic 7254 11/6/48 $ 1.00 No Dade Septic 7370 12/4/48 s 1.00 SOLAR HEATER $ $ GAS $ $ S S INSPECTIONS DATE RE- INSPECT RE- INSPECT BY RE- INSPECT BY ROUGHING 11/1/48 JD JDH H ROUGHING GAS JDH H. W. HEATER CONN SEWER RANGE CONN. SEPTIC TANK 11/8/48 ]DH 12/4/48 JDH SOLAR HEATER FIXTURES & FINAL FIXTURES' 777 `1 y APPROVAL TO POWER CO. FOR SERVICE DATE BY CONTRACTOR Hurst Elec PHONE d PERMIT NO. 73,53 DATE 12/2/48 FEES 10•75 NEW BLDG. I ALTERATION I ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE Hurst 7217 10/27/48 $ 1.00 H. W. HEATER CONN. $ RANGE CONN. S MOTORS $ FIXTURES $ S INSPECTIONS DATE RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE 10/27/48 JDH JDH ROUGHING 12/2/48 JDH H. W. HEATER CONN RANGE CONN. _. ` FIXTURES & FINAL 777 APPROVAL TO POWER CO. FOR SERVICE DATE BY 1 1 BUILDING INSPECTIONS PLUMBING PERMITS & INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS I, • APPLICAT)JN FOR CERTIFICATE OF RE- OCCUPANCY to re- occupy the single family residence . known as : (address) Lot: c—A Iv S , Miami Shores, Florida. Legal Description: I hereby certify that I understand that the zoning. of the property is for single -family iesidential use and that it is unlawful Tor more than one family to reside therein. I also understand that any Certificate of Re :Occupancy that may be issued by Miami Shores Village, certifies only that the referenced property is being used for single - family purposes and that such Certificate does not constitute any representation, warranty or certification as to the condition of the dwelling or other structur - s uch prop Applicant r Date , 1o2_ Print Name ***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Contact Name: • Buyer Seller Block PB & PG: Application Fee (S50) paid: Cash )( Check No. Inspected by. Approved Comments: PrN , hereby apply for a certificate • *********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** For purposes of conducting the inspection required by Section 902 of the Miami Shores Land Development and Zoning Code, please ?0 contact: OINYv \) 1� (Pc Telephone: I U 9 G 1 0 e Realtor Company Name PAGE I OF 2 Denied Date i On behalf of Miami Shores Village, Florida, the undersigned certifies that the property described in the above application has been inspected for purposes of re- occupancy pursuant to Sections 901.and 902 of the Miami Shores Land Development and Zoning Code and that such property may be re- occupied by the above applicant for single - family residential purposes. CERTIFICATE OF RE- OCCUPANCY PAGE 2 OF 2 �IIA - ORES VILL G -, FLORIDA 71" By J oi\ Date of Certification: THIS CERI IFICATE VERIFIES THAT THE REFERENCED PROPERTY HAS BEEN INSPECTED BY MIAMI SHORES VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE MIAMI SHORES LAND AND DEVELOPMENT CODE PERTAINING SOLELY TO THE REQUIREMENT THAT EACH ONE-FAMILY DWELLING IS USED AND INTENDED TO BE USED FOR A ONE - FAMILY DWELLING PURPOSE ONLY; HOWEVER, THIS CERTIFICATE DOES NOT CONSTITUTE ANY REPRESENTATION OR WARRANTY AS TO THE CONDITION OF THE DWELLING OR OTHER STRUCTURES ON THE PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH CONDITION,"AND INTERES T ED PERSONS ARE ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE PREMISES IN ORDER TO DE I hRiMtNE THE CONDITION, • THEREOF. ^ " "" ° °7I> N. Z. y5th 5t_ LEGAL L.Dt 1 -VV R1 {.511s « tut S , PC E.;.- " u 0 r r o ru aC+s o rn . 'i ctf.occ. PAID BY YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID ' RECEIPT y 4-6419 PAID Ges ge ( oi) ca .a ��L , .9 C.s.�•v� (off /95 /a o o /-7• al- 4 o fir 50 5 / s- so /0 7 ,. /951 ' ` 1.2.3/•5/ /Z o / -9 - 5 rc99S • 1 1 PLAN REVIEW COMMENTS DATE : P2°3 !O 3 PROJECT NAME: -6 ( P PROJECT ADDRESS : REVIEWER: // `jLt1��'.G �/ �'QWti r 3 SHEET NUMBER: COMMENTS 5 jcP w // r5 - �lG � ��1 1 O� gnature o Inspector /6 �L" Date Signed G / 2/; �iZ� /G ®G ,.� ✓���o�- Title Total Number of Hours (PLEASE TURN IN A COPY OF THIS FORM AS YOUR TIME SHEET: FOR ALL PLAN REVIEW) JOB ADDRESS 5 7 5 57 APPLICANT L a ' Z- CRITIQUE SHEET 4 PHONE# APPUCATION AOC, SHEET OF • MISCELLANEOUS DATE BUNI.Ny • COMMENTS PERMIT NO. ADDRESS: MIAMI SHORES VILLAGE BUILDING / ZONING DEPARTMENT' SECTION BY DATE ZONING ELECTRICAL MECHANICAL PLUMBING FIRE PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL 1. Subject to compliance with eft Federal. State. County.Yillaga rues end regvtatlons. Village assumes no responsibility sibility for accuracy otlor results fro plans. 2. Thle copy of plans mutt be avellebte oe building site or no Inspection will be conducted. INITIALS 3 1/0/0 3 /1/Qe y ' ���c� ey(s 41 :0 dotes 01 >, 4 1 4 ' c19i ®'1 4114 ��e / M 5-q ,eve ,c/4 ;sd, Cede ri1!' I 0 0111DFe1FR1T SELF - CLOSING/ SELF- LOCKING 'ME N 1111 .gn FENCE: 4' HIGH (MIN.) AND NON -C l IMAARI F IF NEIGHBORS REMOVE FENCE/ WALL. OWNER MUST REPLACE WITH A 4' FENCE ON OWNER'S PROPERTY avt 0 /6 ,41 ( 7 , 0 2- /' `/'/d -3 5e `f A ck S f r Ck_c-S - c a 4e-t„ s it ow St e I 42,,N w d ee w St? JOE 4 ?-e) — 515" ,Vi 95 $f. IY,P RE7 ..5 corz. SC 3ION PAGE LCCL_TION Need tez-/7i " sidh retii rc ( b Rood cri. ort ( /460e. sa- of -11 iv) ArA 5 ?LS T.7• c)kri/ 0e4i) delerwivtaitoi"---‘ e" ervvt (7e;e; I tp/ vi Oekdg- 6 , ) " 5/44 is /, C.06(g x. 4) ( aAt'oc Avers c DZE 3 /e7 • VAle— RESTRICTIVE COVENANTS PROTECTIVE POOL ENCLOSURE ••. . • • • . • . • • • • ... • . . . • . PREPARED BY: . . . •.. . . .• • •• •.. • .. • . .• • • •. • S. • • . . • • • • ... • • • • DECLARA'At1N;O ' ktEST;aICIWE COVENANT KNOW ALL MEN BY THESE.k; E Ei4TT: • ; • • • • • • ••• ..• undersigned is/are the fee simple owner (s) of the following described property situate and being in the Village Lot (s) / Block of / aril 5 ore 5 (Subdivision), A.K.A. (address) 8 according to the plat thereof, as recorded in Plat Book Page of the Public Records of Dade County, Florida, and . Whereas, the undersigned owner (s) pa O. 5 . l.z desire to utilize said Lbtis) as . a single building site, and the undersigned owner (s) do (es) hereby declhre and agree as follows: 1. That the property will not be used in violation of any ordinances of the Village . or Dade County now in effect or hereinafter enacted. MY commission expires: dojo, PV YI l� 4 OFFIC ARLE18 LP DROSNER TART SEAL COMMISStON NUMBER D0058867 7, o? 4.` MY COMMISSION EXPIRES OCT. 12.2005 2. That the purpose of this covenant is to induce the Village *o issue a permit for a pool where the required enclosure is not on the subject property where the pool is located. 3. That if any of our adjoining neighbors remove any portion of their fence or wall, or if our /my property shall fall to meet code requirements for pool barriers, we, as owners will immediately install a protective enclosure to meet code requirements and will obtain a permit for such fence. 4. That, we, as owners, hold the Village harmless for any negligence or injury that results from not having the enclosure FURTHER, the undersigned declare(s) that this covenant is intended and shall constitute a restrictive covenant concerning the use, enjoyment and title to the above property and shall constitute a covenant running with the land and shall be binding upon the undersigned, his/her successors and assigns and may only be released by the Village , or its successors, in accordance of said Village then in effect. IN WIj WHER5Q,F, the undersigned has/have cans hand (s) and seal {s) to be affixed hereto on this S day of c OCR. Lope / Signature and Print . Signature and Print Signature and Print STATE OF FLORIDA ): COUNTY OF DATE ): (1.04/1.0-0 I HEREBY CERTIFY that on this day personally appeared before me I 4 who is personally lcrto me or has produced (type of identification) as identificatton d he/she acknowledge that he/she executed the foregoing, freely and voluntarily, for purposes there In expressed. • SWORN TO AND SUBSCRIBED before me on this a7 • Signature and Print day of WHEREAS, the NOTARY PUBLIC STATE OF FLORIDA Rey. 41Y. 02/20/2003 12:32 9549464596 MARS POOLS INC rtb Ao-4JU,S 12:56 CHOICE ONE NETWORK THANK YOU OUR PI - NO.: . . •.• • . . •.• KEY TITLE &:ES;CjtO;'1t 18400 5W 9•7 dV't' ' • ' • "' MIAMI, FLORIDA 33157 305 - 235 -4571 F AX 3 °0 Z '1 826:: DATE: TO: ,,(( FAX # q q 1 - I I `r . .. .... ••• ••• ••• • • • • • • • • .. • • • • • ... .. FROM : KIM CHAVEZ RY MaTITLEE SCRO MIAM COM TOTAL NUMBER, OF PAGES, INCLUDING THE COVER SHEET: r T 3 a y,,o ---zLier,,t PAGE 01 3052529896 P.01/01 NOTE IF YOU DO NOT RECEIVE ALL OF THE PAGES, PLEASE CONTACT OUR OFFICE IMMEDIATELY AT THE NUMBER LISTED ABOVE. (CLICK HER r AND TYPE RETURN ADDRESS] TOTAL P.01 Dat( 14 30 2003— Miami Shores Village Building and Zoning Department Attention: Building Official • • ••• • • • • • •• •• • • • • • • S. • • ••• • • • • • • • • ••• • • • • • • •• • ••• • • • • • • • • • • ••• • • • • • • • •• • • • • •• •.. • • • • • • • . • SWIMMING P(; aW`N . $ 5 CEIFICATION I certify that I am the legal owner of the property described as /iavn1 shaxes Sep, 2 P8 /0 -37 lo-t- FJ/: 51J , located at 575,L/( 93g` c5�, 7n4lif ,`vies ?3 /gg In accordance with Section 33- 12(f), Code of Metropolitan Dade County, I certify that I understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until a separate permit has been obtained for an approved safety barrier, and such barrier erected, inspected and approved. I further understand that this certification, however, does not eliminate the need for obtaining a permit and erecting an approved barrier prior to final inspection and use of the pool. Legal Owner Note: This certification is to be submitted with a swimming pool permit application in duplicate. NOTICE OF COMMENCEM 1t •••• • A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIM CIF Car I7l$PEC1it11 • • • PERMIT NO. TAX FOLIO NO. /i- 2 - 9-o"1-4 STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE. UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street/address: e C ,e / C) - 3 7- L 2 2. 6/ A 5 / , S /)f: �ls - � - s,- �� ; 11 3s 2. Description of improvement: J tnsi 3. Owner(s) name and address: e /-\ S AS' A- 9,s ft / t 1, S s / f 33 J3� Interest in property: /b a e '/ c? Name and address of fee simple titleholder: 4. Contractor's name and address: C 4� ,0015 t_ 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: ' 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: . €' 4 .T,vC / lc.) 8 Sc. 91 f r Ka( f Uvv ( -�-•I t /e 3 04 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a differ = t date is , •ecified) ature of Owner • • •• •• •• • • • • • • • • • • • • • •• • • • ••• 1 • • • • • • •• •• • • • • • • • ••• • • • • • • • ••• • • • • • •• • • • •• ••• •• • ••• • • • • • • • • • • • • Print Owner's Name G S . )U �-O e t l c- Sworn to and subscribed before me this ol 7 day of jc , 20 a. Notary Public Print Notary's Name My commission ex 123.01 -52 PAGE 4 8/02 MY COMMISSION U DD 002598 STATE OF FLORIDA, COUNTY OF DADE r� ! I HEREBY CERTIFY that this is a true copy of the , original filed in this office on U'7 ' day of id 4 a," -1- original — }.✓t/ o . A 20 0,� i;� ..,�,. �, W:T SS . lA :,.✓ hand nd Cfl:crai S al. 'v .: � kj iAF0. n E4-IK, otCrrci I aad Cnanry Co:Ins ,,.. )/ \,. - , r . ... t' ," • • • • • Prepared by /1/45 / Gin! S Address: l COQ 33o6fi r/ • f4 CO V7 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/7/2003 Applicant: E Z. pr Z FROG u S'E4V o SIe'l (y) Owner: LOPEZ GUSTAVO & SHEILA /Y) JOB ADDRESS: 575 NE 95 ST Contractor MARS POOL Contractor's Address: 1908 SW 84 TERR O Local Phone: 954- 214 -2844 Parcel # 1132060140760 Fees: Description Amount FEE2003 -1335 Building Fee $265.00 FEE2003 -1336 Buildier's Bond $300.00 FEE2003 -1337 CCF $10.20 FEE2003 -1339 Radon $3.33 FEE2003 - 1340 Inpector State Educational Fund $1.66 FEE2003 -1341 Structural Fee $25.00 r Total Fees: $605.19 v \~ 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. i This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. 0 Signed: In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: v Building Permit Permit Number: BP2003 -366 Page 1 of 2 d \ Total Fees: $605.19 Total Receipts: $0.00 (INSPECTOR) BY: Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOT 22 & W1/2 OF 23 BLK 54 LOT SIZE 75.000 (Contractor or Builder) BY: Permit Status: Approved Work: POOL Permit Expiration: 8/31/2003 Construction Value: $17,000.00 ankAtlantic 0 Signed: e $ [ t u r 'MARS POOLS INC. 1000 E ATLANTIC BLVD, STE 11 POMPANO BEACH, FL 3306 954946 PAY S� ?o rte V► ( ' t/1'� T ORDER OF I "` /i h Y • e 1 1 ` d r� ed Cyr , j Tamarac #021 5600 N. University 1331 or •, Tamarac , ' t .. � 0 Vii 26` ?08 37.6 3 N '>l DATE /00 (INSPECTOR) BY: '3 _ 1-03 $7851 DOLLARS l ° ° 1014 63-8376 021 '1. 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. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without -. 1 - """ authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to • • • covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, ser . % employe / Signed: , In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. " (Contractor or Builder) BY: OFF►. €i) • • • • • '• • r9�36 WEST 24TH AVENUE GI) at SIONS I N • • • • • • • • • • • • 1'AL EAH. F LORID A 33016 . • .: • • • : . NONE: (3O) 512 -4225 Land Surveying Services FAX: (305) 512 -1914 FOR: 3HEUA LOPEZ COTS ?2, 1�'iQ OF 23 : ' MIAMI SHORES Roc Awl 575 NE 95 STREET, MIAMI, FL 33138 • _ • —�� -� SIhOb — ><INDDMSION ; SECTION ND. 2 JOE NOs 0212-028 FIELD DATE: 12.10-02 CO FND.I.R.17 JNOJ_ f B'4piiialt Alibi: • • • FND.I.P.1/2" • • • • • • • • • (NO ID • • • : : 73A0' : 4 1001... 4'CLf OrF f 90° Asphalt S Driveway I U 10' Fzi • •L >DEPCRIPTIOlk _.. • FIAT ROOKS 10 PAGE: 37 •• • • • •• ••• •• 2p p . ��/��, ---T 1.5° Conc. Dnveway 10.00 12.40' g 16.80' Cf g g SURVEYOR'S NOTES: 1.) THE SURVEY OF THE PROPERTY SHOWN HEREON IS IN ACCORDANCE WITH THE DESCRIPTION FURIASHED BY CLIENT. 2.) UNLESS A COMPARISON IS SHOWN, ALL BEARING, ANGLES AND DISTANCES SHOWN ARE THE SAME AS PLAT VALUES. 3.) THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENTS OR OTHER RECORDED ENCUMBERANCES NOT SHOWN CAI THE PLAT AND THE SAGE, IF ANY MAY NOT BE SHOWN ON THE SKETCH. 4.) UNDERGROUND PORTIONS OF FOOTINGS, FUNDATIONS OR OTHER IMPROVEMENT WERE NOT LOCATED. 5.) FENCES TIES ARE TO THE CENTER LINE OF THE SHE. B. WALL TIES TO THE FACE OF THE SAME. tELEVATION WHEN SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM (1929) UNLESS OTHERWISE NOTED. 84 THERE NO ABOVE GROUND ENCROACHMENTS OTHER THAN THOSE SHOWN. 9 THIS SURVEY IS FOR MORTGAGE PURPOSES ONLY, NOT TO BE USED FOR CONSTRUCTION PURPOSES. LOT 0 Conc 03 2300' ONE STORY RESIDENCE A 675 CBS 21.90' 1) 5' Conc.Walk 75.00' 25' Parkway ThMB PROPERTY IS MORE _ THAN 2 MILES AWAY FRON THE 110A40 COUNTY LAKE BELT AREA. 51.50' (FLOOD ZONE INFORMATION) ZONE. X _COMM 120652 PANEL: 1 SUFFIX: DATE:.i 95 BASE: N/A NOTls ALL SUMO NINON ARE EASED TO THE PLAT SEARING OF — ON THE CENTER UN! OF PROPERTY UNE. EASEMENT VIOLATION$I 0 YES DI NO APPARENT VISIBLE ENCROACNMENT$: 0 YES 20 NO COVENT'S: A Cone' I 12.90' 20' Asphaf NE 95 STREET S a sr FND.I.P.1/2" (NO ID) 30' v f ti 3 FND.NAIL /1 --- NO ID) MIAMI -DADE .SON1 I, FLORID 79.38' BC / - -{D FND.I.P. Il7 (NO ID) SHEET_ •. 0' CERTIFIED TO: SHELIA LOPEZ ABN AMRO MORTGAGE GROUP INC. ITS SUCCESSORS AND/OR ASSIGNS, KEY TITLE& ESCROW. FIRST AMERICAN TITLE INSURANCE COMPANY ABBREVNA T7ONS: SWK= Sldevelk, CBS. Concrete Block Structure, CLF= Chain Link Fence, PL. Property Line, DUE.'.krrinops Uglify Easement, IP• Iron Pipe, NC. Alr Conditioner Pad, PC. Property Corner, DAY. Drilled Hob. WIF. Wood Fence, RES. Residence, CL. Clear, RB. Reber, UE• UURy Erseme,d, CON C. Cora. Slab, RAN. Right d Wary, DE. Dolmen Eeeement, CA.. Center Lino, O= Diameter, TYP.. Typical, Irk Measured, R. Recorded, ENCR. Encroachment, COW- Computer, ASPH. AsphrR,1UD. Na,' a Dlec . S• Sal, FEE. Finish Floor Elevation, OS. Meat, PIP. Porter Pole, OHP• O.arhe,d Pauamr9ne, WM• Wider Meter. 4 i 7 46% JOSE L. SANFIEL REGISTERED LAND SURVEYOR M STATE OF FLORIDA 1.8 / 0008874 I HEREBY CERTIFY THAT THE ATTACHED SKETCH OF ABOVE SURVEY OF THE ABOVE DESCRIBED PROPERTY IS A TRUE AND CORRECT REPRESENTAT ON OF A FIELD SURVEY MADE UNDER MY DIRECTION, MO MEETS MINIMUM TECHNICAL STANDARDS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL LAND SURVEYORS IN CHAPTER 11 HHI FLORIDA ADMIMSTRATIVE CODE, RSUAMT TO SECTION 47Lh21 FLORIDA S T Page 2 I IPOR'I'ANT NOTI CES DO NOT BEGIN ANY WORK WITHOUT HAVING3tEcnVI D YOOJR; VALIDATED VgRMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Mondaytllitugh Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL .KEC 'F$ 5I 1 E IR'S A? DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED ' tQ1:14 (11:61 V IICLES, 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. STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Owner Print Name O5- '3ket (7e2 Sworn to and subscribed before me this 2 7 day of D-Q o aJ Signature of I■otary Public - 5ttte of Florida pt/ OFFICIAL KJTARYSEAL ARLENEID'ROSNER SEAL: t p1�/ 0 * COMMISSMON 000$8667 c.• MY OOMMIS9310NEXPMES '' CLEF Ft OCT. 14Z2005 Personally known OR, Produced Identification Type of Identification Produced: • .. .. • • • .. .. • • • • • • • • • • • • • ... • • • • • •. • • • • ... • • • • ... • • STAt_ OF ORI I Q / F MIAMI - !*ADE ignature of Contractor / Quali 1 fl /2 ' chqe / • (jets)gr / Print Name Sworn to and subscribed before me this aZi day of 9�� 2010 . Signature of Notary SEAL: Personally known 'AY p OFFICIAL NOTARY SEAL OAP U e ! ARtENE D ROSNER O i0 COMMISSION NUMBER = Q 00058667 q s: MYCOMMISSIONEXPIRES OCT. 12,2005 PERMIT APPLICATION OR, Produced Identification Type of Identification Produced: CONTRACTOR 'Q(� T �j Name M A lS 5 Po � 5 -Li t l-1 License No. od - -10 4 q '1 `�o - IS O Pr -X Address Ig03 5 1,0 gqtf, rer c ,or- lo Aiorl Laocierc{�1 le r'2- 3316E Telephone 7r / - 0 2 ( /�_ � 8 gy Fax g,s�/ 7 /3 - 69607 Qualifier Name nk I e t R ] , 7L PROPERTY OWNER Name `- C7 U 5 TC1dl7 / II P. 1i Lopez. 1 Address c - S Ale- 95 5+, [VI i' yyni 2/7o(95 FL 33/32 ?731 Home Telephone rl �Jq�� 5 7 /n Business Telephone 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. ted along with this permit application. • • • • • • • • • • • • • • • • • • • • • •• • • • • • • • • • ••• • • • • • • • • • • • • • • • • • ••• • • • • ••• • •• • • • ••• Naster No. Job Address: 5 Ale ! 5 STreeI FL PERMIT APPLICATION - 03 31o(o Subsidiatj Pel No. • •• •••• • • INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Complete the attached permit application which jd[at stgnnd py rit;prItiA;hy ektier and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processlw rypu'appli :vion. if rootrig work will be done, a roofing application must be submit- 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 33 32 --a77r Address Apt. City State Zip Folio Number I I ;UCH — 01 1 4 –O 60 Lot 9c Block 59 Subdivision PB PG Zoning Current Use of Property Square Feet in Units Floors Proposed Use of Property Value of Work 11/ 0(20 goo Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. 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 Description of Work Linear Feet ENGINEER Name License No. Address Telephone Fax ELECTRICAL .l.y,i,, Minimum Fee ()Ty. . ypE Dryer QTY. .l.i1,; :. C tL t,Applianne (fry. . l . vl , l•: Service Repair (yr Y. A/C Central 1 -3 Ton Fan • • ' ' (Ltltt,'V Ill • Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch J 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 1 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. TN Generator QTY. (TYPE Refrigeration, Tons Q'r Y. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth J 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 TYPI Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. 'rv Soakage Pit Q'I Y Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping J 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 woi4 being pe fc n ecf aid q iantity(ies) in the space provided below. IP IV VI RECEIVED AND REVIEWED BY: DATE: SECTION BY DA Zonin: r "ISTAIM Electrical �. Mechanical =11 Plumbin: ArTfret M — e ' Fire Public Works Structural MEZI Buildin: Official M I I 1%- . g1f 0 Page 4 OFFICE USE ONLY ❑ 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 • • • • • r • • • • ••• • • • • • • • ••• • • • ••. • • • • • •• ❑ PItOO! OF OWNERSHIP "' (Attach) • • • • • • • •• • • • CIIICKLIST •• •• • • • • • •• . . . • • • • • ❑ H1 / DEW &MCI .' (Nikkei $ewe ;) . .. . . .. • ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ o $ 0 7 $ ` b, ( /1000 x L x ¢.6ft0) $ I 6 v (¢.005 /sq.ft.) $ x,33 $ (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PI ?RNiIT FINS CST' pit cur),JA- TOTAL $ / ViiL. S 1 ISSUING OFFICIAL a ©� We r Pod( ' / r3 ( , IEWE� S e lAc N P ED BY: DATE: 1 ru - mo b a�f CONDITION OF APPROVAL ,./.©fcccc' "SwZ. A ,44. Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Dates/ / / V -S Time Type Insp'n Permit N. Name Address s it) • t Company Phone # l For Inspector3 /I Q_3 4ale ate App vro e ��� Re- Insp'n Fee Correction