Loading...
PAINTCompany Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Type Insp'n Permit No. e,&,21e i Name � /\/�� � Address ,/ ) / " `' q 6-6 For Inspector , . Approved Correction ❑ Re- Insp'n Fee ❑ Name & ~ \ � \ PROPERTY OWNER .` New Construction Name Alteration Exterior °, ‘///4 Address ?? Alteration Interior V Demolish Home Telephone `� © (._ Shell Only i C Business Telephone Add'I Attachment Other Fax Add'l Detachment Other TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'l Detachment Other \ Job Address: Step 1. Step 2. Address :3poi INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: 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 cP Apt. Folio Number.) i' as (Q' 013' (.)9c- Lot 30 ./, Q..? Block G I Subdivision C ) • 1 fl' 4B 1 0'/QPG Current Use of Property Proposed Use of Property Tenant Information 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 Master Permit No. Subsidiary Permit No. cC7 33 ) -- a - -- City �( Description of Work State Linear Feet PERMIT APPLICATION Zip elet/Ev/Pis Zoning Square Feet Units Floors Value of Work /c 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 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All. construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. E OF FLOR DA, COUNTY OF 14 MI -DADE . , ./ CC Si;!'ature o u Signature of Contractor / Qualifier j c e fre r,M //lei\ Pr int Name Print Name '/ - • Swo'r t. • n -2 ( subscribed before me this D day of 0 V , Sworn to and subscribed before me this day of 4 / / ../. • - 1' /P i ■ Signature v Notary Pub l State of orir Signature of Notary Public - State of Florida SEAL: U.::CLAL AVGELA 4l BEC: ':ld icumszn yC7aS397 "r.7;RSS Personally known OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produced (( Y L 1 0 q� .3..5 Type of Identification Produced: 79 0 STATE OF FLORIDA, COUNTY OF MIAMI -DADE SEAL: PERMIT APPLICATION ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer I QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton Fan , Dryer Vents, Number of Outlet, Wall Ventilation, Cost Service, Temporary Air Handler, Tons A/C Central 4 -7 Ton Piping, Flammable Liquid Fire Pump Outlet, Switch Fire Sprinkler System Signs A/C Central 8 -15 Ton Bath Fan - Vented, # Fixture - Fluorescent Pressure Vessel Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -vo t, Fire Renew - Temp Service Roof Inlet Water Closet Demolition Domestic Well Low -volt, Intercom/Teleph. Laundry Tray Repair Circuits Septic Connection Dishwasher Low -volt, Television Service, Number of Amps , Septic Tank MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE. Generator QTY. TYPE 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 Solar Water Heater Air Handler, Tons Ductwor , Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Fixture Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Pump and Abandon PLUNIBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TY Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain I 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 - Profane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Pipin Pump, Replace - Pool Urinal Dental Chair Grease Tr p Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker' Pump, Sump Utility - Water Dishwasher Indirect V astes Relay Repair Vacuum Pump Disposal Intercepto- 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 ee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. Val PERMIT APPLICATION RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE ///34/6 Zoning 71 Electrical Mechanical Plumbing Fire Public Works Structural //6. -\ Building Official 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 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) ❑ OTHER (Specify & Attach) $ 0 o i $ (¢.005 /sq.ft.) (sq.ft. = x/1000 x0.60) (0.01 /sq.ft.) � OP REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ t'J ■ ISSUING OFFICIAL 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 MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: )l 2 6 0( OWNER'S PHONE: , �6 ADDRESS: 1 `s xxxxxxxx xxxxxxxx x xxxxxx xxxxx x ;c ADDRESS OF SITE: —S CONTRACTOR & LICENSE (if applicable) COMPANY NAME: keae* xkcxxxxx*** All Elements on th site must be listed and indicate the color to be painted. Walls L &` 1 Fascia `u k'° E-e_ Drip Cap/Drio Ede 7r..e�? o ti Soffit ma Roof /JO C -e (4'r C' 1 3 Flower Bins 0/1 I / r Shutters i✓ifi h tn Awnings Pik 1 H Chimney �k t to - M x Doors and door jams N a(,?-ule/ /�,c. z Garage Doors t,J ii; 3 to h Railings lu` Fences iNAA- Decorative Metal F5it-t‘ /_ All brick (simulated or regular) Stucco Banding (' Any other stucco feature Accessory Buildings t -)A 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 the work stated. Furthermore , the paint colors will be as per the attached sa fit es. 264 Sen �� 'e o.' • caner Date Signature of Contractor Date * APPROVED: xx xxxliX 7'Cxxx YC xx x?% xxxicxxx* * i Building Officia Date xxx *xxxxxx)txxxxxxx PHONE: .0 >)< .0 .0 >C>( ).0 )4 > * ,11')At WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 e, j f r OwnN Square Pt. Sz- Nf ary as to Owner an My Commission Expires: ,ICATION FOR MIAMI SHORES VILLAGE rt) 95r'` 57- Tax Folio // g °z96 / D7a 5 (04,(62 //9'1.USdr.) crosEe Master Permit # '72/ S T. AA i ce( s fFU Phone 75-4 - G 66 Contract Address Qualifil SS# - - Phone State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor 5 Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION /211(107 r6iz' /L /fZ,(...0f- /77 Estimated Cost(value) 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 authoriz 7= itamed contractor to do the work stated. � ' r Signa 2 8 P;C PsidPnt Signature of Contractor or Owner- Builder �• -.Q � •� er an r ( Date : / �� a�� ✓' °��4 060NmE CHUM Date: : Notify Public. SW d RN�M ' My Cpmmissos Eq, ydalt Notary as to Contractor or Owner- Builder My Commission Expires: ** * * * * * * * * * * * * * * * ** FEES: PERMIT 9 Z RADON C.C.F. - �o NOTARY ,c.7-‘00 TOTAL DUE • a APPROVED: Fire Other Zoning Buildi `' N Mechanical Plumbing Engineering APPLICATION FOR BUILDING PERMIT MIAMI SHORES VILLAGE Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions Of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address No.___, Street___] Registered Architect and /or Engineer Name and address of licensed contractor__ _——..L. i a_ Location and legal description of lot to be built on: Lot_____ Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) _ BUILDING INSPECTION DEPARTMENT Date and for no other purpose. New Building___— Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $_____ C _Amount of Permit (7; Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to — — — - -- — — — — The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such 4ubcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) i 9L STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared — — to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. . . r Permit No Date Read, Sworn to and Subscribed before me. Disapproved .r.. Date_ (Signed) - - - - - -- --- . . 9 Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Chairman ______ Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.