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710 NE 94 St (4)samples. MIAMI SHORES VILLAGE Paint Color Approval and Agreement APPROVED: DATE: / ( 1,9 OWNER'S AM ADDRESS: 'J/ 0 ******************* ************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: Walls Fascia Drip Cap/Drip Edge Soffit Roof Flower 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 � � / /8'Da Building Offi al Date ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on � the,siite must be listed and indicate the color to be painted. 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 Signature of Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305 - 795 -2204 Printed: 1/30/2002 Applicant: MARY Owner: Contractor Local Phone: Fees: FEE2002 -551 FEE2002 -552 FEE2002 -553 Description CCF Notary Fee Total Fees: Signed: (INSPECTOR) Building Permit Permit Number: BP2002 -183 Address: Cellular: Building Permit Application Fef#60.00 This Permit is granted to the contractor or builder named above to construct tt ordinances pertaining thereto and with the understanding that the work will be pe and approved by the proper municipal authorities. This Permit may be revoked a authorization. A further condition upon which this permit is granted is the underst ordinances and regulations pertaining to the work covered hereby whether showr by his agents, servants or employees. In consideration of the issuance to me of this permit, I agree to perform the wor! with the plans, drawings, statements or specifications submitted to the proper autl myself, my agent, servants or employes. Sinned! (Contractor oi DRESSLER Parcel # 1132060141720 Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOT 16 Job Address: 710 NE 94 ST Amount $1.20 $5.00 $66.20 Permit Status: Approved Permit Expiration: 7/29/2002 Construction Value: Work: PAINT EXTERIOR AS PER AGREEMENT (OWNER BUILDER PERMIT) 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. MRS. MARY E. DRESSLER Pay to the Order f Bank of Am ACH Nr 063100277 For • nc. ; LOO 2?71: $1,500.00 Date A rico. „ Page 1 of 1 Total Fees: $66.20 Total Receipts: $0.00 BLK 65 LOT SIZE 50.000 X 3500 63- 27/631 FL 988 Bank of America Advantage Bsurtly "".. dada on M. 00 70008 28911' 3 50 13' GUARD AND PROPERTY OWNER New Construction Name J Z , f ,�� r _g - �5/ Enclosure Address i /0 f\I Alteration Exterior 5--E. Repair Home Telephone r,� 5 (JL_J /9 l7� • �- -� / j1 �/ Business Telephone Relocation of Structure Shell Only Fax Foundation Only Add'I Attachment TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other Step 1. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other 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. 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. A PPLICATION Job Address: , K 7/0 l ii / 67 State ably / /710 Folio Number 16ao CA Description of Work - , 0 i2 li9 /71 0 Lot Block a-5 is 9/2,07% Zonin g CI Linear Feet Address Apt. Subdivision PB PG PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit N PERMIT APPLICATION Current Use of Property , Square Feet Units Floors Proposed Use of Property Value of Work / 500 o 00 Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Page 2 IMPORTANT NOTICES DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. 1. 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, P' 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 STATE OF FLORIDA, COUNTY OF MIAMI -DADE Type of Identification Produced: Signature of Omer PI° /130/71S,_57e.- Print Name Sworn to • •d subscribed before me this—a day o is - Sta of Flori SEAL: SEAL: OFFICIAL NOTARY SEAL o'v Po SEAL: ANGELA M m twines « b y * CC78 Personally known ,^ i C �udNM �: tip: E, /6 ' Signature of Contractor / Qualifier PERMIT APPLICATION 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: ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTV. TYPE Service Repair QTY. A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch 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 Cap - Sewer A/C Central 20-1- Ton Gas - Natural Flood Lights Pump, Fire Stand Plugmold/Strip Temporary Toilet 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 -volt, Fire Renew - Temp Service Domestic We .an ntiry'Dray Demolition Septic Connection Low -volt, Intercom/Teleph. Water Heater Repair Circuits Lavatory Dishwasher Low -volt, Television Drains, Area Service, Number of Amps Meter Set (Gas) Sewer Connection 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 Howl, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Supply, AC Well Cap - Sewer Bath Fan - Vented, # Gas - Natural Fireplaces, Number of Pump, Fire Stand Pressure Vessel Temporary Toilet Catch I.asin PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit QTv. 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 I.asin Gas - Propane Pump, Re- circulate Temporary Water CCeset Cilothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge We Ice Maker Pump, Sump Utility - Water IID'_s27was er Indirect Wastes Relay Repair Vacuum Pump r Dispcsai Interceptor Root IInllet Water Coset Domestic We .an ntiry'Dray Septic Connection Water Heater IIDrair'ie'ci, 4" TE :eti =8es. Lavatory Septic Tank Water Heater Nevi Drains, Area Meter Set (Gas) Sewer Connection Water Re -Wipe Drs-:-s, 7:cor Minimum pee Shower Water Service I ;:Drains, French Miscei"aueous ]Equipment Sink We ::, S .;,,;,:y Page 3 • • PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE <76—) Zoning ' Electrical Mechanical Plumbing Fire Public Works Structural Building Official ,/ / (-.) Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) ' • PEkMIT APPLICATION ® CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) 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 Al Agie J ; $ $ 0 (sq.ft. = x/1000 x0.60) (¢.005 /sq.ft.) (¢.01 /sq.ft.) ISSUING OFFICIAL REVIEWED AND PREPARED BY: TOTAL $ U16 ° 0 , 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