711 NE 94 St (7)DATE: a
OWNER' S
ADDRESS:
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
JosP O - /,i) 4 /1%92r/ PHONE
Z7�e..■V6 -s.e.-d
******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * *. * * **
ADDRESS OF SITE: P./
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME:
PHONE.
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls ,O/13
Fascia
Drip Cap/Drip Edge (.:/ / _1,0
Soffit
Roof 4./atel 76 o.` /—v�� o
Flower Bins (owe zo/
Shutters 0�� •
Awnings
Chimney
Doors and door jams°° y-y
Garage Doors • LiC/�i J -
Railings
Offioo.)44Fences j.
Decorative Metal
1
aja•t1 l G
•
All brick (simulated or regular
Stucco Banding
Any other stucco features
Accessory Buildings
Other
SANTA FE C70 -28
..; //AV
Cy r/ &
75- 7//.
•1
DP -352
Ca
c
42. /e /dam 6(.4)
cA 2aedi
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
sam •. es.
APPROVED:
Building Offici
Date
Signature of Owner ate Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01
•
C ::,.i:LrCL) C:;EEN
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 2/26/2003
Applicant: ELIDA TRIAY VALDES
Owner: VALDES ELIDA TRIAY
JOB ADDRESS: 711 NE 94 ST
Contractor
Local Phone:
Parcel # 1132060141980
Fees: Description Amount
FEE2003 -1208 Building Permit Application Fee $60.00
FEE2003 -1209 Notary Fee $5.00
FEE2003 -1211 CCF $0.60
Total Fees: $65.60
Total Fees: $65.60
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 8/25/2003 Construction Value: $1,000.00
Work: EXTERIOR PAINTING AS PER AGREEMENT
If there is no permit package accessible off-the job -site for ins
fee is $50.00, which must be paid in advance before calling for at
This Permit is granted to the contractor or builder named above to construct the bui.
ordinances pertaining thereto and with the understanding that the work will be perform.
and approved by the proper municipal authorities. This Permit may be revoked at any
authorization. A further condition upon which this permit is granted is the understandir
ordinances and regulations pertaining to the work covered hereby whether shown on tl
by his agents, servants or employees.
Signed:
In consideration of the issuance to me of this permit, I agree to perform the work co
with the plans, drawings, statements or specifications submitted to the proper authorit
myself, my agent, servants or employes.
Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOT 17 & E1/2 OF LOT 16
(INSPECTOR)
Building Permit
Permit Number: BP2003 -323
(Contractor or Bi
Contractor's Address:
'03AH3S31,1 SJH'JIU T1V' IO MOM %O
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Page 1 of 1
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MIAMI SHORES VILLAGE se ,„
Paint 0 N 1 and Agreement 7 #
DATE: 2 -03 . °.. °. .•. • ••:
OWNER'S NAME: .Jbs e-• • ! :.t 4fl PHONE: Sod" 757
ADDRESS: 77/ 4 9
* * * * * * * * * * * * * * * * ** :* . * * :* :'.m *1`: * * * * * * * * * *** * * * * * * * * * * * * * * * * **
ADDRESS OF
CONTRACTOR & LICENSE•(if a�131'i�at3le)
COMPANY NAME:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elemen s on thr site must be listed and indicate the color to be painted.
Walls R. D A vAie , 4c� //o 1C-730
Fascia
f
-=Drip
Cap/Drip Edge (/) // -ems
Soffit 72)A212, 2
Roof
Flower Bins
Shutters
Awnings
Chimney
Doors and door jams
Garage Doors
Railings
Fences
Building Official Date
c- go"?
/ fe , G so
-( bey
Decorative Metal
All brick (simulated or regular)
Stucco Banding
Any other stucco features
Accessory Buildings
Other ( °I"
Clan- 7
PHONE:
C .o.r - 7715 7/43
0
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z
Le � ' cam-
ti
cil
•
0
"
elke,) w'k
OWNER'S AFFIDAVIT: I certify that all the foregoing info ation is accurate
and that all work will be done in compliance with all applicable laws regulating
c struction and zoning. I authorize the above -named contractor, if applicable, to
d • the rk . tated. urthermore , the paint colors will be as per the attached
sa ,�j o es. -
at re of Owner D. to Signature of Contractor Date
******************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
A ' ROVED: WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01
dee
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U5E
�� p Sunshine State
ELIDA T nARTI g 291
711 NE 94.SI •_. r .. . X
HIAMI, ✓p . x `
f" c0 A 20 - 8 8 1 VI 12
pirveP 218E -94 p D0-OD
OPERATOR o� ojo. •wE n .
DRIVER i\ �, ,.
SAFE a ,..„ n i
so.a�oe u�+� .,
PROPERTY OWNER
New Construction
Name r / �//,�AtL_
t `w i �J��
•
Address
l/Al / g1
Alteration Exterior
Home Telephone ` —
Repair
Business Telephone , n . •� / / 3
,
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'l Detachment
Other
•. •• • • • •• •. •
• • • • • • • • • • • • • • •
• • • ••• • • •
• • • • • •
• •
• • • • • • • • • • • •
Master Permit No. •
••; • ••; . ;•• gAsidiary Permit No.
• • • • • • • •
• •• .••.
PERMIT APPLICATION
(9\ ,gc)?
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1. Complete the attached permit application whicbmuatbe siepgd b3atile property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more e accur :ta prgtes your ap$Ijcation. If roofing work will be done, a roofing application must be submit-
ted along with this permit applicati4 ' ' ' ' " ' •
•
•• • • • • • ••• ••
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
Job Address:
Address
Apt. City
Folio Number ✓/description of Work
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
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Zoning
Square Feet
alue of Work �ccc
Zip
Linear Feet
Units Floors
Bldg Value
x Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT CHANGE (✓ )
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone
Qualifier Name
I
Page 2
IMPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YQUI; 4L1:DATE:I) gER1111,' AND TTRMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limi?ed to: °Monday ffiroutfl Triday 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 FREV112014 bIB,' lNIiitEB7t14. • • •
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQOPMEItifi AtalICLEVANDIvIAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk. 0 o 0 0•
• • • • 0 0 • o o
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
Choosin a Contractor.
11
'll
FLO
ignature o i'wner
DA! COU
lic
Y OF
S. ATE
Print Name
♦. to and subscribed before me this day o
(Ihi�
W ILLA • # Ari
Signature of Nrrary Puy
SEAL:
State of Florida
I I -DADE
Angela M BRCS'
My Commission DD960048
o p" Expires November 15, 29131
Personally known OR, Produced Identification .
r
Type of Identification Produced: ) A& ' I ' �' 9.y'I e of Identification Produced:
• •• ••
0 • 0 0 • 0 0 0 0 0
0 0 0 000 0 0 0
0 0 0 0 0 0 0 0
000 0 0 0 0 000 0 0
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:
4 sonally known
P OR, Produced Identification
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer • ;
oTY.
'TYI'i;
Qutlet, Appliance
QTY.
TYI'1:
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 tight
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 -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.
TYPE
Generator
QTY.
TYI
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
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.
TYPE
Drains, Roof
QTY.
TYPE
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
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 tl)e type or werlk beingpertormed and quantity(ies) in the space provided below.
••• •••
•
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
D E
Zoning
0 e
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
CHECKLIST
0 OWNER - BUILDER FORM
(Attach)
Ll FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
CONCURRENCY
(New Construction)
LI OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $
(Attach)
••• •
LI PROOF OF OWNESHIP ° • ° ° ° C'
R NDO ASSOCIATION APPROVAL
(Attach)
00 0•0 •• 0 • 0 00
HRS / DERM APPIZOVVL; : ° ° LI•BP12•APPROVAL (Restaurants)
0 0 • 0 0 • •
(Septic / Sewel') ° 0 e 0 0 0 0 0
00 000 0 0 0 0 0 00
ZI IMPACT FEE
(New Construction)
•
LI OTHER
(Specify & Attach)
PERMIT FEES
Inspector State Educational Fund $ (0.005 / sq.ft.)
State DCA (Radon) $ (Q.01 /sq.ft.)
Code Enforcement Fine $
Zoning Review
Notary
$ 5 O �
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
O e• •• • • • •e e•
O 0 0 0 0 0 0 • 0 0
O 0 0 000 0 • 0
O 0 0 0 0 0 0 0
000 0 0 0 0 000 0 0
(X .ft. = x/1000
•
•
PERMIT APPLICATION
® CONTRACTOR REGISTRATION
(On File)
TOTAL $
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
APPLICATION FOR BUILDING PERMIT
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 �dl.
Registered Architect and /or Engineer
Name and address of licensed contractor...
Location and legal description of lot to be built on:
Lo1.12 a.. ... Block 170-
Subdivision. --- -r, i d -
State work pbe done a d purpose of building ( rs f,!
Street and Number where work is to be done
and for no other purpose.
New Building Remodeling. Addition Repairs No. of Stories
To be constructed of Ki / of foundation /oof Covering ,
Estimated Total cost of improvements $ 1 j v O0 Z.
Zone cubage required
Amount of Permit $
_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 pennit 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, Pennanent 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 subcontractors, on work to be performed under this
permit, as are licensed y Miami Sho Village.
Remarks.ef (Signed)
and who, being by me
of the above described
therein by him stated
1
Permit No
Disapproved )
(Signed) ' "-
Chairman
Member •
Member
STATE OF FLORIDA,
COUNTY OF DADE. j ss •
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Date
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
first duly sworn, upon oath deposes and says that he is the.
construction, that he has carefully read the fo -_oing application, and that he did sign the same, and that all facts
e true.
Date Read, Sworn to and Subscribed before me.
PLA INC BOARD DATE
Date
- Building Inspector
_ _ 2, - 3 2 '7
to me well known,
Notary Public, State of Florida
My Commiss on Expires
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.