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1015 NE 97 St (6)OWNE NAME �� . a�Q K: �o `.e PRESENT ADDRESS I 1 N • C. 11 � LICENSE NO. PHONE NO. JOB LOCATION (ST. OR AVE.) LOT BLOCK 1 SUBDIVISION GENERAL CONTRACTOR 'F. • «• c _ .... c Tv"...., (.9 ADDRESS K.® e ®33. i :••• I - PHONE NO. LICENSE NO. "'b I ) PERMIT NO. ` `'• `1 • BUILDING DATE .1 1° �$ Q_ PERMIT FEE $ ( t BUILDER•S BOND NO. DATE Ato I-r . _� a o ZONE REQUIREMENTS CU. FT. - r0:1, 1 0 0A....A sr (41 2- PLAN CUBE 4• .' ` CU. FT. .� EST. COST S VX ' � " � 1 ` DRAWINGS. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: i .. • N • i A(1..k.. AT= D ` S' c 1 •‘...) NEW CONSTRUCTION TYPE STORIES ROOF CONSTRUCTION p ,INTERIOR CONSTRUCTION J ■ DESCRIPTION At - r1Q REPAIRS 11:0 K 001 -� m U• 4-male-is rva TL c- . r ,,,_‘_,,,,,,,?_, ALTERATION DESCRIPTION ADDITION L � -r 4rr� ' Z + +.'O...L : t '‘e`4A■ aa816. ` 1 ill W. �. `; ,=' ,, SUBMITTED TO PLANNING BOARD APPROVED M/.. - REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD SUBMITTED TO VILLAGE COUNCIL ' REMARKS CERTIFICATE OF OCCUPANCY NO. /Z 37 I ISSUED 7 -Z4^ ` I BY µ"`✓S I TO Z• 1.1 4ILa - oy 4. t . 7 - BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE INSPECTIONS DATE BY INSPECTIONS DATE BY F DATION $ SEPTIC TANK ROOF TEMPORARY SERVICE M $ 'S & LINTELS $ dt gi 4- - POOL $ SOLAR HEATER _ „ RANGE CONN. AIR COND. GAS SEWER FINAL I $ CLEAN UP $ FIXTURES SLAB SEPTIC TANK ��,,J G,.©L.t1 °"-�T c ��-7 - SLAB '' SOLAR HEATER SPECIALS PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE RE - INSPECT BY $ SEPTIC TANK FEE TEMPORARY SERVICE M $ SEWER $ dt gi 4- - TUB & TOP OUT $ SOLAR HEATER $ RANGE CONN. $ GAS SEWER MOTORS $ $ FIXTURES S INSPECTIONS DATE BY RE- INSPECT BY RE - INSPECT BY ROUGHING DATE FEE TEMPORARY SERVICE M -We-4 C g / C. $ dt gi 4- - TUB & TOP OUT H. W. HFATER CONN $ RANGE CONN. SEWER MOTORS $ FIXTURES SEPTIC TANK ��,,J G,.©L.t1 °"-�T c ��-7 - � I/ '' SOLAR HEATER FIXTURES GAS CONTRACTOR 7(-1,F-/C. f,�,. r ,F.'Q 7,oZ PHONE PERMIT NO. 4. 2 S'� 1 DATE L- -2.` -(0 FEE $ 7 NEW BLDG. I ALTFRATION 1 ADDITION X REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE M -We-4 C g / C. $ dt gi 4- - H. W. HEATER CONN. H. W. HFATER CONN $ RANGE CONN. $ MOTORS $ FIXTURES $ S INSPECTIONS DATE BY RE- INSPECTI BY RE- INSPECT' BY TFMP. SERVICE I ROUGHING H. W. HFATER CONN RANGE CONN. FIXTIIRFS & FINAL fly '/' `- BUILDING INSPECTIONS —17 /” CONTRACTOR PERMIT NO. NEW BLDG. ]] PLUMBING PERMITS & INSPECTIONS am._.+ c- f -a. /ji w> C. I PHONE //6.5 I DATE & '` 1` CO / / FEE $ �" 1 ALTERATION I ADDITION )C ELECTRICAL PERMITS & INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE REPAIRS - �Y This Lice ?Jo ass For the p subject to the Pro isio SEAL) I SE for In consideration of t i e it Paid to Miami Shores ilia o v a UST ' SE DISPLAYED IN A CONSPICUOUS PLA - to keep this license exhibited at your establishment or place . es ►: • TRIPLICATE VIA, AGE LICENS de County, State of F lorida, WU 144 Mk Addy is hereby licensed t e nga ge in or operate the business of 0.1 als arm drOs +K Sonosse By and ending MIAMI SHORES Aft 539 RIDA THIS LICE A Penalty is imporod L Y THIS LICENSE I T TRANSFERABLE WITHOUT APPROVAL OF THE V OWNER'S NAME F.L. L:ys PRESENT ADDRESS 149 N.7,". 101st Street LICENSE NO. 440c PHONE NO. JOB LOCATION (ST. OR AVE.) 1015 N.J. 97- h 3t. LOT 12 BLOCK 1 "0 SUBDIVISION T GENERAL CONTRACTOR owner-builder ADDRESS PHONE NO. LICENSE NO. 1371 BUILDING PERMIT NO. ,y As I _ > -3 10-1-52 DATE 24.00 PERMIT FEE S BUILDER'S BOND J1,.:; NO. DATE ZONE PEQUIREMENTS CU. FT. 25,.615 PLAN CUBE CU. FT. 20,000 EST. COST S DRAWINGS. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY DATE x NEW CONSTRUCTION TYPE CB STORIES 1 ROOF CONSTRUCTION tile INTERIOR CONSTRUCTION terrazzo floors, 7_est:r wall; REPAIRS y b , ,a�,,, LL,, DESCRIPTION u id Uel..LI1.y 2 . -2 baths- 1ivinz room- dinin- roam-Fla. room- kitehcn -2 car ..., a -e DESCRIPTION ALTERATION ADDITION SUBMITTED TO PLANNING BOARD APPROVED REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD REMARKS SUBMITTED TO VILLAGE COUNCIL CERTIFICATE OF OCCUPANCY NO. / � Lz. ISSUED BY TO BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE , INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION /0 3 -c: TEMPORARY SERVICE FEE TEMPORARY SERVICE f $ SEPTIC TANK BEAMS & LINTELS /,K- 1 G - f $ 7e) all -1 - "�' SEWER S RANGE CONN. $ SOLAR HEATER FRAMING MOTORS $ GAS $ FIXTURES $ $ INSPECTIONS DATE BY RE- INSPECT BY FINAL BY ROUGHING f c ," .' C- CLEAN -UP GAS • ROUGHING , p CONTRACTOR \f ib � ' � '' 0 ' • PHONE PERMIT NO. 4';h a DATE fib — }V. j - 7i FEE $ /O��-'� REPAIRS NEW BLDG. 1 ALTERATION 1 ADDITION SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE FEE TEMPORARY SERVICE f $ SEPTIC TANK I D . )u . LJ'. . /,K- 1 G - f $ 7e) all -1 - "�' SEWER S RANGE CONN. $ SOLAR HEATER $ MOTORS $ GAS $ FIXTURES $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING f c ," .' C- GAS ROUGHING , p SEWER H. W. HEATER CONN SEPTIC TANK .- ,- -Gt` .S e, O SOLAR HEATER FIXTURES ° ;,„ ✓ )'''‘i `„ CONTRACTOR -' - PHONE PERMIT NO. . • DATE ' ' `, C -. FEE $ /7 :' ' NEW BLDG. 1 ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE f /' C - �. j /CJ' rs- 7 b PI H. W. HEATER CONN. BB _ Jae 'ce • S RANGE CONN. $ MOTORS $ FIXTURES $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING , p H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL `„ BUILDING INSPECTIONS PLUMBING PERMITS & INSPE.CTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL. TO POWER CO. FOR SERVICE DATE 1.••• Cr .. , ( sal • And Further this Deponent says not: STATE OF FLORIDA) SS COUNTY OF DATE ) AFFIDAVIT of the Village of ' Miami *hores, County of Dade and State of Florida, being duly sworn, doth depose and say, that under the provisions of Ordinance No. 185, dated June 15, 1948, amendp ing paragraph (d) of Section B -368 of Ordinance No. 97 of the Building Code of Miami Shores Village, he desires to build a on Lot Block of Subdivision, that he is the owner of said property, and will be the owner of said , that he will Zoning work e he will, at such times as are required by the and Building�Directo,:- 1. File plans and specifications and obtain approval of the Planning Board and the Building Inspector. 2. Apply for and secure a Permit. 3. Pay the required fees. 4. Execute the work in accordance with the provisions of this Code. 5. Apply for inspections. 6, File with the Building Inspector certifie.tes that provision has been made to carry the necessary Workmen's Compensation, Public Liability and Property Damage Insurance. 7, File with the Building Inspector as the job progresses certi- ficates showing the payment required by the Federal Social Security Act to the State of Florida or the United States of America. 8. Assume the responsibility of not employing other than properly licensed contractors by Miami Shores Village for any part or portion of the work. 9. Not set himself up as a "contractor ". 10. Sign an affidavit before col mencing work to the effect that he has read this Article and will do the work personally and observe all of the requirements of the Building, Electrical, Plumbing and Zoning Codes of Miami Shores Village. Such affidavit to be properly notarized upon blanks to be supplied by the Building Inspector. 11. In order to prevent abuses and subterfuge the right of such owner.builder as herein provided,'is limited to but one owner - builder permit each 2 years, and where an owner- builder has once exercized the privilege herein conferred no second appaication for owner- builder permit shall be granted. in less than 2 years., unless the applicant is qualified as a licensed General Contractor under the applicable Ordinances of said Village. SUBSCRIBED AND-SWORN TO. AFORE ME this day of A.. D•, 19 • NOTARY PUBLIC ;UILDING - LECTRICAL IUMBING :OOFING < r_ )weer of il;:. uilding ontractor Builder ,gal Lot escription ddress of _. gilding i MIAMI SHORES VILLAGE. FLORIDA DATE / • 3 ^- 195 Contractor's j License No. �� y PERMIT N° 3108 Work to be performed under this Permit rchitect Bl - f 1 + �L i ' ` •'S 1 Subdi- vision Value of Project $ 4 1 . Amount of Permit $ da -/� Sri.•_ 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 :refor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, awings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any .e 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 anted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations rtaining 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 me by his agents, servants or employees. , `' ,, , Signed. t. � ,/,....--...- *'--e - INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work coveredihereunder in compliance with all ordinances and regulations rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- pting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. s . CONTRACTOR OR BUILDER BY AUTHORITY Sept. 7, 1988 Miami Shores Village Miami Shores, Fl 33138 This is to verify that the undersigned are having a new compressor installed at the side of their house and that in the event their side neighbor complains, we shall move it, at our cost, and hold the Village of Miami Shores harmless. Si ncer / re , oel I. JOEL AMSTELL Att.: Mr. LuBien Y yoyrs, Lf2G/ Amstell rcia D. Amstell 1015 N.E. 97 St. Miami Shores, F1 33138 STATE OF: Florida COUNTY OF: Broward I HEREBY CERTIFY that on this day, before me, an officer duly authorized in the State aforesaid and in the County aforesaid to take acknowledgements, personally appeared I. JOEL AMSTELL and MARCIA D. AMSTELL, husband and wife to me known to be the person described in and who executed the foregoing instrument and they acknowledged before me that they executed the same. WITNESS my hand and official seal in the County and State last aforesaid this 7th day of September 1988 A.D. if [SEAL] NOTARY PUBLIC STATE OF FLORID � � -! NV COMMISSION EXP JUNE 22. 18OOTARY PUBLIC, STATE OF Florida BONDED THRU GENERAL INS. UND.MY COMMISSION EXPIRES: q q OCT 3 2005 MI` MI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date IOI I 1 t 0 Type Insp'n 2^ lCA-) 74'4C-4 Permit No.R — 2 - I q Name � Address 1 o iS NE_ 9 ^l sr Company K L - K1 Phone # (786 / Z`u 1 — e3 G Inspection Date 0 12- 1 Approved Correction ❑ Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Requ ( Data ��ft Time v im S revs Type Insp' Permit No Name Address Company Phone t ` / 'f ~ q o l , For Inspector: 2 3 1 /0- Name Correction Re- Insp'n Fee o o MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 B ilding Inspection Request Dat.� I Time Type Insp'n Permit No 1 a 0 ©`k. - 1 1 D Name Address 10 15 m 9 -- 1_j_fr Compan ��x.) Phone # 61._c t/ 600-- OScA x ®a f For Inspecto . `132 ame Approved Correction Re- Insp'n Fee ■ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Bu'lding Inspection Request Date / 0 d-- Time r Type Insp'n Permit No. Name Address/0 /5 Company C Phone# 9sy-400-056‘ For Inspector ) I z1 0 a-- Name & Date Approved ❑ Correction Re- Insp'n Fee ❑ DO 6,60 Y7/9,ta c?t 1 0 19 AA C 1414 I A/ l 4 2-et f ft- MIAMI SHORES VILLA BUILDING DEPARTME 305- 795 -2204 Building Inspecti Date Ti Type Insp' n - . AI Reque — Permit No. .29 aO o 2 ' / 39- Name 5vm • Address LO l 5 J J •1 1 IS A 1 Company Phone # / 5 For Inspector: I v '3 Name & Date Approved I t Correction Re- Insp'n Fee Type Insp'n MIAMI SHORES VILLAGE BUILDING DEPARTMENT - 305- 795 -2204 Building Inspection Request For Inspector: Appro Correction Re- Insp'n Fee -4 'AA i PO Date Time Permit No. bi2 ' -Or)ta • /3 kYa l O fG 9 Name Address Company Phone O Name & Date Date Type Insp'n Permit No. Name Address MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building .Inspection Request Time y)ci /N Q Company �ir� Phone # 9 Zo -3 For Inspectors fi�Na e & D 0- Approved ❑ Correction Re- Insp'n Fee ❑ Date Type Insp'n Permit No Name Compa>Q Phone # Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 - 795 -2204 Building Inspection Request For Inspector: 1 /;) Address 1 0 L _ S C ct 1 2k ?Jufz. os_63� -��aa & IFte Date Time Type Insp'n Permit No. L/ ' e Name /Y)a , ./U�/ — Address / O/ 90 56, . Company Phone # For Inspector: Approved) V Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date _ Time Type Insp'n ,,� � Permit No. 0`t/ �v e a250— Name 6y-91-6. Address 10 J Al ` 9 . Company / r�: B' Phone # iy�Q, is t 4t°35 '300 For Inspecctor: 7 ( 0 Approved 6 ' 9 n Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Dat. r • Time Type Insp'n LZO Permit No. Name Address 1 o ( S Compan Phone # For Inspector: 1 ° C t Approved Correction Re- Insp'n Fee 35 3 b b 2 . 0 0 a l3 s � MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date! /0/0 R Time / n n Type Insp'n Permit No. L (=L®G h �� Name A/Met* Address 1 0 IS )r r4 ce )7o.0 Comp Phone # For Inspector: 1 Zl 111 0 Name & Date Approved TI Correction ❑ l/a ©� Re- Insp'n Fee ❑ y MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request ��// Time -4 Type Insp'n U �e Permit N Name � '�r Address iJ 7$ Company gdejl Phone # For Inspector: o Name & Date Approved Correction ❑ 7 y L /r Re- Insp'n Fee Date Dat Type Insp'n Permit No. Name Address Compan /�� Pho pt c_, ForInspector8) MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Dat Ti e Type Insp'n . °' si Permit No. ?1 ' / 04/ 09 Id( Name � .c.± Address / Df C• r 77 L1 Company Phone # OS— D ? ' D O" `� For Inspector & / 7/ 0 P e Date Approved Correction Re- Insp'n Fee ❑ lolgo MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date u a ime Type Insp' • _v uT _ i i. Permit No. � atok ) / Name Address t () Compa Phone # For Inspector: L1 Approved Correction ❑ Re- Insp'n Fee ❑ - 133 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request N Type Insp'n Permit No. Address Date Comp Phone-- 0 S For Inspector / 1S /V Approved Correction Re- Insp'n Fee JTi . 9S/. /9/Ep Type Insp'n Permit No. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date - © Time �L v - 0 Name S4/027 Address /0 t r `V C 2 sr Company in/ / & / c 72144 • Phone # 3 D TS /-..21 0 For Inspector: -,20 -02 Approved Correction Re- Insp'n Fee 7 e/4 , 421-etee 30,s" 1s /- 24 0 Date Date Type Insp'n Permit No. Name Address/l 6 5 ' e q , Compan / Phone # / 3c. 5- b .gS — 3 0 ° For Inspector:( / o/ 1:30,4) Name & Date Approved [l + ❑ Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request 0 ?Time � o oa -133 Rev. 10/02/03) • - Miami Shores Village RE- OCCUPANCY APPLICATION Date 10. 11- QS 12 Ulopiz- r Contact Name Buyer Seller Property Address City Miami Shores t IS Building Department b State Fl Realtor //); c'1 6 c`7 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 Permit No. 20 Z —2 - 1 7 Loc ID X86 2431 83 -) h k/ Company Name Phone # Zip 33 0•F I hereby certify that I understand that the zoning of the property is for single - family residential use and that it is unlawful for more than one family to reside therein. I also understand th &t 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 structures on the property. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate. Applicant Signature Sign: Print: My Com 20a 86d/A45 The foregoing instrument was acknowledged before me this 1 l day of � , , 20 by produced N I► TARY PUB fission Expires: o is personally known to me or who has as identification and who did take an oath. Tres: . 27, 2009 Bonded Thru Atlantle Bonding Co,, inc. Building Officials Approval: ctr 11 PAID Re -Occ. $60.00 Notary $5.00 CCF $0.60 Total C .5- (4) . 41c-73 PROPERTY OWNER � New Construction Nam \c hrtek Vet. _ �, ,p_,,, Address � r S 0 c -1 L(+ Alteration Interior Home Telephone ') (: (4 (�,( ( Relocation of Structure Business Telephone L� ' 1 js'l 'j (c.., 0 CD C 3( Fax Foundation Only Add'l Attachment TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Nliami Shores Village: Step 1. Master Permit No. Subsidiary Permit No. 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 submit- ted 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. APPLICATION Job Address: 10 3 L Address Folio Number Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax t 1 osLP Apt. City Description of Work ` State eC re e vt Zoning Square Feet alue of Wo Tax Assessed/ ppraised Value Flood Zone Base Floor Elev. Linear Feet Units PERMIT APPLICATION Floors Zip Bldg Value ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Page 2 INIPORTANT 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 C e s in a Contractor. S SATE OF R !!_; , COUNTY OF MIAMI -DADE e of givner Print Name om to and subscribed before me thi s day of e PERMIT APPLICATION STATE OF FLORIDA, COUNTY OF MIAMI -DADE 'Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of ature of Public V PI 3 ' ! t ^' • Flom. NOTARY Signature of Notary Public - State of Florida e PUa ANGELA M BECi:EW SEAL: < co�ass ow wuaa ®t a SEAL: * - y . C N. " ..: O cpb;; A �OF '.O NOV. y _ 7 ' Personally known OR, Produced Identification // Personally known OR, Produced Identification a Type of Identification Produced/ 55X 3 --5 '� - Type of Identification Produced: ELECTRICAL TYl,l, Minimum Fee QTY. T",l,, Dryer Q TYPE Outlet, Appliance QTY ' Y1'1.: 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 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 -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 'rvPH: Minimum Fee Q'rv. 'rvii. Condensate Drain QTY. TYPE Generator QTY. 'ra'i'l: Refrigeration, Tons Q•rv. 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 TYPL 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 the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: Page 4 OFFICE USE ONLY CIIECKLIST ❑ 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 State DCA (Radon) Code Enforcement Fine Zoning Review Notary ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ ?C Metropolitan Dade County (C.C.F.) $ . 0 6 ( sq.ft. = x/1000 x 0.60) Inspector State Educational Fund $ (0.005 / sq.ft.) $ (0.01 /sq.ft.) $ _5 tea SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ 9 — 0 0 ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 7/30/2002 Applicant: DARIK MARLENIS Owner: AMSTELL JOB ADDRESS: 1015 NE 97 Contractor Local Phone: Parcel # 1132050170120 Permit Status: Approved Permit Expiration: 1/26/2003 Work: FLOOR KITCHEN REMOVAL REPLACEMENT If there is no permit package accessible on the • fee is $50.00. whiek EXTREME INSTALLATIONS, INC 8821 NW MIAMI LAKES, FL 33018 (7; T1 r 414 -i 5`t�; �'s I'AYTOf s ORDEI_ t V� ®,UNION PLANTERS BAN FOR I1�629760043 911' Building Permit Permit Number: BP2002 -1331 SMART I JOEL ST Contractor's Address: Legal Description: 5 6 53 42 Fees: FEE2002 -4219 FEE2002 -4220 FEE2002 -4221 Description Building Fee CCF Notary Fee Total Fees: Amount $85.00 $3.00 $5.00 $93.00 Total Fees: $93.00 Total Receipts: $0.00 Construction Value: DATE 3065 63- 841/6 BRANCH 6297E Page 1 of 1 PB 43 -51 REV PL MIAMI SHORES SEC 8 LOT 12 BLK 180 $4,400.00 y rerify, there will be no inspections. Re- inspection ection. I the equipment or device described in the application herefor in strict compliance with all e with any plans, drawings, statements or specifications that may have been submitted to is not done in compliance with such ordinances or if the plans are changed without actor or builder named above assumes the responsibility for a thorough knowledge of the ings'or in the statements or specifications and that he assumes responsibility for work done I compliance with all ordinances and regulations pertaining thereto and in strict conformity 's Village. In accepting this permit 1 assume responisibility for all work done by either BY: BY: t c sJ-