PAVERSCONTRACTOR
New Construction
Name p
'S \t, �(� PAvc ,
INC--
License No. 6 c9c, 0G C 8 G-3
Alteration Exterior
Address'`? 0_ 13'0 c - 7 S$"7(
£Lo .AL SPS_ FL. 3327
S
Telephoned gi _ 7„7 S – ?j. p Fax
Home Telephone 3 057 876-9 v
Qualifier Nameli r ik , F
/
PROPERTY OWNER
New Construction
Name ij aed, . 1, ,
Alteration Exterior
Address /O ,9 4/.. - 9 ,
. > t5 ,
33 /
Home Telephone 3 057 876-9 v
0 '7 0
/
Business Telephone
Relocation of Structure
Fax 3 6j— 7 —
y7
/a
Foundation Only
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
bPDI ID`K
417'i
PERMIT APPLICATION
Master Permit No.
Subsidiary Permit No.
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
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.
APPLICATION
Job Address:
Folio Number
l0? P � off AZO 32/37
Address Apt. City State / Zip
K Description of Work 51 / u /9 e,sh. ain't/0,47 / k44 -tiCw i A A
Lot , Block
�
tMSS
Subdivision �f PB PG J Zoning Linear Feet
Current Use of Property Square Feet Units Floors
Proposed Use of Property 1s\ Value of Work 3, �95.0 Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other brn - vv
t ll1wta.� are
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
ENGINEER
Name
License No.
Address
Telephone
Fax
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, 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.
SEAL:
Print Name
worn to a d subscribed before me this a day
C7 -�
otary Publl- Stateb €Flefi - • - y
• ti 7`; Pf d
ANCEL14 OLC,: -tt
• C e .
PERMIT APPLICATION
OF FLO 9 t • I► Y OF MIAMI -DADE
Gyc, c cDi 003
Contractor / Qualifier
"'ou�C� LAS �VTT'2Ii
Print Name
Sworn to and subscribed before me this q I day of IDVI -+"r` (
a ov
SEAL:
Signature of Notary Public - tate of
Q 10 Cherri e (=, �,/��,yp�
* i fk My Co mission � C93861'
Explr�+ May 21, 2004
Personally known OR, Produced Identification Personally known /' OR, Produced Identification
Type of Identification Produced il) 6 // t 3 / Qj 02 l / g of Identification Produced:
SECTION
BY
DATE
//12-
Zoning
a"
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
jQ
/ tfVe
Building Official
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
LI PROOF OF OWNERSHIP
(Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
o, od
$3,DO,
$ 1 (s = x/1000
x ¢. 60)
REVIEWED AND PREPARED BY:
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
PERMIT APPLICATION
El CONDO ASSOCIATION APPROVAL
(Attach)
BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $3 Cl e r
DATE:
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE 1
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
A/C Central 1 -3 Ton
Dryer Vents, Number of
Fan
Ventilation, Cost
Outlet, Wall
Ductwork, Cost of
Service, Temporary
Periodic Inspections
A/C Central 4 -7 Ton
Fire Sprinkler System
Fire Pump
Outlet, Switch
Fireplaces, Number of
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
TYPE QTY.
Minimum Fee
TYPE
Condensate Drain
QTY. TYPE
Generator
QTY. TYPE QTY.
Refrigeration, Tons
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
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
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 the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
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ADDRESS:.1,�c-�•c;� , Gi' 7 711 S N 1A. NA (
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,11/06/2001 05:00 7278988706
FROM
STONE AGE PAVERS, INC.
PO, Box 758766 Phone (954) 7554432
Cone! Springs. F1.33075 Sex (954) 755 -9312
Licensed & insured
PROPOSAL SUSOiTT60TO Sut)'01 COnSUUCAOn Co.. loc.
515 North Figgie - Or_ Suite 500
CITY, STATE AND ZIP CODs W 1' 13 , FI, 33401
tY@ NEfEBY SUBNnT SPEC*F)CATioNS AND ESTIMAl til FOP
Cayment to be made as follows:
upon completion
E NO.
nars' et _ _luU t
Custom Driveways
Walkways
Pool Dotes
Paves
CemRletolal
Residential
SUFFOLK CONSTRUCTION
PHONE (561) S32 -1616
400 NAMI Res.; 1 099 NE 07 5t.
JOB LOC VSni Shores
JURA hlrlu a
Stone Age Pavers. Inc, to provide all materials and labor to install Tremron pavers, Shape: 4" x 8 ", Pattern:
I •, ..., crone anti nnrrh halence to be 2 3 /8 ". To be installed on a 1" to 1 compacted sand bed for the
fallowing areas:
Pvt.: vattis asphalt (Street) 515 s/f
Install pavers at street, walkway dt porcn...... &03 s/
Thinset perimeter of porch 561/f
Risers/Steps 10
Note after installation, there will be two steps, rather than three.
Clean up
Total Contract Price: $3,845.00
* *"OPTION * **
Bulinose treads. . . . . . add $75.
Nov. 02 2001 12:16PM P1
PROPOSAL/
ACCEPTANCE
N° 7584
DATE ' i l /02/2007
JOe PHONE
C 007.01 m soxn..•. .vN A ineftrrinw AY rne-rc ThIr -ITV Real VAlt f11ANaFC MADE AFTER CONTRACT 15 SIGNED.
NOTES:
1. Price m tare end 6reight. Permit by others. Curbing by ethers, ee, at adtSonai ,barbs,.
2. Stone Age ?VCR, IOC. Will not be liable for the slight variation in color shades and end= that may occur between
the thick and thin pavers due ie the manufacturing process.
3. Stone Age Pavers, Inc will oat bo omstb10 for any damage that may occur to spritilders, utility lines, or
landscape, Location of utilities to be p ovided by general contractor.
4. Camaro is boamd to applicable terms and condition an the next page except as oat above.
5. Proposal based on bola measurement t oizwt00 r
8111 Murphy: (954) 931 -1574
We Propooe WnI n rn.nnlnMa in 2rrnrtianro with shove soeclt(oatIOhs. or the sum of:
T hy.. •}.e...�ct, ge�ht h,mAo.d. fnriy ttve......... , ,..xx/l09 3845.00
PAGE 02/02
PLEASE SEE PAGE TWO ON REVERSE FOR TERMS, CONDITIONS AND PLEASE SIGN.
Property Location:
Mr. and Mrs. Dwight Tracy
1099 Northeast 97t Street
Miami Shores, Florida 33138
Installation details: for the driveway, walkway and porch
Stone Pavers:
Shape:
Color:
Pattern:
Boarder:
Steps:
Brick 4 "x 8"
Coral 60%
Apricot 40%
Herringbone Design
Random mixture Coral /Apricot
Coral bullnose
* Random mixture if Apricot is available
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This property described a$: 70, !Rork 180 REVISED
TRACT 1 80B, S . OF TRACS• 'RRCT 1 V 1 A AND TRACT
THE REVISED PLAT OF MI1=MI :SF QR •� cEC •$• according to
Plat thereof as recorded In • Plat Book 43, Page 51 of
Records of Dade County, Florida.
• • • •
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Certified to: Mrs. Lee: Tracy . • • ••• • • •
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PROPERTY ADDRESS: 1 c),9 c7( fJ 7 TH
NOT VALID
UNLESS SEALED
WITH THE
EMBOSSED SEAL
OF
CERTIFYING
SURVEYOR
CERTIFICATE BOUNDARY SURVEY
I hereby certify that this sketch of survey of the hereon
described property is a true and correct representation of
a survey made under my direction and that said survey is
accurate and correct to the best of my knowledge and
belief, and unless otherwise shown. there are no visible
encroachments. 1 further certify that the survey repre-
sented hereon meets the Minimum Technical Standards
as set forth by the Florida Board of Professional Land
Surveyors in Chapter 21HH -8 Florida Administrative
Code, ursuant to Section 4 .0 7,)F1od Statutes.
Date • 11 2 q3
ROMAN M. LANNES
Florida Reg. No. 2243
NA 14. NA
EL012OP.
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SUPERIOR SURVEYING, INC.
PROFESSIONAL LAND SURVEYORS o
9701 S.W. 74 Street
Miami. Florida 33173
(305)274 -5339
SCALE: 111= 201
I JOB NO.
`1 3 — 1 I -O<o4