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12 NE 96 St (5)' ' Date 4 / 19 (FY Owner's Name and Address v A `� ° "QfdV " � ' oA el No / Street/ 7 6 . 9SH � 7) • kcaw., -4 br" Registered Architect and/or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot /0-4:i /1 Block Subdivision 'II SHORES VILLAGE INSPECTION DEPARTMENT FOR BUILDING PERMIT statement of the plans and specifications herewith submitted for the building or other structure herein city with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the .na all rules and regulations of the Building Division of Miami Shores Village shall be complied with. whether specifications must be kept at building during progress of the work. (69it$. tie B / �t D, CIO L/9 P Street and Number where work is to be don State work to be done and purpose of building Ib y floors), state exterior colors (submit samples) � . P P g S P and for no other purpose. New Building Remodeling To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements Amount of Permit $ 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 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 obligatons 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 a 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 by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA COUNTY OF DADE. } ss. Before me. the undersigned authority. a notary public. duly authorized to administer oaths and take acknowledgments. personally appeared 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. Permit No. of fa /J Disapproved Date Addition Date Repairs No. of Stories Read, Sworn to and Subscribed before me. Notary Public. State of Florida (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. PROPERTY OWNER New Construction Name /o I, it f C -. p , A i � C/ /�( 51 J ( YL Address /2gOE',6 Fl S ! '3 313 Home Telephone 7 c' � 3 r O (/ 7( • Gry — ✓ ` Business Telephone Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other Step 1. • • • • • • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • • • • • • • • ••••••• •••• •• • • • • • • PERMIT APPLICATION . IV ster Pcrmjt, Vo. • • u • s • jar! l!errrvt No. • • • • •••• • • • . • INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Complete the attached permit application which mustttR sin4r1 Vibe pfiperrewget %nd qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing¶ yQt ffhpOlicftti4rk•If:eofing•.ork 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. A X ob Address: 2- Ale; 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 96 9T. Ai - S PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Apt. City escription of Work rl 33(3 State Zip Zoning Linear Feet Square Feet Units Floors alue of Work 35 ©U Bldg Value ax 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 2 111 POR'I'A NOTIC DO NOT BEGIN ANY WORK WITHOUT HAN/Nig RECCIVELtt6Ut \1LIDIT•D 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 BVICEWIli E bal AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING PAMAG fkadJIOMMI 0R 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. AFFI - 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. STATE OF SEAL: OUNTY OF MIAMI - DADE gnature of Owner C ( $ 17 4>rint Na me Print Name and subscribed before me this day o Signature % Notary Pub 'c - ' tate o Flori ic e 0 Angela M Becker • 4 My Commission DD150048 o„,, Expire jMovember 15, 2006 • .. .. • • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • .... ...... • • STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: PERMIT APPLICATION Personally known L' OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: ELECTRICAL Typr Minimum Fee QTY. TYI ,p Dryer ..• `' '' • • 'I'"I,I; •Outlet, Appliance • QTy. . Service Repair Q . Q . V . 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 "I'YPI'. Minimum Fee QTY. . TYPE. Condensate Drain QTY. TYPI'. 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 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 PLUNIBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY TYPE Miscellaneous Fixture QTY. TYPE. Soakage Pit Q'rY 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 ptrrolillOd arQI Qugntity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY D E Zoning ..- 3 _ Electrical Mechanical Plumbing Fire Public Works Structural Building Official .'7 Page 4 OFFICE USE ONLY ❑ 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 Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund $ State DCA (Radon) Code Enforcement Fine Zoning Review Notary • • • .•. • •.. • • • •.• CHECKLIST t'1 PROOF OF OWNERSHIP (Attach) •• •• • •• • • • • • • • • • • • • • ❑. f RS 7 burl 3 phtd • fSepac ;Sewer) • • •• ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PI R11IT FEES ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: • • • • • •• • • • • • • • • • ••••• • • ..• • ( x . f t. x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ CONDITION OFAPPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com ALLYN BERG PLANNING AND ZONING DIRECTOR Mr. Chris Shorr 12 N.E. 96 Street Miami Shores, Fl. 33138 Re: paint permit Dear Mr. Shorn: p? fl)ictmi SIlorps Villa 3 �� 10050 N.E. SECOND AVE. MIAMI SHORES, FLORIDA 33138 -2382 Telephone: (305) 795 -2207 ftmmieW 3Ft1 I am writing with regard to the paint permit on your house. Because the permit is about to expire and the house has not been completed (permit issued 4/24/03), a new permit will be required. The approved color is a beige and the color painted is a yellow. We cannot locate a permit for the yellow color. Please paint the house the approved color or re -apply to Village Hall for a new permit. Because the house has already been painted without a permit, the cost will not be $65.60, it will be $220 because it will be an after the fact permit for the yellow color. Your assistance and cooperation are appreciated. Sincerely, Al Berg MIAMI SHORES VILLAGE Paint Color iiii�greement DATE: 3_ 4., D OWNER'S NAME: ADDRESS: ! a. * * * * * * * * * * * * * * * * * * * * * * * I ADDRESS OF SITE: ADDRESS OF SITE CONTRACTOR & LICENE COMPANY NAME: Awnings Chimney V' Doors and door jams P Decorative Metal All brick (simulated or regu r Stucco Banding Any other stucco features Accessory Buildings Other ailings Fences APPROVED: ••• to vi * * * * * * * * * * * * * * * * Th_•• r4: •e3:• • • (if applicablt):::.. 1 Garage Doors • ••• :: PI Fb 0 1 * * * * * * * * * * * * * * * * * * * * * * * * ** • •• • •• PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indict the 'rkkr +°° h minted. Walls 13/r.-7 Fascia &) )A1 to Drip Cap/Drip Edge - b.) k c� Soffit tJ Roof /V IA Flower Bins BE Shutters , ✓�` 4 ... 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 x samples ag O 3 Signature of Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION Gem/ a V c* a3 Building Offi ate 4/23/01 ACH Wr 663106277 Memo Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/5/2003 Applicant: CHRIS Owner: SHORR JOB ADDRESS: 12 Contractor Local Phone: Parcel # PARC2003 -1 CHRIS SHORR 03-03 12 N.E. 96TH ST. MIAMI SHORES, FL 33138 -2724 • NE 96 Legal Description: Fees: FEE2003 -1360 FEE2003 -1361 FEE2003 -1362 Description CCF Notary Fee Building Permit Application Fee Total Fees: Amount $0.60 $5.00 $60.00 $65.60 Total Fees: $65.60 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 9/1/2003 Work: EXTERIOR PAINTING AS PER AGREEMENT 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. Bank of A nterica Advantage' Date Pav kw0 --7 V t t to the order of 51 & o OW BankofAmeri a. (:06 3 100 2 7 71: 003 67 ?55333011' 0 1 Building Permit Permit Number: BP2003 -373 SHORR CHRIS ST Contractor's Address: Dollars Construction Value: $350.00 128 63- 27/631 FL 988 I $ .‘,0 8 LAM 1.0•14 tea... mpliance with all ordinances and regulations pertaining thereto and in strict conformity 'illage. In accepting this permit I assume responisibility for all work done by either 3Y: BY: Page 1 of 1 uipment or device described in the application herefor in strict compliance with all ny plans, drawings, statements or specifications that may have been submitted to done in compliance with such ordinances or if the plans are changed without x builder named above assumes the responsibility for a thorough knowledge of the it in the statements or specifications and that he assumes responsibility for work done