PAINTELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
l utlet, Appliance
QTY.
TYPE.
Service Repair
QTY.
A/C Central 1 -3 Ton
- Heating Strips, each
Fan
Outlet, Wall
Service, Temporary
Paint Booth
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
- Piping, Flammable Liquid
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
- Process/Pressure Piping
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Pressure Vessel
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
Pasts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Renge/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. TvI I:
Generator
Q'I'1 . I 1 PE:
Refrigeration, Tons
Q'I'V.
A/C Central, Tons
QTY.
Cooling Tower
- Heating Strips, each
Vent Hood, Cost
A/C WaWWin. 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
Pump and Abandon
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Gas - Appliance
PLUMBING
TYPE
A/C Condensate
QTY.
TYPE
Drains, Roof
QT'.
i
'I'YPli
Miscellaneous Fixture
Q'I'Y.
"NIT
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 'fray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer CO nnectionn
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:
SECTION
BY
D E/
Zoning
d3 ��it�
S/ �` "
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
,
Building Official
' / /�"' 41
Page 4
OFFICE USE ONLY
C;FIECKLIST
❑ 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)
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
I F 0
$
(sq.ft. = x/1000
x 0.60)
(0.005 / sq.ft.)
(0.01 /sq.ft.)
REVIEWED AND PREPARED BY:
PERMIT APPLICATION
® CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $ 10
ISSIIJING OFFICIAL
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
PROPERTY OWNER
Name
(1ag rva_ ono
Address
3$3 NEC((oSC.
Home Telephone ( 305 e2 Is _ 1
Business Telephone 30s- is4 l
Fax / 3C'S 1S4 - coo -5
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'l Attachment
Ottr,er
Add'1 Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a I ern t 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:
Apt. City State Zip
(�
Folio Number Description of Work C ∎ v- c ‘ W CEvt k e .r l0 t'-)
Lot Block
Subdivision PB PG Zoning Linear Feet
Current Use of Property Square Feet Units Floors
Proposed Use of Property Value of Work t 8 Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
Address
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
3S3 !u C q b nAreet
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
sa_c dls -431y
Master Permit No.
,M uuA4. 51n o ceS
PERMIT APPLICATION
Subsidiary Permit No.
C 3313e.
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTO
Name
License No.
Address
Telephone Fax
Qualifier Name
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.
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, P' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choos s, tractor.
Print Name
Sw o to and subscribed before me this
SEAL:
Personally kn
4w`.Y F I MARIELENA DIAZ
MY COMMISSION # DD 017854
• EXPIRES: April 15, 2005
Bondlc n u ddeerrxwn�
Joraxpeb Y8eRM atic
day of ,
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 Signature of Notary Public - State of Florida
SEAL:
PERMIT APPLICATION
Personally known OR, Produced Identification
Type of Identification Produced: Type of Identification Produced:
0
'ay To
Order Of
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 5/6/2002
Work:
arnett
Applicant: GABRIEL
Owner:
JOB ADDRESS: 383
Contractor
Local Phone:
Parcel # .1132060135920
Fees:
FEE2002 -2469
FEE2002 -2470
Permit Status: Approved
037.116
360.41st Street
Miami Bach, Florida 33140
(IQ
'ors
167003 8 5I: 2 L97 L L9895563
NE 96
Description
Building Permit Application Fee
CCF
Total Fees:
g° —� bra7r s
'
P I%
Building Permit
Permit Number: BP2002 -850
OBANDO
ST
Contractor's Address:
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 - 70 LOTS 21 & 22
Amount
$60.00
$1.80
$61.80
Permit Expiration: 10/28/2002 Construction Value:
EXTERIOR PAINTING 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
e is $50.00, which must be paid in advance before calling for another inspection.
a
219
GABRIEL OBANDO
REBECA OBANDO
I �, 4350 NAUTILUS DR.
MIAMI BEACH, FL 33140 -2854
U $X,9
irclulof
63-3981670
116
the equipment or device described in the application herefor in strict compliance with all
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 -
. 'Ictor or builder named above assumes the responsibility for a thorough knowledge of the
- ngs or in the statements or specifications and that he assumes responsibility for work done
BY:
BY:
$2,100.00
Page 1 of 1
Total Fees: $61.80
Total Receipts: $0.00
BLK 43.LOT SIZE
•
•
compliance with all ordinances and regulations pertaining thereto and in strict conformity
es Village. In accepting this permit I assume responisibility for all work done by either
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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
Date
•wner's Name and Address / /1-i liti 7-F- I 5 t-� / ' � � y / '� o.
19 i
treet �(J 1; '<e /4 5: -
R egistered Architect and /or Engineer
�Iv me and address of licensed contractor 0A/hi,
Location and legal description
`�
escription of lot to be built on: y� f� `I�/ J
Lot p J V A d� Block '� Subdivision 7/I /8 I /9_,49 // 4 /3 dial 7
to<reet and Number where work is to be done � /4?:
1 1/S - tate work to be done and purpose of building (by floors). state exterior colors (submit samples) A A/ / /u C,- a 4 ,, ,c_
0 f P.40 (?e.:2
New Building Remodeling
and for no other purpose.
Addition
Remarks (Signe`dr
Repairs No. of Stories
Roof Covering
To be constructed of s,. Kind of foundation
7 Estimated Total cost of improvements S ` ' Amount of Permit 5 3 / r o
Zone cubage required / Plan Cubage
Distance to next nearest building S'ze 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 permit; ;41 post or cause to a posted for inspection
on the site of the work such public notice or notices as are required by the Act. The undersigned a es employ only s h ubcontr to , on work to be performed
under this permit. as are licensed by Miami Shores Village. „
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 foregoin application. and that he did sign the same, and that all facts therein by him stated are true.
Permit No. °X;c1 1 Date Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member _
Member Member
Member Member
Council Approved P ate Disapproved Date
NOTE: A charge of 525.00 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 525.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and or workmanship.
Notary Public. State of Florida
MIAMI SHORES VILLAGE
44
• Paint Color Approval and Agreement
DATE: q- o2.4. I 0.2.
OWNER'S N : (-IAgp . k3q,NID PHONE: 3os- a vs- 4�r7
ADDRESS: hi Atji ca -+-oR ( "Vt.. - 5 - 31.3
********************************** * * * * * * * * * * * * * * * * * *, * * * * * * * * * * **
ADDRESS OF SITE:
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:
********************************* * * * * *F * * * * * * * * * * * * * * * * * * * * * ** **
All Elements on the site must be listed and indic the color to be painted_
Walls . Sod �Cc V C.� °' / 7 C=111
Fascia D ,A 3 'I 3 3 �-I
S u � 5 '/ � � ) l 1
Drip Cap/Drip Edge
Soffit Savn O
Roof
Flower Bins
Shutters
Awnings
4 /11
Chimney /Y/4-
Doors and door jams P ci-c,c P,NeS
Garage Doors S cis 00 tf
Railings PctctT% Pcti2 S
Fences
Decorative Metal (Qc t -C%c. Pane
All brick (simulated or regular)
Stucco Banding A/ /o9 A °
Any other stucco features So E.trt)
Accessory Buildings Ni
Other
OWNER'S AFFIDAVIT: I certify that all t
and th all work will be done in compliance
c9nst r ction and zoning. I auth• rize the abo
• k stated. Furtherm �. ', the paint c
: III /, % // / /, % / it_A
Sig . � t , � / 1�� Date Sig
*** 1* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *4
APPROVED: WH
CA
Building Official Date
Dat ! —Time
Type Insp'n
Permit No.
Name
Phone #
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
B ilding Inspection
Address . ✓ !r
Company
Approved
Correction
Re- Insp'n Fee
'
For Inspector!' / ) ? (�' 4 "3 Name
Request
0„.; r_
to