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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