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546 NE 97 St (4)V . 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 A4 19 ,I1 � ^ c� L Owner's Name and Address V� r � 'L �-� ` (� � " No -41 Streeti�_P Registered Architect and/or Engineer SID L \ 5 v" C � r AfiL0 J �Y u � ^ k— r — e v f� Name and address of licensed contractor ‘ Location and legal description of lot to be built on: j/ svt®6 / 7 S_5 Lot J Block 9 9 Subdivision U Street and Number where work is to be done v ■ -1 1 s r State work to be done and purpose of building (by floors), state exterior colors (submit samples) ecp��e_i vtc 6►'5 k'vtca ' k 4--e -S v u New Building Remodeling Addition Repairs No. of Stories.. To be constructed of (�'1 Kind of foundation Roof Covering Estimated Total cost of improvements $ , 3 Q O Amount of Permit $ 1 ° t ' 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 ks obligatons as an employer of Labor under the Florida Workmen's Compensation Act, being Section 5966. Compiled General Laws of Florida, Permanent Supplement, 11E4_1 - . e• " the •rovisio• - •of, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this rmit; a will pos use to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to °mpl. .nly such bc.y ?tors, n work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) Permit No. Disapproved (Signed) TA-9 rah t D ate x5 4 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 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. Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved ()ate Disapproved 7 End for no other purpose. to me well known. 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 materiels and or workmanship. THESE PLANS ME APPR0 °ED PUA NJU. J. .'; OUILDING PERMIT `; O WITH NO VAROmPn' ; •:It;i :ARIA "'T':.) ! 1STED IN "REMARKS" tl C■O OTHER DEVIATIO 'S FR:iiq T':".:;1: ". ,' c,',•:e.: 5IJ1l.D1NG AND ZONING ORDINANCES WILL BE PFK°rTIEt) Di.: r: SPi::;h ICALI.Y MED DELOW. ALL OTHER APP'I IC91.E STATE • APIA „CJ'!: I'i L",'; ;S MUST BE CO M'L'EC WITH IV ALL PARTIES. FIFtE DEPARTMENT PUBLIC WORKS L POLICE DEPARTMENT r iUILDING DIRECTOR PLANNING & ZONING B©ArJ) VILLAGE COUNCIL • APPROVAL f',' ' i•c;4 S: n9tur °Ito PRELIMINARY: ENALs. REMARKS: COMPLIANCE WITH THE SOUTH FLORIDA BUILDING CODE AS ADOPTED BV MIAMI SHORES VILLAGE IS REQUIRED. THE ARCHITECT, BUILDER S'JB CONTRACTORS ARE CHARGEn V'ITw T "r K +'OV'JLEDGE OF ALL BUILD- REGULATIONS vdliaria `; NDT SP<C` a.A LY • ..,/ ,/ 1 / • • 1' , 10 (J Ai /I //: I 41 1 L 0 Ci 770M • iLL rl ), I /t /01:./ 2 • I / ▪ 7 • a L E I 3 OT5 •-) . • 1 /4 M/ 5 A • 1,1. 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Miami Shores Village 10050 NE 2nd Avenue l 0 Z - Phone:305- 795 -2204 1 An Printed:6 /6/2003 rX Applicant: KENNETH r4 a Owner: KODISH p Q M JOB ADDRESS: 546 NE Z z Contractor A RTISTIC CONCRETE : Local Phone: 305 - 888 -4565 ' PO Work: DRIVEWAY APPROACH BankofAmerica ACH R/T 083100277 ARTISTIC CONCRETE USA INC. PERMITS ACCOUNT 10099 N.W. 89TH AVE. UNIT 8 MEDLEY, FL 33178 -1421 11-02 0) H Parcel # 1132060171520 Fees: Des( FEE2003 -3380 Build _ FEE2003 -3381 Builders Bond rO FEE2003 -3382 CCF i Qp Total Fees: Permit Status: APPROVED Permit Expiration: 12/2/2003 Construction Value: IN S e c u r i t y en 1, n c e 1 d o c u m e u f. S o r F a v k 717 f a i l a. PAY TO THE ORDER OF DATE FOR 11 '00 144 71I' 1 :06 300004 71: 00 54804 297 3011' Ammo. 7=-111915M c s. O z .... N b E a z < $300.00 $1.80 $361.80 ‘-//- as $2,100.00 1447 I $ Ea DOLLARS 8 Total Receipts: .� 331.3 63 -4/630 Ft 1351 1 1 ions pertaining thereto and in strict it I assume responisibility for all work g ription: 5, Block 99, of MIAMI SHORES SECTION N0.4, D the Plat thereof, as recorded in Plat Book 15, Page 14, c Records of Miami Dade County, Florida. l: )dish and Vala Kodish; Abbie R. Salt, Esquire; Attomeys' nce Fund, Inc.; Chase Manhattan Mortgage Corp.; Eastern dortgage Corp., its successors and/or assigns as their �+ appear. Panel: 0093 Flood zone: X Date of fieldwork: 04/08/99 Completion date: 04/08/99 Survey number: G -19467 Property address: 546 N.E. 97 Street Miami Shores, Florida 33138 ., , , .., j LI , . ... , . T :3 ( iOfi1':1.IAN:D BOUNDARY SURVEY — 4000 FENCE -. -.- an FENCE F .v NAIL • PROPERTY CORNER R RECORO M FIELD MEASURED • CALCULATED CL CLEAR ENCR ENCROACHMENT CENTERLINE © CONCRETE Q PROPERTY L/N£ C. CONCRETE MONUMENT F 1..9. FOUND IRON R00 Ft. ?. FOUND IRON PIPE R/W RIGHT OP WAY N4ID NAIL & DISC D.E. ORAINAGE EASEMENT '' ✓.E. J TILI TY EASEMENT F0. FOUND P PLAT icisiate ASPHALT a H.L. OVERHEAD UNITIES P.P. POKER POLE IX TRANSFORMER CATV CABLE RISER W.M. WATER METER TEL. TELEPHONE FACILITIES ® COVERED AREA B.R. BEARING REFERENCE CH CHORD RAO RADIAL N.R. NON RADIAL A/C AIR CONOITICWER 9...V. BENCH MARK Ca CATCH BASIN C. CALCULATED SIGNED CAR D.B. 0. O.H. 0/W fSM E.L. F.F. ram. F.P.K. L.A.E. M.H. N.T.S. O.R. O.R.B. P.P. P.R.M. PG PVMT P.B. P.0.8. P.O c P.O.L. P.C. P. R.0. P.T. R. R.O.E. SLR. s/W T.B.M. T.0.8. TYP. w. c 10.50 CENTRAL ANGLE/DELTA OLEO BOOK 0£SCRIP rION OR 00E0 DRILL HOLE DRIVEWAY EASEMENT ELEVATION FINISHED FLOOR FOUND CONCRETE MONUMENT FOUND PARKER -KALON NAIL LENGTH LIMITED ACCESS EASEMENT MANHOLE Nor To SCALE OFFICIAL RECORDS OFFICIAL RECORDS 800K PERMANENT CONTROL PANT PERMANENT REFERENCE MONUMENT PAGE PAVEMENT PLAT BOOK POINT Of BEGINNING POINT OF COMMENCEMENT POINT ON LINE POINT Or CURVATURE PGVNT OF REVERSE CURVE PONT OF TANGENCY RADIUS (RADIAL) ROOF OVERHANG EASEMENT SET IRON ROO & CAP SIDEWALK TEMPORARY BENCH MARK TOP OF BANK TYPICAL 1St NESS CORNER EXISANG ELEVATi0W GENERAL NOTES: I) LEGAL DESCRIPTION PROVIDED BY OTHERS 2) THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENTS OR OTHER RECORDED ENCUMBERANC£S NOT SHOWN ON THE PLAT. 3) UNDERGROUND PORTIONS OF FOOTINGS, FOUNDATIONS OR OTHER IMPROVEMENTS HERE NOT LOCATED. 4) WALL TIES ARE TO THE FACE OF THE WALL. 5) NOT VALID UNLESS SEALED WITH THE EMBOSSED SURVEYORS SEAL. 6) ONLY VISIBLE ENCROACHMENTS LOCATED. 7) NO IDENTIFICATION FOUND ON PROPERTY CORNERS UNLESS N07E0. 8) DIMENSIONS SHOWN ARE PLAT AND MEASURED UNLESS OTNcR(NS£ SHOWN. 9) FENCE OWNERSHIP NOT DETERMINED. 10) ELEVAT1O/NS If SHOWN ARE BASED UPON N.C. V.D. UNLESS OTHERWISE NOTED. 11) BEARINGS REFERENCED TO LINE N07E0 AS 8.R. HEREBY C£RT,FY THAT THIS BOUNDARY SURVEY IS A TRUE AND CORRECT REPRES£NTA TIGW OF A SURVEY PREPARED UNDER MY DIRECTION. SIGNED 5TATE OF FLORFQA QALPM 514ERDLOFF REGISTERED LAND SURVEYOR NO. 3411 STEREO LANG SURVEYOR NO. 3762 STATE OF FLOR/0A SIGNED F l I \ / ' � STATE OF FLORIDA VC ALUILAR 9E051E9E0 LAND SURVEYOR NO. 5571 THIS SURVEY IS INTENDED FOR MORTGAGE OR REFINANCE PURPOSES ONLY. EXCLUSYVELY FOR THIS USE 8Y THOSE TO WHOM IT is CERn /1£0. THIS SURVEY IS NOT TO BE USED FOR CONS7RUCTKNt PERMITTING OESJGN OR ANY OTHER USE W11HOUT THE IYR/TTEN CONSENT Of FIRST FINANCIAL SURVEYORS. INC First Financial Surveyors, Inc. AND AFFILIATED L.B. 6387 Natlonwld.: 1- 800 -927 -2888 Pax: COMPANIES 7700 North !Caudell Drive Suit. 400 Miami. Florida 33156 (306) 271 -3666 Fax (306) 271 -6499 366 Aulln Avenue Suit. 3 Oviedo. Florida 32765 (407) 977 - 7010 Fax (407) 977 -7020 1157 Witco Boulevard Nashville. Tennun. 37217 615) 366 -8492 AX (615) 368 -8477 1 -800- 227 -2660 /�� � 'ti � 1Crb •• • 1- 0 —J 020' 0.30` 12' F.I.R. 5' Concrete Sidewalk )1 ( � LOT 5 1/Y F.I.P. 19' Asphalt Road 14.60' Metal Shed N Concrte Wall + H=4' w4:1.70' — N.E. 97 Street U z.22 27 Parkway 100.00'(P) 100.06'(M) 1IT F.I.P. One Story Residence #546 15 Alley Barbecue LOT 4 20.10' 8.50' } V Asphalt Rand 9.98' 01; J --020' 112' F.I.P. -- 0.20' 149.90' 3.00' 100.00'(P) 100.04'(M) 3.00' M t- 0 RESTRICTIVE COVENANT DECLARATION OF USE PREPARED BY: ?� KNON ALL MEN BY THESE PRESENTS: WHEREAS, the undersigned V/14.4. ,k'O2v3,,c is/are the fee simple owner(s) of the following described prcperty situated and being in Miami Shores Village, Florida: Lot(s) AY 5 Block f P of i /.�d�',j p,,, , fee � (Subdivision), A.K.A. (address) 5 c, p, 97 5s according to the plat thereof, as recorded in the Plat Book / 5- Page /1 of the Public Records of Miami -Dade County, Florida, and . Whereas, the undersigned owner(s) VAg- desire to L:tilize said Lot(s) as a single building site, and the undersigned owner(s) do(es) hereby declare and agree as follows: 1. That the property will not be used in violation of any ordinances of Miami Shores Village or Miami -Dade County now in effect or hereinafter enacted. 2. That the property will be used for a single family residence only. 3. That the use of the property or building will be as follows: NOW, THEREOF, for good and valuable consideration, the undersigned do(es) hereby declare that he/she will not convey or cause to be conveyed the title to the above property without requiring the sticcessor in title to abide by all terms and conditions set forth herein. FURTHER, the undersigned declare(s) that this covenant is intended and shall constitute a restrictive ' covenant concerning the use, enjoyment and title to the above property and shall constitute a coveaan: running with the land and shall be binding upon the undersigned, his/her successors and assigns and may only be released by Miami Shores Village, or its successors, in accordance of said Village then in effect. IN WITNESS WHEREOF, the undersigned has/have caused It)( hand(s) and seal(s) to be affixed hereto on this _„&"— day of WITNESS(ES) • ignature and Print commission expires DECLARATION OF USE kic3ADA66 ktita 'Signature and Print Signature and Print TATE OF FLORIDA): OUNTY OF MIAMI - DADE): -IEREBY CERTIFY that on this day personally appeared before me dI dab/LS/4— who is personally own to me or has produced (type of identification) as identification and 7knowledge that he/she executed the foregoing, freely and voluntarily, for purposes there in expressed. TORN TO AND SUBSCRIBED before me on this 5 day of u#06 , 20 Q3 � ,,,,,!,,,, Thomas Fitzgerald> `,. tgaFili11�' FLORIDA ''',4 Atlantic BantliakVajaA Q: Expires Oct 28, 2Qfl CONTRACTOR Name , t ,r kr f �(JY Name4 j p e OS // ,/� License No. C Z5/0O Address /669/ i(-)& g 7f rifer , A- 331 66 Telephone ' 19 7 _ g Fax / 1: 3 & , 2:772.40 j Qualifier Name 1€013/00 PROPERTY OWNER Name , t ,r kr f �(JY Address 50 0= 9 7 Home Telephone 7 5 w T / 077 4/ Business Telephone Fax 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 INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shore t liage: Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notariz¢d. 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: -5 TG AA" 97 5 Address Apt. Folio Number 1l - 32 ■ - d r 7 Lot q j Block 77 Subdivision /1.5 . See. y PB PG /1 Current Use of Property .Sc, Proposed Use of Property Sr( 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 /17 / 5ira / City Description of Work PERMIT APPLICATION Master Permit No. 13 P - O�C ," ` q O,L Subsidiary Permit No. State 3 3 / Zip Zoning Linear Feet Square Feet 660 Units Floors Value of Work f 2 t c.b Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Page 2 I MPORTANT NOTIC 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 $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1°' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of `Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUN . Y OF MIAMI -DADE VkA- ,b2I$ I1 - Print Name Sworn to and subscribed before me this day of A. ZOO 3. ,. , `;pray Thomas Fitzgerald ` .' commission # DD161337 _Ne dui i nC Expires Oct. 28, 2006 % etk, Bonded Thru Signature of t'ul�lic - �b St i f'ori ntic BoneinaCO, SEAL: Personally known OR, Produced Identification STATE OF FLORIDA, CO Y OF MIAMI -DADE Signature of Contractor / Qualifier 3f 3 Print Name Sworn to and subscribed before me this ✓ day of lk) Zoa3 "��% , Thomas Fitzgerald •,• �11Y Pp � � ` e� Commission # DD1613W! = c21 1 = Q= Expires Oct 28, 2006 Si a of otary Pub" �i .. 1 �or $a01>C. SEAL: PERMIT APPLICATION Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: ELECTRICAL .l.yl,l,. QTy. nil:. QTY ' E Q . l . V . 1 ) pi. ) l Minimum Fee '1111 Refrigeration, Tons Dryer A/C Central, Tons Outlet, Appliance Cooling Tower Service Repair Heating Strips, each A/C Central 1 -3 Ton Vent Hood, Cost Fan A/C Wall/Win. Tons Outlet, Wall Dryer Vents, Number of Service, Temporary Paint Booth A/C Central 4 -7 Ton Ventilation, Cost Fire Pump Air Handler, Tons Outlet, Switch Ductwork, Cost of Signs Piping, Flammable Liquid A/C Central 8 -15 Ton Periodic Inspections Fixture - Fluorescent Barbecue Oven Fire Sprinkler System Space Heater (kw) Process/Pressure Piping A/C Central 16-20 Ton Supply, AC Well Fixture Light Bath Fan - Vented, # Parking Lot Lights Fireplaces, Number of Spas/Hot Tubs Pressure Vessel A/C Central 20+ Ton Temporary Toilet Flood Lights Catch Basin Plugmold/Strip Gas - Propane Subfeeds, No. of Amps Pump, Re- circulate A/C Window Temporary Water Closet FPL - Load Central Clothes Washer Posts Gas Piping Swim Pool, Commercial Pump, Replace - Pool Air Conditioners Urinal Garbage Disposal Dental Chair Range/Range Top Grease Trap Swim Pool, Residential Pump, Sprinkler Chiller Utility - Sewer Generators, etc. Discharge Well Receptacles Ice Maker Switchboards Pump, Sump Clear Violations Utility - Water Heat Recovery Dishwasher Refrigerator, Comm. (p/PH) Indirect Wastes Temp Serv., Construction Relay Repair Compactor Vacuum Pump Low -volt, Burglar Disposal Refrigerator, Domestic Interceptor Temp for Test - 30 days Roof Inlet Deep Freezer Water Closet Low -volt, Fire Domestic Well Renew - Temp Service Laundry Tray Septic Connection Demolition Water Heater Low -volt, Intercom/Teleph. Drainfield, 4" Tile/Res. Repair Circuits Lavatory Septic Tank Dishwasher Water Heater New Low -volt, Television Drains, Area Service, Number of Amps Meter Set (Gas) Sewer Connection MECHANICAL TYpi; Minimum Fee QTV_ T p Condensate Drain QTV 'l•vpl.; Generator QTY. '1111 Refrigeration, Tons Q I N. 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 PLUNIInNG 'nil:. A/C Condensate (fry. - r m.: I.; Drains, Roof QTY. T) 11.: Miscellaneous Fixture (in. ' I l IT Soakage Pit Q 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 PERMIT APPLICATION F OWNERSHIP ❑ CONDO ASSOCIATION APPROVAL (Attach) tM APPROVAL hewer) EE ❑ CONTRACTOR REGISTRATION struction) (On File) pecify & Attach) ( sq.ft. = x/1000 x ¢.60) (¢.005 /sq.ft.) (¢.01 /sq.ft.) ❑ BPR APPROVAL (Restaurants) -.30 b b de TOTAL $3 v 1 (? ) 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 Electrical Mechanical Plumbing Fire Public Works Structural _�'�kjer) Building Official Page 4 OFFICE USE ONLY PERMIT APPLICATION F OWNERSHIP ❑ CONDO ASSOCIATION APPROVAL (Attach) tM APPROVAL hewer) EE ❑ CONTRACTOR REGISTRATION struction) (On File) pecify & Attach) ( sq.ft. = x/1000 x ¢.60) (¢.005 /sq.ft.) (¢.01 /sq.ft.) ❑ BPR APPROVAL (Restaurants) -.30 b b de TOTAL $3 v 1 (? ) 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