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665 NE 97 St (13)BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawjngs or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N9 289 B1 Signed. 1/ DATE 19 Contractor's License No. Work to be performed under this Permit Subdi- vision Value of 11 Amount of f Project $ 11 Permit $ BY• INSPECTOR r In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specificatfans submitted to the proper authorities of Miami Shores Village. In ac• cepting this permit I assume responsibility for all work done by e)th,er, °myself,. my agent, servant or employee. BY AUTHORITY ABBOT PRINT CONTRACTOR New Construction �r / Name t Air- Ti Z.Z .OI r f 5 j (✓ vA`` -1.! ril J Address ( 4'61 !Lie 4/ 7f'--- I' ,, -,A," ¶/bite 1 ./ 1 ‘ 1 14- Name 0 /4:A X04.0 je",_ Home Telephone(? 5) 70 ` 2. .i ) License No. 0 , nd 0 , 6 , ‘ 7 ) l /_ 1"� ]Fax Address 7 /o p. )' 7 ex Demolish 61 �s„ Relocation of Structure 9 -4/ Telephonef?, � .. /4/19 Fax ,,, T4 , 1%.4. L°.. •. Qualifier N ;7; �( Fax PROPERTY OWNER New Construction �r / Name t Air- Ti Z.Z .OI r f 5 j (✓ vA`` -1.! ril J Address ( 4'61 !Lie 4/ 7f'--- I' ,, -,A," ¶/bite 1 ./ 1 ‘ 1 14- 3) Home Telephone(? 5) 70 ` 2. .i ) Business Telephone 1"� ]Fax License No. Lrb ARCHITECT New Construction Enclosure Name mggmilt_ 00$.4 " 1"� Alteration Interior License No. Lrb Demolish 61 �s„ Relocation of Structure Address 5 7533 p �, �0. - 33 3 o 1 TelephonyE'��q 1 ( l ;7; �( Fax Add'I Detachment Other 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 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 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: /06 Address Folio Number Lot ..P'7 0 e % ev l= 1 o Block Subdivision PB PG Current Use of Property Proposed Use of Propety Tenant Information (( PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other 1-le q/ !' / rtfa Apt. City PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection Description of Work Master Permit No. Subsidiary Permit No. FL State j2a'L prAt/ . PERMIT APPLICATION Zoning Linear Feet Square Feet Units Floors Value of Work Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax ' ”h ?� Zip 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, 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. ST OF FLOR DA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signat i e o Owner 'Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of SEAL: SEAL: 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 PERMIT APPLICATION Personally known OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: 1; Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) MI. • Shores Village t �.:. Bond Zoning Review Notary ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ Metropolitan Dade County (C.C.F.) $ (sq.ft. = x/1000 x ¢.60) Inspector State Educational Fund $ (¢.005 / sq.ft.) State DCA (Radon) $ (¢.01 /sq.ft.) Code Enforcement Fine $ WO SECTION Zonin: Electrical Mechanical Plumbin: Public Works Structural Building Official 1 wI - MIMI/_k PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES 1�-C-L al'l DiseA Cuit C TOTAL $ — 2..y D 4 ISSUING OFFICIAL VIED AND PREPARED BY: 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 'I'1'I'1: Minimum Fee ()Ty. TYPE Dryer QTl' TYPE Outlet, Appliance Q Tv1'I.: Service Repair Q 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, IIntercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE Minimum Fee QTY. TYPE. Condensate Drain QTl. TYPE Generator Q'1'I'. 'fl'I'E 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 PLUMBING TI'1'E A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture Q'I'Y. 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: ,rni Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 4/3/2003 Applicant: JULIET Owner: SUZMAN JOB ADDRESS: 1069 NE 91 Contractor YOCOM, CHARLES WILLIAM Local Phone: 954- 961 -1424 Parcel # 1132050010080 Fees: FEE2003 -1961 FEE2003 -1962 Description Building Fee Code Enforcement Fine Total Fees: Amount $180.00 $100.00 $280.00 Total Fees: $280.00 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 9/30/2003 Construction Value: $1,000.00 Work: POOL PIPING 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 pi This Permit is granted to the contractc ordinances pertaining thereto and with th and approved by the proper municipal al. authorization. A further condi '.n upon v. ordinances and regulations p rtaining to by his agents, se 01 e , ployees. Signed: Signed: In consideration the issuance to me with the plans, drawings, statements or myself, my agent, se fyts o employes. 3 0 Legal Description: WATERSEDGE CHARLES W. YOCOM CUSTOM POOLS PH 954 -961 -1424 710 N 70TH TER HOLLYWOOD, FL 33024 PAY ��] /' TO THE Y/ f/FY3 e 0 F / Z / 41-O !re -- ORDER OF v it WACHOVIA Wacbovia Bank, N.. Hollywood, FL 33024 FOR d upA/V f //244 11 '00 5 33 L" Plumbing Permit Permit Number: PL2003 -91 SUZMAN JULIET TERR Contractor's Address: 710 N 70 TERRACE wiz /4 /L Pecr Page 1 of 1 PB 9 -141 LOT 9 & W1/2 LOT 10 BLK 1 LOT SIZE 75.000 X x:0670 L356to: L9 9970 DATE `l 0 o - 0 3 I $ DOLLARS 5331 63- 1356/670 BRANCH 04301 Beeurily Fanlurn. t Dnlall, sn mc.. A,_ 01 . e. a now vehicle constetees c onsent to any The Sunshine State R S550-425-6 j LICENSE N JULIET N -64 -943 -0 NE MIAMI, FL TERRA 1 `E ,Jl• sex NCr. R EST. sots ISSUED p ENppRSE. 10 4101 SSUED EX . 12 O 7 C • R ATE SAFE requiteobylaw. CONTRACTOR Name �, / �f License No. 2 ® z:48 j Address /3 ,, / s.,p .. sizzisAkfe . JW /Aaf/ iCe, . 331 GP I Telephone $ 9 Z 2 42 46 S 9,2/.7.0, T Qualifier Name 6 ddip4 pi AQA .l it, PROPERTY OWNER \\ Name EA LJL- .4- s e... y 1.--1• VT Address / DJ /„5 1 ,1 6 611, ST l H' i' i Q.E5, Fl, 33 It Home Telephone 305 _ 344 ._ Q S o),5 Business Telephone 9514 _? O J 2 _ 1 O t / I ( `7 Fax ARCHITECT • Namegtc n 4r 9 k - b 43 License No. Alteration - Exterior Address s./7 ' Ali/1m > ."'(' • & .4 33' � Telephone , � <� 4 ( 1 _ 3, !! p / S � ' 0 92a Fax ., 7 76. .S to S Cale 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 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: G7 Cp S N C q 7 744 --.5177 772th,N/ Sligwas FOS • .33 Address /� �Apptt.. City / Folio Number' pZ� v ��`/�v Description of Work P st1 %11 AS 426,3 1 l _ Lot Block L UL I 'rr) A Subdivision PB PG Zoning Linear Feet Current Use of Property gCsi 19 E.Alc.. 'Lt Square Feet Units Floors Proposed Use of Property IE S 10 eikic, Value of Work 13.08:0 ` Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection PERMIT APPLICATION Master Permit No. � S. 00a. 6 73 Subsidiary Permit No. p dona - e:43 State Zip Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Page 2 IMPORTANT NOTICES 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 PROTEC"I'hD 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 Managemest (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 perinit'fo'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 inform" ation 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, OUNTY OF MIAMI -DADE Signature of Owner L Ey o LL -14 rr(,& Print Name Sworn to and subscribed before me this /6 day of Signatur SEAL: Personally known Public - tate of Florida Enrique Chau * *my Commission CC706757 Expires January 18, 2002 Type of Identification Produced: - QR, Prodticed Identification STATE OF FLORIDA, COUNTY OF MIAMI -DADE iziteeet Signature of Contr or /Qualifier 604*W f '4cc,¢ /S.1-0 Print Name • - .�� 4 - 3 Sworn to and subscribed before me this ! 8 day of Signatu SEAL: Personally known Public - State of Florida 4t ts+ ro4 Enrique Chau • *. ?all *My Commission CC706757 ' ° Expires January 18, 2002 OR, Produced Identification PERMIT APPLICATION Type of Identification Produced: Page 4 OFFICE USE ONLY CHECKLIST ❑ 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 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) (sq.ft. = x/1000 x 0.60) $ (¢.005 / sq.ft.) $ (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE �,,• L/- PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ ISSUING 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 ELECTRICAL TYPE Minimum Fee QTY. 'TYPE Dryer QTY. 'fYPE. Outlet, Appliance QTY. 'fYPE Service Repair QTY. A/C Central 1 -3 Ton Dryer Vents, Number of Fan Ventilation, Cost Outlet, Wall ' t network, 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 j 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 2.... Demolition Low -volt, IIntercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television ir Service, Number of Amps Water Heater New MECHANICAL TYPE QTY. Minimum Fee TYPE Condensate Drain QTY. TYPE 1111 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 ' t network, 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. 'fYPE Drains, Roof QTY. TYPE Miscellaneous Fixture Q'rY. TYPE. Soakage Pit QTY. Bath Tub 1 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 j 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 2.... Domestic Well Laundry Tray j Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory ir Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower f Water Service Drains, French Miscellaneous Equipment W 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: Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305 - 795 -2204 Printed: 1/30/2002 Applicant: SHELLEY Owner: WITIAK This Permit is granted to the contractor or builder named above to constr ordinances pertaining thereto and with the understanding that the work will t and approved by the proper municipal authorities. This Permit may be revo authorization. A further condition upon which this permit is granted is the ur ordinances and regulations pertaining to the work covered hereby whether by his agents, servants or employees. Signed: (INSPECTOR In consideration of the issuance to me of this permit, I agree to perform tt with the plans, drawings, statements or specifications submitted to the prop myself, my agent, servants or employes. Signed: (Contr Plumbing Permit Permit Number: PL2002 -23 WITIAK SHELLEY Contractor A 1 VILLAGE PLUMBING & SUPPL'PJii&Bess: 13210 NE 3 AVE Local Phone: (305) 892 -0626 Cellular: Parcel # 1132060171910 Legal Description: MIAMI SHORES SEC 4 AMD PB 15 -14 LOT 20 & E1/2 OF LOT 19 Job Address: 665 NE 97 ST Permit Status: Approved Permit Expiration: 7/29/2002 Construction Value: $8,000.00 Work: PLMBING NEW MASTER BATHROOM , LAUNDRY ROOM, POWDER ROOM If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. fee is $50.00, which must be paid in advance before callil - Al VILLAGE PLUMBING & ASSOCIATES, INC. 13153 NE 3RD AVE. PH. 305- 892 -0626 MIAMI, FL 33161 -3954 l�ID I $10 - e na G / • L ��V 1<,y - T ( �I VE A�IID�DOI LARS tt PAY TO THE • ORDER OF `Pj City National Bank O F F L O R I D A 446 COLLINS AVENUE M�IAMII BEACH, FLORIDA 33139 de 1:066004 36 1: 1 300 3 L 7 MEMO Page 1 of 1 k=• Total Fees: $0.00 Total Receipts: $0.00 Re- inspection BLK APPROVED: Zoning Mechanical Celt 1C g6 1 -f - '553 - 3a7J PERMIT APPLICATION FOR MIAMI SHORES VILLAGE � E`F -Pi Date WO f Job Address 6.6' 5 pc- 97 v t, Tax Folio Legal Description (32‘14r � � et/V C . Owner/Lessee essee /Tenant 1 n t3 iv e Owner's Address Jr Cc. .S Ale cf7 7 geed Contracting Co. 1 ()N2 P((, 4 / / l/ Address D . 130 x 53/ 37 Qualifier U Fr V f S S 0 P SS# Phone � 1 4 g0 Competency # Ins. Co. / 4 e l R4 v e J' „12 S State # C Fc S Municipal # Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL WORK DESCRIPTION Kr-re s e. 7V 6 A r c r J / Address Address Address Plumbing / D to construction and zo ' ermore, I authorize the above- ed contractor to do the work stated. Signs • f owner an J or Condo President Notary as to Owner and/or Condo President Date otary as Contra My Commission Expires: My Commission Ex Historically Designated: Yes No Master Permit # e-/W73 Phone 3 � — �540 MECHANICAL ROOFING PAVING FENCE SIGN Pe! m f) n I 2.77 Ar.Q, P/ X � 2/ .S Square Ft. Estimated Cost (value) 'laoO� CCD WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I 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, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AF I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating 011 c ' I. v -B it�Ico efi I. .; ? ANC j u- uit� ;a o vp' Q CC78o'e ,y 9f R I ��Q CaV CO'”. i SV0- �F f\. 'MC'L • f :... FEES: PERMIT 1 RADON C.C.F NOTARY S' C) /) BOND TOTAL DUE ate 0 Building Electrical Structural Engineer EM TH 11.8 UNIT D FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE DET LIGHT OUTLETS CENTRAL HEATING SHWASHER / RECEPTACLES A/C (WINO) SPOSAL SERVICE TEMPORARY A/C (CENTRAL) {INKING FOUNTAIN- SERVICE SIZE IN AMPS DUCT WORK .00R DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION EASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING ITERCEPTOR RANGE TOP UNDERGROUND TANKS ,VATORY L{ OVEN ABOVE GROUND TANKS ,UNORY TRAY WATER HEATER U.F. PRESSURE VESSELS .OTHES WASHER MOTORS 0- 1 HP STEAM BOILERS DER MOTORS OVER 1- 3 HP HOT WATER BOILERS INK, POT /3 COMP. MOTORS OVER 3- 5 IP MECHANICAL VENTILATION INK, RESIDENCE / MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES INK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS :MPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS 1INAL MOTORS OVER 25-100 HP COOLING TOWERS \TER CLOSET [.r MOTCRS OVER 100 IP VIOLATION 'IRECT WASTES . A/C WINDOW REINSPECTION TER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COWERCIAL WATER SERVICE SIGN TUBES :WER CONNECTIONS SIGN TRANSFORMERS N LITY -SEWER SIGN TIME CLOCK '{CITY -WATER FIXTLRES :PTIC TANK ANTENNA :LAY TELEVISION OUTLETS IAINFIELO, 4' TILE/RES. VIOLATION AP 8 ABANDON SEPTIC TANK REINSPECTION )AKAGE PIT CU. FT. \TCH BASIN ISCHARGE WELL )MESTIC WELL lEA DRAIN )OF INLET )LAR WATER HEATER 1- IRE STANDPIPE )OL PIPING \WN SPRINKLER SYSTEM LS RANGE :TER SET (GAS) LS PIPING ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL • leb pert This permit is granted to the contractor Lion herefor in strict compliance with all or n plans, drawings, statements or specifications i• r at any time if the work is not • o : e i • coin • ie permit is granted is the understan • in that he regulations pertaining to the work o / red ere sibility for work done by his agents ; s rva or TC T► C 'OR or BUILDER IAMI SHORES VILLAGE, FLORIDA . ,Q3 20 AV Date 5 igned• to be performed un • . r this permit N°_ 49516 Contractor's License No. sub, �,, ' " ` / % vision �- vCfJ[�y'� e - /�/ o Sq. Ft.: Value of Project $ V Permit: CCF: Notary: Bond: Radon: Amount o Permit: Building Address of %' �p i1 / l' 51— or builder named above to construct the building or to install the equipment or device described in the applica- ances pertaining thereto and with the understanding that the work will be performed in compliance with any may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked ace with such ordinances or if the plans are changed without authorization. A further condition upon which this contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and by whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- employees. (INSPECTOR) BY In considerat' . a iss I f� m e of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulation. TI ; ••?'f�.: h the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. all work done by either, myself, my agent, servant or employee. BY AUTHORITY Permit No / r 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 work. STATE OF FLORIDA, t COUNTY OF DADE. 6 :) Amount of Permit $ • SS. Owner's Name and Address Nature of Water Supply: City—Wit MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT f No Street Registered Architect and/or Engineer Employing Plumber's Name No i/ Street__17 Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed—No 6 ,ei, ,,-- ' ii 11. street 71 State work to be performed and purpose of building (By Floors) . 1 4/4,-,-;;;J•c; fr ,------ - New Building Remodeling Addition Repairs No. of Stories Type of Tank e) v Size Septic Tank Feet of Drain Tile il Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed) Date Capacity Gals //,, INT'? --------- ----------- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has corn- plied with the provisions thereof, and will require similar compliance from all cc4tractors 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 ok the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contract,' on work to be performed under this permit, as are licensed by Miami Shores Village. ( Signed) My Commission Expires Notary Public, State of Florida Master Plumber. 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. NO E: A re-inspection fee of $100 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materi and/or workmanship. CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT ' NS TOTAL FIXTURES CONTR. LIST / / 00•I' # 2 ' , / 1 7- ... .". CHECK 1' 1 " / O SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM 'G POOL CONTR. LIST / / ' CHECK Permit No / r 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 work. STATE OF FLORIDA, t COUNTY OF DADE. 6 :) Amount of Permit $ • SS. Owner's Name and Address Nature of Water Supply: City—Wit MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT f No Street Registered Architect and/or Engineer Employing Plumber's Name No i/ Street__17 Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed—No 6 ,ei, ,,-- ' ii 11. street 71 State work to be performed and purpose of building (By Floors) . 1 4/4,-,-;;;J•c; fr ,------ - New Building Remodeling Addition Repairs No. of Stories Type of Tank e) v Size Septic Tank Feet of Drain Tile il Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed) Date Capacity Gals //,, INT'? --------- ----------- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has corn- plied with the provisions thereof, and will require similar compliance from all cc4tractors 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 ok the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contract,' on work to be performed under this permit, as are licensed by Miami Shores Village. ( Signed) My Commission Expires Notary Public, State of Florida Master Plumber. 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. NO E: A re-inspection fee of $100 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materi and/or workmanship. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ' ig'0 Approved Correction Re- Insp'n Fee Time Type Insp'n Permit No. Name Wita - e �r Address 4 65 4 / 6 d/ s fr Company /7 / I/6_7 - ?/1 2 Phone # 385' O 9 2- For Inspector: F.../9-0 2) Name & Date �� ,20 62 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ?-- -® Time —� Type Insp'n Permit No. 71 023 Name Address OS" 4/6? N 97 5 Company / 1 1 4 �Li�//I/ Phone # 30.5 For Inspector: 2 / /, 4 9 Name & Date Approved ❑ Correction Re- Insp'n Fee Type Insp'n -MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 7 Time Permit No. .� L 2 Dv 2 -1.3 Name � ri Q fr Address 665 4g 97 Si Company •f Phone # 305 g f cv6 �J For Inspector: .� B Z i Name & D Approved Correction ❑ Re- Insp'n Fee ❑ -3' r �9� 30 7 172 Datel Type Insp'n Permit No. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Name Address 6 65 Company/) Phone # DC— 1 � ^ l7 " C For Inspector: (( .2 ame Date Approved Correction ❑ Re- Insp'n Fee ❑ C-eW7 r ..et/.1:—C '2? -r y /;(x/A,Liziktv 613_ 6,/D1 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request st Date 0 \ Type Insp'n 21 Roc..9 Permit No. P )O 4 Pt5 . Name tCl nnr) n Address 65 S Company u / ✓� f Phone # 1 Inspection Date 1 1 I K Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request � 1 Date Type Insp'n PI_ Roo Q I(� Permit No. 9)0 4- p.F.')c Name // V"1 Cr(J r, Address /,'' 5 S Company ("n ' j7i L. ( n plumb,' Phone # Inspection Date f I I Approved Correction Re- Insp'n Fee