567 NE 96 St (7)PROPERTY OWNER
ame r� 1
Address6-6 7 /0/-:-- /�,- 6 "\ S
/ t aGpil I 6 / re3, /L 33I
Home Telephone(3 , ) .76 _ 79�
6
Business Telephone . ` 02.
3 I s ^ , ...,,
Fax e 6 2 ` 6
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'l Attachment
Other
Add'I Detachment
Other
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
OtherYeJ WI'
APPLICATION
INSTRUCTIONS - The following steps mu t 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.
.5-67 /f/ E 96 +1 ' 6* if1.;_1ev, ; 5 res FL. 3313.
Address Apt. City }� State Zip
Folio Number KDescription of Work ` a—1
>&Job Address:
Lot Block
Subdivision PB PG
Current Use of Property
Proposed Use of Property
Tenant Information
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No.
PERMIT APPLICATION
'63 - /9
Subsidiary Permit No.
Linear Feet
Zoning
Square Feet
Value of Work /.s Bldg Value
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
Units Floors
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name 0 r)e
License No.
Address
Telephone
Fax
Qualifier Name
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 PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT 13E 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, P' 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 0 DA, TY OF J AMI -DADE
Signature of Owner
M1J
X gijr B y (d
C
s to and subscribed before me this/ day of
_ nt N ame
I F. 1 . A A
ignature o d otary Pub 'c Sta ` orida
SEAL:
Personally known
Type of Identification Produced:
Or P(0 Angela M Becker SEAL:
My Commi 150048
�� or p.dv Ex ' November 15, 2008
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
PERMIT APPLICATION
OR, Produced Identification Personally known OR, Produced Identification
Type of Identification Produced:
MJ4MI:SUORES VILLAGE
....... Approval Painx C bIo and Agreement
DATE: Fe r ali fi L7 :., G1 3
OWNER'S MIME: �/• ?Cl►ai4' a .42/ Anci ' rd PHONE: 30 — 76 2.-79 d e
ADDRESS: S7 7 /QE- 910 57 -
* * * * * * * * **c' *9c'i{ *csi5 *! * *I ****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
A D D R E S S ( )
•
•
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
All Elements on the site must be listed and indicate ti
Walls 5+ +. Cry j 01
Fascia LU
Drip Cap/Drip Edge 50 ufh 4i c L (i v�
• Soffit / ),,f)
Roof
Flower Bins
Shutters , 1
Awnings v `1
Chimney
Doors and door jams W h j ---�
Garage Doors W hi f -.
Railings 50 u-i-h }i'e,ict G-r, r,
Fences
Decorative Metal
)LA
All brick (simulated or regular
Stucco Banding
Any other stucco features
Accessory Buildings
Other CvLn ►; e. Ye <<,ov✓
Wm 1 8eo..4u1As
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate
and that all work will be done in compliance with all applicable laws regulating
construction and zoning. I authorize the above -named contractor, if applicable, to
do the work stated. Furthermore , the paint colors will be as per the attached
sa les.
Signature of Owner Date Signature of Contractor Date
************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED:
Date
Building Offic
3 &I -
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
Ne
4/23/01
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
ATE: .2/0,3 G 3
OWNER'S NAME: fri iG is t PHONE:(, s) 76.2 - 79c�
ADDRESS: 7 VE 96 th S brn r SAor s FL 33)
********************************* barn * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: (Se WI •e
CONTRACTOR & LICENSE (if applicable) °cv n er
COMPANY NAME: PHONE:
APPROVED:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls 2- 1��trti i B o
Fascia t 7
Drip Cap/Drip Edge W h i 4c
Soffit W 'Ch.!! 2B
Roof - Ter (-cc_ C0 +4 lightening bug
Flower Bins
Shutters
Awnings
Chimney
Doors and door ams h t e
Garage Doors I& J �i �e� r (2c , /?-(Ac z
Railings W' 1 +C( n +)/V er e i e kdrzr
Fences /c
Decorative Metal WA 1 4-
All brick (simulated Al orre lar) &VA
Stucco Banding /V /f
Any other stucco features See A ff c r.heJ
Accessory Buildings /WA
Other
3B A
sunrays
1B
copper patina
key i-e rye Mod t—Ak7 Ircz
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate
and that all work will be done in compliance with all applicable laws regulating
construction and zoning. I authorize the above -named contractor, if applicable, to
do the work stated. Furthe ore , the paint colors will be as per the attached
samples. .) /
ALP Signature of Owe Date Signature of Contractor Date
*************************:********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
Building Official Date 4/23/01
340
343
619
3 3/4"
Front Porch Column Section (Scale 1/2" r. ee)
Jr l`
2 1/4" 5/8" 2 1/4" 5/8" 2 1/4"
15 1/2"
Concrete Bead Detail
3 3/4"
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 2/26/2003
Applicant: ANA
Owner: BYRD
JOB ADDRESS: 567 NE 96
Contractor
Local Phone:
Parcel # 1132060171580
Fees:
FEE2003 -1200
FEE2003 -1201
FEE2003 -1202
Description
Building Permit Application Fee
CCF
Notary Fee
Total Fees:
Amount
$60.00
$1.20
$5.00
$66.20
Total Fees: $66.20
Total Receipts: $0.00
Permit Status: Approved Permit Expiration: 8/25/2003 Construction Value: $1,500.00
Work: EXTERIOR PAINTING AS PER AGREEMENT
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections.
fee is $50.00, which must be paid in advance before calling for another inspection.
This Permit is granted to the contractor or builder named above to construct the building or to install the eauinmo^t ^�
ordinances pertaining thereto and with the understanding that the work will be nPrfn.. - — and approved by the proper municipal authorities. This Permit may t
authorization. A further condition upon which this permit is granted is
ordinances and regulations pertaining to the work covered hereby wh
by his agents, servants or employees.
Signed:
(INSPEC
In consideration of the issuance to i4fe of this permit, 1 agree to perfc
with the plans, drawings, statements or specifications submitted to the
myself, my agent, servants or employes.
Signed: (C(
Building Permit
Permit Number: BP2003 -319
aN
eve wa 41.0
BYRD
ANA
ST
Contractor's Address:
Legal Description: MiAMi SHORES SEC 4 AMD PB 15 -14 LOTS 17 & 18
0 Q�
Page 1 of 1
Re- inspection
BLK 99 LOT SIZE
5911 .008E 110 b'i :.0E4b01E90:1
lj '83b01-4S IWVIW
NNVB 1SnalHlnOS
:it
Sin:SCIES 44chLS 108111
1S 1 09 6 'TN L94
908L- Z9L -S0C '4d
past euV
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TIVPE
Outlet, Appliance
QTY.
"rYl'1:
Service Repair
QTY.
A/C Central 1 -3 Ton
Fan
Outlet, Wall
Service, Temporary
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
Signs
A/C Central 8-15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16 -20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL
TYPE
Minimum Fee
QTY.
TYPE
Condensate Drain
QTY.
TYPE
Generator
QTY.
TYPE
Refrigeration, Tons
QTY.
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Supply, AC Well
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Temporary Toilet
PLUMBING
TYPE
A/C Condensate
QTY.
TYPE I
Drains, Roof
QTY.
TYI'l?
Miscellaneous Fixture
QTY.
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:
SECTION
BY
DATE
Zoning
a-e
=
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
CIIECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
Cl OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
Notary
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
Metropolitan Dade County (C.C.F.) $ I / V (sq.ft. = x/1000
x0.60)
(¢.005 /sq.ft.)
(¢.O /scj.ft.
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $ t i .�
ISSUING OFFICIAL
REVIEWED 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
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT.
305- 795 -2204
Building Inspection Request
Date r / Time
Type Insp'n 1.
Permit No. I I) i c-
Address )
Approved
Correction
Re- Insp'n Fee
Name
Company L
Phone #
For Inspector: „3 ' ! ' j Name & Date
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date Time
Type Insp'n
Permit No.
Name
Address 56') -- )1E
2, _,p
Company
Phone .#
For Inspector: 211 1 03 f Name & Date
Approved
Correction
Re- Insp'n Fee ❑
/10
Lei ( i
PERMIT APPLICATI(G FOR MIAMI SHORES VILLAGE
ob Address S //, � 1( ST Tax Folio
Historically Designated: Yes
Owner/Lessee / Tenant A2 rl r .'1 c k / ( Master Permit # % v 2fO
Owner's Address c` ^-< - s ciSa ■,-�. Phone ,.. ,Z 7- 7,f6
Contracting Co. (0'- / Address
Qlialifer
State # Municipal #
Architect/Engineer
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
SS# Phone
Competency # Ins. Co.
Address
df G ia✓SL
Square Ft. Estimated Cost (value) . f '2 4 . c.
No
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 AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
FEES: PERMIT RADON
C.C.F.
NOTARY
Signature of Contractor or O er- Builder
My Commission Expires: My Commission Expires:
Notary as to Contractor or Owner- Builder
`pS PLd OFFICIAL NOTARY SEAL
O � (� SCOTT W DAVIS
+ � i i k COMMISSION NUMBER
91V. «a a < CC255237
C
- . MV COMMISSION EXP.
OF E1P ,la ?;. 2 i997
TOTAL DUE
.&- /C- -`/c.,
Date
- /s. ft,
Date
APPROVED:
Zoning Building 7 Electrical
Mechanical Plumbing Engineering