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BP-02-1890PROPERTY OWNER / ''� �� /� Name rA/vl / ' vta fre�l%� ��f/KJiu' Address &'b A/6 CJ# F�eg ,e/1.1' v(V v 6 Home Telephone �g/ 75 / ^ 36¢1 Business Telephone y 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 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 PERMIT TYPE 11 ) , / / Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Address Apt. City Folio Number //"32 4f4 — 11/0 Lot / -37 Block rP / Subdivision PB PG Current Use of Property G//144 Ch Proposed Use of Property Tenant Information PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name N`d License No. Address Telephone Fax 1 of Work Master Permit No. Subsidiary Permit No. PERMIT APPLICATION Zip Gift/USA 5ft £– 10-er, State Zoo ing Linear Feet Square Feet Units Floors h- ue of Work sf 6- Dde9 Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER 7 vfiL 1404,11 Name License No. *724 Address t?e oe i'EP /�1f N p N/ All /) if` 33/ Telephone %PT Fax CONTRACTOR Name License No. 66, /� 7 Address S 5,00 e 0 $ 4 Q At pp. II/ Telephone �o � d/�f 7Z8 Fax ®5 . 56,5 Qualifier Name Yesiyi 1 /v f N Page 2 PERMIT APPLICATION 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 P1,ECTRICAL, 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, l Floor, (305) 679 -1078. Once recorded, the .: e o Coss Ir: ement mus ` be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. R; 'ew the brochure at age al on Construction Lien Law and Choosing a Contractor. STATE OF FLORID STATE OF FLORIDA, CO OF MIAMI -DADS Signature of Owner Pdm(r) 4 44-o e, get/. Print Name Print Name Sworn to and subscri . 1 be _ 1, ' me this Z5 J day of �� i 61.i , � y}.�,i m;,sl . ,h: SJi S . 1 I ' o �ot� •' /''`�'�R)1�T If: SEAL: Personally known x'990098 Expires Jan. 31.2006 Bonded At)auite Hoag g Co q. Its OR, Produced Identification Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: F MIAMI-DADE Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced s MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date / �£ --e7 Time Type Insp'n .q / V - - Permit No. -ad ° Name t'l � �+ �' l to C 4 fce Address Company Phone # For Inspector: Correction „,...,•■••■■■4 Re- Insp'n Fee ❑ 21 g /-? Date Type Inspn Permit No. Name Adfr Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 - 795 -2204 Building Inspection Request Correction Re- Insp'n Fee ❑ For Inspector: �� -� Nanpe & Date Approved / ❑ - z 003- 3F `� MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ( / 03 Time • Type Insp' Permit No. ` Name Addles Companyi(`." Phone # For Ins tor3 1 1 Name. Correction Re- Insp'n Fee ❑ NOi77/r 4 /.ON /T NoUNTED aN fR AN& Y/4 P44-01, GABLE IzooF 3 -0 GONG. cEN?ER Protect Na: 439212 Date: 7- 2. Drawn by: ' checked by: G.s.f Revi ions• lob 9 - 2. (,,A8L-E FIELD V 4 o EX./ '7,w6 RebP Jo/sTs, if ofFfEieENT N cr,f - EN6/NEE N GONG . Roop PEGIc 61// &45E ,LAN (wr) /zoofl OW-51k S6 /way/ gHof‘ES/p/ - 13.11ERI41H GHv,ezG 6 NE VG0 ' T, W411/, P!- 8 ►GkET so fr°RT FSELbw (tE ,e77'4 9E. Duel, /i ,/ 3 1 4N /r E )t/T/Ni CON- BE dN�, (YEPk/Fr /2EINf0 HEN T PR/oR To wofiK), )'67/L /4 t PE. #4 FL GI V/1.4 'T�4�TURG 3510 A°6/4ERNd/�l RD, 11/4 N/ FL 3 05 - 285. — !ioneZP7f oRZ /M Lio 2 7 1 1 515 for doo›l W /Z,c 50 uN/r z ER -. tov /Z x 30 1% I. . T _ uN� NOi77/r 4 /.ON /T NoUNTED aN fR AN& Y/4 P44-01, GABLE IzooF 3 -0 GONG. cEN?ER Protect Na: 439212 Date: 7- 2. Drawn by: ' checked by: G.s.f Revi ions• lob 9 - 2. (,,A8L-E FIELD V 4 o EX./ '7,w6 RebP Jo/sTs, if ofFfEieENT N cr,f - EN6/NEE N GONG . Roop PEGIc 61// &45E ,LAN (wr) /zoofl OW-51k S6 /way/ gHof‘ES/p/ - 13.11ERI41H GHv,ezG 6 NE VG0 ' T, W411/, P!- 8 ►GkET so fr°RT FSELbw (tE ,e77'4 9E. Duel, /i ,/ 3 1 4N /r E )t/T/Ni CON- BE dN�, (YEPk/Fr /2EINf0 HEN T PR/oR To wofiK), )'67/L /4 t PE. #4 FL GI V/1.4 'T�4�TURG 3510 A°6/4ERNd/�l RD, 11/4 N/ FL 3 05 - 285. W/2 x3' w IZ 3 o — — 4.4N Y /EtcJO (NT& c/2, 2 / ► o a 8 /L" /1.04 4, p aGTs W /Zr3o (orb Wr (TYP) 11 o ' p , ' D •Y 0 e < n'� l400 ( //a � ?Ra4ET s vpPoP -r G � . 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Cl Y/41 g noerv,e4L 3580 ockp AN, , P/ 6 7. 11 N /, 3 05- 185- 3/70 Yamil Kuri, P.E., S.I. 3580 Rockerman Road - Miami, Florida 33133 Voice: (786) 290 -7283 Fax: (305) 860 -5657 Civil/Structural FL P.E. # 44726 FL S.I. # 1085 N/ N/ 51, f RE5 - BrrE AN 61/uR61/ PNZ aG kET 5 U fPOAT /a -8 -of E/- /s77N6 ON caL , APPROVED BY DATE ZOMNG 3TRUCTURAL ELECTRICAL ' PLUMBING MECH.ANMAL rrooFING ..al B!..DG. OFFICIAL /I l' '-'2101-- 1 SUBJECT TO COMPLIANCE WITH ALL FEDERAL, STATE AND COUNTY RULES AND REGULATIONS. MIAMI SHORES VILLAGE ASSUMES NO RESPONSIBILMES FOR ACCURACY OF OR RESULTS FROM THESE PLANS. ' COMPLIANCE WITH THE SMITH FLORIDA BUILDING CODE AS ADOPTED BY . !AM SHOE:7; VILLAGE IS REQUIRED. THE ARCHITECT, BUILDER & SUB GNTRACT0f6 ARE CHARGED WITH THE KNOWLEDGE OF ALL BUILDING Ilt.i.31.1LATI0 ; WHETHER OR NOT SPECIFICALLY INDICATED HEREIN. MIA I SHORES VILLAGE ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. 11. PE Outlet, Appliance QTY. TYPI. Service Repair Q Y. A/C Central 1 -3 Ton Dryer Vents, Number of Fan Ventilation, Cost Outlet, Wall ' Ductwork, 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 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 1VIECllANICAL TYPE Minimum Fee QTY. TY Condensate Drain QTY. 'TYPE Generator QTY. TYI'E Q I. 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 ' Ductwork, 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. TYPE Drains, Roof QT Y. TYPE 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 Sprinlder 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 Mmimum 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 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 Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review Notary 4.50 0 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) $5 Metropolitan Dade County (C.C.F.) $ 3 , 0 cD ❑ OTHER (Specify & Attach) $ SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE ( sq.ft. = ) x/1000 (¢.005 /sq.f .) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES 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 10050 NE 2nd Avenue Phone: 305- 795 -2204 Printed: 11/7 /2002 Applicant: MIAMI SHORES PRESBYSTIAN Owner: JOB ADDRESS: 602 NE 96 Contractor ESCON Local Phone: Parcel # 1132060141410 Fees: FEE2002 -6238 FEE2002 -6239 FEE2002 -6240 FEE2002 -6298 FEE2002 -6299 Permit Status: Approvedr If there is no permit pac fee is $50.00, which must 1 This Permit is granted to the con ordinances pertaining thereto and v and approved by the proper municil authorization. A further condition ui ordinances and regulations pertaini by his agents, servants or employe) Signed: In consideration of the issuance b with the plans, drawings, statement myself, my agent, servants or empt Description Building Fee Structural Fee CCF Building Fee Miscellaneous Total Fees: PAY TOME ORDER OF Building Permit Permit Number: BP2002-1890 CHURCH ST Contractor's Address: 2141 SW 1 ST Legal Description: MIAMI SHORES SEC 2 PB 10 - 37 LOTS 1 TO 10 INC BLK 61 LOT SIZE Amount $85.00 $50.00 $3.00 $85.00 $100.00 $323.00 MIAMI SHORES PRESBYTERIAN CHURCH OPERATING ACCOUNT 602 NE. 96TH ST. MIAMI SHORES, FL 33138 r GG1) U n dY G d L kIe. -• pores V( / /a.5'e� 1VA 5 ct /qua Shaul / L. 3313P zr d W oo aJ /% - Page 1 of 2 104 Total Fees: $323.00 Total Receipts: $0.00 DATE 110 //, /V, ycc 11 I:0633,00277n 003664259935 /..)/(10/tef/ AMOUNT )4' 323. ' 19 OLOROCIA ir —The' Sunshine State YAMIL GERARDO KURI 3923 SEGOVIA STREET CORAL 1LES,FL 33134-0000 rrr,■■ • -27-65 'I' Nronro K600-967 CLASS: E SAFE DRI 11414 RL.TPUIU EHOORSEVENT,