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BP-03-469CONTRACTOR Name e,-1-r,. i re. Al e lwork ili'car-5 License No. C• 4 ex) c � 3 Ga Address c t 61 d,Ig)..j 1.14, .s RJ 04 ,40 4_32%24 Telephon 07) Tom-1'MC" Fax 7) rs-7 . 794, l` Qualifier NameacaU L � �Rt.jl PROPERTY OWNER ` ^ Name `r � Of / A r l... 7 ko cz mtY.A (et Lyt.% Ft License No. _ ` Name IN C � i �. -.4) itemv C� �r\ L., Address Lo02- 1 clCst ,s 1i ‘ k s it rt.■ o_,. f L 31 - '' � Home Telephone Alteration Interior Business Telephone o5 0 - 15L® (0 S 'Pe - V2P D IS a VicsAN� Fax Relocation of Structure ENGINEER ` ^ Name `r � Of / A r l... 7 ko cz mtY.A (et Lyt.% Ft License No. Address Lk 1,S f KeVlesz. I S�:A 130 t-4 . m ¶L 7 l Telephone 4131 I t (e ` - n us Fax 401 — (D l0 ° 1 l wo 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 1.,...-- •• •• • • • •• •• • • • • • • • • • • • • • • ••• • • • • • •• • • • • • •• • • • • • • • ••• • • •• •• • • • • • •• • • • • • •••• ••• INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application r VIcleintst be sigeed bytlia proop,rty owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate pv:ssing: f iotr aipycatioti • 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: (.9®� ►� C U -1 ' r-e o ,R,cs_9 -a-. Address Apt. City State Folio Number (e -C) \ LA -1L4 ID Description of Work MA._ UPS Lot - l� Block (11 1 e 1.01/4..0 e WX∎re‘ . CS ki %Nr-J Linear Feet Subdivision 141 con', - reA PB 10 PG 3 - Current Use of PropertyCLvv-tA'. /4e \e ' r . %(Square Feet Units Floors Proposed Use of Property 50,,a _ c. w Value of Wor .- 0® Bldg Value, Tenant Information Ps.` 4 'T NAN, r i? \,�S Tax Assessed/Appraised Value PERMIT TYPE ( ✓) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other 5 g1)1 Li Zoning PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax g59 'LNSs. 79 (� Master Permit No. tes.idiaiy Permit No. PERMIT APPLICATION e7r h M °.aj -ti• s\ne Zip Flood Zone Base Floor Elev. Page 2 • • • • • • ••. • IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECE=VF.p /0DR VAISDATHD PERI AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTIONare Whited 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, IYF ` AT 4ND.SAjV1TARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE K IP'•FRTh FROM Dr1 4. SWALES MUST BE PROTECTED FROM BEING DAMAGELZdY EQ i1PMEINT∎01? V{Hp23S, 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 S1'1'E in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. r ay c o wns �n7 J/.D Print Name Swtom to and subscribed before me this • . / Signature of Notary SEAL: blic - State of 11.47 Cfrfro /Psas t�' I 8 day of Mkec ELQABETH M. REGA MY COMMISSION # CC 999115 F,XPIRES: May 25, 2005 Bonded Piro Notary Public Underwfltom • • • • •• • • • • • • • • • • • • • • • • • • • • • • PERMIT APPLICATION Signature of_ ntractor / Qualifier Print Name � � 4 Sworn to and subscribed before me this day o t-6-6 Signature of Notary Pub tathaffiiikl. Burnam SEAL: My CLnmission DD158188 %,„, w/ Expires November 11, 2008 OR, Produced Identification Personally known ✓ 0 OR, Produced Identification 't%to1 8P1 n Produced: r - . ( °' 0,65-6 Type of Identification Produced: ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer • • • • . QT ". TYPE .Outlet, ppliance QTY. TYPE 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 MECI- IANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QT Y. TYPE Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C WaUWm. 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 Drains, Roof QTY. 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 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 typa of work beat$ per:ot:ned 4nd quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY DA Zonin 2 l \ : Electrical ya AV 9 Mechanical Plumbing Fire Public Works Structural Building Official � A Page 4 OFFICE USE ONLY ❑ 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 Notary ••• • ❑ IMPACT FEE (New Construction) $ o,d- 0 $1 - • • • • • • • • • •• • • • • • • • • • • • • • • • • • ••• • • • • • • ••• • • 3 • • CHECKLIST ❑ PROOF OWNERS IIll'" • ❑ CONDO ASSOCIATION APPROVAL (Attach) (Attach) •• ••• •• • • • •• ❑ HRS / DF AFr QTAL : .': i BPR APPROVAL (Restaurants) (Septic P wW. • • • • • • • • ❑ OTHER (Specify & Attach) PERMIT FEES (ss . U) x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) •.• PERMIT APPLICATION ❑ CONTRACTOR REGISTRATION (On File) 00u Po" 3cl a3 TOTAL $ 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 4041 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date'O Type lnsp'n 4 r 6 f Permit NOT PO 46q Name Address fl Company u Ic_ , Phone # Ins ction Date \ Okr, Approv Correction Re-Insp'n Fee o PERMIT APPLICATION FOR MQAIVI1SHORES:VILTLAGE • • • • • • • • • • 10050 1 N.E. 2nd Avenue • Miami Shores, Florida 33138 • P.hode: X735 -22V4 •; Fax: 305- 756 -8972 • • ••• • • • • ••• Job Address (oC a%. E 96 di- Tax Folio • • ••• • ••• • •• • • • • Legal Description HistoricalltJ3esfgnatd:. Ye% ; ; • . No • • • • • • • • ••• • • • Owner/Lessee/Tenet Al k--v- (l��4 �ti v D) t L J Master Permit # EA c�l.7C. C - 1 / 1S ' uS Owner's Address i 11(60 (TC S cy�Q•. Phone ;g ;� .®UCo2 .sd ,;, -Z.21:eq i7`� ; • • • Contracting Co. /S?Q.0 Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE— INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING WORK DESCRIPTION: GPs r C� Y—t �f'Yw� � �� '� 1"Ps�. ®C51 Square Ft. Estimated Cost (value) 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 ANY 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 are required for all disciplines. OWNERS 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. Furtheugiore, 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 My Commission Expires Date C.C. as to Co Commission pires er F 5° 7 -- 1 3- 11;-D FEES: PERMIT (6 0 RADON APPROVED: , / TOTAL DUE ii Zoning Building Electrical Mechanical Plumbing Structural Engineer r ° D BOND CHECK NO. CHECK DATE VENDOR NO. 158172 4/30/2003 120663 PAY TO THE ORDER OF L SBA NETWORK SERVICES, INC. (561) 995-7670 P.O. BOX 310761 BOCA RATON, FL 33431 -0761 Sixty Five Dollars And 00 Cents Village of Miami Shores 10050 NE 2nd Ave. Miami Shores FL 33138 WACHOVIA BANK, N.A. AUGUSTA, GA 30909 ' 64- 1327 -611 11'00L58L7211' 1:06LLL32791: L3 73L 35911' CHECK AMOUNT 158172 $65.00 10088 The Sunshine State UCENSE NUMBER M 507 -73 -828-0 KIMBERLY GENENE MEDICO 1407 NE 66 STREET 0107 FT LAUDERDALE, FL 333344000 BIRTH DATE SEA NOT. REST. ENDORSE. 09-08-73 F 6-06 ISSUED EJCPIRES DUPLICATE 08-1602 0908-08 000040 SAFE DRIVER Opel t on of a motorvebkb =mutilates consent to any sobdetyteui required by law. • ELIZABETH MOHR REGA C/O MASTEC WIRELESS SERVICES 3201 W Commercial Blvd Suite 116 Fort Lauderdale, FL 33309 ORDER OF Pkte4to aj ) 91, ti 1 4 PAYTO THE CN•-0-r- ab I 06 Rrat Union National Bank Nt firatuni°n"m Org. 003 R 067006432 FOR X /62 HARLAND 1CH8 1:0670064321:10100 L30214210° 083 DATE 0985 63-643/670 BRANCH 09069 1 $ 9 DOLLARS tt" " F FOR MI-139 Mtithli Skores - )n ? 1:067006432C LO LOO L 30 2142 LIP 0 HARLAND 1088 ELIZABETH MOHR REGA ctS4- 39 t-f 54 5 C/O MASTEC WIRELESS SERVICES 3201 W Corninercial Blvd Suite 116 Fort Lauderdale, FL 33309 PAYTOTHE ORDER OF F First Union National Bai* I® *stunt on.com I • Org. 003 R/T 067006432 - o6 DA TE 0983 6 3-643/670 BRANCH 09069 DOLLARS Miami Shores Village Building Permit 10050 NE 2nd Avenue CD Phone: 305 - 795 -2204 Permit Number: BP2003 -469 © Printed: 3/25/2003 Page 1 of 1 en Applicant: Owner: JOB ADDRESS: 602 NE 96 ST cpo C Contractor SPECTRA SITE NETWORK SERVICES Contractor's Address: 19500 SW CIPOLE ROAD C ---- Local Phone: 305-751-6306 D 0 Parcel # 1132060141410 Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOTS 1 TO 10 INC BLK 61 LOT SIZE Fees: Description Amount FEE2003 - 1723 Building Permit Application Fee $60.00 FEE2003 - 1724 CCF $1.80 FEE2003 - 1762 Building Permit Application Fee $60.00 Total Fees: $121.80 (v • Permit Status: APPROVED Permit Expiration: 9/20/2003 Construction Value: $2,800.00 Work: ADD ONE GPS ANNTENA TO EXISITING TILE COMMUNICATIONS FACILITY Total Fees: $121.80 Total Receipts: $0.00 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 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 equipment or device described in the application 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 drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or emplo yees. Signed: (INSPECTOR) BY: In consideration of.t • uance to me of this permit, 1 agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans drawl • . at l ints or pecifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my ag > nt, = or -y • loy Signe:'� (Contractor or Builder) BY: April 17, 2003 Mr. Curtis Craig Building Official Village of Miami Shores 10050 NE 2 Ave. Miami Shores, FL 33138 Re: AT &T Wireless Building Permit #BP2003 -469 Located at 602 NE 96 Street, Miami Shores Revised GPS location Dear Curtis, Sincerely, Kimberly Meckes SBA Network Services 5900 Broken Sound Parkway NW Boca Raton, FL 33487 Tele: 561- 226 -9484 Fax: 561 -981 -9901 • ••• • • • •• • • • • •• •• • • • • • • • • • • • • • • • • • • • ••• • • •• • • • • • ••• • • • • • • • • • • • • • • • • • • • • • • • • • ••• • • • • • • •• •• • • • • • •• • • • • • • • • • • • • • • •• •• • Per our conversation, I am submitting to you two signed sealed sets of Construction Plans, showing the change in location of the GPS antenna AT &T installed. AT &T Wireless currently has a building permit #BP2003 -469 in which a GPS antenna was installed. Unfortunately the location the antenna that was installed cannot reach the satellite needed to pinpoint emergency callers. AT &T needs to revise the location of the GPS antenna. Therefore, as per our discussion, you were going to review the revised sets and determine if they could be inserted as "as builts" or determine if revising the permit formally was required. No work has yet been done by AT &T to reconstruction this site and they are waiting for you determination. In addition, the electrical permit that is required by the Village is in discussion with our DC contractor and the Electrical plans reviewer, to determine if an Electrical Contractor is really necessary. We will make sure that this part of the permitting process is completed as well in a timely manner. If you should have any additional comments or questions, please feel free to call on me,