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857 NE 97 St (5)CONTRACTOR Name :2 /d., 6'. v4-/- .4-,-. ,,,,,,3 License No. G ®� 7 �� 9 Address ) s— A 92 Slyer./ Ad) / cJ /le /lJ i , fJ /mil Telephone dor 753 ._,, 4 , 21 ./ Fax JOT— ) / -/ dr—Kfc' Qualifier Name J ,,, PROPERTY OWNER Name //Y 7 6, 4, Address B- /77„,,5 A, a 77 2; f - FED na,ri ye 1, 1/1 7 Home Telephone Business Telephone 3 Q — -• 75F - 60 22 Fax 36, 7j- 7e—is.— 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 IN STRUCTINS - The following steps mus be taken to obtain a pernut f t h e 1 \�li a m i 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. k AfPPL`ICATION Job Address: F.S ? � ? e= PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Address Apt. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. c Address Telephone Fax Master Permit No. Subsidiary Permit No. Y � . ��.• o f LPO City Tax Assessed/Appraised Value 71A7 r State Folio Number Description of Work �,� r % te/ 4..-oo1 Lot Block . 4 // aa a. / /.- ,:e%/ G Xv /C Subdivision PB PG Zoning Current Use of Property /Frf,. / -%9-/ Square Feet Proposed Use of Property Value of Work Tenant Information Linear Feet PERMIT APPLICATION Zip (2) Units Floors Bldg Value Flood Zone 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 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. 1. 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, Is' 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 ORI A,r�IOUI T OF MIAMI -DADE a ure of Owner Sign Print Name Sworn to and subscribed before me this SEAL: day of Notary ' i1pJL AIfc NOT AR C MMISSION NO. CC836040 FLORIDA MY COMMISSION EXP. MAY 11 003 ture o Personally known OR, Produced Identification STATE OF FLORIDA, COUNTY OF MIAMI- ADE Signature of Contractor / Qualifier ' a e % ‘,/ Print Name Sworn to and subscribed before me this /d day of M g> PERMIT APPLICATION CIAL tary Public -ltiktRyik NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC836040 MY COMMLSSIO,": F';;P. MAY 1: n{'t Personally known r% OR, Produced Identification Type of Identification Produced: Type of Identification Produced: ELECTRICAL 'rvii Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPF, Service Repair QTY. A/C Central 1 -3 Ton Fan Dryer Vents, Number of Outlet, Wall Ventilation, Cost Service, Temporary Air Handler, Tons A/C Central 4 -7 Ton Piping, Flammable Liquid Fire Pump Outlet, Switch Fire Sprinkler System Signs A/C Central 8 -15 Ton Bath Fan - Vented, # • Fixture - Fluorescent - Pressure Vessel 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 Solar Water Heater Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System - Process/Pressure Piping Cap - Fixture Bath Fan - Vented, # • Fireplaces, Number of - Pressure Vessel Pump and Abandon PLUMBING TYPE: 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: Page 4 OFFICE USE ONLY IE e KLIS^F ® 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.) $ 0 Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review CI PROOF OF OWNERSHIP (Attach) • HRS / DERM APPROVAL (Septic / Sewer) • IMPACT FEE (New Construction) CI OTHER (Specify & Attach) $ (sq.ft. = x/1000 x ¢.60) (¢.005 / sq.ft.) (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: SECTION Zoning Electrical Mechanical Plumbing Fire Public Works BY Structural Building Official DATE PERMIT APPLICATION (D CONDO ASSOCIATION APPROVAL (Attach) • BPR APPROVAL (Restaurants) • CONTRACTOR REGISTRATION (On File) PL1211i.IIT FEES TOTAL ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2 AVE., MIAMI SHORES, FL o (305) 795 -2207 FAX (305) 756 -8972 a http : / /www.miamishoresvillage.com Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 5/22/2002 Applicant: MARK Owner: ORLANDI JOB ADDRESS: 857 NE 97 Contractor BLUM BUILDING CONTRATORS Local Phone: 305 - 751 -1546 Parcel # 1132060142620 Legal Description: Fees: FEE2002 -2876 FEE2002 -2877 Permit Status: Approved Description Building Permit Application Fee CCF Total Fees: Work: REPAIR ROTTEN WOOD COLUMN IN FRONT OF HOUSE 2 If there is no permit package accessible on the job -site f fee is $50.00, which must be paid in advance before callinc This Permit is granted to the contractor or builder named above to construe ordinances pertaining thereto and with the understanding that the work will be r and approved by the proper municipal authorities. This Permit may be revok' authorization. A further condition upon which this permit is granted is the um ordinances and regulations pertaining to the work covered hereby whether st 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 prof; myself, my agent, servants or employes. Building Permit Permit Number: BP2002 -960 ORLANDI MARK ST Contractor's Address: 275 NE 92 Pay to the /Nil order of 1 11 ACH R/r 0 MIAMI SHORES SEC 3 PB 10 -37 E1/2 OF LOT 19 & LOT 20 Signed: (Contractor or Builder) 00277 Amount $60.00 $0.60 $60.60 Permit Expiration: 11/16/2002 Construction Value: MARK A. ORLANDI MARY YAGLE ORLAND! 857 N.E. 97TH ST. MIAMI SHORES, FL 33138 -2527 $400.00 / Sit cz., BankofAm . Ica. For oa06 3 100 2 7 71: 0000 70044 1 2Bos BY: Page 1 of 1 Total Fees: $60.60 Total Receipts: $0.00 .- �n�4inr1 Date 2614 Premier Banking Dollars BLK 73 2614 63 27/631 FL 827 $ 60, (z).