785 NE 96 StCONTRACTOV' )a 1 5 /a ,i, - .
la
\Name SOS\ 6
License No. n /a 00 e s O 0 1 1 1
Address / ii. o. ge,
?
.�//9.6 l . 3/6--D
Telephone 43425- ;p6 -3 J - )' (3/>,�..) , a /
U G5
Qualifier Name -3-6) ) fi r A' o/176--e
PROPERTY OWNER
New Construction
Name 54,,,,,.;, 4 t PeLt
Address
9ricopiod tea, T9, 3313
S
Home Telephone 365 7 6
r F t
Alteration Interior
Business Telephone A /
/
Demolish
Fax
Fax
Shell Only
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'l Detachment
Other
•
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1. Complete the attached permibapPliGatipn ¢c•9lgned by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for orer4 a4uitlgfece:ting of•.our application. If roofing work will be done, a roofing application must be submit-
ted along with this peralit • • • •.. .. •
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.
A PPLICATION
*Job Address:
7-es E '9 '74 H/9'1/ 51//e-6
Address Apt. City State
Folio Number Description of Work �f n be /4/6
Lot Block
Subdivision PB PG Zoning Linear Feet
Current Use of Property Square Feet Units Floors
Proposed Use of Property Qalue of Work Z s s ®m• Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
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PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No.
Subsidiary Permit No.
PERMIT APPLICATION
ENGINEER
Name
License No.
Address
Telephone
Fax
Zip
Page 2
IMPORTANT NOTICES
DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIISATIsD ?ERMtT AN? JrERMIZ'AFJt •Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: ItThlldayZhrough 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, NEA CONDITJON•free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT Ala 14E*11. l • •
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENV OR VEi /3NQ 4A' N=)T 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.
STATE OF FLORIDA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE
gnature of Owner ,/
�..J E.n.0•sa -,
Print Name
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
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SEAL: SEAL:
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a ii- It) c.;) L
\__
ignature of Contractor / Qualifier
Print Name
to and subscribed before me this 3. day
ignature of Mary Publ - 'tataof lorida
• PERMIT APPLICATION
e v Angela M Becker
• My Commission DD150048
p w°' Expires November 15.2008 l
Personally known OR, Produced Identification Personally known OR, Produced Identification V
Type of Identification Produced: Type of Identification Produced::
ELECTRICAL
TYPE
Minimum Fee
QTY.
•
I
Tyr E ,
• e DIVeC • N � •
QTY.
ii'i:
" '
Outlet, Appliance
QTY.
i vi'l:
Service Repair
, 1
QTIT.
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
I
QTY. TYPE
Condensate Drain
QTY. TYPE
Generator'
QTY. 'fl'PE
Refrigeration, Tons
Q"fY
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.
1
TYPE
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTY.
TYPE
Soakage Pit
QTV.
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
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PERMIT APPLICATION
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INSTRUCTIONS: Pleaa jntic date t&e v4:o $ tieing performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
D • TE
Zonin :
!' _1
CQ • =
Electrical
'
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
• CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
•
❑ PROOF OF OWNERSI TIP •
(Attach)
•• •••
• •
❑ HRS / DERM APPROVa
(Septic / Sewer) ••• •. •
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
$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
$
$
$ (0.005 / sq.ft.)
$ (¢.01/sq.ft.)
ISSUING OFFICIAL
REVIEWED AND PREPARED BY:
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( x .60) x/1000
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PERMIT APPLICATION
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•❑ CONDO ASSOCIATION APPROVAL
(Attach)
•• • • • • • • ••••
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•
'a tit . 1tiOVAL (Restaurants)
• . '• ' • • • ••
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $(O,P
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
DE LA ROSA PAINTING
251 NW 99 STREET
MIAMI, FL 33150
DATE /0' 2
PAY TO THE �,/ 1 14 e j $ � � - p v
ORDER OF ) S6 �1 6 "C°S C/ / [�
FOR P e r PO; t
First Union National Bank
firstunion.com
Org. 003 R/7 067006432
II'00 2 3 LO"
1:0 6 70064 3 21: 200000 L9 30 20 30
FLEXIBLE BUSINESS BANKING
e ..,_ er u
2310
63-643/670
BRANCH 13093
DOLLARS
1�'11.E 1.lV�.1 Oilkiitt_ V ILLA( -L
Paint. Qolor. &j pt val and Agreement
• •••••• ••
• ••••• • ••
L5WNER' NAM :
ADDRESS: P _ -} .. .� is i � S f eCS . Fes. 3 3 / 5 p
* * * * * * * * * * * * * * * * * * * * * * ** ********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
4 DRESS OF SITP' .S . ,(� r �,(�,• l i —a4/ l ' 3 3/.5
N-TRACTOR & 1;I I� (if • pplioable)
C OMPANY NAMES —
P41 1 4)6 PHONE: 30 . 5 — p
******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * *** * ** * *4 U S
All Elements on the site must be listed and indicate the color to be painted..
Walls 6 3 8 6. 5 W Jiap4 r�r
ascia a 3 25 $ 1-(/ Per
rip Cap/Drip Edge
offit 6 3 g5' SLf/ Der/<r 14/17 d7e
oof
Flower Bins
Shutters
Awnings
Chimney
Doors and door jams 3 ' 5 SW /56 00- AIhi,
Garage Doors . 4 3 3 'SSW Dover I✓,
Railings W / l Te
Fences
Decorative Metal , / / f a/ Said
All brick (simulated or regular) f;3 f 90 A/a be7
Stucco Banding
Any other stucco features
Accessory'Buildings
Other I�I/i�► De�.W4de 6 //y &
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
samples.
APPROVED:
'4 04 11 / 2. 2Ds Ot)oca. /a% S/d _
S ignature of Owner Date Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Building Offic
Date
6
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
w
4/23/01
SW 6386
Napery
56
SW 6385
Dover White
SW 6114
Bagel
Miami Shores Village
10050 NE 2nd Avenue
Building Permit
Phone: 305 - 795 -2204 Permit Number: BP2002 -2124
Printed: 12/11/2002 Page 1 of 1
Applicant: JULIO PEREZ
Owner: PEREZ JULIO
JOB ADDRESS: 785 NE 96 ST
Contractor DE LA ROSA PAINTING Contractor's Address: 251 NW 99 ST
Local Phone:
Parcel # 1132060142270 Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOTS 12 & 13 BLK 69 LOT SIZE 100.000 X
Permit Status: Approved Permit Expiration: 6/7/2003
Work: EXTERIOR PAINTING AS PER AGREEMENT
ilpruirl:
Fees: Description Amount
FEE2002 -7041 Building Permit Application Fee $60.00
FEE2002 -7042 CCF $1.80
FEE2002 -7043 Notary Fee $5.00
Total Fees: $66.80
Construction Value: $2,500.00
Total Fees: $66.80
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 ret
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 abrattee tD
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 c a rys.' doi
authorization. A further condition upon which this permit is granted is the urrierstarriing that the 7J'rtrac't7r cr Suit rarne' a.`x ie aestrn s the r�, f r t`rr q i:iirete49 //to
rin'Sa'1s a- re7.4!et/ r s Y Jrlr1_ t� the w ry '��J ✓'�-1 %r+r is et re- s`vw - ) 71 r 7'a'?= 7 72M'r_ 7 f `.: sc cr✓': 7 sy'�riffs a 1 `e ass.I'F5 'ser craitd}L *7
s r3-r'_5 7 �"17r'r -mac -
(INSPECTOR) BY:
.
In consldl,rution or 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 said .:
vdlh till Irluna, druwlnpa, strrUnnints or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work donsOp41111r �
rn /r;4;11, HI/ ;) t /fr /:ffA. - ,'d 4 11111l l j%r;:,
'2-•: -'mil f iJ ✓%
irr
"
SilLtifi 1 DAs t
The Stinshihe State
JULIO ANTONIO.PEREZ
785 NE 96 STREET
MIAMI SHORES, FL 33138-000p
•
02-17-50 M 5-10
01-22'1793
CLASS: .E
'02-17-1999'
•P620-421-50-057-0
SAFE DOIVER Q 8-1993
.1 054K74
• ,