823 NE 96 St (4)CONTRACTOR
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Name C7 vyyQ/ °-LC L
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License No. e / y /; /
Address /C/'6 , S d It
/2 ,' 3 3/x/
Telephon0dr J r r'g6 L Fax
o
Qualifier Name
y
PROPERTY OWNER
i
Name
Address Ae l / -
Home Telephone p SJ 7f F $ ,
Business Telephone C V � J . �-it63
v
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
Step 1.
Step 2.
Job Address:
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PERMIT APPLICATION
F 1 �
, ,,
• re it r -1
• • Subsimary Peknait:No.
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
•
Complete the attached permit application which must be
print or type to allow for a more accurate processing of y eur i pC1i ccg n. :If be done, a roofing application must be submitted
along with this permit application.
Folio Number
Lot
Subdivision
Current Use of Property
Proposed Use of Property
Tenant Information
F23 ^vim
Address
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
h
ett burner
APPLICATION
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.
ualifier. Both si natures must be u otarized. Please
33 /.r
Zip
91 re
City State
A
Block /7 , ' JUa°+ K'
PB PG Zoni Linear Feet
Square Feet Units Floors
Apt.
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Description of Work
Value of Work
ee �t
Bldg Value
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
Page 2
IMPORTAN
A FFI DAV I'I
NO' 'ICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING ItECEIVED YOUR VALIb '!'ED 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 : eekends or holid .1
2. All construction of demolition areas MUST BE MAI VII'AINW) $N A QLEI Ni MAT�,4ND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BIiKE➢I FRES FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEINd & MAd.EIS B ( ?Qt11PLIErNl GR 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.
- PIe ;e 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 FLORID.., COUNTY OF MIAMI -DADE
�c- O'Z
to %y� /27
Sign e of Owner
0,1e_ Arlyv
V
Prin t Name
Swo o aid subscribed before me this day of
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SEAL:
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PERMIT APPLICATION
STATE OF FLORID , CO OF MI I DADE
Signature of Con � tor / Qj
cif
Print Name
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
SEAL:
Personally known OR, Produced Identification Personally known OR, Produced Identification
Type of Identification Produced: Type of Identification Produced:
ELECTRICAL
TYPE.
Minimum Fee
()Ty.
TYPE
Dryer • •
QT:'.
• •
T`_'I'[.'
Out let, Appliances
QTY.
'I YPE.
Service Repair
QTY.
A/C Central 1 -3 Ton
- Heating Strips, each
Fan
Outlet, Wall
Service, Temporary
- Paint Booth
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
- Piping, Flammable Liquid
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Process/Pressure Piping
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Pressure Vessel
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
T1'1'I:
Minimum Fee
QT1'.
TYPE:
Condensate Drain
QTY. TYPE
Generator
Q'I'1'. 'I I PI.:
Refrigeration, Tons
Q I'1'.
A/C Central, Tons
Q'I'Y.
Cooling Tower
- Heating Strips, each
Vent Hood, Cost
A/C Wa1UWin. 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
Pump and Abandon
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Gas - Appliance
PLU1181N(
'I I'E
A/C Condensate
QT1'.
TYPE
Drains, Roof
QTY.
"1'1'1'1:
Miscellaneous Fixture
QTY.
'I'1'I'I{
Soakage Pit
Q'I'Y.
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
INSTRUCTIONS: Please indicate the type of work I work being performld arftLiludptity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
DA
Zonin :
a 4�
S0
Electrical
Mechanical,
Plumbin
Fire
Public Works
,
Structural
A:
�,„
Building Official
7.
Page 4
MM'
❑ CONCURRENCY
(New Construction)
PERMIT
•.• • • • ••. • •
• .. .. • • • . . 41
OFFICE USE ONLY
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
❑ OTHER
(Specify & Attach)
• •
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... •
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•
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• • • • •
• • • .•. •
•
•
•
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❑ PROOF OF OWNERSHIP
• •
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•
•
•
T
•• (Mu€h) • • • • ••
. • • • • . • •
❑'URS4DERV APPR • •
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
EES
$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
, (00
3
( sq.ft. = x/1000
x ¢.60)
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
REVIEWEI) AND PREPARED BY:
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $
ISSUING OFFI1'IAL
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
Paint Color Appnocal•and:Asgreement
DATE: Z / 0-
OWNER'S : ThJ lea:4 74er .ice 1 ,. • P 1 Nrejari
ADDRESS: • • • • • • •
... • •
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: X823 - let fe, : . t " 9.m.r/ - ,.e • 3 a /se
CONTRACTOR &LICENSE (if appii�a�li); ; •�S;i.L t /
.. . .
COMPANY NAME: Cc * .. . 1 . .. . 1HONE: 9p.7 .
********************* * * * * * * * ** * * * ** ** * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls ti
Fascia
w� 0
Drip Cap/Drip Ede ' r ` •
Soffit IQ / !t z
Roof Lv i . i
Flower Bins .(/ /frit
Shutters
Awnings
Chimney
Doors and door jams
Garage Doors
Railings
Fences
Decorative Metal
Wi 5�
i
w /
All brick (simulated or reg lar) w /fit
Stucco Banding N
Any other stucco features
Accessory
Other
Building Offi 1
1 C4)
ate
• .••.• ..
• .0•••0• •••.
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 attached
samples.
Signature of Owner Date Si natur of Contrack6r Date
g g
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED: WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01
u
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2003 -200
Printed: 2/5/2003
Applicant: JOSE
Owner: RODRIGUEZ
JOB ADDRESS: 823 NE 96
Contractor COMPLETE HOME PAINTING Contractor's Address: 1476 NE 130 STREET
Local Phone: 305 - 895 -1368
Parcel # 1132060142790
Fees: Description Amount
FEE2003 -791 CCF $1.20
FEE2003 -792 Building Permit Application Fee $60.00
Total Fees: $61.20
Total Fees: $61.20
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration:
Work: PRESSURE CLEAN & PAINT ROOF
Signed ' (INSPECT
In consideration of the issuance to me of this permit, I agree to perfon
with the plans, drawings, statements or specifications submitted to the G
myself, my agent, servants or employes.
Signed:
Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOTS 18 & 19 BLK 74 LOT SIZE 100.000 X
(Co
Building Permit
8/4/2003
RODRIGUEZ
JOSE
ST
Construction Value: $1,200.00
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 c .
ordinances pertaining thereto and with the understanding that the work -
and approved by the proper municipal authorities. This Permit may be
authorization. A further condition upon which this permit is granted is V
ordinances and regulations pertaining to the work covered hereby whet
by his agents, servant or employees.
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9ZLT lawa0 ltgaueu! lawns WSZTAweitni vuoN
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MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement ur me plans and specifications herewith submitted for the build
inc or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner s Name and Address A k d demli
Registered Architect and /or Engineer
Name and address of licensed contactor
Location and legal description of lot to be built on:
Lot 18 & 19 Block 74
Street and Number where work is to be done s..
State • ork to be done and purpose of buildilg (by floors)
geared
No.
MIT VW •- ,,,•5,,,111,,TOWItt putt E,1 t1.
Subdivision
iami Shore
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of oundation Roof Covering.
Estimated Total cost of improvements $ AO 0 ..CI Amount of Permit S. .�C 1 2 0 y ,r"?l.' / z,•r}? /IOC)
Zone cubage required plan Cubage
Distance .to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to..
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of Libor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup m leurent,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcon• - ors, on work to be performed under this
pcnnit, as are licensed by Miami Shores Village.
Remuks..._ (Signed)
STATE OF FLORIDA, 1
COUNTY OF DADE. i ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true..
Permit No.._.... Date Read, Sworn to and Subscribed before me.
Disapproved ........_...._ Date .._.. - •-- •-- ........._
Notary Public, State of Florida
(Signed)
Building Inspector My Commission Expires _.......... _ .�_ _
PLANNING BOARD DATE
Chairnan Member
Member Member
Member .. .. _....._......_..._.— ...._....._ Member -- • - - -..
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the PI.innir.g Board.
A re - in.pec•tion fee of $1.00 will be charged when such re- inspection is made necessary by Improper notice for inspection oe faulty
materials anti /or workmanship.
JIIIDING
-1CTRICAL
- LUMBING
OOFING
owner of
rchitect
:ontractor
r Builder
Signed:
In consideration of the issuance to me of this permit I agr
rtaining thereto and in strict conformity with the plans, dra
accepting this permit I assume responsibility for all work
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT IN? 11018
Work to be performed under this Permit
Value of
Project $
BY
DATE
Contractor's
Limns. No.
— gal Lot BI
)escription
ddress of
wilding
11 3
This permit ie granted to the contrsc&r or builder named above to construct the building or to instaX the equipment or device d
trefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in tont
ratting., statements or specifications that i may have been submitted to and approved by the proper municipal authorities. This Pena it =V
lie if the work ie not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon
anted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordiaaEea
,ertaining to the work covered hereby whether shown on the plans or drawings or • the statunents or specifications and that he &saunas
one by his agents, servants or employees.
perform the work covered hereunder in compliance with all ord
tatements or specifications submitted to the proper authorfties of
y either, myself, my agent, servant or employee.
lt
.10 • •