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PAINT2623 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 B;i ing Inspection Request Date 4 Type Insp'n Ii)p ct 1 Permit No. r O23 — I 1 C Name 121 Address Company Phone # Inspection Date (.0 Approved Correction Re- Insp'n Fee 10 .00 e. k. 0/5/ v �� IW PAY TO THE r ORDEROF 3 2 MEMO tt9 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2003 -119 Printed: 1/27/2003 j 1: 26 7084 L3 Applicant: JOHN RILEY Owner: RILEY JOHN JOB ADDRESS: 1104 NE 98 ST Contractor COMPLETE HOME PAINTING Contractor's Address: 1476 NE 130 STREET Local Phone: 305 - 895 -1368 Parcel # 1132050180360 Fees: Description Amount FEE2003 -462 Building Permit Application Fee $60.00 FEE2003 -463 CCF $1.80 FEE2003 -464 Notary Fee $5.00 $66.80 COMPLETE HOME PAINTING BY MICHAEL MICHAEL IWASKEWYCZ 1476 NE 130TH ST. PH. 305 - 895 -1368 NORTH MIAMI, FL 33161 Total Fees: Permit Status: APPROVED Permit Expiration: 7/26/2003 Work: EXTERIOR PAINTING 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. 63.8413 -2670 DATE / /203 r d � pp _ / ��e DOLLARS LU - .d Washington Mu Washinggt[oon Mutual Bank, FA North MIam1/125th Street Financial Center 1728 900 NE. 125th Street 74800.788 -7000 Nort 84 iaml, FL 33161 24 row Customer Service e-704 ,e : 83L4835LL 3 637 Building Permit Legal Description: 5 - 6 53 42 PB 43-69 REV PL MIAMI SHORES SEC 8 LOT 19 BLK 180 Construction Value: BY: BY: $2,450.00 Page 1 of 1 Total Fees: $66.80 Total Receipts: $0.00 the equipment or device described in the application herefor in strict compliance with all 3 6 3 7 I with any plans, drawings, statements or specifications that may have been submitted to s not done in compliance with such ordinances or if the plans are changed without ctor or builder named above assumes the responsibility for a thorough knowledge of the igs or in the statements or specifications and that he assumes responsibility for work done n compliance with all ordinances and regulations pertaining thereto and in strict conformity es Village. In accepting this permit I assume responisibility for all work done by either APPROVED: MIAMI SHORES VILLAGE Paint Color Appto?v�lianii Agreement DATE: / J3 • OWNER'S ADDRESS: 1 /O /1'G 'l Fascia Gt34e Drip Cap/Drip Edge 4 Soffit Lv CGP a 373 Building Official' ate • ••• •. • • PHONE : ********************************** * * * * * * * * * ** * * * * * * * * * * * * * * * * * ** • • ADDRESS OF SITE: //0 /l.)Z-1411 :• • : - CONTRACTOR &' LICENSE (' f ap,Rfic bld }' r IN/3 • • COMPANY NAME: C' 4., - i `� . PHONE: ri7 - 73' ***** * * * * * * * * * * * * * * * * * * * * * * * * * *' ** * * ** All Elements on the site must be listed and indicate the color to be painted. Walls ? if 0 Roof Flower Bins W Shutters •o /k Awnings i" 1At Chimney Doors and door jams & 4 - Garage Doors gcrY Railings /V/ Fences p / ell' 4? I f Decorative Metal ,Lnz - All brick (simulated or regular) ,)/ Stucco Banding N L 41 ' Any other stucco features - Accessory Buildings /(/ D � I V . 7 Other Al 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 the attached sampl / Signature of • - D. to Signature of Contr ctor rate *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (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 ••. • .� • ••• • • • • • • f • •.. • ••• • • •• • • .• • • • . Q PRQPF QP OWNERSHIP • • • . •. . ❑ / bERM'APPROVAE (Septic / Sewer) ❑ IMPACT FEE (New Construction) O OTHER (Specify & Attach) $ $60 $ • • • • • • • • • • • • •' • • • (sq.ft. = x/1000 x 0.60) (0.005 / sq.ft.) (0.01 /sq.ft.) REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ ISSUING OFFICIAL 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 B ' TE Zoning a' SECTION /� /��J l v . ; Electrical Mechanical Plumbing Fire Public Works Structural A' AII Buildin! Official 61 ./ Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (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 ••. • .� • ••• • • • • • • f • •.. • ••• • • •• • • .• • • • . Q PRQPF QP OWNERSHIP • • • . •. . ❑ / bERM'APPROVAE (Septic / Sewer) ❑ IMPACT FEE (New Construction) O OTHER (Specify & Attach) $ $60 $ • • • • • • • • • • • • •' • • • (sq.ft. = x/1000 x 0.60) (0.005 / sq.ft.) (0.01 /sq.ft.) REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ ISSUING OFFICIAL 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 ELECTRICAL TYPE Minimum Fee Q'I'Y. TYPE Dryer (ITN'. '1'."1'1: • Outlet, Appliance (in'. TYPE: 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 Q'1'1'. '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 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 • .•. • •• • • .. • • • • • • • • • •• • • • •• • ••• • • • • • • • • • • • , • • e • • • • • • • • • • • PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work bBMg peNPorn ecf and quantity(ies) in the space provided below. • ••• •• RECEIVED AND REVIEWED BY: DATE: Page 2 Signature of Owner .dy 4 Print Name SEAL: ••• • •• • .•. • • • • • • • • • • .. • • • • • • • • • • • • STATE OF RIDA, C OF MIAMI -DADE Personally known OR, Produced Identification • • • • •• • • • • !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 weekenc1 of fl(idgy s • • • • 2. All construction of demolition areas MUST BE MAINTA aI APCkEAlii,NE91 SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIEISIJALI,:3E,CDFT•FA&Proft DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BYQLTIPIOIENVOR 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 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. Sworn 41 and subscribed before me this � day of f D eu 20 �� .� r a�l� Michael 1W a51GEwy�J a o d Commtssitm # DD 11 Thrii 4 z= Ex 213C6 Signature of Nota Pu - _ ; • o , antic B STATE OF FLORIDA,. Y OF MIAMI -DADE • SEAL: Signature of Co actor / Qualifier / moo Print Name Swell to and subscribed before me thi IA 1 PERMIT APPLICATION of orida • My Commission D0150048 Expires November 15, 2008 Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: CONTRACTOR New Construction Name Ste.* k> 1/ Name C I v A i Ar Address 0 Alt - - 4 �/ >vn,/ R 3 "I Alteration Exterior License No. D, y /9/ 0 - Address / 6 , / 26 / Fax Demolish Telephope3 {J ff / 3� Fax CC__.. J O � 3 -�O 9., L Qualifier Name / t/. ( Foundation Only PROPERTY OWNER New Construction Name Ste.* k> 1/ Enclosure Address 0 Alt - - 4 �/ >vn,/ R 3 "I Alteration Exterior Home Telephone ( p SJ �5 7 — 0 9' < 7 0 Business Telephone Alteration Interior Fax Demolish 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 ohtr in a p2rn i. from the Miami Shores Village: Step 1. • ••• • • • • • • Complete the attached permit application which must be sine&b the prppMrM3to wrier an qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your applieatiolf. If wor;C 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. APPLICATION Job Address: PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other 1/01 NE V Sf Address Apt. Current Use of Property Proposed Use of Property Tenant Information PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax • ••• • • ••• • • • • • • •. •• . . • . . . • • • _ . .•• • ••• • • • ••• • • • • • • • •• • . • astCr Per1n%t l4a . ;. S+.ybsidiary PCrmit No. Square Feet Value of Work • � N , City • ' 33/3 State Zip PERMIT APPLICATION Folio Number Description of Work / ? t.ci r � A' ✓ / Lot Block /5tid Subdivision PB PG Zoning Linear Feet Units Floors Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax