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PAINTMIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Dat- > Time Type Insp'n Permit No. Name Addr Compan ,\ Phone # 6— 77 v For Inspector2 /(/ 03 Name & D Correction Re- Insp'n Fee ❑ Page 2 • • • • • • • • ••• • • • • • • • • • • • •••• ••••••• • PERMIT APPLICATION IMPORTANT NOTICES I. DO NOT BEGIN ANY WORK WITI•ipU2' htkVING REGEIYED Y01312 VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOl?RS OFtONS1'kttTIaN are limited to: IVIonday 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 MIX BE MAINt1INV IIY A NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SFI2111L HE KEPT t'REF FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING D►4MAGEDVI+EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewal16. : ; : • • • • • • • 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 $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1°` Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. ST TE OF FLORA, COUN OF MIAMI -DADE 1 c yy �,py■1 S u re of Owner rrint Name Sworn to and subscribed before me this day of _L J 2002— gnature o SANDIZUCKERMAN tiff MY COMMISSION # DD 131902 for fo EXPIRES: October 7, 2006 14600.1.NOTARY FL Notify Semen 8 Bending, Inc SEAL: Personally known OR, Produced Identification Type of Identification Produced: Print Name SEAL: Personally known Sigh; o tractor / Qpalifier Signa • re o otary ' blic - State of Florida S�srn to . d ribed before this i day of LISA CARSON e + . , A MY COMMISSION # CC 866680 d. °�= EXPIRES: August 26, 2003 l: moll, y� -, i ` ott Public Underwdler liemolo . . .._...... — _ Type of Identification Produced: CONTRACTOR Name Q d1 av & , e k License No. q 8 5 -400 ' P 3 b "/ "J Address CIS ME' Rah ' )7S�..o' Telephort�� /) 9/ Fax Qualifier ame p ' 4 0 , K TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'I Detachment Other PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name Address License No. Telephone Fax PROPERTY OWNER Name Address Home Telephone Business Telephone Fax • • • • • • • • • • • • • • • • • • • • • • • • • .•. • • • • • • • • • • • • • • • ••••••• •... Master Permit No. ': SUbLSidi$ry.Pt✓r114 tic: • • • • • • • • • • ••• • • . ••..•. • PERMIT APPLICATION INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by the i opertyownet and.i .Iifies..Both signatures must be notarized. Please print or type to allow for a more accurate processing of your applie atioui s :f pooh; : crk:will a 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. A PPLICATION Job Address: 1 12a N. E. 1 6� MI turv■I S ho re s PL, 3313` Address Apt. City 1 State Zip Folio Number Description of Work nk I Zr∎ or ho (kse ki nI* 1 fl3_ Lot Block Subdivision PB PG Zoning Linear Feet Current Use of Property Square Feet ^^ Units Floors Proposed Use of Property Value of Wo44 00 Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name Address • License No. Telephone Fax ELECTRICAL TYPE, Minimum Fee QTY. TYPE. Dryer QTY. TYPI. Olathe, • ppliange • • ; QTY. TYPE Service Repair Q'l Y. A/C Central 1 -3 Ton Fan Outlet, vValr - . " ' " . • 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 MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. 'HYPE Generator QTY. TYPE Refrigeration, Tons ()Ty. 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 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. Tvi 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 • • • • • • • • ••• • • • • • • • • • • • • • • • • • • • • •• • • • • • •• •• •..� _ INSTRUCTIONS: Please indicate the type of work beingaperf8rmedsr¢I Qnantitt(its).iin the space provided below. ••• .•. _ -.. • • PERMIT APPLICATION RECEIVED AND REVIEWED BY: DATE: SECTION BY DAT Zoning a"�?pi¢ -r /� r Electrical ff Mechanical Plumbing Fire Public Works Structural Building Official 71 5 Page • •'••• • • • ••••• • • • ••• • • • • • • • • • • • ••• • • • • ••• • • 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.) $ 1 Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review Notary • • • • • • CHECKLIST • • • Cr PROOF OF t? 'IVASHIP (Attach) •• ••• •• • • • •• •• •p• • • / r PROVAL • • • • • : (Seyl'h /;S�w�r�l ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ (¢.005 /sq.ft.) $ (¢.01/sq.ft.) 4 (X .ft. = X/1000 PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ ' ( `� e 0 ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF Revised July 2001 10050 N.E. 2"° AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12 /5/2002 Applicant: BRIAN BARBICK Owner: BARBICK BRIAN JOB ADDRESS: 1122 NE 98 ST Contractor KAWALEK PAUL Local Phone: 786 262 - 1457 Parcel # 1132050180370 ermit Status: Approved Permit Expiration: 6/2/2003 ,Iiiiiiii ork: EXTERIOR PAINTING AS PER AGREEMENT PAUL R. KAWALEK ROOFING & PAINTING 485 N.E. 92ND STREET PH. 305- 754 -0191 MIAMI SHORES, FL 33138 -2566 1:063 L00 2771: 00366060 1.9 L411' 30 L D.,. 1.1190,2 order of ` ey v; rho rs v; � 14,(3€ I $ 61- r� order of n s X — c V Bank of America. 41- 4 ?;/e" IN+ 1 ACH FVr 083100277 /yy�� Fort 1 11 `r' _ l% Building Permit Permit Number: BP2002 -2088 Contractor's Address: 485 NE 92 ST Legal Description: REV PL MIAMI SHORES SEC 8 Fees: Description Amount FEE2002 -6912 Building Permit Application Fee $60.00 FEE2002 -6913 CCF $1.20 Total Fees: $61.20 Total Fees: $61.20 Total Receipts: $0.00 Dollars Construction Value: $1,500.00 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 befnrP rattinn fnr - • ion. 3011 63- 27/631 FL 810 EMMY WM.. t equipment or device described in the application herefor in strict compliance with all th any plans, drawings, statements or specifications that may have been submitted to lot done in compliance with such ordinances or if the plans are changed without br or builder named above assumes the responsibility for a thorough knowledge of the or in the statements or specifications and that he assumes responsibility for work done ompliance with all ordinances and regulations pertaining thereto and in strict conformity Village. In accepting this permit I assume responisibility for all work done by either 3Y: BY: Page 1 of 1 PB 43-69 LOT 20 BLK 180 LOT APPROVED: MIAMI SHORES VILLAGE Paint Color Appro41. anid ::40CHient DATE: � I \ol. OWNER'S NAME: ADDRESS: laa n/ N/ Flower Bins 01 Shutters w Couh'Fr'7/ oG -']6 N /tk ••• Awnings Chimney Doors and door jams 0 la Lo c& .r y/ OC_ '76 Garage Doors O Id_ Co GLh4 r O C-7 6 -2 4 ) /07- Building Official D ate • • PI-IOI�IE: • ••• • ••• * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: Ill WE c‘ch t:: : : :. •. CONTRACTOR &'LICENSE (if a licable)' : fj:p"01�. COMPANY NAME: } Wtt )e ? �j �.1 �4 i n . PHONE: p 3 S �sv ei l ******************************* * * * * * * * * * * * * * * * * * * * * * * *c * * * ** All Elements on the site must be li t d and indicate the coloro be painted. Walls �'; lit J::;. i ►: %— . Q V(� O IAA I IC . Fascia C•ehl C In Ve p cf Drip Cap/Drip Edge r?"''• Scenic- Drive bQ r7 - Soffit O Id c°GVl Y)/ OL ri 6 Roof Railings N��l Fences n'j A- Decorative Metal IVA All brick (simulated or re ular) DI d Coca y/ 0 C-`? Stucco Banding PRA l Any other stucco features /V/ Accessory VU/ Other 0 0 0 nn V C 01 - L) b _,5 ntie ,S' / OWNER'S AFFIDAVIT: I certify that all the foregoing informati and that all work will be done in compliance with all applicable la construction and zoning. I authorize the above -named contractor, if applicable, to do the work stat . Furtherer e , the paint colors will be as per the attached s • ples. E *J PmQ �' q J5 I Dz ignature o Owner Date Signature of Contractor Date g g *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 b Owner's Name and Address /A- --h2 /G A Mc./ {/ Location and legal description of lot to be built on: Zone cubage required Distance to next nearest building Maximum live load to be borne by each floor I hereby submit all plans and specifications for said buildint 1/A Building Inspector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT 4 €,, 7 0 93 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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. Registered Architect and,or Engineer Name and address of licensed contractor V �/�/ E // //a 2 / ' E ry _S�r e �t Lot / 8 ote Block / Subdivision �il✓ 6 & & / 1 Ge/v / /� 31#6 �1 0057e9 Street and Number where work is to be done 1 /0 2 ^/. �• 74e. e L° State work to be done and purpose of building (by floors). state exterior colors (submit samples) �/ and for no other purpose. New Building Remodeling Y Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering PA4/4/ /1y y ? 00 Estimated Total cost ofe,,p�uoements S �J 5 V The undersigned applicant for this building permit does hereby certify that he understands and acc Compensation Act. being Section 5966, Compiled General Laws of Florida. Permanent Supplemen compliance from all contractors or sub - contractors employed by him in the work to be performe on the site of the work such public notice or notices as are required by the Act. The undersigne under this permit. as are licensed by Miami Shores Village. Date Remarks (Signed) Amount of Permit S ,3 2. 093 / se Ca- // w ke_ rid y it/ ,7c- - P6e / OF, /c e Date / � ' — b — c ?7 19 No. Street of ding and its construction may be sent to is his obligatons as an employer of Labor under the Florida Workmen's d has complied with the .rovisions thereof. and will require similar u der this permit: and wi post . cause to be posted for inspection ees to r ploy only su 1 sub - o ractors. on work to be performed STATE OF FLORIDA COUNTY OF DADE. } ss. Before me. the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments. personally appeared 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. e2 -/ (p e / Date /c /a'/ Read. Sworn to and Subscribed before me. Disapproved (Signed) Notary Public. State of Florida My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved 1 ate Disapproved Date NOTE: A charge of S25.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of S25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and or workmanship.