125 NE 98 St (5)3 PROPERTY OWNER
New Construction
Name Sc2npL�r f 7 C rl1a
Alteration Exterior
\Address (Z c eue 9 3 -,
!-(t..,,' S &o i=-r_ 3
13
&
Home Telephone/' 3 6 s - - ) ?S 6 _ ®O3 )
Demolish
Business Telephone (3 d c) t3 _ 2120 k o �
Fax (?M - ) 2S-I• � 6 16 3
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 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 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.
APPLICATION
b Address: f .L 5 / ° E /
Address
Ap
Folio Number
Lot Block
Subdivision PB PG
Current Use of Property
Proposed Use of Property
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No.
Subsidiary Permit No.
City
escription of Work 1
Zoning Linear Feet
S are Feet Units Floors
alue of Work a, co v
Assessed/Appraised Value
Flood Zone Base Floor Elev.
rex FL
State
PERMIT APPLICATION
3 3 /3 tc r
Zip
Bldg Value
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone
Fax
Qualifier Name
Page 2
PERMIT APPLICATION
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.
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, P' 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.
OF FLORIDA, 9UNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE
ti r
e of Owner Signature of Contractor / Qualifier
a.t d ��
1
Print Name
m to and subscribed before me this L da of
O
.STA
i
gnature of N
SEAL:
Personally known
Print Name
Sworn to and subscribed before me this day of
ry Public - S to of Florida Signature of Notary Public - State of Florida
SEAL:
Angela M deeker
••� My Comftllssion DD150048
yip Or Expires November 15, 2008
OR, Produced Identification � Personally known OR, Produced Identification
Type of Identification Produced: FLD )_. 1S D 1)[1 ?Sc--(1sq ()Type of Identification Produced:
I ^
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY
TYPE
Outlet, Appliance
Q'rY•.
Service Repair
QTY.
A/C Central 1 -3 Ton
Fan
Outlet, Wall
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.
TYPE
Generator
Q'rY•.
'1'Y'1'E
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
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'.
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
Drainlield, 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:
SECTION
BY
D TE
Zoning
ie `�yti!—
// 15 0
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
C1- IECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(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
$ (J o
(X .ft. = X/1000
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF A PPROVAL
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
10050 NE 2nd Avenue
Phone: 305 -795 -2204 Permit Number: BP2002 -1991
Printed: 11/19/2002
\\ Applicant: RONALD PELHAM
'' Owner: PELHAM RONALD
'Y JOB ADDRESS: 125 NE 98 ST
Contractor
ocal Phone:
Parcel # 1132060132301
Fees: Description Amount
FEE2002 -6587 Building Permit Application Fee $60.00
FEE2002 -6588 CCF $1.80
FEE2002 -6589 Notary Fee $5.00
Total Fees: $66.80
Total Fees: $66.80
Total Receipts: $0.00
Permit Status: Approved Permit Expiration: 5/18/2003 Construction Value:
Work: EXTERIOR PAINTING AS PER AGREEMENT (OWNER BUILDER PERMIT)
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 anot' o
- -
This Permit is granted to the contractor or builder named above to construct the buildinl
ordinances pertaining thereto and with the understanding that the work will be performed i
and approved by the proper municipal authorities. This Permit may be revoked at any tim
authorization. A further condition upon which this permit is granted is the understanding t
ordinances and regulations pertaining to the work covered hereby whether shown on the
by his agents, servants or employees.
Signed:
Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 18 BLK 17 LOT
(INSPECTOR)
In consideration of the issuance to me of this permit, I agree to perform the work cove
with the plans, drawings, statements or specifications submitted to the proper authoritie
myself, my agent, servants or employes.
Signed: CCIA/NdA4-A--• (Contractor or Buil
Building Permit
Contractor's Address:
Pay to
the Order of
1 : 26 70 ? 78 2 11:
$2,500.00
SANDRA PELHAM 6-91
PH. (305) 7 56 -0031
125 N.E. 98TH STREET
MIAMI SHORES, FL 33138
dilit SOUTH FLORIDA EDUCATIONAL FCU
7800 S.W. 117TH AVENUE
MIAMI, FLORIDA 33183
Grin/ f
Page 1 of 1
Date _11/ SO
Dollars
1673
63-7 782/2670
8rt o
..a
1V11.1-tiV11 O11kJ1 Lta V 1.1 LAUE
Paint Color Approval and Agreement
DATE: —
OWNER'S NAME: e(k a•y, PHONE:
ADDRESS: /zs f'
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:
ADDRESS OF SITE:
*************************** * * * * * * * * * * * * * * * * * * * * * ** * * * * * * *7
All Elements on the site must be listed and indicate the color to be p:
Walls 't wee f- 'Pe ac
Fascia / c- 74`1 6i/tea I e ,
Drip Cap/Drip Edge T era c 6 f t -
Soffit c o 'f't
Roof
Flower Bins
Shutters 7 rra q
Awnings
Chimney
Doors and door jams Sheet Pe c i
Garage Doors
Railings
Fences
Decorative Metal
All brick (simulated or regular)
Stucco Banding
Any other stucco features
Accessory'Buildings
Other
APPROVED:
Building 0 ff!•
1114 2-
Date
tVa JQ
OWNER'S AFFIDAVIT: I certify that all the foregoing information i
and that all work will be done in compliance with all applicable laws r
construction and zoning. I authorize the above -named contractor, if ap
do the work stated. Furthermore , the paint colors will be as per the att
am es.
i 'gnature of Owner D to Signature of Contractor
** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *_
`?1 -dc 3/
WHEN PAINTING IS FINI
CALL FOR FINAL INSPECTION
4/23/01
C;(6
oh_ .02oi to-22090
--.-wation of a Motor vehicle
•
The Sunshine State
Lic eNseNum sER
P450-783-55
SANDRA CHL
1 2$ NE OE PEL 98 ST
3313 & 2 333
182.079.55DATE r so9HOZ REST. evoolisE.
issue
10.22.01 _ExPoxes ouPucAre
72 19.07
004 0.00
SeIFE oftept
re quinkl by law
Legal Description
Owner / Lessee / Tenant
Owner's Address
Contracting Co.
APPROVED:
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Job Address , �, � � Y,, Tax Folio // 3 5P /1 (Jt✓ / 5
t
/ 1 G71i.4. /
r- ,S//7/24 Master Permit #
3 V7f
/2 5 /OE: 5 1 P 74L Phone
C Lc1 (2af Q
Qualifier /eteie ifive e e(2 / j
State # Municipal #
Architect /Engineer
Bonding Company
Square Ft. j2.3
Notary as to Owner and / t Condo President
My Commission Expi; ,s3 ;-Ug;_.iC smE 0:= I "LORXDR
f•', C0i•i: tSSTOP! EXP SEP1.20, 1994
nCNn.-n i -RU GENERAL INS. Uiao.
** *
Zoning
Mechanical
FEES: PERMIT %' RADON C.C.F. i1
Competency # //. i ,5 Ins .Co .
Address
Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFINGJtNG PENCE IGN
WORK DESCRIPTION V2.&-,c5 -194) /it) -- 611 -
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT ANA YOUR FAILURE TO DO
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, and
on the attached addendum (if applicable). I 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, PLUMING, SIGNS, POOLS, ROOPING and MECHANICAL WORK.
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. Furthermore, I
aui orize the above►-named contractor to do the work stated.
C l ' /& - 244.4
S ignature of owner and /or Condo President Signature of Contractor or Owne wilder
bate: Date:
Fire
Plumbing
Address
2 ( 7 SI
- Phone 9 '7 - �6e
Estimated Cost(value)
:'
Other
Notary as to Contractor Owner-Builder
My Commission Elk . � *i1 2t - ,�
r :D ;'D T RU C- E('''•10L
* * * *
NOTARY TOTAL DUE 3t
Building AR Y1/2,Aelectrical
Engineering