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PAINTMIAMI SHORES VILLAGE' Paint Color Approval and Agreement DATE: fc 3 �4 / OWNER'S NAME: ADDRESS: Flower Bins ti/ Shutters „ Awnings (AI ILA` e Chimney Doors and door jams / Garage Doors 4if e Railings Fences Decorative Metal All brick (simulated or regular) w`u Stucco Banding Any other stucco features Accessory Buildings Other APPROVED: <13/07 Building fir Date L i 1 O / h t a PHONE: 7 3 - p7OF *********** ************************* ***** ******hexxxx*** * * * ** ***** ADDRESS OF SITE: /c--9) /U £. ?r 57 CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ** * *** *********** ** * * * *** ***** ** *** * * **** * **************** ***** All Elements on the site must be listed and indicate the color to be painted. Walls ' 3 /' Y.e (f Fascia Drip Cap/Drip Edge AJ/9 Soffit cti4( Roof Ai + 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. /o -S - -o 1 Sig nature of Owner Date Signature of Contractor Date * ******************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 MIAMI SHORES VILLAGE Paint Color Approval and Agreement ti DATE: 9t � , aoo DOWNER'S NAME : .. 7�.u;t� �P- L lr'HONE 3 - — ADDRESS: /z4 8 ` `1 8.5 - ,.r.a , 4, 02e 3 i - 4 f * ******************************* * * * * * * * * * * * * * ** * * * * * * * * * ** * * * ** ADDRESS OF SITE: CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: * * * * * * * * * * * * * * * * * * * * * * * ** ..... ) CC * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls �`^�� Fascia 1h2... Drip Cap/Drip Edge /114 Soffit T Roof N/P Flower Bins Shutters N/ /c b �9\6 Awnings 14" Chimney Doors and door jams t\iJi4 dv Garage Doors N/g Railings 14'►-R. Fences iv/fl Decorative Metal N�f� All brick (simulated or regular) 1MI& Stucco Banding NJ4- Any other stucco features /V /1- Accessory Buildings N ff Other /4/ //f- 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. Si ri�ture of Owner Date Signature of Contractor Date * g * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION Building Official Date 4/23/01 PROPERTY OWNER New Construction Name R ' R &_ '[Z d „ �. 77 �� , _ "� Address 1 a-q /V 98 2 4 4— Ae 4 Alteration Exterior a Home Telephoned+ .7 f ?o a Repair Business Telephone 2 _ )s-CA. Aw_ J J , xx 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'I 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 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. A PPLICATION A Address: f eq 9 8 Nye l 9 Address Apt. Folio Number Lot Block Subdivision Current Use of Property PB PG Proposed Use of Property "v\ Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing I/ Fence OtherPO- A PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax City Description of Work State PERMIT APPLICATION Master Permit No. Subsidiary Permit No. 33/� -are/ Zip Zoning Linear Feet Square Feet Units Floors XValue of Work 1 ,1ob,ce— Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Page 2 PERMIT APPLICATION 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 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, 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 NSigna of Owner Signature of Contractor / Qualifier R C IA I 141- &'tr -1.z5 Print Mahe Print Name wo s and subscribed before me his 3 day of OCR , Sworn to and subscribed before me this day of SEAL: ure of Notary Public - State of Florida Signature of Notary Public - State of Florida v�v ■.4,4 Roper D Shearon tk My Commission CC826922 J Expires Agnt 14, 20031 SEAL: Personally knownR, Produced Identification Personally known OR, Produced Identification Type of identification Produced: Type of Identification Produced: SECTION BY DATE Zoning aL 7 l O7 Electrical Mechanical Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) ❑ IMPACT FEE (New Construction) $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 $ 4 0 $ /I o ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ OTHER (Specify & Attach) PERMIT APPLICATION CHECKLIST (sq.ft. = x/1000 x t.60) (¢.005 / sq.ft.) (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2"° AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com ELECTRICAL - TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton Cooling Tower Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton - Paint Booth Fire Pump Ventilation, Cost Outlet, Switch Air Handler, Tons Signs Ductwork, Cost of A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) - Process/Pressure Piping A/C Central 16 -20 Ton Fixture Light Bath Fan - Vented, # Parking Lot Lights Fireplaces, Number of Spas/Hot Tubs A/C Central 20-1- 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 0 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 QTY TYPE Refrigeration, Tons QTY A/C Central, Tons Bath Tub Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of - Paint Booth Filter Replace Ventilation, Cost Pool Piping Air Handler, Tons Sprinkler Repair Ductwork, Cost of - Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System - Process/Pressure Piping Cap - Water Gas - Appliance Bath Fan - Vented, # Pump, Domestic Fireplaces, Number of Pressure Vessel Cap - Sewer 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 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: Date PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address J - f8,4) Tax Folio Legal Descri. ' on Historically Designated: Yes No x Owner/Lessee / Tenant /6 V} 4. / /C, u 7 Lig 4/9/eie Master Permit # Owner's Address 1- /l/ ?' ( .YI' 77i/es-mc Phone Contracting Co. ©`,( ( , t ri. Address Qualifier SS# Phone State # Municipal # Competency # his. Co Address Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): /5, DING ELECTRICAL PLUMBII�TG MECHANICAL ROOFING PAVING FENCE SIGN tl� WORK DESCRIPTION a Address S quare Ft. Estimated Cost (value) < :::?..ra. WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND 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, PLUMBING, SIGNS, POOLS, ROOFING 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 authorize the above -n: ued contractor to do the work stated. 4 Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President My Commission Expires: a J —Q., /0.) Signature of Contractor or Owner - Builder Date 1 ///c c 70.b Date Notary as to Contractor or Owner - Builder My Commission Expires: FEES: PERMIT ` O RADON C.C.F. , ' NOTARY v ciY Pli OFFICIAL WCTARY S .AL SANfRA 1/ MONTIEL ( COMMISSION NUMBER ' .a ti • Gtr 012.'51 " t F , H �� MY COR".Y+IS IJN EXP. Electrical ST BOND TOTAL DUE APPROVED: Zoning Building Mechanical Plumbing Engineering Date �/1 Y- Job Address is 9d / l /E 91' bligL Tax Folio II 1265 0 g Legal Description / / Owner / Lessee / Tenant t 7 , Master Permit #,.5) / Owner's Address Contracting Co. ■...7;)`i1 �a�v.o�iyG Qualifier Phone C'Vr d 3 7fl State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one BUILDI► LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION /s�'v O 4 Td' / o/, e //)dose L W"'T`e1 Square Ft. Estimated Cost(value) 447D WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND 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, PLUMBING, SIGNS, POOLS, ROOFING 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 authorize the above -named contractor to do the work stat Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: ** * APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Zoning Buildin * * * Address LPG L 41c /7/ o4C . 111. 0.1r11 1 ► s '� t.' -.. u � e of Contractor or Owner- Builder L. 1�i a ir as to Co y Commission E Phone 757 ) vry JD FEES: PERMIT ,57)50 RADON C.C.F. / i .0 NOTARY 440d0 TOTAL DUE?` '/ `4 ** Fire Other Electrical Mechanical Plumbing Engineering