240 NE 99 St (5)Company
Phone.#
For Inspector:
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date Time
Type Insp'n
Permit No.
Name .
Address / O 1 *
3 ®s
Z'/ 6- ' - $ Name &ate
C v /I /-
1 31 --PA\ -
')
Pay to the
Order of
ACM RR 063100277
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 11/6/2002
Applicant: PASTOR
Owner: GONZALEZ
JOB ADDRESS: 240
Contractor
Local Phone:
Parcel # 1132060134330
Work:
Fees:
FEE2002 -6293
FEE2002 -6294
r LDA%E. LANSING 09-97
240 N.E 99TH ST.
MIAMI, FL 33138
Bank America��
NE 99
Description
Building Permit Application Fee
CCF
Total Fees:
Permit Status: APPROVED Permit Expiration: 5/5/2003
CHAIN LINK FENCE 4' and two (2) 5' WOOD GATES
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
feels $50.00, which must be paid in advance before calling for another inspection.
Date
1 6 2c�Z
Mr l sees 1$ Go. &O
°d 1tdD
For
':063L002771: 0034356725L81I' LO L
Building Permit
Permit Number: BP2002 -1906
GONZALEZ
PASTOR
ST
Contractor's Address:
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 7 & W1/2 OF LOT 6 BLK 32 LOT SIZE
o0 19
Construction Value:
Amount
$60.00
$0.60
$60.60
63- 27/631 FL
689
BY:
BY:
$900.00
Page 1 of 1
Total Fees: $60.60
Total Receipts: $0.00
e equipment or device described in the application herefor in strict compliance with all
ith any plans, drawings, statements or specifications that may have been submitted to
not done in compliance with such ordinances or if the plans are changed without
or or builder named above assumes the responsibility for a thorough knowledge of the
Is or in the statements or specifications and that he assumes responsibility for work done
compliance 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
PERMIT NO. -
ADDRESS: .
MIAMI SHORES VILLAGE
BUILDING / ZONING DEPARTMENT•
SECTION
BY
DATE
ZONING •
ELECTRICAL
MECHANICAL
PLUMBING
FIRE
" PUBLIC WORKS
STRUCTURAL
BUILDING OFFICIAL
1. Subject to compliance with all Federal. State.
County. Village rules and regulations. Village assumes
no responsibility tor accuracy otlor resutts from
these plans.
2. This copy of plans must b■ available on
building site or au Inspection will be conducted.
JOB ADDRESS 2 o / q ? 7 sr
APPLICANT L 09/4.1 5/416
PHONE It
APPUCAI1ON F
SHEET OF •
MISCELLANEOUS
DATE - ..:
(1/5/61,2-
CRITIQUE SHEET
I JVa.II y - COMMENTS
C./MX L /k'/( Pe C e /.S 40,e6 e■cl
�i2a.tJT D/c O a SE
5 f /E x )(k x
D� Go c4770"' 5LeA
INITIAL
4 /
•
1
STATE OF FLORIDA)
COUNTY OF DADE)
' ) ./ 11/1 • • -V
performed on
The undersigned Affia
attached survey, performed by
. t
Wimess(sign and print)
as ysr Angela M Becker
i ` My Commission DD150048
a,9 Expires November 15, 2008
AFFIDAVIT
(property o ner)
does hereby attest that the
name o s �' o s com any)
SWORN T AND SUBSCRIBED before me this ) day o
Affiant • personally known to me, produced
___„_____--.4_—
Affiant/Propert owner
Witness(sign and print)
•
•
Q S:. 5 , is an accurate representation of the existing conditions and •
(date(of survey)
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the
as identification.
property without first providing a survey less than six (6) months old. The Affiant, as property owner; further
agrees to remove or obtain permits for any structures which now may exist on the property which are not
permitted or which may violate zoning or building code regulations. The Affiant further understands that the
existence of any such structures may affect final inspections as applicable to this or other permits..
Further, Affiant sayeth naught.
-1108/2002 2002 14:43
•
•
i
Set
ei1 ,v S
■•••••••■•
e� a.Att
Teasley
/0
TsAn:wa POST
SITE
VALL SII!Cv .$,
3059475107
hii
Sepion 2303.2(0. 0ceyeei egze..ts of 12 :cu heti tt a ba C
( Q &i44 Enit Cmxe {c°;hut'12 act la be{ b
2303.2(0 � sn+aod 10 meet a+ Scied:=m
Tahle SS-
C2uio Unit Paq 1424= tzta•TteS
.
STA80A110 $$9P ORAVIKG
C�►tr t lxx FEIr.(
Tit
ie -cr to e1tsJar
•
00 SIZE
•
LIMP. MUST
VALI III If ;PMP
• �' S
s
Tolt ail
SUNNY ISLES BLDG
6 -
• i0
TUI•
A
OG SIZ2
37g ...
•
10 tlse iosdi u specified in Seeum.
ipocatod is 7cbt0.21:4.
•
•ao ^ �(� to tbo lotdt as £pec;fied III
of R4It
p
..4 t 1.
VAI T /ttt / >•1
Moron Concrete
Fooadttlon Size
(D4neter x Depth)
•
PAGE 03/03
•
&/08/2002 14:43
•
•
8t1.,t
set &stet
/0
3059475107
10' -0 to :4 it
sunlautta
SUNNY ISLES BLDG
• ( Cfuin Gek,feneu jet e.ce1.1 of 12 Feel La &z (.114 1:4 d
Section 2103.2(b).
• 2l0 tJsuo CNc reooer ko Nut' 12 Cod to � b0 e
(b) or guy OO,�Q od to meet (19
' Table 28.4
Chti4 Link raq let(aImtzo•Re4
•
STA /emu R t1uAVfKc
C6 CKatr LINZ ?ME
II 01 Ere
imam lir
�� • 11. •
`• •..
•
j - =rows, N,ri oA
6
77
TUI•
O G :NU
*Mt r{n3 re Oa IcaQ& as specified t„
to tie foal As specified in Sect
NUM la Twte se:� `"
*NUM
•
Line Poet Concrete
Fenadetlon Size
(Dimmer t Depth)
PAGE 03/03
PROPERTY OWNER Nil Lt A- LAY\ s I S' ,
Name f- To R, C o n Lei t CZ
Address
zcto Nom% cl ft 9 j
M l A- 1 srUx e PK
3
3) 3 Y
Home Telephone 1.5O.S 1 s 7.—S 8t)
Repair
Business Telephone
Alteration Interior
Fax
Relocation of Structure
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.
Step 2. Submit the completed aoplication 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
ri Address:
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.
Zo gji
Address
Folio Number
Lot Block
Subdivision PB
Current Use of Property
Proposed Use of Property
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
9 t
Apt.
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No.
City
Description of Work
(NI I PIM I -)S
State
F
yU PT CiiAIn Ors C 2
PERMIT APPLICATION
Subsidiary Permit No.
331 xE
Zip
t�.loo cl C Cl A fe
PG Zoning Linear Feet
Square Feet �]
(Value of Work �/
0 -'
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
Units Floors
Bldg Value
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone
Fax
Qualifier Name
Page 2
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.
AFFIDAV1'1' - 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
Signature of Odmer
Pri tl r�d� LINI,N5
t Name �� Print Name
to and subscribed before me this ( day of S l.li V Sworn to and subscribed before me this day of
ture o
?Il]
� ►" , lMS : £ Ilk► 1— i
Si tary Public tate o Flori
SEAL:
Angela M Becker
• n sa:DD160048
� 22t A ovember 16, 2008
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Contractor / Qualifier
Signature of Notary Public - State of Florida
SEAL:
PERMIT APPLICATION
OR
Personally known Produced Identification Personally known OR, Produced Identification
Type of Identification Produced: Type of Identification Produced:
ELECTRICAL
TYPE.
Minimum Fee
QTY.
'I'YI'E
Dryer
QTY.
TypE
Outlet, Appliance
QTV'.
TYpi;
Service Repair
QTY.
A/C Central 1 -3 Ton
Dryer Vents, Number of
Fan
Ventilation, Cost
Outlet, Wall
Ductwork, Cost of
Service, Temporary
Periodic Inspections
A/C Central 4 -7 Ton
Fire Sprinkler System
Fire Pump
Outlet, Switch
Fireplaces, Number of
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 QTY.
Minimum Fee
TYPE. QTY.
Condensate Drain
TYPE
Generator
QTY. TYPE. QTY.
Refrigeration, Tons
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
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
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:
•
S
BY
D E
///i1/
Zoning
Or /
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
CHECKLIST
❑ 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
$60
,ti
$
0 (sq.ft. = x/1000
x ¢.60)
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
NED AND PREPARED BY: DATE:
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $
ISSUING OFFICIAL
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
Date
Legal Description
Qualifier
gnature o
Notary as to Own
My Commission
FEES: PERMITSC1 RADON
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 2 0 / J (� S' Tax Folio
Owner/Lessee / Tenant fp' 1 3 -O O' C10 n 7P I e
Owners Address 21 4 OVfi q 64' •
Contracting Co. f cp e ye Wet
` A ZA t o
State # /4 I N I Municipal # Competency #
Architect/Engineer Address
Bonding Company Address
Mortgagor
Permit Type (circle one):
WORK DESCRIPTION I�
UILDING
ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Square Ft. Estimated Cost (value).
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOU. '
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 sta
/
owner and/or . ' President Date ctor or Owner a uilder
oath ftelitlefil
v 1� Ci,mm .A;. r a/Gin 03
tSo. CC e4345/
I I Peevr»f v r.Mr.'r. i I Other t.O.
Historically Designated: Yes No
Master Permit #
Phone
Address / 70 5:s" /L7(i 7g 4-J E% .
ss# VPhone o j �K e 2Q /
Address
i
r ' -B.Ws
.-!. 'An,-, `.mss. fr4/2003
' f ' 3457
• ^ 110ther I.O.
Notary as to Con
My Commission
C.C.F. (.2 0 NOTARY --"" ` BOND
//320 3N{330
05'5
Ins. Co.
/0
J2 �
TOTAL DUEL/ -�
Date
Date
9
APPROVED:
" f ®�� / / /
Zoning Building k � r Electrical
Mechanical Plumbing Structural Engineer