245 NE 99 St (4)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date 9°4 - . Time
Type Insp'n 6
Permit No. $ 2D0Z - /6 7
Name C1`4jj /g/ei/
Address oNcifig I f s
Company & / W s 4 2 O /t vcl( PO
Phone # 30S 756- 3Z/
For Inspector: q- . ; o- 2 Name / te
Approved L ■
Correction
Re- Insp'n Fee
200. - �s�
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date 9`�4 `t,? . Time
Type Insp'n //par / / s 7"
Permit No. P 13 1tc7
Name e/ W i !/( o
Address 0796— - 4/g 99 c7 t
Company 3 /U» lrar LP V
Phone # �/�J 7,5 - ,2J/
For Inspector: C} 7 OZ
Approved / ' ❑
Correction
Re- Insp'n Fee
Name & Date
Pay
to t
Phone: 305 - 795 -2204
inted: 9/12/2002
Applicant: C � - I
Owner: rEtWIN
JOB ADDRESS: 245 NE 99
Contractor BLUM BUILDING CONTRATORS
Local Phone: 305 - 751 -1546
Parcel # 1132060134550
O
I
Miami Shores Village
10050 NE 2nd Avenue
JULIE A. DAVIES
348 N.E. 103RD ST.
MIAMI SHORES, FL 33138 -2433
i
ACH R/T 08310027
Fees:
FEE2002 -5093
FEE2002 -5094
FEE2002 -5095
Description
Building Permit Application Fee
Buildier's Bond
CCF
Total Fees:
Amount
$60.00
$300.00
$1.80
$361.80
t
Total Fees: $361.80
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 3/11/2003 Construction Value: $2,200.00 /dik,
Work: REPAIR / REPLACE DAMAGED FLOOR JOIST AS PER PLAN SUBMITTED
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
f__ is $50.00, ...h:..h........a :..advance be ca lli ng for ono Inaction.
Bank of America,
Memo
1:06300004X: 00 Lt,6327 L
Date
MIAMI SHORES VILLAGE
NOTICE
Owner is Responsible for Maintenance of
All Village Sidewalks as per Village of Miami
Shores Code of Ordinances, Including D:iveways,
�1lsFri By Current Construction Actiai:ies.
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 17 & E1/2 OF LOT 16 BLK 33 LOT SIZE
9 3 ;-°G
$ 3‘1,1
Building Permit
Permit Number: BP2002 -1576
ST
Contractor's Address: 275 NE 92
367
63-4/630 R.
1348
Dollars
IYP
BY:
BY: .
Page 1 of 1
0
the equipment or device described in the application herefor in strict compliance with all
with any plans, drawings, statements or specifications that may have been submitted to
is not done in compliance with such ordinances or if the plans are changed without
ictor or builder named above assumes the responsibility for a thorough knowledge of the
ings or in the statements or specifications and that he assumes responsibility for work done
1 compliance with all ordinances and regulations pertaining thereto and in strict conformity
ss Village. In accepting this permit I assume responisibility for all work done by either
CONTRACTOR
�,_�//
Name / CGx /leif f Zee.
License o. /
Address 75 ._ �£ , 9.2 J f'A, -ce,
" - ,f hr /f ,C i il,/,
Telephone Q S 2sG ,?e/' Fax 3ar ?0 -/fl
Qualifier Name z` /� air /✓
on
PROPERTY OWNER
('
Name A (/',i� �l ff eP.� -�/'
Address 7 .., y? ffre£
/ . J ,cc lid
Home Telephone 3 05 _ _
7 5 _ 5 ,
_ 5
Business Telephone 3 vc
7 1 S—
— Z 7..
Fax
Demolish
ENGINEER
rr ^ L
Name Y• , [ „ x f t //7� _ 7;,,,..,4,.. Z.-c,„
License No.
Address / 3 . / 1 S: 4 , /,Z 8 s/ - ,
7/74;,,' fe . ? /X
Telephone 3,) ,_ ?7/ %,�
Fax 36 r ? 7 / - € . 4 1 3 Z.
ARCHITECT
New Construction
/+
i C ,om b
cN,i.- e 4,:f
1,...t._
License No. l
Repair
Address
Demolish
Telephone
Relocation of Structure
Fax
Foundation Only
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Add'l Attachment
Foundation Only
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 propel 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.
APPLICATION
Step . 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.
Job At.ress: „. ' S /V7 S9 f"
Address
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
/ 27, ; , / C-e Ard
Apt. City State Zip
4 1%;,P>.- A747 Az. / t s1'
Description of Work
Master Permit No.
Subsidiary Permit No.
PERMIT APPLICATION
Folio Number
Lot Block /,- 14 i'r ,'.Pi "."- hii,&, lc,
Subdivision PB PG Zoning Linear Feet
Current Use of Property Square Feet Units Floors
Proposed Use of Property Value of Work "2 °? 0 ' Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
Page 2
1f 1PORTANT 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 ca refully.
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.
STAT r • F FLORIDA, 0 OF u_ u _ DE
Signature of Owner
Crk1:5 Print Name /
Sworn to and subscribed before me this I day of
— lc .
Signature of Notary
SEAL:
L - S-f-e ✓ r.X►.4
A-EA O FFICIAL. N
blic - Staten
NUTARY PUB ATE OF FLORIDA
COMMISSION NO. CC836040
MY COMMISSION r•XP. MAY 11
Personally known ! OR, Produced Identification
STATE O. RIDA, COUNTY OF MIAMI -DADE
7
Signature of Contractor / Qualifier
Pr int Name
Sworn to and subscribed before me this
2003— •
SEAL:
PERMIT APPLICATION
day of
Signatu a of Not ryPublic - S�,Ig yU�Di Y1ES
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC836040
MY COMMISSION IXP. MAY 11,2003
Personally known OR, Produced Identification
Type of Identification Produced: Type of Identification Produced:
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TY1'E
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
Water Re -pipe
MECHANICAL
TYPE QTY.
Minimum Fee
TYPE QTY.
Condensate Drain
'I'1'I'E
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.
'l'YPE
Soakage Pit
Q'1'1'.
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
Sewer Connection
Water Heater New
Water Re -pipe
Drains, Area
Meter Set (Gas)
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:
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
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
$ 4 °
$ goo
$
$
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
9/io/
71 Ira-
$ ) s ? ( 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)
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