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DRIVEWAYDate — Type Insp' Permit No. Company Correction MIAMI SHORES VILLAGE BUILDING DEPARTME 305- 795 -2204 Building Inspection Requ Name l) --' Address_ Phone # For Inspector: /0 r -2 A pproved Re- Insp'n Fee ❑ 4n 0 .\ Time Name & Date 0 Date Type Insp'n — Permit No. Name — Address Company Phone # For Inspector: Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Time ,ok auk Z-e, r nze,abl. CONTRACTOR ame 3 Ja l 1 r Name Q' (, 691A/C)Lete License o. Fax Address Repair Telephone Fax Qualifier Name Demolish PROPERTY OWNER ame 3 Ja l 1 r Address ` 30 N.F . qq -w. S r e\ Home TelephoT 3)5) 794 : 2 9r ` l 7 I OC1 ' Business g � c ss Telephons ... 3 /r:o Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other Step 1. ob Address: • Address PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other • • . • • ••• • •. • • • • • • • • • • • • • • • • • • • • • • ••• • • • • • • • • .. ..•• • • • • • • • ••• •. •. • .. • • • •.. • ... INSTRUCTIONS - The f9llowi.lg steps must be taken to obtain a permit from the Miami Shores Village: • •. • • Complete the atttehedreamit s rydst 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 IAM I S Folio Number ... C Lot Block Subdivision PB PG Zoning Linear Feet Current Use of Property are Feet Units Floors Proposed Use of Property a e of Work 1 1 00. 00 Bldg Value Tenant Information Tax As essed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No. RES PERMIT APPLICATION 3 Ap City , State Zip escription of Work ,'JAI W vat L /fie j am- T ENGINEER Name License No. Address Telephone Fax 786 3c/c/ qu4/ Page 2 000 0 0 0 •00 • 0 O 00 00 0 0 • es •• O 0 0 • • • • • • • O 0 • ogle • • • • • • • • • • • 0 0 0 O 0 0 0 • o • e s • • • • •• • • 0 0 0 ° 0 • • • • • • .PERMIT APPLICATION to 0 ee • • • • • 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 thz090 70 am: t« 6:Q0 pm., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 0 0 0 • • • e ••• • 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT ANDoSANITA ' fr fPbpconstruction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AI� °DgItItIS. e e o 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. ST E OF .•' ORID •I i .. 0 Y OF MI 'i i I ADE � * ature a Owner t 1/ a/ fa I"1 -firm. ► Or 'nt Name Sw to and subscribed before me this 1 day of Angela M Recce 1 Myy Commission DD150048 Lei- lkovavd' EupaS November 15, 2008 STAT,'" OF FL ri RIDA, C ' NTY OF MIAMI -DADE // .4 'Mr of Contractor / Qualifier :rrha.i-a Mi -ry Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Personally known 1/ OR, Produced Identification 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. TYPE 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 ()Ty. TYPE Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/VVin. 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 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 being performed and quantity(ies) in the space provided below. . • • • .. ••• • • • • •• • . • • •• • • • • • • • . . • ••• PERMIT APPLICATION RECEIVED AND REVIEWED BY: DATE: Page 4 OFFICE USE ONLY CHECKLIST LI OWNER - BUILDER FORM (Attach) ® FIRE DEPARTMENT APPROVAL (Commercial / multi- family) LI CONCURRENCY (New Construction) LI 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 LI PROOF OF OWNERSHIP (Attach) ® HRS / DERM APPROVAL (Septic / Sewer) LI IMPACT FEE (New Construction) 0 0 0 0 • LI OTHER (Specify & Attach) 0 0 $ $3 - ()IJ $ / ) 1 0 ( sq.ft. = x/1000 x ¢.60) $ (¢.005 / sq.ft.) $ (¢.0l /sq.ft.) $ S r od 0 O 0 O 0 • • • • 000 0 0 0 000 • • O 00 •• • • • •• •• o • • • • • • • • • • • • ••• • • • 0 O 0 • 0 •• •• SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE 0 0 0 O 0 • • • • REVIEWED AND PREPARED BY: PERMIT APPLICATION 0 0 0 0 00 O 0 0 • • • • •• • •• 00 0�o C A�SQCIATION APPROVAL 0 0 0 0 Attacl=1 ••• 0 O 0 . 0 0 O 0 0 •••• 0 0 00 000 0 • 0 • 0 00 • BPR APPROVAL (Restaurants) • CONTRACTOR REGISTRATION (On File) TOTAL 3Z I ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL o (305) 795 -2207 o FAX (305) 756 -8972 http : / /www.miamishoresvillage.com Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12 /12/2002 Applicant: BARBARA Owner: MCGREGOR (� JOB ADDRESS: 30 NE 99 Building Permit Permit Number: BP2002 -2140 MCGREGOR BARBARA ST Contractor RA' 8 - GANRETE Contractor's Address: 0 Local Phone C. Parcel # 1132060131080 Fees: FEE2002 -7108 FEE2002 -7109 FEE2002 -7110 FEE2002 -7111 i Description Amount Building Permit Application Fee $60.00 Buildier's Bond $300.00 CCF $1.20 Notary Fee $5.00 $366.20 Total Fees: Total Fees: $366.20 Total Receipts: $0.00 A v Work: DRIVEWAY CONCRETE If there is no permit packaaa n fee i BARBARA E. McGREGOR 30 N E 99th 33138-2339 Miami, Permit Status: Approved AAA p tothe•i 1i' order of Permit Expiration: 6/9/2003 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 8 & 9 BLK 8 LOT SIZE 100.000 X Date Construction Value: $1,900.00 63- 943 BRANCH 89232 D.�.IIa r on Dollars Back. 1 • of I Q_ l i SouthTrust b/w jenict Bank F, ` , i ' - 260a0. y ( 6 0 LB?" 0335 : 9 6 3 3 109430 • .___-_____ .clot or Builder) ierify, there will be no inspections. Re- inspection 335 ection. Page 1 of 1 'I the equipment or device described in the application herefor in strict compliance with all e 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 actor 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 compliance with all ordinances and regulations pertaining thereto and in strict conformity s Village. In accepting this permit I assume responisibility for all work done by either BY: BY: • • • • • • • • • • • • • • • • • •. . ... • ... • • • • • .... .... • •. . • • .. • .. • • .. • • . • • • • • .. • • . • • • • •• • • • Tax Folio #: • • ••• c 5 ' R 'y 7 . • • •• : • •• • • • requests permission to install: • �'� /iami SIioreJ Wage • • . • • . • • • • • • • • Lot Block Subdivision within the public road right of way of •• • COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY WHERE 1 i // 1 c fte,q(i 7' , hereinafter referred to as the Owner of the (owner) / following described property: Legal description /folio #: [1 Asphalt, concrete, brick pavers [ ] Landscaping [ ] Other SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE SIGNED. SEALED AND DELIVERED in the prese 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 -2382 Telephone: (305) 795 -2207 Fax (3051756-8972 �/-' L' I r- l, (address) IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows: I. To maintain and repair, when necessary, the above- mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligation has been canceled by an affidavit filed in the Public records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized repres ative). • •• • • • • • •. •.• ••• s •••• • .•• • • • • • • • • • • • •• •• •• • • • •• • • •• • • • ••• SWO y^TO AND SUBSCRIBED before me this Affiant is personally known to me, produced • • • • • • •• ••• ... AFFm pra • • . • • •• • • • . • • • • STATE OF FLORIRFIJ • • • • ; •••• • COUNTY OF DADE) The undersigned Affiant, f does hereby attest that the • (prop ^r .;ynef) attached survey, performed by performed or y : , is an accurate representation of.the existing conditions and • • date of surve 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 • • property without first providing a survey less than six (6) months old. The Affiant, as property owner, further (name of surveyor's company) agrees to remove or obtain permits for any structures which now may exist on 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. Witness(sign and print) Witness(sign and print) day of 01111.: Moab M 6it#l� My commute", MINN_ a Nareatibii11, .2o as identification. D2IVELIA/A :•ice "��� �•► YA x / SrRO ET ?L4,\J • 40( hx.2_0 T xNG u I7 - 0 Y $vux 5 w12.-k ;cam Y NA J Eat As cd-l F ► - E - r`_f TQ E XX • • .•• •• • •• •... • .. • • •• •• ... ..• • • • •. • •• •• • .. •..... • •• •• • • • . •• • •••• .• .... . •• • • • •••• •... • . •• • • . • ...... .: ...... ...... . . ..... •.... • • • •• .. • • repteeSe(t S4arap Cove - , rq roe irrs pl eJ r2 CD . 15 /G /7 /8 /9 20 Z/ I N I z3 5o r. " y " r, - SS.v5 `■ r�� p,o ■ 4 la N- I ! I KEW( CERTIFY that 1k. attacked • ,t.feb egr•sests • recast survey NN 'Odor ■y dIr•cf••. sod Is true mud cor- rect' to fie bast ed ay kaswI.+p ad belief. There Trs a sacrs•sl�eslL 4 CHARLES W. CARR 924S S. W. 44th Street LAND SURVEYOR SURVEY NUMBER 89 - - 316 MIAMI. FLORIDA SURVEY OF r • MIAMI SHORES. REGISTERED LAND SURVEYOR MO STATE 9! KARIDA r /so a /0 ta // s. /3 g /3o LOCATED IN: DADE COUNTY, FLORIDA. LOCATION SKETCH: SCALE: 1' = 150' 9v TH The Florida Flood Insurance Rate Map, dated 1 1 7 published by the United State Department of Roue ng •nd % Development delineates the herein described land to be within tone This is not a Flood Hazard Zone. This is a land survey and was prepared in accordance.vith and satisfies •the minimum technical standards of Section 472.027 of the Florida Statutes and. die rules promulgated thereunder of the FSFLS and of the FLTA. • •• • • • • • • • •• • • • • • • • • • • • • • • • • • • ••• • • • • • • • • • • • ••• • T ewp M • paa: ••••• • 221 -3416 - . • • • •. • • • • • SAT ' R and 4 Rboci' • • R • • • • • • EiltwY,SICN AN AMENDED PLAT. OF MIAMI SHORES SECTTnAM flc2. •1 ! • Asc.rdl.t to Ito P1st Ther«t •s tec•r'sd Id Plot Seek N. 10 of roes N•.• •'• Polls Records of Dade C... Melds_ Constantine Hinds o .t.. October 31st, 1989 for 30 N E 99th Street. Miami, Shores. F1 • • • 70 •.•• • .. •.• •• • • • • • • • • , • • • . • • • • • • • ST. ... • • • •• • • • • • 3 • • • • • • • • • • • -- e.. • •• 0 M o e40 //7 /;7 Fe/fee /L9 - 00 x_— s10 �. •• • • • • • •• • • • • • • • • • • •.• • • • • • • • • • • • • • • • • •'•'• • • •LO, 4ETAILS: • • S. • • • S • k • • • • • •' . • • • f cOcsf 5s Y.a SrooP • • • SCALE:. 1' = 20' •••• •••• a? rtOCW _ SS / U W A L k 4 M 2/. 85 • _ • • N •�� . 20'R4V'7`. /8.47 /7. oD 24.00 JTy e& Res. x`.34 trl a . `VATE€e /✓7,4 /,e/ /5 " 4 7 L r. 1)D /z .o 50 A.••• • 0.20 cc.P. 9',34VFMEN7 I • .aQ /t A/o F, GY,l�F