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
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• ...
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
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O 0 • ogle • • •
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0
0 0
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• o • e s •
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0 0
0 ° 0
• •
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• •
.PERMIT APPLICATION
to 0 ee
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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
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INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
. • • • .. •••
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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
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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
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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:
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.... ....
•
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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,
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as identification.
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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
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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.
• •• • • • • • • • ••
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• • • • ••• • • • • •
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••• • 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
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