PAINTINGMiami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 9/7/2005
Applicant: LUIS
Owner: ZARATE
JOB ADDRESS: 276
Contractor
Local Phone:
Parcel # 1132060134160
Signed:
NE 98
(INSPECTOR)
Signed: (Contractor or Builder)
Building Permit
Permit Number: BP2002 -607
ZARATE
LUIS
ST
Contractor's Address:
Permit Status: APPROVED Permit Expiration: 12/31/2005 Construction Value: $3,000.00
Work: EXTERIOR PAINTING AS PER AGREEMENT (OWNER BUILDER PERMIT)
BY:
Page 1 of 1
Legal Description: 1 53 41 6 53 42 .45 AC MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 3 & 4
Fees:
FEE2002 -1706
FEE2002 -1707
FEE2002 -1708
(FEE2005- 12157
Description
Building Permit Application Fee
CCF
Notary Fee
Renewal /Extension Fee
Total Fees:
Amount
$60.00
$1.80
$5.00
($60.00
$126.80
Total Fees: $126.80
Total Receipts: $126.80
In consideration of the issuance to me of thispermit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statement: or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Type Insp' n i n0 I 1
Permit No. 8PoZ - 4 X; .1
Name
Address
Company
Phone #
3
MIAMI SHORES VILLA
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Dat I1 105
alo n K LoiS Zo ra
2276 K1E. 9 5 r
Inspection Date
Approved
Correction
Re- Insp'n Fee
ou....-ye If
Cao5 ) - .
cr [e [o5
R id 2eY / / (-Mens i
s � p J -)or) %;(:)., CO
SEPO7
PERMIT APPLICATION FOR MIAMI SHORES VIA.'
Date //7 9 ?lob Address v? 7 6 /U6 96C-- S/ Tax Folio
Legal Description Historically Designated: Yes
Owner/Lessee / Tenant 6 /='?
Owner's Address ```l 7a. A) 9 S
Square Ft. Estimated Cost (value)
Master Permit #
Phone 7.1 7 — ei/ p 1 5 - 3 %
Contracting Co. Address .
Qualifier SS# - Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
_d / oZ
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESUILT 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 stated.
Signature of owner and/or Condo President Date Signature of Contractor or Owner -B 'lder
Notary as to Owner and/or Condo President Date Notary to Contractor or Owner- Builder
My Commission Expires: My Commission Expires:
FEES: PERMIT RADON
APPROVED:
Zoning Building
Mechanical Plumbing
C.C.F.
Electrical
c
NOTARY BOND
/,'
TOTAL DUE
Date
Engineering
PROPERTY OWNER
Name S /I , On
Address 27 6 4S ? F/k St
Horne Telephone ('OS l 1 7575 6, 9
Business Telepho 77,,,r) ) 30 �/o927
Fax '?(, / 5° 76
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
Step 1.
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
I 112
INSTRIJCT,IONS - T he following steps must be taken to obtain a permit from the Miami Shores Village:
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.
PPLIrtAT'ION I
K Job Address:
Address Apt City
e7276 /17- `/ s f - /?/2. So/lizS
State Zip
Folio Number Description of Work A-7/J/ r>(//'-"X.X-0
Lot
Subdivision PB PG Zoning Linear Feet
Current Use of Property Square Feet - Units Floors
Proposed Use of Property /Value of Work U� c? Bldg Value
Tenant Information � 00(0 Tax Assessed/Appraised Value
Flood Zone
Block
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
PERMIT APPLICATION
Master Permit No. �� o2��oZ • �QL �
Subsidiary Permit No. 2 _
Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone
Fax
Qualifier Name
Page 2
1NIPORTANT NOTICES
PERMIT APPLICATION
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:
1.
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 ection 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contr ! tor.
•
efore me thi2O • • y . f
•
'c
State of Flo da
O7nCIAL NOTARY SEAL
6 1P1Y pUeei ANGELA FA BECKER
I t> commisS7O11 NUPASCR
qp. • Q CC766697
N ° P CG:t.':alON E ( 5ES
F ®�tp �duced ET1!'efti < tifi 1s c:'�� 00
STATE OF FLO
Signature of Owner
Z,01 A / /1'I-
Print Name
Sworn to and subscribed
; l' L
if r
• Si ti
SEAL:
Notary Pu
Y OF MIAMI -DADE
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Contractor / Qualifier
Print Name
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
SEAL:
Personally known Personally known OR, Produced Identification
Type of Identification Produced: /1. G ) - Type of Identification Produced:
ELECTRICAL 1
TYPE i
QTY. TYPE
QTY. TYPE
QTY.
TYPE QTY.
Minimum Fee
.1 .vi'i:
Refrigeration, Tons
Dryer
A/C Central, Tons
Outlet, Appliance
Cooling Tower
Service Repair
Heating Strips, each
A/C Central 1 -3 Ton
Vent Hood, Cost
Fan
A/C Wall/Win. Tons
Outlet, Wall
Dryer Vents, Number of
Service, Temporary
Paint Booth
A/C Central 4 -7 Ton
Ventilation, Cost
Fire Pump
Air Handler, Tons
Outlet, Switch
Ductwork, Cost of
Signs
Piping, Flammable Liquid
A/C Central 8 -15 Ton
Periodic Inspections
Fixture - Fluorescent
Barbecue
Oven
Fire Sprinkler System
Space Heater (kw)
Process/Pressure Piping
A/C Central 16-20 Ton
Cap - Water
Fixture Light
Bath Fan - Vented, #
Parking Lot Lights
Fireplaces, Number of
Spas/Hot Tubs
Pressure Vessel
A/C Central 20+ Ton
Cap - Sewer
Flood Lights
Gas - Natural
Plugmold/Strip
Pump, Fire Stand
Subfeeds, No. of Amps
Temporary Toilet
A/C Window
Catch Basin
FPL - Load Central
Gas - Propane
Posts
Pump, Re- circulate
Swim Pool, Commercial
Temporary Water Closet
Air Conditioners
Clothes Washer
Garbage Disposal
Gas Piping
Range/Range Top
Pump, Replace - Pool
Swim Pool, Residential
Urinal
Chiller
Dental Chair
Generators, etc.
Grease Trap
Ice Maker
Indirect Wastes
Receptacles
Pump, Sprinkler
Pump, Sump
Relay Repair
Roof Inlet
Switchboards
Utility - Sewer
Utility - Water
Vacuum Pump
Water Closet
Clear Violations
Discharge Well
Heat Recovery
Dis ' osal
Refrigerator, Comm. (p/PH)
Interceptor
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Drains, Area
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Drains, Floor
Dishwasher
Low -volt, Television
Service, Number of Amps
Drains, French
MECHANICAL
'nil:
Minimum Fee
(fry.
.
Condensate Drain
Q
. i - l . i'i•:
Generator
Q . 1 -
.1 .vi'i:
Refrigeration, Tons
Q'F\
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
Cap - Water
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Cap - Sewer
PLUMBING
"nil.:
QTV TYPE
Q . Q . V ..
. i . vpi , ;
Q
T1.P,E,; QTY.
A/C Condensate
Drains, Roof
Miscellaneous Fixture
Soakage Pit
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
Ice Maker
Indirect Wastes
Pump, Sprinkler
Pump, Sump
Relay Repair
Roof Inlet
Utility - Sewer
Utility - Water
Vacuum Pump
Water Closet
Discharge Well
Dishwasher
Dis ' osal
Interceptor
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:
SECTION
BY
ATE
Zoning
,' / f
— Df
,j'o �
111
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
.
Building Official
3 --Li'_
Page 4
OFFICE USE ONLY
I I L illI,ST
® OWNER - BUILDER FORM
(Attach)
ID FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
® CONCURRENCY
(New Construction)
B OTHER
(Specify & Attach)
FPNRMIT 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
dilhA
$
LI PROOF OF OWNERSHIP
(Attach)
® HRS / DERM APPROVAL
(Septic / Sewer)
LI IMPACT FEE
(New Construction)
OTHER
(Specify & Attach)
$
$
k ISSUING OFFICIAL
( sq.ft. = x/1000
x ¢.60)
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
REVIEWED AND PREPARED BY:
PERMIT APPLICATION
CI CONDO ASSOCIATION APPROVAL
(Attach)
BPR APPROVAL (Restaurants)
LI CONTRACTOR REGISTRATION
(On File)
TOTAL $ b , D
DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL o (305) 795 -2207 o FAX (305) 756 -8972 o http : / /www.miamishoresvillage.com
DATE:
..MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
‘ .7 2olp Z
OWNER'S NAME: PHONE
ADDRESS: 2 2 (- /Ve 9 (/
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE:
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements o the site must be listed and indicate the color to be painted.
Walls V/ —
Fascia &Wu PE -41
Drip Cap/Drip Edg -
Soffit
Roof
Flower Bins
Shutters
Awnings dt! 0
Chimney r -
Doors and door jams
Garage Doors
Railings
Fences
Decorative Metal
All brick (simulated or re ular)
Stucco Banding ( -
Any other stucco features &o
Accessory Buildings Pe - 4// -
Other
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
constr ttion and zoning. I authorize the above -named contractor, if applicable, to
do the ork stated. Furthermore , the paint colors will be as per the attached
sample'
-YAW° 2-
Signat of Owner Date Signature of Contractor Date
******.**************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPR
VED:
Building Official
4Z7,_
Date
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
sy.s'G - 9
4/23/01
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 3/25/2002
Applicant: LUIS
Owner: ZARATE
Contractor
Local Phone:
Parcel # 1132060134160
Job Address: 276 NE 98 ST
Fees:
FEE2002 -1706
FEE2002 -1707
FEE2002 -1708
Permit Status: Approved
Description Amount
Building Permit Application Fe$60.00
CCF
Notary Fee
Total Fees:
Permit Expiration: 9/21/2002
Work: EXTERIOR PAINTING AS PER AGREEMENT (OWNER BUILDER PERMIT)
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
This Permit is granted to the contractor or builder named above to constrt
'jr ordinances pertaining thereto and with the understanding that the work will b
and approved by the proper municipal authorities. This Permit may be revoi
authorization. A further condition upon which this permit is granted is the un
ordinances and regulations pertaining to the work covered hereby whether s
by his agents, servants or employees.
Signed: INSPECTOR)
In consideration of the issuance to me of this permit, I agree to perform the
with the plans, drawings, statements or specifications submitted to the prop(
myself, my agent, servants or employes.
Signed: (Contra(
Building Permit
Permit Number: BP2002 -607
Address:
Cellular:
Legal Description: 1 53 41 6 53 42 .45 AC MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 3 844
ORDER T E 0-41 1 l 1 it NI L $ E ) /
CL/—(
1 :066001436?I :L30030L67L6 0728
ZARATE
LUIS
$1.80
$5.00
$66.80
Construction Value:
$3,000.00
LUIS ZARATE, M.D.
B. ADRIANA ZARATE
276 NE 98TH ST.
MIAMI SHORES, FL 33138 -2408
ci City National Bank
O F F L O R I D A
446 COLLINS AVENUE
MIAMI BEACH, FLORIDA 33139
Page 1 of 1
r)i 1/al
Total Fees: $66.80
Total Receipts: $0.00
66 13 728
13003016./16
DATE to 10
DOLLARS
8 Som. F..,..,
,w111°:
11 111
— The Sunshine State •"'"'"'"'
LICENSE MASER
Z630-061-72-607-0
BURKA ADFUANA ZARATE
. 276 NE 8EM4 STREET
MIAMI SNORES, FL 33138-2408
•
EURTI DATE SEC HOT - REST &MORSE
03-27-72 F 6.04A
ISSUED EXPIRES OUPUCATE
10-30-00 03-27-08 12-04-01
SAFE DRIVER
12040715
Operation of a motor vehicle constitutes consent to any sobriety teat required by law
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 9/7/2005
Applicant: LUIS
Owner: ZARATE
JOB ADDRESS: 276
Contractor
Local Phone:
Parcel # 1132060134160
NE 98
Building Permit
Permit Number: BP2002 -607
ZARATE
LUIS
ST
Contractor's Address:
Permit Status: APPROVED Permit Expiration: 12/31/2005 Construction Value: $3,000.00
Work: EXTERIOR PAINTING AS PER AGREEMENT (OWNER BUILDER PERMIT)
Page 1 of 1
Legal Description: 1 53 41 6 53 42 .45 AC MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 3 & 4
Fees:
FEE2002 -1706
FEE2002 -1707
FEE2002 -1708
( -12157
Description
Building Permit Application Fee
CCF
Notary Fee
(Renewal /Extension Fee
Total Fees:
Amount
$60.00
$1.80
$5.00
$60.00
$126.80
Total Fees: $126.80
Total Receipts: $126.80
Signed: (INSPECTOR)
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit 1 assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
I
a
0 /
Passed
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Permit Number: PT -12-05 -1063
Inspection Date: 01/1012006
Inspector: Grande, Claudio
Owner: BOURNE, ROBERT
Job Address: 276 98 Street NE
Project: <NONE>
Miami Shores Village, FL 33138-
Contractor: HOME OWNER
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Paint
Inspection Type: PAINTING
Work Classification: Miscellaneous
Phone Number
Parcel Number 1132060134160
Lot:
Monday, January 9, 2006
Page 1 of 2
Issue Date: 12/7/2005
Owner's Name: ROBERT BOURNE
Permit Type: Paint
Work Classification: Miscellaneous
Job Address: 276 98 Street NE
Contractor(s)
HOME OWNER
Phone Primary Contractor
Yes
Additional Information
Miami Shores Village, FL 33138-
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Expires: 12/01/2006
Type of Work: Exterior
Additional Info:
Color:
In consideration of the issuance to me of this permit, I agree to perform the work
covered hereunder in compliance with all ordinances and regulations pertaining
thereto and in strict conformity with the plans, drawings, statements or specifications
submitted to the proper authorities of Miami Shores Village. In accepting this permit I
assume responsibility for all work done by either myself, my agent, servants, or
employes. I understand that separate permits are required for ELECTRICAL,
PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING
POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work
stated.
Building Department File Copy
Applicant Signature
Parcel #:
Block:
Section:
Permit Status: APPROVED
Permit Number: PT -12 -05 -1063
Phone:
1132060134160
Lot:
PB:
Total Square Feet: 0
Total Valuation: $ 9,500.00
Required Inspections
Final
DEC 0 7 PAID
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee
Technology Fee
Total:
Amount
$6.00
$2.00
$5.00
$60.00
$1.50
$74.50
Invoice Number
PT - 12 - 05 - 1141
Total:
Amt Due
$74.50
Amt Paid
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
4
City
fri
BUILDING
PERMIT APPLICATIO
FBC 2001
Miami Shores Villa •e
Is Building Historically Designated YES
Contractor's Company Name
Contractor's Address
City State
Qualifier
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
e_L.(305 795.2204 Fax: (305) 756.8972
DEC 0
CLa jo 000
Tenant/Lessee Name Phone #
Master Permit No.
Permit Type (circle): Building Electrical
Owner's Name (Fee Simple Titleholder) & 6ocei Phone #
Owner's Address 2 / A/C 9 9f 4
�
Cit �" 1( C/i State
Plumbing Mechanical Roofing
zip 33138
Job Address (where the work is being done)
ty Miami -Dade Zip
NO
Phone #
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit
Permit No.PrO5 063
do qin. VqSI
Zip
Square Footage Of Work:
Type of Work: ['Addition ❑Alteration ['New ❑ Repair/Replace
❑Demolition
Describe Work: �� 001W
Submittal Fee $ Permit Fee $ (00 CCF $ CO /CC
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: 1 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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified dopy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
Owner or Agent
Contractor
2 The foregoing instrument was acknowledged before me this
yof ,20by
who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
_illirro
� � v A Print:
"_ ,„, , J ul Y:��,2Z 4 My Commission Expires:
d "I'l
The foregoi . instrument c
day of �/� ,
w
died befor m
who is personally known to me or who has produced
Sign:
Print:
NOTARY
My Commi ion Expires:
* * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
chc 05/13/03
Signature
****************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
o✓
Plans Examiner
Engineer
Zoning
Date '2
Owner's Name
Owner's Address
City State Zip
the work is being done) 2 7 1 `"5 9, 6
Job Address (where � O
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name (if applicable)
Phone #
********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painted
Walls
Fascia
Drip Cap /drip Edge
Soffit _ NON,
N°
Roof NI f•
Flower bins Ni
Shutters
Awnings
Chimney 1 \1 'p,
Doors and door jams
Garage doors N3/ P
Railings_ NJ/ P
Fences_ Ni ( I\
Decorative metal
Miami Shores Village
Paint Color Approval and Agr
05
"P---0 0e4 - Phone #
KI LA-
All brick (simulated regular)
Stucco banding
Any other stucco features NI 0
Accessory Buildings / 1 �"
Other 1 V) il"*-
************************************************************************************************************
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.
c/ l Date
Signatwe
Owner or Agent )
Date (.0 IC1J�
chc 6/18/03
APPLICATION APPROVED BY:
P& Z Official
D e 6 2015
2_
3
C �
= LIMI Cu lu/ r1 "T' i 4 r I�i v.1�.
a\-c ∎3\..bq= rti,a1
t- V SR 0 e S , c, ,,t=, -e-o 4-\-, s 'TZ1 r', 1/4.. orl . 'Palk- 5
Address:
DATE
Painting Critique Sheet
Applicant: 72--3 k, ru' �s ..i 2
COMMENTS
Permit # Pr(2 (1) /0 c 3
INITIALS
r qJ
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Address:
Painting Critique Sheet
Applicant: 6 cr T
DATE
COMMENTS
Permit # Prf 2 d = / 3
INITIALS
I ,S■'
3_ '
t
So
S
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1,
P
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00
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18
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20
21
22
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92 5.V. 44 STREET
MIRMI, FL. 33165
TELEPHONE: (305) 553 -1910
ALL SOUTH SURVEYORS, INC.
MO SURVEYOR
P.O. BOX 55 - 7580
SURVEY NO.9J_03_13 MIMI, FL. 33255
LOT $ 3 5 T
SUBDIVISION ,g1tADED ggra /!'Me 2 .qEC'r,ON ,4'.1
ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK NO ./0 AT PAGE N0.22
IN THE PUBLIC RECORDS OF }q,DE COUNTY. FLORIDA
CERTIFIED FOR
e'Aed,l 4 plat, A U/. / ,P/v
X74 A41F. YP7' S74
J//M/ 21 AL,F /DA
CERTIFIED 10
.:. /.
FIELD DATE: Ay(}/ 4,5 /114
RECERTIFIED: /I*
I HEREBY CERTIFY THAT THE ATTACHED
SKETCH REPRESENTS A RECENT SURVEY
MADE UNDER MY DIRECTION, AND IS TRUE
AND CORRECT TO THE BEST OF MY KN04IIEDGE
AND BELIEF THERE ARE ENCROACHMENTS.
STATE GOF •
•
FLORIDA
VALID COPIES WILL BEAR
EMBOSSED SEAL OF
ATTESTING LAND SURVE'OR
I. 7HE SURVEY HEREON REPRESENTS A PER :.'^.. -X
IOUNDARY SURVEY WITH EXISTING ABOVE
.Y.PROVEHENTS LOCATED. :10 UNDERGRO' 2 770TINCS.
ECUNDATIONS. 'V I:17 :ES OR STRUC7EIE
LOCATED. 750055 OTHERWISE NOTED.
2. 50 ENCROACHMENTS WERE NOTED BY 7HI5 FIE.ICY
UNLESS SHOWN HEREON.
% ✓%'. i
3. ANY NOTORIOUS EVIDENCE OF OCCUPAT :C:: AND/OR USE
OF THE DESCRIBED PARCEL FOR RIGHTS -G: -SAY. INGRE5S
OR EGRESS I5 SHOWN ON THIS SURVEY :SAWING.. HOWEVER.
THIS SURVEY DOES MIT PURPORT TO REFLEX' ANY RECORDED
EASEMENTS OR RIGHTS -OF -NAY OTHER THAN .710•.:1 09 THE
RECORDED PUT OR STATED IN THE :. - "GRIPTION AS
APPEARS ON 71125 DRAWING. THIS - 70E5 ::O7
CERTIFY THAT SUCH I5570171E7705 LC - - : :D : -:::CS
SHOW HEREON WERE NOT ABSTRACTED : :.:.-.._:FITS .:.VD /OR
RIGHTS -OF -WAY OF RECORD.
THIS SURVEYOR. DID :MT RESEARCH :ME '
AS REQUIRED EY THE 20:::`:0 OF THE : -:
DOES THI5 SURVEY CERTIFY THAT ANY :
:PO : :: ARE IN C0:?LIANCE t:I711
SURVEY FOR:
..LIE SE
SO PARCEL., NOR
IMPROVEMENTS
RF.C.u1ATIONS.
SURVEY :1T75
5.
6.
BLOCK
3/
5'ALL
97 Sr_
:HE NORTH ARROW AND .'.EARINGS. %•5 SHO'W':. ARE DERIVED
1501 THE ASSIT:ED ::ERID :AN ON :HE RECORDED PLI'.T11E
LEGAL DESCRIP7 :ON HEREON. :7 SAID DE::C.0[PTIO.1 I5 A
7ETE5 S BOUNDS 07 FRACTIONAL SESCRIP ^.IOU, BEARINGS
ARE DERIVED FROM COUNTY 5ECT :ON RAPS AND 50071 ON THE
LOCATION SKETCH.
C O //��77 �Jr
OM FLRIDA i•:5'. RATE ::AP F " ^C° r • I .. E] DAT
0 . :ATID ::AL r 1*7D 30 3:7'„U[ DAT
DELI NFy. A n - _c !WED E LAN 7 TP.IN
CONE _ VATION�r�'. THIS IFIDOD HAZARD LONE.
ELEVATIONS A7.0 :ABED ON : :GV 0ATUM .600 P.EUCII PARE5 ARE
Cr. 7:' 7505TY ... L'S O5 57..T:CAL REFRRENCE ::0`:01071.5.
:EC 7 7
1 STANDARDS :.0 CHAT TH:: J:
TS 'i:E RE(i1RE:!E:IT.:
:1170[]:. L5::J T.T__
LOCATION SKETCH
SCALE: 1" = / X '
74.s
A
J.(S j
S r J'
75'
CBS
gs y ; ,a Lt
0
'IpIL
$0,°./ ' ALLE 1S Y 8 F/�v v
O- GE. /N6S M ea'
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LOT DETAILS
SCALE: 1" 2''
v l SCDG .07/ L. 0 ,OD
///
�10 �PAdcD SWL7LE 7
(..0'
LOCATED IN J:'':*5k'1.
�� 1�� COUNTY, FLORIDA