DRIVEWAYDat
Type Insp'n
Permit No.
Name
Address
Company
Phone #
.. >. ..• L Am
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
as P
For Inspector) / ) /
1 J
a Time
Contractor ARTISTIC CONCRETE
Local Phone: 305 - 888 -9500
Parcel# 1132060340090
Miami Shores Village
10050 NE 2nd Avenue
(`\ Phone: 305 - 795 -2204
Printed: 11 /15/2002
Applicant: Ret Tom' 5 ot
Owner: `MV R�TIN fip re_cm ►\.
Z ADDRESS: 803 NE 99
Signed:
Signed:
Building Permit
Permit Number: BP2002 -1959
MAR -TAN } ore
H YScot,
ST
Contractor's Address: 8720 NW 93 ST
Permit Status: Approved Permit Expiration: 5/13/2003 Construction Value: $3,200.00
Work: DRIVEWAY
Page 1 of 1
Legal Description: MIAMI SHORES SEC 8 PB 14 -33 LOT 12 & W1/2 OF LOT 13
Fees:
FEE2002 -6464
FEE2002 -6465
FEE2002 -6466
Description
Buildier's Bond
Building Permit Application Fee
CCF
Total Fees:
Amount
$300.00
$60.00
$2.40
$362.40
Total Fees: $362.40
Total Receipts: $0.00
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
ordinances pertaining thereto and with the
and approved by the proper municipal aut
authorization. A further condition upon wi
ordinances and regulations pertaining to ti
by his agents, servants or employees.
In consideration of the issuance to me I
with the plans, drawings, statements or s;
myself, my agent, servants or employes..
A
PAY
TO THE
ORDER OF
OCEAN BANK 1
760 N W 42ND AVE.
MIAMI, FLORIDA 33126
FOR
U Seeu ri t y enhanced doruntent.See bark for detai Is E+ t`"" -
ARTISTIC CONCRETE OF FLORIDA, INC.
PERMIT ACCOUNT - BROWARD OFFICE
7921 N.W. SOUTH RIVER DRIVE, SUITE 107
MEDLEY, FL 33166
s s vi d9fc
DATE <l Ap 0 c)
BLK 169
Z.
4619
63- 1139/660
01
DOLLARS '
3 5
//
‘sel.
oi5'
cL
o
/Z Q .00 4 SPNACT RA!/E/I WT
Mgt
72 "(i
p• 5 c
Asphalt, concrete, brick pavers
[ ] Landscaping
(J Other
within the public road right of way of � 9l 6
SIGNED, SEALED AND DELIVERED in the presence of:
7/7/iami SIiorei
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 -2382
Telephone: (305) 795 -2207
Fax: (305)_756 -8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, %-
following described property:
Legal description/folio #: 1/- 3204, - O,. c./ ^ oe,90
Lot 1 t(1o7/3 Block /4 9 Subdivision, '$1�/ 54,..6
Tax Folio #: / Q
requests permis n to install:
, hereinafter referred to as the Owner of the
SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this day o
owner)
(address)
IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows:
1. 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 representative).
s P
APPRolicti
` ti`'yip Thomas Fitzgerald
i '_Commis sion # DD161337 eg Expires ott 28. 2006
Vale Atlantic Bonding Co, inc,
cor ei63r
ame /)
License No.
J
(�
✓ / 6
Address
/CD 99 �w "Q
A 33i
Telephone
y p` l e r Fax all) ¥3a
Qualifier Nam
1.. k oD e f 4 u��_
PROPERTY OWNER
Name F,,k`
Address
f per 995/
/' /viii flW e' GL 331 38
Home Telephone wo Z _ 4Otio , f
Business Telephone 7 73 95"e2
7
Fax
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. 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.
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 �� ��)) 57.- , u,�
Job Address: / O3 /(-) 7/ �/4m� �r
Address Apt. City State
Folio Number /1' 32iC , - 034 - 096
Lot /a. f t.J o 13 Block He
Subdivision SELF PB /y PG 33
Current Use of Property / .
Proposed Use of Property "
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No.
Subsidiary Permit No
PERMIT APPLICATION
3 & 3 P
Zip
`"Description of Work
Linear Feet
Units Floors
Zoning
Square Feet ,57)lJ
"'Tar; of Work 7 '3 2.00 Bldg Value
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
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.
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.
STATE OF FL RID COUNTY OF MIAMI -DADE
ature of Owner
Print Name �j
Sworn to and subscribed before me this ec day of ,f,.130
Signature of Notary
SEAL:
Personally known
blic - ,3tpR°°tphomas Fitzgerald
a ° mA . Commission # DD161337
. % Expires Oct 28. 2006
tm. 44„ Atlantc Boding Q gne3
OR, Produced Identification
Type of Identification Produced:
OF ii ' ID ; , ' : NTY OF MIAMI -DADE
Signature of Contractor / Qualifier
eAOL 2 16U
Print Name
Sworn to and subscribed before me this day of /J()l!
Signature of Notary Public :,� o , ,Fl�i�mas Fitzgerald
G : Commission # DD161337
SEAL: S'S o Q= Expires Oct 28, 2006
°° p � az - z Bonded Timm
a ,AW Atlantic Bonding Co„ ft,
PERMIT APPLICATION
Personally known OR, Produced Identification
Type of Identification Produced:
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
T1'PE
Service Repair
QT Y.
A/C Central 1 -3 Ton
Fan
Cooling Tower
Outlet, Wall
Service, Temporary
A/C Central 4 -7 Ton
'
Fire Pump
Dryer Vents, Number of
Outlet, Switch
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Ductwork, Cost of
Oven
Space Heater (kw)
A/C Central 16 -20 Ton
Fixture Light
Fire Sprinkler System
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Fireplaces, Number of
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.
QTY.
TYPE
Condensate Drain
QTY. TYPE
Generator
QTY.
TYPE
Refrigeration, Tons
QTY.
A/C Central, Tons
Drinking Fountain
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
'
Filter Replace
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Fountain
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Gas - Appliance
Fire Sprinkler System
Process/Pressure Piping
Supply, AC Well
Bath Fan - Vented, #
Gas - Natural
Fireplaces, Number of
- Pressure Vessel
-
- --
PLUMBING
TY PE
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:
SECTION
BY
D TE
/ / /,?/ea
Zoning
L-- /--.'
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
j /
Page 4
OFFICE USE ONLY
CHECKLIST ,
CI OWNER - BUILDER FORM
(Attach)
LI FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
(� CONCURRENCY
(New Construction)
B OTHER
(Specify & Attach)
CI PROOF OF OWNERSHIP
(Attach)
HRS / DERM APPROVAL
(Septic / Sewer)
CI IMPACT FEE
(New Construction)
CI 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
(x s . 6. x/1000
(¢.005 /sq.ft.)
(¢.01 / sq.ft.)
PERMIT APPLICATION
® CONDO ASSOCIATION APPROVAL
(Attach)
BPR APPROVAL (Restaurants)
CI CONTRACTOR REGISTRATION
(On File)
TOTAL $ b , �l
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: 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
Disapproved __
( Signed)
Member
Council Approved
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approyal of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
� J � � t`
Date__ 4,6 ' ! , 19�Dr
Owrigr's Name and Address y . 1. U �-- _.1 ---- - -- - -- - -- N556� ----- -- ---- - -- Street._11J t__ 1
Revered Architect and /or Engineer..
Name and address of licensed contractor_.__ - N 'L.__ - __.
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors). _I9 `,y �rt 5 �p
----- - - - - -- - • and for no other purpose.`
New Building Remodeling Addition Repairs No. of Stories
� To be constructed of UL Kind of foundation__ it- Roof Covering
Estimated Total cost of improvements $ ZQl! Amount of Permit $
\
Zone cubage required Flan Cubage____ ..
Distance to next nearest building.._.___ . _ Size of Building Lot
Maximum live load to be borne by each floor___
I hereby submit all the plans and specifications foi said building. All notices with reference to the building and its construction may
be sent to__-
The undersigned applicant for this building permit dot hereby certify that he understands and accepts'his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Sec :ion 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted f r inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such kl t ntracto , on ` t' . - performed under this
permit, as are licensed by Miami Shores Village.
Remarks
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
- - to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No._ _�f S _ Date__
(Signed)
Read, Sworn to and Subscribed before me.
Notary
Member
Date Disapproved
PLANN ! BOARD __ . DATE
Chainnan -. Member
Member Member
Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
N
1
'1
f" •
L- €- - t
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner's Name and Address
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Registered Architect and /or Engineer
Name and address of licensed contactor wiliKD R ; ,,De WU IX 5t)N
Location and legal description of lot to be built on:
Lot Block Subdivision (�p�
Street and Number where work is to be done '2b IV _ ..11�' __ _..._.. _ __,....._
State work to be done and purpose of building (by floors) ... 1 - cM-1-- — TWO S-t.'I : ...8.P - _..._
�IULy zro
No g street_.Ot 9.9 9r
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ / t �7/ Amount of Permit S. .6r 0Q
Zone cubage required plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Vorkinen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public o ice
or notices as arc required by the Act. The undersigned agrees to employ only such su ntraykors, on worn �o _ . •_,. ormed u
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No.._..__ Date // --- ...._._._ Read, Sworn to and Subscribed before me.
1 / Disapproved _.. i . Date.. _p..
(Signed) -
Building Inspector
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chairman Member
\fernber Member
Member ....... _....__..._._ .._._ Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning hoard.
A re- inspcction fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.