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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.