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DRIVEWAYPROPERTY OWNER New Construction Name /� r / ,o p 4"" Q l 1 /✓ � L � Address �"-5 N 2 5 -7 Home Telephone 3 y- 75-7 __ 3 i . 2 7 3 Business Telephor Demolish , G Z .2 6, 3 2_ ( 3 Fax J 5 75—Li , / 2—_ 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 Till :III 111 I 1111 1111 1111111111111111116 lJ1. i 1.1 i INSTRUCTIONS - The [following steps must be taken to obtain al p erm i t from the r 1iami lShores Tillage: Step 1. 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 I II I ill /i4 City Folio Number ii 3Q-0 Co 0 ! a escription of Work I N 3 1' '- f e%li I :-,1 ,4-c/. 2 S Lot Block ) I' 1 `i Rc;, .a444. L/ft. V- 4 ,i 61/,4 ✓ Subdivision PB PG Zoning_ Linear Feet Current Use of Property a Square Feet Units Floors Proposed Use of Property 1 '� Value of Work /"7-7 s Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. Job Address: PERMIT TYPE ( ✓ Building Electrical Mechanical Plumbing LPGX Roofing Fence Other ARCHITECT Name License No. Address Telephone F 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. e,20 Address Apt. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection Master Permit No. Subsidiary Permit No. _ c: • c) y ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name State PERMIT APPLICATION Zip Page 2 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 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 13E 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. A FFI DAVIT - 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 I F FLO .JE7c !z/ ( (14( Print Name SEAL: Notary Pu ic- State.fForida SPR PO4 ANGELA t9! ,• ' Q C0786691 714, U'f CaVifiadiOk EXPIRES Personally kno F P� • .a" d a 20112ifi c Type of Identification Produce :1 —_— F MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE day ofc Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: PERMIT APPLICATION Personally known OR, Produced Identification Type of Identification Produced: ELECTRICAL TYPE Minimum Fee tin'. I i 1 PI Dryer Q'I I III Ty IT Outlet, Appliance ()TV. TYPE Service Repair QTY. A/C Central 1 -3 Ton Drinking Fountain Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Pool Piping Fire Pump Sprinkler Repair Outlet, Switch Cap - Fixture Signs Fountain A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) Pump, Domestic A/C Central 16-20 Ton Supply, AC Well Fixture Light Cap - Sewer Parking Lot Lights Gas - Natural Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Pump, Re- circulate Subfeeds, No. of Amps Temporary Water Closet A/C Window Clothes Washer FPL - Load Central Gas Piping Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Pump, Sprinkler Range/Range Top Utility - Sewer Swim Pool, Residential Discharge Well Chiller Ice Maker Generators, etc. Receptacles Switchboards Clear Violations Relay Repair Beat Recovery Vacuum Pump Refrigerator, Comm. (p/PH) Disposal Temp Serv., Construction Interceptor Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Septic Connection Deep Freezer Water heater Low -volt, Fire Drainfield, 4" Tile/Res. Renew - Temp Service Lavatory Septic Tank Demolition Low -volt, Intercom/Teleph. Repair Circuits Sewer Connection Water Re -pipe Dishwasher Drains, Floor Low -volt, Television Minimum Fee Service, Number of Amps Water Service MECHANICAL Tl'PI: ( 1 ' t r 1 I Fl 1 I Q'I'Y. TYPE QTY. Y. TYPE. i QTY 'TYPE QTY. Minimum Fee QIh PYPI'. Miscellaneous Fixture Condensate Drain TYPE Soakage Pit Generator Bath Tub Refrigeration, Tons Drinking Fountain A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost Pool Piping A/C Wall/Win. Tons Sprinkler Repair Dryer Vents, Number of Cap - Fixture Paint Booth Fountain Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Pump, Domestic Periodic Inspections Supply, AC Well Barbecue Cap - Sewer Fire Sprinkler System Gas - Natural Process/Pressure Piping Temporary Toilet Bath Fan - Vented, # Fireplaces, Number of Pump, Re- circulate Pressure Vessel Temporary Water Closet Clothes Washer PLUMBING TYPE 1 , A/C Condensate QTl' �I YPE I Drains, Roof QIh PYPI'. Miscellaneous Fixture Q "ICY. 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 VI II 6 1 1:11111 I 11 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¢. f�( :, Zoning Electrical Mechanical Plumbing Fire Public Works Structural �� Z °(2 Building Official Building Page 4 OFFICE USE ONLY CHECKLIST O OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $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 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ 0 don $ 1, y O ( sq.ft. = x/1000 x ¢.60) $ (¢.005 /sq.ft.) $ Lo cD REVIEWED AND PREPARED BY: (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ 46,3 c9 DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2"° AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305 - 795 -2204 Printed: 1/28/2002 Applicant: ANNE Owner: WRIGHT Contractor Address: Local Phone: Cellular: Building Permit Permit Number: BP2002 -164 WRIGHT ANNE Page 1 of 1 Parcel # 1132060142480 Legal Description: 5 -6 53 42 MIAMI SHORES SEC 3 PB 10 -37 LOT 15 & E1/2 OF LOT 14 BLK 72 LOT Job Address: 825 NE 98 ST Fees: Description Amount FEE2002 -491 Buildier's Bond $300.00 FEE2002 -492 Building Permit Application Fe$60.00 FEE2002 -493 CCF $1.80 FEE2002 -494 Notary Fee $5.00 Total Fees: $366.80 Permit Status: Approved Permit Expiration: 7/27/2002 Construction Value: $1,800.00 Work: INSTALL BRICK PAVERS IN CIRCULAR DRIVEWAY (OWNER BUILDER PERMIT) If there is no permit packag fee is $50.00, which must be I This Permit is granted to the contrac ordinances pertaining thereto and with and approved by the proper municipal , authorization. A further condition upon ordinances and regulations pertaining t by his agents, servants or employees. Signed: In consideration of the issuance to rr with the plans, drawings, statements o myself, my agent, servants or employe Signed: d BOB'S SURFACE COVERINGS 754 -2632 825 N.E. 98 ST. MIAMI SHORES, FL 33138 PAY ORDER THE P 3� 6• ORDER OF � �•`'`• t i >�'�'f / i1�= ��Gr.✓�4 — �� l -Sls� f s Miami Firefighters Federal Credit Union Phonc (305)324 -4(8)4 11 I 1 N.W. 7th St., Miami, FL 33136 tioLf rw4e( &i Memo 11. 00 3 3 6 211' 1: 2 6 6080 3 7 21:90 L000 Total Fees: $366.80 Total Receipts: $0.00 000 700 311' 63- 8037/2660 / f oz 3362 DOLLARS 8 nr STATE OF FLORIDA) COUNTY OF DADE) The undersigned Affiant, attached survey, performed by Witness(sign and print) • e S OJ J/ e J im caInce.o AFFIDAVIT '--` J %' ' y fl ' does hereby attest that the: (property owne (name of surveyor's company) performed on ? t i / , is an accurate repre of the existing conditions and (dalte o survey) 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 agrees to remove or obtain permits for any structures which now may exist on the 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. Affiant/Property owner Witness(sign and print) SWORN TO AND SUBSCRIBED before me this c day of J SRN 2 — Affiant is personally known to me, produced p. � � , , • as identification. OFFICIAL NOTARY 0 l PAY P !r ANGELA NI BECKER � r. � COe NUMBER CC786 commisstoN EXPIRES r�� NOV. 15 FLOOD ZONE: X • " /2' // ■ Not valid unless embossed with Surveyor's Seal. /(2/�/ , f�� This property described as: Lot 15 and the East. '_ of Lot 14, Block 72, MIAMI SHORES SECTION NO. 3, according to the Plat thereof, as recorded in Plat Book 10, Page 37 of the Public Records of Dade County, Florida. Note.: Underground encroachment and utilities, if any, not located. CertifiedTo: Atlantic Coast 'Title, Home Savings of America, F.A. and Wright, Robert and Walsh, Anne, Marty Patrick, P.A. and Attorney's Title Insurance Fund, Inc.. A BOUNDARY SURVEY' I hereby certify that the survey repre- sented hereon meets the minimum technical standards set forth by the Board of Land Surveyors pursuant to Section 472:)27, Fla. Statutes. There are no encro ments, overlaps, easements appea ng on the Plat, other than as shp n hereto. 7 . Fla. Reg. Land Syrveyor No. l il • • • • • • • • • • • 0 - ` J O O • • • • • • ' J J 'T ^;r . fi r PROPERTY OF: Wright, Robert & Walsh, Anne, O • • • • • • • • • • • • • • • • • • • • • 0 • • • • • • • • • • • • • • • • • • • • DATE • • ••• • • • • • • • •, • •• • • • • O •• • ••• • • • • • • • • • • • •• • • • • • • • • • • • • • • • • ••• • • ••• i ••• • • SCALE 825 N.E. 98th Street, Miami Shores F1.oAr i 111 . ES and GARCIA, INC. ENGINEERS - LAND SURVEYORS - LAND PLANNERS Office address: 4080 S.W. 84th Avenue, Miami, Florida 33155 Mailing address: P.O. Boy. 561131, Miami, Florida 33156 DRAWN BY 0 w DRWG. NO 189 -6263 _ :�.►� —r : • FLORIDA uEvgl 111• ■uratihnte' `.f.th' ' T1 0EEAT DA'JIL WRIGHT 825 NE 98 ST MIAMI SW S FL -3 -3138 -0000 0 -08 -48 H 5-10 E 11 1 4 19‘) We12)-76 v 10 0E -14:' , :LASS. D Ot 199.1 7 0394050: MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date / Time Re- Insp'n Fee L� Type Insp'n Permit No. 8 r2.m Name g Address_•_ _g_g /!/ [ 9 A D Company 1Lh } T) Phone # 3a1 --7` k 7 Y For Inspector: l 3 /- U Name & D Approved I Correction C� Date Type Insp'n Permit No. Name A ress Compan Phone # For Inspe Approve Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 -795 -2204 Building Inspection Request Date Time Type Insp'n ��,F. Permit No. 1 ' aLi(9 p / 6, Name 2I Address j A -, ff Company C � "_� Phone # (��<� • o3 2 For Inspector: / 1 Correction ❑ Re- Insp'n Fee ❑ Name & Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 fig - r " 4 Registered Architect and/or Engineer 44 4,/ Z 4 S 72/c___ V/ 121 L (� , / L Name and address of licensed contractor / e A i S 7 /Z. � if., G '5 - 6 - — t 6 /�i9 //� al _ (1 3a /5 -7 S � Location and description of lot be built on: � / '` g 3 n0 , � � r' A- t� Lot t i � i i t Block d� Subdivision _ G Street and Number where wor to be one Z.% e"S'. / State work to be done and purpose of building (by floors). state exterior colors (submit. samples) j/v �-A 1 - z- //7.-- � N �q U d Ai Ir lie 0/ f DOD --, Ari L ",koe-k 4 /' igs / )4/i .-.; _ 5 /5i7,, •l/ 5;'7)c- li- Sr r t kot r Fr b ii}6 1 Repairs No of Stories Kind of foundation Ad e- k Roof Covering Estimated Total cost of improvements $ ! O a Amount of Permit $ ✓ / C N 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 plans and specifications for said building. All notices with reference to the building and its construction may be sent to New Building To be constructed of STATE OF FLORIDA COUNTY OF DADE. ss. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Remodeling Addition / Date Fig lid_ 81 ��" No Street et The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons as an employer- of Labor under the Florida Workmen's Compensation Act, being Section 5966. Compiled General Laws of Florida. Permanent Supplement, and has complied with the provi ions thereof. and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit: a fl will posyor cause to be posy for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned ages 9f employ o y such sup4contractors, on wo to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) /oz Before me. the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments. personally appeared to me web 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 foreg ing 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. Disapproved \ b Date (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials andior workmanship. Notary Public, State of Florida