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857 NE 98 St (8)Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reque Type Insp' Permit No. () N ) Time Name Address 2'S '2 r Y) Company -1S 1S . 3 ( (co.( ) Phone # For Inspector: V L / Name & oat 9qp MIAMI SHORES VILLAGE . BUILDING DEPARTME 305- 795 -2204 Building Inspection Reque Date Type Insp'n e Permit No. Name .4_ Address gS 7 Company Phone # For Inspector: Approved 1 Correction Re- Insp'n Fee 03 Name & Date 'II: I l' '1 11' 1' 1 1' I Page 2 STA OE FLORR/ A, i e .f • caner SEAL: C u D� Print Name Swo t nd subscribed before me this 1 U TY OF MIAMI -DADE 61 kf VV • •• •• • • • •• •• • • • • • • • • ••• • • • • • • • • • • • • • • •••• • ••••••• • IMPORTANT NOTICES DO NOT BEGIN ANY WORK WITHOUt 1- IIVINtr REC I'4ED POUR tAIJDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION atttifhited 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 PROPERTItt6HA1.1. Pet EB7 E CRa t.DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BANG 13 OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk.• • • • • • • o • • • 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 cadrefully. 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. day of STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of PERMIT APPLICATION Signature. Notary ' blic Sta ll te of Florida Signature of Notary Public - State of Florida OFFlCIALNOTARYSEAL T or' P 6' GLADYS J VILLAR 1 '` ' CI A. COMMISSION NUMBER yl1' O 0D091094 9 l "� c� MY COMMISSION EXPIRES Personally known vnta P k r IdentMftati4u2006 1 Personally known OR, Produced Identification Type of Identification Produced: PL coo 1 13 / J °' b 22 - Type of Identification Produced: SEAL: PROPERTY OWNER �/ Nam S( l.�l�t y'W(G L1 FYI 1 m t aw4 i Sk uses 1 A 3 � 18 4 9 . Home Telephone x (30) " — 6 4 Business Telephone y (3) — t? /_ !! 1 I �, g / X _I l 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 1NSTRUCI'IONS - The following steps must be taken to obtain a permit from the Nliami Shores Village: Step 1. Complete the attached permit application which must be sig h bf tle pr8gien tyvn:f Ihddfdlifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of you? apontidp. NPfin: cork dill 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. A PPLICITION Job Addres PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other v City State Folio Number Description of Work j CTAAA7V Lot Block Subdivision PB PG Zoning Linear Feet Current Use of Property S�quar Feet Units Floors Proposed Use of Property Km of Work 10 003 , Z !L Bldg Value Tenant Information PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax • • • • • • • •.• • • • • • • • ... • • • • ..•. • • • • .... Tax Assessed/Appraised Value ... Maste; Pfimit.N4 • S�tibs'idiav Berrn.t No. • • • • • •. •••• • • .•• • • PERMIT APPLICATION Zip Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name ELECTRICAL T1'1'F. 1 Minimum Fee QTY. 'rvi'I'. 1 l Dryer Q FY. • '''''''I'. ^ u' e Asp iaoc• • Ivry. 1 TYPE Service Repair QTY. A/C Central 1 -3 Ton Miscellaneous Fixture Fan " Outlet, Wail • Dryer Vents, Number of Service, Temporary Drinking Fountain A/C Central 4 -7 Ton Miscellaneous Repairs Fire Pump Ductwork, Cost of Outlet, Switch Bidet Signs Filter Replace A/C Central 8 -15 Ton Fire Sprinkler System Fixture - Fluorescent Sprinkler Repair Oven Cap - Fixture Space Heater (kw) Fireplaces, Number of A/C Central 16-20 Ton Pump and Abandon Fixture Light Sprinkler System Parking Lot Lights Cap - Water Spas/Hot Tubs Gas - Appliance A/C Central 20+ Ton Pump, Domestic Flood Lights Supply, AC Well Plugmold/Strip Cap - Sewer Subfeeds, No. of Amps Gas - Natural A/C Window Pump, Fire Stand FPL - Load Central Temporary Toilet Posts Catch Basin Swim Pool, Commercial Gas - Propane Air Conditioners Pump, Re- circulate Garbage Disposal Temporary Water Closet Range/Range Top Clothes Washer Swim Pool, Residential Gas Piping Chiller Pump, Replace - Pool Generators, etc. Urinal Receptacles Dental Chair Switchboards Grease Trap Clear Violations Pump, Sprinkler Heat Recovery Utility - Sewer Refrigerator, Comm. (p/PH) Discharge Well Temp Serv., Construction Ice Maker Compactor Pump, Sump Low -volt, Burglar Utility - Water Refrigerator, Domestic Dishwasher Temp for Test - 30 days Indirect Wastes Deep Freezer Relay Repair Low -volt, Fire Vacuum Pump Renew - Temp Service Disposal Interceptor Demolition Roof Inlet Low -volt, Intercom/Teleph. Water Closet Repair Circuits Domestic Well Laundry Tray Dishwasher Septic Connection Low -volt, Television Water Heater Service, Number of Amps Drainfield, 4" Tile/Res. Lavatory MECHANICAL! Tl'PI', Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator Qin '. TYPE Refrigeration, Tons Q'I'Y. A/C Central, Tons Cooling Tower Heating Strips, each Miscellaneous Fixture Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Drinking Fountain Ventilation, Cost Miscellaneous Repairs Air Handler, Tons Ductwork, Cost of = Piping, Flammable Liquid Bidet Periodic Inspections Filter Replace Barbecue Fire Sprinkler System Process/Pressure Piping Sprinkler Repair Cap - Fixture Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Pump and Abandon Sprinkler System PLUMBING ! 'Fyn QTY. I TYPE I QT''. rv QTY. TYPE. (YT 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 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 11I III I GI1II 611 1 I !'. Page 3 • • • • • • • ••• • • • • • • • • • • ••••••• • • • • • • ••• ••• • •• •• • • • • •• • • • • • PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being gn* qu4tttyiie5) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY D TE Zoning . 3 /.3791 Electrical Mechanical Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) O OTHER (Specify & Attach) • • • • • •.• • •.• • • • • • • • • • • • • • ••••••• • ••• • • • • • C11ECKL1 ❑ OWNER - BUILDER FORM t] PROOF OWARSHIP (Attach) .. • •• -• •• • • • • • • •, .' 0 'I2.RS./:DER14 PYbvAL ' • • • •:(leptc'/4wer; 9 .. ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERNI1 1' 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 ( s .ftt. = x/1000 (¢.005 / sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) O BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ CJ ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2 14) AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/18/2003 Pay to the Or l er of 1 A mat A _ROACH_ Owner: Id •- RtCARBO JOB ADDRESS: 857 ) NE 98 ST Applican Contractor Local Phone: Parcel # 1132060142500 • Permit Status: APPROVED Permit Expiration: Work: EXTERIOR PAINTING AS PER AGREEMENT CINDY M. KIM 100447 H H ARBOR O TE BAY Memo 1 :25407 Date Building Permit Permit Number: BP2003 -431 Contractor's Address: . _..LLl , /10 / I ' I JUSTICE FEDERAL FC U CREDIT UNION www.11cu.org 3i 1100553630 .4/id — m at Page 1 of 1 Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOTS 18 & 19 BLK 72 LOT SIZE Fees: Description Amount FEE2003 -1579 Building Permit Application Fee $60.00 FEE2003 -1580 CCF $0.60 Total Fees: $60.60 Total Fees: $60.60 Total Receipts: $0.00 9/13/2003 Construction Value: 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 adva 15-7441/2 $6Ok 264 Ion. $1,000.00 equipment or device described in the application herefor in strict compliance with all th any plans, drawings, statements or specifications that may have been submitted to of done in compliance with such ordinances or if the plans are changed without r or builder named above assumes the responsibility for a thorough knowledge of the or in the statements or specifications and that he assumes responsibility for work done BY: mpliance with all ordinances and regulations pertaining thereto and in strict conformity illage. In accepting this permit I assume responisibility for all work done by either MIAMI SHORES VILL,AGE Paint Color Approvai;and , • • •••••• •••• DATE: �j / i J f o5 OWNER'S NAME: y C,l ndy Yt O Y .� ' .' � 0 (30 s--) 7 �� a s43 ADDRESS: XX X57 IU 0 qE l� 1 ********************* * * ** * * * * * * * * * * ** * * * * * * * * * * * * * ** * * * * * * * * * * ** ADDRESS OF SITE: sa -e ' Gl- (,l °t?ij) ' •• :••-.••• CONTRACTOR & LICENSE (if applicable) • •• •• •: COMPANY NAME: • • • • f'IfONE: * ******************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted.. Walls W., Fascia .1---a. e. n Drip Cap/Drip Edge - !X I ' a_ 1 ) o r . 0 Soffit k ( 11(/n i1 �- Roof tiu 4 t"i-e-- Flower Bins 0 la Shutters lip /a yip Doors and door jams Kt I i VYl pl c Garage Doors K t (IVY) &( Railings Y1 /61 LUAU Fences 1 A Decorative Metal VI, 1 G1 t /l' All brick (simulated or regular) i / Stucco Banding OM Any other stucco features Accessory'Buildings VJ � m Other G' k'Etoo1`-er5 �irs r0 C kjuLJA tje h e(ve5 - 1 : i' 91 1 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. I authorize the above -named contractor, if applicable, to do the work stated. Furthermore , the paint colors will be as per the attached Awnings Chimney to1/49( SW 6106 Kilim Beige Signature of wner Date Signature of Contractor Date * * * * * * * * ** ************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: Building Official Date WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 SW 6108 Latte By( j b1 Avya 4 $(i /)12 Owner VILLAGE OF:MY M' I(Sp S . . ..... • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • BUILDING DEPARTMENT OWNER BUILDER DISCLOSURE STATEMENT .... . .. ... .. • I L -1 Myytivt being the legal property owner, for the property Located o f q stY,uU V la 1 Ski l e`'S 3 13 Legally described as Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S. 489.103(7),,gnd I have read and understand the following disclosure Statement, which entitles me to fork as my own contractor, I further understand that I as the owner must appear in person to complete all applications. DISCLOSURE STATEMENT State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one- family or two- family residence or a farm out - building. You may also build or improve a commercial building at a cost of $25,000.00 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is completed, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A. and with- holding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes and zoning regulations. Proof of ownership provided ( ) initial of reviewing clerk. The foregoing instrument Was acknowledged before me this / day of V4,L, 4' , 20 who is personally known to me or who has Produced . A / S1/20 - //3 - /2 `I, z, ' as identification and who did take an oath. • ••• • • • ••• • • • •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • ••• • • • • • •• N0 P OFFICIAL NOTARY SEAL GLADYS J VILLAR COMMISSION NUMBER � DD091094 F` ps i• U Y COMMISSION EXPIRES MAR. 1 OWNER'S AFFIDAVIT: be do a S Date • Notary as to Owner a My Commission Expire APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date i 'N-'1"1 Job Address gg1 a 19 S Legal Description / Lessee / Tenant `RAVI LI I V1 Owner's Address 657 +O6 0IQ) SI Lez_111 Contracting Co. Address Qualifier SS# - State # Municipal # Competency # ngineer fCGW1U E . 6Cati\ Bonding Company Mortgagor Address ‘,7k-4 ,:_AQ„1 nature of orize 0-Pre - - -, -_ ,\p,RY P4, OFFICIAL NOTARY SEAL . W DAVIS ,j ,..COMMISSION NUMBER Q CC255237 ** * * * !t✓,c „ 4 0 MY 4OMMISS$N EXP. y_ OF F'. 114 251 FEES: PERMIT l l If ,, .._ _ RADON � U �. C.C.F. - r Tax Folio Master Permit # 37102/ Phone 7 ( .- R79 Co Phone Ins.Co. Addressl N &� Address Permit Type(circle one): UILDING) ELECTRICAL PLUMBING MECHANIC iI'FING PAVING FENCE SIGN W • ' K DESCR I PT I O =- P.(47.16 C.oi,r. RCLH' Po.+In e- 4 Square Pt. Estimated Cost(value) 14C/00. S Lo �a WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). 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, ROOPING and MECHANICAL WORK. rtify that all the foregoing information is accurate and that all work will h all applicable laws regulating construction and zoning. Furthermore, I contractor to do the work stated. President Zoning Buildin Mechanical Plumbing Signature of Contractor or Owner- Builder Date: Notary as to Contractor or Owner- Builder My Commission Expires: * * * .�° * * * * ** NOTARY ;L TOTAL DUE r Fire Other 11 - Electrical Engineering 44elzAkTivl Ikaa:4"4 W A-t\- A 3 --AA) e-A-1\-- \ MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed state;...enc ur the plans and specifications herewith submitted for the build • ine or other structure herein described. This application Is made in compliance and conformity with the Building Ordinance of Miaml Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miaml Shores Village and all rules and regulations of the i.luileling Division of Minini Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications nsust be kept at building during pr grew of the work. , 19. Owner's Name and Address .®'. - RS 1 ._.' l : _ . . . . . . ._._ No.. StreetJI t S • Registered Architect and /or Engineer ,.....,,,,.<,.... Name and address of licensed contractor �wsr 2/1 Location and legal description of lot to be built on: Lot ( a Iilock Subdivision. Street and Number where work is to be done 5 02. qb .Lbez7=i State work to be done and purpose of building (by floors) New Building Remodeling Addition Repairs (Signed) Amount of Permit $- The undersigned applicant for this building permit does hereby certify that he understands and accep of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws and has complied ss ith the provisions thereof, and will require similar compliance from all ntractors in the work to be performed under this permit; and will post or cause to be posted for ins a tion or notices as are required by the Act. The undersigned agrees to employ only such subco tr¢cto pcnnit, as are licensed by Miami Shores Village. Remarks (Signed) peared and for no other purpose. No. of Stories To be constructed of Kind of foundation Roof Covering Qcreo . e.� Estimated Total cost of improvements $ 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.. 1 Notary Public, State of Florida Building Inspector My Commission Expires........_ his obligations as an employer orida, Permanent Snp Clement, contractors employed by him of the work such public notice o be performed under this 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- 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 fads therein by him stated arc true. . 11 Permit No.. 99k Date....tl1 ©. X. Read, Sworn to and Subscribed before me. 4 Disapproved W _. Date. PLANNING BOARD DATE Chairman Member Member Member Member .. .. _.....__....._..._._ ...._ Member Council Approved Date Disapproved ...................Date NOTE: A charge of $l.00 will be made for making corrections or changes to this application after apprmal has been obtained tarn the Plannir.;; llu.vd. A rc•in.pectiun fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anti /or workmanship.