DRIVEWAYDate
Type Insp'n
Permit No.
Name
Address mil/
Company
Phone #
For Ihspector:;
Approved 1
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Ti
an
z17
Phone: 305 - 795 -2204
,�'Printed:12/23 /2002
Applicant: JOHN
Owner: MCCAUGHAN
JOB ADDRESS: 860 NE 99
Contractor
Local Phone:
N Parcel # 1132060142421
(4
illEant7 Village
row NE 2nd Avenue
Permit Status:
Work:
JOHN B. MC 'PATRICIA L. C MALLOY OR
305.. 758 -17
S M�I , FL CT. 37
Fees:
FEE2002 -7365
FEE2002 -7366
FEE2002 -7367
FEE2002 -7368
Description
Building Permit Application Fee
CCF
Notary Fee
Buildier's Bond
Total Fees:
Amount
$60.00
$0.60
$5.00
$300.00
$365.60
Total Fees: $365.60
Total Receipts: $0.00
Permit Expiration: 6/21/2003 Construction Value: $1,000.00
PATIO 20/30' BACK OF HOUSE & WALKWAY 3 FOOT SIDE 4 :Dr ' t 'l YJet
erify, there kvill be no inspections. Re- inspection
ection.
Approved
If there is no permit package accessible on the ioh
fee is $50.00 w isb
p�:063 771: '0034
Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOT 6 & W1/2 OF LOT 5 BLK 72 LOT SIZE
1569
63- 27/
DATE (2, ��� o
Building Permit
Permit Number: BP2002 -2209
MCCAUGHAN
JOHN
ST
Contractor's Address:
DoLLA15 8 e,.
1
BY:
BY:
Page
1 of 1
I the equipment or device described in the application herefor in strict compliance with all
e with any plans, drawings, statements or specifications that may have been submitted to
is not done in compliance with such ordinances or if the plans are changed without
ctor or builder named above assumes the responsibility for a thorough knowledge of the
ngs or in the statements or specifications and that he assumes responsibility for work done
compliance with all ordinances and regulations pertaining thereto and in strict conformity
s Village. In accepting this permit I assume responisibility for all work done by either
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•••.••• ••• • • •••
• • . AFFIDAVIT
STATE OF FLORIDA)' •• • •
COUNTY OF DADE)
The undersimzed Affia
•
_�g.__ LGLjf'2L
20j'e L
� .„— • • .•. • . O • �oR1D?` • • •.• • •
• • • • ... • • • • • •
•
• •.. ...
Witness(sign and print)
• • .
• • •
• • •
•••
•:• . ••• •••
•.•..••
• • a• - _ • •
• •
• •• •
• • • •• - •'a
SWORN TO AND SUBSCRIBED before me this day of
/`- Y
Alnant isr personally }mown to me, produced
Witness(sign and print)
oes hereby attest that the
(prop er► r wrier)
attached survey,
y performed �7��
(name of surveyor'
_ s com P 'an
Y)
perfocme is an accurate representation of the existing conditions and
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 Afnant, as property owner, furiher
agrees to reff7AV or nf. ►,'., for . perrnits
Permitted or which may violate zoning or building code regulations. The Afdant further understands that the
existence of any such structures may affect final inspections as applicable to this or other permits..
Further, A6tant sayeth naught.
as identification.
i
JOB NO.: 2001 -5 -46
DATE: March 31, 2001
LEGAL DPTION:
. • • • ...
..
• • • •
• • • ••• •
• • • .. • •
• • ... • • •
860 perty Street Address:
E.•99th. St., Miami Shores,
Miami-Dade County, Florida.
AU. U r DraniE•'Li . y .5
on
Professial Surv . I s ..
Registration ID. 2263)
STATE OF F1,ORIDA.
• •
• ...
• �� • 4-?6.7.s. Tµ
• —�- . • • I
• . . . . . • T --ter
' E ,(= b
i
Lot 6 and the West 1/2 of Lot 5 in Block 72 of MIAMI SHORES
SECTION I�10 • . 3 , according RES
Plat Book 10 at Page 37 of Thee Plat thereof as recorded in
C ounty, Florida, Public Records of Miami-Dade
a D
D/s _ O!y .
P.N.. nu m NAIL
PL.. PLANTER
(M) . MEASURED
Ic) - axatnro
s - t cztfreR Laze
BASS
Lzr�
N.V.: WAER VALVE
W.w.. WATER Porra
t.rL. a. asro,t, Ptr.3t
E - PROPERTY L/NE
C.L.F..
CHAIN LILAC FEN:E
O.R.UC OVERHEAD UTILITY CABLE
A/C - AIR OCNOISILGi.,
R %:t . RIU=r CT WAY
K.T.S.. NOT TO SCALE
W. F.- WOODEN FI
F.I.P.. MAID 1/2" IRON PIPE
. S.I.P.. SET 1/2" alai PIU'F
S.N.D.. SET NAIL. AND DISC
?LIL. ►aDLE
C.B.. CA2Qt BASIN
U.S.. U TIL/TY EASF.vc IT
( L.D. )- AS PER LEGAL ECSCU rr N
=ATT.. CHATIAID:CHM
(P)- ASTER FLAT
F.D.B.. Fug DRILL SSE
C.B.S.. CONCRETE MOCK SIRUCIVit-
L.F.EL.. LOWEST nom ELEVATILN
P.C.P.. PERMANENT CCNTROL pony:
P.R.K..
PERMANENT REFIREtm NDiL1 E
NZ: V.D. IATTCPAI. GEOZZAPIQCI
G - CH �
R.. RADIUS
T.. TANGENT
A.- » DLS
CD.. aim
P.C. POINT OF CURVATURE
P -T.. Porte CF TANC;F2,CY
X- D.C.B.PL- KITHI_Dnre CCUNTY Bart
$.C.B.PS.. BRCiARD CRnr mho' Mzu
D.PLE..
DRAINAGE MitEtcjs MEMO
D.. Dr» r
This Survey is Certified to:
John B. McCaughan and Patricia Mallo M
Stuart A. Lipson, Es Y cCaughan
Attorneys' Title Tfsu_rance Fund, Inc.
='...00D INFORMATION: FLOOD ZONE r x
=-LOOD INSURANCE RATE MAP., 120 652 -0093 K (7/17/1995).
ALBERT BARTHELEMY, P.S.M.
34th. St.,
Mir, Florida, 33175
Ph. 305 - 221_3663
Fax 305 - 221_6317 •
Beeper 30 5 - 880-60 i
3• N t �e s t` ---. a i\.r;:.r�� �
4 .- L3 P n t _�- a3 -�_ �' °� �at v ---�
- LQ
rth .-' shown is as. .:F ._ , - �, ;
per Plat Book.10 ("'- P ubli
• Page 37, Ml_Dade County Public Records.
arbd t� + at a azU PL.A N of suRv� a• the above s1,oi. o 1 r .to e* fy mY �e^..1or ; •lio Mit property. . )s above-wound ar,E tzuie., to the bed of my la�otv)eC e
c p 410174. Fes1 34 w Codes P,esu: to=Section� dse: forth bY the Ronde bwlC e Proses/Jars/1 Linc Surveyor:
i
•
860 Street Address:
N.E. E 99th. St., Miami Shores
Miami-Dade County, Florida. ,
r
•
• ••• • •
•• •
ALBERT DATIT IELEMY, P.:,
Professional Surveyor Mapper ..
Re4istraL[aI ND. 2263
STATE OF F1QUDA.
• •
• • • • • • •
• •
• • • • • •
•
411 • • • • •
41:0 • • • •
• • •
- �_•��•• • -1'
LOGdT' lout
Map
LE '7l
boo
i
JOB NO.: 2001 -5 -46
DATE: March 31, 2001
LEGAL DESCRIPTION:
Lot 6 and the West 1/2 of Lot 5 in Block 72 of MIAMI
SECTION NO. 3, accordin SHORES
Plat Book 10 at Page 37 t o he Plat thereof as recorded in
Co unty, Florida: Public Records of Miami-Dade
Z:
F 61
aD
•
CL Clear
0/S OFF SET
ENE, ENcROACU
P.N.. FOUND NAIL.
PL.. PLANTER
(M) - ME
(c) - q?gVhy
LZ
B ■ sass =NE
N.V.:
RA DER V7LVL'
W.x.• WATER mETER
L.M.. ELEC=RICAL mr..•.TR
k - PROPERTY
C.L.F.. QIAat Lixx FF2AS
b - CITY mONU -.NT LYRE
O.R.U.0 . OVERMAD UTILITY CABLE
A/C - AIR COISZ=litZn-
RiW . RIIIr; cr WAY
N.T.S. - NOT TO SSE
K. F.- WOODEN FENCE
F.I.P.. FOUND 1/2 IRON PIPE
S.I.P.- scr 1/2 117(21 PII":;
S.N.D. - SET NAIL AND DISC
M.B..E
C.B.■ CATCU BASIN
U.S.. U.'a.ITY EAsETIENT
(LE.). AS PER L&z, D=1117:13,1
QQ.IT.. QR lluccr s
(P)- ASTER mom PLAT
F.D.B.. FOUND ERILL Irma
C.B.S.. CONCRETE BLOCK SnRUC
L.F.EL.. LowcsT riccR E.EvA I
P.C.P. - PERMANENT CONMROi. POTN:
P.R.ti.
PERMANENT REFERENCE MONU E
z .G.V.D.. NATIONAL CMIRILRIIML
4^1= C (AL ANGLE
R.■ RADItS
T.. TANGENT
A•- Aic DISTANCE
P.C. - POINT OF QTRvAIVRE
P.T. - mac OF •a•
MIAMI-Dry CCuNTY BEND(
E.C.E. M.. BROta1RD mtx:•r Itr,o rv7R
D.M.E..
DRAINAGE ENTaim E`sa =�
D.- DD7. ER
This Survey is Certified to:
John B. McCaughan and Patricia
Stuart A. Lipson, Esq.; McCaughan;
Attorneys' Title Insurance Fund, Inc.
LOOD INFORMATION: FOOD ZONE r X
-FLOOD IN;SUrR. wr, RAT. MAP!'
12 0652 -0093 K (7/17/.1995),
ALB S , P.S.M.
34th. St.,
Mid, Florida, 33175
Ph. 305 -221 -3663
Fax 305- 221 -6317
Beeper 305 880 - 6016
1 -
valid 2a 1 � , a
&es n t the �-�I r.G:v.La32 (1529)
� - - � a=7.7 _ S`,•^ve: ;� Z;,: �
6'N°rth Arrow shown is as per Plat Book 10, Page 37, ', (�.� ==ems o�� -ti;se �...�,•e`) 2�
1 HEREBY ane belief as c> »,,,_ ,� P of , Miami-Dade County Public Records.
'"" h' :vet( abo ve e _
�+•. 1 f e u t ; y w the CI+ re Teiv7)at Standards r by nd et7�r to t)x of e o(my ane S fl v
in »7�sts othc than those
Code, P�auant to Section �- - � �� set the Ronda
Board or Professional :sr>C Si+rrewnc
PROPERTY OWNER
Name O� / •/ 4 a• c �hVGrf- 4/0
/'
Address
Home Telephone .3.Oc . 7 8 2es
e 7 &G _.g.SJ0 2-6
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'l Detachment
Other
PERMIT TYPE (✓) /
Building �/
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
/,- 0 v 7 ( Az_ (,C c.c/ tait
• • ••• • • • •••
• • • ••• • • •
• • • • • • • •
• • •••••• ••
• • • .: • • . • • . • ,Master Permit No.
• • • ...Subsidiary Permit No.
••
• • •• • • • • • • •• ••• • • •••
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
• • • • • •• ' ••• ••
Step 1. Complete the attached permit ap�lioation W hich p nuit tiecigngd,by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more•acr qT your application. If roofing work will be done, a roofing application must be submit-
• •
ted along with this permit app'• cation. • • • ••• ••
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.
'6 NE7Q.-5(-
Address
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Apt. City
Folio Number Description of Work a
� , -t. to 2
/
Lot Block c< c J ass SE- ± L L 1.&d14 k ( 3 Kcr
Subdivision PB PG Zoning Linear Feet
Current Use of Property iZZ t Pc.A5c E. Square Feet
Proposed Use of Property Llue of Work Bldg Value
Tenant Information
Tax Assessed/Appraised Value
State
PERMIT APPLICATION
Zip
Units Floors
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone Fax
Qualifier Name
Page 2
IMPORTANT NOTICES
•
DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR °VALIDATED PZRM9? AND refefv11 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 CLEA><l N & ° 5;41�iI�AR' CbNUIITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE ;ROM 4 I3EI1R4r • °
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIP N /11 1N1:1 lt)la 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, P' 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 FLORIDA, COUNTY OF MIAMI -DAL€ STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Si
Print Name
Sworn to and subscribed before me this 1 day ,
Signature
SEAL:
re of Owner
Notary
blic - State of Florida
a te+ v Angela M 950
o ExplresNOVC
Personally know[{/ OR, Produced Identification
••• 0 0
0 ••• • •
• • • ••
e 0 0 000 • •
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
• •
SEAL:
•
0
0
•
Signature of Contractor / Qualifier
Print Name
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
PERMIT APPLICATION
Personally known OR, Produced Identification
Type of Identification Produced: Type of Identification Produced:
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Drgiit • • • • • • • •
QTY.
• •
TYI'E,
Outlet, Appliance
QTY.
TYI'I:
Service Repair
QTY.
A/C Central 1 -3 Ton
Dryer Vents, Number of
Fan
Ventilation, Cost
Outlet, Wall
Ductwork, Cost of
Service, Temporary
Periodic Inspections
A/C Central 4 -7 Ton
Fire Sprinkler System
Fire Pump
Outlet, Switch
Fireplaces, Number of
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16 -20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
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 QTY.
Minimum Fee
TYPE QTY.
Condensate Drain
TYPE
Generator
QTY. TYI'I: QTY.
Refrigeration, Tons
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
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
PLUMBING
TYPE
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
• • ••• • • • •••
• • •• • • • •• •• •
• • • •. • • •
• • • • • • • •
• • ••• • • If • • •••
• • •
•• •• •• • • • • • •
• • • • • • • • •
PERMIT APPLICATION
•
INSTRUCTIONS: Please inehoat;4he typeiofwork being:porformed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
DATE
/ L /77CA
Zoning
4'.0j5,
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
1 % _
Building Official
;4*'' . ir.
t' � W6
Page 4
OFFICE USE ONLY
❑ 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
Notary
❑ PROOF OF OWNERSHIP
(Attach)
00 000
0 0
• 00
❑ HRS / DERM APIIROVAI9
•0 000
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
0 '
$3 o ,
$ , 6 o
$ (¢.005 /sq.ft.)
••• 0
( sq..ftt. = x/1000
(¢.01 /sq.ft.)
O 0 •• •
•
O 0 0 000 0 0
O 0 0 0 0 0 0
00 0 0 0 0 0 00 0
0 0 0
• • • • 0 0 •• • 0
• • • • • • • • .
0
0
• •
•
PERMIT APPLICATION
CHECKLIST
❑ CONDO ASSOCIATION APPROVAL
00 0 0 (+Attach)
O 0 0•• 0 •
O 0 0 • ••0 0
00
O 0
O 0
g o ft]J'ROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL $3 C, /6 0
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 0 FAX (305) 756 -8972 o http : / /www.miamishoresvillage.com