DRIVEWAYType Insp'n
Permit No.
Name
Address
Company
Phone #
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date
Approved
Correction
Re- Insp'n Fee
,M'3 -/f7
It 3 ,t/Jp9sr-
3 03 &f7 3 a 9
Inspection Date l /6 -
L 2Z, • 41- E
1
l� `° r
3
a/ SAS of Gtrt u t 4-j
MIAMI SHORES. VILLAGE 4(
BUILDING DEPARTMENT �?�
305- 795 -2204
B ilding Inspection Request
Date 1 _ S�'�Q UJQ-
TypeInsp'n FrnGl 13[C�C1 , ��I�
Permit No. BP U3 — (
Name
Address �� Iv- Ga 54- •
Company 1:611SC 0
Phone #
1
Inspection Date
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305-795-2204 �
Building Inspection Request
Date t °I t
Type lnsp'n C fp UVV T tO'V)
Permit No.
A PO 3— l 9 -7 7
Name
Address (D N c— q 9 ST •
Company
Phone# " 8 7 -309 h
Inspection Date
Approved
Correction
Re -Insp' n Fee
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 12 /29/2003
Applicant: HORTENSIA
Owner: MENESES
JOB ADDRESS: 863
Contractor PAMSCO INC
Local Phone:
Parcel # 1132060340140
NE 99
Signed: (INSPECTOR)
Signed: (Contractor or Builder)
Building Permit
Permit Number: BP2003 -1977
MENESES
HORTENSIA
ST
Contractor's Address: 9350 NW S RIVER DR
Page 1 of 1
Legal Description: MIAMI SHORES SEC 8 PB 14 -33 LOT 20 & E1/2 LOT 19 BLK 169 LOT SIZE
Fees:
FEE2003 -8660
FEE2003 -8661
FEE2003 -8662
FEE2003 -8663
FEE2003 -8664
Description
Building Fee
CCF
Training and Education Fee
Technology Fee
Scanning Fee
Total Fees:
Amount
$100.00
$3.00
$1.00
$2.50
$3.00
$109.50
Total Fees: $19.50 7i
D
Total Receipts: $0.
JAN O
Permit Status: APPROVED Permit Expiration: 6/20/2004 Construction Value: $4,300.00
Work: INSTALL PAVERS AT WALKWAY, LANDING AND DRIVEWAY
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit 1 assume responisibifity for all work
done by either myself, my agent, servants or employes.
BY:
-, g 3tq
PAID
Total Fee Now Due $
(Continued on opposite side)
Miami Shores° Village
, Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No.
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) Phone #
Owner's Address
City State Zip
Tenant/Lessee Name Phone #
Li Si i/t/s
Submittal Fee $ ,O Permit Fee $ /(22
Notary $ Training/Education Fee $ A00
Scanning $ Radon $
Code Enforcement $ — Structural Plan Review. $
Master Permit No.
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit Square Footage Of Work:
Type of Work: ['Addition ❑Alteration ❑New Repair/Replace ❑ Demolition
Describe Work:
Contractor's Company Name Phone #
Contractor's Address
City State Zip
Q»alifier
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
* * * * * * * * * * * * * * * * * * * * * * * *k * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CCF $
Technology Fee $ p J ,J� 0
Bond $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S A}rIDAVIT: 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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose properly is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of , 20 _, by , day of , 20 by
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
My Commission Expires: My Commission Expires:
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
State Certificate or Registration No. Certificate of Competency No.
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * **
APPLICATION APPROVED BY:
Chc 10/14/03
(Certificate of Competency Holder)
Utz
****. . 200 .0************************
2
Plans Examiner
Engineer
Zoning
CONTRACTOR
Name n lc oMNEY
Name I MS C O 6J C-
Home Telephone / 3os) 75(-1- 5 9 05
/
License No. c 7 c_ 06 i o et I
Fax (3 - 45 Z
Address CI 3 70 AR.) Sam /{ Aim
MEnc.eY , FL 33(66
DR .
Telephone (J - 3090 Fax VO5
i 887 -
1877
Qualifier Name . 3 -1 ..5u5 A'ZAK /0
Demolish
PROPERTY OWNER
Name n lc oMNEY
Address b 3 N e. 9 of 51-
M rA SNORES, F. 33i38'
Home Telephone / 3os) 75(-1- 5 9 05
Business Telephone
Fax (3 - 45 Z
TYPE OF MANAGEMENT (✓ )
New Construction
z
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'1 Attachment
Other
Add'I Detachment
Other
Step 1.
DEC RECEOVED
2 2005
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
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
Job Address: g63 NE 19 ST,
Address
Apt.
Folio Number De of Work ) J STR!L 1�Av.2S AT Alit t_KGJAY
Lot ZO E• %L ,‘C Iq Block /gq 7�-u, P , 1V€ ✓AY T�I/CK
"N IAMI 541O4E5
Subdivision Setri E' r" PB 11 PG 33 Zoning / Linear Feet
Current Use of Property FS t DENCE Square Feet 1000 s/ Units Floors
Proposed Use of Property Value of Work $ y300 Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
1
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
'Foca ox- 79.k.( soicn
Master Permit No. 3P3 — lq
Subsidiary Permit No.
1 SNORES
City
FL.
State
PERMIT APPLICATION
33138
Zip
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.
STA OF FLORIDA CO Y • MIAMI -DADE
VIVIAN DeQUESADA
(' MY COMMISSION 2 099750
EXPIRES:AprI 8,008
1$0:3 NOTARY FL Nolen/ Service & Bonding, Inc.
Sign ;y a of Own
U2'3 BAlge 7 /44
Print Name Print Na
Sworn to and subscribed befo> 1 day o
Signature of Notary
SEAL:
Personally known
Type of Identification Produced:
blic - State of Florida
uced dentification
STA
Signatur
Sworn to and subscribed before
• . • '4 A, COUNTY OF MIAMI -DADE
. f
C. tractor tt�
Signature of Notary Pu
SEAL:
Personally known
lic - State of Florida
Type of Identification Produced:
PERMIT APPLICATION
• Z' day of ,
VIVIAN DeQUESADA
/ MY • OMISSION # DD 099750
E XPIRES: April 18, 2006
1 OTARY FL Not Seri l & =.. , . Ina
ELECTRICAL
Tvi
Minimum Fee
QTV.
TYPE
Dryer
QTv.
TvPi:
Outlet, Appliance
()TV.
TvPE.
Service Repair
QTV.
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
J 'IECHANICAL
Tvr
Minimum Fee
QTY. .,-.7.1:-):1
Condensate Drain
OTv. TYP'r,
Generator
(yr\. TYI'I; ()ry.
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
Tvii;
A/C Condensate
QTY.
TYPE:
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTY.
T1'PI:
Soakage Pit
QT1'.
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
DATE
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
/ >'
Building Official
/i�. Lawme n
Page 4
OFFICE USE ONLY
CHECKLIST
la OWNER - BUILDER FORM
(Attach)
ID FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
CONCURRENCY
(New Construction)
CI 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)
• HRS / DERM APPROVAL
(Septic / Sewer)
• IMPACT FEE
(New Construction)
IJ OTHER
(Specify & Attach)
PERMIT FEES
$ (¢.005 /sq.ft.)
$ (¢.01 /sq.ft.)
( x .ft. x/1000
PERMIT APPLICATION
® CONDO ASSOCIATION APPROVAL
(Attach)
• BPR APPROVAL (Restaurants)
® CONTRACTOR REGISTRATION
(On File)
TOTAL $
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL ° (305) 795 -2207 ° FAX (305) 756 -8972 http : / /www.miamishoresvillage.com
FOU
PIPE
CHAIN LINK FENCE I
0.57' SOUTH J
0.93' WEST
k
I
1 I }
O)
ti
}
O
V
0., 0.04'
EAST
Er
od
O
FOUND IRON
PIPE (NO 1.D.)
25.00'
10. 54
AlTh,z€s5 : g 63 N E
R
X - X - X- X- X- X- X- X- X -X - X
e 150.
RON
I. D.)
CHAIN IJNK FENCE
0.25' SOUTH
1.30' WEST
Planter
11' wile
dri�e� -Y
:15'AL.LE ;
9.4'ASPHALT ;PAVEMENT
BA ST 7500' _, WPP
37.70'
ONE' STORY
C.B.S. BUILDING
HOUSE No. 883
Plan 1 er
21.15'
• EAST 75.00'
5' SIDEWALK
20' ASPHALT PAVEMENT
FOUND
PIPE (N
- I
O wt c g^
w u.z4) s �
NK FENCE 4 hc 0
' WEST 4 '0.�
oNDi
FOUND IRON t 4
PIPE (NO I.D.) -
STATE OF FLOR1DA, COUNT OF DADE
I HEREBY CET2TI that this :s a true copy (Attie
da
original Wad in this office o y
CAP
6'IITNESS ivy ha
MFRVEYY
ay •
•
11111111111111111111111111111111 III11 iIIi .1111
Cr N 2004 - 80001658
. OR Bk 21947. Ps 2009; (fps) • .
' RECORDED 01/002/2004 13:34:43
*HARVEY RUVIHr CLERK OF COURT
MIAMI -DADE 'COUPITY,.•FLORIDA
LAST PAGE ..
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. ' TAX FOLIO NO. / 3 Z o6 o 34- Q/ Y
STATE OF FLORIDA:
COUNTY OF DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Legal description of property and strool, address: • Lo Z� E 1 /2._ Lot t'o c k
frifApt 1 E 5e G an l w tF
At 5 •
2. I scription of improvement: IIN5 . PAVEKS AT WALKWAY k LAMDiAtq (i H i.i) DRIv C ►Y
(-1'14 l C K)
3. Owner(s) name and address:
ass: X63 E '�
"2 3ASo7 IGMAleY
.r Ak..
Interest i porn
Interest /4 E5 r DEAJc &
Name and address of fee simple titleholder:
4. Contractor's name and addres ?A, 4 S(-v / C •
R350 nit.) Soya X41vErL PI. /1cv'&eY tL 33
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
7. Persons within the Stale of Floi'ida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7.. Florida Statures, .
Name and address:
8. In tllddition lo. himself, Owner designates the following person(s) to receive a copy of the Uenor's Notice as provided In
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of !his Notice of Commencement: (tho expiration dale Is 1 year from,thO dale of recording unless a
different date Is specified)
it ._%44kkar ../AtZte
Sig; : turn of 0 /nor
P t Owner's Name
Sworn to and subscribed before this day of , 20c7..�_•
• Notary. Pubilc
Print Notary's Name
My Commission Expires
�ENN!Y t 3Asor f oMnIEY
VIVIAN DeOUESADA
EXPIRES: April 18, 2016
Prepared by MA '&L PJAZAI1 O
Address: 1350 /JO 50 yr,*
),( 1 vEK_ 17
Nl 6PLEY n 33I b