90 NE 98 St (7)J
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2
Building Inspection Request
Date
Type Insp'n
Permit No.
Name
Address
Company
Phone #
Inspection Date
Approved
Correction
Re -Insp' n Fee
PRESENT ADDRESS
•
LOT
E• 94th Street
PERMIT FEES 18 00
N CUBE 2
ADDRESS
6
DFCONSTR U CO NSTRUCTION
DESCRIPTIO
IFERRED TO C OUNCILI
.I
• To
CORD —MIAMI
REMARKS
LICENSE NO
SUBDIVISION
MIAMI SHORES SPX • N
I
PHONE NO.
0778
NO.
2
CU. FT. I EST. COST S
RES VILLAGE
4
BUILDER'S BOND
REASONS
UI
000
PHONE NO.
LICENSE NO.
DATE 2 /� /r
DATE
I
INTERIOR CONSTRUC 2 1
I ON
i Oak Floors_P1as.Wa11
N 8 & Ceil
19SPECTfONS
PHONE 7
BY
RE- INSPECT
BY
RE- INSPECT
BY
FOUNDATION
/n► DATE
oC `i?_45-
DATE
FEE
TEMPORARY SERVICE
H. W. HEATER CONN.
BEAMS & LINTELS
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SOLAR HEATER
FRAMING
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1 / PECTIONS
DATE
FINAL
4-R'3 T�' i
BY
RE- INSPECT
BY
ROUGHING
CLEAN -UP
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CONTRACTOR C 64„0? _,/ *.y LAG/ ,.
PHONE 7
PERMIT NO./07 kr/
DATE
FEE $��
REPAIRS
NEW BLDG. ALTERATION
ADDITION
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
H. W. HEATER CONN.
S
SEPTIC TANK ,y�t.a.,..;t'
SEWER
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SOLAR HEATER
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1 / PECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
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PERMIT NOW 19 5 DATE 3 y - $
f
FEE $ / -��
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NEW BLDG. I ALTERATION I ADDITION
REPAIRS /
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
H. W. HEATER CONN.
S
RANGE CONN.
S
MOTORS
S
FIXTURES
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
TEMP. SERVICE
RQUGHING
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H. W. HEATER CONN.
RACONN.
FIXTURES & FINAL
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GUILD VNSPE TIONS 1 , 6
PLUMBING PERMITS & INSPECTIONS
ELECTRICAL. PERMITS & INSPECTIONS
CONTRACTOR '7� /-, iz . - -gin_ /' XfL.e� C_rs _ PHONE
APPROVAL TO POWER CO. FOR SERVICE DATE
CER 1 IFICATE OF RE OCCUPANCY
On behalf of Miami Shores Village, Florida, the undersigned certifies that the property described
in the application has been inspected for the purposes of re- occupancy pursuant to Sections 901
and 902 of the Mani Shores Land Development and Zoning Code and that such property may be
re- occupied by the applicant for single - family residential purposes.
THIS CERTIFICATE VERIFIES THAT THE REFERENCED PROPERTY
HAS BEEN INSPECTED BY MIAMI SHORES VILLAGE AND HAS BEEN
DETERMINED TO PRESENTLY COMPLY WITH THE SCHEDULE OF
REGULATIONS OF flhJ MIAMI SHORES LAND AND DEVELOPMENT
CODE PERTAINING SOLELY TO THE REQUIREMENT THAT EACH
ONE - FAMILY DWELLING IS USED AND INTENDED TO BE USED FOR
A ONE-FAMILY DWELLING PURPOSE ONLY; HOWEVER, THIS •
CERTIFICATE DOES NOT. CONSTITUTE AMY REPRESENTATION OR
WARRANTY AS TO THE CONDITION OF THE DWELLING OR O'i "HER
STRUCTURES ON rriE PREMISES DESCRIBED HEREIN, OR ANY
ASPECT OF SUCH CONDITION, AND INTERESTED PARTIES ARE
ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION
OF THE PREMISES IN ORDER TO DETERMINE THE CONDITION
THEREOF.
APPLICATION FOR CERTIFICATE OF RE-OCCUPANCY
(,,,- AtewOc gEtcr,
hereby apply for a certificate to re- occupy the single family residence Imown as: (address)
9 N E 9$ S7i2EET. , Miami Shores, Florida.
Legal description:
Lot: 1 A.P Z ,Block 7 7 PB&yPG: 5 EC 1 AiVW PQ 1n -?O
I hereby certify that I understand that the zoning of the property is for single- family residential use
and that it is unlawful for more than one family to reside therein. I also understand that any
Certificate of Re- Occupancy that may be issued by Nfiami Shores Village, Florida, certifies only
that the referenced property is being used for single - family purposes and that such Certificate does
not constitute any representation, warranty or certification as to the condition of the dwelling or
other structures on such prop
Applicant:
Print Name: (AMR.1.4tC gErcrl
**_***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
For the purposes of conducting the inspection required by Section 902 of the Miami Shores
Development and Zoning Code, contact
Contact Name:
Inspection: B
Comments:
fn► AKWtck . RE ICri
Application Fee (S50) Paid: Cash: Check Number: 1- 21 .
Date: i f / z7/ 4 .
Telephone: g 3 9 1 EkT 11 5
Buyer. Seller. Realtor. V Company Name: PEua&rM L FL 259 t ry
1
Proved: _ Denied: Date: 5 /i/q
V
E cka to- T—fe
P -12829 2 -2 -51 PAID BY John M. Dils
YEAR
ANNUAL TAX
PERIOD USED
AMOUNT PAID
DATE PAID
RECEIPT
NUMBER
i r ✓� 1� L , •
/9S e2
X07 '
-
$ G ° 4
/0 .31 -5" 1
oal f -S'
/
ADDRESS 90 N.E. 98th St.
LEGALDot 1 and 2, Bk 7 M.S.
RECORD GARBAGE TAX
PROPERTY OWNER
Name
c a . ney
Address
o No ak- s-i- rnicu-n1 shores , PL
JJI 0
Home Telephone (05.--) •,' ,, - ' / 03
Business Telephone C 757-707D
Fax ( ( S� 1 �� -1 -392__
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 submitted
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
Vol) Address: q() A/C 9f , c`7n✓es
Address Apt. City
Folio Number b 0 13 o?q ` Description of Work 5 J 1 'c ci ey 1!(/e /l ,cap
p
Lot Block 4Z,; 164-, / ,� s hoL et' 1 rt s rAraij e
Subdivision PB PG Zoning Linear Feet
Current Use of Property Feet Units Floors
Proposed Use of Property � ue of Work ` 1,000 '" Bldg Value
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No.
Subsidiary Permit No. �OPJLA,
FL—
State
PERMIT APPLICATION
33 i3E
Zip
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT CHANGE (✓ )
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone
Fax
Qualifier Name
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 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 constrtiction 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, 1g 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.
ST • Y OF FLORIDA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE
,v
el a Al. ,Qncs/
Print me
worn to and subscribed before me this
day of Q ('t ,
ature of
SEAL:
otary Pub - State of Florida
u , ' r,RY P4,
Z tl�rrr
. Q
Personally know ? ' " " + ( } p er
ti_ C F f .
ANGELA IW SF!;.. 7:;
�CO is
CC783 7
fftce1 N. I1 ifi, a
NCI /.
ion
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: Type of Identification Produced:
ELECTRICAL -
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
A/C Central 1 -3 Ton
Heating Strips, each
Fan
Outlet, Wall
Service, Temporary
Paint Booth
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
- Piping, Flammable Liquid
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Process/Pressure Piping
Oven
Space Heater (kw)
A/C Central 16 -20 Ton
Pressure Vessel
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
Minimum Fee
QTY.
TYPE
Condensate Drain
QTY. TYPE
Generator
QTY. TYPE
Refrigeration, Tons
QTY.
A/C Central, Tons
QTY.
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
Pump and Abandon
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Gas - Appliance
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
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
Page 4
OFFICE USE ONLY
CIIECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
LI CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Inspector State Educational Fund
State DCA (Radon)
Code Enforcement Fine
Zoning Review
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
LI IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
Metropolitan Dade County (C.C.F.) • $ t 0 (sq.ft. = x/1000
x0.60)
$ (¢.005 / sq.ft.)
$ (¢.01 /sq.ft.)
—4 S. o c�
REVIEWED AND PREPARED BY:
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL $ 64 o�
ISSUING OFFICIAL
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