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PAINTPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 4/3 y.� Job Address 7P 4 /� Tax Folio Legal Description / � 1Z Historically Designated: Yes No Owner/Lessee / Tenant ! 4 3/ ' -/ Master Permit # 3 7, © V Owner's Address 6 / , 4 • ` � A • .J Phone Contracting Co. etr 'i-e't—j Address Qualifier SS# - Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT 3 SU RADON C.C.F. r ?/ Square Ft. Estimated Cost (value) . £ U 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, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work stated. c.2 e of Contractor Own - Builde{ Date evinta Notary as to Contractor or Owner Builder My Commission Expires: , Pt/ OFFICIAL NOTARY SEAL O <- BARBARA ANN FUGAZZI 2 l , / (1 * . COMMISSION NUMBER •rPir• , Q CC360191 !� , © Q) MY COMMISSION EXP. QF fk b Ap. 2LpOk M ,, S 0 NOTARY S • c, TOTAL DUE (-{ 3 ( 113/-5 - Date Date APPROVED: N Zoning Building / I 15 Electrical :hanical Plumbing Engineering Page 2 1 PERMIT APPLICATION 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 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 O I A, COUNT OF MIAMI -D E STATE OF FLORIDA, COUNTY OF MIAMI -DADE ........../ ignature of Owner Signature of Contractor / Qualifier Print Name Print Name nd subscribed before me this da .4 , Sworn to and subscribed before me this day of ature ofiotary Public Statrw o /lK •Y- 2 L FIE/ SEAL: - SEAL: Signature of Notary Public - State of Florida Personally known OR, Produced Identification � l Personally known OR, Produced Identification Type of Identification Produced:7 .J j ,L v' / [ 13-� ['1° ' Type of Identification Produced: CONT'•CTOR Ar Address Are 7 : , Name yy P ` Ho ephone 2'es— 7s SL —V373 Business Telephone License No. Repair �1 Address Go(1 it.) . A t/ / 11 43' 1 /ys rib/ Telephone 114 9 .a 9 8 i5 5 6'3 -11 Qualifier 6 1,0 me S. c.,A Foundation Only PRO' ERTY OWNER ' , /�i' -, Ar Address Are 7 : , Enclosure Ho ephone 2'es— 7s SL —V373 Business Telephone Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the \Iianti Shores Village: Step 1. Complete the attached permit application which trust 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 X \Job Address: PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other . 9 Address A Folio Number Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax • t. Master Permit No. Subsidiary Permit No. PERMIT APPLICATION P-1 ez , 5 halt- e 5 !£ City State Zip escription of Work A e.p tq , v J k C.k - - O�1 " i4 k se Zoning Linear Feet Square Feet Units Floors Value of Work ,i$` . 7 a 0. Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax ELECTRICAL 11 1'F Minimum Fee Q'I 1. T1PI{ Dryer Q'r1'. T11'1.. Outlet, Appliance Q 1 1. 1 1 1'I: Service Repair ` 1. AJC Central 1 -3 Ton Heating Strips, each Fan Outlet, Wall Service, Temporary Paint Booth AJC 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 1IECHANICAL T 'P1': Minimum Fee QI'1'. T1 PF; Condensate Drain QTY. TY!'I: Generator Q °11. '11 I'I: Refrigeration, Tons QY1 1. A/C Central, Tons Q i 1. 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 011 '1'111: Drains, Roof ()Ty. 'I1 I'I Miscellaneous Fixture Q 11. 1 11)1.. Soakage Pit Q i 1. 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 ATE ,e // 6 01 Zoning ( Electrical Mechanical Plumbing Fire Public Works Structural /0(0 Building Official Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) PERMIT 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 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) LI OTHER (Specify & Attach) $ (s .60) X/1000 x (¢.005 / sq.ft.) (¢.01 /sq.ft.) i PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) O CONTRACTOR REGISTRATION (On File) TOTAL s - 7 . `10 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 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10 /16/2002 Applicant: ISABELLE Owner: JOB ADDRESS: 906 NE 98 Contractor Local Phone: r Parcel # 1132060143300 Fees: Description Amount FEE2002 -5792 Building Permit Application Fee $60.00 FEE2002 -5793 CCF $2.40 FEE2002 -5794 Notary Fee $5.00 Total Fees: $67.40 Total Fees: $67.40 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 4/14/2003 Construction Value: $3,700.00 Work: EXTERIOR PAINTING AS PER AGREEMENT 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 advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for worts done by his agents, servants or employees. Signed: (INSPECTOR) BY: In consideration of the issuance to me of this ermit, I agree to perform the work covered hereunder i n r/rrn . ��. - ••i -- ' i " P 9 P !Au✓✓.e artt ;�! �iyr.ir✓.rt r.4•ry� fits . /� with the plans, drawings, statements or specifications submitted to the proper euUunibeb r4 IAlerrn f)r•et: ' /d,', :r. rri ryvi e,,,t yowl artmoy myself, my agent, servants or employes. i Building Permit Permit Number: BP2002 -1764 ST Contractor's Address: Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOTS 6 & 7 BLK 78 LOT SIZE 100.000 X i/ ../ •■ i .ray KUNZLER Page 1 of 1 1viiAlvlt StluKES VILLAGE Paint Color Approval and Agreement DATE: '' • / —�� OWNER'S N • : • /Lei //T' % PHON)_. .� ADDRESS: .2� 71 - r - "� . ;_ ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: . ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted.. Walls ' C c te -A Fascia Drip Cap/Drip Edge �; tvx; A t. Soffit Roof ; k Flower Bins Shutters Awnings Chimney Doors and door jams ; rc Garage Doors �- Railings Fences Decorative Metal All brick (simulated or regular) Stucco Banding Any other stucco features Accessory Other tidlin; a J ye+ )41446,1;164" 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 arr tiles, -_ , ,-;/, ,, I s' fry /,^ ( r j ° Signature of Owner Date Signature of Contractor Date ************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: WHEN PAINTING IS FINISHED, ( d o a C t t% * s ; se) CALL FOR FINAL INSPECTION tj Building Offici = Date 4/23/01 FLORIDA 8CVNse The Sunshine Strife ISABELLE MARIE KUN2I,ER 906 NE 98TH ST MIAMI SHORES, FL 33138 -2535 12- 10-21 F 5 -05 A K524- 413- -21- 950 -0 CLASS: E SAFE DRIVER 11 -22 -91 12 -10 -97 00 -00 -00 S 920 721 Name f For Inspector: / 1 Approved` 1 Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time — 7 Type Insp'n !` Permit No.1- Address C � f �_ i '\ f h i r ( l i �^ 'p 1 Company _ i _ _ c Phone # / "� Re- Insp'n Fee ❑ For Inspector: MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Type Insp'n Ce--' -, , 2 -- L- t�t� Permit No. l_/C /7(i Name 2 -1=4_54 Ci--\ 6 C A i ? g Address ' :, A Company Phone # C J ` L 4 ' Approve 1— Correction ❑ Re- Insp'n Fee ❑ ate PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address 7o g Owner / Lessee / Tenant �ii� • � Master Permit # 33�as' Date Legal Description ‘V WORK DESCRIPTION Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: )6e-e-sia 41-W ;441' ** * * * * * * * * APPROVED: Fire Zoning Tax Folio/ flab Owner's Address � O(P /j" ( d Phone ` `f — Contracting Co. dress /' 5 j f Qualifier ainteA/ SS4� - - Phone / State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN Square Ft. Estimated Cost(value) !J 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, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work stated. e 4p —'! ,�. S gnatur of Contractor orbvner- Builder Date: /D,Qf tar as to y Commission FEES: PERMIT 3 7! -0 RADON C.C.F. 4 1 NOTARY a -Q O TOTAL DUE 73. D ** Other Electrical Mechanical Plumbing Engineering Date Legal Description Owner/Lessee / Tenant X Owner's Address PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address x � p � 6 � d' Tax Folio / ` Historically Designated: Yes No Municipal # Master Permit # Phone c) s — s y Contracting Co w t ^L Address Qualifier SS# State # Architect/Engineer Bonding Company Ac Mortgagor MAMA Permit Type (circle one): BUILDING ELECTRII AL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION -� Phone . Co. Square Ft. Estimated Cost (value) 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, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and/or Condo President Date ‘ 3 -9- Notary as to Owner and/or Condo President Date No : , as to Contractor Owirtittlet ate NOTARY SEAL My Commission Expires: My ommission Expires GLADYS j VILLAR FEES: PERMIT ?/ RADON C.C.F. ' 6e" NOTARY S BOND APPROVED: TOTAL DUE T 6,c) Zoning Building 41c/9 Electrical Mechanical Plumbing Structural Engineer ,eg; Signature s Contractor or Builder` /3- NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC714103 MY COMMISSSION EXP. MAR. 10302 /Yy Date ov