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PAINT PERMIT
ELECTRICAL 'FITE, Minimum Fee QTY. TYI'E Dryer : ,y'I : : '1`,'1 ;Ma E1p)liance : (1 'I'Y I'1. Service Repair Q "I'Y A/C Central 1 -3 Ton Fan "" ' Outlet, Wa'd' " Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch 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'Iubs 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 "I'Y1'E. Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE: Generator Q"I'Y. '1'1'1'1: Refrigeration, Tons QTY. 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 Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING TYPE A/C Condensate QTY TYPE Drains, Roof QTY. TYPI: Miscellaneous Fixture QTY. TYPE Soakage Pit Q 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 worl'biing ptrfoWed aidipAtity(ies) in the space provided below. • •• - • • RECEIVED AND REVIEWED BY: DATE: Page 4 OFFICE USE ONLY ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ qONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) .$ 1 , v Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review Notary • • • • • •.• • •.• • • • • • • •.•• • • • • • . • • • • • •••••.. • • • • • • • • • CHECKLIST a PROOF a O"tRSIIIP (Attach) .• ... .• • • • .• • • • • • • • . • ❑ I ORS /'I,Ef I PI;ROVAI,' . •(Sepik /Heaver) • • • • ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ $5. - 0 SECTION Zonin Electrical Mechanical Plumbing Fire Public Works Structural Building Official DA (sq x/1000 x (¢.005 /sq.f .) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑. BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERAIIT FEES TOTAL $ , I y 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 Page 2 • •• •• • • • •• •• • • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • • • • • ••• • • • •• • • • ••• • .• IMPORTANT NOTICES DO NOT BEGIN ANY WORK WITHOUT HAVI 4G 'ALID • �It?) PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSWUCPION are•Iimitea td! Morltlay 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 SHJCL tan t E$ TROLL OIRVAND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING IMAGED 11Y LQDIlv1Ir't OeVEHICLES, 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. PERMIT APPLICATION 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. STATE OF FLORIDA, COUNTY OF MIAMI -DADE G. - c . Print Name Sworn to and subscribed before me vv, C�w - s this 10.411_ day of OFFICIAL NOTARY SEAL RONA SOLIS s • Ir COM� �• ION NO. CC892250 MY COMMISSION EXP. DEC. 6 003 Signature of Notary Public SEAL: C Personally known OR, Produced Identification Print Name om to and subscribed before me this / day Aor IC* S ature of S i 5 OF FL I ►, A, COU ► ; Y OF MIAMI -DADE • lure of Contractor / Q alifier SEAL: , . ta ry Publi. j i g a M Becker My Commission 00150048 if p. Expires November 15, 2006 Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: CONTRACTOR • Name V, 5 i oar �,-F $ 6' License No. 9 7 5 S OOZ( il Address / e70, D 4iikev,,S O Motogo 510 �t Telephone 7 7 _ 7i6 y Fax Qualifier Nam e76 1 PROPERTY OWNER Name,2 i frix5 Mor✓EIQ Address "75— ^/ /0! sr Home Telephone ( 305-) 7 g77i1 7 Business Telephone ,,._.. Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'1 Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Complete the attached permit application which mugt't stgn:d tf ttepfcipe¢9 hwger •and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processingbj yQtl:appli atin! If• fork will be done, a roofing application must be submit- ted along with this permit application. •41, • • • • • ••• • • • 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. Step 1. APPLICATION Job Address: PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other �/ 7 S �✓ E7- /6/ s7 Address 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. Telepho .. . •. . • • • • . • • • • • • • • • • • • • • • • • • • •.• • • • • • • • • • • • • • • • • • • • ... • • • • 00* PERMIT APPLICATION • . Master PoniiU h? -.2m-; '.S 531 :. •:Subsidiari P.erl�iit No. • • • •••• • .•• • • Apt. City State Description of Work 7,4Arr 33(3j' Zip Zoning Linear Feet Square Feet Units Floors Value of Work 2- cc, Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Telephone F Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2003 -584 Printed: 4/15/2003 Applicant: JEFFREY MOWERS Owner: MOWERS JEFFREY JOB ADDRESS: 1175 NE 101 ST Contractor VISCOUNT PAINTING & DECORATING Contractor's Address: 640 GRAND CONCOURSE Local Phone: 305 - 751 - 7164 Parcel # 1132050190230 Fees: Description Amount FEE2003 -2152 Building Permit Application Fee $60.00 FEE2003 -2153 CCF $1.80 FEE2003 -2154 Notary Fee $5.00 $66.80 Total Fees: Total Fees: $66.80 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 10/12/2003 Construction Value: 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 F ' °_ _ _.._� _ _.`�_ _.,� __�_ - ..� _ ._ _ This Permit is granted to the contrac ordinances pertaining thereto and with and approved by the proper municipal i authorization. A further condition upon ordinances and regulations pertaining t by his agents, servants or e . ployees. 4,7 Signed: In consideration of the issuance to m with the plans, drawings, statements o1 myself, my agent, servants or employe • Look For hluo background on 111v front of this cheek and the itnageS:de© logo on hack. If not present. do 1ni cash. - PAY TO THE DER OF VISCOUNT PAINTING AND DECORATING 4 e.r,“ Sitifrc ‘//1(a5, • - i 4 _ 2107 63- 27/631 FL �f DATE ! ' 17• 03 6 988 � 0 i Building Permit Page 1 of 1 Legal Description: MIAMI SHORES SEC 8 REV PB 43-67 LOT 13 BLK 176 LOT SIZE / DOLLARS Ba kofAmerica• ACH F1/7063100277 FOR 000 2 LO 711' ':063 LOO 2 771: 00360 2 Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date I of 1 1 1 Time Type Insp'n + nc) Th r n-)-- Permit No. 'BP C J `) 64 Name MO S. Address (113 SE__ IC) 1 Company V tSc ' ?oi 14 Phone # For Inspector: la) la . Re- Insp'n Fee ❑ Name & Da i MIAMI SIjcRES ;VILLAGE Paint Color Approval and.Y#greement DATE: y- /Z • O 3 APPROVED: a 4, YAY / Building eficial Date • • • • ... • • • • • • • • .. • • OWNER'S NAME: /Lt� /f.,/ 0.016-4* • ••• 14 ONE: 7s' 9r1L( ADDRESS: //755- A4 E; /0/ ST ************************4:* iSt 4:ot 40 de 40 lc **1 * * * * * * * * * * * * * * * * * * * * ** • •••••••.• • ADDRESS OF SITE: /1 n/. E: • ' S'` • • CONTRACTOR & LICENSE (if applicable) q4 g Soo COMPANY NAME: V cscoJntT d(A/Trnl PHONE: .... 7.57-7/ e ********************************* * * * * * * * * * * * * * * * ** * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls 02)5 3 - 50 Fascia (9/ .53 -10 Drip Cap/Drip Edge - /24. Soffit 0 2153 — 7b Roof ,,(/ Flower Bins % C `{7 Shutters Awnings lSA Chimney N k Doors and doo jams 0 2/53 - 7 Garage Doors 021 5 3 — 70 Railings 1J1A� J Fences Decorative Metal All brick (simulated or regular) ..1 - 5 Stucco Banding �J1� Any other stucco features Accessory Other - LAfric,5 — 2i 5.3 -- 70 1B n 2153 -50 • WHEN PAINTING IS FINISHED CALL FOR FINAL INSPECTION • 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 b, as per the attached samples. 41 Lel /-/• 6 .3 gn ur of Owner Date Signature of Contra for Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 4/23/01 Date r _ Legal Description / 3 1 / Lessee / Tenantk (C //n Ph C - 6 r X Master Permit # ��/�� Owner's Address II S I /O/ (T v ii) S Phone Ds?-V13 Contracting Co. 't / Address Qualifier SS4 - Phone State # Municipal # Competency # Ins.Co. / O Architect /Engineer Address m Bonding Company , Address of Mortgagor Signature of owner and /o Condo President S nature of Co Date Fv OFFICIAL. NOTARY SEAL SCOTT W DAVIS !Hw'w 0 - % 31Pf ndoCiitt2SIget t :a. � MY COMMISSION EXP. � F. P\P > �1?�. 26 1997 Notary as to Owner My Commission Expi APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 5.-7 Job Address/0- 6 /0/ Tax Folio // 3203 / 5 0dZ.3 o d ti Fire Zoning Buildin Mechanical Plumbing Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHAN ICAL ROOFING PAVING FENCE SIGN --(3 WORK DESCRIPTION � /Jz � S✓ IY Pe,L Square Ft. 366:20 Estimated Cost(value) �O 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 FINANCI 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 complia with all applicable laws regulating construction and zoning. Furthermore, I t oi a the :•o - :med co ractor to do the work state Notary as to Contractor or Owner- Builder My Commission Expires: ** * * * * * * * * * * * * * * * ** FEES: PERMIT 3 / _ „-a RADON C.C.F. S J NOTARY Ci. ca ' TOTAL DUE 4/3_ Other Electrical Engineering Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted fl S Majorca Peach OP-47 described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village. Flori � �� State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shore' herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. / 4 / 1 /A1,, 1 1 i12Z Q JQZ 2 /9 6 D Subdyi vision / 12 7 �/ _ �' "' � � / i .4 / s" /� 4 ;�.� f F4 Owner's Name and Addre Registered Architect and/or Engineer Name and address of licensed contrac Location and legal description of lot to be built on: Lot (3 Block APPLICATION FOR BUILDING PERM: 77" Street and Number where work is to be done State work to be done and purpose of buildi. • by floors), state exterior colors (submit samples) and for no other purpose. New Building Remodeling Estimated Total cost of improvements S . " AM ' ' 0 O MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Addition To be constructed of Kind of foundation Roof Covering 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 plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons as an employer of Labor under the Florida NVorkmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and 11 require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit: and will post or cause to be po.ted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ-..ly such subcont'actors, on w rk to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Sig Amount of Permit $ Repairs No. of Stories STATE OF FLORIDA COUNTY OF DADE. } ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 facts therein by him stated are true. Permit No. 7472* Date I 1 7/0 Read, Sworn to and Subscribed before me. Disapproved Date (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Date / / 19 // /.- Street 77 //,.5"/ Notary Public. State of Florida ( Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. r�� )/ l Owner's Name and Address ! )1 ) [.t W 1 Registered Architect and /or Engineer L/ Name and address of licensed contractor d./n.! yi.P� Location and legal description of lot to be built on: Lot /v Block /71 Street and Number where work is to be done MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT r Subdivision l / / 4?r �Q1'7 State work to be done and purpose of building (by floors), state exterior colors (submit samples) New Building Remodeling Remarks (Signed) Date L /` 19 No. /P7.) Street/" - /0/5 , S'6 hc. r . _ilk■■ 'AAA, . - %lU / Addition Repairs Kind of foundation Roof Covering No of Stories To be constructed of Estimated Total cost of improvements $ 0 0 Amount of Permit $ bb 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 plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons as an employer of abor under a Florida orkmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement. an has complied with the provisi •. s thereof, : d will re. ire similar compliance from all contractors or sub - contractors employed by him in the work to be performed u . er this p mit; an will post . r, ause to posted 'or inspection on the site of the work such public notice or notices as are required by the Act. The undersigned es • a .l,, only s �. bc be performed .under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA COUNTY OF DADE. } ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 facts therein by him stated are true. Permit No. eV ' v 6 9 Date! Disapproved (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Date Disapproved Date Council Approved Date Read, Sworn to and Subscribed before me. Notary Public, State of Florida and for no other purpose. NOTE: A charge of 525.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.