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120 NE 100 St (5)Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 4/4/2002 Applicant: ANUAR Owner: MEJIA JOB ADDRESS: 120 NE 100 ST Contractor Local Phone: ANUAR T. MEJIA 4 OR BIBIANA E. MEJIA 120 N.E. 100 ST. MIAMI SHOR S, FL 33138 Bankof America. ACH R/r 06 100277 Memo 406 3 100 7 7': 048 L4 2 L046 Building Permit Permit Number: BP2002 -683 MEJIA ANUAR Contractor's Address: Parcel # 1132060132160 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 - 70 LOT 12 & W1/2 OF LOT 11 BLK 16 LOT SIZE Fees: Description Amount FEE2002 -1943 Building Permit Application Fee $60.00 FEE2002 -1944 CCF $0.60 FEE2002 -1945 Notary Fee $5.00 Total Fees: $65.60 Permit Status: Approved Permit Expiration: 10/1/2002 p Construction Value: Work: EXTERIOR PAINTING AS PER AGREEMENT (OWNER BUILDER PERMIT) M hr If there is no permit package accessible on the job -site for inspectors to veri fee is $50.00, which must be paid in advance before t. Bruck of America Advantage'. dvantag ' 1368 63-27/631 FL 995 Y-z- $ �S d Pay to the orde Dollars IP $500.00 Page 1 of 1 Total Fees: $65.60 Total Receipts: $0.00 will be no inspections. Re- inspection or device described in the application herefor in strict compliance with all >, drawings, statements or specifications that may have been submitted to : ompliance with such ordinances or if the plans are changed without named above assumes the responsibility for a thorough knowledge of the atements or specifications and that he assumes responsibility for work done h all ordinances and regulations pertaining thereto and in strict conformity cepting this permit I assume responisibility for all work done by either MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: s2' //P/2- - 3 — 2 0 o OWNER'S NAME: ,g4/c/#9R -- 8 Aiern PHONE: 3oS- ?s /ie l ADDRESS: /zo ir/F' /o o -s'T * * ** * * * * * * * * * * * * * * * * * * ?Ic * * * * ** * * * * * * * * * * * * * * * *..* * * * * * * * * ** 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 7iti/z /a Nr L'RFgM1- Fascia p - -,/ bRCAM• Drip Cap/Drip Edge " i Soffit 4w. li Roof ANA Flower Bins - \"A-2(.4.-- 40' eYx4Yzvvtes.. /TC- Shutters IQ 0 Awnings L o Chimney ,tJ 0 Doors and door jams Garage Doors 4 p- H//L S Railings jA — r� Fences 0/A 70 Cn Decorative Metal 025 All brick (simulated or regular) '02, Stucco Banding )J Any other stucco features N _a m Accessory Buildings ll9a Other Caluwv — - c401-k_ hi 1� S 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 samples. a ure of •wner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION a' 62_ Building 0 icial Date 4/23/01 ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE. 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 Violatio 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 . 1 . 1'1'E Condensate Drain QTY TYPE Q'I'Y Generator '1 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. 'fl'1'i; 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: SECTION , , , - BY - -- - D TE Zoning Electrical Mechanical - . , ' •-: Plumbing Fire Public Works Structural )---7-41\7'c--C Building Official Page 4 VIOTTADLITT.A TIMSEN OFFICE USE ONLY CHECKLIST 0 OWNER - BUILDER FORM (Attach) - ICI FIRE DEPARTMEN1, I APPROVAr / L_ . multi-family) ; 5 CoNCURRENCY.1.• I ' (Nell / .0011StrUCtiCIII)u'e, ! •k){:9.! 4 - 1 • (Speeiryd&Atta:clir t 1 . _ . PERMIT FEES .1.12 [ (Scanning F r ee), .10 mole, - Mia - MITS461 - eis Village " : , -- -, ....;•, - ,,,..$:,;..- ;:-.-' - -. :‘-• ' . .::::',`, ...`',..., -..:':.:. ' 'i l '' ' '- 1. 'i '.:. ,t: ". • ::::?,'" ' ';. '4 1 .' ' I Bond ,..,,.r! r I ! t',:e; ,r. oiteliJris4 I ! _ : Metibl'ibliffirDiqe —I C, - L 1 , tt • „, 11••■....-.p Y. 1 ------1- Inspctor_State_Educational_Eund I $ • ,..: . ':', ',... ', ','; ] aj:-.. ,a , t-,, ., .- - -- ,..r,, . . • ••,-,-_,-.L, .' . , •;' , ";, , ;16% - ”.. , ' ,- Ito , 1.. I Cosle_Enforgementitifief 1 i I. t •t7:W 1.. i li,Qui--1. --30.!.eilu 1 i .._ rZ onlng Review t * 1 . 1 i 1 I 0 PROOF OF OWNERSHIP (Attich) HRS7rDERM APPROVAL (Stkil, Sewer) -1 : 17 IMPAcTiFEE (I■Ipistruction) OTHE1,2 , & Attach) $ Ti u1 z-.uoulhe a.72, (sq.ft. = x/1000 x 0.60) (0.005/sq.ft.) (0.01/sq.ft.) PERMIT APPLICATION 0 CONDO ASSOCIATION APPROVAL (Attach) BPR APPROVAL (Restaurants) U CONTRACTOR REGISTRATION (On File) m ISSUING OFFICIAL TOTAL $ I , REVIEWED AND'PREPAItED BY: DATE: CONDITION OF APPROVAL Revised July 2001 --10050-N-.E72ND-AV-E-TMIANHORESTFL-•-(305)--795-2207 • FAX (305) 756-8972 • http://www.miamishoresvillage.com MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT 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. Owner's Name and Address Fier R e Registered Architect and/or Engineer Name and address of licensed contractor Street and Number where work is to be done g'i Heirloom Pink 1 BM -71 -9 ,c Location and legal 1escription of lot to be bu•lt on: Lot J r . �� 1/ Block /6 Subdivision State work to be done and purpose of building (by flo s). state exterior colors (submit samples) /,& New Building Remodeling Addition Repairs RA (Signed) Date Date Date /s 26 19 D 2 No. /'1V /V reef /OQ 5 9l i 4-111 /1 s-5,20‘ o� / 3 ..z1176 ..z1176 S L •- V To be constructed of Kind of foun ion Roof Covering Estimated Total cost of improvements S 7es7 ® o � Amount of Permit S 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 0 .rl/‘r/ ©� `��tiet.;AG‘e.- - � 421'° and for no other purpose. No. of Stories The undersienedannii ,, . , f_r , .__a.:__v• . ;permit does hereby certify that he understands and accepts his obligatons as an employer of Labor under the Florida Workmen's C (piled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof. and will require similar ci rectors employed by him in the work to be performed under this permit: and will post or cause to be posted for inspection of r notices as are required by the Act. The undersigned agrees to employ op y such sylricontractors. on work to be performed ui i Shores Village. 8 ors-70 Read, Sworn to and Subscribed before me. Before me. the undersigned authority, a notary public. duly authorized to administer oaths and take acknowledgments. personally appeared 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. Disapproved (Signed) T W`� V �t/�' Y✓ Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved P ate 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. Notary Public, State of Florida to me well known.