1217 NE 100 St (11)Type Insp'n
Permit No.
Name
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date 4 00 Time
B P 202 --//d
a4 9
Address a �i' /opSY
Company
Phone #
For Inspector: I0 2 - D z Name
Approved / ,>
Correction
Re- Insp'n Fee ❑
Type Insp'n /zua I4 h4
Permit No. 7P c)00, -8i 7
Name
Address
Company
Phone #
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date F`' /- oz.) Time
For Inspector:-, -O
Approved ❑
Correction
Re- Insp'n Fee ❑
17 /v' /DO S'f
G� 6-344z7
30C, a • 66
Name & Date
A. .1. Ande 'son, Jr. or
Kostine Ancie /son •
1200 1290 Street
North mi anii, rl 33161
Pato pc
44
6 70 ••••••'
_COB
/
.64-ploitte, cthcl Protecting the Phozet
ars 114'477440.
e 301
46 79
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 5/3/2002
Applicant: AJ
Owner:
JOB ADDRESS: 1217 NE 100 ST
Contractor ARCO CON TRUCTION
Local Phone: 305 -892 -6507
Parcel # 1132050090631
Signed:
Building Permit
Permit Number: BP2002 -867
ANDERSON
Signed: (Contractor or Builder) BY:
Contractor's Address: 1665 NE 137 TERR
Page 1 of 1
Legal Description: 5 53 42 EARLETON SHORES PB 43 -80 LOT 2 BLK 5 LOT SIZE
Fees: Description Amount
FEE2002 -2517 Building Fee $150.00
FEE2002 -2518 CCF $3.60
FEE2002 -2519 Notary Fee $5.00
Total Fees: $158.60
Total Fees: $158.60
Total Receipts: $0.00
Permit Status: Permit Expiration: 10/30/2002 Construction Value: $5.900.00
Work: BATH ROOM REMODELING (NEW TILES NEW PLUMBING FIXTURES)
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 ! under 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 whetner shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees.
'OR) BY:
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 I assume responisibility for all work done by either myseif, my agent,
servants or employes.
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
028261856 2002 APR 29 12:06
PERMIT NO. TAX FOLIO NO.
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 street address: L�,± a 3 OC- S E r(1'° n J t 6 re' CCCo rot P /a
2. Description of improvement:
3. Owners) name and address:
I a 1� N 100 sr
V- 7 1-e e (.rnr,
/1
/ J p rsu
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name a d address:
65
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $_
6. Lender's name and address:
,41/4"
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address: 1 0 (7 N C 100 s
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address: 102 (7 NE 100 s T
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
A d6c4-01
Signature of Owner
Print Owners Name .j IQ 4 d(e 5 r.
Sworn to and bscribe� 4g�r rr a this ° day of
p 26T/ -. , - 'y5` ,4 -s-3� -030
Notary Pu
Print Not
My Commi
ion Expires: 7/6 /
Prepared by: 4 5 ° Sol r' 1il .
, 19 2-O,Z
^a Address: 1at ,U 00 s r
J . (•-(3
'3'313 V
Cr1MISSION #CC 852506
JULY 6, 2003
OF
IOA. C 'e . DADE of the
ST ATE Y FL Oa Y that this 1s a:tru day of
HEREBY CERTIFY
tthi MO on Ap 20
mat filed
origin
Of f o f? ircuit an d County Co its
C.
12301.52 2/93
CONTRACTOR co c ms- r e t i c Ti O e 6
i
NameName
License No. (y3 0 6 g
Address I b b 5 M L — = -7 1 � cce 7 T-0 ��
JV „I - It(,7 /iA1. FCC '31?l 1
Telephone s aS” Z 6 5-07 Fax 9C' A� p�9
a ,/
.
�—
Q ' erN LJ 'L
PROPERTY OWNER
New Construction
Name 4 V gl n Jr-.
Address
iaoo
IJF
100 sr
Home Telephone
Repair
Business Telephone
co 7 3
7 1 R 3
Fax
6 73
(0 3 S
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
X Job Address:
I9I
Address
Folio Number \fDescription of Work rOoY) / ') tom° ` w (�
Lot Block "e_)9 77,1_,-, 6, ► yyi t� 'aci
Subdivision PB PG Zoning Linear Feet
Current Use of Property Square Feet O Units Floors
Proposed Use of Property )( Value of Work s 0 Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT TYPE ( ✓) l
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
N
/o ()
Apt.
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
PERMIT APPLICATION
Master Permit No.
Subsidiary Permit No.
/Kam SJ lore s F a . 33(3g
City State Zip
ENGINEER
Name
License No.
Address
Telephone
Fax
Page 2
[NI PORTANT 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.
A FFI I)A \•I'I' - 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, 1s' 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 O FL�IDA� Y MIAMI DADS
ar of
Owner
wner
/44dersoo � c
Print Name
Sworn to and subscribed before me
.l.. /. ! �1 i,∎ .
ature of i tary Publi
SEAL:
ta eef da
r ri,
S ' • OF FLORIDA, CO OF MIAMI -DADE
Print Name
Sworn to and subscribed before me this
SEAL:
PERMIT APPLICATION
to of Florida ::.
•
Personalty known OR, Produced Identification
Type of Identification Produced: FA P). / ?3G- 03 (n., �°/ (J'pe of Identification Produced:
V Personally known OR, Produced Identification
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE.
Outlet, Appliance
QTV'.
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
Hood 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
1\tECHANICAL
,1.}.1,1,, QTY.
Minimum Fee
.1.},1,1,;
Condensate Drain
QTY. .I.YI,E QTY.
Generator
nil.: Q.LV
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
PLUn1131NG
TVI
A/C Condensate
QTY.
TpE
Drains, Roof
Q . I . V .
TYPI
Miscellaneous Fixture
Q . L .
.
Soakage Pit
QTV
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
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
❑ CONCURRENCY
(New Construction)
❑ OTIIER
(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)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
$ �s
Metropolitan Dade County (C.C.F.) $ 3 - 0
(sq.ft. = x/1000
x ¢.60)
$ (¢.005 /sq.ft.)
$ (e.01 /sq.ft.)
SI
REVIEWED AND PREPARED BY:
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
z
DATE
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL $ S8
ISSUING OFFICIAL
DATE:
CONDITION OF A PPROVA L
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com