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1290 NE 101 St (10)O Pay to the order of Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10 /2/2002 Applicant: CECELIA Owner: WEIDMANN JOB ADDRESS: 1290 Contractor MK ROLLAND Local Phone: Parcel # 1132050140010 Fees: FEE2002 -5478 FEE2002 -5480 NE 101 Description Building Permit Application Fee CCF Total Fees: Permit Status: APPROVED Permit Expiration: 3/31/2003 Work: AFTER THE FACT GLASS PORCH ENCLOSURE PERMIT FOR FINAL SALVATORE D. ANNESE 01-02 LAURIE F. ANNESE TEL 305- 756 -9510 9510 BISCAYNE BLVD. MIAMI, FL 33138-2537 Ban kofA>ica. Date ACH FI/T 083100277 For 1:0 6 30000 4 71: 00 5484 3 2 Ba 93811' 0569 Building Permit Permit Number: BP2002 -1671 Dollars 8 WEIDMANN CECELIA ST Contractor's Address: 1559 NE 167 ST Legal Description: 5 53 42 GORDON TRACTS 569 63 -4/630 FL of America Advpnage® 1348 I$ ®K.0"-p Amount $60.00 $0.60 $60.60 Construction Value: `$300.00 BY: BY: Page 1 of 1 PB 55 -20 TRACT A LOT SIZE SITE VALUE OR Total Fees: $60.60 Total Receipts: $0.00 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. " he equipment or device described in the application herefor in strict compliance with all with any plans, drawings, statements or specifications that may have been submitted to : not done in compliance with such ordinances or if the plans are changed without :tor or builder named above assumes the responsibility for a thorough knowledge of the igs or in the statements or specifications and that he assumes responsibility for work done 1 compliance with all ordinances and regulations pertaining thereto and in strict conformity ss Village. In accepting this permit I assume responisibility for all work done by either ;Sep 1 19 02 03:35p Building Department Occupational License 6 Zoning Oept 159 North Perviz Avenue Opa- locka. Fl 33054 Telephone: (305) 953 -2827 Fax: (305) 953 -2897 To : 1 ESA' Date: 7 - Fax: 7-s_C ` 8 PTz From: Fax 4 (305) 953 - 2897 including this page, there are 2 "A COMMUNITY OF BROTHERHOOD AND SISTERHOOD" total pages. 1 NAAZ O Fjc J ln'dez FAX COYER SHEET Telephone: T9--c= Telephone: Comments: 2 2 °• Telephone: (305) 953 -2827 Nct6Su(,E. j IL 4- CITY HALL • 777 SHARAZAD BOULEVARD, OPA-LOCKA, FLORIDA 33054 • (305) 688-4611 AN EQUAL OPPORTUNITY EMPLOYER AND DOES NOT DISCRIMINATF ON THE RASIS nF N aNni'AP p. 1 J • .'Sep 4 18 02 03:35p p.2 4101 SW 139th Avenue Miramar, Fl. 33027 -3025 e -mail: jrodg21944 aol.com INSPECTION REPORT Residence Owner: Mrs. Cecilia Weidmann Job Address: 1290 NE 101 Street, Miami Shores, Fl. Date /Time: September 17, 2002 / 6:30 P.M. Weather: Fair and Clear Inspectors: Jim Rodgers, P.E. and Sal Annese, Gen. Contr. & Bldg Official September 17, 2002 Mr. Charles Esher, Building Official, Village of Miami Shores 10050 NE 2 Ave, Miami Shores, Fl. Dear Mr. Esher: James Rodgers, DPI., P.E. Consulting Engineer An inspection was made at the address referenced above to update the Building Permit Records for this residence. A Building Permit was issued for a three -wall Screen Enclosure at the rear of the residence in the late fifties or sixties. The roof structure over the enclosure is wood frame and in good condition. Some years later the Screen Enclosure was removed and replaced with an enclosure consisting of plate glass panels. No Building Permits were obtained nor were any inspections made for this work. On September 16 2002, a phone call was received from the son -in -law of the Owner, Mr. Tim Stickney, Esq. requesting that an inspection be made to bring the Building Records up to date with the Building Department. The plan for implementing this was to first obtain the services of Mr. Sal Annese, a licensed General Contractor to join me in this inspection. If the structure was found to be safe for human occupancy, a letter to that effect would be written and Mr. Annese would take it to your office to obtain a building permit and upon receiving the permit, to request a Final Inspection of the Enclosure. The enclosure consists of three walls of glass panels. The two walls in the East -West direction are vertical walls. The wall in the North -South direction which faces Biscayne Bay is angled so that the top of the wall extends 18 inches out from the base. The glass panels are supported by 2 "x 4" aluminum tubular columns at 2'- 10" centers. The horizontal tubes are 43 inches up from the ground. The glass panels are 42" high by 32" wide on the bottom row and 46" high by 32" wide on the upper row. There is a glass door on the South wall and consists of Hercules glass which is proper for the swing door. The glass walls are protected by accordion shutters on all three sides. It is this writer's professional opinion that the structure is safe for human occupancy and safe for high velocity winds due to the accordion shutters that ware installed and are all in good condition. If you have any questions please do not hesitate to call. Yours truly, es Rodgers, Fla. P.E. 7405 Phone: (954) 437 -6742 Cell: (786) 236 -8361 Fax: (954) 433 -3446 Owner's Name and Address 7 W� �n- Registered Architect and /or Engineer Name and address of licensed contractor CC/. A :- Location and legal description of lot to be built on: Lot. 09: Block peared Disapproved (Signed) MIAMI SHORES VILLAGE 44 • BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby uinde for tilt approval of the detailed start 111c c 01 ore plans and specifications herewith submitted for the build • inc 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 progreu of the work. Street and Number where work is to be done. ,lam 9 A..71 _. c- Id State work o be done and pusp ,1 � osc of building (by floors).. 44.61 --- /..may -<--�Q � i _je Yf/ . ._.... _.•.— ._!c¢ r . .._.�Q _._._...__ _ _..:.. for no other purpose. Ncw Building Remodeling Addition Repairs ,lam . No. of Stories / To be constructed of Kind of foundation ( Roof Covering Estimated Total cost of improvements $..J /. '/ V Amount of Permit S. . 1" "50 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 the pla l' s and spc ifi ations for said buildi g. All notices with re(erence'to the building and its construction may be sent to.. �,� .. Building Inspector 0 • , 330/3 Subdivisionc.a.thA .4.fdj QaIO_ J The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will 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 posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this pcnnit, as are licensed by Miami Shores Village. Retnuks... (Signed) Date Notary Public, State of Florida My Commiuion Expires PLANNING BOARD — DATE STATE OF FLORIDA, COUNTY OF DADE. ss• Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments; personally ap- _—.....to rite 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.. 4Obi5k Date 1 4 7-1 /4.€6 Read, Sworn to and Subscribed before me. Chairman Member Member Member _ ..._:..._....___ Member.. .. _.._._....._..._. _ ...._...__ Member —.._._......__.._....__._...__......_.----.•-•-•.- Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to thls application after approval has been obtained from the I'lannir.g Board. . A re- in.pec•tion fce of 31.00 will be charged when such re-inspection is made necessary by improper notice for inspection at faulty materials and/or workmanship. CONTRACTOR Name M 1 17 �0 1--'114/ JD l 'tE L.i p - l/, ` / � / �j / /� License No., n [ e � if _ Address /v 13 /$eA1 ke AL-v? Telephone 7 .3d / .Q / j / Fax / / 7 Qualifier Name 41.474 brat_ 2) . A - -it s PROPERTY OWNER New Construction Name &..? t L 1 /'4- W44)/4 Aviv Address 1 -iD dy,e lb/ sr Home Telephone Repair Business Telephone Alteration Interior Fax Demolish TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must he 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 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. A PPLICATION ob Address: / 15 Al Address Folio Number Lot Block Subdivision PB Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other ARCHITECT i Name 1 License No. Address Telephone Fax PERMIT APPLICATION Master Permit No. Subsidiary Permit No. P a ' LU'7 Apt. City State Zip d escription of Work f PG Zoning Linear Feet Square Feet Units Floors Value of Work r Bldg Value Tax Assessed/Appraised Value PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision E tension Supp ment Reinspection Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Page 2 I MPORTANT NOTICES I. 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. STATE OF FLORIDA, COUNTY OF MIAMI -DADE <iature of Owner Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Personally known OR, Produced Identification Type of Identification Produced: ST • NW, r.• Signer of n..ctor /Q Print Name SEAL: alifier PERMIT APPLICATION Swo , s • u d subscribed before me this -2 s gnature of stary .e. It - to of Flori PU OFFICIAL ANGELA M BEG.i- �• I v COMtiSSION NUMBER ' OFF •'F\k: Personally known dlrProduced Identific Type of Identification Produced: ELECTRICAL 'FYPI. Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TY PE 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 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 QTY. Minimum Fee TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE 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. 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 C EC K L I ST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) 4, , ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) Cl OTHER (Specify & Attach) T. PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) 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 $ . i l / ( sq.ft. = x/1000 x0.60) SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE (¢.005 / sq.ft.) (¢.01 /sq.ft.) TOTAL $ (4s d 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 PROPERTY OWNER • Name dec I /'/ A 0e /,S ittAill Address / -4 /o/ S7 --- Home Telephone adS to —' eve Business Telephone Fax sac 7.5 oi-7_ 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. 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. A PPLICATION Job Address: Complete the attached permit application which must be signed by the property owner and (waffler. 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. /(1296 /L/& Address Apt. Folio Number Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax escription of Work Zoning Master Permit No. Subsidiary Permit No. / U/ . S7 Ii/i/3-n/ ,SWO re5 FL City State 19 ' /lbv -ex /sr PERMIT APPLICATION 33 /3 Zip 7 c e hcl©5eq' Linear Feet ...„ quare Feet Units Floors aloe of Work 7/� b7 �ZO/L/ Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Page 2 IIsIPORTAN"1' 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. STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Owner LT L STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Print Name Print Name Sw . s to nd subscribed before me this day o " �I J Sworn to and subscribed before me this day of SEAL: Pul;lt+- to offFl dd. N O . i ANGELA M B =t..' 11.4 2 14 �`� # n oomtssso;a !uc15 :a N '9P - 41 ' Q CC786697 .c. Nis wrt co .:`:,s- 3 . ?:N S OF Ply McVV, 'i 5 '%' Signature of Notary Public - State of Florida SEAL: PERMIT APPLICATION Personally known OR, Produced Identification I/ Personally known OR, Produced Identification Type of Identification Produced: / 1 I 355- ) ` o1— 9 6 °( -, O 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 Fan Dryer Vents, Number of Outlet, Wall Ventilation, Cost Service, Temporary Air Handler, Tons A/C Central 4 -7 Ton Piping, Flammable Liquid Fire Pump Outlet, Switch Fire Sprinkler System Signs A/C Central 8 -15 Ton Bath Fan - Vented, # Fixture - Fluorescent Pressure Vessel 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 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 Q'TY'. 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 Solar Water Heater Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Fixture Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Pump and Abandon PLUNIBING 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 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) ❑ OTHER (Specify & Attach) $ (¢.01 /sq.ft.) ISSUING OFFICIAL REVIEWED AND PREPARED BY: SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE (Xq..ftt. = x/1000 (¢.005 / sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ CONDITION OF APPROVAL 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com DATE: Revised July 2001 - -� i 'III 1111111 111111 .4 1 1 y • . . .n• ' _ • .■■ NIP& ;7: 016-_ LJ, till MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date B / `i►�; Time f - Type Insp'n / °1- Permit No. Name j Address r v 1 V ( � 1 , Company Phone # For Inspector: Approved Correction Re- Insp'n Fee Name & Date Trc:72e-vvIk7-6-2 47 / 03 z , Approved Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Request Date ___ Time F Type Insp'n Permit No. Name 61Z. L C i lu.vf kV Address l 2 (. c /S kV 1 tf Company Phone # For Inspector: Re- Insp'n Fee Vc:7 72 0) T