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230 NE 100 St (2)Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 11 /6/2002 v Applicant: LAUREN Owner: BENTON JOB ADDRESS: 230 NE 100 Contractor LASSETER PLUMBING CO INC Contractor's Address: 865 NE 130 ST Local Phone: 305 - 893 -7180 Parcel # 1132060134480 Fees: FEE2002 -6286 FEE2002 -6287 Permit Status: Work: REPLACE KITCHEN SINK If there is no permit oa fee is tCn ^^ • TOM I. BENTON 230 NE 100th St. 33138 Miami Shores, FL SouthTrust Bank% for I :063 APPROVED Permit Expiration: 5/5/2003 p to t h e I G -1 O order , of _ LA Checking Money Multiplier Multiplier ct k 4 9 0 1 028t'' 2763 0 9 3 0�: (Contractor or Builder) Plumbing Permit Permit Number: PL2002 -299 BENTON LAUREN ST Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 8 & 9 Description Building Permit Application Fee Notary Fee Total Fees: 2763 63.943/63 BRANCH 89232 / / / 1 o _te b 6 -�L Da " $ a el Dollars Amount $60.00 $5.00 $65.00 Construction Value: $100.00 Total Fees: $65.00 Total Receipts: $0.00 ierify, there will be no inspections. Re- inspection ection. BLK 33 LOT SIZE 100.000 1 the 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 is not done in compliance with such ordinances or if the plans are changed without •ctor 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 : ompliance with all ordinances and regulations pertaining thereto and in strict conformity Village. In accepting this permit I assume responisibility for all work done by either BY: BY: PLUMBING TYPE A/C Condensate Q "TY. TY Drains, Roof QTY. TYPE Miscellaneous Fixture (in'. '1'1'PE Soakage Pit Q'1'1'. 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. ELECTRICAL TYPE QTY. TYPE QTY. '1'YI'I? QTY. 'fl'i'p. Minimum Fee A/C Central 1 -3 Ton A/C Central 4 -7 Ton A/C Central 8 -15 Ton A/C Central 16 -20 Ton A/C Central 20+ Ton A/C Window Air Conditioners Chiller Clear Violations Compactor Deep Freezer Demolition Dishwasher Dryer Fan Fire Pump Fixture - Fluorescent Fixture Light Flood Lights FPL - Load Central Garbage Disposal Generators, etc. Heat Recovery Low -volt, Burglar Low -volt, Fire Low -volt, Intercom/Teleph. Low -volt, Television Outlet, Appliance Outlet, Wall Outlet, Switch Oven Parking Lot Lights Plugmold/Strip Posts Range/Range Top Receptacles Refrigerator, Comm. (p/PH) Refrigerator, Domestic Renew - Temp Service Repair Circuits Service, Number of Amps Service Repair Service, Temporary Signs Space Heater (kw) Spas/Hot Tubs Subfeeds, No. of Amps Swim Pool, Commercial Swim Pool, Residential Switchboards Temp Serv., Construction Temp for Test - 30 days MECHANICAL "TYPE Minimum Fee A/C Central, Tons A/C Wall/Win. Tons Air Handler, Tons Barbecue Bath Fan - Vented, # QTY. TYPE Condensate Drain Cooling Tower Dryer Vents, Number of Ductwork, Cost of Fire Sprinkler System Fireplaces, Number of QTY. Generator Heating Strips, each Paint Booth Piping, Flammable Liquid Process/Pressure Piping Pressure Vessel QTY. 'TYPE Refrigeration, Tons Vent Hood, Cost Ventilation, Cost Periodic Inspections QTY. RECEIVED AND REVIEWED BY: DATE: PROPERTY OWNER Name ._fri r3r0,,D Address 3 0 `ve /00 Home Telephone -7 5-p'1 DBq Business Telephone 7 9r 2 2c 7 Fax CONTRACTOR Name L. ,4SJr' sy„, "400i1"7 License No. Address . Telephon113 7 ? Q Fax Qualifier Name � 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 4 , ..,kb Address: Folio Number Lot Block PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other vc ARCHITECT Name License No. Address Telephone Fax 2 3o Address /ice / ov'' Apt. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection Description of Work PERMIT APPLICATION Master Permit No. Subsidiary Permit No. 4 ?_/ 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 1 • ned b the .ro. ert owner and •ualifier. Bo h i nature mu t 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 11 gi City S4D » State 37/3r Zip PB PG Zoning Linear Feet .operty Square Feet Units Floors Proposea Use of Property Tenant Information 7Value of Work ' op `� Tax Assessed/Appraised Value Flood Zone Base Floor Elev. Bldg Value ENGINEER Name License No. Address Telephone Fax PROPERTY OWNER Name —Pr' arwlhvd Address -230 `v - /0o) r Home Telephone '-7 S7..1 01' Business Telephone - qr; 7 2.07 Fax Qualifier Name CONTRACTOR New Construction Name L 4.u r, h'A. /94e,thui License No. Alteration Exterior Address • Repair Telephone)9 3 :] ? o Fax Qualifier Name 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 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 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 Kj.....Jqb Address: 23 o Address NY /00 Apt. Lot Block 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 Master Permit No. Subsidiary Permit No. ) 2 00� /qt./ City Folio Number (Description of Work 5tIat.. )0ej/lac t f State PERMIT APPLICATION ki Si >aIC 33/3, Zip PB PG Zoning Linear Feet ,operty Square Feet Units Floors Proposea Use of Property V $I 1 alue of Work 00 Tenant Information " Tax Assessed/Appraised Value Flood Zone Base Floor Elev. Bldg Value ENGINEER Name License No. Address Telephone Fax Page 2 INIPOR'rAN'r 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 D1 V1'r - 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, P' 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 o Owner °el 73Tv Print Name / Sworn to and subscribed before me this S day of l. X Signature of Notary Public - State of F ef Barbara Ann Fugaal My Commission DD083828 l'e Expires March 29, 2006 SEAL: Personally known OR, Produced Identification STATE OF FLOR 'Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: PERMIT APPLICATION i MI- .•— eE 1 NIB DA-v /0 Personally known OR, Produced identification Type of Identification Produced: Type of Identification Produced: SECTION BY DATE Zoning Electrical Mechanical Plumbing /9-6 <1, Fire ,,/- Public Works Structural Building Official Page 4 OFFICE USE ONLY CHECKLIST O 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) • ( x sq..60) x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) . }0 a TOTAL $ 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 ELEC'T'RICAL TYPE Minimum Fee QTV. 'I'YI'E. Dryer QT1'. TVPI? Outlet, Appliance Q'I'1'. TYPE Service Repair QYI'V. A/C Central 1 -3 Ton Fan Outlet, Wall 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 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 PLUMBING 'I'1'in: A/C Condensate QTY. TYPE Drains, Roof QTY. 'I'YP@ Miscellaneous Fixture QTV. TYPE. Soakage Pit Q'I'V. 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. NIECHANICAL TYPE Minimum Fee A/C Central, Tons A/C Wall/Win. Tons Air Handler, Tons Barbecue Bath Fan - Vented, # QTY. 'fYPL Condensate Drain Cooling Tower Dryer Vents, Number of Ductwork, Cost of Fire Sprinkler System Fireplaces, Number of Generator Heating Strips, each Paint Booth Piping, Flammable Liquid Process/Pressure Piping Pressure Vessel QTY. TYPE Refrigeration, Tons Vent Hood, Cost Ventilation, Cost Periodic Inspections RECEIVED AND REVIEWED BY: DATE: M r-!1 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 11/6/2002 Applicant: LAUREN Owner: BENTON JOB ADDRESS: 230 Contractor MOODY ELECTRIC INC Local Phone: (305)758 -2000 Parcel # 1132060134480 TOM J. BENTON 230 NE 100th St. Miami Shores, FL 33138 Fees: • FEE2002 -6283 FEE2002 -6284 (� J Permit Status: Permit Expiration: 5/5/2003 � — Work: ELECTRICAL FOR KITCHEN REMODEL order of SouthTrust Bank For 3 Pi ' ro J 1:063 09430i: 49 0 LO 0 280 NE 100 //Aid Date 2763 Electrical Permit Permit Number: EL2002 -362 BENTON LAUREN ST Contractor's Address: 669 NW 90 ST Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 8 & 9 Description Amount Building Permit Application Fee $60.00 Notary Fee $5.00 Total Fees: $65.00 Construction Value: 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. 2763 63.943/631 BRANCH 89232 Pay to the M / G-" r ] k&Ate'S ✓ L4 Q .._ $ a t1 N v tsb/ �"II , LV �" p*-4 7 t -OI'1.2- 3 K Q-2--r Dollars L!J Money Multiplier Checking e:lc� BY: BY: $350.00 Page 1 of 1 Total Fees: $65.00 Total Receipts: $0.00 BLK 33 LOT SIZE 100.000 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 compliance with all ordinances and regulations pertaining thereto and in strict conformity s Village. In accepting this permit I assume responisibility for all work done by either Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. ELECTRICAL TYPE QTY. 'I'YI'E QTY. TYPE (1'1'1'. QTY. Minimum Fee A/C Central 1 -3 Ton A/C Central 4 -7 Ton A/C Central 8-15 Ton A/C Central 16-20 Ton A/C Central 20+ Ton A/C Window Air Conditioners Chiller Clear Violations Compactor Deep Freezer Demolition Dishwasher Dryer Fan Fire Pump Fixture - Fluorescent Fixture Light Flood Lights FPL - Load Central Garbage Disposal Generators, etc. Heat Recovery Low -volt, Burglar Low -volt, Fire Low -volt, Intercom/Teleph. Low -volt, Television l Outlet, Appliance Outlet, Wall Outlet, Switch Oven Parking Lot Lights Plugmold/Strip Posts Range/Range Top Receptacles Refrigerator, Comm. (p/PH) Refrigerator, Domestic Renew - Temp Service Repair Circuits Service, Number of Amps Service Repair Service, Temporary Signs Space Heater (kw) Spas/Hot Tubs Subfeeds, No. of Amps Swim Pool, Commercial Swim Pool, Residential Switchboards Temp Serv., Construction Temp for Test - 30 days MECHANICAL TYPE Minimum Fee A/C Central, Tons A/C Wall/Win. Tons Air Handler, Tons Barbecue Bath Fan - Vented, # tin'. TYPE Condensate Drain Cooling Tower Dryer Vents, Number of Ductwork, Cost of Fire Sprinkler System Fireplaces, Number of QTY. TYPE. Generator Heating Strips, each Paint Booth Piping, Flammable Liquid Process/Pressure Piping Pressure Vessel ()Ty. TYPE IIN Refrigeration, Tons Vent Hood, Cost Ventilation, Cost Periodic Inspections PLUMBING TYPE QTY. TYPE QTY. TYPE. QTY. TYI'E QTY. A/C Condensate Bath Tub Bidet Cap - Fixture Cap - Water Cap - Sewer Catch Basin Clothes Washer Dental Chair Discharge Well Dishwasher Disposal Domestic Well Drainfield, 4" Tile/Res. Drains, Area Drains, Floor Drains, French Drains, Roof Drinking Fountain Filter Replace Fountain Gas - Appliance Gas - Natural Gas - Propane Gas Piping Grease Trap Ice Maker Indirect Wastes Interceptor Laundry Tray Lavatory Meter Set (Gas) Minimum Fee Miscellaneous Equipment Miscellaneous Fixture Miscellaneous Repairs Pool Piping Pump and Abandon Pump, Domestic Pump, Fire Stand Pump, Re- circulate Pump, Replace - Pool Pump, Sprinkler Pump, Sump Relay Repair Roof Inlet Septic Connection Septic Tank Sewer Connection Shower Sink Soakage Pit Solar Water Heater Sprinkler Repair Sprinkler System Supply, AC Well Temporary Toilet Temporary Water Closet Urinal Utility - Sewer Utility - Water Vacuum Pump Water Closet Water Heater Water Heater New Water Re -pipe Water Service Well, Supply RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning Electrical / _ 11- i ®` Mechanical Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY U OWNER - BUILDER FORM (Attach) U FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) U OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review Notary REVIEWED AND PREPARED BYfr $ �© CHECKLIST ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES Metropolitan Dade County (C.C.F.) $ (sq.ft. = x/1000 x ¢.60) $ (¢.005 / sq.ft.) t� %�� eC DATE /'A '�• • (0.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ 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 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 $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1°' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FL RI I COUNTY OF MIAMI -DADE F 4ORI A COUNTY OF AMI -DADE Signature of Contractor / Qualifier Signature of Owner Print Name Sworn to and subscribed before me this 5 day of _:_: , ata, . 6, a 44 1 Signature of Notary Public - State of Florida f o Barbara Mn Fugazzi � T My Commission X083828 cv n�' Expires March 29, 2008 Personally known X OR, Produced Identification SEAL: 6 - 21.)$,./ Print Name to and subscribed before me this Signature . " kotary ' b c - State of Florida SEAL: PERMIT APPLICATION day o))/1:5\- e_ -ry, Angela M Becker • 1 _• My Commission DD150048 l ' c o s o ,n cif Expires November 15, 2008 Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: Page 2 IMPORTANT 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. 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 FL RIDA, COUNTY OF MIAMI -DADE F . ORI A COUNTY OF AMI -DADS � / r Signature of Owner Print Name Swom to and subscribed before me this 5 41h day of c_x: eatiata 1 Signature of Notary Public - State of Florida L . 4 0y'"'h. Barbara Ann Fugazzl '� My Commission DD083828 a nri Expires March 29, 2008 Personally known X OR, Produced Identification SEAL: frtt Signature of Contractor / Qualifier Print Name to and subscribed before me this day of/ . ♦ U A Signature ,p. lotary b c - State of Florida SEAL: PERMIT APPLICATION o r Angela M Becker II d� My Commission 00150048 ` p a Expires November 15, 2008 Personally known V OR, Produced Identification Type of Identification Produced: Type of Identification Produced: CONTRACTOR Name J eil /T ed �� / s 9 Name Y t ,00 �C L 1 rt sic_ .T/uic License No. Si- /og' -/ Business Telephone Address fi b 1 itieli 90 S T Telephone 757, 2 Fax Fax 7 rt . / _ /7 73 Qualifier Name Shell Only PROPERTY OWNER Name J eil /T ed �� / s Address 2 3 0 ,e /0 0J Home Telephone Si- /og' -/ Business Telephone , p 720 Fax 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 Step 1. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Square Feet PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax PERMIT APPLICATION Master Permit No. Subsidiary Permit No. 4:2. 0Oc ' 3 INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: 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. Job Address: °23 0 Nu; /00 cr 1 iiQci 8140,0 rf 33/3 k Address Apt. City State Zip Folio Number LJDescription of Work 4 rio Jr l gh. I+ rpi Lot Block j'Aidd n PB PG Zoning Linear Feet Units Floors _ iuposed Us,, .t Property Niue of Work N 03 Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax For Inspector: Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Re- Insp'n Fee ❑ 03.3 Address Company -' Phone # Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 11/6/2002 Applicant: LAUREN Owner: BENTON JOB ADDRESS: 230 NE 100 -�e— Parcel # 1132060134480 - / Fees: FEE2002 -6288 FEE2002 -6289 Contractor Local Phone: TOM) BENTON 0 L 33138 NE 230 Miami Shores, Miamt order of the Southirust Ba!k Money Multiplier Checking Description Building Fee CCF Total Fees: Permit Status: APPROVED Permit Expiration: 5/5/2003 Work: REMOVE AND REPLACE KITCHEN CABINETS Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 8 & 9 1: 49 010 028th 2763 1:1430 Building Permit Permit Number: BP2002 -1904 Date BENTON LAUREN ST Contractor's Address: Construction Value: $9,500.00 276 63.943/6 B11pp1G11 89232 $ a$i �—� Dollars el (Contractor or Builder) Amount $145.00 $6.00 $151.00 toP ?rify, there will be no inspections. Re- inspection ction. 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 or or builder named above assumes the responsibility for a thorough knowledge of the s or in the statements or specifications and that he assumes responsibility for work done mpliance with all ordinances and regulations pertaining thereto and in strict conformity illage. In accepting this permit I assume responisibility for all work done by either BY: Page 1 of 1 Total Fees: $151.00 Total Receipts: $0.00 BY: BLK 33 LOT SIZE 100.000 ELECTRICAL TYPE Minimum Fee QTY. TYPE. Dryer QTY. TYPE Outlet, Appliance QTY. 'TYPE Service Repair QTY. A/C Central 1 -3 Ton Fan Outlet, Wall 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 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'I'Y. 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. TYPE Miscellaneous Fixture QTY. TYI'E 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) ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) 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 Q ft. = x/1000 x ¢.60) $ (¢.005 / sq.ft.) $ (¢.01 /sq.ft.) ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE TOTAL 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 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 13E 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 STATE OF FLORIDA, COUNTY OF MIAMI -DADE ' ignature of Contractor / Qualifier Y of Owner -7'o wt pc- Th., Print Name Sworn_ tond subscribed before me this day oft_ Signature of Notary Public - State of Flori SEAL: rise��� �� Barbara Ann Fugazzi • My Commission 00083828 a, Expires March 29, 2006 Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: PERMIT APPLICATION Personally known JV OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: PROPERTY OWNER New Construction Name -- T - 0 r'" r '-ry e✓ 14)ea,c) 4e='k Address 2 3 0 A) E /00 _("177 er Home Telephone Address 6j— Di Business Telephone Telephone ei p ^ Sp _ 9 , 92/ Fax Fax Qualifier Name 8. Cig c fe/ ,� A V ., 2 „. CONTRACTOR ■ New Construction Name ) " 5 Cus ro" 14)ea,c) 4e='k Si.., License No. Repair Address 6j— Di Demolish Telephone ei p ^ Sp _ 9 , 92/ Fax Qualifier Name 8. Cig c fe/ ,� A V ., 2 „. Foundation Only 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 Miami Shores Village: Step I. Step 2. 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. 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. Z3 Address w � /00 Sr 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 Master Permit No. Subsidiary Permit No. r if got S City description of Work ,�Jue of Work /Qe ratil, Tax Assessed/Appraised Value Flood Zone PERMIT APPLICATION ? 7 0 y 77/3i) State Zip t ge plcer je, ¢ zkg,. ( 4 Zoning Linear Feet Square Feet Units Floors Bldg Value Base Floor Elev. ENGINEER Name License No. Address Telephone Fax