PRECAST&PAVERSCONTRACTOR
Name IAu L. 15 TAM /n!
c' -1
Name FAMsc D //v ( •
Home Telephone
Ego- 2.77V
/ V 7
License No. Ask C � C — 061011 q
l
*
Fax (3 psi 37q 6'109
Address
q A M.A.) 50.178 R,veA 17'0.
kIe'u y FL 33/6b
Repair
Telephone (3 0 s) vs 7 _ 30,1 0 Fax (30s..) 7 I g 7
/ T
7
Qualifier Name
es us i\ L A iftlici 0
Demolish
PROPERTY OWNER
Name IAu L. 15 TAM /n!
Address
141 I NE /0/ s1
H soy.,,...: S G. s i FL
Home Telephone
Ego- 2.77V
/ V 7
Business Telephon v (015H1
e
*
Fax (3 psi 37q 6'109
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
/
V
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
Job Address: NW NE /01 5 T
Zip
Folio Number 3 Description of Work ` iA5 � I p re c aS F •A f 5 5 k'
Lot /0 Block 3 Fe et po.'}?o
R of r.,scr ot.
Subdivision /1 -t- Skye S. Pe -ek PB 5C PG 5‘::, Zoning Linear Feet e 1 it — Si
Current Use of Prope y r \ e5;d e..,...te_ Square Feet /000 5 Units Floors
Proposed Use of Property Value of Work /Z 000 Bldg Value
Tenant Information
PERMIT TYPE ( )/
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
Address Apt.
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
PERMIT APPLICATION
Master Permit No. b
Subsidiary Permit No. cz 2aak___45
f ,,1, 5toREs
City
FL
State
ENGINEER
Name
License No.
Address
Telephone
Fax
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 FLORIDA, CO, NTY OF MIAMI -DADE
� ' ,L_
laDe 4 "
Signa a of Own
Alexis
Print Name
Swom to and s
5Q07— .
Cit
Signature of N
SEAL:
Personally known
cribed before me this
day of
VIVIAN DeQUESADA
MY COMMISSION # DD 099750
EXPIRES: April 18, 2006
1 FL Notary Sayan & Bonding, Inc.
OR, Produced Identification
Type of Identification Produced:
1c- ta eo on
VIVIAN DeQUESADA
MY COMMISSION # DD 099750
EXPIRES: April 18, 2006
13.NOTARY FL Notary Service & Bonding, Inc.
STATE
Signature o
Print Name
Swo d subscribed bef
Signature of
SEAL:
PERMIT APPLICATION
COUNTY OF MIAMI -DADE
is Zor_ day of — ,
Personally lcnown OR, Produced Identification
Type of Identification Produced:
ELECTRICAL
"I'Y'PI:
Minimum Fee
QTY.
TYPE
Dryer
QTY:
T1'PI:
Outlet, Appliance
Q"I1
"I'VI'1•'
Service Repair
Q'fY
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
PLUMI31NG
TYPE
A/C Condensate
QTY.
TYPE.
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
()Ty.
'1'11'1:.
Soakage Pit
Q'fl'.
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.
i'IECHANICAL
TYPE
Minimum Fee
A/C Central, Tons
A/C Wall/Win. Tons
Air Handler, Tons
Barbecue
Bath Fan - Vented, #
QTY. -Tl'PE
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
QTY. '1'11'1:
Refrigeration, Tons
Vent Hood, Cost
Ventilation, Cost
Periodic Inspections
RECEIVED AND REVIEWED BY:
DATE:
SECTION
BY
-
� `,
Zonin:
J i#
:
� 4 U
► DA
r
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
L'11
1 -2-- -_
Page 4
OFFICE USE ONLY
CHECKLIST
® OWNER - BUILDER FORM
(Attach)
® FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
® CONCURRENCY
(New Construction)
LI OTHER
(Specify & Attach)
$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
LI PROOF OF OWNERSHIP
(Attach)
LI FIRS / DERM APPROVAL
(Septic / Sewer)
LI IMPACT FEE
(New Construction)
LI OTHER
(Specify & Attach)
PERMIT FEES
$U o
$ , 7 o
(Xq..ftt. = x/1000
$ (¢.005 /sq.ft.)
(¢.01 /sq.ft.)
PERMIT APPLICATION
LI CONDO ASSOCIATION APPROVAL
(Attach)
® BPR APPROVAL (Restaurants)
LI CONTRACTOR REGISTRATION
(On File)
TOTAL $ Y) c ()
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL o (305) 795 -2207 o FAX (305) 756 -8972 ° http : / /www.miamishoresvillage.com
Miami Shores Village
10050 NE 2nd Avenue
FN
Phone: 305 - 795 -2204
Printed: 12 /16/2002
Applicant: ALEXIS
Owner: BENJAMIN
JOB ADDRESS: 1441
Contractor PAMSCO INC
Local Phone:
Parcel # 1132050240270
Fees:
FEE2002 -7180
FEE2002 -7181
^ - EE2002 -7182
Permit Status: APPROV
Work: INSTALL PRECA
If there is no permit pac
fee is $50.00, which must I
This Permit is granted to the cor
ordinances pertaining thereto and ■
and approved by the proper munici
uthorization. A further condition u
nces and regulations pertaini
nts, servants or employe
In consideration of the issuance
with the plans; drawings, statemen
myself, my agent, servants or emp
PAY
TO THE
ORDER OF
MEMO
NE 101
Legal Description: MIAMI SHORES BAY PK ESTS AMD
Description
Building Fee
Buildier's Bond
CCF
Total Fees:
(3os)7- 3 bc7,9
PAMSCO, INC.
9350 NW SOUTH RIVER DRIVE
MIAMI, FLORIDA 33166
CITY OF MIAMI SHORES /
�J l c - /7c.�t/J2 4> i Xfee .. c�-. C "°
xx
CITY OF MIAMI SHORES
Building Permit
Permit Number: BP2002-2156
P 1 of 1
BENJAMIN
ALEXIS
ST
Contractor's Address: 9350 NW S RIVER DR
Amount
$190.00
$300.00
$7.20
$497.20
UNION PLANTERS BANK
63- 841/670
11 L 2811' ':0 6 7008 4 3.41: 11' 6 3 7 L 6O 3 3 511'
PB 56 -86 LOT 10
Total Fees: $497.20
Total Receipts: $0.00
12/11 /2002
BLK 3
6128
DOLLARS
PERMIT NO.
ADDRESS: -
MIAMI SHORES VILLAGE
BUILDING / ZONING DEPARTMENT•
SECTION
• BY
DATE
ZONING •
ELECTRICAL
MECHANICAL
PLUMBING
FIRE
PUBLIC WORKS
STRUCTURAL
BUILDING OFFICIAL
1. Subject to compliance with alt Federal, State.
County. Village rules and regulations. Village sasuntas
no responsibility for amtrecy oftor results (coca
these plans.
2. This copy of plans must be available on
buftdtng site or no Inspection will be conducted.
YI
/ - 1
CRITIQUE SHEET
JOB ADDRESS • 45W XI FAO/ 'r/
APPLICANT t6 T /Al
PHONE#
APPUCAT1ON M/ -S /P - riv
SHEET OF •
MISCELLANEOUS
DATE
ZQNING
COMMENTS
INITIALS
C_iu r r6- /C,€ ov 5 - Mice
:.'.: ono iteeec,64 ,4 - U /f/G 2 ? 7 ,t
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444 r a ' r' 4/e
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Sri. /(xi Afar
of b 5 5 &loop Oc v at rago,67dry
riot a"Der7) Clidiv 6-7)
NOV (9:04 AM PAULBENJAM1N
A
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305 379 6409.
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P. 03
It
IZSTISNIP.TITLE,CO”:1ANY . .
•
DL ALPRI.$ P. BENJAmiN
RUNDMAL MORTCAOt COMPANY TNCAP.P9KATED
4pAtifl'I.211A MitiwANCIK romPAM,
Village of Miami Shores
N° 4245
JOB ADDRESS /4'/,JE 'Or
INSPECTION
TIME READY
REMARKS
INSPECTOR DATE
N° 4120
Village of miavni Shores
\r
JOB % g=
ADDRESS "1/ /U . / 0 / S T ,
INSPECTION �. i0. /¢ S, �- o-b.t
TIME READY f in - -/ - 47,.
REMARKS
INSPECTOR DATE
/! -.3Z,
Village of Miami Shores
JOB
/'1/ /Yt',
ADDRESS �� /7 ?'
INSPECTION
TIME READY
REMARKS
g3o
INSPECTOR
N? 4038
kr
DATE
Village of Miami Shores
JOB Y u � .t) s
ADDRESS ",€ `'./ /,S " - •
INSPECTION /�° ° ,- / 5 -
TIME READY 4.4 - 2 6
REMARKS
N9 3978
INSPECTOR DATE : ` 2 6`
BUILDING
ELECTRICAL
PLUMBING
ROOFING
f
Owner of e*
Building •
Architect
Contractor .',.
or Builder
Legal Lot
Description
Address of
Building
MIAMI SHORES VILLAGE. FLORIDA
PERMIT N° 3664
f•
DATE
Contractor's / ;.
License No.
195
Work to be performed under this Permit
B1
Subdi-
vision
Value of Amount of 2 4. - -.:.
Project $ _> r. • ` Permit $
This permit is granted to the contractor or builder named above to construc 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 further 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 whether 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. / \
Signed. .J f s• lt ..... - � >0
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work cover etg hereunder in compliance with all ordinances and regulations
pertaining thereto and in•ltrie conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either myself, my age y, servant or employee.
1
CONTRACTOR OR BUILDER
BY
AUTHORITY 6
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 build-
ing 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 keRt at building during progress of the work.
Owner's Name and Address
Disapproved
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision.
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
D
•
/ Date , . / .-
c ---11— � _
! ' 7 No
(Signed) .1.
Building Inip'ector My Commission Expires
,19
10 / Street
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind gf foundation Roof Covering
Estimated Total cost of improvements $ fr� Amount of Permit $
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 plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building permit does hereby certify that he understands and accepts his 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 s' .f the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on ork ' be performed under this
permit, as are licensed by Miami Shores Village.
Remarks ( Signed)
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
■
STATE OF FLORIDA,
COUNTY OF DADE. j ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are
Permit No ' (O T Date -//
PLANNING BOARD DATE
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 this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
/ 1 /
o 1r�
T (i - Rd,
i