145 NE 101 St (4)Permit Type (circle): Building
Owner's Name (Fee Simple Titleholder) IT) i � i 'e
Owner's Address 17 G N ID
City fltAtt -' \.4 iM State c
Tenant/Lessee Name
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING RECEOVED
PERMIT APPLICATIOIT jth e 1 ��
FBC 200111
Job Address (where the work is being done) 14C 1 ( 0 1
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO
Zip /3g
Phone #
Contractor's Company Name AR-cre v N / .'=z- Ware- Phone #
Contract is Address 5 [ 5 G b
City State 1 147
Qualifier ' u I-- LA' / i r7
$ Value of Work For this Permit
Submittal Fee $60' C # i PuTermit Fee $
Notary $
Scanning $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $ 531 3 o
(Continued on opposite side)
140
Training/Education Fee $
Radon $
I D
Zonin
Permit No. tGLa 1 - 7 2
Master Permit No.
Plumbing Mechanical Roofing RPJ ) ua / y / Phone # 1ib ''b /�
Zip "5
S 0 07
Architect/Engineer's Name (if applicable) Phone #
Square Footage Of Work:
Type of Work: ❑Additi on era on ew ❑Alt ti ❑N R /R 1 ace
Describe Work:
Re air
/Replace
► re 2 - i/S x h ep am
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
❑ Demolition
CCF $ . p 75 CO /CC
Technology Fee $
Bond $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of com encement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued the absence such posted notice, the
inspection will not be approved and a einspection fee will be charged.
Signature
The foreg
day of
wh
ing
is personally kn
e
Owner or Agent Contractor
strument 'as acknow dged beforeole this 1 The for sin _ 'nstrument was acknowledged / bee re me this
an , day of 1 20 by U (4 1r) ,
or who has produced
As identification and who did take an oath.
NOTARY: _ NOTARY PUBLIC:
Sign: //9/ Sign:
Print: , Sierr Print:
My Commission Exp ire; ;u8, `dICYa N• BIER 82
h1`i ; c,Phossi0N # BD X007
My Commission E
* * * * * * * * * * * * * * * * * *0 Al* '0 ' ft 1. * * * * * * * * * * * * * * * * * * * * * * * * * **
d> mn' ' �r B0 did Yhru q00 ®gyp
g (Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
APPLICATION APPROVED BY:
Chc 12/15/03
Signature
e or who has produced
as identification and who did take an oath.
U •
MY COMMISSION # DD 176222
* # *0 007
Bonded Thru u ge
a 1 J��K -' Plans Examiner
Engineer
Zoning
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 7/8/2004
Applicant: MICHELLE
Owner: PIJUAN
JOB ADDRESS: 145 NE 101
Parcel # 1132060131940
Signed: (Contractor or Builder)
Electrical Permit
Permit Number: EL2004 -178
PIJUAN
MICHELLE
ST
Contractor AFFORDABLE ELECTRICAL CONTRACTORStffractor's Address: 515 NE 190 ST
Local Phone: 305 - 940 -0777
Fees:
FEE2004 -6852
FEE2004 -6853
FEE2004 -6854
FEE2004 -6855
Description
Building Fee
CCF
Training and Education Fee
Technology Fee
Total Fees:
Amount
$100.00
$0.60
$0.20
$2.50
$103.30
Total Fees: $100.30
Total Receipts: l $0.00
s3, 3 a
Permit Status: APPROVED Permit Expiration: 12/28/2004 Construction Value:
Work: WIRE 2 TON A/C W/5 KW HEAT
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 20 & E1/2 LOT 19 BLK 14 LOT SIZE
BY:
$150.00
Page 1 of 1
Signed: (INSPECTOR)
In consideration of the issuance to me of this permit, 1 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 myself, my agent, servants or employes.
Type Insp'n
Name
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
'Building Inspection Requ
Date l Time
i nC3_i f'1QcL
Permit No.{ E 0/3"
P-w -
Address t 4S t-t C 101 ST
Company s \O Y' O •1 I Y C ; rt i 0x.64G •
Phone # 3�a - 2 qS (Q
For Inspector: 1...46 (O?.-L3 Name & Date
Approved �SIJ 7
Correction ❑
Re- Insp'n Fee ❑
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Req
Date 5 - L3 Time
Type Insp'n LL .. � au-)
Permit No. M ai vm3 — O S
Name 7j17t
Address /1/5 ' / 0/ 1'
Company CL41,Glit Cv sg/ _
Phonee3D ^ „6 ?” gel' 2-
For Inspector: 5 3..03 Name & Date
Approved �� f � 6 J , 4.O-
Convection ❑
Re- Insp'n Fee ❑
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305 - 795
Building Inspection Request
Date Time
14e
Type Insp'n no t .
Permit No. 14€_ C3OC
Name
Address 145 KE 1 O l 5+
Company 2 ' l 1 can
Phone # 305 k 4 - E Ids
For Inspector:
Approved
Correction ❑
Re- Insp'n Fee ❑
Name & Date
PERMIT APPLICATION FOR MIAMI SHORES VIL
• 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138 • Phone: 305- 795 -2204 • F
Date J ~- Y-0- Job Address �f s °/‘ /eV 5
Tax Folio
SION #
Legal Description Historically Designated: '" •.o : ,. ,
_,� • .April
• � I �J ` ' ��'/ /�/� �/� n •,P,, BondedThruN. /
�L1r Mari 1 (� )'•a r
Owner /Lessee/Tenet Master Permit # lI
Owner's Address / s� /✓‘. / 0 / S ° Phone
Contracting Co. / - Dear' i •
State # G DS ro 3 8 Municipal #
WORK DESCRIPTION: (7 -Q
a
FEES: PERMIT 7o
Address F6 7 GCJ :35
Qualifier D‘ i L4 / ss# // Phone (5W) W) •C' -5 / 3 6
Competency # Ins. Co.
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING (MECHANICAL . ROOFING
Square Ft. Estimated Cost (value)
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN
YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR ANY ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I 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 all disciplines.
OWNERS AFFIDAVIT: I certify that all the for going information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Furthermore authorize the above named contractor to do the work stated.
\\/\ Signature of owner and/or Condo President
Date Signature of ontractor or Owner Builder
0 Date
4,5
Notary as to Owner and/or Condo President Date Notary as to C ;;trcf: ) cr riAtigeNrNumBER UMBER
My Commission Expires My Commissi ' � Y°' "�
9
p DD091094
c� OF F0—I 7
0O MY COMMISSION EXPIRES
C MI
RADON C.C.F NOTARY ^ % " (� 6
^ CE0VED
:
Date
BOND
APPROVED: TOTAL DUE
Zoning f-6, / Building Electrical
Mechanical C; 1".(g-0) Plumbing Structural Engineer
El
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: ME2003 -85
Printed: 5/16/2003
Contractor HAVANA AC
Local Phone: 305 - 558 - 9136
_r Permit Status: APPLIED Permit Expiration: 11/10/2003 Construction Value:
r y Work: EXHAUST FAN
Applicant: MARIO
Owner: PEREZ
JOB ADDRESS: 145 NE 101
Parcel # 1132060131940
P &H ADDITIONS INC.
PAY TO THE
ORDER OF
0 0
_Sc
Total Fees: $
Total Receipts: $0.00
7448 N.W. 8th Street
Miami, Florida 33126
Phone (305) 264 -8092
• INTERCONTINENTAL BANK
5722 SW 8th Street
West Mlami, Florida 33144
VILLAGE OF MIAMI SHORES
One. h0h(if8 Gvd s -eC/eR+ -FtUe c oll rs and -�;�� DOLLARS
«050 L s' ':0670 L5 2741: 0 2"L0 L9 L 2"
Mechanical Permit
PEREZ
MARIO
ST
Contractor's Address: 887 WEST 34 ST
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 20 & E1/2 LOT 19 BLK 14. LOT SIZE
DATE May 21, 7003
50155
Cern- S
63- 1527/670
02
s pertaining thereto and in strict
assume responisibility for all work
CONTRACTOR
^ /�
Name KOAG2 ® 7AR- o O K /C�
License No. C ^ n i /�
(� V
Address
�
mMv1
m0 gem .. .0(Z
SPA ,1 1s i �
Telephone 0
29/6772 F ax
C/
Qualifier ame
PROPERTY OWNER
s (/t Pea Name halo )120
/ 1115
Address
Nt= la
Y1 Ams 5 , Ft 33/38
Home Telephone -30 3 eik 7 -) 633
Business Telephone 3 S 175—ti—,12571
Fax 3,c- fj -f7 / - ( /:9 p 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
• • • • • •
• • • • • ••• •
• • • • • • • •
• • • • • •
• • • •••
• •
• •
• •
PERMIT APPLICATION
• • • • • Master P�ilXtit lf
• • • • • Subs1diary' P o
• • • • •
••• • • •
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Complete the attached permit application which mustbe si Rc th • • •••
•
Com wne1 and qualifier. Both must be notarized. Please signatures P PP g e • p� � P�D��a 9 e
print or type to allow for a more accurate processing or Your a.plicadott •II roofing wcitk 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: /1-/ r / V 10/- JT
Address
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
Apt.
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
M /117 S4oeq
City
Zoning
Square Feet
Value of Wor
790
State
3.3/x'
Zip
Description of Work etO.L,Or TQ G X /5774
40A4 al2..c JAI tht/77
Linear Feet
Units Floors
eel
Bldg Value
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
Page 2
STATE 0
Signature
...
g WINS,
Signature o ot* l • Pe iorida
SEAL: VO 18
� N ' .
` �•4ra ; *
a #CC 792694 • Q —
Personally k ' 1 �a /0 nded XN O P ed Identification
,..:1;91- ';? Undo.":• 0, S
•
Type of Identific 0
16 11111 1\
• •
• •
• •
..• •
IMPORTANT NOTICES
• •
1. DO NOT BEGIN ANY WORK WITHOUT HAVILVfi INCEIVED lotz 'RI yALID &'I3D 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 MA4NTAIb1ED IN.q.CL1 AN,.NE SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHAL BEk> E M D11 PAND DEBRIS.
4 SWALES MUST BE PROTECTED FROM BEING DeAMA(iEQ BT EVI.DPIp1E 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- o . Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a ;i ontractor.
OF MIAMI -DADE
Print Na e
S . m to and subscribed before me this J day of F� -
• • •
• ••• • •
• • • • -
•••••••
•
•
•
•
ST • F ORID
Sign Contrac
R &i2 'r 6
Print Name 11 A
day of t
Sworn to and subscribed before me this
'
.a• N,,
S i . gt 4.6 18
*• *_
� ; #CC 792694 :''t
.9 .
z
'.State of Florida
e
PERMIT APPLICATION
I -DADE
J�
P6j h 1� �Q_ OR, Produced Identification
Type 'clfIe"'n►r 4od ced: d✓
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 3/18/2003
Applicant: MARIO
Owner: PEREZ
JOB ADDRESS: 145 NE 101
t?i Contractor FAJARDO AIR CONDITIONING Contractor's Address: 588 MORENA DR
Local Phone:
Parcel # 1132060131940
Qv
Total Fees:
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration:
Work: RELOCATE EXISITNG CONDENSING UNIT
Signed
9/14/2003
MekanicaI Permit
Permit Number: ME2003 -28
PEREZ
MARIO
ST
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 20 & E1/2 LOT 19 BLK 14 LOT SIZE
Construction Value:
$500.00
Page 1 of 1
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.
J .�
Signed: 'CC/� v l (INSPECTOR) BY:
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 boon 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.
In consideration of the issuance to me • f this permit, 1 agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity
with the plans, drawin . , statements o • pecifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either
myself, my agent, s ants or empl
REG CO1 032103 1672 NC #01 005604 CASH $60,60
(Contractor or Builder) BY:
ELECTRICAL
"I'VPE
Minimum Fee
QTY.
TYPE
Dryer
Q "!'`'.
• •
TYPE
• • Oltet,•AQpI aj e..'
QTY.
'1'1'
Service Repair
Q'fV.
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
AJC 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
QTY.
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
AJC Condensate
QTY.
TYPE
Drains, Roof
QTY.
'I'V'PE
Miscellaneous Fixture
QTV'.
"I'V'I'E
Soakage Pit
Q'fY.
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 l3eitg pertorrired and g in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
DATE
Zoning
Electrical
Mechanical
f%'� .4.
• (3 •O
Plumbing
Fire
Public Works
Structural
Building Official
• . • •
Page 4
OFFICE USE ONLY
• •
• •
•• •
•• •
• • •
•
• ••• • • •
• • • • • • •
••••• •
•• • •
••
•••
•
PERMIT APPLICATION
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
❑ PROOF OF OWNERSHIP
• • (
•. • • • • ••
• • • f I
HRS rpivi A itc VAL
• • (ss / Sewtr) • • • •
❑ IMPACT FEE
(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
$ ) (/ 0 ( sq.ft. = x/1000
x ¢.60)
(¢.005 / sq.ft.)
(¢.01 /sq.ft.)
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2"° AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
•
•
•
• •
• ••• •
• ••• • • •
•
•
•• • • •
•• •••
Sec. 6 -3 Air Conditioning Regulations. • • • : • •
.. • • • ••• ••
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MiaLaf Shores Village •
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(a) All individual air conditioning units installed in walls or windows shall be securely anchored
to the walls by approved methods. Units installed over public property, paths of egress or more
than ten (10) feet above grade shall be secured to the structure by bolts or screws to resist horizontal
wind loads. Such units cantilevering more than eight (8) inches on the exterior of a building shall
be supported by steel angle brackets secured by bolting. Bolts to masonry shall be set . in lead shields
or similarly rot - resistant fastenings
(b) The following special requirements shall apply to the control and regulation of noise nuisance
from air conditioning machinery.
(1) All equipment, existing or hereafter installed, regardless of location, shall be
maintained in good working order. Equipment so located that normal operating
noises create a nuisance to adjacent owners or occupants shall be provided with
soundproofing, or sound- absorbing baffels, or enclosures, as approved to insure
maintenance of a reasonable noise level.
(2) All equipment on outer walls, on roofs, or in the other exposed locations, which are
unduly noisy, and which causes valid complaints from adjoining property owners or
occupants may be required to be relocated, redesigned and/or enclosed in noise-
retarding materials when, in the opinion of the building official, such enclosure is
necessary or would be effective.
(3)
Special consideration shall be given to the planning of all future installations to
minimize the noise nuisance to adjoining property owners or occupants and the
building official shall have authority to reject or require the redesign of any system
which, in his opinion, would cause such a noise nuisance.
(c) Violation of this section shall be punished as is now or may hereafter be provided by law
(Ord. No. 299, Sec. 1 -3, 2- 21 -61).
I have read a e ab ce and will comply with the regulations thereof.
r /signature / •ntrac or i
I have read the above ordinance and will comply with the regulations thereof.
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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 Villap shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
�,y Dde 6 .. No.. ._ . Street.... EP /L/ 377 Owner's Name and Address / .r � /L � ��'� — . - -. =s . • ----
Registered Architect and /or Engineer
Name and address of licensed contractor ,4// A /: AiD '' . .... 74 / eP 4.4 r• 4
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done._...
State w9 lk to be done and purpose of building (by floors) 11.,tE e.PeA) C e
2-%a was
and for no other purpose.
New Building Remodeling Addition x Repairs No. of Stories
To be constructed of _- Kind of foundation R; .f Co v ng ��_ ® �
Estimated Total cost of improvements $ �! b!!D Amount of Permit $.
Zone cubage required plan Cubage
Distance to next nearest building .5 P -4743 c 1 5 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 site of the work such p notice
or notices as are required by the Act. The undersigned agrees to employ only such su. •_ , ; ri1r -• • . .' k to be performs -nder this
pernit, as are licensed by Miami Shores Village. �--�
Remarks
(Si • ed � �/ .i _ ,
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-
peared - --
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 s edd true.
Permit N o . — Date 6 / 1. t f '-73 Read, Sworn to and Subscribed before me.
Disapproved Date
( Signed)
Building Inspector / My Commission Expires
Date.. T.l.,r/! Bt _. ✓� ..... ,19Z
Notary Public, State of Florida
to me well known,
PLA INC 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 of faulty
materials anti /or workmanship.