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230 NE 101 St (6)PROPERTY OWNER Name RCS p1 R . U rcp u 1 0( 0% Address a -3, cj k)t 101 r . tr) is m' Shores, Fc. 33► 3$ Home Telephone f ^s ../ 51 u Business Telephone 30 5 , 5 % , Li? j, ,( Fax 5 ° 5 I to' 3(P TYPE OF ;MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation' of Structure . Shell Only Foundation Only Add'I Attachment Other Add'l Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Step 2. A PPLICATION X Job Address: Address Apt. City State Zip f � ,� Folio Number Description of Work l l ��-e � " ��- ti0 R 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 ARCHITECT Name License No. Address Telephone Fax 3 s -33a4ess (� PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection Master Permit No. Subsidiary Permit No.j PERMIT APPLICATION Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. 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. off toe ID( St m )a rem � 11().4S 4 L. 331 Zoning t Linear Feet Square Feet U Units Floors Value of Work 4 i p , Bldg Value i Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. I Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Page 2 IN'IPORTANT 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. COUNTY tr_ MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE ST 19 OF ignature KSa rint Name Sworn to and subscribed before me this/ 6 Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of PERMIT APPLICATION Signature o 1 Notary bl' . " . of ' Orida ..,� ' � Signature of Notary Public - State of Florida .0P � ti ® e Ai ::L A M t i".. .rs II SEAL: h rrr C ,, co: ' „:03 r, ae..: a SEAL: 't - Personally known OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produced: //2 LL If O O! L/ - t -- ) ) yp of Identification Produced: SECTION BY D • TE Zonin: '�1`� -- r a Electrical Mechanical Plumbing Fire Public Works Structural -eVG( 7.—Z Building Official Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond ❑ HRS / DERM APPROVAL (Septic / Sewer) ing Review •ku — ISSUING OFFICIAL Metropolitan Dade County (C.C.F.) $ 1 ' 0 Inspector State Educational Fund $ State DCA (Radon) Code Enforcement Fine $ ❑ PROOF OF OWNERSHIP (Attach) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ o , S - o o REVIEWED AND PREPARED BY: ( sq.ft. = x/1000 x 0.60) (0.005 /sq.ft.) (0.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL 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 ELECTRICAL TYPE Minimum Fee Q'I'Y. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair 'I'Y. 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 AJC 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 TY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost AJC 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 ath Fan - Vented, # Fireplaces, Number of Pressure Vessel '— Temporary Toilet 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: MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: 9 © ) OWNER'S A : eosc5 Ola PHONE: 3O ' 3 3a:- /015 c(e-xe-6 ADDRESS: a3c Ic' I S1- ************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: a 30 /0. 6 . /0/ CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ******* *************************** * * * * * * * * * *i * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls WV, (on S Fascia Blue Drip Cap/Drip Edge 014 Soffit )Q Roof P, ckd.Q— f=e vvo2, (.101 ite--- Flower Bins Aida+ Pe \ C.Q, c Shutters 0 14 Awnings iv)/ A- Chimney fh e(or1 Se.QCQ Doors and door jams P dce - Fe v+c2. 0 - 31, ; - 1 - - � Garage Doors !° t c_ki2 — fevv' c2 0011;1-e_., Railings ti'/ Fences (wc+ll) M.efon SeecP Decorative Metal A c— —1-- Femc.. ft- All brick (simulated or regular) P I u -z►ik. Stucco Banding Pn-e tors Seem Any other stucco features r) er, .eel Accessory Buildings / Other 04 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. I authorize the above -named contractor, if applicable, to the work stated. Furthermore , the paint colors will! be as per the attached plc 0 ,et.,,, vArio....-_, ig .. ture • APPROVED: Building Of " cial pow`- Aoe9 er II a e Signature of Contractor Date ****** ****************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 7 //0, 2 Date got Melon Seed 1B13-1 Picket Fence White • WW57 4/23/01 Miami Shores Village 10050 NE 2nd Avenue Phone: 305-795-2204 Permit Number: BP2002 -1209 Printed: 7/9/2002 Applicant: ROSA Owner: URQUIOLA JOB ADDRESS: 230 NE 101 Contractor Local Phone: Parcel # 1132060134640 Permit Status: Approved Permit Expiration: 1/5/2003 Construction Value: $1,800.00 Work: EXTERIOR PAINTING HOUSE & ROOF If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A 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. Fees: Description Amount FEE2002 -3767 Building Permit Application Fee $60.00 FEE2002 -3768 CCF • $1.20 FEE2002 -3769 Notary Fee $5.00 Total Fees: $66.20 Total Fees: $66.20 Total Receipts: $0.00 Signed: Signed: Building Permit URQUIOLA ROSA ST Contractor's Address: Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 W1/2 OF LOT 8 & LOT 9 BLK 34 LOT SIZE (IN ECTOR) BY: In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. (Contractor or Builder) BY: ,W 1 FLORIDA iraSF 1 � ' The .Sunshine Slade' ROSA RAMONA URQUIOLA 2105 BRICKELL AV 4107 MIAMI,' FL 33129 -0000 08- 31 - -55 F 5 -07 05 -08 -91 U624- 736 -55 -811 -0 08 -31 -97 CLASS: E SAFE DRIVER 70191046084 j'I ''00 -00 -00 • ' Paint Color Approval and Agreement DATE: 4-1 Up(DcL OWNER'S NAME: kSct ( , U./ uio(A PHONE:3os -15)• S yet, ADDRESS: A C, /OE (o( s ?o/"e---S *********************************** * *. * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: a 3c /OE 101 5t, CONTRACTOR & LICENSE (if applicable) COMPANY NAME: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** MIAMI SHORES VILLAGE All Elements on the site must be listed and indicate the color to be painted: Walls G Su nse cl-c4 � 2 Fascia +nnoa cei 417L n Drip Cap/Drip Edge rl` o o r 4,AX o Soffit 10)/1 Roof -Pi c,ke,� Fex\32 � Flower Bins G-c.,1 cP Sc.c,r,S Q (— Shutters //3 6-c. Id Su r>se Doors and door jams FP,r c t.)31-:A Garage Doors F cz. LO ►�;� E. Railin NbA �r Fences L Z/I) 0 Sorns. -f- Decorative Metal Rick k" Fe-v\ cie LOh t \' All brick (simulated or regular) 6-old Su vw.2_ Stucco Banding Cst, l Q-t Any other stucco features Gold) Accessory Buildings L) / 4 Other /0 IA 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. I authorize the above -named contractor, if applicable, to the w s stated. Furthermore , the paint colors will be as per the attached Awnings Chimney APPROVED: Building Official Date 1 041/40., atur- p • wner Date Signature of Contractor Date **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION Paik, PHONE: 27YY 68/470 Pucsta Dorada Auho Dore V 1 Gold Sur.ect rx cn 4/23/01 A MIAMI SHORES VILLAGE Paint Color Approval and Agreement BATE 4 iq ©a 3OS" 3 - /a 55 (c .e//) 12 WNER'S N M : Rosa R . lifgU i O 1 q PHONE: 305 "l5 / 518 9 ADDRESS: 9D be /Dl ST, ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: a:),6 luE 10 / St. CONTRACTOR & LICENSE (if applicable) i COMPANY NAME: !PHONE: ********************************* * * * * * * * * * ** * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls C(ecpme& e e 1 Fascia &)•I n na f•' ku I Drip Cap/Drip Edge Soffit N (4 Roof Pi d th— F.e v\ mil^ c\ 27 Flower Bins Cf ecAry tboW2J ' Shutters - N /-4 Awnings A) / -A 0 Chimney C�.24,, aane.e9 (o+ QC W Doors and door jams fl'ciet.4 F oe lk►1� V Garage Doors P ► cic + F v , t.-uh �i , g Railings /0/44 ,,.{ g w l l .2 rnatO ( (N` Fences ( a � Cr a ik Decorative Metal -pi d * F'Q.M Cp vok ti'2. All brick (simulated or regular) (4001,4 Sur Stucco Banding C_r_o_otrru i Any other stucco features Creo, & eti-Q.r Accessory Buildings ?J 1 Other i0 } OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with al applicable laws regulating construction and zoning. I authorize the above -named contractor, if applicable, to do the work stated. Furthermore , the paint colors will be as per the attached s • •i pies. SIP !ALA TA.. /' ¢ /? 0D-- Sign: . e o O) ner ate Signature of Contractor D ate * * * * * * * * ** *********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: Building Official Date z,A rg.k Creamed Butter 1 A 12 -3 PICKET FENCE WHITE • WHO5 WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01