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PAINT PERMITSDate PC1104 Permit No. 3j 2{ _ IS4J . Name "ar') �` Address i4 NE 100 34- Company 6W re r Phone # Type Insp'n Inspection Date Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING-_DEPARTMENT 305- 795 -2204 \ Bgtilding Inspection Request it;itc Permit Type (circle): Building Electrical Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305 .. ` '' • , . .' 8972 ► � � VIED BUILDING OV 2 4 204 PERMIT APPLICATION FBC 2001 Plumbing Owner's Name (Fee Simple Titleholder) Dar PJ z_ Phone # Owner's Address £C iJ e (n D S 4 City M. R.r:. Sl. c State FL Zip 3 31 3 8 Tenant/Lessee Name .--- Phone # 30 S - -7V/ - ZS i 9 •' H C° 41(1)-113- 1 1 1 .131 — Ce11 Job Address (where the work is being done) �Oi An. e, Pf ti City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO ✓ u/� Contractor's Company Name -, PA 1 n/'(i fJ (r to /--) i 7 O Phone # Contractor's Address City State Zip Qualifier State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit- 1.109 0O. O Permit No.SPbq — 15 (4 5 ster Permit No. Square Footage Of Work: Mechanical Roofing Type of Work: ['Addition 2<lteration ❑New ❑ Repair/Replace El Demolition Describe Work: en; Dif /10 , r ***********************c***** FF * * * * * * * * * * * * * * * * * * * * * * * ** ** * ** Submittal Fee Permit Fee $ 60 r `�" CCF $ • 2i 0 CO /CC Notary $ Training/Education Fee $ C90 Technology Fee $ j • Sn Scanning $ Radon $ Code Enforcement $ Structural Plan Review. $ Zoning Bond $ Total Fee Now Due $ 2 2 pa (d gri S. (Continued on opposite side) 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. 1 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 82500, 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 commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will nod be approved and a reinspection fee will be charged. Signature The foregoing instrument was acknowledged before me this , - -;i day of ';v . , 20 ( , by it who is personally known tome or who has produced As identification and who did take an oath. NOTARY PUBLIC: Owner or Agent Sign: Print: f. n1 My Commission Expires: Chc 05/13/03 APPLICATION APPROVED BY: Signature Contractor The foregoing instrument was acknowledged before me this day of , 20 _, by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: t►cYP'' Erika * * ' lo mmissto n 7. a • P� Expires: Oct 28, 2007 ' i ` °,,` � }'Q,, Bonded Thru �r � *** * * * * * * * * * * *** *** * ** *** ** * * ** *�M WW4=4% * * * * * * * * * * * ** X11 I ' ********* * ** * * *** * * * *** ** * *** * * ** *** * * ** 143V a 0 2004 Plans Examiner Engineer Zoning Miami Shores Village .Paint Color Approval and Agreement Date t( 91 oY Owner's Name % a ter L„ � Pa Phone # 7-76 _q 7 3 -4431 Owner's Address LR N a C City ' ` N. S (,..o /e s State Zip 3 3 ( 3 q Job Address (where the work is being done) (sk'' City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO . V Contractor's Company Name (if applicable) Phone # ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 11 All elements on the site must be listed and indicate the color to be painted Walls (J L 190 R{- (,dv11Tl; y `R S o rSe44 Fascia Drip Cap /drip Edge Soffit Roof Flower bins Shutters t - pq(:^) Z ^d' GOOD-7 Awnings Chimney tottti Doors and door jams Q �� Garage doors - Railings Fences Decorative metal All brick (simulated or regular) L C'R.II P 611-r. red Stucco banding Any other stucco features Accessory Buildings Other ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 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 ns ' , ction and zoning. Signature APPLICATION APPROVED BY: Owner or Agent ,Q —L P& Z Official Date W 01 Date ceR- L ^ SC I' /? Y d/d chc 6/18/03 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12 /2/2004 Applicant: KENNETH Owner: WYNN JOB ADDRESS: 46 Contractor Local Phone: Parcel # 1132060131220 NE 100 I Signed: Signed: (Contractor or Builder) (INSPECTOR) Building Permit Permit Number: BP2004 -1545 WYNN KENNETH ST Contractor's Address: Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 7 & E1/2 OF LOT 8 BLK 9 Fees: FEE2004 -12113 FEE2004 -12114 FEE2004 -12115 FEE2004 -12116 Description Building Painting Fee CCF Training and Education Fee Technology Fee Total Fees: Amount $60.00 $0.60 $0.20 $1.50 $62.30 Total Fees: $62.30 Total Receipts: $62.30 Permit Status: APPROVED Permit Expiration: 5/23/2005 Construction Value: $1,000.00 Work: PAINT AS AGREED 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. BY: Page 1 of 1 DEC 0 3 P410 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12/2/2004 Applicant: KENNETH Owner: WYNN JOB ADDRESS: 46 Contractor Local Phone: Parcel # 1132060131220 NE 100 Building Permit Permit Number: BP2004 -1545 WYNN KENNETH ST Contractor's Address: Permit Status: APPROVED Permit Expiration: 5/23/2005 Construction Value: $1,000.00 Work: PAINT AS AGREED Page 1 of 1 Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 7 & E1/2 OF LOT 8 BLK 9 Fees: FEE2004 -12113 FEE2004 -12114 FEE2004 -12115 FEE2004 -12116 Description Building Painting Fee CCF Training and Education Fee Technology Fee Total Fees: Amount $60.00 $0.60 $0.20 $1.50 $62.30 Total Fees: $62.30 Total Receipts: $62.30 DEC 0 3 PAID Signed: (INSPECTOR) 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. Signed: (Contractor or Builder) BY: MIAMI SHORES VILLAGE BUILDING DEPARTM 305- 795 -2204 Building Inspection Requ Date 61'03 % Time Type Insp' n� 2t'i frit.gt Permit No. ' 0V03 -Co 3 Name YV if?ni Address i /V ° /jZ Si" Company -- Phone # 3 .0, 9 37 For Inspector:6 /O_a3 Name & Date Approved Correction Re- Insp'n Fee 1�iiL�l ►liiV _ 4 1J ♦ 11-1 V J' 1 DATE: OWNER'S NAME: , W vt PHONE: 2-S71C 1‘ _37 ADDRESS: 5 /U` % S`7` ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the Walls u Fascia (.4) r i e Drip Cap/Drip Edge ZJ (7`C Soffit t) 4 (`t& Roof Flower Bins Shutters Awnings Chimney Doors and door jams atife- Garage Doors Railings - Fences Decorative Metal APPROVED: Paint Color Approval and Agreement }}'te must be listed and indicate the color to be painted. (trIA) (_e) 1ttt -� All brick (simulated or regular) --- Stucco Banding Any other stucco features Accessory Other 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 do the work stated. Furthermore , the paint colors will be as per the attached samples Signature of Owner " Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 00 Building Of ial Date WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/28/2003 Applicant: KENNETH Owner: WYNN JOB ADDRESS: 46 Contractor Local Phone: Parcel # 1132060131220 NE 100 Building Permit Permit Number: BP2003 -503 WYNN KENNETH ST Contractor's Address: Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 7 & E1/2 OF LOT 8 BLK 9 Fees: FEE2003 -1856 FEE2003 -1858 FEE2003 -1859 Description Building Permit Application Fee CCF Notary Fee Total Fees: Amount $60.00 $0.60 $5.00 $65.60 Total Fees: $65.60 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 9/24/2003 Construction Value: $300.00 Work: PAINTING AS PER AGREEMENT 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. Signed: This Permit is granted to the contractor or buil ordinances pertaining thereto and with the unders and approved by the proper municipal authorities. authorization. A further condition upon which this ordinances and regulations pertaining to the work by his agents, servants or employees. Signed: In consideration of the issuance to me of this p, - ;'_:. with the plans, drawings, statements or specifica ,, myself, my agent, servants or employes. � " 6L OL9Z/EL6e - E9 1 11 111 9h099 4 1 1 $ 4 � 8 ' �S E 1;'80/, 92 :1 1 1103 At! 33I S H3wQ H t' 000L- 88L - L ELSE ti� S3HOHS IWVM I`�AV ONZ 3N 0696 113 N3B NVNI31p3HOHS IINVIW _ M 7iNdS 1V j lf1W OIJNIHSVM 4,3 i 001, 3N 917 - : - (eapue$' compliance with all w ie been submitted to hanged without ;. Igh knowledge of the ionsibility for work done ij IIOREs oc• aft and in strict conformity vork done by either MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: 3 k-k D 3 OWNER'S NAME: &&tiv1 fib V( PHONE: 3 0._S'7 S ADDRESS: ( j( T STi ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * ** * * ** ADDRESS OF SITE: CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate tbp olo- :f tie painted. Walls yei(o Fascia (c) tt c Drip Cap/Drip Edge L Soffit . t e_ Roof Flower Bins Shutters GJ k cf� Awnings Chimney Doors and door jams Gt) Inc Garage Doors Railings Fences Decorative Metal All brick (simulated or regular) Stucco Banding Any other stucco features Accessory'Buildings Other 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 do the work stated. Furthermore , the paint colors will be as per the attached sampl ignature o Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED CALL FOR FINAL INSPECTION Building Official Date 4/23/01 APPROVED: t. • cn ro PROPERTY OWNER New Construction Name S, , ,� ", 61 �"" '"_r Enclosure Address .- l> ( 48 Lr e ( ' Home Telephone 3 6S --7s-q_ _ ° (p / . ''7 Business Telephone 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 INSTRUCTIONS - The following steps must hci taken to obtain a permit from the Miami Shores Village: Step 1. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. A PPLI CATION Job Address: Complete the attached permit application which must be signed by the properly 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. Address Apt. Folio Number Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax PERMIT APPLICATION Master Permit No. Subsidiary Permit No. 33(3? City t State Zip ascription of Work To �X 4,4 2rr Zoning Linear Feet Square Feet Units Floors xValue of Work 0 0 "4. Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Page 2 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. 1. 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, 1P' 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 0 0 IDA, COUNTY OF MIAMI -DADE Signature of Owner QQ ' 1 & 6>,-. . LA-) II lam( Print Name — �. Print Name 1 Sworn to an • sworn to and subscribed before me this day of Signature of Notary Public - State of Florida Signature of Notary Public - State of Florida SEAL: p orn Angela M Becker My Commission DD150048 4%01, �p� 9% . Ex pire s Rlovember 15, 2008 Signature of Contractor / Qualifier SEAL: PERMIT APPLICATION STATE OF FLORIDA, COUNTY OF MIAMI -DADE Personally known OR, Produced Identification is Personally known OR, Produced Identification Type of Identification Produced: F2 D1— .DO -798 4 to Type of Identification Produced: SECTION BY DATE 3 /cz8 Zoning ' '4 - Electrical Mechanical Plumbing Fire Public Works Structural / Building Official ���,l' V 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 Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund $ State DCA (Radon) Code Enforcement Fine Zoning Review Notary O PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ 0 0 3 ( x sq..60) x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: PERMIT APPLICATION 0 CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ 6 C , C) ISSUING OFFICIAL DATE: CONDITION OF Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com ELECTRICAL 'FYPE Minimum Fee QTY. TYPE. Dryer QTY. TYrE Outlet, Appliance QTY. TYrI': 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 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 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: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE . Date Job Address it ,4 /ro -' (; Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant KPi1/11/1 P TV �� ''StrC y kl v Master Permit # Al Owner's Address 7 t- (bD S* Phone 3 0 S 7 Sy 4 3 Contracting Co. MA571.(24/ W N v v Qualifier I State # Municipal # Architect/Engineer Bonding Company co 0 j(� w Mortgagor Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION P I> eft;t:tt P�C + �I�I Lint S QL' �[ i" In fre r� !� t f 1 ` l r wt GJ 8'I� L / k1 ter,( 3-e ,c.('!,?pr Square Ft. Estimated Cost (value) Ain Signature of owner and/or Condo President Date 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 AN 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 ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named tractor to do the work stated. ignature of Contractor or Owner - Builde Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder My Commission Expires: My Commission Expires: 4jSY Pi OFGI ©AL C:,1)17 ),MV 0',i-.. 0 ei cx,In:1Q Ca r^© :0i0L . A % 4(141 cr C p0 r �©�S09 23 ' y/ C y OP FLP c'wr,'.i. �i'if, '1 `.; d2 FEES: PERMIT 1L' RADON C.C.F. t' NOTARY BOND Da Date TOTAL DUE APPROVED: ft4'11 Zoning Building 4, Electrical Mechanical Plumbing Engineering PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY fit (OWNER TO RETAIN COPY) Date Job Address �9O 5t Tax Folio # 3. /5 / it 0 6 Legal Description / N / r 9 'i194) 7 q Master Permit # .1/ /y„j Owner / Lessee / Tenant -3-ZW-Abi IAA �,e.c�� 4A-uL)L( Owner's Address (- Ho ion ST M o, 1 \ f[.es Phone iSz '-S 3g ) Contracting Co. Address Qualifier Sign Date: lota 1y k 'ERMIT FEE: State# Competency# Ins.Co. Architect /Engineer Bonding Company Mortgagor Address Permit Type (circle one): CUILDIN ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION PA- I JT IgoU S Square Ft. Estimated Cost ®f 9, 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 AN 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 ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING, and MECHANICAL work. 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. Furthermore, I authorize the above -named contractor to ao the work stated. e of Owner a d /or Condo President Signature of Contractor or Owner- Builder Date: as o Owner and/ o do President mmission Expires: Y/ / APPROVED: Mechanical SSA - - Phone 25273 Pom Pom * Fire oning Building Plumbing Notary as to Contractor or Owner - Builder My Commission Expires: * * * * * * * Electrical Engineering 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 Mianii . 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 Mianii Shores Village 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. Owner's Name and Address 1_ 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) _ . _ ∎t.1 and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ 0"13 - (1 Amount 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 hint in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act.. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) 4 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 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 e. Permit No ! _ Date Disapproved (Signed) Buildin Igspector Date Read, Sworn to and Subscribed before me. Notary Public, State of Florida 3 6 , Street__ • C / 0'D My Commission Expires 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.