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467 NE 100 St (9)MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date - Time Type Insp'n hit.t, Permit No. P 01002 1 .3// Name Na,le v elewc 4> Address 9 /100,5 Company ✓�� al" Phone # 3I S , A 6 ,9g For Inspector: /„ 3 _O > , Name & D to Approved ``�� Correction Re-Insp'n Fee ❑ x 30s gad - ;Os° Type Insp' MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Permit No.. •Name C }C_�l Address /4,t- - Company ..L�t 4�/► i Phone # For Inspector: Approve Correction ❑ Re- Insp'n Fee ❑ PROPERTY OWNER / /� / Name Ca ei,.sr o ■4 Address /Z c* /up,/ /6-7 4c qi.,,,., t;Od ? r►rt, re , 33 O t° 8 Home Telephone rf ) n Z — 23 ro Business Telephone 78G'- e o 2 03' o Fax (k ) 3Z a —Z.V / 5Z- 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 Step 1. Job Address: Lot Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Block 4. r 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 submitted 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. A PPLICATION %7 yE /00 551. a il : Sil..><1 3313 T Address / Apt. City State Zip Folio Number ! l 3� "�- D °5 36 D escri p t io n of Work / Subdivision PB PG Zoning Current Use of Property Square Feet Chg. Contractor Renewal Revision Extension Supplement Reinspection PERMIT CHANGE (✓ ) ARCHITECT Name License No. Address Telephone Fax PERMIT APPLICATION Master Permit No. Subsidiary Permit No. 6 / - a Q r • 3) L/ i ((.. ¢- Cale ✓ ,9 Proposed Use of Property 1 - -- <itTe of Work 3 S- _ Bldg Value Linear Feet Units Floors 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 IA'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 ca ref ul Iv. 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 wi a Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a 'o actor. nt Name �) Sworn to and subscribed before me this l day o , ature of No PICIAL OP 4,1.0 pU 6 :i ANGELA M BECKER 4 - 1 t r 0 COMMISSION NUMBER * y,. Q CC786697 MY CO EXPIRES OF f �0� NOV. 15,200 Si SEAL: Personally known Type of Identification Produced: OR, Produced Identification STATE OF FLORIDA, COUNTY OF MIAMI - DADE 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 Personally known OR, Produced Identification Type of Identification Produced: Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305 - 795 -2204 Printed: 2/13 /2002 Applicant: GUILLERMO Owner: MESA Contractor Local Phone: Parcel # 1132060170530 Legal Description: AMD PL OF MIAMI SHORES SEC 4 Job Address: 467 NE 100 ST Fees: • FEE2002 -913 FEE2002 -914 FEE2002 -915 FEE2002 -916 Permit Status: Approved Permit Expiration: 8/12/2002 Construction Value: Work: EXTERIOR PAINTING AS PER AGREEMENT (OWNER BUILDER PERMIT) If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. fee is $50.00, which must be paid in advance before calling for another inspection. GUILLERMO -E LAGUDELO 1244 NW 167TH AVE. PEMBROKE PINES; 'FL ' 33028 • ' 0// of 04 1 PAY TO THE OF / / / Or e �Sv , 79 7"r'e‘e _0.1101 Washington Mutual Washington Mutual Bank, FA Silver Lake Financial Center 1771 18475 Pines Bind. 1.800-788 -7000 Pembroke Pines, FL 33029 4 hour Customer Se,vice NrSf / °lIF 14e• 41 :.26`7084 13 1I:3'881't:30 16'2 %t2 aryl- 53 c j Description Amount Building Permit Application Fe$60.00 Building Fee $60.00 Notary Fee $5.00 CCF $0.60 Total Fees: $125.60 63- 8413/2670 3883016228' Address: Cellular: DATE O V A / `• Building Permit Permit Number: BP2002 -314 AGUDELO DIEGO 177 DOLLARS t —� MP BY: BY: PB 15 -14 -LOT 22 BLK 90 Total Fees: $125.60 Total Receipts: ::;$0.00 Re- inspection to equipment or device described in the application herefor in strict compliance with all vith 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 gs 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 is Village. In accepting this permit I assume responisibility for all work done by either MIAMI SHORES VILLAGE - Paint Color Approval and Agreement 'DATE: 0 `/Z /19Z DOWNER'S NAME: 6 / /e .o ,99(cl ' PHONE: 966 Z°z ✓DDDRESS: 4 tiE /0 c 2 • ********************************** ** *** ** * * * * ***** * * * * * ** * *** **** (DDRESS OF SITE: 1-6.P .tie / S f ile , .5.% &vej 7 " . "(, 37/3 b' CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * ** * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls CkQ 1 S � � 1 ) — y Fascia Drip Cap/Drip Edge Soffit 13, Roof a ' ;, Oi r,n. / (day : while Flower Bins bJ Shutters 1 Awnings Chimney p) Doors and door fams 1V Garage Doors B Railings f' Fences �) Decorative Metal /\ f All brick (simulated or regular Stucco Banding (\) l ; *� Any other stucco features Ai / Accessory Buildings pi / ) Other APPROVED: Corn Silk c u 3 t U 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 constru o, and z• .'ng. I authorize the above -named contractor, if applicable, to do th rmore , the paint colors will be as per the attached sa O z / Ae ignature of Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION Building Of ('ial Date 4/23/01 11314-2 ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton - Heating Strips, each Fan . Outlet, Wall Service, Temporary - Paint Booth A/C Central 4 -7 Ton Fire Pump Outlet, Switch - Piping, Flammable Liquid Signs A/C Central 8-15 Ton Fixture - Fluorescent - Process/Pressure Piping Oven Space Heater (kw) A/C Central 16-20 Ton Pressure Vessel 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 • 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 QTY. 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 Pump and Abandon Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Gas - Appliance PLUMBING Ty A/C Condensate QTY . TYPE Drains, Roof QTY TYPE,, Miscellaneous Fixture QTY . - ' fl 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: SECTION BY DATE Zoning Electrical � r y Mechanical Plumbing Fire Public Works Structural Building Official `� ,G� 2 ( , 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 FEES $3.00 per page (Scanning Fee) $ Miami Shores Village Bond r� Metropolitan Dade County (C.C.F.) $ v (sq.ft. = x/1000 x ¢.60) Inspector State Educational Fund $ (¢.005 / sq.ft.) State DCA (Radon) Code Enforcement Fine Zoning Review $ (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: PEWIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL .(Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ I - v 6 ISSUING OFFICIAL 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