54 NE 100 St (6)Phone: 305 - 795 -2204
Z . Printed:5 /2'2002
Applicant: ALICE
Owner: WILLIAMS
JOB ADDRESS: 54
CEO Contractor
Local Phone:
Miami Shores Village
10050 NE 2nd Avenue
Parcel # 1132060131210
Permit Status: Approved
Signed:
•
NE 100
Building Permit
Permit Number: BP2002 -849
WILLIAMS
ALICE
ST
Contractor's Address:
Fees:
FEE2002 -2466
FEE2002 -2467
FEE2002 -2468
Description
Building Permit Application Fee
CCF
Notary Fee
Total Fees:
Amount
$60.00
$2.40
$5.00
$67.40
Total Fees: $67.40
Total Receipts: $0.00
Permit Expiration: 10/28/2002 Construction Value: $3,200.00
Work: EXTERIOR PAINTING AS PER AGREEMENT (OWNER BUILDER PERMIT)
CTOR) BY:
Signed: (Contractor or Builder) BY:
Legal Description: MIAMI SHORES SEC 1,AMD FB 10 -70 LOT 6 & W1/2 OF 5 BLK 9 LOT SIZE
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.40, 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.
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.
REG C01 092502 1109 MC 1401 001403 CASH 157.40
ALICE CUINN WILLIAMS
54 N
era MIAM
Of
03 ;4. 14 F c.. 06
V4,2 22' 14 • 604 0 0.3 -1998
CLASS: E
SAFE DRIVER ti.9 -14 1994
ct
SO4 9n 12355
FLORIDA u�E�
-- fitr. Sunshine State
•
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: / /
OWNER'S NAME: _
ADDRESS: A/4 / DC 3
* * * * * * * * * * ** ******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE:
CONTRACTOR & LIC
COMPANY NAME:
All Eleme is on the site m
Walls
Fascia 2j14; - E.
Drip Cap/Drip Edge 'j (�
Soffit G�,�
Roof /mil.
(if applicable)
PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
be listed and indicate the color to be painted.
Flower Bins
Shutters 'N 7�
Awnings � 6L l t7v\
Chimney
Doors and door jams )
Garage Doors ri,{ )1
Railings
Fences
y\I
Decorative Metal
All brick (simulated or regular)
Stucco Banding
Any other stucco features
Accessory Buildings
Other
PHONE OS) 9"5, ^ o L Q L
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.
("elS t te)/ 40 9 /oz
Signature of Owner Date Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED: WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
aee Building Official Date
4/23/01
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE,
Dryer
QTY;
TYPE
Outlet, Appliance
QTY.
TYPE
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
TYI'l
Minimum Fee
QTY.
TYPE
Condensate Drain
QTY.
TYI'F;
Generator
Q'fY.
TYI'L
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:
SECTION
BY
D TE
Zoning
t
l�._1-e -z
�! a-
Electrical
Mechanical
•
Plumbing
Fire
Public Works
Structural
513 L 'mc-
Building Officiali
Page 4
OFFICE USE ONLY
CH ECK LI ST
❑ 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 $
Metropolitan Dade County (C.C.F.)
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
$ Cam✓ '
$
$
0 0
(sq.ft. = x/1000
x ¢.60)
(¢.005 / sq.ft.)
(¢.01 /sq.ft.)
REVIEWED AND PREPARED BY:
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $ I • L v
L�i1.lJ
ISSUING OFFICIAL
DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL o (305) 795 -2207 0 FAX (305) 756 -8972 ° http : / /www.miamishoresvillage.com
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, ls' 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.
STA ��RID� C /[Jh(TY . F MIAMI -DADE
e of Owner
`73(tc'arLe)1
Print Name
Sworn to and subscribed before me thi
SEAL:
Signs[ ee of ota hc- StAte of Florida
r r -
"
o � P t2Y PU ANGELA u B - :k
* )y'+# couir.:!snoa Nuuc.
�i V. W' -'r= Q CC786897
% s cis MY COM;F.t: «:NH^S II
OF FV° IdCr . S '•;r.:r9
Personally known - ' ` - - - - OR;- Produced- Identification
I14M
day of
Type of Identification Produced:
PERMIT APPLICATION
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:
Personally known OR, Produced Identification
• Type of Identification Produced:
PROPERTY OWNE
New Construction
.
Addr.-7
5Lt
IQF TOO 5E
Home Telephone
4 (-6;) GI O q
Telepho`lg
O Business
��' 9 6 .-Q 7" a
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
I NSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Complete the attached permit application which tnust 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
X Job Address: J 4 A/4- 10 0 S `�
Address Apt.
Folio Number )escription of Work
Lot Block
Subdivision PB PG Zoning Linear Feet
Current Use of Property Square Feet
Proposed Use of Property Value of Work
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
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
City
State
Units
PERMIT APPLICATION
Master Permit No.
Subsidiary Permit No. 3/) r ,' o� .
Zip r .
QA
Floors
Bldg Value
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACT R
Name
License No.
Address
Telephone Fax
Qualifier Name
�j PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date J 7 Job Address .6 ' /O6 $t Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant / e G Master Permit # 4`, ?,,
Owner's Address //1 /66 St Phone
Contracting Co. (9 Z/2 (2e_7
Qualifier /e2 /�..(JC e e,' ) e / 7 SS# - - / Phone 9 F6 G 2 ' "
State # Municipal # O a 3,42-73 Competency # O //.3So Ins. Co.
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION $
„e-pia44 pa,;(_/- 024,1a V,' e_ t/o-c c,(21LT „A.-ey e.et,;,z,t
Square Ft.
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 do the work stated.
( ,g
s
ture of owner and/or Condo President
TEES: PERMIT - !0 1 RADON
APPROVED:
toning
Mechanical
Building
Date Signature of Contractor or Owner-
Address
Address
Address
Address
Estimated Cost (value)
Not as to Co
My Commi
/'l' / 7f
Electrical
Date
7
Date
Plumbing Engineering