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55 NE 100 St (12)Type Insp'n Permit No. Name MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date; /3 / L Time P 1 Address ✓ ` ter- /Mg Company 1)1044I PhP3 Per- D »/ For Inspector /[/�0� Name : Date 7 Approv- Correction ❑ Re- Insp'n Fee ❑ Type Insp'n Permit No. Name Address Company Phone # For Inspector Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date -642, Time . :r-,'o a -, " 3 6 O #4 Z Name & Date GT /JU � o/6 MIAMI SHORESYILLAGE Paint Color Approval and Agreement ATE: 2/0/0 z- p R'S NAME: Ai ,x -e 'ssi,�� 44' - ONE: 34/" ti�� D .,i'.! N e bee 1/ *-A / s 4 �L ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** //ADDRESS OF SITE: CONTRACTOR & LICENSE (if applicable) ANY NAME: p2oN/ ,ac, 'BONE: 5 yes = obi z ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls Fascia Drip Cap/Drip Edge Soffit Roof �-- Flower Bins. Shutters Awnings Chimney Doors and door jams Garage Doors Railings Fences Decorative Metal All brick (simulated or regular) "/4 Stucco Banding 5 w / 3 9 7 Any other stucco features AJ/4 Accessory Buildings /oh) Other /J/4- 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. -�- 5 e. a iB, /r°/L 5 3 S3 i � 1 4 p L Signature of Owner Date Signatu of Contractor ate *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: Building Official 5 g X373 ,v,4 5 w /3'7 N/4 Date co N V WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 CONTRACTOR ■ Name O/LD/✓/ / AIC License No. Address , &/ L/0 c 4 e7` Av, /-/1,4,u / Telephone 0r i S _ ®y � Z Fax � � 3or c s-e SJ ,tro Qualifier Name A, c_iisfg p Z. PROPERTY OWNER New Construction Name " 14<e• 6 gS i,vG tot- Address /f M /00 if Repair Home Telephone 3 or 7f 4 7 / 9 Business Telephone Relocation of Structure Fax Shell Only 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 oe taken to obtain a permit from the Miami Shores Village: Step 1. 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. APPLICATION 7N Job Address: ..5 ' - /PC ✓ / Folio Number 11 3 o2 0 t/. P ' 0/3 l 4 of Work Lot Subdivision PB PG_ Zoning Linear Feet Current Use of Property Square Feet Units Floors Proposed Use of Property 'Value of Work ,d , 040, °O Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Address Apt. Block PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. xit 353 Subsidiary Permit No. ° a- R- 0 City PAO I State PERMIT APPLICATION Zip � t x7~e tz wi. w4 /is ENGINEER Name License No. Address Telephone Fax Page 2 LIMPORTANT 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. PERMIT APPLICATION 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. STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Owner Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: SEAL: Personally known OR, Produced Identification Type of Identification Produced: STATE F FL' IDA, COUNTY OF MIAMI -DADE /\Si ature . Contractor / Qualifier Print Name Sworn to and subscribed before me this day of `E%/IU45t2y el-CO Z. Signature of Notary Public - State of Florida es° 44, Criatina Hue * *my Commission CC896557 ",, Euplros December 19, 2003 Personally known OR, Produced Identification Type of Identification Produced: A—J/ SECTION BY D T Zonin ge_-€1- Z Electrical Mechanical Plumbing Fire Public Works Structural Building Official �)7 ��- ' -17- '2. Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) O 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 (sq.ft. = x/1000 x 0.60) (¢.005 /sq.ft.) (0.01 /sq.ft.) A REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) O CONTRACTOR REGISTRATION (On File) TOTAL $ 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 ELECTRICAL TYPE Minimum Fee QTY. 'TYPE. Dryer QTY. 'TYPE. Outlet, Appliance QTY. 'TYPE Service Repair QTY' A/C Central 1-3 Ton Dryer Vents, Number of Fan Ventilation, Cost Outlet, Wall Ductwork, Cost of Service, Temporary Periodic Inspections A/C Central 4 -7 Ton Fire Sprinkler System Fire Pump Outlet, Switch Fireplaces, Number of 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, IIntercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE QTY Minimum Fee 'TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE QTY. Refrigeration, Tons 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 Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel 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 r asin 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: CONTRACTOR New Construction Name /`n 3 * ` l 1 1 INC Enclosure License No. cte.0677 26 Alteration Exterior ( r NW(occoca1 N.NiONI 1 F1 S3(ls Repair e -one (o 4a . ax5 G15 Quali er Name (� � � gn ii2b 1 �(_ fi jFl l f7 Demolish TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'I Detachment Other Step 1. PERMIT APPLICATION Master Permit No. 3 3 1 Subsidiary Permit No. 0�©0 a INSTRUCTIONS - The following steps must he 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. APPLICATION Job Address: 55 1.1E 100 Address Lot lg E 112 OiIOIB ock 10 PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Othergpd ( 14e Apt. Folio Numbertl 3206013 LIMO Description of Work TQIr nc 1-44. c rzrOT . color ( _.yre rn egAsiryr _ lerrctc co\q ((2, Subdivision PB PG_ Zoning L inear Feet Current Use of Property Square Feet / Proposed Use of Property Value of Work / 00 0 . 00 Bldg Value Tenant Information It Ke. € SS - 1 Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax PROPERTY OWNER Name Address Home Telephone Business Telephone Fax Miami Shores FI 33(38 City State Zip Units Floors 1 Or1 Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) ENGINEER Name License No. Address Telephone Fax Page 2 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 klealth and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami- Dade:Water and S werDeoarttnent (MDWASD) approval is required for applications invvolving sewer AFFIDAVIT - Please read carefully. Application is hereby maFle to obtain a permit to $o work and installation as indicated. I, the OWNER of the property,' certify that all work will be performed to meet the standards of all lat'5 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 nay hortv tr.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 $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE STATFOF FLO A, COUNTY OF MIAMI -DADE Si . ature of 'S er Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: r , . 0 0 • Personally known OR, Produced Identifieati$n Type of Identification Produced: • v SiggSture of Contractor / Qualifier Print Name d ,n Sworn to and subscribed before me this � day of Signature of Notary Public - State o orida $ �o Cristina Hua it,;? — *My Commission CC896557 `' ;,.,,o Expires Oacmmber 19, 2003 Personally known OR, Prodduceed Id ntification Type of Identification Produced: ° /� SEAL: PERMIT APPLICATION r� . • Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C:C.F.) $ ( sq.ft. = x/1000 x 0.60) Inspector State Educational Fund $ (4.005 /sq.ft.) State DCA (Radon) $ (¢.01 /sq.ft.) Code Enforcement Fine $ Zoning Review ISSUING OFFICIAL REVIEWED AND PREPARED BY: SECTION Z oning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY 10050 N.E. 2" AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com ❑ PROOF OF OWNERSHIP (Attach) ❑ HR.S / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) DATE PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ La,C) DATE: CONDITION OF APPROVAL Revised July 2001 ELECTRICAL TYPI? Minimum Fee QTY. TYPE Dryer QTY. TYPE. Outlet, Appliance QTY. TYPE Service Repair QTY., A/C Central 1 -3 Ton Dryer Vents, Number of Fan Ventilation, Cost Outlet, Wall Ductwork, Cost of Service, Temporary Periodic Inspections A/C Central 4 -7 Ton Fire Sprinkler System Fire Pump Outlet, Switch Fireplaces, Number of 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, IIntercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE QTY. Minimum Fee TYPE Condensate Drain QTY. TYI'li. Generator QTY. TYPE QTY. Refrigeration, Tons 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 Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel 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 asin 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 Trains, 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: OWNER'S AM : PHONE: ADDRESS: 5- Th ,.�.,, /0D ********************************** * * * * * * * * * * * * * * * * * * * * * * ** * * * * * ** ADDRESS OF SITE :5 'S ( )() • 1 CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls Fascia Drip Cap/Drip Edge Soffit Roof i ee.A co Pxtsi r? - AAA Flower Bins Shutters Awnings Chimney Doors and door jams 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 samples. Signature of Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION Building Official Date 4/23/01 • Square Ft. 000 2� PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 3/3 ASi Job Address S /'✓d' Tax Folio Legal Description C '1 /( ,4/'I D i`r�� �, �2 o f LoT /7 ,4ND %,fig u..) 2 Gvr Owner / Lessee / Tenant Master Permit # (119 Owner's Address S /00 L T //I44 C�1�?G S - Phone 258 -oU Contracting Co. C% JA/F,- Qualifier SS# - - State # Municipal # Competency # Ins.Co. Architect/Engineer Bonding Company Mortgagor Address Permit Type(circle on WORK DESCRIPTION 7/9 /A/ T .1% 76/ i9-N2 . /Zc ?5F A,,_ 27.4 /NT ,C'oo� I 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 e above -named contractor to do the work stated. re ato4Pb • BARBARA. ANN FUOAZZI * COMMISSION NUMBER a _ CC360191 e citPP tzi, MY COMMISSION EXP. Sig Da Notary as to Owner My Commission Expi FEES: PERMIT r/ RADON APPROVED: of owner and /or Condo President Zoning Mechanical (Y/7 C.C.P. Fire Buildin Plumbing Address Phone Address Address ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN Estimated Cost(value) Signature of Contractor or Owner- Builder Date: Notary as to Contractor or Owner- Builder My Commission Expires: ** NOTARY / TOTAL DUE 1 11/1 Other Electrical Engineering APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the det.iled statemon• of the plans and specifications herewith submitted for the build- ing or o h. -ructure her 1 described This t licatic is made in compliance and con•o'm-ty w.th the Building Ordinance of Mia ii Shores Village, .or.da, and all pro• isions of the Laws o f the Statc of 1.krid. all o d nances ,,f Mi m Shores Village and all rules and regu•a ion. of the Building Div.. i of .lam Sho, illage b '1 e ro. ipl.ed with, whether herein specified or not. A copy of approved plans and specificati m must be kei • at building durin progress of tl.e wcrk. Owner' Name and Address._ (L,A)-L61, Registered Architect and /or Engineer.__ Name nd address of licensed contractor Location and legal description of lot to be built on: Lot Block_ STATE OF FLORIDA, COUNTY OF DADE. Ss. Bui ding Inspector MIAMI S H O R E S VILLAGE BUILDIN INSPECTION DEPARTMEN Subdivision PLANNING BOARD Chairman Member Member ____ _ _ ______ __ _ Member Member _ .__ . Member Council Approved. Date Disapproved Date No Street. _. Street and Number where work is to be done_ ..__ State work to b one n purpose of building r and for no other purpose. New Building_ _ - _ Rernodeling ____ _ __. Addition____ ____ ___ _____ __ _ Repairs_ - _ No. of Stories. To be constructed of ___ _ _ Kind of foundation �___ _ Roo o� ring__ Estimated ,tal cost of improvements $__. y ..0-0 _ .___.__ Amount c` Permit $__ . _ Zone ^ubage required_ __. __Plan Cubage Distance to next nearest building__ - - _ Size of Building Lot Maximum live load to be borne by each floor. _ . 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 unde signed appli -ant for th's bu'Iding perrnit does hereby certify ;'fat he understands and accepts his ,•bligations as an employer of 1- bor under he Florida Workmen's Coinpensation Act being S. -tion 5966 Col p led Gen al Laws of Florida P r anon. S+ipplc vent. and h s compl ed w;th -he prov':mns thereof, and will require s•milar comp lance from all contractors or sub-contractors emplo •ed by him in the wo k to be p rf med under th s pern it and ill post or cause to be posted for inspection on the site of the work su :h public not. -e or .otices as are requir d by the Act. The u. d.r ign.-d agrees to employ only such 'dbcpntr. ctors, on work to be perform d . der this perrnit as are licensed by M am. Shores N. i1:: ge. Remarks (Signed). Before me, the undersigned authority, a notary ;public, duly authorized to adm:nister oaths a:nd take acknowledgments, personally ap- peared and who, being by me first, d. ly sworn, upon oath deposes and says that he is the of th abov. de.. ibed istruction t h has careially read the foregoing application, and that he did sign the same, and that all facts thereof by him stated are tr ie. Permit No ____ /- 471 413 . -- Date__ ___. $/ Read, Sworn to and Subscribed before me. Disapproved (Signed) ____ ____ ______ ._ __ Notary Public State of Florida My Com:nission Expires_ DATE ,19 • to me well known, Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application ift.•r approval his becn obtained from the Plans ng Board A re- inspection fee of $1.00 will be charged when such re- inspection is ma= e necessary by improper notice for inspe:•t•ap or fa• ity materials and /or workmanship. BUILDING L " ELECTRICAL PLUMBING ❑ ROOFING Owner of Building MIAMI SHORES VILLAGE, FLORIDA ❑ PERMIT .N? 14700 ❑ Work to be performed under this Permit Architect Contractor or Builder Legal Lot II Bl. Description Address of Building CONTRACTOR OR BUILDER Subdi- vision Value of Project $ ; f DATE 195 Contractor's License No _ Amt. of Permit $ j •N^ 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. - i Signed: BY r .. 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 responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY