848 NE 100 St (6)Page 2
PERMIT APPLICATION
IMPORTANT NOT 1 C ES
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.
S ATE RIDA, COUNTY OF MIAMI -DADE
C&
Signature of b wner
„i c> ckal DC R
Print Name
5 c. ubscribed before me this /� • • y of ( � ( � y �
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
= PRY PUe ANGELA M BECKER SEAL: 1 4' g ( COMLISSION NUMBER
•
9 f �k ` Q CC786697
i s 4 MY COMMISSION EXPIRES
OF FL NOV. 15,2002
Personally known ^^ ]P1/ UK, rrouuced Id�uuf ,ation 4f)*. Personally known OR, Produced Identification
Type of Identification Produced '4 /P //S 53 b3 - Type of Identification Produced:
CQ D' ' D
SEAL:
PROPERTY OWNER
Name ba V :l L—. k I
Address ..e0N 1.1:o 8 4 i,,, • e (00 S'r 1-(i Pr
7305- 75 1 -G 4q 3 - sty
Home Telephone 305— gas , / ' E/�
l�
Business Telephon S ^ - 7 '5 � 13
/O `
Fax
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
INSTRUCTIONS - The following steps must be 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.
APPLICATION
/\ Job Address:
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.
Address
Folio Numberl l 3a 00
Ov '
Lot Block
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
Apt.
Subdivision PB PG Zoning Linear Feet
Current Use of Property //���� Square Feet Units Floors
Proposed Use of Property !/� Value of Work k 00 . Bldg Value
Tenant Information
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
PERMIT CHANGE (✓ )
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No.
Subsidiary Permit No. p- nr) X
City
Tax Assessed/Appraised Value
PERMIT APPLICATION
Zip
Description of Work V ro f 11 CNN C�C'Y.o eve
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone Fax
Qualifier Name
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
i'VPE
Service Repair
QTY.
A/C Central 1 -3 Ton
Fan
Dryer Vents, Number of
Outlet, Wall
Ventilation, Cost
Service, Temporary
Air Handler, Tons
A/C Central 4 -7 Ton
- Piping, Flammable Liquid
Fire Pump
Outlet, Switch
Fire Sprinkler System
Signs
A/C Central 8 -15 Ton
Bath Fan - Vented, #
Fixture - Fluorescent
- Pressure Vessel
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
()Ty.
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
Solar Water Heater
Air Handler, Tons
Ductwork, Cost of
- Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
- Process/Pressure Piping
Cap - Fixture
Bath Fan - Vented, #
Fireplaces, Number of
- Pressure Vessel
Pump and Abandon
PLUMBING
.
A/C Condensate
Q
.1.1.1,E
Drains, Roof.
Qm.
TYPt.
Miscellaneous Fixture
QTY.
Ty
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 .0
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 Ta
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer C
nnection
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:
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
Cl 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
❑ PROOF OF OWNERSHIP
(Attach)
• HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
(sq.ft. = x/1000
x t.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 $
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
Village of Miami Shores
10050 NE 2nd Avenue
Miami Shores, FL 33138
Phone: 305 - 795 -2204
Printed: 1/17/2002
Applicant:
Owner: SCHAFMEISTER
Contractor
Local Phone:
Parcel # 1132060340030
Job Address: 848 NE 100 ST
Fees:
FEE2002 -322
FEE2002 -323
FEE2002 -324
Permit Status: Approved
Address:
Cellular:
Legal Description: MIAMI SHORES SEC 8 PB 14 - 33 LOT 5 & W1/2 LOT 4 BLK 169 LOT SIZE
Description Amount
Notary Fee $5.00
Building Permit Application Fell)60.00
CCF $0.60
Total Fees: $65.60
Permit Expiration: 7/16/2002
Work: DEMOLITION OF CONCRETE SLAB (OWNER BUILDER PERMIT)
If there is no permit package accessible on the job -si
fee is $50.00, which must be paid in advance before call
This Permit is granted to the contractor or builder named above to cons)
ordinances pertaining thereto and with the understanding that the work will
and approved by the proper municipal authorities. This Permit may be rev.
authorization. A further condition upon which this permit is granted is the
ordinances and regulations pertaining to the work covered hereby whether
by his agents, servants or employees.
Signed: (INSPECTOF
In consideration of the issuance to me of this permit, I agree to perform
with the plans, drawings, statements or specifications submitted to the prc
myself, my agent, servants or employes.
Signed:
Building Permit
Permit Number: BP2002 -108
PAY TO THE
(Contractor or Builder)
CAROL
Construction Value:
$100.00
Mllly �. INararl
Ph. 305 -135 -4077
3301 N. Country Glut Pr. Apt. 50q
Aventura, FL 33180 -1614
DATE
Page 1 of 1
Total Fees: $65.60
Total Receipts: $0.00
ORDER OF q _ / ^' 1 $ :.5-
VVV/ DOLLARS CD Back.
Calmat
WASHINGTON MUTUAL BANK, F.A.
SURFSIDE FINANCIAL CENTER 1744
9556 HARDING AVE., SURFSIDE, FL 33154
1. 800 - 788.7000 24 HOUR CUSTOMER SERVICE
FOR k4 Mgt
1:26 7084 L 3 Ll:8 3 L111 2138 9 2 6111 1,0 0669
f aa-
0669
PJIMAGE CHECKS. 1997 .•
ELEGANCE
,1-900•562.0769 www.lo, Jochoche.com
1
- • .-•■ ■ --• -•
The Sunshine State
LICENSE MAWR
H660-557-63-607-0
MILLY SARA HARARI
3301 N COUNTRY CLUB DR 1609
AVENTURA, FL 33180-1641
BIM DATE SEX HOT. REST. ENDORSE
03-27-63 F 6-02 A
DUPLICATE
05-01-96 03-27-02 10-10.97
ISSUED EXPIRES
SAFE DRIVER
.S099710100328
Operation of a motor vehicle constitutes consent to any sobriety test required by law
APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY
P p—rp_ic_K
to re- occupy the single family residence known as : (address)
RAN N C / C fe , Miami Shores, Florida.
Legal Description:
Lot: Block PB & PG:
Comments:
PAGE I OF 2
Realtor Company Name
Application Fee (S50) paid: Cash Check No. 1, '
roved � Denied
, hereby apply for a certificate
I hereby certify that I understand that the zoning of the property is for single- family residential use
and that it is unlawful for more than one family to reside therein. I also understand that any
Certificate of Re- Occupancy that may be issued by Miami Shores Village, certifies only that the
referenced property is being used for single-family purposes and that such Certificate does not
constitute any representation, warranty or certification as to the condition of the dwelling or other
structures on such property.
Applicant
Date Ot96Y
Print Name P �'7Qrc -(,� L
**************************************_******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
For purposes of conducting the inspection required by Section 902 of the Mliarni Shores Land
Development and Zoning Code, please contact:
Contact Name: VI N cE Le- S' - 1S72 -- Telephone: — 757 - S - ' 7
Buyer
/ 1 ?es - 77 .- "TD-/ g a-i o ( u.)& a- v. -VA
PAGE 2 OF 2
CER1 1CATE OF RE- OCCUPANCY
On behalf of Miami Shores Village, Florida, the undersigned certifies that the ro e
described in the above application has been inspected for u oses of re- occupanc supar
Sections 901 and 902 of the Miami Shores Land Development and Zoning n p t to
property may be re- occupied by the above applicant for single-family y Code and that such
�l residential purposes.
MIA M[ SHORES VILLAGE, FLORIDA
B
ate of Certification:
THIS CER fl±ICATE VERIFIES THAT THE REFERENCED
PROPERTY HAS BEEN INSPECTED BY IvrIAM SHORES
VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY
COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE
MIAMI SHORES LAND AND DEVELOPMENT CODE
PERTAINING SOLELY TO THE REQUIREMENT THAT EACH
ONE-FAMILY DWELLING IS USED AND INTENDED 10 BE
USED FOR A ONE - FAMILY DWELLING POSE ONLY;
HOWEVER, THIS CERTIFICATE DOES NOT CONSTITUTE ANY
REPRESENTATION OR WARRANTY AS TO THE CONDITION
OF THE DWELLING OR OTHER STRUCTURES ON THE
PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH
CONDITION, AND INTERESTED PERSONS ARE ADti1SED AND
ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE
PREMISES IN ORDER TO DETERMThrE THE CONDITION,
THEREOF.