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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.