890 NE 100 St (4)Company
Phone
For In
Appro
Corre
Re-Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Name
Address :2'9 �/ ^ O O SI
ector:
at
FT - . - r, (• .-'. r"',:L'F., COUNTY OF DADE
, t -! :c }
v L Y ihaf 1;115IS a foie crp of the
day of
c�i nsi �
, A D 20 OZ/
V ,',fir[ r : . Officio/ Seal.
Y, :Alc. ; :(, of Circuit and County Courts
D.C.
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO. 1 / 3 2_c4 93' 00 ( O
STATE OF FLORIDA:
COUNTY OF DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Legal description of property and street address: L ° T ! 4 2 8 L(t / Ca ? , , m (A-141( 2a° P-E- 26c 9
e ere o N6 /0 D C' to ! /-41( .I'efo (1.6f -
2. Description of improvement: f (LiM .I'(¢c,) rre('
3. Owner(s) name and address: W A-P••0 0 Y t2.0
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address:
*Cgs" N a) 3 ? cT- M / Aitt
5. Surety :(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
Notary Public d tie
Print Notary's Name
My Commission Expires
q a Ai & ( -Cr nil /RM2! 3 02 -&.S' Ft- 3 3 (3,
SE (N Dvi'?it{ 6f
Signature of Own
Owner's Name ��fid4iii,/ i, 4rd
Sworn to and subscribed before me this . ! D day of 0 cr 20 0 2 .
Lee C Picker
' MYCOMMISSION# 00136338 EXPIRES
•. September 13, 2006
BONDED THRU TROY FAIN INSURANCE, INC
028637.45 1 2002 OCT 15 13:07
Fe- 3 3 ( 'ez -
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
0. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified) -
Prepared by ti251 C P(,C {_
Address: 564146•c...-) (A.)0 of T7L.tt
45 S N u - r
/► 1(4 - nc( Fc- 3 3 G c 2_
CUSTOMER I CUSTOMER NAME'
ADDRESS:
MEAN ROOF HEIGHT:
BUILDING WIDTH:
Pq 0 N E /0 3T
/1
LENGTH'
WINDOW HEIGHT ABOVE GRADE'
PEAK ROOF HEIGHT'
PRODUCT' (0 e
/4
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CUSTOMER I CUSTOMER NAME'
ADDRESS:
MEAN ROOF HEIGHT:
BUILDING WIDTH:
Pq 0 N E /0 3T
/1
LENGTH'
WINDOW HEIGHT ABOVE GRADE'
PEAK ROOF HEIGHT'
PRODUCT' (0 e
/4
3eni By: SEAVIEW INDUSTRIES .INC;
BASIC WINO = 1 46 MPFI
IMPORTANCE FAC DRS: 1 =1.0
DIRECTIONALITY FACTOR: h;d = 1
TRIBUTARY ,•.REA: 10 SQ. FT.
RESIDENTIAL CONSTRUCTION ONLY
FOR IMPACT RESISTANT SHUTTERS OR WINDOWS WITH
(BASED ON INFORMATION PROVIDED BY CLIENT)
CUEN :T: SEA I C /N OJg TL(ET
JOB: CPwn-R-D Byj2
fi'9 0 A9 E /cc. s
. • /n( S 2 -ef --
BUILDING • HEIGHT:
DR. HUMAYOUN FAROOQ
STRUCTURES
FLA. PE I 16537 .'-
2002.
305 634 9060; Oct-10-02 12 :45PM;
S.
WIND LQ 1LI BLES FOR
COMPONEi' TS & CL.ADOING
AS PER SPECIFICATION
ASCE 7 -9$
NOTES;
1
SHUITCRS
LOADS, POSITIVE AND NECATI
TAKEN AT MEAN ROOF HEIGH
APPLY TO ALL FLOORS.
TABLE` ABOVE SHOWS MAXIMUM DESIGN LOADS FOk SHOWN BUILDING HEIGHTS IN ENO ZONES
FOIi ANY OTHER CONDITIONS /ZONES, DESIGN LOAC TO BE EVALUATED ON JOB TO JOB BnSI
AL - FAROOQ CORPORATION
ENGIN.'ERS, PLANNERS & PRODUCT DESIGN
23`, SW 87 AVE
MIAMI, FLORIDA 331'74
TEL, .;:'05) 264 -8100 FAX. (305) 262 -6978
Page 4/6
ARE
AND
OA�I COUNTY
THIS UrKUMENT IS NUT VALID WITHOUT TIIE EMBOSSED SEA OF AN ENGINEER
- EMPL0E0 BY AL- FARUUq I.'URPORATIUN.
440 P,OR'ION or TNIS DOCUMENT MAY BE USED OR REPROOU
wHAf51.4 WIT)/OUT THE WRITTEN PERMISSION OF AL -FARO
(EXCEPT. HOwEvER, TOR MAT PORTION OF ASCE 7 -98. SET FORM H
D IN ANY MANNER
CORPORATION I
IN).
AEC -23A )
f
BUILDINGS EQUAL OR
LESS THAN 40 FEET HIGH
ROOF SLOPE > 10 DEC.
• EXPOSURE 'C
_
MEAN ROOF
.ELE'(. FEET
MAX, DESIGN LOADS-PSF
gXt. ( +)
INT. ( -)
115
54,7
— 81.2
73J
e j25 •
81.9
30 •
63.1
84.5
15
65.0
87.I
40
67.0
89.7
3eni By: SEAVIEW INDUSTRIES .INC;
BASIC WINO = 1 46 MPFI
IMPORTANCE FAC DRS: 1 =1.0
DIRECTIONALITY FACTOR: h;d = 1
TRIBUTARY ,•.REA: 10 SQ. FT.
RESIDENTIAL CONSTRUCTION ONLY
FOR IMPACT RESISTANT SHUTTERS OR WINDOWS WITH
(BASED ON INFORMATION PROVIDED BY CLIENT)
CUEN :T: SEA I C /N OJg TL(ET
JOB: CPwn-R-D Byj2
fi'9 0 A9 E /cc. s
. • /n( S 2 -ef --
BUILDING • HEIGHT:
DR. HUMAYOUN FAROOQ
STRUCTURES
FLA. PE I 16537 .'-
2002.
305 634 9060; Oct-10-02 12 :45PM;
S.
WIND LQ 1LI BLES FOR
COMPONEi' TS & CL.ADOING
AS PER SPECIFICATION
ASCE 7 -9$
NOTES;
1
SHUITCRS
LOADS, POSITIVE AND NECATI
TAKEN AT MEAN ROOF HEIGH
APPLY TO ALL FLOORS.
TABLE` ABOVE SHOWS MAXIMUM DESIGN LOADS FOk SHOWN BUILDING HEIGHTS IN ENO ZONES
FOIi ANY OTHER CONDITIONS /ZONES, DESIGN LOAC TO BE EVALUATED ON JOB TO JOB BnSI
AL - FAROOQ CORPORATION
ENGIN.'ERS, PLANNERS & PRODUCT DESIGN
23`, SW 87 AVE
MIAMI, FLORIDA 331'74
TEL, .;:'05) 264 -8100 FAX. (305) 262 -6978
Page 4/6
ARE
AND
OA�I COUNTY
THIS UrKUMENT IS NUT VALID WITHOUT TIIE EMBOSSED SEA OF AN ENGINEER
- EMPL0E0 BY AL- FARUUq I.'URPORATIUN.
440 P,OR'ION or TNIS DOCUMENT MAY BE USED OR REPROOU
wHAf51.4 WIT)/OUT THE WRITTEN PERMISSION OF AL -FARO
(EXCEPT. HOwEvER, TOR MAT PORTION OF ASCE 7 -98. SET FORM H
D IN ANY MANNER
CORPORATION I
IN).
AEC -23A )
f
m» ' J > 21(Lr
Dear
We are the Dade County Notice of Acceptance Holder for the SSA/(6.8" — HR)
Aluminum Accordion Shutter under number 01- 0404.10.
This letter authorizes SeaView Industries, Inc. to use our 6.8" Accordion Shutter to be
used at the following job:
Sincerely,
Mathew Cicero
President
Coastal Shutters, Inc.
3789 N.W. 46th Street • Miami, Florida 33142
Office 305 - 633 -3351 • Fax 305 - 633 -3516
1- 888 - 927 -3740
Yg-D
'90 Ac /too Sr
M I A M I•DADE
ACCEPTANCE NO.: 01- 0404.10
EXPIRES X02/04/2003
APPROVED: 06/08/2001
PRODUCT CONTROL NOTICE OF ACCEPTANCE
Coastal Shutters, Inc.
3789 N.W. 46th Street
Miami ,FL 33142
Your application for Notice of Acceptance (NOA) of:
SSA / (6.8" - HR) Aluminum Accordion Shutter
under Chapter 8 of the Code of Miami- Dade County governing the use of Alternate Materials and Types of
Construction, and completely described herein, has been recommended for acceptance by the Miami -Dade
County Building Code Compliance Office (BCCO) under the conditions specified herein.
This NOA shall not be valid after the expiration date stated below. BCCO reserves the right to secure this
product or material at any time from a jobsite or manufacturer's plant for quality control testing. If this
product or material fails to perform in the approved manner, BCCO may revoke, modify, or suspend the
use of such product or material immediately. BCCO reserves the right to revoke this approval, if it is
determined by BCCO that this product or material fails to meet the requirements of the South Florida
Building Code.
The expense of such testing will be incurred by the manufacturer.
THIS IS THE COVERSIIEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND GENERAL
CONDITIONS
BUILDING CODE & PRODUCT REVIEW COMMITTEE
This application for Product Approval has been reviewed by the BCCO and approved by the Building
Code and Product Review Committee to be used in Miami -Dade County, Florida under the conditions set
forth above.
\\s045000I \pc2000\ \templates \notice acceptance cover page.dot
Internet mail address: postmaster @buildingcodeonline.com
MIAMI -DADE COUNTY, FLORIDA
METRO -DADE FLAGLER BUILDING
BUILDING CODE COMPLIANCE OFFICE
METRO -DADE FLAGLER BUILDING
140 WEST FLAGLER STREET, SUITE 1603
MIAMI, FLORIDA 33130 -1563
(305) 375 -2901 FAX (305) 375 -2908
CONTRACTOR LICENSING SECTION
(305) 375 -2527 FAX (305) 375 -2558
CONTRACTOR ENFORCEMENT DIVISION
(305) 375 -2966 FAX (305) 375 -2908
PRODUCT CONTROL DIVISION
(305) 375 -2902 FAX (305) 372 -6339
Raul Rodriguez
Chief Product Control Division
Francisco J. Quintana, R.A.
Director
Miami -Dade County
Building Code Compliance Office
Homepage: http : / /www.buildingcodeonline.com
Coastal Shutters, Inc.
ACCEPTANCE No.: 01- 0404.10
APPROVED
EXPIRES
•
NOTICE OF ACCEPTANCE: STANDARD CONDITIONS
06/08/2001
02/04/2003
1. SCOPE
This revises the Notice of Acceptance No. 99- 1220.09, which was issued on February 4, 2000. It
approves an " 6.8" — HR" Aluminum Accordion Shutter, as described in Section 2 of this Notice
of Acceptance, designed to comply with the South Florida Building Code, 1994 Edition for
Miami -Dade County, for the locations where the pressure requirements, as determined by SFBC
Chapter 23, do not exceed the Design Pressure Rating values indicated in the approved drawings.
2. PRODUCT DESCRIPTION
This " 6.8" — HR" Aluminum Accordion Shutter and its components shall be constructed in strict
compliance with the following documents: Drawing No. 01 -855, titled " Coastal 6.8 " -HR
Residential Accordion ", prepared by Knezevich & Associates, Inc., dated December 8, 1998, last
revision #6 dated February 08, 2001, sheets 1 through 11 of 11, bearing the Miami -Dade County
Product Control approval stamp with the Notice of Acceptance number and approval date by the
Miami -Dade County Product Control Division. These documents shall hereinafter be referred to
as the approved drawings.
3. LIMITATIONS
All permanent set components, included but not limited to embedded anchor bolts, threaded
cones, metal shields, headers and sills, must be protected against corrosion, contamination and
damage at all times.
4. INSTALLATION
This " 6.8" — HR" Aluminum Accordion Shutter and its components shall be installed in strict
compliance with the approved drawings.
5. LABELING
Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and the
following statement: "Miami -Dade County Product Control Approved ".
6. BUILDING PERMIT REQUIREMENTS
6.1 Application for building permit shall be accompanied by copies of the following:
6.1.1 This Notice of Acceptance.
6.1.2 Duplicate copies of the approved drawings, as identified in Section 2 of this Notice
of Acceptance, clearly marked to show the components selected for the proposed
installation.
6.1.3 Any other documents required by the Building Official or the South Florida
Building Code (SFBC) in order to properly evaluate the installation of this system.
11 4. ,fi
Helmy akar, P.E.- Product Control Examiner
Product Control Division
2
Coastal Shutters, Inc.
ACCEPTANCE No.: 01- 0404.10
APPROVED
EXPIRES
NOTICE OF ACCEPTANCE: STANDARD CONDITIONS
06/08/2001
02/04/2003
1 Renewal of this Acceptance (approval) shall be considered after a renewal application has been filed and
the original submitted documents, including test - supporting data, engineering documents, are no older
than eight (8) years.
2. Any and all approved products shall be permanently labeled with the manufacturer's name, city, state, and
the following statement: "Miami -Dade County Product Control Approved ", or as specifically stated in
the specific conditions of this Acceptance.
3. Renewals of Acceptance will not be considered if:
a. There has been a change in the South Florida Building Code affecting the evaluation of this product
and the product is not in compliance with the code changes.
b. The product is no longer the same product (identical) as the one originally approved.
c. If the Acceptance holder has not complied with all the requirements of this acceptance, including
the correct installation of the product.
d. The engineer, who originally prepared, signed and sealed the required documentation initially
submitted, is no longer practicing the engineering profession.
4. Any revision or change in the materials, use, and/or manufacture of the product or process shall
automatically be cause for termination of this Acceptance, unless prior written approval has been
requested (through the filing of a revision application with appropriate fee) and granted by this office.
5. Any of the following shall also be grounds for removal of this Acceptance:
a. Unsatisfactory performance of this product or process.
b. Misuse of this Acceptance as an endorsement of any product, for sales, advertising or any other
purposes.
6. The Notice of Acceptance number preceded by the words Miami -Dade County, Florida, and followed by
the expiration date may be displayed in advertising literature. If any portion of the Notice of Acceptance
is displayed, then it shall be done in its entirety.
7. A copy of this Acceptance as well as approved drawings and other documents, where it applies, shall be
provided to the user by the manufacturer or its distributors and shall be available for inspection at the job
site at all time. The engineer needs not reseal the copies.
8. Failure to comply with any section of this Acceptance shall be cause for termination and removal of
Acceptance.
9. This Notice of Acceptance consists of pages 1, 2 and this last page 3.
END OF THIS ACCEPTANCE
3
Helmy akar, P.E.- Product Control Examiner
Product Control Division
CONTRACTOR
Name /
wee
S /xi oar (ei
License No. C�, G a se-5 (Zr
Address 41_5- Q S A ) 3 7 ell
m Knee ( Fe.- 3 3 14-Z
Telephone 305 alio 96,5 Fax 3 ds 6 31( Pc ho
Qualifier Name m rT S a t CVc24 .
PROPERTY OWNER
New Construction
Name j60A'9.-0 6Y2Q
Enclosure
Address ? 90 Ne 1 c S'?
mon s y) tzef I (.Q
3 3l 3Q
Home Telephone 3 415 757 3 g Get
Business Telephone 3 c :73(
c :73(
75 - 5 ,
Fax
Fax
ENGINEER
New Construction
Name /lily N(GE, 4--�1'D�
Enclosure
License No. , E `v 9 A3
Alteration Exterior
Address l2 6 O N . U ,etr ve_ez, err 0 (L # (dam
104. A- t ) '- 3 33 22-
Telephone
el 50 3 , 2 _ Ate,
-O x
Alteration Interior
Fax
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'l Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Step 2.
APPLICATION
Job Address:
Folio Number
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 submit-
ted along with this permit application.
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.
/1 - 3 2-04 03Co
Lot 1 4 2 - Block / 6 -/
ss G"G
Subdivision I% (AM S (to2E1 PB PG 33 Zoning Linear Feet
Current Use of Property 5 F1
Proposed Use of Property J F
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
Poo /Vi fdO
Address
Apt.
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT { C��
Name
License No.
Address
Telephone
Fax
Master Permit No.
Subsidiary Permit No.
nx(am( SE160&
City State
PERMIT APPLICATION
c Y ) 7Cp 3
33131
Zip
Description of Work MSTA -(Q) A-cc-v s' 1r? '
Square Feet AP 7 Units Floors
Value of Work Co 1 4d sm Bldg Value
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
Page 2
�• r
PERMIT APPLICATION
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, 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
� . � , A ' , ,���
Signature of Own
Print Name
GG1Glr�f ���
Sworn to and subscribed before me this day of
.ZOO Z
t � � �t =
Signature of Notary Public - State of f ig MY COMMISSION # DD136338 13 2006
SEAL:
Personally known
Lee C. Picker EXPIRES
lu � September '? oP' BONDED THRU TROY FAIN INSURANCE, INC.
OR, Produced Identification
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Contractor / Qualifier
414-7 -:r e_ CC 0
Print Name
Sworn to and subscribed before me this i(
O
SEAL:
Signature of Notary Public - State of Fl P
' y Lee C Picker
r: �•_� .r MY COMMISSION # DD136338 EXPIRES
September 13, 2006
,t P° , F BONDED THRU TROY FAIN INSURANCE, INC
day of d
Personally known OR, Produced Identification
Type of Identification Produced: Type of Identification Produced:
ELECTRICAL
.l.VI,l,
Minimum Fee
QTY .
TYPE
Dryer
Q.l.V
TYPE.
Outlet, Appliance
(fry.
T1 pi,:
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
TYPE{
Minimum Fee
QTY.
TYPE:
Condensate Drain
QTY.
11'1li
Generator
QTY.
TYPE:
Refrigeration, Tons
Q'rY.
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
QT Y.
'TYPE':
Soakage Pit
OTT.
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
Mechanical
Plumbing
'Fire
Public Works
Structural
(0
/222-
Building Official
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
O 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
Notary
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
LI OTHER
(Specify & Attach)
PERMIT FEES
$ -25
$,75 .) b
$
(s .60) x/1000
x
(¢.005 / sq.ft.)
(¢.01 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $d ,)\
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: 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