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361 NE 102 St (3)Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Type Insp'n Permit No. Name • Address Company CTIl1Wtn Phone # , For Inspector: 16 ` I ` b "` - {'' Name l4, PROPERTY OWNER Name Address 1(0/ Ai& /oa St Home Telephone i n s 7 5 _ 7 _ S'y e) R' Business Telephone 3 6 _ j 3/- 3. 7 D d 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 INSTRUCTIONS - The following steps must be 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 submit- ted 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 K Job Address: 3(0/ Address Folio Number Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Other Fe Apt. City PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax escription of W Master Permit No. Subsidiary Permit No. PERMIT APPLICATION sA d ✓e5, S ORAL ! FL 3 3i35 Zip Zoning Linear Feet Square Feet Units Floors 4 alue of Work / /a C--O Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name 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, 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 ORIDA, COUNTY OF MIAMI -DADE 1- 7 C4 Sigttature wner � /J (°fin /7 ; 6ei,s Print Name / Print Name worn . nd subscribed before me thi2 b day , Sworn to and subscribed before me this day of SEAL: SEAL: PERMIT APPLICATION STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Signature of Notary Public - State of Florida Personally known OR, Produced Identification v r���'� �p Personally known OR, Produced Identification Type of Identification Produced: S- )D 5 . y , j»pe of Identification Produced: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 9/26/2002 Applicant: CONNIE Owner: BENSON JOB ADDRESS: 361 Contractor Local Phone: Parcel # 1132060135090 Signed: NE 102 If there is no permit package accessible on the job -site for ins fee is $50.00, which must be paid in advance before calling for This Permit is granted to the contractor or builder named above to construct the ordinances pertaining thereto and with the understanding that the work will be perfor '`` and approved by the proper municipal authorities. This Permit may be revoked at ar"r authorization. A further condition upon which this permit is granted is the understanr ordinances and regulations pertaining to the work covered hereby whether shown of by his agents, servants or employees. (INSPECTOR) In consideration of the issuance to me of this permit, I agree to perform the wo t with the plans, drawings, statements or specifications submitted to the proper autt '. myself, my agent, servants or employes. Building Permit Permit Number: BP2002 -1661 BENSON CONNIE ST Contractor's Address: Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 E1/2 LOT 19 & LOTS 20 & 21 BLK 37 LOT SIZE Fees: FEE2002 -5405 FEE2002 -5406 FEE2002 -5407 Description Building Permit Application Fee CCF Notary Fee Total Fees: Amount $60.00 $0.60 $5.00 $65.60 Total Fees: $65.60 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 3/25/2003 Construction Value: $1,000.00 Work: EXTERIOR PAINTING AS PER AGREEMENT Connie Benson / - P..Benson 305- 7 57 -5408 - 361, N.E.,102.d ST Fl :33138 - ORD ER ' � I i ^ FIRST UNION NATIONAL BAN' •_` .j DOWNTOWN BANKING CENTE FLORID - - ONE SOUTHEAST FINANCIAL CENTER , MIAMI,: FL 33731 539 O R �� Unre ANN - u!:06 7 0064 3 2I: L6 5 3906 ; 4 19 -i e e will be no inspections. Re- inspection 11 3090 The Sunshine State P1,11010r-h B525-103-56441-0 • CONNIE CONTRATA BENSON • 361 NE 162STREET MIAMI SHORES, FL 331384128 BIRTH DATE SEX liar. REST, ENDORSE. 09,21-66 F 506 ISSUED EXPIRES DUPLICATE 00-00.00 084648 0921-04 ORGAN DONOR SAFE DRIVER X06900006312S at a motor vehicle constitutes consent to any sobriety test reqtaed by taw. MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: Q f y— OWNER'S NAME: e e, V - �_�;'� PHONE: 3o S 5 760 x 3.3 cc, ADDRESS: 3c,/ /Lye /6 3 ,e '1S6 ' S /- 1d '"es /PL. *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: / AJ c j St CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted.. Walls o /c-e- 5 y (a/a // # � 3 V ae -° Fascia Al 06 Fe rh 0-- 9[o / (a/o „5 radC 1.; n e) ( Drip Cap/Drip Edge Soffit Roof Flower Bins Shutters )J / Awnings W 1,L) L; Chimney 4 /1 o (AD Doors and door jams wh.4.2”' Garage Doors W Railings C,J Fences A //,1 Decorative Metal w All brick (simulated or regular) OM- Stucco Banding til/A- Any other stucco features Accessory'Buildings e //6 c,J n)//A- 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 samp s. APPROVED: Building Official 6 /( 2 40/0. Date (x 1 ee.7 .P. 0 r H • z c W • rxi z nature of Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 ELECTRICAL TYI'P, Minimum Fee QTY. 'I'VI'E Dryer Q'I'1'. TYPE Outlet, Appliance QTY. T1'1'N. Service Repair Q'FY. A/C Central 1 -3 Ton Heating Strips, each Fan Outlet, Wall Service, Temporary Paint Booth A/C Central 4 -7 Ton Fire Pump Outlet, Switch Piping, Flammable Liquid Signs A/C Central 8 -15 Ton Fixture - Fluorescent Process/Pressure Piping Oven Space Heater (kw) A/C Central 16 -20 Ton Pressure Vessel 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 "1'YPE, Minimum Fee QTY. INIT. Condensate Drain QTY. '1'V Generator QTY. '11 PE Refrigeration, Tons QTY. A/C Central, Tons QTY. 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 Pump and Abandon Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Gas - Appliance 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 DATE Zoning /ee ' 6 p„Z Electrical Mechanical Plumbing Fire Public Works Structural yb,-2 2- Building Official Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ 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.) $ • 6 0 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) ❑ OTHER (Specify & Attach) PERMIT FEES $ o $ $ ( x .6 x/1000 0) (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION O CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ v a 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 BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE, FLORIDA Lam` PERMIT IN? 13288 n Work to be performed under this Permit t / • CONTRACTOR OR 13611d)I L .- - 1 t u r i Subdi- vision Value of Project $ BY - . t • DATE � / ' 4. 195 Contractor's License No. Amt. of Permit $ 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. Signed: _ s, ...,,0 x BY 1... INSPECTOR In consideration of the issuance to me of this permit I agree to perform 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, mygelf, my agent, servant or employee. AUTHORITY Alp MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date 67 /L , 19 . _ Owner's Name and Address _ V e ak - L L_ �__S No. 61 Street AIe.10 Z• b i Registered Architect and /or Engineer. _ Name and address of licensed contractor__ L�7 0712 Location and legal description of lot to be built on: �j/ - Lot 2 / gi 2. 1 Block 3 7 ^ Subdivision 1 4- 41 - 5 • / 127. / 4/ 11. re) 2... S /. State worl be done and pur ose of building by floors) _._ • .e' _�e¢.� C I A. 4-1'_� f_ ee t•J_ d for no o her purpose. No. of Stories Street and Number where work is to be done STATE OF FLORIDA, COUNTY OF DADE. ss. New Building Remodeling To be constructed of Kind of foundativ Roof Covering Estimated Total cost of improvements $ 2 S 00 .— Addition Repairs I� Amount of Permit $ Zone cubage required plan Cubage Size of Building Lot Distance to next nearest building Maximum live load to be borne by each floor I hereby mit all the lans and specificatio s for said buil ing. All notices. wi be sent to__ ___ __ _ _ and has complied with the provisions thereof, and will require similar compliance fro in the work to be performed under this permit; and will post or cause to be poste or notices as are required by the Act. The undersigned agrees to employ only s permit, as are licensed by Miami Shores Village. Remarks ( Signed reference to the building and its onstru ion • e 4 4r ) 1 The undersigned applicant for this buil ing permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, all contractors or sub - contractors employed by him nspectio : • the site o e works 1 1 l' t' .- .c•ntra or • r •' uci u�ic noi . e P e� • r ry n• f , a Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 1 � Permit No L_ ' Date Read, Sworn to and Subscribed before me. Disapproved atg >_ J_ Notary Public, State of Florida (Signed) Build g I Spector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.