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400 NE 102 St (11)MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Time Date Type Insp'n � I J Permit No. �i r _ I Name /�} Address 0 AJ v ) (2 — Company Phone # ) D a ) ) For Inspector Na Date Approved Correction ❑ Re-Insp'n Fee ❑ o -_ J PO4 ciptiA 7,440 -To Loo 1_00 ,eyaQ) . )1V°) PROPERTY OWNER Name A Egakt 2 Z1 Z•a-L1 Address 00 N G- 1 oz._ S-} mIFtt ijo0211 -1=-1 3,8/ Home Telephone 75-1 — / /� � (O 1 Business Telephon� . L f C Ci '/ a 7 / (o Fax 771 -too 7 SI Ca L ( be-C f L 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. 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 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 Address Folio Number s Description of Work 430 Al c" Lot Block Subdivision PB PG Zoning Linear Feet Current Use of Property S uare Feet Units Floors Proposed Use of Property LIueofWork ¢ O • Value Tenant Information ax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other LI0b N t 101 S Ap PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No. m A-ry, City State PERMIT APPLICATION 23/3x' Zip ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name \K Page 2 IMPORTA 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 WAt and Sewer Department (MDWASD) approval is required for applications involving sewers. 1. 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, dr 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 sing a Contractor. \ sign s TE OF FLORIDA, CO7 OF—MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE Print Name to and subscribed before me this gnature o otary Public StateCof ` q}ida P". — ANGELA A c. :e. SEAL: A, �'^''' . :. " co „ .I, d P.,' Personally known day of C, C ±. Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: PERMIT APPLICATION OR, Produced Identificatio Personally known OR, Produced Identification Type of Identification Produced,LJ) 21 -33 l '/ S '3 -4)I of Identification Produced: Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: BP2002 -1787 Printed: 10 /18/2002 Applicant: ANTHONY ZIBELLI Owner: ZIBELLI ANTHONY JOB ADDRESS: 400 NE 102 ST Contractor Local Phone: Parcel # 1132060170620 Permit Status: APPROVED Permit Expiration: 4/16/2003 • Work: EXTERIOR PAINTING AS PER AGREEMENT /75 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. 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 vA� 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 rdinances 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: ' (INSPECTOR) ECTOR) BY: In consideration ofe 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 responisibility for all work done by either myself, my agenr.servants or employes. Signed: Building Permit Contractor's Address: Legal Description: AMD PL OF MIAMI SHORES SEC 4 Fees: Description Amount FEE2002 -5884 Building Permit Application Fee $60.00 FEE2002 -5885 CCF $0.60 FEE2002 -5886 CCF $0.60 Total Fees: $61.20 Total Fees: $61.20 Total Receipts: $0.00 Construction Value: (Contractor or Builder) BY: $500.00 Page 1 of 1 PB 15 -14 LOT 12 BLK 91 REG CO1 102102 0959 MC#01 002131 rypRGE $61.20 1V11AMV11 SHORES VILLAGE Paint Color Approval and Agreement DATE: O t0 2 002 , OWNER'S NAME: l T �2 E� �1 PHONE: 757 - 6 tf fL- ADDRESS: 6 r .1= O� -L 1'Y) _I 3 t? r ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: . ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site mus be {fisted and indicate the color to be painted. Walls APPROVED: Building Offici Date C, \on � c�.` c1► 0 Fascia C./ scc. co (T Drip Cap/Drip Edge Co \O r`+ c Soffit r',fASScL Roof /)1/ Flower Bins C PAS( wH Shutters - ' Awnings N Chimney • to Doors and door jams Garage Doors £ \ c LSS c_c--` Railings Fences Decorative Metal Date y All brick (simulated or regular) ('_`,.p, -& cP U t -((�' Stucco Banding Any other stucco features Accessory Other Classical White SW 2829 Colonial Yellow SW 0030 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 d • he work stated. Furthermore , the paint colors will be as per the attached sa ples. Signature of Owner Signature of Contractor Date ************************************* * * * * * * * * * * * * * * * * * * * * ** * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01 ELECTRICAL TyPE Minimum Fee ()Ty. '1'vPl? Dryer QTY. 'rm.: Outlet, Appliance Q'I'y. TyII: Service Repair QT1'. 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 M ECHANICAL 'I'yII Minimum Fee QTY TYPE Condensate Drain Q'I'y TYPE Generator QTY TYPE Refrigeration, Tons Q'I'l 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. TyPI. Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. ' fypl: Soakage Pit ()Ty. 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 aiatl/G6 (/ D TE /V /ko% Zoning Electrical Mechanical Plumbing Fire • Public Works Structural Building Official ! ( Y L Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) ❑ PROOF OF OWNERSHIP (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 ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ Zo $ { b $ S,a� x 6U) 1000 $ (¢.005 /sq.ft.) $ (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ 6s. 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 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date /0 ob Address 46 /d 349/ Tax Folio Legal Description O Owner / Lessee / Tenant /4 Master Permit # 3 7(,Y Owner's Address ' AP / <7__ 76 2 Phone 3 e) 8 7�� Contracting Co. _ 1 -5 Sao Address .I ? D l"/"' /?/,s pdcya__nit, Qualifier i 44.1 SS# - �� - 1 State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION C / C .1- r /-4-7 //c' `O Gz�f Square Ft. Estimated Cost(value) 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 constr4ction and zoning. Furthermore, I authorize the above amed contractor to do the work stated. � Vim(. Signa owner and /or Condo President Sig e of Contractor or Owner- Builder Date: Date: /C / / eXt.-- Notary as to Contractor or Owner- Builder Notary as to Lwner and /or Condo President My Commission Expires: APPROVED: Fire Zoning Buildin Mechanical Plumbing My PR • ,.._ • • SY P( OFFICIAL NOTARY SEAL O SANDRA M MONTIEL ** * * * * * * * * * 2 , * COMMISSION UMBER ��� Q C401 2 61 * * ** S - a ' 2 " j MY COMMISSION .EXP. Old ,1 FEES: PERMIT � RADON C.C.P. • , • r 119 17, •DUE T 3 . .. Other Electrical Engineering Date CI I0 _��, Job Address 400 e (07, Sf - Qualifier 6(/9 r(,, SS4 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Tax Folio // 5ao6 /10,0,0f Legal Description/O? ' / g'in,0 o hs 1 rd 0 d ti( Ell &4 Os I t e /f / Lessee / Tenant -- Mas ter Permit ����% Owner's Address 1 -loo - NE (02 Sf., �VA Sl&ol(9, i�--- Phone Contracting Co. A !te%1_, 4=4e Address - - Phone State # Municipal # Competency # Ins.Co. Architect /Engineer 50' Address Bonding Company - Address Mortgagor ---- Address Permit Type(circle one): BUILDING ELECTRI PLUMBING MECHANICAL C ROOFING PAVING FENCE SIGN WORK DESCRIPTION P � , a e�( or-0 Roo o f /iaUStI E b Cvlit1 Square Ft. Estimated Cost(value 0 - 4000 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 the above -named contractor to do the work stated. Signs /�J / owner and /.r Condo President Signature of Contractor or Owner- Builder Date: l o< AP"'w; : MGEMME CMAKH Date: ' :Notary Punic, State of FIomb M Commute Eja.30,1 fN nt Notary as to Contractor or Owner- Builder M r " o r age B i rr o iL'8 rSa ; . ' My Commission Expires: ersona nown LjjUIZ 1 roduce<1 I.D. Type anJ nu n r gf i D. produced: * t] AD rake an oath, or pi DID NOT take a ' �J FES : PERMIT . RADON C.C.F. , .7 v NOTARY , ..5 - 040 ©0 TOTAL DUE y 8,9 (/ APPROVED: Zoning Building AN * * * * * * * * * ** Fire $9/Vti Other Electrical Mechanical Plumbing Engineering