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415 NE 102 St (8)13 Time Type Insp'n . = • LA— Permit No.. V ZO0 °� I P v 7 Name Address `S t oa \ Company C ` Phc�r(e �-‘ q l L u 0 For Inspector: 1 I L I Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTME 305- 795 -2204 Building Inspection Requ Name & Date Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request DateL ? / -Sn/ D Time Type Insp'n Permit No. 'IDne in 7 Name .+—t,/Ntt•- Address 41 S t c• ( 0 /0-7/ Company Phone # For Inspector: ) Re- Insp'n Fee ❑ PROPERTY OWNER New Construction Name / q/f // & f r Ad ��e l/t/ , v� ,/ i/�/ Home Telephone y./ 9\5'(/--,,K7 Business Telephone � L t _` Relocation of Structure Fax / G 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 ob Address: 4 / 5/ /t J i Address Apt. City r� Folio Number Description of Work 1W Lot Block Subdivision PB PG Zoning Linear Feet Current Use of Property Square Feet Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other/7 PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax atalfof Work Subsidiary Permit No. State PERMIT APPLICATION Master Permit No. Units Floors Bldg Value Zip 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 $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF Signature of Own ry Public tat of orida Signature of Notary Public - State of Florida OFFICIAL NOTARY SEAL RY PEA ( ANGELA PA BECSiEFt SEAL: � A.0 1. ~ t P � i ,., ,. , r • oo t �s$Oii NUMEIZA Z 4 * C7d6.u97 PP S 4 7 0¢ ; 71 .•' 1 ' _ - -s Personally known c , OR, Produced Identification Personally known OR, Produced Identification SEAL: NTY OF MIAMI -DADE Name to and subscribed before me t day oD C PERMIT APPLICATION STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Type of Identification Produced: Type of Identification Produced: r' MEMO Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2002 -1869 Printed: 10/31/2002 Applicant: LARRY Owner: M JOB ADDRESS: 415 Contractor Local Phone: Parcel # 1132060170780 ' t: + -i *r" :.ter~5 ;x' LARRY D. OR KAREN PUMA P.O. BOX 531429 MIAMI SHORES, FL 33153 -1429 COMMERCEBANK NATIONAL ASSOCIATION 1900 Biscayne Miami, rata 11 NE 102 1:0670 L05091: I L O 3569 L6011'06 30 Building Permit PUMA ST Contractor's Address: Legal Description: AMD PL OF MIAMI SHORES SEC 4 Fees: Description Amount FEE2002 -6188 Building Permit Application Fee $60.00 FEE2002 -6189 CCF $0.60 FEE2002 -6190 Notary Fee $5.00 $65.60 Total Fees: Total Fees: $65.60 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 4/29/2003 Construction Value: Work: EXTERIOR PAINTING AS PER AGREEMENT 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. Wgelixed- v ,.9, PAY 1 E01 De OF e equipment or device described in the application herefor in strict compliance with all Oh any plans, drawings, statements or specifications that may have been submitted to 63 - 1050 /670 3 0 6 3 not done in compliance with such ordinances or if the plans are changed without 1103569160 or or builder named above assumes the responsibility for a thorough knowledge of the IDATIP,/w ('/Y )s or in the statements or specifications and that he assumes responsibility for work done compliance with all ordinances and regulations pertaining thereto and in strict conformity Village. In accepting this permit I assume responisibility for all work done by either BY: BY: $500.00 Page 1 of 1 PB 15 -14 E1/2 OF LOT 14 & LOT 15 OWNER'S NAME: fl5DRESS: ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ,DDRESS OF SITE: � e Ti's CONTRACTOR & LICENSE (if applicable) Ai( )1, COMPANY NAME: PHONES ,DATE: / O — �0 MIAMI SHORES VILLAGE Paint Color Approval and Agreement OG� ********************************* * * * * * * * * * * * * * * * *i * * * * * * * * * * * * ** I1 Elements on the site must be listed and indicate the 'nlnr to be painted. alts F .. scia ip Cap/Drip Edge G -» offit Gv /ilk Flower Bins oof F Shutters Awnings Chimney Doors and door jams Garage Doors G� Railings Fences Decorative Metal a,/-y All brick (simulated or regular) Ge/%fie Z' I.7' VA, Stucco Banding Any other stucco features a// Accessory'Buildings ther 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 state urthermore , the paint colors will be as per the attached sa • J A7 'Z.--- ignatu e of Owner • . to Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED: WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION Building Official Date 4/23/01 ELECTRICAL T1 PE Minimum Fee QTY. TYPE. Dryer QTY. TYPE Outlet, Appliance QTY. 1 PE Service Repair Q 11'. 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 . 1 . 1 , 1E Minimum Fee QTY Fhl, Condensate Drain QTY . .11,131,. Generator ()Ty. . Refrigeration, Tons Q . F1 . 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 QTY. 'r1'PE Soakage Pit Q'FY. 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: 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 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) $ 0 > Metropolitan Dade County (C.C.F.) $ (sq.ft. = x/1000 x ¢.60) Inspector State Educational Fund $ (¢.005 / sq.ft.) $ (¢.01 /sq.ft.) $ .S' a l� REVIEWED AND PREPARED BY: SECTION ae Zoning Electrical Mechanical Plumbing Public Works Fire Structural Building Official BY DATE PERMIT APPLICATION ❑ CONDO ASSOCIATION'APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ LC b ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2"° AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Date 0 Zc? 3 Job Address Os /W 6 (02 -57 Tax Folio Legal Description Historically Designated: Yes No V P'e D TC, . 6//244 Owner/Lessee / Tenant 4 L Owner's Address 5 H 11 E Contracting Co. D \-( ^- (i Address Qualifier SS# State # Municipal # Competency # Architect/Engineer Address Bonding Company Addres Mortgagor A laws regulating co ction , 11 . 1 1 g La� • .'s e� / o s er and/or o • o President Notary as to Owner and/or Condo President My Commission Expires: FEES: PERMIT ( RADON PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date C.C.F. Master Permit # /0 zq 9 ij/IiLij Date ioii;kac o , Ov APPROVED: rr Zoning Buildin g S " l� ` 3 Electrical Mechanical Plumbing 43'7 Phone 3or - 1 - q 7 2. C Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION - P4 / N E X T F kin 7 E - f I /O CJ E e A 12'/2 i 6 6 ROOc iiv' /I rTE tO w,q TTE 4/o �b 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 that all the foregoing information is accurate and that all wo will be done in compliance with all applicable g. Furthermore, I authorize the above -named contracto . o the wor Notary as to Contractor or Owner - Builder My Commission Expires: F o- 00 4' O Jac F 6 ,eA j Pe. I Date Date a NOTARY BOND TOTAL DUE Engineering