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BP-02-2080PROPERTY OWNER Name 1 12G_ A-- RZOS 19.14 Vl CerrSkerti Address Gl s Sd n ` KJ c.,loto K e D K- (rh c e Yt ‘ 3to&i R. 3313 t Home Telephone 30 J e 7 -r -a. 4 (08 Business Telephone 30 S_ a- i 10 — 2-6 Y Z Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure 1 Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other ob Address: Address PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • ••• Master Permit No. • • • •.• • `• • : . ; StiNidiar•Pcrmit No. • • • • • • • • • • • • • PERMIT APPLICATION INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which Mnstbe eigned bythe property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate proces g e your aip1 anoni •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 Q550 N. 45hoi e l7er tve. n'1 t . E- 33138 Apt. City State Zip Folio Number Description of Work P ► % A \ & l S� Lot Block Subdivision PB PG Zoning Current Use of Property Square Feet Units Floors Proposed Use of Property slue of Work a� (Y) Bldg Value Tenant Information T'�x Assessed/Appraised Value Flood Zone Base Floor Elev. Linear Feet ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Qualifier Name Page 2 IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RE€EFJ&D YOWR•VA4.IHATED PIER/ *.AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRI'I TOgare limited to: tIonday riday 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 MAINTAIrir.D I A CLuN, t EA4A1a1D„S.NITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE ICEPRFRFErtO){ DMANVDEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMtGED BY .QUAPIE iT:OII' V HICLES, 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 ranks. 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. TATE OF FLORIDA, COUNTY OF MIAMI-DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE S gnature o Owner Ro -nl1 CR 6 Print Name Print Name w. . and subscribed before me thiaL day of , Sworn to and subscribed before me this day of • • • • • • • •, • • • • • • • • • • • • • ... • •• • SEAL: SEAL: Signature of Contractor / Qualifier Signature of Notary Public - State of Florida PERMIT APPLICATION Personally known OR, Produced Identification V / � Personally known OR, Produced Identification Type of Identification Produced: f J D / C ) 6 ��® ?BeCi Identification Produced: ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer • • • • QTY. • TYPE PiletAPInalce QTY. TYPE 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 QTY. 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 =� Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Pump and Abandon 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 o f vw&k being per rmad: ntccuantity(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) • •• •• • • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • • ••• • • • • • • • • ••• • • • • ••• • ❑ I6OF'OF OWNERSHIP ' . ...Li CONDO ASSOCIATION APPROVAL (Attach) (Attach) •• ••• •• • • • •• • • • • • • • • • ❑ HR$ / DEW IN,I;PIOVAT ' •' ❑ BPR APPROVAL (Restaurants) (Septic4S$vcier; '.' • • '.• ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $3.00 per page (Scanning Fee) Miami Shores Village r n le-0 6 Bond Notary Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine $ Zoning Review $ te $ r7 • • • • • • • • ( x .60) x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONTRACTOR REGISTRATION (On File) TOTAL 4, t 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 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12 /3/2002 Applicant: JORGE Owner: CABRERA JOB ADDRESS: 9550 N BAYSHORE Contractor Local Phone: Parcel # 1132060143860 Permit Status: Approved Permit Expiration: 6/1/2003 Work: EXTERIOR PAINTINS AS PER AGREEMENT If there is no permit package accessible on the job -site for fee is $50.00, which must be paid in advance before calling This Permit is granted to the contractor or builder named above to construct ordinances pertaining thereto and with the understanding that the work will be and approved by the proper municipal authorities. This Permit may be revoke authorization. A further condition upon which this permit is granted is the undo ordinances and regulations pertaining to the • rk covered hereby whether shc by his agents, servan or employe Sign Signed: Legal Description: MIAMI SHORES SEC 3 'PB 10 -37 E125FT OF LOT 2 LESS N41.45FT & E 125FT OF Fees: FEE2002 -6866 FEE2002 -6869 FEE2002 -6870 Description CCF 44iseelln ioous Notary Fee Building Fee Total Fees: Amount $1.20 `9891306- $5.00 $120.00 $226.20 Total Fees: $226.20 Total Receipts: $0.00 ( SPECTOR) In consideration of the i uance to me of this permit, I agree to perform the with the plans, dra*nis, statements or specifications submitted to the props myself, my age t!servants or:emp yes (Contra Building Permit Permit Number: BP2002 -2080 CABRERA JORGE DR Contractor's Address: Construction Value: $2,000.00 Washington Mutual M�mUHe Mutual Rank, FA M : 3 1 Finan cial tenter 17 9 7 7 � 24 near Customer Sefte NOTES ,A: 2'6 7084 1311 :. 8 3 1 2 5 6868 inspectors to verify, there will be no inspections. Re- inspection "--�- :•+enaction. JORGE A. CABRERA ROSANN THORNTON "CABRERA 9550 N BAYSHORE DR; MIAMI SNORES, FL `33138:3514 ry PAY TO THE ORDER OF '!" -- -11°„� with all _ MIAMI SHORES VILLAGE Paint Color ikpijnbyAttailuVAgreement • D ATE: OWNER'S N PHONE: ADDRESS: 9-T b 4). .. Yifo /i• :.., , 1. ************************;********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: .1 .•• CONTRACTOR &'LICENSE (ifaiiidaMl &) : • COMPANY NAME: PHONE: ** ******************************* * * * * * * * * * * * * * * * * * * * * * * *4 * * * * * ** All Elements on the site must be listed and in dicate the color t be painted. Walls 4 1 / 6 6 6 C u rn me . L' 1 l Fascia -e 1±L v ° \\\\)s Drip Cap/Drip Edge R. c tee- 8 l vs k Soffit Roof Flower Bins hutters Awnings Chimney Doors and door jams Garage Doors Railings Fences Decorative Metal APPROVED: j1L All brick (simulated or regular ) 8rvek A wh Stucco Banding °l Any other stucco features Accessory Other SUMMER VILLA X -79"' Blush a z tcl ri z c 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 const tion and zoning. I authorize the above -named contractor, if applicable, to do e ' ®`rk st . s • Furthermore , the paint colors will be as per the attached wner Date Signature of Contractor Date ******************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION //7 Building Offatal Date 4/23/01 •• • • • • • • • •• • •• • • • • • • • • • • • • • � • • • • • • • • • • • • • • • • • •• • • • • • • • • • • •••• •••• • • • • •••• •••• •• • • • • • •• • • • • • • • The Sunshine State LICENSE tanseER C166- 73845 -805 -0 ROSANN THORNTON CABRERA 9660 N BAVSHORE DR MIAMI SHORES, FL 331363614 BIRTH DATE sot HOT. REST. ENDORSE. 11.05 F 606 ISSUED EXPIRE; DEPURATE 07 -1241 11-0606 000000 Parcel Owner Report Parcel Number: 1132060143860 9550 BAYSHORE Drive Miami Shores FL 33138- Tax ID: 1132060143860 Owner Information JORGE CABRERA Phone: ROSANN CABRERA Phone: Current Owner: Yes Current Owner: Yes Related Permits Electrical - Residential Electrical - Residential Imported Permit Imported Permit Imported Permit Imported Permit Mechanical - Residential Plumbing - Residential Plumbing - Residential Residential Construction Roof Permit Number EL- 1 -09 -82 EL -9 -07 -1968 BP2005 -516 MC -9 -07 -1965 PL -7 -07 -1390 PL -9 -07 -1969 RC -2 -06 -431 RF -11 -08 -1956 Application Date 01/20/2009 09/19/2007 04/13/2005 05/12/2005 08/29/2003 12/03/2002 09/19/2007 07/03/2007 09/19/2007 02/21/2006 11/06/2008 Expiration Date 07/27/2009 08/18/2008 05/14/2006 11/08/2005 02/25/2004 10/25/2003 04/12/2008 01/05/2008 04/12/2008 07/11/2009 05/24/2009 Status APPROVED ON HOLD CLOSED (EXPIRED -.l APPROVED APPROVED APPROVED APPROVED APPROVED Friday, January 30, 2009 Page 1 of 1