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FW-09-717 llL Miami Shores Village eN g q N�M Building Department, 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8072 L qll BVILDIN EI eV Permit Nod PERMIT APPLICATION Z 9 �QO� ter Permit No, FBC 20 ArP_ Permit Type(circle): Building R g o -7 { Owner's Name(Fee Simple Titleholder) M CA r� �� ' 1 Phone# Owner's Address n T �( ) City_l 1 i Q 1��11 1�1�SY� State zip �-3 /3 Tenantazssee Name I Phone# 3 b / g ' J Email Job Address(where th work is being done) 41 s4ytf� S hores Vil1 a g { City Miami S e County_ Miami-Dade Zip �� �3 FOLIO/PARCEL# Is Building Historically Designated YES NO Flood Zone Contractor's Company Name � . Phone# — -D Contractor's Add(/re-�ss 7 '�, 5 w �` S+ City l..�l1f. State Qualifier Name -5 _ Ph p one# 1 `rt State Certificate or Registration 'Culp of Co*petqfic+NA. 'C-/49 >.(n-�( �� Contact Phone Emailµ --W pI"�Q.V i© �� Architect/Engineer's Name(if applicable) Phone# v G P Value of Work For this Permit$ I P Square/Linear FootagesOf Work T�1�7"�"• Type of Work: Additi n Alteration, New [1 Repa' epi ce ❑Demolition_ Desc 'be Work• IBC ® 1� ( 11J � � f0 Gi c AM- 612 1 Submittal Fee$, Perm_it Fee$� CCF$.�: O Ceoec Notary 5` ry �_; Trail ' ucation Fee$ 0`x Tecbnoloq Fee$ �+ Scanning$ • Rad $ DPBR'$ Zoning$ Bond$ Cod Enforcement$ Double Fee$ Structural Review.$ Total Fee Now Due$ ��• See Reverse side Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address city State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and AIR CONDITIONERS,ETC..... 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must Promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven(7) days after the building permit is issued. In the absence of such posted notice. the inspection will�anot be approved and a reinspection fee will be charged. Signature - Signature ' W Owne r Agent G Contractor The for of instrument was ac wledged fo me this t The foregoing instrument was acknowledged before me this �� day of ,2ODq by of ,20 ,by who is rsonally nown to me or who has produced ✓ w o is personally known tome or who has produced 2 G2tification and who did take an oath. as identification and who did take an oath. NOT PUBLIC: a�c�As NOTARY PUBLIC: Sign: +1o'CP,�1 Sign: �. f %J s Q Print: 6� p Print.. V M Commission Y Expires: •� P c " M Y P Commission Expires: JEAN-CLAUDE FORTILUS MY COMMISSION#DD470105 IXPWXS:September 8.2009 . I NOTARY Ft.Notary Discount A=m-COo. kk�kk�s kk�kk�kR:k��?k�:�eokaok��aa&k��ak�>$�i&�3'ekek�ok�s&kk#R��k��ab�e��tk���ka���$ffi��R#��eeRaZ�BSjkk�k��R�� &�ffi��cikR�k�BR��k3kkk�k& APPLICATION APPROVED BY a ns Examiner r S Zoning Engineer * Clerk checked (Revised 07/10/07) K:{305)264.0229 C •.• v �;/ u-t u a rz auKYEY Nc 4+.W BY.—L!i LAN# SURVEYORS SHEET No. ��J :. BOUNDARY SURVEY 0� � �� " ' SCALE /"C y 30 Oloc ami Shores Village exlS�l u��ll �.�®u,nd � APPROVED BY T�� f�v Cl ��OLlL DATE � ZONING DEPT � S �Ole- _6L®G DEPT O nd 6 I , SUBJECTTb COMPLIANCE WITH ALL FEDERAL LOT-5 STATE AND COUNTY RULES AND REGULATIONS � . BLOCK-4 LO/K T�-4 BLOC -4 LOT-3 BLOCK-4 LOT-2 BLOCK-4 U.P. J 10.88 F.I.P 112" ! NO CAP 0.40`--CL h : --- • F.LP 1/2" •- 32'' it I NO CAP ' 3• i 10.8 ( °PL °0 0.45'CL. w • ALL COLUMNS I 1.40 X 1.40 10.76 per. �K N 11.01 Rusa S A ALL COLUMNS . L 4 ' w$t 1.40 X 1.40 �EAWV.4 K NEW A-29 6 •F LOT. 19 4 C.6.✓ CK-4 Ev.sij ,. .. :.• �, Oro� • '• T - � :� _ 10.02• A.C. LOT-22 10.00• 1.1 S° RES 67Y � GWGE �82' 4'C.S.W. BLOCK-4 /�9.9s• s OT-21 / �•F1. c LOTO B OCK-4 w .E 1 . 2 h H h/ 20 0.40'CL. �BLOCK-4/, 2S.951 10.04 20.00'0/ iN ��• A ' �_• •• 19.00' `' 10.81 .. F.I.P 1/2" 160 ••. NO CAP' 1 10.0n' �• 1/2" • �P • • 0 X. PwY 10.67 .52 F.I. 10 '7W2�3 Planni.f and Zonling Critenia Miami Shores Village Permit No. FW-4-09-717 Q. 10050 N.E.2nd Avenue ............ ... Miami Shores,FL 33138-= ........... �ax ... ..................... Phone: (305)795-2204 Fax: (305)75"972 .... I ., .....................—.. Issue.Date:.Not Issued ... ... Expires:Not Issued ...... ......... ............... Folio Number)132060130570 ............. ..................-... ","------------------------- Owner's Name:MICHAEL BURKET Owner's Phone: (415)595-3910 Job Address: 67 94 Street Total Square Feet: 1000 Miami Shores, FL 33138- Total Job Valuation: $ 3,000.00 ..................................................-................................................................................................................................................ . ...... Contractor(s) Phone Primary Contractor Planning and Zoning Criteria and Comments Approved:Yes Date Approved: 5/1/2009 : Yes Comments: INSPECTION POST ON SITE REC R �� o Miami Shores Village Permit NO. FW409717 t�artta ' �� g s > 5.. -.. .... ... . ...:::. .:::; ; ; ; :: ; f: : :: . .; : ; ;; : 1 :; ; 1 :1005 0 N.E.2nd v enue ....-: so� . ---- -— t' Miami Shores,FL 33138-0000 ............ Phone. 305 795- _ 11:.,:<::: ^� .:::: :..��:::..::.:....... 2204 Fax: 305756-u972 ..; :::.;:;::.<.::;::<;;;;;;;;;;;;;:;;;:;:<:;:<:.;;;:;;;<.;;;;:;;;;;;;:;<�;;;:<;;;;: s:<�»:;;:::.::::.......:::::,::: ::::::::::,.::::.......... :... Issue Date: 5/7/2009 Expires: /0 /,,2 INSPECTION REQUESTS:ESTS: Q (305)795-2204 REQUESTS ARE ACCEPTED DURING 8:30AM-3:30PM FOR THE FOLLOi ING BUSINESS DAY. FenceNVall Parcel #:1132060130570 L..- ........ ......... ........ . ..................................................................................... Owner's Name.MICHAEL BURKET m Owner's Phone: (415)595-3910 Job Address: 67 94 Street NE _a Total Square Feet: 1000 Miami Shores. FL 33138- Total Job Valuation: $ 3,000.00 Bond Number: WORK IS ALLOWED MONDAY THROUGH SATURDAY, Contractor(s) Phone y Prom y oslirraor 7:30AM-6:OOPM.NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS. BUILDING INSPECTIONS ARE DONE MONDAY THROUGH THURSDAY. ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY. NO BUILDING INSPECTIONS DONE ON FRIDAY. RUN a j y L* to s t: 1401popor J ad NO INSPECTION WILL BE MADE UNLESS THE PERMIT c ',;;,.. DISP!.A,YED A',")HAS BEEN APPROVED. PLANS ARE READILY AVAILABLE. IT IS THE PERMIT APPLICANT'S RESPONSIBILITY TO ENSURE ''.' vVOPI1 iS ACCEbafBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER THE BUILDING OFFICIAL NOR THE CITY SHALL BE L;ABL.;7. C f XPF!,-S_ c N '.1-70 IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL WARNING TO OWNER: Y0 3. fr. l,ILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESIN-`' `?4 ,'JR P44YING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTiC,l" ? ,, 9MMi-Fu�!CLMENT MIDST BE RECORDED AND POSTED ON THE JOB SITE BED 7 Y ''G- TI FAT INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT Wk. H YOI IR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECOF>SING YOUR NOTICE OF COMMENCEMENT. ''INSPECTION RECORD STRUCTURAL 20NING PLUMBING INSPECTION I DATE I INSP INSPECTION DATE INSP INSPECTION DATE INS- Foundation Zoning Final Stemwall ZONING COMMENTS Rough Slab Water Service Columns 1st Lift) 2nd Rough Columns(2nd Lift) Top Out Tie Beam Fire Sprinklers Truss/Rafters Septic Tank Roof Sheathing Sewer Hook-up Bucks Roof Drains Windows/Doors ELECTRICAL Gas Interior Framing INSPECTION DATE INSP LP Tank Insulation Temporary Pole Well Ceiling Grid 30 Day Temporary Lawn Sprinklers Drywall Pool Bonding, Main Drain Firewall '' Pool Deck Bondina Pool Piping Wire Lath Pool Wet Niche Backflow.Preventor Pool Steel Underground Interce for Pool Deck Footer Ground Catch Basins Final Pool Slab Condensate Drains Final Fence Wall Rough HRS Final Screen Enclosure Ceiling Rough Driveway Rough PLUMBING COMMENTS Driveway-Base Telephone Rough Tin Cap Tele hone Final Roof in Progress TV Rough Mop in Progress TV Final Final Roof Cable Rough Shutters Attachment Cable Final Final Shutters Intercom Rough Rails and Guardrails Intercom Final MECHANICAL ADA compliance Alarm Rough INSPECTION DATE INSP FINAL Alarm Final Underground Pipe DOCUMENTS Fire Alarm Rough Soil Bearing Cert Fire Alarm Final Rough Soil Treatment Cert IService Work With Floor Elevation Survey Ventilation Rough Reinf Unit Mas Cert ELECTRICAL COMMENTS Hood Rough Insulation Certificate Pressure Test S of Survey Final Hood Final Surve Final Ventilation ' Truss Certification Final Pool Heater STRUCTURAL COMMENTS Final Vacuum MECHANICAL COMMENTS INSPECTION DATE INSP Finaf Sprinkler Final Alarm (4u5) 264.0229 C - `'" �•:� u.t u �' U rs b b.�•. Ourcve Y Nc " , +� er.•�'.Lr._.L_y LAND SURVEYORS SHEET No. b Act� ° f oy 20UNDARYSUR y C ( 'n6y Hoc_-K5 7j� SCALE �1'm30' �� r =�Y'e�e Miami Shores Village APPROVED BY DA C6d6 cave �o a,I ,�����-�I m 'E ZONING DEPT �� Gr1� S UeCo 1�.� � : �• . BLDG DEPT SUBJECT TO COMPLIANCE WITH ALL FEDERAL L STATE AND COUNTY RULES AND REGULATIONS LOT.S BLOCK-4 LOT-4 I BLOCK-4 Or-3 BLOCK-4 LOT-y BLOCK-4 U.P. J 10.88 F.1.P 1/2" NO CAP t - -- 0.40'CL. y : --- - - �• NO CAP e 3 r 10.8 - I 'P°OL °p 0.45'CL. I � • ALL CO I LUMNS 1.40 X 1.40 10.78 • H 11.01 '"6 A_LL COLUMNS �' 48RVS wR�q H + 1.40 X 1.40 �E T�tuk NEW 4Z9 S •F LOT.f 9 4'C.B.✓ 11.1 9cn &*L.- 1 ' 1 80' 2A iru NC-LD BLOCK•4 A/ EV.� t" V A.C. ;28.30' ,� 73. -- 10.02& i TL? y / i LOT-22 10.00''' 11 RES #67 G En 82' 4'C.S.W. BLOCK-4 �f y � ., �or-21 . L.F H h� o , F .Eal 21 Lor-20 B O�-4 r 0.44 CL.''' ® -BLOCK-4 21.04f 9. •M ,•, 10 20.000 ,/ �► '®� '� ' .0a 1 �:. .. 19.00 � •'"I •44 CL... .• 10 : I us lie NO CAp 1 10.On SHME *OF ' • M 2'P" 10.67 • �•'•' ••a.'• 10.82 rAn A� Invoice �j Miami Shores Village ( ✓ 10050 N.E.2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 For Inspections please call: (305)762-4949 eturn to: Miami Shores Village Invoice Number: FW-4-09-34693 10050 N.E.2nd Avenue Invoice Date: April 30,2009 Miami Shores, FL 33138-0000 Permit Number: FW-4-09-717 Bond Number: Bill To Comments: MARIA COYNE 67 NE 94 Street MIAMI SHORES, FL 33138-2819 Date Fee Name Fee Type Fee Amount 09/04/2013 DCA Fee Calculated $2.00 05/07/2009 Scanning Fee Calculated $3.00 04/30/2009 Submittal Fee Fixed $0.00 05/07/2009 Education Surcharge Calculated $0.60 05/07/2009 Permit Technology Fee Percentage $2.50 05/07/2009 Permit Fee-Concrete&Masonry Calculated $100.00 05/07/2009 Notary Fee Fixed $5.00 09/04/2013 DBPR Fee Calculated $2.00 05/07/2009 CCF Calculated $1.80 Total Fees Due: $116.90 Wednesday,September 4,2013 I�