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PL-03-000810 r bo r Miami Shores Village Plumbing Permit 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: PL2003 -8 Printed: 1/15/2003 Page 1 M 1 Applicant: ANNETTE WATKINS Owner: WATKINS ANNETTE JOB ADDRESS: 1421 NE 102 ST 1 Contractor 1�.i4 Contractor's Address: Local Phone: Parcel # 1132050240190 Legal Description: MIAMI SHORES BAY PK ESTS AMD PB 56 -86 LOT 23 Fees: Description Amount FEE2003 -270 Building. Fee $80.00 Total Fees: $85.00 FEE2003 -271 Notary Fee $5.00 Total Receipts: $0.00 Total Fees: $85.00 Permit Status: Approved Permit Expiration: 7/14/2003 Construction Value: $500.00 Work: ABANDON SEPTIC TANK 6332 INC. s3- eals�zs7o I MR. CS SEPTIC RAAC DRAIN, ! aci 3 P.O. 60X 693239 305 -651 -7859 DATE IA- MIAMI , FL 33269-0239 71* PAY pir bl DOLLARS L�J TO THE / /N ORDER OF 4_0 D ®Washington Mutual NP ikeaM Mutual a con¢r 1919 ��pg�gnth 1.800.786.7000 1M75 ��jyy, 199th Street 24 tour GCB Miaml, R 33199 FOR II•.;�; 267084 13 1�: 38303084 2011° u'0000006 3 3 I'll ...ntuac[or or Builder) BY: II_ . Re- inspection BLK 1 ication herefor in strict compliance with all ifications that may have been submitted to s or if the plans are changed without )onsibility for a thorough knowledge of the that he assumes responsibility for work done s pertaining thereto and in strict conformity sponisibility for all work done by either Page 4 PERMIT APPLICATION OFFICE USE ONLY CHECKLIST ❑ OWNER -BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $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 ISSUING OFFICIAL REVIEWED AND PREPARED BY ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) SECTION BY DATE Zoning Enclosure $ Repair Mechanical Alteration Interior Plumbing ( sq.ft. = x/1000 Fire Shell Only x ¢.60) r $ (¢.005 /sq.ft.) $ Other (¢.01 /sq.ft.) Building Official Other SECTION BY DATE Zoning Enclosure Electrical Repair Mechanical Alteration Interior Plumbing CJ Fire Shell Only Public Works Add'1 Attachment Structural Other Building Official Other ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ DATE: Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com PERMIT APPLICATION Master Permit No. t- L Subsidiary Permit No. 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 Job Address: Address Apt. City State Zip Folio Number Description of Work C '��4A J_M Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other ARCHITECT Name License No. Address Telephone Fax PROPERTY OWNER N e / Address Home Telephone Business Telephone Fax Square Feet Value of Work Tax Assessed/Appraised Value Flood Zone PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Linear Feet Jnits Floors Bldg Value Base Floor Elev. TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'1 Attachment Other Add'l Detachment Other ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name Page 2 PERMIT APPLICATION IMPORTANT 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. )AVIT - Please rear 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, 151 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 llage Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE 2 Signature of Owner Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Personally known Type of Identification Produced: OR, Produced Identification STATE QF FLORIDA, Print Name _ m au4ubscribed before me this day of > e 2a) ature of otary Public - tate of Florida Angela M Becker SEAL: My Commission pp150048 (Of Expires November 15, 2006 l Personally known OR, Produced Identification Type of Identification Produced: Page 3. PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. ELECTRICAL TYPE QTY. Minimum Fee TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Q-1-1'. Service Repair A/C Central 1 -3 Ton Air Handler, Tons Fan Fountain Outlet, Wall Fire Sprinkler System Process/Pressure Piping Service, Temporary Bath Fan - Vented, # A/C Central 4 -7 Ton Fire Pump Pump, Domestic Outlet, Switch Supply, AC Well Signs Dental Chair A/C Central 8 -15 Ton Grease Trap Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16 -20 Ton Pump, Sump Fixture Light Utility - Water Parking Lot Lights Dishwasher Spas/Hot Tubs Indirect Wastes A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps Roof Inlet A/C Window Water Closet FPL - Load Central Domestic Well Posts Laundry Tray Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Septic Tank Swim Pool, Residential Water Heater New Chiller Drains, Area Generators, etc. Meter Set (Gas) Receptacles Switchboards Clear Violations Heat Recovery Shower Refrigerator, Comm. (p/PH) Water Service Temp Serv., Construction Drains, French Compactor Miscellaneous Equipment Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Demolition Low -volt, Intercom/Teleph. Repair Circuits Dishwasher Low -volt, Television Service, Number of Amps MECHANICAL TYPE QTY. TYPE QTY. TYPE QTY. TYPE QTY. Minimum Fee Condensate Drain Generator Refrigeration, Tons A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost Pool Piping A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Fountain Barbecue Fire Sprinkler System Process/Pressure Piping Sprinkler System Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel A/C Condensate Drains, Roof Miscellaneous Fixture Soakage Pit Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet 77Filter 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 RECEIVED AND REVIEWED BY: DATE: ��d'�zx �s MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approyal 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 7 ,'- in specified or not. A copy of approved be plans and specifications must kept at building during progress of the work. Owner's Name and Address... - -. -., -4-7 Registered Architect and/or Engineer... Zs Name and address of licensed contractor.. ............... Location and legal description of lot to be built on: A '00 Lot... ell- -.3 •.•.......... Block .. -- -- 1---Z .......... Subdivision.._Z��_'__.vE --- 06 .... . ....... . ......................... ... Street and Number where work is to be done.- /,(/Z State work to be done and purpose of building (by floors)-- ----•_•_-----_----__•-- _-_---------- ••----- •---- -• - - .. . ...... .......... .... . .. _....t....__. . .... -- - - -- . . ..................... . ... _ ----- . ........ . ...................... . .. . .................. - ---- - --- ------------- _ .................................. . ... - . . ........ . ............. . ......... . ..... . ........ _._-__•and for no other purpose. New Building .................... °-- _ - - - - -. Remodeling .......................... Addition-- _----- .-- _---- . - -_._ Repairs__._..........._-- _. - - -- No. of Stories......_............_.... .................. To be constructed of -_---------_-----_----- Kind of foundation - - - -- - ------- ......•.• ..... Roof vering ................................. .............. - - -------- ------------------ Estimated Total cost Of improvements $.... of Permit $__21 ........ . .... 7 . Zone cubage required- _ -. -__ ------------- -_----- - -----..-Plan Cubage_..%;_ Distance to next nearest building---- ._._._.._.. - - - -- ----- -- - - - - Of Building Lotl4i ....... .... ...... Maximum live load to be home by each floor___.._ ......... . . .. . . ................. . ... . . . ...................... I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent- The undersigned applicant for this building permit does hereby certify that be of labor under the Florida Workmen's Compensation Act, being Section 5966, CoT and has complied with the provisions thereof, and will require similar compliance I in the work to be performed under this permit; and will post or cause to be posted or notices as are required by the Act. The undersigned agrees to employ only such permit, as are licensed by Miami Shores Village. j I . (Signed STATE OF FLORIDA, COUNTY OF DADE. IS& A accepts his obligations as an employer Laws of Florida, Pqrmanent Supplement, ,tors or sub-contracibrs employed by him Du$e si" of the work such public notice y6rk to be performed under this 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, b:� by me first duly sworn, upon oath deposes and says that he is the . ............... ................................. ...................................... of the above isciibed 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.® Permit Read, Sworn to and Subscribed before me. DisapprovedDate- __ _----- - - - - -- --------_--_------ - ----- -----_--------- (Signed) -__ ----- Notary Public, State of Flori, � - �BQil My Commission Expires------ _--- - - - - -- _--------_----------- - ---------------- Chairman _- - - Member Member .................. PLANNING BOARD___ -------------- - --- - - - - — - - ------ DATE Member Member Member Council 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 $100 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship: IP I � i 1�