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BP-02-15473 ,SNORES s�`• �i�� PERMIT APPLICATION n I ne.� - �- Master Permit No. _ `T Subsidiary Permit Nom~'' INS'FRLJCTIONS - Tbe folloisiDg steps nitist be taken to obtaill a permit frorn the Nlianli Shores N'illage. 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 am- leQ ted an li cation 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. �c Job Address: le( o / o f b� A92 Address Apt. City Q State% Zip " Folio Number Description of Work , `eo " �&'p k IC.-�� Lot Block Subdivision_ PB PG Zoning Linear Feet Current Use of Property Square Feet ¢, Units Floors Proposed Use of Property Value of Work `/' 2 / Z -3'6 Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT TYPE( ) Building Electrical Mechanical Plumbing LPGX Roofing Fence ARCHITECT Name License No. Address Telephone Fax PERMIT CHANGE (✓ ) Ch . Contractor Renewal Revision Extension PROPERTY OWNER p� Name d�/�-0 Addre1 y fit A J� 102— S� Home Telephone N S-, 7 r 96 i� p- Business Telephone o Fax TYPE OF MANAGEMENT (/) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'1 Attachment Other Add'1 Detachment Other ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name Pt' `'c License No. i79�// Address < /VZ6 AO/30 Telephone Fax Qualifier Name1 , u V Page 2 2. 3. 4. 6. 7. 8. 9. PERMIT APPLICATION 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. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 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 streettsidewalk. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. PORTABLE TOILETS for a construction site require a separate permit. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 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. 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, ls' 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 FLORIDA, COUNTY OF MIAMI -DADE Signature of Owner V U Print Name w ©m to and subscribed before me this � day of -A , C_ n A / A Signature of Notary SEAL: Personally known Mic+liael Iwaskewya Commission # DW96211 &PiM April 10, 2006 Bonded Thru Atlantic Bonding Co., Inc. OR, Produced Identification STATE OF FFLO A, CO Y OF MIAMI -DADE . —f' _— - Signature of Co ctor / Qualifier Print Name nd subscribed before me this da LA a1g.ature i of N Public - fate of F1 rids `PRY PUe OFFICIAL ;, a SEAL: Q ANGELA M E �' z `Rp> C L r Personally known !/ OR Primed Identification Type of Identification Produced: Type of Identification Produced: Page 3 PERMIT APPLICATION B INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. 1 Minimum Fee Condensate Drain Dryer Refrigeration, Tons Outlet, Appliance Service Repair Heating Strips, each A/C Central 1 -3 Ton A/C Wail n. Tons Fan Paint Booth Outlet, Wall Service, Temporary Ductwork, Cost of A/C Central 4 -7 Ton Periodic Inspect Fire Pump Fire Sprinkler System Outlet, Switch Signs Bath Fan - Vented, # A/C Central 8 -15 Ton Pressure Vessel Fixture - Fluorescent Cap - Fixture Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs Gas - Appliance A/C Central 20+ Ton Pump, Domestic Flood Lights Supply, AC Well Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Catch Basin Air Conditioners Gas - Propane Garbage Disposal Pump, Re- circulate RangeMange 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 Vacuum Pump Demolition Disposal Low -volt, Intercom/Teleph. Interceptor Repair Circuits Roof Inlet Dishwasher Low -volt, Television Service, Number of Amps Septic Connection Mlvjlfi�vm Minimum Fee Condensate Drain — Generator Refrigeration, Tons A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wail n. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspect Barbecue Fire Sprinkler System Process/Pressure Piping Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Mtrell&�&,Vww A/C Condensate Drains, Roof - Miscellaneous Fixture Soakage Pit Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprhdzler Srtem Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toild 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" 711e/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: $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 REVIEWED AND PREPARED BY: BY f Page 4 $ Electrical PERMIT APPLICATION OFFICE USE ONLY x 0.60) ❑ OWNER -BUILDER FORM ❑ PROOF OF OWNERSHIP ❑ CONDO ASSOCIATION APPROVAL (Attach) (Attach) (Attach) ❑ FIRE DEPARTMENT ❑ HRS / DERM APPROVAL ❑ BPR APPROVAL (Restaurants) APPROVAL (Commercial / (Septic / Sewer) multi- family) 4 ❑ CONCURRENCY ❑ IMPACT FEE ❑ CONTRACTOR REGISTRATION (New Construction) (New Construction) (On File) ❑ OTHER ❑ OTHER (Specify & Attach) (Specify & 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 REVIEWED AND PREPARED BY: SECTION BY DATE, Zoning3 $ Electrical $ ( sq.ft. = x/1000 x 0.60) $ (0.005 / sq.ft.) $ (0.01 /sq.ft.) Public Works $��G� Structural SECTION BY DATE, Zoning3 Electrical Mechanical Plumbing Fire Public Works Structural Building Official 4 TOTAL $ 6 "� y DATE: 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Miami Shores Village.,. . BUilding 10050 NE 2nd Avenue Permit Phone: 305 - 795 -2204 �. '{ Permit Number: BP2002 -1547 Printed: 91412002 a Page 1 of 1 Applicant: .GEORGE /KAREN GODFR�Y Owner: GODFREY ` GEORGE /KAREN (� JOB ADDRESS: 1481 , NE 102 ST (Contractor. COMPLETE-HOME PAINTING ocal Phone: 305 -895 -1368 vJ Parcel # 1132050240130 Contractor's Address: 1476 NE 130 STREET Legal Description: MIAMI SHORES BAY PK ESTS AMD PB 56 -86 LOT 17 & E1/2 OF LOT 18 Fees: Description Amount FEE2002 -4968 Building Permit Application Fee $60.00 FEE2002 -4969 CCF $1.80 FEE2002 -4970 Notary Fee $5.00 Total Fees: $66.80 Permit Status: Approved Permit Ex iration• 3/3/20n i $2 25 P Construction value: 0.00 Work: PAINTING EXTERIOR PAINTING AS PER AGREEMENT Total Fees: $66.80 Total Receipts: $0.00 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 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 ordinances and regulatio s pertaining tot rk 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, sen a r plo Signed (INSPECTOR) BY: In consideration of the 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 agent, servants or employes. �,x igned: (Contractor or Builder) BY: t COMPLETE NO - - - - -- MICHAEL pA1NTllyra g 1476 NE 130TH S WASKEWYCZY MICHAEL NORTH MIAMIPH. 305- 895 -1368 FA Y TO -r L 33161 ORDER OF ®N/ashin ! Wash gton Mut a� North �Miam Mutua Bank FA u North "Mjdm?F� 3tree�reet Financial Center 1728 s1 1- doa7as.7oo ME MO /� ^ 24 hour dust C /w. J omersemco 29 ?013 83j!'B3 3521 i 63- 8413-2670 35 �1 DATE / $ 1.-3 DOLLARS Ap MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: Z-1-3016 Z OWNER'S NAME: PHONE: 75-/- 0f� ADDRESS: AA ADDRESS OEF SITE: CONTRACTOR & LICENSE (if applicable) B/ /3 COMPANY NAME: PHONE A9J =134X All Elements on the Site must be listed and indicate the color to be painted. Walls _ �Q Fascia 92 Drip Cap/Drip Edge Soffit ,Ar Roof ,NIA?' - Flower Bins /w /!!� Shutters a�lg Awnings Chimney Doors and door jams 92 Garage Doors 9 Z Railings Fences Decorative All brick (s� Stucco Ban, HE 1/A Any other stucco features P /0 Accessory Buildings A 10 Other tr 0 r 0 HC -81 ro r -� Cn H H e.I C 925 Cn 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 stated. Furthermore , the paint colors will be as per the attached samples. 1,2,0,,, Signature of Owner Dat4 Signature 4 Contractor Date APPROVED: 26� Building Offi ial Date WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION 4/23/01