Multiple (11)•
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
In
Inspection Date: 05/30/2008
Inspector: Grande, Claudio
Owner:
Job Address: 425 103 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor COMPLETE HOME PAINTING BY MICHAEL
Permit Type: Paint
Inspection Type: Final
Work Classification: New
CA0••••• Phone Number
Block:
Parcel Number 1122310150150
Lot:
Phone: 305-895-1368
Building Department Comments
WALLS - GRAY
TRIMS - WHITE
DOORS - TOWNSEND HARBOR
BROWN HC64
Passed
Inspector Comments
cc
Failed
Correction
Needed
Re-Inspection
Fee
($75)
No Additional Inspections can be scheduled
re-inspection fee is paid.
until
Friday, May 30, 2008
Page 1 of 2
i
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Parcel Number
Gigs
1 -08 -17
Type: Pain
Jon: Nom,:_
�atus:APPRO\
Expiration: 08/03/2008
Applicant
425 NE 103 Street
Miami Shores Village, FL
1122310150150
Block: Lot:
JOSEPH M & BARBARA
Owner Information
Address
Phone
Cell
JOSEPH M & BARBARA DMYTRIW TRS 425 NE 103 ST
MIAMI SHORES FL 33138 -2456
i
Contractor(s) Phone Cell Phone
COMPLETE HOME PAINTING BY MICI 305 - 895 -1368 (305)215-0016
Valuation: $ 2,100.00
Total Sq Feet 0
Type of Work: Exterior
Color.
Additional Info:
Classification: Residential
Color. Approved
Color. Approved_
Code Comments: ben morre - walls - whales gray 15€
Color. _Denied
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee
Technology Fee
Total:
Amount
$1.80
$0.80
$5.00
$60.00
$1.50
$68.90
Total
Amt Paid I Amt Due
$ 0.00 $ 0.00
Payment Type:
$ 0.00
Available Inspections :
Inspection Type:
Final
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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,
PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated.
February 05, 2008
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
Tuesday, February 5, 2008 1
HURST'
PHONE: (305) 635 -0900
AWNING COMPANY, INC.
P.O. Box 1492 - Hialeah, Florida 33011
5795 N.W. 36th AVENUE
MIAMI, FLORIDA
SOLD TO
ADDRESS
APPROXIMATE (Q .Qe
HOVERY
PHONE
.73';/.36
/ 3 8r
DATE
Job No.
Terms
Fairwing ( ) Famine ( ) Bahama Shutter ( ) Panels (Alum. Roof ( ) Screen ( ) Roll -up Shutter ( ) Other ( )
OPG
NO.
OUANT.
WIDTH
PROJEC-
TION
HEIGHT
ADDITIONAL IINoB M A T I O N
1
_M
-niter �V _ ����1.N
2
3
6
B
IIIIIIIII
9
10
11
COLO zi
.,t
TRIM
INSTALLATION ON CBS ( FRAME ( ) 1 St. 2 ND. ( )
The Seller agrees to sell and Custom Manufacture and install for •
Purchaser, who agrees to purchase the above improvements and materials which
are to be installed on the premises located at
Florida, owned by Purchaser and described as Lot Block
Subdivision Plat Book , Page
Purchaser agrees to pay therefor to Seller a contract price of $
which is to be paid in equal successive monthly installments of $
each, commencing on the day of 19
and continuing on the same day of each month thereafter until paid except the final
installment which shall be the balance due.
/
Contract Price .$ ` J'�
Sales Tax $
Total Cash Price ., i $ / ✓ ?6 (Q4
G�
Less Down Payment
ascribe
Difference
Add Official Fees .5
and / or insurance
( describe )
Principal Balance $
Add Time Price Differential $
Time Balance
Executed 17t ' irate , one copy o
L day of
APPROVED AND ACCEPTED
BY
ich was delivered
/t-^i , 19
NOTICE TO BUYER
The products hereby ordered are to be custom built to fit purchaser's requirements; and th
order is NOT CANCELABLE.
All payments due hereunder shall , after default, bear Interest from date of default
10 0/0 rate of interest.
In the event the monies due hereunder have to be collected upon demand of an attorn,
or suit has to be instituted for the enforcement hereof, the purchaser agrees to pay all cup
thereof, including reasonable attorney's fees.
This contract shall not become binding upon seller until) acceptance and approval there.
by an authorized executive of seller at its home office. Upon such approval, this agreemel
shall be binding upon the heirs, personal representatives, successors and assigns of ti
respective parties hereto.
You are entitled to an exact copy of the contract you sign .
t•�Q' - pt is hereby acknowledged by buyer. Ibis
(X)
lL.
( Purchaser sign here )
(X).
( Purchaser sign here )
( Seal )
( Seat )
Permit No..
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING P%ke.MIT
Date
Application is hereby made for the approval of the detailed statement of the plans and specificatios herewith submitted for the building 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 herein specified or not A copy of approved plans and specifications must be kept at
building during progress of k.
Owner's Name and Address No
Registered Architect and /oznineer
Employing Plumber's Name...,
Location and Legal Description Lot
Street and Number where work is to be performed—No
State work to be performed and purpose of building (By Floors)
New Building ' Remodeling
1._
S
Subdivision...._
Street
Addition____
Repairs_....__ ....... .....__ No. of Stories_ ........ _..... _.
Size Septic Tank_
Feet of Drain Tile E r
Nature of Water Supply: City —Well
'Rif. Tank
e,
Feet o j
_Capacity Gals
Drain Field from Wet...
Size of Soakage Pit.
Amount of Permit $
(Sig>)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts o > ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida .: ent Supplement, and has com-
plied with the provisions thereof, and will require ' imidar compliance from all contractors or sub- contra ,i employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
STATE OF FLORIDA,
COUNTY OF DADE. J
Before me, the undied authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon'oath oses and says that he is the.__..._
of the above described 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.
Master Plumber. 0
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
BATH
TUBE
SHOWER.
LAVA.
TORIES
SINKS'
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CLOSETS
CONTR.
LIST
CHECK
•
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE'
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
CONTR.
LIST
CHECK
--
-
--
_ -- - -- -_.
.-
-..
Size Septic Tank_
Feet of Drain Tile E r
Nature of Water Supply: City —Well
'Rif. Tank
e,
Feet o j
_Capacity Gals
Drain Field from Wet...
Size of Soakage Pit.
Amount of Permit $
(Sig>)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts o > ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida .: ent Supplement, and has com-
plied with the provisions thereof, and will require ' imidar compliance from all contractors or sub- contra ,i employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
STATE OF FLORIDA,
COUNTY OF DADE. J
Before me, the undied authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon'oath oses and says that he is the.__..._
of the above described 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.
Master Plumber. 0
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Hurst Awning. Co. Inc. ACCEPTANCE NO.: 92- 1123.5(91)R,
: -OCT 141993
APPROVED
EXPIRES : March 16. 1995
NOTICE OF ACCEPTANCE: STANDARD CONDITIONS
1. Extension of Acceptance may be considered after a new application has been filed and the
supporting data, test report no older than ten (10) years, have been re- evaluated.
All reports of re- testing shall bear the seal, signature and date of an engineer registered in
the State of Florida.
2. Any revision or change in the materials, use, or manufacture of the product or process
shall automatically be cause for termination, unless prior approval is granted for revisions
or change.
3. Any unsatisfactory performance of this product or process or a change in Code provisions
shall be ground for re-evaluation.
4. This acceptance shall not be used as an endorsement of any product for sales or
advertising purposes.
5. The Notice of Acceptance number preceded by the words Dade County, Florida, and
followed by the expiration date may be displayed in advertising literature. If any portion
of the Notice of Acceptance is displayed, then it shall be done in its entirety.
6. Product approval drawings, where required for permit applications, shall be provided to
the applicant by the manufacturer or his distributors; unless otherwise noted in the Notice
of Acceptance. The prints need not be re- sealed by an engineer.
7. Failure to comply with Standard Conditions shall be cause for termination of Approval.
•
-3-
Gil Diamond,
Supervisor
Product Control Division
1-)-0115c
METROPOLITAN DADE COUNTY, FLORIDA
METRO -DADE FLAGLER BUILDING
BUILDING CODE COMPLIANCE DEPARTMENT
SUITE 1603
METRO -DADE FLAGLER BUILDING
140 WEST FLAGLER STREET
MIAMI, FLORIDA 33130-1563
(305) 375 -2901
FAX (305) 375-2908
PRODUCT CONTROL NOTICE OF ACCEPTANCE
Hurst Awning Co. Inc.
5795 N.W. 36th Avenue
Miami, Florida 33142
Your application for Product Approval of Aluminum or Steel Storm Panels under Chapter 8 of
the Metropolitan Dade County Code governing the use of Alternate Materials and Types of
Construction, and completely described in the plans, specifications and calculations as submitted
by Knezevich & Associates drawing #91 -195. pages 1 and 2 dated 8/25/93 and Engineering
Calculations dated 5/12/93 and test report dated 5/7/93 all signed and sealed by V.J. Knezevich,
P.E. has been recommended for acceptance by the Building Code C. mpliance office to be used in
Dade County, Florida under the specific conditions set fo -- 2 .1 e Standard
Conditions on Page 3.
ACCEPTANCE No.: 92- 1123.5(91)R
Gil Diamond, P.E.
Supervisor
Product Control Division
EXPIRES : March 16.1995
* *PLEASE NOTE **
THIS IS THE COVER SHEET, SEE ADDITIONAL PAGES FOR SPECIFIC AND
GENERAL CONDITIONS
BUILDING CODE COMMITTEE
This application for Product Approval has been reviewed by the Metropolitan Dade County
Building Code Compliance Department and approved by the Building Code Committee to be used
in conditions set forth above.
APPROVED: r� 1 4 1993
41r/
Charles Danger, P.E.
Director
Building Code Compliance Dept.
Metropolitan Dade County
Hurst Awning Co. Inc. ACCEPTANCE NO.: 93- 1123.5(91)R
APPROVED
"CCT 1 4 1993
EXPIRES : March 16. 1995
NOTICE OF ACCEPTANCE: SPECIFIC CONDITIONS
1. This approves an aluminum or steel storm panel designed for the following locations:
a. Non - coastal building zone to 250 feet in height.
b. Coastal building zone' Class 1 to 60 feet in height.
c. Coastal building zone Class 2 to 250 feet in height.
2. This design uses a factor equal to 1.0 in accordance with Table 23 -E of Chapter 23 of the
South Florida Building Code. .
3. All components shall be 6063 -T6 aluminum alloy or as indicated on drawing No. 91 -195.
The panels shall be constructed and installed in accordance with approved detailed
drawing #91 -195 Page 1 and 2 bearing the Dade County Product Control stamp.
4. Anchorage of the shutter system shall be to concrete or masonry and shall consist of 1/4"
dia. "Diamond Hammer" drive pin anchors spaced as indicated on drawing No. 91 -195.
Anchors shall provide a minimum of 1 -1/4" embedment into the masonry and/or concrete.
5. Permanent set fastener components, embedded anchor bolts, threaded cones or metal
shields, not in use, must be protected against corrosion, contamination and damage at all
time.
6. Each unit shall bear a permanent label with the manufacturer's name or logo.
7. Application for building permit shall be accompanied by two copies of the following:
a. Complete detailed plot plan indicating openings to receive shutters.
b. Duplicate prints,of approved drawings #91 -195, Pages 1 and 2.
8. This renewal supersedes Product - Approval 92 -1223.
-2-
ch 16, 199
1..i
Gil ' iamond, P.E.
Supervisor
Product Control Division
MIAMI SHORES VILLAGE'
Paint ■lor Approval and Agreement
DATE: /Z /Ze/Zoai'
OWNER'S NAME: 15/9xzwel avyr,aa
ADDRESS: vzr ,ti1 /03
3<xxxx>
V4 it 3%* <*** ;e**sjt* sx3 * * *
PHONE oi)75 -Od
ADDRESS OF SITE: I/2c i✓.- /03
CONTRACTOR & LICE,NSE (if applicable)
COMPANY NAME:
x** * *Kvxx * * *k * *KK*
All Elements on the site must be listed and indicate the color to be painted.
Walls 627 — 4/2/ - /5-8'V
Fascia
St-
31, as )i x x 3[ )4 )4 .fit * x x x x x a
rescx�c$caxaa3ca�>cx , hc* . *
PHONX:Stu
* * * * * * * * * * * * * * * * * * e3, ***
Drip Cap/Drip Edge 4) lbt
Soffit 1uM
Roof w At a-
Flower Bins iv /d!
Shutters /v /d1
Awnings A frt
Chimney
Doors and door jams ov%t
Garage Doors /ti /$
Railings f/11
Fences
Decorative Metal N /frit
All brick (simulated or regular) iv/if
Stucco Banding /11
Any other stucco features �"/
Accessory Buildings
Other
i
COLOR SAMPLES WITH NUMBERS
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 zoni g. I authorize the above - named contractor, if applicable, to
do the work stated. Fu hermore , the paint colors will be as per the attached
samples.
116
Signature of Owne Date Signature of Contractor Date
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
APPROVED:
Building Offic
ate
4/23/01
Positive Roofing &
Protective Pointing
Lic. &I s.
Dade Broward
FREE Estimate
.C' ails. .Lacs.
Positive Roofing &
Protective Pointing
' Lic. & Ins. 652 -1633
Dade & I3roward PETER KELSCH
FREE Estimate Owner/ Contractor
652 -1633
PETER KELSCH.
Owner / Contractor
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval 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 herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Owner's Name and Address
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal descri tion of lot to be built
Lot Block
Street and Number where work is to be done
Date / D'.- ..•-
,19
No Street
Subdivision J
State work to be done and purpose of building (by floors) 1t"+"'•
and for no other purpose.
New Building r R modeling Addition Repairs No. of • ' • s
To be constructed of _ Kind of founds 'on ` ..3'""' •A ,0.... Roof Covyering
Estimated Total cost of improvements $.1_ __. „ _S�__ Amount of Permit $__________ _ __F+ 0.,•i
Zone cubage required - __ - 0 Plan Cubage > _ _ILA!
Distance to next nearest building Size of Building Lot
Maximum live load to be borne 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
besent to- ------------- --- - - - - -- - - - - -- - -- - ------ - - - - -- - - - -- - - - - - --
- ---- ------ ------ - - - - --
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the of the wor such public no 'ce
or notices as are required by the Act. The undersigned agrees to employ only , c • ` •ntractors, onk,to be ,'> armed unde^; s
permit, as are licensed by Miami Shores Village. f�
Remarks (Signed)
of _pp.
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
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, being by me irst duly sworn, upon oath deposes and says that he is the
of the above described onstruction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated a • ■ e.
Permit No.__L_____
Disapproved
(Signed)
Al /III► l
___
=a Buildin i nspector
Date
ate
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE N
Chairman Member
Member Member
Member Member
Council Approved
Date 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No. _. Date 11
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith itted for the building 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 )yaws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior
of Miami Shores Village 'Shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer f
Employing Plumber's Name
Location and Legal Description Lot_..._. '" loc&
a 63 77 t
Street and Number where work is to be performed--No
State work to be performed and purpose of building (By )
New. Building —
AfearAted No Street..: '
Strom —
Subdi ll (R.te.
Str ..... ® 4.4
_._ -- No. of Storm.__--____._.___.
Remodeling Addition - Repairs - - -__
Size Septic Tank_
Feet of Drain Tile - -.- .__------.--Dist. Feet of Tank or Drain Field from Well_
_Type of Taub
Nature of Water Supply: City -Well.
Size of Soakage Pit
Capacity Gals
Amount of Permit $ (Sigma)
Plumbing Inspector.
The undersigned applicant for this b,ildii g permit does hereby certify that he understands and accepts his obligations as an employer of laber
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and has corn.
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the 'site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. ®g
(Signed)
STATE OF FLORIDA,'
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
f/=
Master Plumber.
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing: application, and that he. did sign the same, and that all fat
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made _:necessary by improper notice for inspection, or faul
mat d /or workmanship.
FLOOR
DRAIN
DR! NKING.T
FOUNT' NS
/A 0
YYY��.
TOTAL
FIXTURES
0
CLOSETS
BATH
TUBS
SHOWERSI
LAVA.
TORIES
SINKS
SLOP
smut
LAUNDRY
TUBS
URINALS
CATCH
BASIN
CONTR.
LIST
q
9'
f
/
21
r
CHECK
SEPTIC -
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
- SWIM'G
POOL
�,I
/
1 Z
-
Corm.
LIST
CHECK
,
Size Septic Tank_
Feet of Drain Tile - -.- .__------.--Dist. Feet of Tank or Drain Field from Well_
_Type of Taub
Nature of Water Supply: City -Well.
Size of Soakage Pit
Capacity Gals
Amount of Permit $ (Sigma)
Plumbing Inspector.
The undersigned applicant for this b,ildii g permit does hereby certify that he understands and accepts his obligations as an employer of laber
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and has corn.
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the 'site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. ®g
(Signed)
STATE OF FLORIDA,'
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
f/=
Master Plumber.
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing: application, and that he. did sign the same, and that all fat
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made _:necessary by improper notice for inspection, or faul
mat d /or workmanship.
- '1111`7!w^-
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
.
Perwit No.. ® Date � ��.� ...... ----_....
------
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. •A copy of approved plans and specifications must be kept at
building during progress of work.
- x -a
Owner's Name and Address )fl
011 “,"__ No
Registered Architect and /or Engihie4 SEPTIC TANK CO. INC.
Plumber's Name 1123 E. 23rd ST., HIALEAH No
Employing '
Location and Legal Description L3o� 1` 111-+ 7 88-4955
Mock
Street and Number where work is to be performed —No. `ii- a"..
State work to be performed and purpose of building (By Floors)
New Building --_ —. Remodeling Addit� --_ Repai*R - - -._ ,
I -
Street__ .
Subdivision)
Street_-_.b.
No. of Stories__________________.
Size Septic Tank_ G "
Feet of Drain —Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Wel. Size of Soakage Pit____
-_Type of T •
Capacity Gals 6
Amount of Permit $_
(Signed)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5888, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this . permit; and will post or cause to be posted for inspection on the site of the work such iiublic notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
SS.
(Signed)
Master Plumber.
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did si i, the same, and that all fac
therein by him stated are true.
My Commission Expires ' • Notary Public, !tate of Florida
GTE: A re- inspection fee of $1.00 will be made when such re- inspection is m4dd necessary by improper notice for inspection, or faul
als and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA
LAVA-
TORIES
SINKS.
SLOP ,'LAUNDRY
SINKa'
TUBS
URlNALB
%ATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT NB
TOTAL
TOTAL
CONTR.
LIST
CHECK
MPG
OOL
SEPTIC
TANK
SEWER
'CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE'
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
CONTR.
LIST
•
CHECK
Size Septic Tank_ G "
Feet of Drain —Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Wel. Size of Soakage Pit____
-_Type of T •
Capacity Gals 6
Amount of Permit $_
(Signed)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5888, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this . permit; and will post or cause to be posted for inspection on the site of the work such iiublic notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
SS.
(Signed)
Master Plumber.
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did si i, the same, and that all fac
therein by him stated are true.
My Commission Expires ' • Notary Public, !tate of Florida
GTE: A re- inspection fee of $1.00 will be made when such re- inspection is m4dd necessary by improper notice for inspection, or faul
als and /or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
•
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws of the State of Florida all ordinances of Miami Shores Village and all rules and
regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during piQgress of the work.
Owner's Name and Address..... d0.
Registered Architect and /or Engineer
Name and address of licensed contractor
L Date /C .19.V
. A$ lo, a d Street_L02_ 1
40.0••••»• «aa,a,ar•*•fn•estt - am�a amnanam,et t..
to ineBaMP... 31.B.. :..l.1—C .
..... 4040
Location and legal description of lot to built on: .
Lot_....Lr Block. ... Subdivision
Street and Number where work is to be done_._..�t_!___.._......
State work tp be d ne and l purpose of building ,(by
_ floors) 2.M&. _ 1.0 1i$ c .. � 14ri �'
L4.olat llrtki,..._l �1t.A' ._.i11LIEy.18
4-11-04 -'7 -i _, _ .......40.00_...... and for no other purpose.
&ix& *ye, 1r
_too
New Building Remodeling Addition Repairs:...... No. of Stories .....•
To be constructed of Kind of fo`undation_... .._..... eng._
Estimated Total cost of improvements $.._.�.1 _.� _Amount of Permit $, _._
Zone cubage required _40_40 _4040._._ 4040__. - 4040_... - . __.Plan Cubage_.
Distance to next nearest building
Maximum live load to be borne 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 to
The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for insp- ion on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such su • •- "actors, on work to be performed under this
permit, as are licensed byaMiami Shores Villar.
Remarks (Signed)---
Size of Building Lot......... _4040 ......_._._ ...f..._...._......
• STATE OF FLORIDA,
COUNTY OF DADE.
r
Before me, the undersigned authority, *notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well kaowa,
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the fo egoing application, and that he did sign the same, and that all facts
therein by him rye n,,s� i 57
Permit No. �� '�// Date....—:-.______:_—_-- _ dead, Sworn to and Subscribed before me.
Disapproved•
(Signed) .
D <te
Building Inspector
Chairman
Member
Member 4040.....
Council Approved _4040
Notary Public, State of Florida
N y Commission Expires
PLANNING BOARD.._.._
Member
Member
Member
Date Disapproved
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessCp improper notice
materials and /or workmanship.
A
...DATE
Date
has been obtained from
for inspection or faulty
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
}V-S Date- 3
Permit No
Application is hereby made fol the approval of the detailed statement of the plans, and specifications herewith submitted for the building 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 DiVi8i031
of Miami Shores Village Shall be complied with, whether herein specified or not A copy of approved plans and specifications must be kept at
building during progress of .worlt.
Owners Name and Address ir.k.h.k. .144.hr4.4.i., 1414N°. Street
Registered Architect and/or En • eer T
Employing Electrician's Name . J/414444. No Street
Location and Legal Description Lot Block — Subdivision
Street and Number where' work is to be performed—No /V .. Street .1 0.3 S 7° •
State work to be performed and purpose of building (By Floors)
New Building- Remodeling _Addition
.Repairs... No. of Stories..
,
Size Feeders Conduit/ 4.-- -Main Sw .Amps. .Main
Installation—Conduit Tubing B.X.L .Metal Moulding..
•
Amount of Permit $. (Signed)
'aft
Electri . ector.
The undersigned applicant for this building permit does hereby certify that he understan&Iand accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such publie notice or notices
as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
1
'
STATE OF FLORIDA,
COUNTY OF DADE.
(Signed)...
-Meier Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
ii
appeared 4 .... ' , ' ...
■
to me well known, and who being by me first duly sworn, upon oath deposes and says that he is the . - ,
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts '
therein by him stated are true.
Notary Public, State Flotilla
—
My pommi.ssion Expires .
NOTE: A re inspection fee of $1.00 will be made when such re inspection is made necessary by improper notice for inspection, or faulty
m terials and/or workmanship.
/
1
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE•P•FS
FIXTURES
NO. LAMPS
REPRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
/47
11n4—,.11-------L-
J ., Go
■*,
CHECK
. . ... ,
ENT.
SW.
DIST.
CAB. I
SERVICE
TEMP.
SERVICE
PERM.
MOTORS MOTORS
0.1 HP 1-15 HP
04F
Ai
NEON
TRANS.
RADIO
TOTAL,
CONTR.
LIST
i
1
-,
'r
CHECK
/C
1r0
/ 10
6 0
,
Size Feeders Conduit/ 4.-- -Main Sw .Amps. .Main
Installation—Conduit Tubing B.X.L .Metal Moulding..
•
Amount of Permit $. (Signed)
'aft
Electri . ector.
The undersigned applicant for this building permit does hereby certify that he understan&Iand accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such publie notice or notices
as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
1
'
STATE OF FLORIDA,
COUNTY OF DADE.
(Signed)...
-Meier Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
ii
appeared 4 .... ' , ' ...
■
to me well known, and who being by me first duly sworn, upon oath deposes and says that he is the . - ,
of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts '
therein by him stated are true.
Notary Public, State Flotilla
—
My pommi.ssion Expires .
NOTE: A re inspection fee of $1.00 will be made when such re inspection is made necessary by improper notice for inspection, or faulty
m terials and/or workmanship.
/
1
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No. f /t9
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of wor
Owner's Name and Address
Registered Architect and /or
Employing Plumber's Name
Location and Legal Description lot—.
Street and Number where work is to be performed —No
L(2
No Street.
Subdi
State work to be performed and purpose of building (By Floors)*— _._.__ ._..__..._...... -. - -. _ ...._....... _ ....�
New Building _- .__.... -. Remodeling Addition._ __ ._. _ _... Repairs__--._-... _____ No. of Stories .............
Size Septic Tank Type of Tank
Feet of Drain Tile - -_— fist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of
F
_Capacity Gala. --
Amount of Permit $ (Signed)
Pi > ing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or ces as are
required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be ,' ' under t7'init, as are
licensed by Miami Shores Village. /
A ..t',
/ /
(Sign
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
Master r Plum
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the ®ains application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when anis re fnipeWma is mads'nsoewey by improper notice for inspection, or faulty
materials and /oe workmanship.
CLOSSTa
BATH
TUBS
SHOWEIta
LAVA'
TORIES
SIN"
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINK NO
FOUNT' NS
TOTAL
FIXTURES
COHTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DRIB
WELL
SPRKLR.
SYSTEM
SW IN •G
POOL
-
CONTR.
LIST
-.
CHECK
Size Septic Tank Type of Tank
Feet of Drain Tile - -_— fist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of
F
_Capacity Gala. --
Amount of Permit $ (Signed)
Pi > ing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or ces as are
required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be ,' ' under t7'init, as are
licensed by Miami Shores Village. /
A ..t',
/ /
(Sign
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
Master r Plum
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the ®ains application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when anis re fnipeWma is mads'nsoewey by improper notice for inspection, or faulty
materials and /oe workmanship.
MIAMI SHORES VILLAGE,:rez-AkW
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement oe we 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 herein specified of not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Du-mei Name and Address.. Mr. _ & Mrs. Dmytriw.
Date Sept. 4 .1985
425 N.E._ 103 Street
Registered Architect and /or Engineer................. ��._• - • »••••_I • ».. .••._..•••.•.••••••• »• nnr•• •n»••nn•x,r�e�eenee.,•mnwen +<e:
0000. N/s//
Nameand address of licensed contractor .a« ..._............».. » »..._..._. .0000»., _.»..........
Location and legal description of lot to be built on:
. ».» Subdivision._.. Mi rrow Lake / f
tot 15 Block.»:.... 0000__». ,�...��s��..,� �.� 9
Street and Number where work is t o be done 425 1 \ 1 - - R . 1 0.1 S tr e...e t._...... »_....
State work to be done and purpose of building (by floors). tile tear off; tin cap one' #4•3 base
sheet; hot mo one 490 lb. f and set flat white tiTe in a beef —
of cement. ?.... ............. »... »...._ . 0, *Tel -511 T–AW— ... »......_......_ _0000.
0000.._ ...»..... »....».....»....._.. .» ..0__. and for no other purpose.
New Building Remodeling Addition Addition Repairs No. of Stories
To be constructed of Kind of foundation ... _0 000. ». — Roof Covering
Estimated Total cost of improvements $.A 6.5 000. 00 ....Amount of Permit s... »... $ 20.00
Zone cubage required 000__0..__. __..»..Plan Cubage ..............._.... ...
Distance .to next nearest building ..... »._._.__Size of Building Lot. ».....»»..... »..._........ _..
Maximum live load to be borne 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 to..
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village. ,,(� ,��
Remarks ( Signed) ,C � � t • d-D
STATE OF FLORIDA.
COUNTY OF DADE. j ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
pealed .......»..
...to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the.
of the above described 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.. ,ter
Permit No __._..�E� Date....�.�`�..'� Read, Sworn to and Subscribed before me.
Disapproved -.
(Signed) 0.000.. _0000.
Date.._......... _..._._.. ........
Building Inspector
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD. .. ....._........_DATE
Chairman00 00 .. .. _.._00 _00 00. _.. _0000... ._..........» Member ......... .0000.. ».»__._.»._..
.Mfcrrsber .»........ »..» 00._00»_ ... 000_0_ Member _ ._._.....»..._.... ».•••....»•.. »..... » _
Member0_000.... » ....._.....»:.. » ........................... Member _..»..»........»_....._..... ._ .... ........._ »..._.....—...__»
Council Approved ... Date 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.in•peetion fee of $1.00 will be charged when such re- inspection is made necessary by Improper notice for inspection or faulty
materials and /or workmanship.
Village of Miami Shores
10050 NE 2nd Avenue
Miami Shores, FL 33138
Phone: 305 - 795 -2204
Printed: 1/4/2002
Applicant:
Owner:
Contractor
Local Phone:
Parcel # 1122310150150 Legal Description: MIRROR LAKE SUB
Job Address: 425 NE 103 ST
Building Permit
Permit Number:
Address:
Cellular:
BP2002 -21
Fees:
FEE2002 -56
FEE2002 -57
FEE2002 -58
FEE2002 -59
Description
Building Fee
Building Fee
Notary Fee
CCF
Total Fees:
Amount
$120.00
$100.00
$5.00
$1.20
$226.20
Permit Status: Approved Permit Expiration: 7/2/2002 Construction Value:
Work: EXTERIOR PAINTING AS PER AGREEMENT (OWNER BUILDER PERMIT)
if there is no permit package accessible on the job -site for
fee is $50.00, which must be paid in advance before calling for
This Permit is granted to the contractor or builder named above to construct the
ordinances pertaining thereto and with the understanding that the work will be perfc
and approved by the proper municipal authorities. This Permit may be revoked at s
authorization. A further condition upon which this permit is granted is the understar
ordinances and regulations pertaining to the work covered hereby whether shown o
by his agents, servants or emmplloo
Page 1 of 1
PB 56 -15 LOT 15 LOT SIZE 75.000 X 110 OR 16065 -0675
$1,500.00
Total Fees: $226.20
Total Receipts: $0.00
COMPLETE HOME PAINTING
BY MICHAEL
1476 NORTH MIAMI, FL 33161 130TH ST. PH.
63- 8413/2670
8314835113
3284
3'z-
�GGGpp_. —/,04
DOLLARS U -�
Signed: ' (INSPECTOR)
In consideration of the issuance to me of this permit, I agree to perform the work c
with the plans, drawings, statements or specifications submitted to the proper autha
myself, my agent, servants or employes.
Washington Mutual
Nom Mia.0 m sveetTnancial S Center 1728
900 NE. 125th Street 24800 788•7000
North Miami, F1.33161 4Ilau Customer Sense
MEMO
1. 2670134 L3LI:13 3 Ionia 35LLyn30 3284
(Contractor or Sumer)
BY:
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Building Permit
Permit Number: BP2002 -1523
Printed: 8/29/2002 )
Applicant: DIN\N\ I)" l,v )
Owner: ®S e p D T t i i)
JOB ADDRESS: 425 NE 103
Contractor DALEY ROOFING INC
Local Phone: (305)754 -9892
Parcel # 1122310150150
ST
Contractor's Address: 78 NE 106 ST
Legal Description: MIRROR LAKE SUB
Page 1 of 1
PB 56-15 LOT 15 LOT SIZE 75.000 X 110 OR 16065 -0675
Fees:
FEE2002 -4875
FEE2002 -4876
Description
Building Permit Application Fee
CCF
Total Fees:
Amount
$60.00
$0.60
$60.60
Total Fees: $60.60
Total Receipts: $0.00
Permit Status: Approved Permit Expiration: 2/24/2003 Construction Value: $510.00
1 SEAL AROUND VENT STACK 2 REPAIR LEAKS AT THE REAR & FRONT OF THE yPROX 40 TILES
v ► Work:
If thwra is nn ne.r.r.aa ....-'' -
Securtt
I,I DALEY ROOFING, INC.
78 N.E. 108TH STREET
MIAMI SHORES, FL 33138
305- 7549892
hanced document. See back
ILI
PAY
TQ
O.DERTHE OF
1_'%
Bankof America. .
ACH Rif 083100277
FOR
or detatle•®
DATE -
4091
•D CL2bA RS
f4
000409 Li" 1:0630000101: 00 L596 2 L9 SO 3'l
53-4 Fl.
1035
Beostyleasaf
•
le-inspection
motion herefor in strict compliance with all
fications that may have been submitted to
0 or if the plans are changed without
onsibility for a thorough knowledge of the
' hat he assumes responsibility for work done
s pertaining thereto and in strict conformity
tsponlsibility for all work done by either
SECTION 1524
HIGH VELOCITY HURRICANE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING
CONSIDERATIONS
1524.1 As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with
the required roofing permit, and to explain to the owner the content of this section.. The provisions of Chapter
15 of the Florida Building Code, Building govern the minimum requirements and standards of the industry for
roofing system installations. Additionally, the following items should be addressed as part of the agreement
between the owner and the contractor. The owner's initial in the adjacent box indicates that the item has been
explained.
Aesthetics Workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane
Zone) are for the purpose of providing that the roofing system meets the wind resistance and water intrusion
performance standards. Aesthetics (appearance) issues are not a consideration with respect to workmanship
provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should
be addressed as part of the agreement between the owner and the contractor.
2. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be
renailed in accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida
Building Code. (The roof deck is usually concealed prior to removing the existing roof system).
tiD 3 . Common Roofs: Common roofs are those which have no visible delineation between neighboring
units (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or
owner should notify the occupants of adjacent units of roofing work to be performed.
bP4. Exposed Ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be
viewed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail
penetrations of the underside of the decking may not be acceptable. The Florida Building Code provides the
option of maintaining this appearance.
4 5. Ponding Water: The current roof system and/or deck of the building may not drain well and may
cause water to pond (accumulate) in low-lying areas of the roof. Ponding can be an indication of structural
distress and may require the review of a professional structural engineer. Ponding may shorten the life
expectancy and performance of the new roofing system. Ponding conditions may not be evident until the
original roofing system is removed. Ponding conditions should be corrected.
6. Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof is not
overloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge if
overflow scuppers (wall outlets) are not provided. It may be necessary _.to install overflow scuppers in
accordance with the Florida Building Code, Plumbing.
7. Ventilation: Most roof structures should have some ability to vent natural airflow through the
interior of the structural assembly (the building itself). The existing amount of attic ventilation shall not be
reduced. It may be beneficial to consider additional venting which can result in extending the service life of the
roof.
boViAllti /YMf4"°).-'
Owner's/Agent's Si a Date
P1 J/O?
Contractor's Signature
•s
Contractor's Name:
SECTION 1525
HIGH VELOCITY HURRICANE ZONES
UNIFORM PERMIT APPLICATION
❑ (Low Slope Application)
❑ (Asphalt/Fiberglass Shingles)
•
❑ New RooT ^'
FIGURE
Job Address. l/0-s A a3 49-
ROOF CATEGORY
❑ (Nail -On Tile)
❑ (Mortar -Set Tile)*
. ❑ (Metal RoofsfWood Shingles & Shakes) ❑ (Other)
ROOF TYPE
❑ Recovering Repair 0 Maintenance
❑ Re- roofing
Flat Roof Arca (fO Sloped Roof Area (ft2) Total (ft2) Master permit No.
Exposure category (per ASCE 7 -98): Building Classification category (per ASCE 7 -98):
ROOF HEIGHT AND SYSTEM DETAILS (Draw details as needed)
FT
DECK TYPE:
FT
ATTACHMENT
FASTENER TYPE:
SPACING
FIELD: PERIMETER: CORNER:
DETAIL 1842
r
ROOF RAY
L
t
I.
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF DADE:
02R469966 2002 OCT 29 11 :52
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
442. /U3
1. Legal description of 'property and street address:
/l f ia4'u _5413 -re 4,, 3313E
2. Description of improvement: t- fpe I- 1.E ?D / .frj
LOH,r1
3. Owner(s) name and address: / , ri&) :bM `/ j L / 1/1)
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address:
5. Surety:(Payment bond required by owner from contract C FLORIDA. COUNT OF DADE
I HERE IPV that this is a true c •, - • f the
Name and address: , ,• • oa
eoowa4 lam
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
01 r
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Uenor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address: t _
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
Signature of Owner
Print Owners Name U4,P, 1,e:? 1�r►'r j'i @ tJ
Sworn to and subscribed before me this day of
Notary Public
Print Notary's Name /4'L-
My Commission Expires:
,19_ .
,„ _ "'.� ,), �_ ,tit
•
rte t Atlann..
Prepared by: Det 2GL'
G
Address: 7/ lt.F' %Q4 �i ?
1•
12901.52 2199
SECTION 1525
HIGH VELOCITY HURRICANE ZONES
UNIFORM PERMIT APPLICATION
Contractor's Name: iLl/ieitezi L % /yv Job Address.
•
❑ (Low Slope Application)
❑ (Asphalt/Fiberglass Shingles)
❑ New RooT A:
•
ROOF CATEGORY
4 2 s 5t-
❑. (Nail -On Tile) Mortar Set Tile)*
. ❑ (Metal Roofs/Wood Shingles & Shakes) O (Other)
ROOF TYPE
❑ Recovering ❑ Repair
.)etRe- roofing
FIGURE 152;
❑ Maintenance
Flat Roof Area (ft2) Sloped Roof Area (ft2) )50D Total (ft2) aSOe Master Permit No.
Exposure category (per ASCE 7 -98): Building Classification category (per ASCE 7 -93):
ROOF HEIGHT AND SYSTEM DETAILS (Draw details as needed)
FT
DECK TYPE:
FT
ATTACHMENT
it
FASTENER TYPE: VIII Rao fNAt47' c4P
`,
•
SPACING
� r
FIELD: A PERIMETER: !1� CORNER: b
DETAIL 1E42
FLORIDA BUILDING CODE — BUILDING
r
ROOF PLAN
r
r
r -,
MIAMI
Sl-10RE3 _
Metal Flashing all chifrfg'e of Plane
15.3:
l
i
/ ,FIGURE 1525
1titlIittlllitltIlitifItttt2
ItIllltil SIIIII tJ t1it2 tit tttltiJ ti111It1II1t1l IIttIIiJITJtII iti lti 11I l l flti I Iitil i1I1i111 i1itl ititiititl ittl Il 1i11iIttIItIII IIItIfiIit lflIIilItilIiliiiitlliif III21IS11I1IIiIIJiIilttIttlit
RIDGE VENTILATION
I WA I
MEANHEIGH ,y
SECTION 1525
HIGH VELOCITY HURRICANE ZONES
UNIFORM PERMIT APPLICATION
DECK TYPE:
UNDERLAYMENT:
INSULATION:
FASTENER TYPE &SPACING:
CAP SHEET:
SLOPEDSYSTEVI DESCRIPTION
1 IS P,Ne &At&
42'
ROOF SLOPE
DETAIL 3
('i'reRat* pekt-rin,cnP t
-ROOF COVERING:
DRIP EDGE:
ATTACHMENTS REQUIRED
1) FIRE DIRECTORY LISTING PAGE
2) DADE COUNTY PRODUCT CONTROL
NOTICE OF ACCEPTANCE -COVER SHEET
A) SPECIFIC SYSTEM DESCRIPTION
B) SPECIFIC SYS i LIMITATION
C) GENERAL LIMITATION
0) APPLICABLE DETAIL DRAWINGS
3) MUNICIPAL PERMITAPPLICATION
4) OTHER COMPONENT APPROVAL.
TILE CALCULATIONS
(Pmarl: ix? (Aerodynamic Multiplier): I / ) -Mg: 5 , ). = Mr1: Id- S PCA:(14 ' 0
S`.
(Pmax2: ) l (p 17) x7! (4erodynamic�tlultiplier): ' ) -Mg: +2 = Mr2:? ' 7) PCA:I I b + /iJ
(Plttar3 :. I tie , ?x1l (Aerodynamic 4Vultlplitr):, 1.2A1 ) — Mg5 ? =Mr3: a I1 IPCA: I t g'(;) D
15.33 . - -- FLORIDA BUILDING CODE — BUILDING
SECTION 1524
HIGH VELOCITY HURRICANE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING
CONSIDERATIONS
1524.1 As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with
the required roofing permit, and to explain to the owner the content of this section.. The provisions of Chapter
15 of the Florida Building Code, Building govern the minimum requirements and standards of the industry for
roofing system installations. Additionally, the following items should be addressed as part of the agreement
between the owner and the contractor. The owner's initial in the adjacent box indicates that the item has been
explained.
lb
. Aesthetics - Workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane
one`
are for the purpose of providing that the roofing system meets the wind resistance and water intrusion
performance standards. Aesthetics (appearance) issues are not a consideration with respect to workmanship
provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should
be addressed as part of the agreement between the owner and the contractor.
} r 2. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be
r accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida
Building Code. (The roof deck is usually concealed prior to removing the existing roof system).
a ma
3. Common Roofs: Common roofs are those which have no visible delineation between neighboring
un.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or
owner should notify the occupants of adjacent units of roofing work to be performed.
4. Exposed Ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be
om below. The owner may wish to maintain the architectural appearance, therefore, roofing nail
penetrations of the underside of the decking may not be acceptable. The Florida Building Code provides the
option of maintaining this appearance.
5. Ponding Water: The current roof system and/or deck of the building may not drain well and may
ter to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of structural
distress and may require the review of a professional structural engineer. Ponding may shorten the life
expectancy and performance of the new roofing system. Ponding conditions may not be evident until the
original roofing system is removed. Ponding conditions should be corrected.
6. Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof is not
tided from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge if
overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in
accordance with the Florida Building Code, Plumbing.
7. Ventilation: Most roof structures should have some ability to vent natural airflow through the
nor of the structural assembly (the building itself). The existing amount of attic ventilation shall not be
reduced. It may be beneficial to consider additional venting which can result in extending the service life of the
roof.
r.'norm,F.J anti ,LOCALS- 11Temp\SF.CTION IS2l.doc
P
Date
Contractor's Signature
U.S. SOUTH
Engineering & Testing Lab., Inc. N2 4164
6065 N.W. 167th Street, Suite B -23 • Miami, Florida 33015
Telephone: (305) 558 -2588 • Fax: (305) 362 -4669
ON -SITE CONCENTRATED UPLIFT LOAD TESTING OF ROOF TILE IN
FULL ACCORDANCE WITH METRO -DADE BUILDING CODE COMPILANCE
PROTOCOL PA 106
SITE SPECIFIC INFORMATION
Owner's Name: P \+ivollia b 10 Permit # 71902 I ec. 3
Job Address. 4Th t to 3 ' ., 'i t A .4 a. 54-104C5 ,.c1'
Roofing Contractor• At Igy R co `-V t N 67
Type of Tile: 4 IA r 1- / Pe °• F®ik 6-4 `S� 1 Date Installed. 12°'3 ° 47-
Approximate Roof Height: / 2 feet Roof Pitch: ' t 2-
Type of Access to Roof: Scaffolds ✓ Ladder Other
Approximate Square Footage of Roof. 2 C0 ft2
Required Testing Force: 35 lbs. Testing Equipment Chatillion100
Date Tested- I- I -1:' 3
TEST RESULTS
P = PASS, F = FAIL
Test Location
Uplift Pull Test(P or F)
Test Location
Uplift Pull Test(P or F)
Test Location
Uplift Pull Test(P or F)-
Test Location
Uplift Pull Test(p or F)
Fir ‘v a.p
26
rA." .1)
51
76
2
27
t
52
77
3
28
53
78
4
29
54
79
5
30
55
80
6
31
56
81 .
7
32
57
82
8
33
58
83
9
34
59
84
10
35
60
85
11
36
61
86
_
12
37
62
87
13
38
63
88
14
39
64
89
_
15
40
65
90
16
41
•
66
91
17
42
67
92
18
43
68
93
19
44
69
94
20
45
70
95
21
46
71
96
22
47
72
97
23
48
73
98
24 .
49
74
99
25
50
75
100
IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL PA 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT
QUALITY CONTROL TEST.
THIS R. • •'/ SUBMITTED Y.
if
/
Civil Engineer.
Lab Certification # 98- 0608.04
P.E. 4t- Vt7
//3/05
State of FL Certificate Authorization # 4100
(v),
fie
e JOB 42, � � w Lb-r, 4. S ttfAgs, 1
SHEET NO O�
CONTRACTOR
CHECKED BY DATE
SCALE
SKETCH OF ROOF
2-C:;"
a
i
64
NOTES:
OWNER'S NAME
s :.0.-
PRESENT ADDRESS I
I_.
LICENSE NO.
PHONE NO.
44.550B LOCATION (ST. OR AVE.)
Ei3g, 103rd St.
LOT
15
BLOCK
Tom'
Mirror Lake Sub.
GENERAL CONTRACTOR
John Myers
ADDRESS
PHONE NO.
LICENSE NO.
J
BUILDING PERMIT NO. 14108
DATE 1 -2 -53
n 19
PERMIT FEE $ 19.00
BUILDER'S BOND
NO. 1512 DATE
ZONE REQUIREMENTS CU: FT.
PLAN CUBE 20,344- CU. -FT. -
EST. COST $ ----111 -(6 � ��
DRAWINGS; SPECIFICATIONS: RESTRICTIONS AND CUBE-CHECKED BY: _ -. - - - - - --
DATd -
R
NEW CONSTRUCTION
TYPE
CBS
STORIES ROOF CONSTRUCTION
1 I tile
INTERIOR CONSTRUCTION
terrazzo floors, plaster walls
REPAIRS
DESCRIPTION and ceilings -
3 bdrm. -2 baths - living room - dining room- kitchen -Car nortd
ALTERATION -
DESCRIPTION
ADDITION
SUBMITTED TO PLANNING BOARD
APPROVED
REJECTED
REFERRED TO COUNCIL
REASONS
RE- SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE COUNCIL
REMARKS
CERTIFICATE OF OCCUPANCY NO. TISSUED
BY
TO
BUILDING PERMIT AND INSPECTION RECORD -MIAMI SHORES VILLAGE
l"b & V A BUILDING
NSPEC;TIONS
INS ACTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
FOUNDATION
BEAMS & LINTELS
FRAMING
FINAL
CLEAN -UP
PLUMBING
ERMITS & INSPECTIONS
CONTRACTOR
PHONE
q�� -
' ((
PERMIT NO. J /j ?C�4Z
j DATE s I( -4-1
FEE $ y)=
NEW BLDG. I ALTERA -ION
• I ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$
SEPTIC TANK
�—/
$ ist 11
H
SEWER
$
SOLAR HEATER
$
GAS
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
GAS
SEWER
SEPTIC TANK
0 °S',
QP,
SOLAR HEATER
FIXTURES
L�""
ELECTRICAL PERMITS & INSPECTIONS
CONTRACTOR '- .,1 Co-A...11 ! ,o „ix,
l r
PHONE
PERMIT NO. / / 3 I DATE Q D-0--
jF'EE $ / 53-
NEW BLDG. ALTERATION I ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT
DATE
FEE
TEMPORARY
TEMPORARY SERVICE
/NCO.
A-L) dA --0.—
nC
(__) '`
34
W. HEATER CONN.
ii/
$
RANGE CONN.
$
MOTORS
$
FIXTURES
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
TEMP. SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
APPROVAL TO POWER CO. FOR SERVICE DATE 4 -2.1--,y3 .
V
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
N9 1718
Miami Shores Village, Fla., I
Owner, Agent or Tenant of Building
Lot Block Subdivision
Street Address
Approved use by occupancy
Remarks:
This Certificate of Occupancy is issued to the above named
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known 2, s the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to
the erection, construction, alteration or remodeling of buildings or structures.
at t `: 1-r a-4
'11 ft
BUILDING DIVISION
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
B ilding Inspection Request
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Dat. • Time Date
Type Insp'n L.� - _ �� Type Insp'n
Permit No. 0 ®% '1 ) Permit No.
Name Name
Address 1\ ,(i ) D 3_41-
Address
r Company
Phone #
For Inspector:
Approve 1
Compan
Phone #7
I 1 9-
For Inspector: 3 (v_
Approved
Correction
Re-Ins p' n Fee
ame & Date
2_ 0 o3
Time
Correction
Re- Insp'n Fee ❑
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date
Type Insp'n
Permit No.
Name,_
Time
•
Address `y
0
Company
Phone #
For Inspector: � ,� 4 ,, Name & Date
Correction
Re- Insp'n Fee ❑
C1
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date 2- V "Time
Type Insp
Permit No.
Name
Address'`'
Company
Phone #
For Inspector:
Correction
Re- Insp'n Fee ❑
kitt,T (4.408 Immu ,tL .
Miami Shores Village
Building Department
10050 N.E,.2nd Avenue. Miami Shores, Florida 33138
Tel: (305) 795.2209 Fax: (305) 756.8972
BUILDING Permit No. P'rb8'IT1
PERMIT APPLICATI01 RECEWED Master Permit No.
FBC 2004 1 AJAN 31 2008
.ZIP
Permit Type: PAINT PERMI
Owner's Name (Fee Simple Titleholder) gifJ� -eil flC J Phone #
Owner's Address /L/2�J /V /O—€ 2�
City " //0 /4/ J /k? `GJ State AZ— Zip 33 /
E -MAIL:
Name
Phone# -02-- —t lJer-y y
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip 3 3 /3 cf-
FOLIO / PARCEL #
4423— /0 3 171-
Is Building Historically Designated YES NO
Contractor's Company Name /� -- ���L C%� k e. / " V Phone # �41� � -� /J bd
Contractor's Address / �/ %p �/ /29 �/
City A1/9/11/ State ^
/
Qualifier Name /i%/ 4. 5�`-w L Phone # �J ��� • /3 v e
Zip 33/6/
State Certificate or Registration No.
OWNER BUILDER:
Value of Work For this Permit $ 2y /a Type of Work: El Addition / El Alteration / ❑New / ❑ Repair/Replace
Certificate of Competency No. 0O00 / v'/ 3/
Describe Work: 11� � � e_ �f/ 4 e
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 reaulatin, construction in this jurisdiction. I understand that a separate permit must he secured Mr
ELECTRICAL WORK. PLUMBING, SIGNS. WELLS, POOLS. FURNACES, BOILERS, HEATERS. TANKS and AIR CONDITIONERS, ETC
"WARNING T() OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOE
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORI
RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: Asa condition to the issuance of a building permit with an estimated value exceeding 52500, the applicant //lust promise /n (goodfaith Mai a copy Of' the
notice of commencement and construction Gen law brochure will be delivered to the person whose properly is subject to attachment. Also, a certified copy of the recorded notice
of commencement must he posted at the job site for the first inspection which occurs seven (7) days of er the building permit is issued. In the absence of such posted nonce. the
inspection will not he approved and a reinspect ion. fee will he charged.
::, ern - * ***** **** **** ***** ** ** ** **** ** :Fees**** *x, ***** * * **** **** * ** * ** ** * * ** * * * *** * **
fsn
Permit Fee $ (DU CCF $ 1b 80
Notary $ 15,0
Double Fee $ Zoning $ Total Fee Now Due $ (fit p •60
Training /Education Fee $
b. 6 6
Technology Fee: l
Code Enforcement $
See Reverse side --j
Directions•
Wa�j1ls!'/
1 •
Fascia:
PAINT COLOR APPROVAL AND AGREEMENT
All elements on the site must be listed and indicate the color to be painted
tease circle corresponding number to appropriate color sample.
1
Attach color ssmnLLo 'lame and
Drip Cap /Drip Edge: I��
Soffit:
Roof: I
Flower Bins:
Shutters:
Awnings: I
wales gray
1585
3
4
4
2
Chimney:
Doors and Door Jams:
Garage Doors: I 2 111 �
Railings:
Fences: w�
All brick (simulated or regular): I CA, 3
W
int
Stucco Bandin i4: I '0:C`
wG
Any other Stucco Features:
Accessory Buildings
dv
4
4
Other:
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.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this 3/
day or 1 q_4 . 20 _ . by .Bu 1
who is personally known to me or who has pmduccd
As identification and who did take an oath.
yr
NOTARY PUBLIC:
Sign:
Print:
RIDA
•'iitzi 9
My Commission tixpires: Expires: APR. l if 2010
ended Thu Atlantic Bonding Co., Inc.
***
�PPI,IC'A "PION APPROVED BY:
Signature
Contri for
The foregoing instrument was acknowledged before me this 31
day 01' ?WA/ . 20 A. by ifidittel 11-0SreatitGt
who is personally known to me or who has produced 'J.n'P' KG/t5
622ZI D as identification and who d ) u�o\
50 6.60
NOTARY PU : "
Sign: `y"` , ,\. Ci Oio"
����� \f',
Print:
My Commission
***** xXY. Y.xx xxxx XY.x,.w,. *** ** * * * *** * * * * * * * * **
. • ..XxY. Y. *X XXXxxx Y.wwwwwww . .. Y. Y. Y.
ti
Plans Examiner
Preservation Board
Code Enlbrcement
(Revised 04/24/0
MIAMI SHORES VILLAGE, FLORIDA
BUILDING
ELECTRICAL El PERMIT N? 14 316
PLUMBING ❑
ROOFING
Owner
Buildin
Archite
Contrac
or Build
Legal
Descrip
Addres
DATE 195
Contractor's
License No
El Work to be performed under this Permit
Df
a
for
er
Lot '
'A I
II BI. S
S vision '
' }_
Building
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 regulations
pertaining to the work 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, servants or employees.
Signed • BY
INSPECTOR
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 responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER By AUTHORITY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING ❑
ELECTRICAL ❑ PERMIT N? PLUMBING I N ? 8 701
ROOFING ❑
DATE 195
Contractor's
License No
Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Ait
Lot
Bt.
Subdi-
vision
S. Ft
Value of
Project $
Amt. of
Permit $
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 regulations
pertaining to the work 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, servants or employees.
Signed • BY
INSPECTOR
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 responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
BY
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 14549
DATE 195
Contractor's
License No.
❑ Work to be performed under this Permit
Architect
Contractor
or Builder
Uvl'Asio
Legal Lot II Bl. Subdi-
Description. vision
Address of
Building 1 J
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 regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in tb1e statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Value of
Project $
Amt. of
Permit $
Signed.
INSPECTOR
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 responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
BY
AUTHORITY
PERMIT APPLICATION
Master Permit No.
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 submitted
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:
3 S
/'ri_r% S
36
Address
Apt.
City
Folio Number ,/ 1 3 / / b ' 0/51) Description of Work
Att,) -e
Zoning
Lot
Subdivision
Current Use of Property %/��/- Square Feet Units Floors
Proposed Use of Property Value of Work --,r/, rQ° Bldg Value
Tenant Information
Block
PB PG
State
Zip
Afi N / /?4/ 1:1-A-7 7/ b
Linear Feet
PERMIT TYPE (✓ )
Building
License No.
Electrical
Telephone
Mechanical
, '
Plumbing
LPGX
—!x/23 d0 R0
Roofing
/C,C.I•J
Fence
Other
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
PROPERTY
New Construction
e dOWNER
Name U,/Y/�! �'''1 yT2iG"
Address /e_4,
757,Q .:e4 • 33/ 3,
Telephone
Home T e l e p h o n e C 3 o r ) 7 s
rep--
, '
Business Telephone
Fax
—!x/23 d0 R0
TYPE OF MANAGEMENT (✓ )
New Construction
License No.
Enclosure
Telephone
Alteration Exterior
Repair
,.%�
Alteration Interior
—!x/23 d0 R0
Demolish
/C,C.I•J
Relocation of Structure
Shell Only
Foundation Only
Add'! Attachment
Other
Add'! Detachment
Other
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR C �%Y� /
r ,
/
Name ���
License No. D /y /J /
Address / y 7L LE /lc
1'V v /�� /j /e
,.%�
TelephoneJvr eR5 /J hp Fax 9j
—!x/23 d0 R0
Qualifier Name . ' D %wa)
/C,C.I•J
Page 2
PERMIT APPLICATION
- -...:.-
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, 1s' 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, C
Signature of Owner
TY OF MIAMI -DADE
give 1/j ,T `gym >'T1e/ u�
Print Name
Sworn to and subscribed before me this 2 tr day of .O eC
2OO/
f
Signature of No
SEAL:
Personally known
ICHAEL IWA EWYCZ
MY COMMISSI0 # CC 721000
EXPIRES: April 10, 2002
-4; . ••' Bonded 7hru Notary Public Underwriters
OR, Produced Identification
Type of Identification Produced:
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
w /l
Signature of Contractor / Qualifier
Mt c/o
Print Name
and subscribed before me tls day of
gnature of otary Pub
SEAL:
Personally kno OR Produced Identification
Type of Identification Produced:
Master Permit No.
PERMIT APPLICATION
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
)1\ Job Address: _4;"'S- /03 IN icukti Slic.(9
Address Apt. City
Folio Number 1/ rl 2.3/) /SO / SD
Lot Block
Subdivision PB PG
Current Use of Property
Proposed Use of Property
Tenant Information
PERMIT TYPE (✓ )
Building
"..V.) c
Name c cc), `J
Electrical
Address ?..>17 IE to S�%(ITiL
M (1 HM ( �t11.C..) re_S, 4 (S1 t
Mechanical
-2 S 4Er Ca-V9/
Plumbing
Qualifier Name
LPGX
Roofing
Fence
Other
1 33,38E
State Zip
X. Description of Work K.-e' C' PC/F:1--r ) 1/-77-6--
Zoning Linear Feet
Square Fee ("w- _,..._ its Floors l
Value of*or (27 5270 - Bldg Value
Tax ssessed/Appraised Value
Floo Zonee Floor Elev.
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Telei :,ne
PROPERTY OWNER
New Construction
"..V.) c
Name c cc), `J
-
� y�,�
1 J (1nyL �1}3"/f
Address ?..>17 IE to S�%(ITiL
M (1 HM ( �t11.C..) re_S, 4 (S1 t
Home Telephone
L o
-2 S 4Er Ca-V9/
Business Telephone
Qualifier Name
Fax
TTYPE -O 1 f NAGEMENT (✓ )
New Construction
Name ') Ai � " "°C° r...1 +.3
Enclosure
License No. an_s 1 1 Q 0
Alteration Exterior
Address / S lou
)J1'u u ..st tzlz'', 41 '.0.1-S
Repair
Qualifier Name
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'l Attachment
Other
Add'I Detachment
Other
ENGINEER
Name
License No.
Telepho
F
CONTRACTOR
Name ') Ai � " "°C° r...1 +.3
oC
License No. an_s 1 1 Q 0
Address / S lou
)J1'u u ..st tzlz'', 41 '.0.1-S
TelephoneaysiV GiI 0 Fax30S, 7S-4, q 8 ca.
Qualifier Name
Page 2
PERMIT APPLICATION
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, 1S1 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, ,
'GS UNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI-DADE
1,. .- -''T n? Al l...tr
Signature of Owner
J � /e- —27
Gr1
Print Name y-
Smo od subscribed before me this f o day of
SEAL:
blic - StIFIRLFlorida ," _ d a
=9'1 : Banded lira
�'•ngF,;�. � Atlantic BandiagCC.mc --
Signature of Contractor / Qualifier
Print Name
:+ om to and subscribed before me this day o
al...1.0.1...._____
,..„....L.....„ •
: ignature •:' Notary Pu
SEA
State of Florida
Personally known OR, Produced Identification Personally known OR, Produced Identification
Type of Identification Produced:
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.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
Minimum Fee
A/C Central 1 -3 Ton
Vent Hood, Cost
Fan
A/C Wall/Win. Tons
Outlet, Wall
Dryer Vents, Number of
Service, Temporary
Ventilation, Cost
A/C Central 4 -7 Ton
Air Handler, Tons
Fire Pump
Ductwork, Cost of
Outlet, Switch
Periodic Inspections
Signs
Barbecue
A/C Central 8 -15 Ton
Fire Sprinkler System
Fixture - Fluorescent
Oven
Bath Fan - Vented, #
Space Heater (kw)
Fireplaces, Number of
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
QTY.
Cooling Tower
- Heating Strips, each
Vent Hood, Cost
Drinking Fountain
A/C Wall/Win. Tons
Miscellaneous Repairs
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Bidet
Air Handler, Tons
Filter Replace
Ductwork, Cost of
- Piping, Flammable Liquid
Periodic Inspections
Sprinkler Repair
Barbecue
Cap - Fixture
Fire Sprinkler System
- Process/Pressure Piping
Pump and Abandon
Bath Fan - Vented, #
Sprinkler System
Fireplaces, Number of
- Pressure Vessel
Gas - Appliance
PLUMBING
TYPE
QTY.
TYPE
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTY.
TYPE
Soakage Pit
QTY.
A/C Condensate
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
RECEIVED AND REVIEWED BY: DATE:
CONDITION OF APPROVAL
Page 4
PERMIT APPLICATION
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
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
$ I Xq..-5Z)
$9,cL
0 ( sq.ft. = x/1000
x ¢.60)
$ (¢.005 /sq.ft.)
$ (¢.01 /sq.ft.)
TOTAL $
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
SECTION
BY
DATE
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
Revised July 2001
10050 N.E. 21'`D AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TYI'E
Service Repair
QTY.
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 Seri, 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
QTY. TYPE
QTY. TYPE
QTY. TYPE
QTY.
Minimum Fee
QTY.
Condensate Drain
QTY.
Generator
QTY.
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
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.
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
RECEIVED AND REVIEWED BY: DATE:
DATE:
CONDITION OF APPROVAL
Page 4
PERMIT APPLICATION
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
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
't.;-)1,_
$
5
( sq.ft. = x/1000
x 0.60)
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
TOTAL
aaC�. ao
4, D
ISSUING OFFICIAL
REVIEWED AND PREPARED BY:
SECTION
BY
DATE
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
el--7
Building Official
-
Revised July 2001
10050 N.E. 2' AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
10050 N.E. 2nd Avenue • Miami Shores, Florida 33138.305- 795 -2204
Date G 2, Job Address / S /1),...3 Sit Tax Folio
Legal Description Historically Designated: Yes No 0 OwneLessee/Tenet kit)ScP/f ,l✓f?"t y7k1 al Master Permit # 60 1 5 r:
Owner's Address 9,2S A /0 3 SI Phone -(,)s--. 7S R. OS- 4'
Contracting Co. a t i i/,,,ic.r Address 7( Le- /46
itel '' 4,1ei
State # 60,,a,0 C ) JC) 0
Qualifier
SS# Phone
Municipal # Competency #
Ins. Co.
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOThER INSFECT ION.
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL
WORK DESCRIPTION: f) J�jl[.,J J/� i VE 7 S I ?�"Q 2) �jQ /1e ( i s
1. � -1 -N.t3 14-r -°uU ! � izo6F -- - /P C }� • ,L/v 771E
Square Ft. t.L�l+�.�LQ. ( e/d Estimated Cost (value) �P Sip
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 ANY 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 all disciplines.
i uNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
lating construction and zoning. Furthermore, I authorize the above named contractor to do the work stated.
1 .g
nature of owner and/or Condo Pre�ldent
,
tary as to Owner and/or Con
My Commission Expires
FEES: PERMIT
APPROVED: TOTAL DUE
Zoning Building Electrical
Mechanical Plumbing Structural Engineer
Date
P
..ept JUDITH F. FISCHER Date
c!� „I MY COMMISSION # OD 076092
teNrr
.�,, = EXPIRES: December 3, 2005
or `t Bondod Thru Notary PubDi Uodonvtnars
nuil.l„-
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, 04, A
Nota - M . 71-"""or
or s
My ommission xpires
F
Date
u' !der
C.C.F 6) NOTARY;
BOND
rJ
Applicant JOSEPH
CWrrer:
JOB ADDRESS: 425 NE
Contractor DALEY ROOFING INC
Local Phone: (305)754 -9892
Parcel # 1122310150150
103
Building Permit
Permit Number: BP2002 -1803
DMYTRIW
ST
Contractor's Address: 78 NE 106 ST
Legal Description: MIRROR LAKE SUB
Page 1 of 1
PB 56 -15 LOT 15 LOT SIZE 75.000 X 110 OR 16065 -0675
Fees:
FEE2002 -6022
FEE2002 -6023
FEE2002 -6024
Description
Building Fee
Buildier's Bond
CCF
Total Fees:
Amount
$187.50
$300.00
$1.80
$489.30
Total Fees: $489.30
Total Receipts: $0.00
Permit Status:
APPROVED Permit Expiration: 4/19/2003
Construction Value:
Work: RE ROOF FLAT WHITE TILE TO FLAT WHITE COLORTHRU
If fhcrn is nn nnr.++:4. ,,....1,. -,,... =•-•- - - ••
PAY
TO THE
ORDER OF
DALEY ROOFING, INC.
78 N.E. 106TH STREET
MIAMI SHORES, FL 33138
305 - 754 -9892
S
s8A,00
l�,500,
DATE ///5/0Z
4/ SAO
- 1,1...f in-Lc/Lid-1 v .
Bank of America.. .
ACH R/T 063100277
FOR
11'004 L9to'
1:0630000471:
is yS9-30
00 LS96 2 L9503113
•
1035
e- inspection
ation herefor in strict compliance with all
ications that may have been submitted to
or if the plans are changed without
Dnsibility for a thorough knowledge of the
iat he assumes responsibility for work done
s pertaining thereto and in strict conformity
!sponisibility for all work done by either
Date
Legal
Owner
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Description
Lessee
Owner's Address
Contracting Co.
Qualifie
State #
Job Address 25 Ili / 0 3 Tax Folio 6't 22.3 10 C.5-0 ) SO
/ Tenant -b5q*k c)1-TPALlii Master Permit # 34-3-3`:"Z-
L-(7:5 Ic.)3 Phone 70 l
tU1F-; l E ( l p 11 `"" r6 Address 95 N'1)3
CIS Ll15 Phon •--e ?dd
Municipal #000/ 0-513
Competency # Ins.Co.
Architect
Enginee
Bonding Company
Mortgagor
Address
6q(
Address
Address
Permit Type(circle on : BUILDING ELECTRICAL PL
UMItIN
G MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTIO
Square Ft.;; APPRH)
Estimated Cost(value) I) 3'()
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 certify that all the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regu ting cons ructio z on ing. Furthermore, I
authorize the above -named contractor to do wo - •.
Signatui: of
Da
IPA
Nod- s
My Commission
• and /or Condo President
1661161 Art s48;4111 ui.fs luuuo) 4111
S tfl"dgmwN .,41
r and /oi_ Cond/Z Pfin afFlorfia
Expires :M, Commi on Whin July 19,1994
Gondod TAru key Fain • Insurance Ina
** * * * * * *
* *
ture of Contractor or Owner -Burr er
r '';.4
FEES: PERMIT RADON C.C.F. E
APPROVED:
Zoning
ar Lip - ontra • Owner- Builder
My Co II!'r Co' ssion Expires:
* * * * * * * **
Fire
Buildin
Mechanical Plumbing
NOTARY TOTAL DUE 51'1°
Other
Electrical
Engineering