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BP-02-4320 SNonEs h�� PERMIT APPLICATION yid Master Permit No. Subsidiary Permit No. ��ORIDp' INSTRUCTIONS - The following steps must be taken to obtain Step 1. Complete the attached permit application which must be signed by the propM 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. Job Address: ICI �! IvJ� A Jt1�ZL`s" 1 F L City State Zip el.- L C A- '5'77¢ '— Address Apt. Folio Number P\ Description of Work�r�A"fr u P ° Lot Block Subdivision PB PG Zoning Linear Feet Current Use of Property Square Feet Units Floors Proposed Use of Property ao ea y ild C7c -11< Value of Work 12- n — Bldg Value I Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT TYPE (v/) Building Electrical Mechanical Plumbing LPGX Roofing Fence OtherSL�� cr ✓ ARCHITECT Name License No. Address Telephone Fax I Che. Contractor I I Revision Extension PROPERTY OWNER New Construction N2 Ne<t_yL C Address IVA KIZ7 12, C' P4 C-1 Al 7- /16 Demolish Relocation of Structure Rome Telephone Foundation Only Business Telephone Other Add11 Detachment Other a z— TYPE OF MANAGEMENT ( ✓ New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'1 Attachment Other Add11 Detachment Other e • ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name l L L_ PA0e l U kkA 1. License No. Address 110 O N L1% Mt A,-- . 7 3 2 0 cSTr4C��j €L- 33 rSo Telephone 1., 3-- S3 b ` 150 b Fax 50 S Qualifier Nam A q e • e 134u" Page 2 PERMIT APPLICATION 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. _)AVIT - Please reac Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50%) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50%) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679-1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713-35 of Florida Statutes. Review the brochure illag Hal n Construction Lien Law and Choosing a Contractor. OF, FLORIDA; COUNTY OF MIAMI-DADE STATE,OF FLORIDA/COUNTY" MIAMI-DADE Print Name Owner to and subscribed before me this 7 / Z, Type of Identification Produced: Sign a 6f Contractor AQualif r Print Name Sworn to and subscribed before me this_ y of , C Signature of Notary Public - State of Fl ' 'a' + Carol E. Johnson SE ': Commission # DD 018W 060 Expires May 31, 2005 Bond6d ru Atlantic Ga. b& Personally known OR, Produced Identification Type of Identification Produced: 4J� J Page 3 PERMIT APPLICATION N INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. N RECEIVED AND REVIEWED BY: DATE: TYPE TYPE 'I YPI,-, QTY. ELECTRICAL TYPE TYPE TYPE TYPE QTY. Minim Fee QTY. Dryer QTY. Outlet, Appliance QTY. Service Repair A/C Centr 1-3 Ton Fan Outlet, Wall Service, Temporary A/C Central -7 Ton' Fire Pump Outlet, Switch Signs A/C Central 8-1§ Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-2 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Tok 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 w -volt, Fire Renew - Temp Service Laundry Tray Demolition Lo -volt, Intercom/Teleph. Repair Circuits Lavatory Dishwasher Low- it, Television Service, Number of Amps Meter Set (Gas) RECEIVED AND REVIEWED BY: DATE: TYPE TYPE 'I YPI,-, QTY. MECHANICAL TYPE QTY. Minimum Fee Condensate Drain QTY. QTY. Generator Refrigeration, Tons A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number o Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Pump, Domestic Bath Fan -Vented, # Fireplaces, Number of Pressure Vessel Pump, Fire Stand RECEIVED AND REVIEWED BY: DATE: TYPE QTY. PLUMBING TYPE TYPE TYPE QTY. QTY. A/C Condensate QTY. Drains, Roof Miscellaneo Fixture Soakage Pit Bath Tub Drinking Fountain Miscellaneous epairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Aban&Q 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 Waterter Drainfield, 4" Tile/Res. Lavatory Septic Tank ter New Drains, Area Meter Set (Gas) Sewer Connection iDrains, Floor Minimum Fee Shower ice Drains, French Miscellaneous Equipment Sink Supply RECEIVED AND REVIEWED BY: DATE: Page PERMIT APPLICATION OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi -family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $3.00 per page (Scanning Fee) Miami Shores Village Bond ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER $ 601 (Specify & Attach) Metropolitan Dade County (C.C.F.) $ O v (sq.ft. = x/1000 x ¢.60) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review ISSUING OFFICIAL REVIEWED AND PREPARED BY: $ (¢.005/sq.ft.) $ (¢.01/sq.ft.) SECTION BY DATE Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official t ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $a DATE: 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795-2207 FAX (305) 756-8972 • http://www.miamishoresvillage.com� f' MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305-795-2204. Building Inspection Request Date Time Type Insp'n 11 Permit No. Name Address ?7-W- *W—.?a-6Z4e-- Company Phone # �� ,J6 — 6y, 2 -- For Inspector: - Name &Date Approved Correction ❑ Re-Insp'n Fee ❑ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305-795-2204. Building Inspection Request Date Time Type Insp'n 11 Permit No. Name Address ?7-W- *W—.?a-6Z4e-- Company Phone # �� ,J6 — 6y, 2 -- For Inspector: - Name &Date Approved Correction ❑ Re-Insp'n Fee ❑ Village of Miami Shores BuildingPermit10050 NE 2nd Avenue Miami Shores, FL 33138 Permit Number: BP2002-432 Phone: 305-795-2204 Printed: 2/28/2002 Page 1 of 1 Applicant: Owner: Contractor ALL DADE DRIVEWAY Local Phone: 305-836-7209 Parcel# 1132060134230 Job Address: 9705 NE 2 AVE Address: PO BOX 430350 Cellular: Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 13 & 14 Fees: Description Amount FEE2002-1269 CCF $1.20 FEE2002-1270 Building Permit Application Fe$60.00 Total Fees $61.20 Permit Status: Approved Permit Expiration: 8/27/2002 Construction Value: $1,200.00 Work: SEAL COATING & RESTRIPING If there is no permit fee is $50.00, which n This Permit is granted to t ordinances pertaining theretr and appruved by thu prupur authorization. A further con( ordinances and regulations I by his agents, servants or e Signed: In consideration of the iss with the plans, drawings, st: myself, my agent, servants Signed: nZ $ lNnowv NO3H0 099-9£b-£9 8E6 0119L E 7 2 91 007 Total Fees: $61..20 Total Receipts: $0.00 :149E,]00990:1 .118Eb000.11 0£t££ valuo-ii'Iwvlw Vaiuold d0 HNV13 IVNOIIVN Alto BLK 31 y ceG9R-�£R- �P£ 1NnOWV N0UVNVldX3 INnowe AVd OtIL t-£bZ££ Id 1111YVIW 'S Ot'L Mt, Xo8 'O'd '�NIWb�b�dbr . � s v�yg� rl ry o �1 j u M ti3ewnN )103HO NOIldtliOS30 d0 U3080 3H1 Ol 31V0 y ceG9R-�£R- �P£ 1NnOWV N0UVNVldX3 INnowe AVd OtIL t-£bZ££ Id 1111YVIW 'S Ot'L Mt, Xo8 'O'd '�NIWb�b�dbr . � s v�yg� rl ry o �1 j CRITIQUE SHEET JOB ADDRESS _� T7 OF r' e • 2. Ai% APPLICANT �y PHONE # APPLICATION �f tiL k 6 Lo T SHEET _.OF MISCELLANEOUS PERMIT NO. ADDRESS: MIAMI SHORES VILLAGE BUILDING / ZONING DEPARTMENT• SECTION BY DATE ZONING ELECTRICAL MECHANICAL PLUMBING: FIRE PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL • t. Subjact to compalnc+ vdth elf Federal, State. Cocztit X 4age rotes Ind regutattons. VM4ge assume ao responstbtllty for accvrdcy oftor resutts from these plans. 2. This copy of plans must be vfatltbla as buRdinp site at no Inspection *fl b4 Mducted. DATE �Vd vid v y\ \ COMMENTS INITIALS h'irwl 04frl u�l ©Thi r, Ne e.4d — c lose - 6 j'lu'-- E c A �7; -�j 71 f .4 -iS 6 4 �i:s ng 7�PtEL-c L ou > o Qao CI VAC;K f-0" FROM E -.0p. 13LLX- WHEEL STOP Typica 4' SOLID BLUE 1411>-TRAF-FIC PAINT D 12 - LL -q -Ag PARKING BY DISABLED PffRkvT ONLY TOW AWAY ZONE aFINE TO .260.00 Oul At* CI VAC;K f-0" FROM E -.0p. 13LLX- WHEEL STOP Typica 4' SOLID BLUE 1411>-TRAF-FIC PAINT D 12 - LL -q -Ag PARKING BY DISABLED PffRkvT ONLY TOW AWAY ZONE aFINE TO .260.00 Mr. C's Plumbing & Septic Inc. i 19932 NW 2" Avenue P.O. Box 693239. Miami, Florida 33269-0239 Dade: (305) 651-7859/5652 Fax: (305) 651-56.10 Brow: (954) 927-2140 JAN 27 2015 May 13th, 2013 Miami Shores Village 10050 NE 2"d Ave Miami Shores, FL 33138 Re: Permit # PL -4-13-814 1421 NE 104 Street Miami Shores, FL 33138 To Whom It May Concern: We are requesting cancellation of permit PL -4-13-814. It appears that we inadvertently applied for a duplicate permit for the above referenced address. Thank you for your assistance in this matter. Best regards, Kemble Ettrick Operations Manager License SR061536