DS-17-368 11 N01"'
st!O y, Miami Shores Village t Pomit Type �riV"'I" ewalks/Slabs,.
�+ 10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000
ditiont lte)I' tion
'P R ?' EG
Phone: (305)79-r-2204OR
issue Date:3/2/2017 Expiration: 29/2017
Project Address Parcel Number Applicant
1298 NE 95 Street 1132060144030
Miami Shores, FL Block: Lot: EDITH DAYLE PECK
I
Owner Information Address Phone Cell
EDITH DAYLE PECK 1298 NE 95 ST
MIAMI SHORES FL 33138-2550
Contractor(s) Phone Cell Phone
STAR ISLAND CONCRETE DESIGN C( (305)776-7916 Valuation: $ 18,000.00
_..... ._ _.. _ _ _ Total Sq Feet: 1800
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied: Foundation
Type of Work:REPLACE AND WIDEN CURRENT DRIVEV Additional Info: Review Planning
Bond Return: Classification:Residential Review Building
Scanning:3 Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Contractors Bond $500.00 Invoice# DS-2-17-62925
CCF $10.80
DBPR Fee $2.63 03/02/2017 Credit Card $668.06 $50.00
DCA Fee $2.63 02/14/2017 Credit Card $50.00 $0.00
Education Surcharge $3.60 Bond#:3324
Permit Fee $175.00
Scanning Fee $9.00
Technology Fee $14.40
Total: $718.06
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,MEC D DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDA all- oregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction o`re,I authorize the above-named contractor to do the work stated.
March 02, 2017
if� orized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
March 02,2017 1
' = 3
Miami Shores Village RECEIVED
Building Department FEB 142017
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
n\ �� Tel:(305)795-2204 Fax:(305)756-8972
V INSPECTION LINE PHONE NUMBER:(305)762-4949 �,�►�� FBC 20115
BUILDING Master Permit NoPS 1 `3U�r
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
F-1 PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1 2, g T NJ L: (AS f k 5 -t.
City Miami Shores County: Miami Dade Zia: 33,30
Folio/Parcel#: it - 320v/-
at4 - tto3c? Is the Building Historically Designated:Yes NO X _
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):'ip ay L L--- P L;Tc 1G. Phone#:T 06-6 1 4) 96 2:z
Address: a R 9
City:-I"I YN WI ) !S Ij in 0(=S State:_(=L zip: 3 3 1 3 8
Tenant/Lessee Name: )U.44 Phone#:
Email: e�
CONTRACTOR:Company Name:<-rA 2 7f C; mg �*2C' �-�e`i� �o.�� Phone#: �y5-Z?y`7l'f
Address: /®/F
City: /�'/,�/-r' State: Fe Zip: 3-30 27
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address City: State Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work: /90;10
Type of Work: ❑ Addition ❑ Alteration ❑ New ® Repair/Replace ❑ Demolition
Description of Work: j2egC� c--,l L., c,;,14 ®i�.Z C/6�'ee"per
Specify color of color thru tile:
Submittal Fee$-50°0c� Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014) .
+ - a
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable) f3 13 4t
Mortgage Lender's Address ? 0 13 Q X 2 'l (o ?
City G 1'2, NV LL 1:7-* State S 6 y T l d (�1 fU IA Zip 2,q 60g- '2 4 167—
Application
7—
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature _ Signature.,' /
O NERorAGENT 0 � CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
10 day of -� ,20 by �_day of 31 20 by
who is�erso ly knewn to �'� ho is personal) o
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: L—ASign:
CORPAS
Print: � � Print: C�4
Seal. � A.ukL, N.BARBARA ZEEMAN Seal: s �= EXPIRES:August 16.2020
MY COMMISSION#EE 860789 Bonded Thru Notwry Public Undervrrbm
.. .N
EXPIRES:February 15,2017
�lvr_,+f�oe^OP Bonded Thru Budget Not Services
APPROVED BY b Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
CFF 2 e 17R, eB a374 as o
OR BK 30421 Fss 4834-4331 (3Fss)
RECORDED 02/14/2017 15:05:33
DOCUMENT COVER PAGE HARVEY RUVINY CLERK OF COURT
MIAMI-DADE COUNTYr FLORIDA
For those documents not providing the.required 3 x 3 inch
space on the first page,this cover page must be attached.
An additional recording fee for this page must be remitted.
--------------------------- --
(Space above this line reserved for recording office use)
Document Title: V'L
(Mortgage,Deed,Etc.)
Return Document To/Prepared By:
Rule 2.520(d)On all...documents prepared...which are to be recorded in the public records of any county. C
3-inch space at the top right-hand corner on the first page and a 1-inch by 3-inch space at the top '
cL9Q t
oneach subsequentpageshallbeleftblankandreservedfor use by the clerk of court. cJ
�.:... ao
_ r 6d C-OD vjt rP.'`5T
S'•�oLfi�.��,�1'l s
CLK/CT 155 Rev.08/16 Clerk's web address:www.miami da m
0 y Miami Shores Village
:... aR.M Building Department
.�. 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
tORIDp' Tel: (305) 795.2204
Fax: (305) 756.8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
Whereas, (owner) 'D KAY t-Lc 2 L=Gtr hereinafter referred to as the owner of
the following described property(address): a 4 9 IV[= qS f� S �--
DA t o YVX I S' 10g o gs s 6 L. 33 t 38
Legal DescriptionH,/gr4� ,5E yce3 Lot &2 Z^s Block 9S Subdivision
F3 f0-37 4,2 Fr
Folio# ll - 32c5d-oto- !�to3c,
Requests permission to install(describe work):,4ofz,'�
Within the public right of way of(address) f2gfj' Ale-q5 s✓ 33138
IN CONSIDERATION of the approval of this permit by the Village,the owner agrees as follows:
1. To maintain and repair,when necessary,the above-mentioned item(s) installed within the dedicated right of
way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said
items within public right of way including restoration of street by reason of the Owner's failure to do so,
such expense shall be paid by the Owner or shall constitute a lien against the above described property
until paid.
2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any
and all liability,which may rise by virtue of permitting the installation of these items within the public right of way.
is
25
1 tr 0
OR BK 30421 PG 4836
LAST PAGE
3. The Owner does hereby agree to remove or relocate their facilities at their own expense,within 60 days
notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s)
to be removed and a lien being placed on the property and/or assessed against the Owner for all costs
incurred in the removal and disposal of the item(s).
4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land
and shall remain in full force and effect and be binding on the undersigned,their heirs and assigns, until
such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County,
Florida by the Village Manager of Miami Shores Village (or his fully authorized representative).
SIGNED,SEALED, EXECUTED AND ACKNOWLEDGE on this /2 day �,¢d , 2017
( tier's Signature)
SIGNED,SEALED,AND DELIVERED in the presence of:
CAFtLOS RAUL CORPAS
MY COMMISSION 0 G 3
EXPIRES:Au 2020
Bonded ThN N I!b
1Z n�LtC LG'n��
STATE OFFLORIDA, UWrY OF DA�
I MER CERTIFYthei this is e true
y oiPrrraU 0A
e �-� •��e
odgfnul h/ed in thi:�&Rc:a ova dm r of
LU7TAIE myhan and CIi«ciel Ses(Q.20 'a
2 HARVEY RUV , LEIRK.of Cj , d C.ou►#y Courts ^�V r l
F�11'L'L7
• ...
,Stn�REs � Miami shores Village
• ... . . . . ..
Boom Department
10050 N.E.2nd Avenue
lyres
— .� Miami Shores, Florida 33138
�IORIDA Tel: (305) 795.2204
Fax: (305) 756.8972
SURVEY AFFIDAVIT
STATE OF(FLORIDA)
COUNTY OF(DADE)
The undersigned Affiant, EAS TiJ QA�� ,does hereby attest that
(Property owner)
The attached survey, performed by a F- ,4ss�c.' {�s s'
(Name of surveyor's company)
For address: 12-qt? /V R•S5� l�l� h-t � Sid
Performed on (date of survey)is an accurate representation of the existing conditions and
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property
without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to
remove or obtain permits for any structures which now may exist on the property which are not permitted or which
may violate zoning or building code regulations. The Affiant further understands that the existence of any such
structures may affect final inspections as applicable to this or other permits.
ZFuAffJ th naught.
erty Wcan
er Signature Property Owner Print Name
SWORN TO AND SUBSCRIBED before me this 1'L day of
Affiant is personally known to me, produced LOS RAuLcoRPAu
�`c�-. �$•••• = MY COMMISSION#GG 01
EXPIRES:August 16,2v•.
'�•eR °`� Banded Tlvu Notary Public UnBe-.
Notary
Revised(6/25/12)Revised on 5/22/2009/Revised on 6112/09
Vt AN,
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FEB 14 20V d6 To 13 b,
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BLOCK 86
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FINISHED FLW.
17. ELEYAT ION - L 4s,
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LOCK 85 ......._44.5* m
16 u9 4?1%6- V-"4-0 L�
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BLOCK 85
CONMETE NALL
F
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ALL OF LOS I Aid 2,*&U:K 315,*Al bU CBS ET1,8LOCK STRUCTURE
CNO COM
SHORE' T E CHECKE Y
PLA T THIERT' CONC CONCRETE
AVAE OWN DRAWN By
10, PAGE 37 OF THE PUBLIC RECORDS OF DADE FB/PG FIELD BOOK AND PAGE
COUN Y ORIDA, LESS THAT P T LYING
WEST -- WOOD FENCE / CHAIN LINK FENCE
FROM A P LOWIJG DE301BED tfa:,e. SIR SET 5/8, IRON ROD AND CAP 6448
NT N THE-NDATH-LINE OF-LOT* e
FIR FOUND IRON ROC
CERTIFIED TO: 1. A D CE:OF 7VO(C FECr, EAST2015,TIE Fill FOUND IRON PIPE
MORT COWR OF SMD C-01 I. Ate FX FOUND MAIL AND CAP
SOUTHERLY 100.2 FEET TO A PC I N'' I ff THE A/C AIR CONDITIONER SLAB
LESLIE A. NORTHUP AND EDITH DAYLE PECK SOUTH LINE OF LOT 2. LYI83 81 U FEET P.11. PLAT BOOK
COMONWEALTH LAND TITLE INSURANCE COMPANY EAST OF IM6@60971INEST &ORNE4,01F 11AID *
KEITH RACK. LEWIS, COHEN A LUMPKIN LOT 2. 0.C.R. DADE COUNTY RECORDS
NAVY kDERAL CREDIT UNION E OVERHEAD POWER L INES
R RAO I US
a CENTRAL ANGLE
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A PORTION
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to
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lu
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LAND DESCRIPTION: CBS CONCRETE BLOCK STRUCTURE
ALL OF LOTS i AND 2, BLOCK 85, 8MIAMI CKO CHECKED BY
SHORES SECTION NO. 3', ACCORDING TO THE CONC CONCRETE
PLAT THEREOF, AS RECORDED IN PLAT BOOK DIIN DAhWM BY
10, PAGE 37 OF THE PUBLIC RECORDS OF BADE FBiPG FIELD BOOK AND PAGE
COUNTY, FLORIDA, LESS THAT PART LYING -- WOOD FENCE / CHAIN LINK FENCE
WEST OF THE FOLLOWING DESCRIBED LINE: SIR SET 5/8' IRON ROD AND CAP 6448
FROM A POINT IN THE NORTH LINE OF LOT rip FOUND IRON ROD
I. A DISTANCE OF 75.00 FEET EAST OF THE Fill FOUND IRON PIPE
CERTIFIED TO: NORTHWEST CORNER OF SAID L07 t. RUN FXC FOUNU NAIL AND CAP
SOUTHERLY 1,00.2 FEET TO A POINT IN THE AA' AIR CONDITIONER SLAB
LESLIE A. NORTHUP AND EDITH DAYLE PECK SOUTH LINE OF LOT 2. LYINS 02. 1.2 FEET P.III PLAT BOOK
COMMONWEALTH LAND TITLE INSURANCE COMPANY EAST OF THE SOUTHWEST CORNER OF SAID 0.C.rL DADE COUNTY RECORDS
KEITH, MACK. LEWIS, COHEN & LUMPKIN LOT 2. f OVERHEAD PDWER LINES
NAVY FEDERAL CREDIT UNION A RADIUS
CENTRAL ANGLE
--_ x
--�' ARC
III mm|n
r1p. TYPICAL
__