REV-17-533 ISAV
Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 201L(
BUILDING Master Permit No. S `` b " 3229
PERMIT APPLICATION Sub Permit No. RENI - S
BUILDING ❑ ELECTRIC ❑ ROOFING 81 REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
tt aa `` C.� 1_ CONTRACTOR DRAWINGS
JOB ADDRESS: �� � W 1,�V4 �`
City: Miami Shores County: Miami Dade Zip: Sglrr�--o
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type:
� Flood Zone: BFE: FFE: �(�q
OWNER:Name(Fee Simple Titleholder): Lem �/v V v/�uln-4 �'/,�uQe#: 1S—(f 1 �+Q 11
Address:
City: /�ll�' l c /� y-State: L Zip: zz�C0-
Tenant/Lessee Name: Phone#:
Email: 1�.
CONTRACTOR:Company Name: —4 V w Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$X SQ0 Square/Linear Footage of Work: a
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace / ❑ Demolition
Description of Work: z. QeQLSI��I 70 P—CP l42��(
Specify color of color thru tile:
Submittal Fee$ 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$
(RevisedO2/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City State Zip
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 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
ER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing inst ment was acknowledged before me this
--
day of /t-k LG� 9
20 1, , by day of 20 by
Y . U f YNA who is personally known to who is personally known to
me or who has produced 1S� as me or who has produced as
1 Y�V"e 1 C�Y
identification and who did take a 41,1rt identification and who did take an o h.
NOTARY P BLIC: NOTARY PUBLIC:
Sign: d Sign:
Print: Print:
Seal: , �P�a•,, YANADYPRIETO Seal:
MY COMMISSION#FF 214031
EXPIRES:March 5,2019
p °•' Bonded Thru Notary Pubrif Underwriters
x* ** *w***r
APPROVED BY �7. Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
BOUNDARY SUkv'V' ` : : : : .:.
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Land Surveyors 1 c3` J •• • • • • •h+ • •• f r c o
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CERTIFY TO: N � �` in � 9G�G� 1—ON PL. � � ,� i r �„ a o
MARIAN LEANN FREELAND AND JOHN CURRY r 4�
COLUMBIA TITLE OF FLORIDA, INC.D/B/A EWM TITLE
2.5' asp
CL. Ri. s I ,fl a i
CHICAGO TITLE INSURANCE COMPANY X� o R?>'rxXxR N i 0i
EVERETT FINANCIAL, INC. DB/A SUPREME I ENDING,IT 1 o x}��a `}' VIEW OF SUBJECT PROPERTY N Nw
SUCCESSORS AND/OR ASSIGNS,A.T.I.M.A. ( x x vy' hY I civ c`v f a ZQ
1 v Six 3.6' 1 n+>o mm
N h
18.9' i v g1� r�
.. X X h, A h R R AAA k (f ROPERTV ADDRESS:
x '. xv uxxxxxxx'ix xxX
LEGAL DESCRIPTION: (� x� � ,���t�x r r r r r r�<r x x) I�•
THE EAST/OF LOT 20 AND 2), > I 45 NW 93rd STREET
BLOCK I G8 x yA 1 MIAMI SHORES, FLORIDA 33)50
SUBDIVISION:MIAMI SHORES SECTION.GA z n vv 29.60'
ACCORDING TO THE FLAT THEREOF A5 RECORDED IN x R rx 10' Encroachments Noted:_NONE_
PLAT BOOK: 12 PAGE: 54 x �� POOL `p
PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA 1 n X> 24.0'
'�-2.5'CL. r>r .: „ ,.'`� Z. I 0.8'CL � cn
x A, ''�A/�A/< 1
FLOOD ZONE INFORMATION: � Lx x x x 4r I � - N91oG5st rfEt�nss } p ,J LU C_
THE NFIP FLOOD MAPS HAVE DESIGNATED THE HEREIN"1 14.25' -1 w <
8.30 I � LOT 22 Nm99ws HE99LhSR hFs _I� �, ^ _ w C
DESCRIBED LAND TO BE SITUATED IN � o n '1 Nw tnss HE9emst �9r LLJ w ` w LL
IL
FLOOD ZONE: X 1� ��. x BLOCK 16� Hw9 est NE97Rh5t Y w _� - L
PANEL NO/SUFFIX: 302/L �,� `- x O Nw9wEs Nrf96NSi `r.61hSt - I Z
COMMUNITY NO.: 120652 .'(N 14,g• x x x Miami Shores ' cn
DATE OF FIRM: 09/11/2009 6 N a (� f-0Yfy� �, aE 95th$I z NE9sa 0 0 0 C
28.20
THE SUBJECT PROPERTY DOES NOT UE INA NLLJ
SPECIAL FLOOD HAZARD AREA �, o k t` z m = Cr
e g nE!Wm51 G Qar
,� as m 3 REd sl
Q P C
'p _ :a o a h:.9hd 5t �' "mal Sl = C
® ONE STORY
� Q' (S?91s15[ fiF 7lai�
RES. No.45. 1.4'CL. ® c
a taeDa qd s MEm4 lZ LLi L , c
Atew c6 ® NrfB�JIS[_ NE e9:11S1 >
o)real Al Clearances and /or encroachments Shown ffi Ora D n
haare of apparent nature.Fence ownwah1p trH f A El Portal
by mearm 1� amership of fenncee not VICINITY MAP
I
8 7hIhts y Is intended form or refinance 14.2' 32.50 ��J� N
_ _
purposes ordy mcdueiv ty f« tics u� y the to 1s.2' N 23.3' -
dnann k 1 aertNt�.'this ssrrvey is not to be used
for oonatruatiom pannittinS design,or any°Riser• 8
use without written consent of'thorns J.Kay.Ina. Y
C)Code restriction and title search aro not reflected .
on this survey. o 3 o I ' 1p I J i