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DS-16-1251 Permit No. DS-5-16-1251 Miami Shores Village Permit Type:Driveways/Sidewalks/Slabs Perlill 10050 N.E.2nd Avenue NE Work Classification:AdditionlAlteration Miami Shores,FL 33138-0000 Permit Status:APPROVED yF� � Phone: (305)795-2204 Issue Date:5/13/2016 Expiration: 11/09/2016 Project Address Parcel Number Applicant 10204 NE 2 Avenue 1132060131720 MARK TERRY Miami Shores, FL Block: Lot: Owner Information Address Phone Cell MARK TERRY 349 NE 102 Street (786)443-7720 MIAMI SHORES FL 33138- 349 NE 102 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 350.00 HOME OWNER Total Sq Feet: 262 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final Date Denied: Foundation Type of Work:EXCAVATION AND APPLY CONCRETE 61 Additional Info: Review Building Bond Return: Classification:Residential Review Planning Scanning:3 Fees Due Am]$2 Pay Date Pay Type Amt Paid Amt Due Bond Type-Owners Bond Invoice# DS-5-16-59717 CCF 05/13/2016 Check#:1419 $69.60 $550.00 DBPR Fee DCA Fee 05/10/2016 Check#:1416 $50.00 $500.00 Education Surcharge 05/13/2016 Check#:1415 $500.00 $0.00 Notary Fee Bond#:3088 Permit Fee Scanning Fee Technology Fee Total: $6 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. Futhermor horize the above-named contractor to do the work stated. —4E May 13,2016 Authorized Signature Owner / Applicant / Contractor / Agent Date Building Department Copy May 13,2016 1 � I :1 IQ AY ----- ----- ' ,1•PET sy � 'vIV • • p'Ad7 't t� ,.� .� L,Lr a� •ri • • ••• • r `k ------------------ 0.4 .- r L • •• 00000• ---i-- ------ ----- 7 F#P t gpOs b� f• • • i Gll[a�4Hew/, w fMIN i o. �o. I.g�"9 QPbO 0.4 uN 0000•• I/ .a+T• 0000 • • • • `°0 5 'aJJ�• .Ace• • •••••• ` J 0000 • 0000• • • t'�d1�4 N 0000• 0000 0000• �p @ k",-4` a �kr°., ��"--._ - • •• 0000 ••11••• •' �d F-F k t fb - . �„ � � y_�► � 00009 • • CO►1C-rte `r �- `I�d,-v_ I • ! • T • • • 0000•9 1 �.F� • Al ( 0000•• 5• • • • • MQNa�� �5 � � 0.4• N • 0.00•• ••I--• 000.0• • • r ,^ 3.00• ..20.00. .., r '�f1Vi $f G � � � 3 r I n :_�" ,> 2. 11.26' c m -1 ' 1290 2.60. ?}^+ p.30' { - ANO OBJECTION Yr g „ 27.11' R.vs' FI rida Healih Miami-Dade County 17 ®.S.T.D S. & Well Program t r _ 1 , A " App kation Nol f Datc t. Sig e - ature h Lr ' 1$ t j, r 'P OIRCRetE StDA9a>1L '70.93'P..&M. In .4a as �uC' i d•W ",. zMw � � raL +•� r ?- '� Xr �'y.. '�"I r``b'°��i'�O��a x yy.,` kj70Y�.�rt.� .L � .,,,s„ � � � ���' �,��a��' ' 3 PALAV Or ]MO ay Fort: 10204 N.E. 2ND AVENUE MIAMI FLORIDA 33138 LEGAL DESCRIPTION: CERTIFIED TO LOTS 4 AND 5.BLOCK 13.AN AMENDED PLAT OF MIAMI SHORES SECTION DAMIAN MARTINEZ.DAWN E.MART44EZ:GRAHAM P.A..ITS SUCCESSORS ANDIOR ASSIGNS.AS THEIR NO.1.ACCORDING TO THE PLAT THEREOF.AS RECORDED IN PLAT BOOK 10.PAGE INTERESTS MAY APPEAR., 70 OF THE PIBUc REcom OF MIAMI-DAOE COUNTY.FLORIDA. GENERAL NOTES I HEREBY CERTIFY THAT THIS SKETCH LEOD@ 6 ABBRRWATIONS 1. LEGAL DESCRIPTION PROVIDED BY OTHERS.UNLESS OTHERW;SE NOTED. OF SURVEY OF THE HEREON :1_� `im`m„+[ I.__ 2. AWS SURVEY DOES NOT DETEM409 OR IMPLY REAL PROPERTY OWNf5t5l1�. DESCRIBED PROPERTY IS A TRIS AHD -` ...womce. t u.awl•c :ntwapen 3. THE LANDS SHOWN HEREIN ARE SUBJECT TO RESTHUCTIC OF RAT 491 OF CORRECT REPRESENTATION SEA "V" °,'.i°"'°4� '°4..o.•r"°®•P9p1 SURVEY HAVE UNDER MY DIRECTION K-.dun rpm RECORD.RECORDS HAY 8E ADDITIONAL RESTRICTIONS THAT MAY BE FOUND W THE n.ann :'. ianu'm PtRUt RECORDS THIS COUNTY,AFFECTING THESE LANDS. AND SAID SURVEY MEETS T1ff ,•y, y, .a• r.� `. l IONU1UH TECHUMAL STANDARDS AS enn.a L. MEASURED VALUES OF BOUNDARY DISTANCES.DIRECTIONS AND INTERIOR ANGLES. s� .u•rw.oamaa u:mvemaam SET PORTS IO THE FLORIDA BOARD pw.mu � FMYE SEEtN FONID CON515TEM WITH VALUES OF RECMD.UNLESS OTHERWISE ,rw ,.� _ SHOWN. OF PROFESSIONAL Si1RVEY0R4 AIID 'i:= .a�ieq•wueat 91omeeo�.rt MAPPERS W CHAPTER 5.1-0 FLOIDA a.ucnc. na..ra.ow.ma To 5. ELEVATIONS,IF SHOWN.ARE REFERRED TO NR.V.O.1920. c<. arra•.arom..at m•muoer.r..�+a gEQ2,02 COOS PURSUANT TO �4• �Oq1 ae•ar A.wmw- _ ate+ A. UNDERGROUND U�ROYENffNTS,FOOTINGS AND UTILITIES ORE NOT LOCATED O7SECTIONr p mivacca+t P^"fJ° w•L°+'"`^•°O1 LCURAT F AND aaaro ...rauoaw mp ... w.e.w � 1105 SURVEY MAP. A1B)IS ACCURATE AAo CNRRECT TO p.w�p�rw«o "'a•'p°° °^•iP�"'p"" ..ianwpwa eun-. � '^i 7. FBNCE OKYt2RSNOP NOT DETERMINffD,APPARENT CLEARANCES AN.IDJOR 1}B'.BEST OF MY KNOWLEDGE AND ia•aewaivom.m 'vc.e,•pp° b S•a ENCROACHMENTS ARE NOTED BY VISUAL MEANS ONLY. BEWRII. ii::r ane �� � Y+ S. NO IDENTIFICATION CAPS FOUND ON SURVEY MONUMENTS,UNLESS OTHERWISE ..waaa.ti ,ae. to Q$ NOTED. LFA o <o 9. THE SCALE.AS SHOWN IS THE INTENDED PLOTTING SCALE OF THIS MAP. FLOOD INSURANCE RATE MAP(FIRM)INFORMATION! r ID. S SAMY LS EXCLUSIVELY FOR THE USE OF Tiff PARTIES TO WHOM IT 15COMMUNITY NUMBER:120652 PANEL NUMBER:0302 rt' -moi & , THIS SURVEY MAP AND THE COPIES THEREOF.ARE NOT VALID WITHOUT THESUFFIX: L PANEL REVISED DATE:09111/2009 � c SIGNATURE AND RAISED SEAL OF A FLORMA LICENSED SURVEYOR AND MAPPERFLOOD Zwe:X12. ADDITIONS OR DELETIONS TO SURVEY MAPS OR REPORTS BY OTHER THAN THE p F $ A SIDHNG PARTY OR PARTIES S PROHIBITED WITHOUT WRITTEN CONSENT OF THE STATE OF FLORPDA Ai WO FIELD RM GATE:07ISIr2gL DRJOI MAR!(USED: p SIGHNX.PARTY OA PARTIES. COMPLETION DATE.08!0412014 N/A THIS SURVEY O NOT CovERED DY PROFESSIONAL LIABILITY INSURANCE Miami Shores Village �- p BuildingDepartment P17 � 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 I � © 20 as Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20(qS+1q BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: i02_014 W E 21,c! I+c» City: Miami Shores County: Miami Dade Zip: / 3c Folio/Parcel#: (p e 3 ZCC, C-31 Is the Building Historically Designated:Yes NO_ x Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): N"te r k- T-�r r„ Phone#: Address: 1()2.C;,L4 t_)C-- City: NA I C"M S(r­'=,-'�f_-_ State: FL Zip: Tenant/Lessee Name: Phone#: Email: v'y)c, rj-4 Ja r"F,r. , c e-)N,-) CONTRACTOR:Company Name: PV--tI'NC,C -XL r- Phone#: Address: City: State: Zip: Qualifier Name: Phone#: State Certification or Registration M Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: / Zip: Value of Work for this Permit:$ )L Square/Linear Footage of Work:) Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑�Demolitiion Description of Work: P��,,��e# �c�e� edo�j �,��.�/� c� ac a G r'e.z�� c�� 1fly riiyi1PQN/Q1/, Specify color of color thru tile: Submittal Fee$ Go ' C)O Permit Fee$ CCF$ CO/CC$ Scanning Fee$ r QZ) Radon Fee$ &2 " r� DBPR$ Notary$tet=�s��jA ,, Technology Fee$ 9b Training/Education Fee$ 0 ' 2-0 Double Fee$ T` Structural Reviews$ Bond$ Sv ®® " 00 TOTAL FEE NOW DUE$ �,01 o G (Revised02/24/2014) �q 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 OWNER or AGEN CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of N�L�' ,20 ! f by day of ,20 , by who is personally known to who is personally known to me or who has produced _ LI me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARYPUB NOTARY PUBLIC: Sign: Sign: Print: �� _ _ _ Print: Seal: �o�pavnv�� �lotary P,mwic State of Florida SLI: Sindia Alvarez c cQ My Commission FF 156730 FFA°p Expires 09103/2018 *>K**>k**>k*>«>k*>xs>«>«*>«>K>«t***>«>x>«**>« ** ** ********rx*********************>«**>xs>«>«*>k*>«**>k*>«**>k***>k*>K**>k*****>K>k**>k*>«* APPROVED BY Plans Examiner r //Z./;' Zoning Structural Review Clerk (Revised02/24/2014) v w ,r�HORES ,pG„9a Miami Shores Village gni Building Department ”" ""'�' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 �toR Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: T�r r`Y DATE: 3-- l S--I Cv ADDRESS: Io4 L3e; Zai fue Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida,FS 489.103(7). And I have read and understood the following disclosure statement,which entities me to work as my own contractor;I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor.You have applied for a permit under an exception to the law.The exemption allows you,as the owner of your property,to act as your own contractor even though you do not have a license.You must supervise the construction yourself.You may build or improve a one-family or two-family residence.You may also build or improve a commercial building at a cost of$25,000.00 or less(The new form states 75,000).The building must be for your own use and occupancy.It may not be built for sale or lease.If you sell or lease a building you have built yourself within one year after the construction is complete,the law will presume that you built for sale or lease,which is a violation of this exemption.You may not hire an unlicensed person as a contractor.It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances.Any person working on your building who is not licensed must work under your supervision and must be employed by you,which means that you must deduct F.I.C.A and with- holdings tax and provide workers'compensation for that employee,all as prescribed by law.Your construction must comply with all applicable laws,ordinances,buildings codes and zoning regulations. Please read and initial each paragraph. 1, I understand that state law requires construction to be done by a licensed contractor and have applied for an owner-builder permit under an exemption from the law.The exemption specifies that I,as the owner of the property listed,may act as my own contractor with certain restrictions even though I do not have a license. Initial 2. 1 understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. Initial 3. 1 understand that,as an owner builder,I am the responsible party of record on a permit.I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name.I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts. Initial 4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding.I may also build or improve a commercial building if the costs do not exceed$75,000.The building or residence must be for my use or occupancy.It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease,which violates the exemption. Initial 5, 1 understand that,as the owner-builder,I must provide direct,onsite supervision of the construction. Initial 6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence.It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. Initial /I� a 7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner-builder permit that erroneously implies that the property owner is providing his or her own labor and materials.I,as an owner-builder,may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner-builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Initial 8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done.Any person working on my building who is not licensed must work under my direct supervision and must be employed by me,which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act(FICA)and must provide workers compensation for the employee.I understand that my failure to follow these may subject to serious financial risk. Initial 9. 1 agree that,as the party legally and financially responsible for this proposed Construction activity,I will abide by all applicable laws and requirement that govern owner-builders as well as employers.I also understand that the Construction must comply with all applicable laws,ordinances,building codes, and zoning regulations. /J,�,/� Initial `f 10. 1 understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service,the United States Small Business Administration,and the Florida Department of Revenues.I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http://www.myfloddalicense.com/dbor/pro/cilbfiindex.html Initial 11. 1 am aware of,and consent to;an owner-builder building permit applied for in my name and understands that I am the party legally and financially responsible for the proposed construction activity at the following address: �JA , !'���,; f� 33/30' Initial 1 12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the information that I have provided on this disclosure. �� Initial Licensed contractors are regulated by laws designed to protect the public.If you contract with a person who does not have a license,the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court.It is also important for you to understand that,if an unlicensed contractor or employee of an individual or firm is injured while working on your property,you may be held liable for damages.If you obtain an owner-builder permit and wish to hire a licensed contractor,you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued,this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit.A copy of the property owner's driver license,the notarized signature of the property owner,or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this a 3 day of 20 (JG By �- '� who was personally known tome or who has Produced there License or F�— � � L' �� as identification. owl NOTARY �o`pav Pomo Notary Puglic State o1 Florida 5india Alvarez c c My Commission FF 156750 ®p E�cpires 09/0312019 Property Search Application-Miami-Dade County Page 1 of 1 P� P R A I E OFFICE OF THE PROPE 1U 0 B") Summary Report Generated On:5/10/2016 Property Information Folio: 11-3206-013-1720 ° ,y Property Address: 10204 NE 2 AVE Miami Shores,FL 33138-2348 Owner MARK TERRY PA 801 BRICKELL AVE 800 a Mailing Address " i MIAMI,FL 33131 USA N `� `� � - Primary Zone 0900 SGL FAMILY-1901-2100 SQ g m ry a r X 0101 RESIDENTIAL-SINGLE Primary Land Use r � FAMILY: 1 UNIT 7, r Beds/Baths/Half 2/1/0 " _ Floors Living Units Actual Area Sq.Ft Rh g Area Sq.Ft Living Adjusted Area 1,776 Sq.Ft Taxable Value Information Lot Size 12,480 Sq.Ft 2015 2014 2013 Year Built 1936 County Assessment Information Exemption Value $0 $50,000 $50,000 Year 2015 2014 2013 Taxable Value 1 $311,377 $88,924 $86,871 Land Value $237,051 $237,051 $162,244 School Board Building Value $74,326 $120,413 $120,413 Exemption Value $0 $25,000 $25,000 XF Value $0 $0 $0 Taxable Value 1 $311,377 $113,924 $111,871 Market Value $311,377 $357,464 $282,657 City Assessed Value $311,377 $138,924 $136,871 Exemption Value $0 $50,000 $50,000 Taxable Value 1 $311,377 $88,924 $86,871 Benefits Information Regional Benefit Type 2015 2014 2013 Exemption Value $0 $50,000 $50,000 Save Our Homes Assessment Taxable Value $311,377 $88,924 $86,871 Cap Reduction $218,540 $145,786 Homestead Exemption $25,000 $25,000 Sales Information Second Homestead Exemption $25,000 $25,000 Previous Sale Price OR Book-Page Qualification Description Note:Not all benefits are applicable to all Taxable Values(i.e.County, 12/23/2015 $375,000 29906-2543 Qual by exam of deed School Board,City,Regional). 08/07/2014 $300,000 29270-2738 Qua[by exam of deed 01/31/2014 $255,000 29038-2792 Qual by exam of deed Short Legal Description 07/01/1986 $80,000 12952-2594 Sales which are qualified MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 4&5 BLK 13 LOT SIZE IRREGULAR OR 12952-2594 0786 1 The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at http://www.miamidade.govlinfo/disclaimer.asp Version: http://www.miamidade.gov/propertysearch/ 5/10/2016 Mission: Rick Scott To protect prarte&iffVm the health Gmem of all people in Flaida#Tough inbegrated Celeste Philip,MD,MPH state,mu ty&a mnuutyetfofts. HEALTH Interim State General Vision:To be the HeaW*stSUde in the Nation March 25,2016 Grace Garcia 10204 NE 2 Avenue Miami, FL 33138 RE: Modification to a Single Family Residence-No Bedroom Addition Application Document Number: AP1231470 Centrax Permit Number: 13-SC-1670145 10204 NE 2 Avenue Miami, FL 33138 Lot:4&5 Block: 13 Subdivision: Miami Shores No. 1 Dear Applicant, This will acknowledge receipt of a floor plan and site plan on 03/23/2016 for the use of the existing onsite sewage treatment and disposal system located on the above referenced property. This project is for the construction of a driveway approach. No objection letter issued on March 25th, 2016 by Paul Levelt andre This office has reviewed and verified the floor plan and site plan you submitted,for the proposed remodeling addition or modification to your single-family home. Based on the information you provided, the Health Department concludes that the proposed remodeling addition or modification is not adding a bedroom and that it does not appear to cover any part of the existing system or encroach on the required setback or unobstructed area. No existing system inspection or evaluation and assessment, or modification, replacement, or upgrade authorization is required. Because an inspection or evaluation of the existing septic system was not conducted,the Department cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use. You may request a voluntary inspection and assessment of your system from a licensed septic tank contractor or plumber, or a person certified under section 381.0101, Florida Statutes. If you have any questions, please call our office at(305)623-3500. Si erely, •• ••; .•. •• Paul evelt And e, P.E. .. ..• Profees nal Engineer Supervisor I •• ••• •• •• Departmen f Health in Dade County • ••• • ••• • • • • • • • • • • • • •• • •• • • • • • •• • • • • • •• • • • f7mtda D"wft of of Rea f6 tttt�.�o moo• in Dade County• •,Florida •• + • • ++ TWITTER:HealthyFLA PHONE: (305)623-3500 + • • • • • • FACEBOOK:FLDepartmentofHealth • + • + • • • • • • YOUTUBE:fldoh • •• •• • • • •• •• •a• • • • ••• 0 0 OR Miami Shores Village CFN 21316RC1223381 list nits Building Department OR BK 30039 Pg 3003 (Pgs) 10050 N.E.2nd Avenue RECORDED 04_/15./2016 13-21 x,116 Miami Shores, Florida 33138 HARVEY ``'-'V INP CIERK OF -,.T 0 NIANI—DADE COUHTYFLORIDA Tel: (306) 796.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) Ivici r K Ic t-b-� hereinafter referred to as the owner of the following described property (address): N& 24 -1 — Legal Description: Lot Block Subdivision Folio # [,., I - -2, -n I )—17 2-C Requests permission to install (describe work): Within the public right of way ` (address) ay6f (address) ,o2C_,4 t,,jC-4 Zn4tq�,r_,, t—ti'CW71 I=L 3!;1 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. 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). Te—rr)c Signature 1171 Owner or Agont State of Florida County of Miami Dade The foregoing instrVment was acknowledged before me this J :5 day of 20 by mpe�� eey who is personally known to me or who has produced ��- pQ_kkjt-a- identification. NOTARY PU Sign: Print: SEAL-74.^ Notary Public State,of Florida sindia Alvarez 675() g My Commission FF 156750 0 Expires 09103/9018 Permit ivo. DS-5-16-1251 s�!O1 y Miami Shores Village Permit Type:DrivewaystSidewalks0abs 10050 N.E.2nd Avenue NE e r m i work Class cation:AdditionlAlteration ••• Miami Shores,FL 33138-0000 PPermit Status:APPROVED Phone: (305)795.2204 F`OR1DAIssue Date: 5/13/2016 Expiration: 11/0912016 Project Address Parcel Number Applicant 10204 NE 2 Avenue 1132060131720 MARK TERRY Miami Shores, FL Block: Lot: Owner Information Address Phone Cell MARK TERRY 349 NE 102 Street (786)443-7720 MIAMI SHORES FL 33138- 349 NE 102 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 350.00 HOME OWNER Total Sq Feet: 262 Approved:In Review Available Inspections: Comments: LInspection Type: Date Approved::In Review Date Denied:Type of Work:EXCAVATION AND APPLY CONCRETE 61 Additional Info: ildingBond Return: Classification:Residential nning Scanning:3 Fees Due Am]$2 Pay Date Pay Type Amt Paid Amt Due Bond Type-Owners Bond $ Invoice# DS-5-16-59717 CCF 05/13/2016 Check*1419 $69.60 $550.00 DBPR Fee DCA Fee 05/10/2016 Check#:1416 $50.00 $500.00 Education Surcharge 05/13/2016 Check#:1415 $500.00 $0.00 Notary Fee Bond#:3088 Permit Fee $Scanning Fee Technology Fee Total: $61 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. Futhermor horize the above-named contractor to do the work stated. May 13,2016 Authorized Sig I natural Owner / Applicant / Contractor / Agent Date Building Department Copy May 13,2016 1 -; E s; y' 6 - -�------------- f•••• •••ff• ti • - ------s --�- s••••• 0.4 IN Ti11CAHaa�IeDI� py� "� A' D�SO �� m °,bombe fff• • • •••f•; 3 q ' ' a •sf•• •fss •sis•• • f• •••• f••••• • s •••• • f • • • •••••• i MQQ�Ye a c + ' K 0.4' f• •••••• f r�" � 148 •.GUI—• ••f• • • AIR 3.00' E0.0D' Q q w i' 215. H.ffi' Ip g OC � ro 6p n b 'x � �s 8 �(H 129°' Qp' s 2.601 tr r 27.R' 12.95' Florida Healih Miami-Dade County MR+ O.S.T.D S. & Well Program 0. App fcation No. I ! 13 r $ " Dat S. Sigr ature Q w ' !P CONCI�re siuEwuK' 70:93'Is.,&•M. r Iket k -Et 1 xz N bye .f h v. s � # 'rx xiHp 4a 9 '7� 1 �' � WE �;✓ , �" ,uv �s ar f �� -ati Y .7`S ""�i° : '�yr r... , FOR: 10204 N.E. END AVENUE MIAMI FLORIDA 33138 LEGAL DesaGFT1O0 CERTIFIED T0: LOTS 4 AND 5.BLOCK 13,AN AMENDED PLAT OF MIAMI SHORES SECTION DAMIAN MARTINEZ:DAWN E.MARTINEZ:GRANADOS P.A-.ITS SUCCESSORS AND/OR ASSIGNS.AS THERM NO.1.ACCORDING TO THE PLAT THEREOF,AS RECORDED IN PLAT BOOK 10,PAGE INTERESTS MAY APPEAR.- 70 OF THE Puauc RECORDS OF MIAm-DADE COUNTY.FLORIDA. GENERAL NOTES I HEREST CERTIFY THAT THIS SKETCH LEGEND•ABGREVIATIONG L LEGAL DESCRIPTION PROVIDED BY OTHERS.UNLESS OTHERWISE NOTED. off: Z THIS SURVEY DOES NOT DETERMINE OR IMPLY RAND EAL PRW'ERTY ,.r,, }'„r,urn.ut nes•rwoartom S. THE LANDS SHOWN HEREIN ARE SUBJECT TO RESTRICTIOR IS A TRUE RAT{D F CORRECT REPRESENTATION OF A W.. gpanw RECORD.THERE MAY BE ADDITIONAL RESTRICTIONS THAT MAY BE FOUND W THE SURVEY MADE two MY DIRECTION .��u �!��++*+� �*•"^F�^Q'P+ v^ PYLIC RECORDS OF THIS COUNTY.AFFECTING THESE LANDS. AND SAID SURVEY MEETS THE .an..oe1g1f'�iuert e.awdreiu.amm H.ea H2p1 MINIMUM STANDARDS D wrra A. MEasuEO vALUEs OF 801XDARY WSTANNCEs.IORECitOS AND INTERIOR ANGLES. SET PORTS IO THE FLORIDA SOAK •ra.+aa�mrtan i aem r' l Have BEEN FOUND CONSISTENT WITH VALUES RELOAD,tR0.E55 OTFERWLSE O:PROPESSIONAI.SURVEYORS AAD SHOWN. MAPPERS IN CHAPTER SJ47 FLORIDA rr ewrtr u.,aa o..,.rwoom�m.M°ern S. ELEVATIONS,IF SHOWN.ARE REFERRED TO N.G.V.D.1929. �<.• m.n.e.e r<.,w ADMINISTRATIVE C0�PURSUANT TO �G•ro^',a°A"1Y°a�+a xr is nu,.-.awe 6. UNDERGROUND IMPROVEMENM FOOTINGS AND UTILITIES ARE HOT LOCATED ON r v a.rmcow[ SECTION CURATE AND CORRECT TO •oaw �...eo%'a'w`mw . ,ppfOO' THIS SURVEY OWNERSHIP MAP. AND R ACCURATE Atm LEDGE A D Kowa Ntla n +„p 1V, '^ 7. FENCE OWNERSWP NOT OEl'ERMHEO.APPARENT CLEARANCES AND/OR THE BEST OF MY KNOWLEDGE AND �a.eeMv,a.aem,x �•'Op1,bII9"' "e'':��"� MAEa ENCROACHMENTS ARE NOTED BY VISUAL MEANS ONLY. ;LI1F J.—t„O 8. NO IDENTIFICATION CAPS FOUND ON SURVEY MOAA4MM LRI.ESS OTHERWISE im:ew a eusaa a ;e:�rmwnn..a NOTED. <o 9. THE 4CAlE,AS SHOWN R THE INTENDED PLOTTING SCALE OF THIS MAP FLOOD 1 ANCE RATE MAP(FIRM)INFORMATI tt t0. THIS GUIMY IS EXCLUSIVELY FOR THE USE OF THE PARTES TO WHOM IT IS COMMUNITY NUMBER:120652 PANEL NUMREIE 0302 m y w g U THIS SURVEY MAP AM THE COPES THEREOF,ARE NOT VALID WRHOUT TDIE SUPflIL• L PANEL REVISED GATE:09/H/Z009 z o P n a G SIGNATURE AHD RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER FLOOD ZONE:X y 12. AO MING OR DELETIONS TO SURVEY MAPS OR REPORTS BY OTHER THAN THE S NAS ` o a STATE OF FLORIDA F7£. 9GRI G PARTY OR PARTIES R PROHIBITED WI'HFi01HT WRTITEN CONSENT OF THE FIELD WORK DATE: I I A d SIGRNG PARTY OR PARTES. BENOI MAR(UBt3>: ,. COMPLETION GATE RIA THIS SURVEY�NOT COveREO BY PROFEEDIONAL LIABILITY INSURANCE Miami Shores Village - �- Building Department 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 MAY 10 201A Tel:(305)795-2204 Fax:(305)756-8972 ---- INSPECTION LINE PHONE NUMBER:(305)762-4949 -0— FBC 20 ILA BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ROOFING ❑ REVISION EXTENSION RENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: It ©2-0,4 WE 2Li c,, City: Miami Shores County: Miami Dade Zip: 33136 Folio/Parcel#: I I 1 2-C Is the Building Historically Designated:Yes NO_ X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): Nlc r k T- r r" Phone#: 1-4 9 3-- ) Address: (U z� LA City: �'Z i c,mj State: rL Zip: Tenant/Lessee Name: r Phone#: Email: "-ic,r k_ r-r 4 t-; r u-n . ce)v,-, CONTRACTOR:Company Name: 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:$ )L Square/Linear Footage of Work: G U! 5 a Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Demolition Description of Work: tctia,�►� tr�v, c-�v.�-� �rea�e� ��- sc 1-,LG r'e,�/ws c( rr2 .!d ' Specify color of color thru tile:_10 h Submittal Fee$ �® Permit Fee$ �a1 ® CCF$ 0 CO/CC$ Scanning Fee$ 9 cj'-:) Radon Fee$ ®� " DBPR$ Notary$ (AN Technology Fee$ Training/Education Fee$ ® Double Fee$ Structural Reviews$ Bond$ S 00 ° GO TOTAL FEE NOW DUE$ a (Revised02/24/2014) 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 114 Signature OWNER or AGEN CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of l ,20 t fo , by day of 20 ,by who is personally known to who is personally known to me or who has produced - L( me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUB NOTARY PUBLIC: Sign: Sign: Print: cl;::�,T Print: Seal: ` ro�491 Pf,� Notary P,fo'ic State of Florida S l: Sindia Alvarez cQ NlyCommission FF 156750 FGio4\ Expires 09;0312018 APPROVED BY Plans Examiner ` Zoning Structural Review Clerk (Revised02/24/2014) w I> ° S�OREs Miami �+ Miami Shores Village Building Department --:. ""'�' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 ��oRIDA Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: T�r r-y DATE: 3 i S--eC,- ADDRESS: 10 4 U(=-; Z--j lb-,e- Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida,FS 489.103(7). And I have read and understood the following disclosure statement,which entitles me to work as my own contractor;I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor.You have applied for a permit under an exception to the law.The exemption allows you,as the owner of your property,to act as your own contractor even though you do not have a license.You must supervise the construction yourself.You may build or improve a one-family or two-family residence.You may also build or improve a commercial building at a cost of$25,000.00 or less(The new form states 75,000).The building must be for your own use and occupancy.It may not be built for sale or lease.If you sell or lease a building you have built yourself within one year after the construction is complete,the law will presume that you built for sale or lease,which is a violation of this exemption.You may not hire an unlicensed person as a contractor.It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances.Any person working on your building who is not licensed must work under your supervision and must be employed by you,which means that you must deduct F.I.C.A and with- holdings tax and provide workers'compensation for that employee,all as prescribed by law.Your construction must comply with all applicable laws,ordinances,buildings codes and zoning regulations. Please read and initial each paragraph. 1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner-builder permit under an exemption from the law.The exemption specifies that I,as the owner of the property listed,may act as my own contractor with certain restrictions even though I do not have a license. Initial 2. 1 understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. Initial 3. 1 understand that,as an owner builder,I am the responsible party of record on a permit I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts. Initial 4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding.I may also build or improve a commercial building if the costs do not exceed$75,000.The building or residence must be for my use or occupancy.It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially improved A for sale or lease,which violates the exemption. Initial 5. 1 understand that,as the owner-builder,I must provide direct,onsite supervision of the construction. Initial_ 6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence.It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or municipal ordinance. Initial s pop 7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner-builder permit that erroneously implies that the property owner is providing his or her own labor and materials.I,as an owner-builder,may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner-builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Initial_ 8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done.Any person working on my building who is not licensed must work under my direct supervision and must be employed by me,which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act(FICA)and must provide workers compensation for the employee.I understand that my failure to follow these may subject to serious financial risk. Initial 9. 1 agree that,as the party legally and financially responsible for this proposed Construction activity,I will abide by all applicable laws and requirement that govem owner-builders as well as employers.I also understand that the Construction must comply with all applicable laws,ordinances,building codes, and zoning regulations. Initial 10. 1 understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service,the United States Small Business Administration,and the Florida Department of Revenues.I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http://www.mvfoddalicense.com/dbor/aro/cilbrndex.html Infia14�-- 11. 1 am aware of,and consent to;an owner-builder building permit applied for in my name and understands that I am the party legally and financially responsible for the// it proposed construction activity at the following address: l� 10)0 q N �1/IE of A , - ,,; PL 33/� Initial 12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any of the information that I have provided on this disclosure. �� Initial Licensed contractors are regulated by laws designed to protect the public.If you contract with a person who does not have a license,the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court.It is also important for you to understand that,if an unlicensed contractor or employee of an individual or firm is injured while working on your property,you may be held liable for damages.If you obtain an owner-builder permit and wish to hire a licensed contractor,you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued,this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit A copy of the property owner's driver license,the notarized signature of the property owner,or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this 13 day of ���� , 20 (b By NT' rt'`'e� �`� who was personally known to me or who has Produced there License or �� il1E� L' as identification. OWN NOTARY rotpRv PumNotary P13011C State of Florida , 5india Alvarez c My Commission FF 156750 ��oQ� Expires 09/03/2018 Property Search Application- Miami-Dade County Page 1 of 1 OFFICE OF THE PROPERTAPPRAISER Summary Report Generated On:5/10/2016 Property Information a N' F r Folio: 11-3206-013-1720 Properly Address: 10204 NE 2 AVE xk ; Miami Shores,FL 33138-2348 3 Owner MARK TERRY PA aR a • 801 BRICKELL AVE 800a Mailing Address MIAMI,FL 33131 USA Primary Zone 0900 SGL FAMILY-1901-2100 SQ r �f 0101 RESIDENTIAL-SINGLE Primary Land Use FAMILY: 1 UNIT , 1z, € Beds/Baths/Half 2/1/0 ' Floors Living Units 1 Actual Area Sq.Ft ' Living Area Sq.Ft � r �. Adjusted Area 1,776 Sq.Ft Taxable Value Information Lot Size 12,480 Sq.Ft 2015 2014 2013 Year Built 1936 County Assessment Information Exemption Value $0 $50,000 $50,000 Year 2015 2014 2013 Taxable Value 1 $311,377 $88.9241 $86,871 Land Value $237,051 $237,051 $162,244 School Board Building Value $74,326 $120,413 $120,413 Exemption Value $0 $25,000 $25,000 XF Value $0 $0 $o Taxable Value $311,377 $113,924 $111,871 ___T Market Value $311,377 $357,464 $282,657 City Assessed Value $311,377 $138,924 $136,871 Exemption Value $0 $50,000 $50,000 Taxable Value $311,377 $88,924 $86,871 Benefits Information Regional Benefit Type 2015 2014 2013 Exemption Value $0 $50,000 $50,000 Save Our Homes Assessment Taxable Value $311,377 $88,924 $86,871 Cap Reduction $218,540 $145,786 Homestead Exemption $25,000 $25,000 Sales Information Second Homestead Exemption $25,000 $25,000 Previous Sale Price OR Book-Page Qualification Description Note:Not all benefits are applicable to all Taxable Values(i.e.County, 12/23/2015 $375,000 29906-2543 Qual by exam of deed School Board,City,Regional). 08/07/2014 $300,000 29270-2738 Qual by exam of deed 01/31/2014 $255,000 29038-2792 Qual by exam of deed Short Legal Description 07/01/1986 $80,000 12952-2594 Sales which are qualified MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 4&5 BLK 13 LOT SIZE IRREGULAR OR 12952-2594 0786 1 The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp Version: http://www.miamidade.gov/propertysearch/ 5/10/2016 Mission: Rick Scott To pried,pranrote&irrpra%e lite tleallh Govemor ofall people inRaidattmoughirde� Celeste Philip,MD,MPH tdeooUtY&oorrrn1*eftts HEALTH TH InledrnShadeSugeonGeneral Vision:Tobe the Heeltldest Slate in the Nation March 25,2016 Grace Garcia 10204 NE 2 Avenue Miami, FL 33138 RE: Modification to a Single Family Residence-No Bedroom Addition Application Document Number: AP1231470 Centrax Permit Number: 13-SC-1670145 10204 NE 2 Avenue Miami, FL 33138 Lot:4&5 Block: 13 Subdivision: Miami Shores No.1 Dear Applicant, This will acknowledge receipt of a floor plan and site plan on 03/23/2016 for the use of the existing onsite sewage treatment and disposal system located on the above referenced property. This project is for the construction of a driveway approach. No objection letter issued on March 25th, 2016 by Paul Levelt andre This office has reviewed and verified the floor plan and site plan you submitted,for the proposed remodeling addition or modification to your single-family home. Based on the information you provided, the Health Department concludes that the proposed remodeling addition or modification is not adding a bedroom and that it does not appear to cover any part of the existing system or encroach on the required setback or unobstructed area. No existing system inspection or evaluation and assessment, or modification, replacement, or upgrade authorization is required. Because an inspection or evaluation of the existing septic system was not conducted,the Department cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use. You may request a voluntary inspection and assessment of your system from a licensed septic tank contractor or plumber, or a person certified under section 381.0101, Florida Statutes. If you have any questions, please call our office at(305)623-3500. Si rely, �•• ••; +•. Paul eveltAn e, P.E. •' Profees nal Engineer Supervisor I . .. . . . . ... . •• ••• •+ •• Depa t f Health in Dade County • ••• • ••• • • • • • • • • • • • • •• • • • • • • •• • • • •• • • •• • • • Worts Dopwbnont of 0Ada6attlr�ov in Dade County• •,Florida •.• + • • • •++ • • TWITTER:HealthyFLA PHONE: (305)623-3500 • • + • • • • FACEBOOK:FLDepartmentofHealth • + • + • • + • • • YOUTUBE:fldoh • •• •• • • • •• •• ••• • • • ••• • • OR 193 Miami Shores Village CFN 2016RO223331 Building Department OR BK 30039 Pg 3003 (Pgs) 10050 N.E.2nd Avenue RECORDED 1_141115/2016 13=?1 till Miami Shores, Florida 33138 HARVEY R.UVINP CLERK OF COURT OR Tel: (305) 795.2204 IIIAMI-DARE COUNTY. FLORIDA Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) 1�ia t-K Ic r i-� hereinafter referred to as the owner of the following described property (address): N' C- Z4 J 4v'(z Legal Description: Lot Block Subdivision Folio # i I - I ac°(r ®n J �-17 2-0 Requests permission to install (describe work): C"a 4w4.�4�/t' 17 Within the public right of 'ay 6f (address) t'jc-! 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 Owners 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. 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). Signature Z Z= Owner or Agnt State of Florida County of Miami Dade The fore oing instrWnent was acknowledged before me this day of 20 by M-W-Y= VERDra (2zy who is personally known to me or who has produced t't.-D!?:A't a- G4& 0 identification. NOTARY PU Sign. Print: SEAL: N , " V. of F�I.nd .01% Notary Public State of Florida Sindia Alvarez My Commission FF 156750 Expires 09/0312018 ".j