REV-16-408Miami 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 20 (L -it
BUILDING Master Permit No. Pi�II— 29
Sub Permit NoTEE\I (.0 — 409
( 'BUILDING ❑ ELECTRIC ❑ ROOFING lEfREVISION ❑ EXTENSION ❑RENEWAL
PERMIT APPLICATION
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
5 �LQCONTRRACTOR
/
JOB ADDRESS: I Q I I pE_.�
City: Miami Shores County: . Miami Dade
DRAWINGS
zip: '3 3 i 3.
Folio/Parcel#: / / d 2.- / i - c 0 S - o' / v Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: C 4 Flood Zone:
BFE: FFE:
OWNER: Name (Fee Simple Titleholder): l pf C p J 4)1-0)1 Phone#: 3 Z o ` 3 I 33
'I
Address: 26 1 /v �• � tA� �rc-e---12-- ,5pI1
City: l G1. lM it 5 ' l B (/ e 5 State: 7E1 �p C/\ I' GC Gi Zip: ?
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address: o2 -\/L %.
City: I N-\--1 State:
(4-. S • la,�,
Qualifier Name:
State Certification or Registration #: �
�G ` SG? 13
Phone#: 30s 9C .3.4"1
Phone#:
Zip: "ak "-S
3oS c>t TCS -31--1
Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ Z 2, S 4,0 Square/Linear Footage of Work: _S ----c7 2_ 5
Type of Work: ❑ Addition ❑ Alteration ❑ New
❑ Repair/Replace ❑ Demolition
Description of Work: 4' /17Y4 / e G vL 4,6/1 4/0 fi0 „Pc) A/ 7-G/74-4-74-- / , 4' ✓ /g'
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ 6 . 03 CCF $ 1 3 ' & co/cc $
Scanning Fee $ (G ,00 �Radon Fee $ i t> , (3 DBPR $ I 13 Notary$ l
Technology Fee $ 9 a "f O Training/Education Fee $ . 60 Double Fee $ j'
Structural Reviews $ tj 4:6 a70, Bond $ �� Tfiy mp, •r--
TOTAL FEE NOW DUE $ 9'Q. gej
(Revised02/24/2014)
qo 6(0
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
OWNER or AGENT
The/foregoing instrument was acknowledged before me this
ir/ day of��ek.F4U(n'Y l� , 20 l b , by
\/ ')\-/ /i c c2 --t-Tc/41/49 c'( , who is personally known to
me or who has producd fL - /)G, as
identification and who did take an oath.
NOTARY PUBLI
Sign:
Print:
Seal:
1104
044 (C v7 C
************
CONTRACTOR
The foregoing instrument /�wy was acknowledged before me this
1/Pi/ day of h& ? Y"(/O-✓y , 20 I �, , by
C /C061 ft, &Wilde Z, who is personally known to
me or who has produced
DL
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
NAOMI VASCONCELOS Seal:
In),")MY COMMISSION #FF088554 r
',„..•, EXPIRES February 2, 2018
APPROVED BY
(Revised02/24/2014)
Plans Examiner
as
.4'4!-":4> = NAOMI VASCONCELOS
`'i MY COMMISSION #FF088554
-A EXPIRES February 2, 2018
********
Zoning
Structural Review Clerk
•
CC1
CERTIFICATE OF LIABILITY INM; DIY"
d/..l/GU.LO
THIS CERTIFICATE 18 ISSUEO AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the polity(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER
Torres Insurance Agency Inc.
6135 NW 167 STREET () 325
11 Shore Drive Bast
Miami Lakes FL 33015
ts� `4CT Torres Insurance Agency
jy1, Rxa (305)512-5800I PaX Nut 005)414 -seer
TAW
L;
DRAWING AFFORDING °OVERAGE
NUCA
IR6u86RALint '1 Ins Co of Hannover SE
ulBNni
INSURED
Clemente Gonzaleacba:Clemdel Construction Corp
11 Shore Drive Feet
Miami FL 33133
rnveoaneo}°
IMsueeRa:
UAeiirTY
CIDAMERCAL GENERAL.
mmmeks.
ICOBC002$35-02
INSURER D:
3/28/2217
INSURER E;.
6 1,000,000
DAMAGE70 RENTETJ
PRE MISE6IEasCraperm)
$ 100, 000
THIS
INDICATED.
CERTIFICATE
EXCLUSIONS
Ittti
RCVII]IUIY PIUDIDCN;
IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
NOTNATHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDEA BY THE POLICIES DESC801E0 HEREIN IS SUBJECT TO ALL THE TERMS,
AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
TYPE of BNSi 84*0e
AGA
ENG
SWOT
00
POLICY woes
1 *86/vlYn
AMA
CMrdtAOIYYY00v)
ulBNni
A
GENERAL
X
UAeiirTY
CIDAMERCAL GENERAL.
GA$ILUY
n OCCUR
PUL Claim
ICOBC002$35-02
3/28/2016
3/28/2217
EACH OCCURRENCE
6 1,000,000
DAMAGE70 RENTETJ
PRE MISE6IEasCraperm)
$ 100, 000
' CIA2I$•MAOE
M7:O Exp pvvmaPmew.
s 5,000
X
Art
1,000 8D
PERSONAL & ATN INJURY
g 1,000,000
DAI'
mamma. AGGREGATE
4 2,000,000
4 2,000,000
AGGREGATELMT APPLIES P�
PDL�Yn ; n,..,
PRODUCTS - COMP/OP A0G
AUTOMOBILE
—
LIABILITY
ANY AUTO
ALL omen
AUTOS
AUTO$
—
&cam AF,O
AUTO
AU�
EDD SOMME LIMEY
BOORT INJURY (Per peason)
8
BODILY EMORY(Per oorJdm,13
PROPERTY DAMAGE
s
8
UMBRELLA LAB
EXCESS LAB
_ OCCUR
CLAws-MADE
EACH 0 1mE*CE
8
AGGREGATE
$
020 1 I RETENTION $
8
WORKERS COMPENSATION
AND EMPLOYERS' UA6SJTY TM
ANY PROPRIETOMPARTNERIEXECUTNE
Wm/Eatery InFrJiCLU0EO9
PTIGN OF OPERATIONS b444
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DESCRIPTION OF OPERATIONS /LOCATIONS Aton YE$ ``Adaob ACORD /81, Additional Rem.Hle eelmdldo, Nmae space is roqulnd)
General Contractor- Contractor Licenee8C00047393.
Blanket Additional Insured (from 002010) owners, lessees or contractors.
CANCELLATION
City of Miami Shores
Building and Zoning Department
10050 NE 2nd Aveneue
Miami Shores, FL
ACORD 25 (2010108)
INS02Scame et
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 0E CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTH0A2E0 REPRESENTATIVE
01088-2010 ACORD CORPORATION. All rights reserved.
The ACORD mune and logo ore registered narks of ACORD
•
oae
'
L's\r
DAVID A. DACQUISTO, AICP
DEVELOPMENT ORDER
File Number:
Property Address:
Property Owner:
Address:
Applicant:
Address:
b
10050 N.E. SECOND AVE.
MIAMI 8I IORES. FLORIDA 138 2382
T lel,hc,n': (305) 795-2207
Fa. (305) 75972
PZ -01-16-2016003
186 NE 106th Street
CK Property Solutions LLC
209 NE 95 Street. Suite 7, Miami Shores, FL 33138
Viju Koottungal
209 NE 95 Street. Suite 7, Miami Shores, FL 33138
Whereas, the applicant Viju Koottungal, with the consent of CK Property Solutions LLC
(property owner), has filed an application for site plan review before the Planning Board
on the above property. The applicant sought approval as follows: Pursuant to Articles IV,
V and VI of Appendix A Zoning, Sec. 400 Schedule of Regulations and Sec. 600. Site
plan review and approval required. Garage conversion..
Whereas, a public hearing was held on January 28, 2016 and the Board, after having
considered the application and after hearing testimony and reviewing the evidence
entered. finds:
1. The application was made in a manner consistent with the requirements of
the Land Development Code of Miami Shores Village.
2. The conditions on the property and the representations made at the hearing
merit consideration and are consistent with the requirements of the Land
Development Code.
The Board requires that all further development of the property shall be performed in a
manner consistent with the site plan, drawings, and the conditions agreed upon at the
hearing:
1) Approval is granted as shown on the plans submitted and made a
part of this approval to convert an existing 10 ft. by 20 ft., 200 sf attached
garage at the front of the residence to a new kitchen.
2) The applicant to provide 2 legal parking spaces on the plot subject to approval
by the planning director before issuance of any building permits for this
project.
Page 1 of
3) Applicant to obtain all required building permits before beginning work.
4) Applicant to obtain all required permits and approvals from the Miami -Dade
Department of Regulatory and Economic Resources, Environmental Plan
Review Division (DRER, EPRD) and the Miami -Dade Department of Health
(DOH/HRS) as required.
5) Applicant to meet all applicable code provisions at the time of permitting.
6) Applicant to complete a covenant in the form of a `Declaration of Use"
assuring the property is used only for a single family purpose, record the
covenant with the Miami -Dade County Recorder and provide the planning
director with a copy of therecorded document prior to the final inspection by
the Building Official.
7) This zoning permit will lapse and become invalid unless the work for which it
was approved is started within one (1) year of the signing of the development
order by the board chair, or if the work authorized by it is suspended or
abandoned for a period of at least one (1) year.
Additionally, the applicant must, satisfy all applicable Miami Shores Village Codes,
Miami -Dade County Codes, the applicable building and life safety codes required for
development, and provide a copy of the development order to the Building Dept.
The application with conditions was passed and adopted this 28th day of January, 2016 by
the Planning and Zoning Board as follows:
Mr. Abramitis No
Mr. Busta Yes
Mr. Reese Yes
Mr. Diaz Yes
Chairman Fernandez Yes
i`
Date Ric)iafd M. Fernandez/
Chairman. Planning'13oard
Page 2 of 2
DAVID A. DACQUISTO, AICP
I l aini jAopei litti a// qe
,)
DEVELOPMENT ORDER
File Number:
Property Address:
Property Owner:
Address:
Applicant:
Address:
100 50 N E SECOND AVE
MIAMI SI !ORES. FLORIDA 33138 2382
Telephone: (305) 795-2207
Fat (305) 756-8972
PZ -01-16-2016003
186 NE 106th Street
CK Property Solutions LLC
209 NE 95 Street. Suite 7, Miami Shores, FL 33138
Viju Koottungal
209 NE 95 Street, Suite 7, Miami Shores, FL 33138
Whereas, the applicant Viju Koottungal, with the consent of CK Property Solutions LLC
(property owner), has filed an application for site plan review before the Planning Board
on the above property. The applicant sought approval as follows: Pursuant to Articles IV,
V and VI of Appendix A Zoning, Sec. 400 Schedule of Regulations and Sec. 600. Site
plan review and approval required. Garage conversion..
Whereas, a public hearing was held on January 28, 2016 and the Board, after having
considered the application and after hearing testimony and reviewing the evidence
entered. finds:
I. The application was made in a manner consistent with the requirements of
the Land Development Code of Miami Shores Village.
2. The conditions on the property and the representations made at the hearing
merit consideration and are consistent with the requirements of the Land
Development Code.
The Board requires that all further development of the property shall be performed in a
manner consistent with the site plan, drawings, and the conditions agreed upon at the
hearing:
I) Approval is granted as shown on the plans submitted and made a
part of this approval to convert an existing 10 ft. by 20 ft., 200 sf attached
garage at the front of the residence to a new kitchen.
2) The applicant to provide 2 legal parking spaces on the plot subject to approval
by the planning director before issuance of any building permits for this
project.
Page 1 of 2
3) Applicant to obtain all required building permits before beginning work.
4) Applicant to obtain all required permits and approvals from the Miami -Dade
Department of Regulatory and Economic Resources, Environmental Plan
Review Division (DRER, EPRD) and the Miami -Dade Department of Health
(DOH/HRS) as required.
5) Applicant to meet all applicable code provisions at the time of permitting.
6) Applicant to complete a covenant in the form of a "Declaration of Use"
assuring the property is used only for a single family purpose, record the
covenant with the Miami -Dade County Recorder and provide the planning
director with a copy of the recorded document prior to the final inspection by
the Building Official.
7) This zoning permit will lapse and become invalid unless the work for which it
was approved is started within one (1) year of the signing of the development
order by the board chair, or if the work authorized by it is suspended or
abandoned for a period of at least one (1) year.
Additionally, the applicant must, satisfy all applicable Miami Shores Village Codes,
Miami -Dade County Codes, the applicable building and life safety codes required for
development, and provide a copy of the development order to the Building Dept.
The application with conditions was passed and adopted this 28th day of January, 2016 by
the Planning and Zoning Board as follows:
Mr. Abramitis No
Mr. Busta Yes
Mr. Reese Yes
Mr. Diaz Yes
Chairman Fernandez Yes
Date
Ric,hard M. Fernandez'
Chairman. Planning'Board
Page 2 of
e
1)I: ELur\IE T ORDER
File \limber:
Prolptri _lcltIrc'. :
1'rulit•r'ry 01, iter.
Address.:
Applicant:
1 r\ l C t f��etA ` siee-1
L. h'roperte Solu"ti,o s 1_t.E.
�irpcl � 1" `)5 Street. Shite '. Miami Slaore,. t 1. ? i aN
\. t u K.avpiture__ai
'PO \F Sfreo'%. Shite ?. N i:)mi `hares. 1'1. is 1. g
Whereas. the apaplicaut 't shti K.o_ottungal. uint the craisesat til C%: hrtvp)e t. Solutions 1.1.E
prttpeutt OA%net 1. ed. ;iii appliie:ltit'n for site pian rel te'ee befiu'e tilt Planning Board
on th): ;l1' \ prop\,'r1'.. l he daprttieutn ti-.-tag1it [1f,1"ro a) ;is: llltlet ti: 110T>,itcuis It) .-lrtit:lt,
and V1 or _'tppen.d \ A. `.onitA`'.. ,ec. 400 Schedule eit' E\qrttl:ition ; am} Sty:. (t011.
late roe istt :111ct ;.ip 11,1-0. BY reglureli. 4.iaTage conversion..••••
• •
• ••
••••
• • •
it here';is. ,i public: tie:8rag2 held On SatiAiial',. 2R. `f91(c :aid the (.3oar+.1?!t1ter l7;ititi,'•
consielt'tt'r.i the a atTlit:01iiloit :8iic? art\ r hearing tcstanit►i)\ and rel iettttli?•t1R�i'e •
itiC1� ••
• •
entered.itYicls: •••• ••••
• • • •
•••• ••••
'Llan. application et: -.1s. made in a 819et8tnel t'011jigeilt 4aifh the i4'rtinmentrof •
•
nn! land D,e'el pment C't $e (bs Shore, l'i11i . •• •• • ••
E lAc'. conJittons c.tu the propert ret and the representations 811:it1•.'•litMe heartil,t
merit consideration and are eiltasiSICIM With, the ret.ptiil'einevt. Illt: 1:r,ni••
l et. e1Optl)e nt
• • •
•• •
•
••
•
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•
•
• •
•••• • •
• • •
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flet: Board ).equir.s ilrtt ;0! titi,ile'r of` ate propert..) sh:►1! he performed in :1
111;itlme?' t'c:,Pltiistetl: t'.tth the •.itc' plan. dray)ings. and the condtaif''ns agreed upon :It 111c
Eae:u�►il��.:
A.plpl.rotbil is granted :ts shOvi tl On the plans salt\aalitte d and made
p:trt .at this :tptpiere.I 1te COnt. eft an e:s.iStirtg 10 1t. he' 20 11_. 2111) si Attarht:ti
g:ara:,:e air, the front t\, the residence tai a tic't\ kitchen.
_' i [hr.' ,iri tia:;1111 to, provide 2 le itl parking spaces on the plo1 stihjt'e1 io vpl-m ;t1
the pl:ti8nt11c: ta`ireecor 1-Ncltlrt' :4:st8:i8li:t' of any building permits for 1171.
proicez
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.7c _tin ar; 5k.‘fOrC
4.2 alioa orproN:IG!. thc
of"1in-
LtthL flR rtic.'S-011112‘.',. 1.13\
1.1R1 R. I.PRI)), thc i)cpartivh:T.! t);
prt :11
pnru.-..-.riz ..'orlirkqe co‘;:11.3)1"4 ill ale 101-11) of d -1)%.•clor,.ition 01.
proTN.i-t) uNed ft:or sin..!ik.• unikptirpoc. !-,-cord t!ic
\ 111V 1}..}111i-1).10‘: Rccorder nd pro\ idt:2 p1annin2z2
diro.21or ‘2, ith of :ht.' !-cf,:orocki tiocumen: prior h.., in,,,po...tion
111.N. 2,krun,:.1 \‘iit as-Ri ht.Norne ;in the v.ork for ',2,1iit2(.1
k‘a:, onc ol thL till: 11C \ ciopm(!':,
o:. h
ottthorizo.1
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.1pr:icaiIk Nli;a2,1C
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