REV-18-3186�'�\ RECEIVED
Miami Shores Village
f � Ig p _� Building Department OCT 181016
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 l ,f
Tel: 305 795-2204 Fax: 305 756-8972
1 ) 1 )
INSPECTION LINE PHONE NUMBER: (305) 762-4949 lS1
BUILDING
PERMIT APPLICATION
❑ BUILDING ❑ ELECTRIC ❑ ROOFING
PLUMBING MMECHANICALPUBLIC WORKS
JOB ADDRESS:
F(�Bt C� ,20 l-4
Master Permit No. T v l� 900
/^
Sub Permit No. Q'C `� V
REVISION EXTENSION ❑RENEWAL
❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores
County: Miami Dade Zip: L I n6
Folio/Parcel#: {`:WE-\)12() Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction �T,y,�pe: i—� Flood Zone: BFE: G FFE:Q/�%�
OWNER: Name (Fee Simple Titleholder): Pavia (r 411 Az Phone#:s�l�� ' l JR ' !l_ I
Address:
City: 15)COYrrs, State:
Tenant/Lessee Name:
Email
Phone#:
CONTRACTOR: Company Namee!- Yfl1— _ 1C�7��� -- 1"T1. Phone#:
--pi
Address: 1 I No ' 7CO�h ST _
City: 5-y)If_SS State: _ L Zip: 2 61 o
Qualifier Name:
State Certification or Registration #: 045-z� Certificate of Competency #: O(D Y 11(OU. )
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
2 t 1 f
E
Value of Work for this Permit: $ ��. Square/Linear Footage of Work: 32. �GY
Type of Work: Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $ CO/CC $
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ (.�)
(Revised02/24/2014)
Bonding Conpany's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
Zip
City State Zi
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 � Signatu
OWNER or AGENT
The foregoing instrument was acknowledged before me this T�regoing instrument was acknowledged before me this
iy day of CX�r �'IY1 i 120 , by 13'-'day of r 20 by
,who is personally known to 1 r whoiCpeyk
r�sonallnowo
me or who has produced -T7 LDL. as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOT4PU NOTARY BLIC:
Sign: Sign:
Print1180 Print: Y Y�
Seal: Seal: Eoz
Notary P,� State ofFlorida
Not"* ry PuState of Florida Gruel Brito
c� GriBel grjto ay Commiaabn ciG 129924
Cornmiasion GG 128924 Expires 07/2712021
******* ****:lia/d�c3,�
APPROVED BY _ Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
156.00'`
IP D ° `
ID ASPHALT
A�--•I x DRIVEWAYPOOL
1. UTILITY t�
�• CO E
.,.
CONCR�TE
DECK
i 'ivt h'IJU'�
FNO 314" IP
CBS NO ID
INVOICE NO.:11-3551
PROPERTY ADDRES:
1285 NE 102 STREET, MIAMI
33138
' CBs LEGAL DESCRIPTION
�+ .. Willa LOTS 4 5 5, BLOCK 186 OF •E
^" SECTION MIAMI SHORES" AC
' TO THE PLAT THEREOF, AS I
33 Q ti _ ALL IN PLAT BOOK 42, PAGE 25 C
W
PUBLIC RECORDS OF MIAMI
a+ i COUNTY, FLORIDA.
ox ONE STORY '► * 1
X STRUCTUR LCfi 4 �, : ~ ; CERTIFICATIONS:
�•
a #1285 B , W� 11 y
t Loc>fc se MAURICE LEBOWITZ
t- g i' FLOOD ZONE DATA:
COMMUNITY NUMBER: 1206:
PANEL AND SUFFIX: 030
DATE OF FIRM: 9/11109
----___ BASE FLOOD ELEVATION: AE
LOT Q:b
TILE x TILE Miami ShcrM Village LOWEST FLOOR E4EVATION
BLOCK 186 APPROVED�1 O�
lu►kh 5 ' Y DAtE
6Ck PLANTER ' ZONING DEPT � 16 /��
•• ••• i BLDG DEP F � S�vi"l Alum
• • • • PLANTER FND 1/2" IP �- -- �- .
• • • i : i : : • : • • S Uc3 =CT j p CCkIPU_F`� �n101
• • • • • • • r ER
ALO/S 4.75' VU}; , 1 p!►
ST N. CI�tYYRI,LS / !D REGULATIONS �`�j,~ �i/ X �%a `t��lGh.lri_��'JC_..
3 •a 76.E-- J .5 X � G� l T�C� e
Btl�CK }�7
CORNER
�e �` SE CORNER OF
a �� XI�,Z,J.I•y?-Y'v�-x7S1 f'.�� -fl TR 186-C
• • • • . .•,� • M �C ��- \ �G j (NOT A PART OF
M �L �ii:Y� • • • . l 1(•1 . • + �'n A� Yi 'V l ! I1 k 4 ' r THIS PLAT)
I• •• •• • •• •• FN01/2"IP
6A-T�S.
r
-` FND 3/4' IP
CBS NO ID
VALL
INVOICE NO.: '11-35514
PROPERTY k.DDRES:
1285 NE 102 STREET, MIAMI SHORES,
33138
�iL Cou.
ux TO
Office: (954) 7 -4� -
Fax: (954) 777-2707 j
5950 W. Oakland of, Blvd. - Suite 309 - Lauderh8l, FL 33313
-'CBS
WALL LEGAL DESCRIPTION:
LL
LOTS 4 & 5, BLOCK 186 OF "BAY BREEZ MAP OF BOUNDARY SURVEY
- x SECTION MIAMI SHORES" ACCORDING
TO THE PLAT THEREOF, AS RECORDE
IN PLAT BOOK 42, PAGE 25 OF THE
o 9 =iL PUBLIC RECORDS OF MIAMI-DARE
COUNTY, FLORIDA
LO CO t a
`' " CERTIFICATIONS:
CV V og
Q MAURICE LEBOWITZ SCALE. 1"=20'
0
Z FLOOD ZONE DATA: FERAL NOTE&;
COMMUNITY NUMBER 120652 (1) THIS SURVEY IS BASED UPON RECORDED INFORMATION AS PROVIDED BY
PANEL AND SUFFIX 0306 L � NO SPECIFIC SEARCH OF THE PUBLIC RECORD HAS BEEN MADE BY
DA' E OF FIRft911 (Z) U WROVEMEM HAVE NOT BEEN LOCATED EXCEPT AS
BASE FLOOR ELEVATION: AE 8 �t.Y SFIEIWN,
LOWEST FLOOR EL1EVATION:10.92 ( �1T �gTh'M ARE UPONNATIONAL GEODETIC VE 2TICAL DATUM 1929
(4) IN .SOW OAS GRAPMC REPRESENTATIONS HAVE BEEN MXAGGERATED
FOR CIEW4M *Lj1STRATION. MEASURED RELATIONSHIP SHALL HAVE
P OVE P,SCALEPOSITIONS
(S) ALL OVAENSIM SHOWN ARE FIELD MEASURED AND CORRESPOND TO
RECORD W-O�TION UNLESSSPECIFICALLY NOTED OTHE l;r MSE-
(6) UNLESS OT SE SPECrW. THIS SURVEY IS NOT TO BE USED FOR
CONSTRI! -noN PURPOSE
(7) WE�1L-TIFIED FEATURES IN THIS SURVEY AND MAP HAVE BEEN
ST .BRED TO AN EM IMATIE6 HORIZONTAL POSITIONAL ACCURACY OF 0.10
(8) NOTE 7 HERERY CERTIFY' IS UNDERSTOOD TO BE AN EXPRESSION OF
_ P RVEYOR tM OPRdION BY THE SURVEYOR AND ED ON THE
— % A GUARANTEE OR WARRANTY MAPPERS KNOWLEDGE.AND �� AND IT 19N" ..
/ (9) ATTENTION IS •
BLOCK CORNER REDUCED OR TO THE FACT l THIS SURVEY Y HAVE QM :.
TAKEN D O ENLARGED.IN SIZE DUE TO SHOUEA BE
SE CORNER OF RATION WHEN aWA MNCtS�,Mp ppPfA
TR 186-C ......
(NOT A PART OF I HEREBY CERTIFY *Goo:*
b THIS PLAT) THAT THIS SOUNDAI" PARTIAL TOPOGRAPti � •
R FIB 1/2� IP MEETS THE MINIMUM TECHNICAL S71�1 )tSDS FCA Uft(EYS, A%
SET'FOIM BY THE FLORIDA BOARD�pF WRVEYOft 18YD
NO 10 MAPP6� ((� gAPT'ER 61G17-E3 OF TI�F�. • • • • � •
CODE, PiJRSUgNT TO SECTION 472t>'�T, F'hOR! A 8,IISTRATiVE .:.
DATE OF ORIGINAL FIELD WORK; 4/1111,1. • � ; � .. � • • • •
GINO FUFMMO, PROFESSIONAL SURVEYOR & MAPPER
FLORIDA REGWRATION NO 5044
MOT VALID UCEN TSI
FLORIDANATURE AND L RAISiM SEAL OF THE
DA LIED SURVEYOR AND MAPPER SHOWN ABOVE)