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DS-14-2535Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 I Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION J_8NOV014 BY— _ FBC 201(0 Master Permit No. -DS —1 t-/-DLrj:j Sub Permit No. '' BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL [—]PLUMBING ❑ MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP �j' CONTRACTOR DRAWINGS JOB ADDRESS: `��4 / ,! 57— City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Typee.:) Flood Zone: BFE: �7 FFE: OWNER: Name (Fee Simple Titleholder): I��GG�✓Y �L%/� �Ct�E:f Phone#: City Tenant/Lessee Name: Email CONTRACTOR: Company Name: v Address: !� W �� 1�< 71�> rgq Z�<)44) City: State:: G 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: $ ����� Square/Linear Footage of Work: Type of Work: ❑ Add' , ❑ Alteration &New ❑ Repair/Replace ❑ Demolition Description of Work: t%�/r/�Gt>i/` Specify color of color thru tile: n Submittal Fee $ CP ,.Permit Fee $ (DO CCF $ %� ' U� CO/CC $ Scanning Fee $ -C i v Radon Fee $ DB��PRR ��$ q Notary $ Technology Fee $ ('0 Training/Education Fee $ "V Double Fee $ Xf Structural Reviews $ Bond $ - G;M a TOTAL FEE NOW DUE $ (Revised02/24/2014) l—� •1 G Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) _ Mortgage Lender's Address City State Zip 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 reinsoection fee will be charged. Signature OWNER or AGENT The foregoing instrument was acknowledged before me this / 1/ day of y0✓Q"�5�� 20 /4-/ by Ale i Ste/ who is personally known to me or who has produced 4cL L 3'LD- / 0 ° nd who did take an oath. NOTARY PU Signature ONTRACTOR The foregoing instrument was acknowledged before me this l C/ day of d.P.k �-4"r 20 ,-/ by f�iu�� rjC Cawho is personally known to me or who has produced �a^Y14(i�/as identification and who did take an oath. NOTARY PU Sign: Sign: c Print: Print: Seal: ���. Seal: �c 'r P1, Notary Pu die State of Florida y ? Adrian Noya Ott blic State of Florida My :ommission EE077614 Noya 'f• ' `c F, es 03/24/2015 ission EE077814***3i1�a0114r*****APPROVED BY 4 f Plans Examiner ` Zoning * Structural Review (Revised02/24/2014) Clerk Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 5865044 BUSINESS NAME/LOCATION SOMI TECH CONCRETE & PAVING ENGINEERING INC 890 SW 128 AVE MIAMI, FL 33184 OWNER SOMI TECH CONCRETE & PAVING Worker(s) RECEIPT NO. EXPIRES RENEWAL SEPTEMBER 30, 2015 6116925 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS 196 SPECIALTY ENGINEERING E0601099CONTRACT PAYMENT RECEIVED BY TAX COLLECTOR 74.60 08/19/2014 0228-14-008252 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit or a certification of the holders qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles- Miami -Dade Code Sec 68-276. MIAM For more information, visit www.mismidade govAncollector Municipal Contractor's Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY CC NO: E0601099 BUSINESS NAME/LOCATION SOMI TECH CONCRETE & PAVING ENGINEERING INC 890 SW 128 AVE MIAMI, FL 33184 MC RECEIPT NO. EXPIRES NEW BUSINESS SEPTEMBER 30, 2015 7453489 Must be displayed at place of business Pursuant to County Code Sec 10-24 OWNER TYPE OF BUSINESS SOMI TECH CONCRETE & PAVING SPECIALTY ENGINEERING CONTRACTOR Restricted to City of Miami Shores MIA For more information, visit MMM miamidade gov/taxcollector PAYMENT RECEIVED BY TAX COLLECTOR 37.50 10/27/2014 02 24-15-000302 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore. You may be personally liable for the worker compensation injuries of any person allowed to work under this permit Please check with your insurance carver since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Owner Print Name: p Signature: S State of Florida ) County of Mia '-Dade ) Sworn to and sikbkribed befo day of AM v .4�` , , '® of Notary Public State of Florida Adfien Noya My Commission 077614 as 03/24/2015 State of Florida ) ,County of Miami -Dade ) ►Sworn to and subscribed before me this day of ✓pals-,r , 20 / y . of Notary Public to of Florida Adrian Noya My Commission EE077614 Parcel Owner Report Parcel Number: 1132060171530 526 NE 97 Street Miami Shores FL 33138- Tax ID:1132060171530 Owner Information JAMES SAGE Phone: ROBERT & ALLISON LUDICKE Phone: (305)754-2903 Related Permits Driveways/Sidewalks/Slabs Imported Permit Imported Permit Imported Permit Imported Permit Imported Permit Imported Permit Imported Permit Paint Plumbing - Residential Public Works Re -Occupancy Residential Construction Roof Windows/Shutters Current Owner: No Current Owner: Yes Permit Number Application Date Expiration Date Status DS-11-14-2535 11/18/2014 06/14/2015 EXPIRED -- R02004-216 10/01/2004 01/01/2999 CLOSED BP2004-602 05/05/2004 01/01/2999 CLOSED BP2002-323 02/14/2002 01/01/2999 CLOSED MC2004-202 11/15/2004 01/01/2999 CLOSED BP2002-431 02/28/2002 01/01/2999 CLOSED BP2003-52 01/13/2003 01/01/2999 CLOSED EL2004-299 10/25/2004 01/01/2999 CLOSED PT-11-06-2787 11/14/2006 01/01/2999 CLOSED PL-9-14-2018 09/16/2014 01/01/2999 CLOSED PW-11-14-2454 11/07/2014 01/01/2999 CLOSED REOC-9-14-1905 09/02/2014 01/01/2999 CLOSED RC-10-14-2242 10/14/2014 12/08/2015 APPLIED RF-12-08-2108 12/05/2008 01/01/2999 CLOSED WS-12-14-2612 12/01/2014 11/17/2015 APPROVED Related Code Cases Case Number Case Status Case Date Compliance Date Ordinance Violation CASE-9-08-4805 Case Closed 09/10/2008 1/16/2009 Lot Clearing CASE-9-08-4899 Case Closed 09/26/2008 10/6/2008 Friday, July 24, 2015 Page 1 of 1 '= '-z 'Z�) . Parcel Owner Report Parcel Number: 1131010220240 125100 Terrace Miami Shores FL Tax ID:1131010220240 Owner Information ALVARETTA PITTS Phone: Related Permits Decks/Gazebos/Trellises Fence/Wall Imported Permit Imported Permit Paint IT' (� �-? r Current Owner: Yes Permit Number Application Date Expiration Date Status DGT-10-11-1833 10/05/2011 01/01/2999 CLOSED FW-1-08-20 01/07/2008 01/01/2999 CLOSED EL2005-393 11/09/2005 01/01/2999 CLOSED BP2002-1496 08/27/2002 01/01/2999 CLOSED PT-5-08-854 05/09/2008 01/01/2999 CLOSED <D� �r'1 Friday, July 24, 2015 Page 1 of 1 ;w .ow -9 2N 1�_ M r- J 3 w z J mz 6 O a3) BOUNDARY SURVEY ti •.5SIDEWALK 50 __ cM� •� ' _ x 8 35 ! 250.00' REM LJ I � U_ 1 O 01-1 >< O BRICK PORCH'AaA`, a x O Lq 4G. 10' O m 22.70' 5 "M -23.4G' t7C' TWO-STORY RESIDENCE $ ❑ NO.52G N ❑ / N FINISH FLOOR ELEVATION = 1 1.53 .;. U❑ A/C C] 22.70' 7R_97 - Ln lD x B A7' Ln ,(i O 34. 10' to N 6 _ I 27.. 5EPTIC TANK IL a I x S ; : LOCATION PROVIDED c o p ;'GONG BY OWNER v PAD 2.00, LOT-8 14.00' �n nnl LOT-7 LOT-G x—Y1-Y Florida Health Mi Lti=C7 O.S.T.D.S, ,, a�o� % I \ Nell P ASPHALT \ GGv I Application No.: # DD °'- 1 50.00R&M M 0 1 51 ALLEY m LOCATION MAP NOT TO SCALE 1` rJt� b4 �E E. STREETNe'97TN ST Shores Village l I l Wijl-I ALL FEDERAL AND REGULATIONS Miami APPROVED PT Z6-NING DE0 NEbG DEPT SU[3JFCT TO COMPLIANCE S 1 AFE AND COUNTY ! cISSOOAT6. /VC. LB NO. 7633 PROFESSIONAL SURVEYORS AND MAPPERS PO.BOX 127GOI HIALEAH, FLORIDA 33012 PHONE: (305) 55G-4002 FAX: (305) 55G-4003 W WW. LMSUP VEYI NG.COM EMAIL-LANDMARK5URVEYI NG@HOTMAIL.COM ABBREVIATIONS AND LEGEND: A/C =DENOTE5 AIR CONDITIONING UNIT APPR. =DENOTES APPROXIMATE A5PH. =DENOTES ASPHALT B.C. =DENOTES BLOCK CORNER B.M. =DENOTES BENCH MARK C.5.5. =DENOTES CONCRETE BLOCK STUCCO CONC. =DENOTES CONCRETE C 4 G -DENOTES CURVE 4 GUTTER V.G. -DENOTES VALLEY GUTTER =DENOTES CENTERLINE aDENOTE5 MONUMENT LINE D.M.E. -DENOTES DRAINAGE 4 MAINTENANCE EASEMENT DIA. =DENOTE5 DIAMETER D.H. -DENOTES DRILL HOLE (M) -DENOTE5 MEASURE (R) =DENOTES RECORD LEGAL DESCRIPTION: RAY=DENOTE5RIGHT-OF-WAY U.E. =DENOTES UTILITY EASEMENT w i i I 1 IVF'D i LOTS G, 7, AND 5, OF BLOCK 99, OF "AMENDED P.B. =DENOTES PLAT BOOK PG. -DENOTES PAGE PLAT OF MIAMI SHORES SECTION 4", ACCORDING P.C.P. -DENOTES PERMANENT CONTROL TT11 Nu' g ZO14 I TO THE PLAT THEREOF, AS RECORDED IN PLAT POINT P.O.B. -DENOTES PPOINT OF BEGINNING .. BOOK 15, AT PAGE 14, OF THE PUBLIC RECORDS TYP. =DENOTES TYPICAL -ii - DENOTES WOOD FENCE OF MIAMI-DADE COUNTY, FLORIDA. —%— -DENOTES CHAIN LINK FENCE � =DENOTES IRON FENCE `---'---- -` ---- - PROPERTY ADDRESS: O -DENOTES FOUND IRON PIPE (NO ID.) Q -DENOTES FOUND NAIL AND DISC 01 FOLIO No. 1 1-320G-0 17-1530 a 52G N.E. 97th STREET -DENOTES ASPHALT PAVEMENT MIAMI SHORES, FL 33135 ® =DENOTES BRICK - `' Yr U CERTIFIED TO: ;- -DENOTES CONCRETE PAD - ROBERT LUDICKE AND ALLISON LUDICKE • • • • • • • - LANDMARK BANK, N.A., ISAOA/ATIMA • • • • • m ...... - FIRST AMERICAN TITLE INSURANCE CO. • ALL BARING5 AND D15TANCE15� LL In • ,S�HOWN * * � t�REON ARE REL!ORD AND IVt`Yi W, -GRAY ROBINSON, P.A. ❑ r' • • UNLE35 OTH @RWI5E NOTED. • GENERAL NOTES: ••• • ••••• Ln m LEGAL DESCRIPTION PROVIDED BY OTHERS. • • • :FLOOD lLL�v% • • •� • EXAMINATION OF THE ABSTRACT OF THE TITLE WILL HAVE • • • • • ELEVATION: • NM 0 0. TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, • AFFECT THISPROPERTY. • • • • J THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR • EASEMENT OR OTHER RECORDED COMy1UNTPY. `20G5? • ENCUMBERANCES NOT SHOWN ON THE PLAT. • • • PANEi: • • • • 000 • 30G' THE WRITTEN CONSENT OF LANDMARK SURVEYING E ASSOCIATES, INC. UNDERGROUND PORTIONS OF FOOTING, FOUNDATIONS OR OTHER IMPROVEMENTS WERE NOT LOCATED. W ONLY VISIBLE AND ABOVE GROUND ENCROACHMENTS LOCATED. DATE OF FIRM: 09- 1 1 -2009 IZU / WALL TIES ARE THE FACE OF THE WALL. I/ PEI NOT NE DETERMINED. FERENCEED SUFFIX: L B APJNGG-9 REPENCE TO LIHIP AS B.R. w Z UNDARY SURVEY MEANS A DRAWING AND/OR GRAPHIC = PRESENTATION OF THE SURVEY WORK PERFORMED IN FIELD DATE 09-04-20I 4 z E FIELD, COULD BE DRAWN AT A SHOWN SCALE AND/OR NOT [jj OP SURVEY O c 0 0 SCALE. U O IDENTIFICATION FOUND ON PROPERTY C09NER5 UNLESS NOTED. OT VALID UNLE55 SEALED WITH THE SIGNINGS SURVEYORS EMBOSSED SAL. BENCH MARK: N-GO3 IMENSIONS SHOWN ARE PLAT AND MEASURED UNLE55 OTHERWI5ED SHOWN. ELEVATIONS IF SHOWN ARE BASED UPON N.G.V.D. 1929 UNLE55 OTHERWISE Q U (RED NOTED. ELPVATION: 8.05 THIS 15 A BOUNDARY SURVEY UNLE55 OTHERWISE NOTED. Q de County THIS BOUNDARY SURVEY HA5 BEEN PREPARED FOR THE EXCLUSIVE USE OF ty THE ENTITIES NAME HEREON. THE CERTIFICATIONS DO NOT EXTEND TO ANY Z DATE DRAWN BY SCALE Dgram UNNAMED PARTIES. 09-04-2014 JP 1'=20' CERTIFICATION: � SURVEYOR'S CERTIFICATION: I HEREBY CEKTIFY THAT THIS TINAL SURVEY' _ - S'o SPj FI 15 A TRUE AND CORRECT REPRESENTAION OF A SURVEY PREPARED UNDER MY _ _ _ _ �� p•Z� CgT'I'0 �•c� �• DIRECTION. THIS COMPLIES WITH THE MINIMUM TECHNICAL STANDARDS, AS SET m REVISION / UPDATE OF SURVEY v FORTH BY THE STATE OF FLORIDA BOARD OF PROFESSIONAL LAND SURVEYORS IN CHAPTER 5J- 17, FLORIDA ADMINISTRATIVE CODE. DATE DESCRIPTION No. 2946 ; 0. . a f.'• STATE OF a WA WA �LpRlp � • • .� �DHgL SIGNED P THE FIRM JOB No. SURNE�� P.S. . tJo. 2946-STATE Of FLORIDA ERNEST01CSEAL — NOT V UT AN AUTHE E CT ONI SIGNATURE ANO AUTHENTICATED ELECT AND/OR THIS MAP I OT ALID WITHOUT THE SIGNATURE AND 7 409-2❑ 7 SEAL: THE ORIGINAL RAISED SAL OF A LICENSE SURVEYOR AND MAPPER.