REV-19-1371�ScV-Ob-19-1311
11
BUILDING
PERMIT APPLICATION
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
BUILDING ❑ ELECTRIC ❑ ROOFING
❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS
JOB ADDRESS: 1W\' J�
RECEIVED
JUN .1 t in
FBC 2011 b
Master Permit No. F(,3 CSS ` % 9 - )-» q
Sub Permit No.fjZ-y I ( � 3 /
VS,REVISION EXTENSION ❑RENEWAL
CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zip: 3 / L I
Folio/Parcel#: ) r 213L 'O / - Oyb Is the Building Historically Designated: Yes NO
Occupancy Type: 5 L Load: Construction Type: QL-V- Flood Zone: NL BFE: FFE:
OWNER: Name (Fee Simple Titleholder): -�h �% wt-T�►� Phone,(3oS) ` O -7 18
Address: W NE /d g-ki _-_-
City: M I ,arv1 I 'S 1,0r`S State: rL 33 r = ( Zip:
Tenant/Lessee Name:
hone#:
Email: "I N S P', L- . J p � 01 YYYN L'
CONTRACTOR: Company Name: `>�� F Phone#:�
Address:
City: State:
Qualifier Name: Phone#:
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Certificate of Competency #: _
Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ ID � C7 � Square/Linear Footage of Work:
Type of Work: ❑ Addition 0 Alteration 11 New E]Repair/Replace ` ❑ Demolition
Description of Work: CI 1(40 9 1t)9 IM,4y -0 nl- t�- 2- (C �Ai'� �N Y''►
(-o)o(z
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $_
Structural Reviews $
(Revised02/24/2014)
Permit Fee $ CCF $ CO/CC $
Radon Fee $ DBPR $ Notary
Training/Education Fee $
Double Fee $
Bond $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
A I
Mortgage Lender's Address
City
Zip
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 b, Qveei ffrrd�o reinspection fee will be charged.
Signature / Sign
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before
me this
day of :5U 20 r / by
who is pe a y n wn to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: _
Seal:
i
APPROVED BY
(Revised02/24/2014)
1111111/Id/lie,
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n
The foregoing instrument was acknowledged before me this
day of , 20 , by
who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
y va
x
G -1y _ Print: '
• p o �+
Ao9 a Seal:
yoae+; •��
i%, •iisl�Wnr�
as
Plans Examiner al S Zoning
Structural Review
Clerk
U
**NOTES:
*FENCE GOOD SIDE OUT
*POSTS ON 6' HT. FENCE
SPACED @ 4'-0" MAX
2X2 ALUM.
FRAME
HORIZONTAL 1X5
ALUMINUM
TUBES WELDED
TO 2X2 ALUM.
FRAME
Cb�i7M
. . ... . . .. . . ...
.. .. . . .. .
. . . .
... . . . .
...
. ....... ....
... .. . .. ..
............
.... . ... . ..
. . ... . ... ..
.... . .. ... ..
. ......... .
.. .. . .......
SELF
CLOSING
FIXED GATE FIXED
------------------- -----------------------------------------
-------------------- -----------------------------------
------------------------------ -----------------
---------------------------------- � - --------------------
----- ----------------f- -------------------
-----------------------------------------------------------
------------------------------- ------ - -------------------
---------------- -------------------
----------------------------------------
------- ----- ---
-J
0.
2X2 ALUM. POSTS
EMBEDDED 2'0" INTO °I I of °I I `~CID
CONCRETE FOOTING
10" DIA. (TYP)
0
Z
vl
SVW=SIDEW4LK, CBS=CONCRETE BLOCK STRUCTURE, CLF=CHAIN LINKFENCE, PL=PROPERTY LINE, DUE=DRAINAGE UTILITY EASEMENT, IP=IRON PIPE,
F=FOUND, A/C=AIR CONDITIONER PAD, P/C=PROPERTY CORNER. D/H=DRILLED HOLE, W1F=WOODEN FENCE, RES=RESIDENCE, CL -CLEAR, RB=REL'AR
00.
UE=UTILITY EASEMENT. CONC=CONCRETE SLAB. RMpRIGHT OF WAY, DE=DRAINAGE EASEMENT, C/L=CENTER LINE, O=DIAMTER, TYP=TYPICAL,
NOT VALID UNLESS EMBOSSED WITH
M=MEASURED, R=RECORDED, ENCR=ENCROACHMENT, COMP=COMPUTER, ASH=ASPHALT, N/D=NAIL & DISC, S=SET, FEE=FINISH FLOOR ELEVATION,
SURVEYOR'S SEAL
O/S=OF FS ET. P/P=POWER POLE,OHP=OVERHEAD POWERLINE,W,4=W4TER METER
WOODFENCE=
V
MASONRYVALL=l I I I ELEVATION BASED ON LOC. #
CONCRETE=Alk .:•.•.•:.t•.:.•:: t:•.••�•:.••� :.•.� •: .
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SURVEYOR'S NOTES' 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATURE
fit=
R.qbm
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:.:.:.;.•i:
UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC
�.:
VERTICAL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL
RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAYBE FOUND IN THE PUBLIC RECORDS
•.••
OF THIS COUNTY. 9)
CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING
INFORMATION. 1 0)EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED
1 '
INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY.
BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB PAGE
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SURVEY OF: 61 N.E.
9
LOCATION SKETCH
SCALE: NTS
N.E. let AVENUE
ABBREVIATIONS: `
SVW=SIDEW4LK, CBS=CONCRETE BLOCK STRUCTURE, CLF=CHAIN LINKFENCE, PL=PROPERTY LINE, DUE=DRAINAGE UTILITY EASEMENT, IP=IRON PIPE,
F=FOUND, A/C=AIR CONDITIONER PAD, P/C=PROPERTY CORNER. D/H=DRILLED HOLE, W1F=WOODEN FENCE, RES=RESIDENCE, CL -CLEAR, RB=REL'AR
UE=UTILITY EASEMENT. CONC=CONCRETE SLAB. RMpRIGHT OF WAY, DE=DRAINAGE EASEMENT, C/L=CENTER LINE, O=DIAMTER, TYP=TYPICAL,
NOT VALID UNLESS EMBOSSED WITH
M=MEASURED, R=RECORDED, ENCR=ENCROACHMENT, COMP=COMPUTER, ASH=ASPHALT, N/D=NAIL & DISC, S=SET, FEE=FINISH FLOOR ELEVATION,
SURVEYOR'S SEAL
O/S=OF FS ET. P/P=POWER POLE,OHP=OVERHEAD POWERLINE,W,4=W4TER METER
WOODFENCE=
V
MASONRYVALL=l I I I ELEVATION BASED ON LOC. #
CONCRETE=Alk .:•.•.•:.t•.:.•:: t:•.••�•:.••� :.•.� •: .
G
W
CBM#
MAINTENANCE& DRAINAGE EASEMENT= M & D.E. • • ELV. TYPE OF SURVEY: BOUNDARY SURVEY
�
SURVEYOR'S NOTES' 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATURE
fit=
AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT
COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5)
UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC
REVISED:
VERTICAL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL
RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAYBE FOUND IN THE PUBLIC RECORDS
OF THIS COUNTY. 9)
CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING
INFORMATION. 1 0)EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED
1 '
INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY.
BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB PAGE
:V::::
SURVEY OF: 61 N.E.
9
LOCATION SKETCH
SCALE: NTS
N.E. let AVENUE
108TH ST., MIAMI SHORES, FLORIDA 33138.
f5`
IF
CERTIFIED TO: JOSEPH FULTON AND RYAN M. SMALDONE, CHRISTOPHER P. KELLEY, P.A.,
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY, PROSPECT MORTGAGE, LLC., ITS
SUCCESSORS AND/OR ASSIGNS, ATIMA.
LEGAL DESCRIPTION: LOT 14 BLOCK 215
OF DUNNINGS MT.AMI SHORES EXTENSION NO. 7 SUBDIVISION-
ACCORDING
UBDIVISION_ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 52 AT PAGE 33
OF THE PUBLIC RECORDS MIAMI-DADE COUNTY, FLORIDA
i HEREBY CERTIFY That the survey represented
thereon meets the minimum technical requirements
adopted by the STATE OF FLORIDA Board of Land
Surveyors pursuant to Section 472.027 Florida
Statutes.
There are no encroachmerits, overlaps, easements
appearing on the plat or visible easements other than
as shown hereon.
-�1
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REGISTERED
NUNEZ
REGISTERED LAND SURVEYOR
STATE OF FLORIDA #5924
�e
SINCE 1987
BL,,NGO SURVEYORS INC.
Engineers • Land Surveyors • Planners • LB # 0007059
555 NORTH SHORE DRIVE
MIAMI BEACH, FL 33141
(305) 865-1200 Email: blancosurveyorsinc@yahoo.com Fax: (305) 865-7810
-LUUU LUNE: X SUFFIX: - L DATE: 9/11 09BASE: N/A
'ANEL: 0093 COMMUNITY # 120652
)ATE: SCALE: DWN. BY: JOB No -
113 09 1" = 20' F. Blanco 09-761
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108TH ST., MIAMI SHORES, FLORIDA 33138.
f5`
IF
CERTIFIED TO: JOSEPH FULTON AND RYAN M. SMALDONE, CHRISTOPHER P. KELLEY, P.A.,
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY, PROSPECT MORTGAGE, LLC., ITS
SUCCESSORS AND/OR ASSIGNS, ATIMA.
LEGAL DESCRIPTION: LOT 14 BLOCK 215
OF DUNNINGS MT.AMI SHORES EXTENSION NO. 7 SUBDIVISION-
ACCORDING
UBDIVISION_ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 52 AT PAGE 33
OF THE PUBLIC RECORDS MIAMI-DADE COUNTY, FLORIDA
i HEREBY CERTIFY That the survey represented
thereon meets the minimum technical requirements
adopted by the STATE OF FLORIDA Board of Land
Surveyors pursuant to Section 472.027 Florida
Statutes.
There are no encroachmerits, overlaps, easements
appearing on the plat or visible easements other than
as shown hereon.
-�1
DI
REGISTERED
NUNEZ
REGISTERED LAND SURVEYOR
STATE OF FLORIDA #5924
�e
SINCE 1987
BL,,NGO SURVEYORS INC.
Engineers • Land Surveyors • Planners • LB # 0007059
555 NORTH SHORE DRIVE
MIAMI BEACH, FL 33141
(305) 865-1200 Email: blancosurveyorsinc@yahoo.com Fax: (305) 865-7810
-LUUU LUNE: X SUFFIX: - L DATE: 9/11 09BASE: N/A
'ANEL: 0093 COMMUNITY # 120652
)ATE: SCALE: DWN. BY: JOB No -
113 09 1" = 20' F. Blanco 09-761