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PW-5-17-1214, 141 NW 96th StMiami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 �= 4Lftii 60 OR Phone: (305)795-2204 Project Address 141 NW 96 Street Miami Shores, FL 33150- Permit NO. PW-5-17-1214 Permit Type: Public Works Permit Work Classification: Public Works Permit Status: APPROVED Issue Date: 5/17/2017 1 Expiration: /15/2017 Parcel Number 1131010250110 Block: Lot: Owner Information Address PETER GOLDSMITH 141 NW 96 Street MIAMI SHORES FL 33150- 141 NW 96 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone FLORIDA POOL PATIO CORP (305)815-0181 Scanning: 1 Fees Due Amount CCF $M0 DBPR Fee $2-00 DCA Fee $2.00 Education Surcharge $0.20 Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $108.60 Applicant PETER GOLDSMITH Phone Cell Valuation: $ 100.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # PW-5-17-63892 05/03/2017 Credit Card $ 50.00 $ 58.60 05/17/2017 Credit Card $ 58.60 $ 0.00 Available Inspections: Inspection Type: Excavation Review Public Works Review Public Works Final Public Works 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 in Futhermo e, I authorize the above -named contractor to do the work stated. E� �l�ii?C�(�S �U�6 May 17, 2017 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy May 17, 2017 RECEWE® =v Miami Shores Village W,—I—aff Public Works Department (305)795-2210 Public works forms are available from the building department, 10050 NE 2"d Ave., Miami Shores, FL 33138 D J PUBLIC WORKS PERMIT APPLICATION Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property PVC A-l21 Permit#: Name of Applicant (if utility see below): Owner off the following described property: Legal Description: Lot Block _ Folio #; 1 It 5101 5-01 1 Address: 141 W 4:71C� 5t r l UTILITY NAME: Qualifier/Authorized Agent: Address: City: Telephone: State Certification or Registration #: Email: _ Subdivision (,k7nVPYR1r E j7,QSVPJ Q f (ju.LJ State: CONTRACTOR NAME: Claudk o �'uc ZIP: Certificate of Competency # Qualifier/Authorized Agent: Address: 122Lfi1���'� GI City: M (Qr3) I State: k ZIP: Telephone: C)S �1SOI rl Email: 10Y�t - Ysi� 1 State Certification or Registration #: Certificate of Competency #: Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of way: :.3 5� _��=C'� YL C�1 2��y� C C�J(iCr6t+ Type of Work: ❑ Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation ❑ Landscape ❑ Antenna rg Other: P DESIGNER: Architect/Engineer: Address: City: Telephone: Registration #: State: Email: ZIP: Value of Work for this Permit: $ Square/Lineal Footage of -Work: Fees - Permit Fee $ 100.00 Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $, Bond $ (if required) Total Fee Now Due $ J� Bonding Company's Name (if applicable): Bonding Company's Address: City: State: ZIP: Application is hereby made to obtain a public works permit to do the work in the right of way 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, regulation, construction in this jurisdiction. I understand that separate permits must be secured for APPLICANT'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with applicable laws regulating construction and specifically construction in the right-of-way. "WARNING TO APPLICANT: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO THE RIGHT-OF-WAY. 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 public works permit with an estimated value exceeding $2,500, 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 the 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) cjays after the public works permit 's-Issued n the he absence of such posted notic , ; section wij n be approved and a rei ection will be charged/ Signature Signat Applicant 1r AuthoriY6d' Ag rit Company/Utility Agent The foregoing instrument was acknowledge efore The foregoing instrument was acknowledged before me this Z day of _t��q 20� by me this 2 day of 20�, by R1�4� Q�� �`�`^If� who who is personally known to me or who has produced is personally known to me or who- has produced as identification. NOTARY PUBLIC - Sign: Print: ^- c/���e )c i aS SEAL: as identification. NOTARY PUBLIC: Sign: 0 Print: �(SJVAQ, 6!a,06 SEAL: ,N AGUu ;y 'L NADINE AGUAS MY COMMISSION # GG090407 s A1Y ,"ION # GG090407 EXPIRES April 04, 2021 '• EXPIRES April 04, 2021 �'•' APPROVED BY: 2017-04-15 Public Works Director, or Designee RECEIVED MAY - 3 2017 "4�OA I T�t lot, CU4 CT�P-6, Hr'�) v 0 n &O-AS iete Of ERNT #: Miami Shcr. s Village APPROVED BY DATE ZONING DEPT BLDG DEPT SUE-� � ALL FEISUBJECT1-0 CCNI'*P � LW STATE ANL) CCUNjy AUL.L=S AND REGULATIONS IP N 10; aw 12w M E G( npr�.C?e�1. f 1 Cl o �CJJ i ��Gc,11,1 / t He ©f� � U F' � ` RECEIVED MAY - 3 2011 " k00% PERMIT #: Miami Shcres Villa e APPROVED BY DATE ZONING DEPT BLDG DEPT r,J Su ECT ro ccn.I r� wi Au. D STATE ANO CGUN"iY RULES AND REGULATIONS 1 41 ' 1-C1m El r 7210 SW 126th Court, Aniano J. Garcia, PLSM Ph (305) 856-4566 .iiami, Florida 33183 Land Surveyor & Planner Fax (305) 595-1454 Record Survey Property Address: 141 NW 96th Street, Miami Shores, Florida 33150 Scale 1°= 20' Legal Description: Lot 11, Block 3, of "RESUBDIVISION OF BLOCK 3, BONMAR PARK", according to the Plat thereof, as recorded in Plat Book 42, at Page 60, of the Public Records of Miami -Dade County, Florida. 15' Wide Alley FIP 10' Asphalt 04' 0 a N89°47'30"W 75.00' Pavement v This survey is certified only to the FIP — entities listed and only for this particular — I — a 4 transaction. Any use or reproduction of cl I 0.5' this survey without the express written CI permission of the surveyor is prohibited. Use of this survey in any subsequent 9.0, 1 transactions is expressly prohibited a is not authorized. The surveyor expr-s y4 disclaims any certification to any pa i s .y ° in future transactions. No entity oth r '� o Block 13 / than those listed should rely upon thi , survey. p Stes : �jJ `•P 15.2 • • • •or• •••O�• •` �`: "• 1.8 / es• CI Conc / 8.3 \ •eo •• • s,••e• a 00 s,e•e tO • • e ip e. • 1D.11• �+? •P, 18.7' n • • e seee�• LO — s �ns•Pe • P e! Lot 12, CI "- ✓ . • • • CD tl,a 410! Block 3 W d a,• , o Bloch `3 R • • � e • CD ` p c 12.4' o o ' Residence • s .,..,+ c� o " #141 • .. Ze QI Z DIMLr Y NI o 0.7' cl 0.7' �loo L ` CI Z o PL `r a 10.21' —� Wall of yIc N Conc 10' Encr CH Q N a) ,� C 00 O N V4 c N O wi BOB FIP 0 FIP _S89'47'28"E (111, 01.1 _ _ FIP �T 00 375.' �„ I 5' Sidewalk S89°47'28"E 75.00' — — (BC) There may be easements and/or other instruments affecting this property, recorded in the Public Records not shown on this survey. The purpose of this survey is for use in obtaining title insurance and financing and should not be used for construction purposes or plans. Visual Encroachments Noted: 1Q — Concrete wall encroaches 0.2 feet into the east adjoining property 11' Parkway 16' Asphalt Pavement 15' Grass Median 96th Street (80' Total R/W) 0 t Lt(3AL IV V I tJ Date Field Wc."k 06-12-2014 j ror: This Survey does not reflect or determine ownership; Examination of the Abstract of Title will Peter Goldsmith; Town & have to be made to determine Recorded Instruments, if any, affecting the property, This Country Title Guaranty of Survey is subject to dedications, limitations, restrictions, reservations or easements of reco ; Anian PLS 5105 Legal Description provided by client; The Liability of this Survey is limited to the cost of e Hollywood, Inc.; First Survey; Underground Encroachments, if any, are not shown; This firm has not attempted o Note alid without a signature American Title Insurance locate footing and/or foundations and/or underground improvements of any nature; If s wn, and the original r ised seal Company Bearings are referred to an Assumed Meridian; If shown, Devotions are referred to Nation of a Florida sed surveyor Geodetic Vertical Datum of 1929 (NGVD 1929) per _ _ _ Order No 14-0207 A = Arc Length; AC = Air Conditioner, AE = Anchor Easement; BC = Block Comer, 3M = Bench Mcrk_ BOB = Basis Of Bearings; (C) = Calculated Dimension; CB = Catch Basin; CBS = Concrete Block Structure; CFW = Concrete Fence Wall; CH = Chord Length; CHB = Chord Bearing; Cl = Clear, CML = City Monument Line; Z O CME = Canal Maintenance Easement; Conc = Concrete; DE = Drainage Easement; DME = Drainage & Maintenance Easement; Dr = Drive; E = East; Elev = Elevation; ENCR = Encroached; ETP = Electric Transformer, FDH = Found Drill Hole; FIR = Found Iron Rod; FFE = Finished Floor Elevation; FH = Fire Hydrant; RP Q — - Found Iron Pipe; FN - Found Nail; FT = Feet; LME = Lake Maintenance Easement; LB — Licensed Business; LFE — Lowest Floor Elevation; LP = Light Pole; (M) 0 Q Measured Dimension; ME — Maintenance Easement; MON = Monument; N = North; NGVD 1929 - National Geodetic Vertical Datum of 1929; NTS = Not To Scale; OE — Overhead Cables; OH — Over Hang; ORB — Official Record Book; O/S Off Set; Pb — Plat Book; PC — Point of Curvature; PCC = Point Of Compound Lu W Curvature; PCOR — Property Comer, PCP = Permanent Control Point; Pg = Page; PL = Planter or Property Line; PLS — Professional Land Surveyor, PLSM = U D� Professional Land Surveyor and Mapper, POB — Point Of Beginning; POC = Point Of Commencement; PRC — Point Of Reverse Curve; PRM — Permanent Reference J m Monument; PT = Point Of Tangency; R = Radius; (R) = Recorded Dimension; RLS = Registered Land Surveyor and Mapper, R/R = Rail Road; R/W = Right Of Q Way; Sec = Section; T = Tangent, S = South; SIP = Set Iron Pipe With Cap Stamped PLS 5105; UE = Utility Easement; UP = Utility Pole; UTY = Utility; W = West; WF = Wood Fence; WM = Water Meter, WV = Water Valve; (; = Centerline; —x— = Chain Link Fence; ® = Concrete Wall; ' = Degrees; o = Central Angle; 0 = Diameter, ,-* - Existing Elevation; ' = Minutes; ' — Seconds; —,— — Wood Fence I