9950 NE 4 Ave Rd (13)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Reque
Date 1 2 4
Type Insp'n --e C�
Permit No. 5 ( - a9 L
Name ! l/iC G U w e
Address 5:r l 'V S`
Company
Phone #
Inspection Date
Correction
Re- Insp'n Fee ❑
07r 7; g
l■MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204 n
Building Inspection Request
Date
Type lnsp'n g1 — 3 . 7 9 r
Permit No. t0 w w �4 ►--�.P >^
1l e c.■<
Name V. "�'Q
Address
Compan e _
Phone #
Inspection Date
Re- Insp'n Fee
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle):
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
DECEIVED
! 0 5 2" ^a
Permit No. SPX L i
Master Permit No.
Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) Q e 1 E -aN 11 a,C --Oi5 ZJPhone #
Owner's Address SAO N tr. 1, b l SAT ett-i
City N t Ant t S,yp /42 VIu.Ar
Contractor's Address
FL
RI to c0 Cr
Zip 3 3 138'
\ Tenant/Lessee Name Phone #
‘ 6 ' D 1 s E t n i ST 4Er r
Job Address (where the work is being done)
City Miami Shores Village County Miaaini -Dade Zip
Is Building Historically Designated YES NO X
Contractor's Company Name . 1) 0 e,Feezm 'T tettG'60 T ue,Phone #
c v 4 s !`lam
City Lia -IG1= W6 e State Zip 284617
Qualifier
State Certificate or Registration No. CC, 2.06 l Certificate of Competency No.
Architect/Engineer's Name (if applicable) MAC. eA„v.1/4 p Phone # 3 DT 7 Sk ,a 3
$ Value of Work For this Permit c • c.fYO
Type of Work: ❑Addition
Describe Work:
(tun
Submittal Fee $ . T U ' ��l J Permit Fee $ 5
Notary $ Training/Education Fee $ f p2 (/
Scanning $ Radon $ ' Zoning
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite side)
Square Footage Of Work: Oe
g]Alteration ['New ❑ Repair/Replace ❑ Demolition
mot cad
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CCF$ 60
Technology Fee $
Bond $
0/CC
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address '� t
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 gootritith that a copy notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attach t. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection iv ich • curs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be apt , ed an a reinspection fee will be charged.
Signature Signa
ft
i
r who has produced
• ification an d who did take an oath.
: v
4
i
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1
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hn�
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rsonall
mt: ��t�NW ,i�LY •/ Y �
4
* **
*
Own: or Agent
The forego ng ins . ment was acknowledged before me this
day of / , 20 aJ , by
who is person y known to me
As id "'
NOTARY
Sign:
Print: / 1
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 05/13/03
The foregoing instrument was acknowledged before me us
day of / , 200 ,by
ho is
ANA GONZALEZ
MY IIO 062330
Bonded Thru Notary Pudic
NOTARY P
Si
****************************** * * * * * ******* **** ******* * ** * **** , h. ************ * ** * ** ** *** * *** * ** * * ** ** * * * * ***
* * * * * * * * * * * * * * * * * * * * * * * * **
My Commission Expires:
AN 1 9 2
Contractor
own to me or who has produced
as iden ation . • is who did take an oath.
6 _, t
nm inion DD325642
xp 'nos July 16, 2008
* * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
PERMIT NO.
ADDRESS:
MIAMI SHORES
BUILDING / ZON
VILLAGE
NG DEPARTMENT
SECTION
BY
DATE
ZONING
ELECTRICAL
MECHANICAL
PLUMBING
FIRE
PUBLIC WORKS
STRUCTURAL
BUILDING OFFICIAL
1. Sub3ect to compliance with alt Federal, Stat
County, Village rties and regulations. Vlitage assurel
no responslblllty tor accuracy oflor resutts fro
these plans. ..-----'--"
2. This cop p ens must be available c
building or no Inspection wttl be conducts
CRITIQUE SHEET
.JOB ADDRESS - ' J () /(}g
v / ��
APPLICANT
PHONE It
APPUCATION
SHEET OF
MISCELLANEOUS
ZUNING
MENTS
INITIALS
5 ga ( Q f-- gJ off` (0s774cc/ (oL
SLATE APPLIED TO THIS AREA
EXISTINF ROOF Sc
COLUMNS AT TERRACE
TO BE REMOVED
SEE PAGE A -3 NORTH ELEVATION
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 1 /20/2005
Applicant: VICTOR ORTEGON
Owner: ORTEGON VICTOR
JOB ADDRESS: 550 NE 101 ST
Contractor DRACON CONSTRUCTION INC Contractor's Address: 8710 WOODBERRY CT
Local Phone: 800 - 795 -0065
Parcel # 1132060171160
Signed: (INSPECTOR)
Building Permit
Permit Number: BP2005 -14
Page 1 of 1
Legal Description: MIAMI SHORES SEC 4 PB 15 -14 LOTS 1 -2 -3 BLK 95 LOT SIZE SITE VALUE
Fees: Description Amount
FEE2005 -841 Building Fee $250.00
FEE2005 -842 CCF $0.60
FEE2005 -843 Training and Education Fee $0.20
FEE2005 -844 Technology Fee $6.25
FEE2005 -845 Scanning Fee $9.00
FEE2005 -846 Submittal Fee ($50.00)
Total Fees: $216.05
Total Fees: $216.05
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 7/3/2005 Construction Value: $50,000.00
Work: FACIA INSTALATION
eto
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
'
PERMIT NO. P O –1 `t / TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
1. Legal description of property and street/address: Sbt h 10 t S7(ZC -G! Al- 1 (1 n'l•I S N - D CU
ELIf,LACZ, F-L , 3313
2. Description of improvement: Sb Err W 0 le.-4 F-A-. C' iR W10 et
(n A -Ai S o1.4 U/1-1-41
3. Owner(s) name and address: b �Tf.a4sTJ P,\. O, Co Gi Ss
(Y� t "mt S'0.14 4-r-8 t) , F< t
Interest in property: i� j A
Name and address of fee simple titleholder: N14
4. Contractor's name and address: e Xi ac T4 ;TQ-u.0 ,''L6141 7-1v4 _ ' 1 f 0 W6 n'a�% )1
'6k.. -r4 , 334(7
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
NIA
7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes,
Name and address: `7J t`.A O C6 14WLu,C - l0 $ 3 .
W t i - c - , 3.34(
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided
in Section 713.13(1)(b), Florida Statutes.
Name and ad • • -ss: TD .A.Cov4 NIJ,ST Tt01.4 Wit? , 2 LD kJ,' $
9. Expir
differ
ion dat- of thi
t dat- ' specif
Notary Public
Print Notary's Name
My commission expires:
123.01 -52 PAGE 4 8/02
6. 4 PL 334h'1
Si. ature of Own
P t Owner's Name
Sworn to and subscribed before r e
otice of Commencement: (the expiration date is 1 year from the date of recording unless a
Fte
ANA GONZALEZ
MY COMMISSION # DD 062330
EXPIRES: October 2, 2005
1111111 1111111111 111111111111111111111111 1111
CFN 200 Fi RO03331
OR Bk 22993 F's 0353; (1's)
RECORDED 01/12/20 165 10:39:27
HARVEY RUVIN, CLERK OF COURT
MIAMI --DARE COUNTY? FLORIDA
LAST PAGE
�h( ETA
CLAN \t, a.
RY 10 w o n'3t- .t?st e--r"
// Prepared by
day o f 200(..
00(0 ''^^
Address: G�4
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