DS-10-1793Inspection Number: INSP- 152147 Permit Number: DS -10 -10 -1793
Scheduled Inspection Date: November 10, 2010
Inspector: Bruhn, Norman
Owner: BACH, STEVEN
Job Address: 9304 NE 5 Avenue
Miami Shores, FL
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
OVERLAY CITY SWALE 45 X 8 ASPHALT
Passed
Failed
Correction
Needed
Re- Inspection
Fee
November 09, 2010
No Additional Inspections can be.scheduled until
re- inspection fee is paid.
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspector Comments
C C
For Inspections please call: (305)762 -4949
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: Repair
Phone Number (305)754 -2705
Parcel Number 1132060140420
Page 8 of 23
ASSOCIATED CONCRETE INDUSTRIES z
9304 N.E. 5th AVENUE
MIAMI SHORES, FLORIDA 33138
Construction Renovation
and Coordination
Miami 305- 75 -9950
STEVEN J. BACH
BUILDINGS
PARKING LOTS
• 0
Address:
BUILDING
PERMIT APPLICATION
FBC 20
Miami Shores Village EaE
111 OCT 0 8 201
Building Department ®r
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 �...
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
� Av .
COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by:
Master Permit No.
City: I ! {d'b( State: F 'mil
Tenant/Lessee Name: Phone #:
1 p
Value of Work for this Permit: $ '` Square/Linear Fooage of Work:
Permit No tsIO I
g0 i) .qwL5'
Permit Type: BUILDING q� /�
�ar -r�. 1 L1 A ..1 I
OWNER: Name (Fee Simple Titleholder):
Email: U -e. � � (c0 !. V12.
JOB ADDRESS: 1 v 9 dv E AVE • (c c-rq SWJ LE)
zip: 3g
City: Miami Shores County: Miami Dade Zip: 5 3 ` 3q
Folio/Parcel#:
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: 9.] 2 / � ( et) 1 �" Phone #:
Address: A-5* A
City:
State: Zip:
Qualifier Name: Phone #:
State Certification or Registration #: Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER Architect/Engineer: Phone #:
Type of Work: ❑Address ❑Alteration ❑New epair/Replace ❑Demolit on
Description of Work: ZS VC2 LA 9 (:L-4< 6 -s-,Q (
e * * * * * * * ** see+****** * **** ********* **** **F ******* **********+ e****** * ***************
Submittal Fee $ 4, Permit Fee $ JO CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary Training/Education Fee $ Technology Fee $
Structural Review $
TOTAL FEE NOW DUE $ 1
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which oc seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approv : a a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me tthissb
l
day of 0 , 2t, by L511CINAN3 c t-2 , l `
who is personally known to me or who has produced 'CC- (`T)
"' identification and who did take an oath.
Sign:
Print:
NOTARY PUBLIC:
U) � O C '
D16 g (
FLOv
* �x�e******** * * * *******e�xe�+��x**** * **** * ** 4Mfi1 11 * * * ****** *** * ************* ***** * ********* *********** * ** ****
My Commission Expires:
APPROVED BY
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10)
•
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of , 20 , by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Plans Examiner 6 Zoning
Structural Review Clerk
FROM :
STATE OF FLORIDA)
COUNTY OF DADE) . .
permits.
Further, Affi
Property Owner Signature
FAX NO. :
Maffei S'keitesVitlafe
Vellagemote
10050 NE 2' Ave
Miami Shores, Fi 33138
Phone 305- 795.2204; Fax 305 -756 -8972
www.miamishoresvdlage.com
AI+AVIT
The undersigned Affiant,
(pro rty o
The attached survey, performed by s ✓rC.
Property Owner Print Name
SWORN TO AND SUBSCRIBED before me this ? 621 clay of S
Affiant is
nally known to me, produced
as identification.
41 .I ESUEW SEN
MY 03MASSONIIDDEMB90
EXPIRES May 1$ 2O10
8000 Ita No* &mica
z"
(n s or "s company)
for address:
• Notary
Oct. 21 2010 01:30PM P2
, does hereby attest that
performed on __ ( 7 4 - 1,C (date of survey) is an accurate representation of the
existing conditions and locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a
buildingpermit for the prop without first providing a survey less than •six (6) months
old. The Affiant, as property owner, further agrees to remove or obtain permits for any
structures which now may exist on the property which are not permitted or which may
violate zoning or building code regulations. The Affiant farther understands that the
existence of any such structures may affect final inspections as applicable to this or other
a
FROM : FAX NO.
,U I J. 4 e.Vi V 1U• Vi 1l►.a 1. VU,' UUU l u ail l ,1 JV11.1 1 L ied/ •. //yla„..,1%.1
Oct. 21 2010 01:57PM P1
7JVVJ/ uu9
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33135
Tel: (305) 795.2204
Fax: (305) 756.8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
2 67
Whereas, (owner) C N A hereinafter referred to as the owner of
Legal Description Lot 7-3 Slack 1 Subdivision ('? a9geg.° (7cfiD
F o l i o # 1 " Z ` / 6 1 : 7 1 1 4 ° 1 - 1 2 , (
Ciyeefi.1.44 y1) z PAakt
Requests permission to install (deacnbe wlvk):
t� C , 4v eAs-T S3
Within the public right of way of (address) Q 3° t . NJ S V+�
me following described property (adress):
IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows:
1. To maintain and repair, when necessary, the above - mentioned items) installed within the dedicated right of
way. If it becomes necessary for Miami Shores Village or Dada County to make repairs or maintain said
items within public right of way including restoration of street by reason of the Owner's failure to do so,
sUOh ecperiee shall be paid by the Owner or shall constitute a Hen against the above descried property
until paid.
2. The owner does horoby agree to indemnity and hold Miami Shores Village or Dade County harmless from any
and ail liability, which may rim, oy virtue of permitting the Installation of these Hens within the public right of way.
FROM :
V111V 1V.VU 1,13
2
FAX NO. :
L vvu uu,a idsu VA1A btJAA HELD SEIGlt:1 $
3. The Owner does hereoy agree to remove or relocate their facilities at their own expense, within 60 days
notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s)
to be removed and a lien being placed on the property and /or assessed against the Owner for al; costs
incurred in the removal and disposal of the itern(s).
4 . The undersigned further agrees that these conditions shall be deemed a covenant running with the land
and shall remain in fuIl force and effect and be binding on the undersigned, their heirs and assigns, until
such time as this obligations has been canceled by an affidavit filed in the Fubilo Records of Dade County,
Florida by the Village Manager of Miami Shores Village (or his fully authorized representative).
SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this 2 } day o 7:)66-
SIGNE ED. AND DELIVERED in the presence of:
Oct. 21 2010 01:57PM P2
J004 /0U4
wner's Signaturg )
FROM :
SI.111.1FCT TO COMPL
STATE AND COUNTY
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Oct. 28 2010 02:29PM P1
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Sat Boole 10 at page • 37 of the • FubLie • . •
e County,
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rtrtf, Milt ins srtacheit • •
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