Driveway BP2003-1237MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date CI 21 Time
Type Insp'n F C4 tPu e s
Permit No. 02003 /M"
Name
Address 1.01 m6 T e.YY
Company
Phone #
For Inspector: OP 9130 Name & Date
Approved ❑
Correction
Re- Insp'n Fee ❑
IQefrteN• -e. Fzyckt-
topk,k-5 avid
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building
City 'AA, ..., 5lv f
State
Tenant/Lessee Name -$,a/. e
Miami Shores Village
Building Department
Electrical
Owner's Name (Fee Simple Titleholder) ,,l;',,itic 61:1
Owner's Address € 9/ re
lumbing Mechanical
Phone #
J 2 5 200
10050 N.E.2nd Av ue
_ mi Shor s, -Eloridt 38
I� UL Tel: (305) 795.2204
P`c 5t Fax: (305) 756.8972
0 , , � Permit Na ZtO3 -1 k )
Master Permit No.
Zip 33/3
County Miami -Dade Zip
REC
Roofing
cos 75 - s en
Phone # 305 -- 9DS-,L/
Job Address (where the work is being done) /20/' A/6" f'/ rGc
City Miami Shores Village 35/3 8
Is Building Historically Designated YES NO
Contractor's Company Name O � Phone #
Contractor's Address
City State Zip
Qualifier
Architect/Engineer's Name (if applicable) . Phone #
Architect/Engineer's Address
City State Zip
$ Value of Work For this Permit 3 a 1 ) Square Footage Of Work: f
Number of: Bays Stories Families Bedrooms
Type of Work: ❑Addition iteration ONew ❑ Repair/Replace
Describe Work: 90 e � � � gi4y Llkoo
Baths
❑ Demolition
wi4 ,' 4
* * * * * * * * * * * * * * * * * * * * * * * * * ** *Fee Calculation -Misc Permits * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
County Escrow Fee $ ' , Permit Fee $ h D
Education/Training Fee $ Tech $ Scanning $
Code Enforcement $ Bond $ 3 0 G i / Struct�$
Minus Plans Check Fee $ Fee Totals $ 3 (J' cC� U
Notary $
Radon $
(Continued on opposite side)
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 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 reinspection fee will be charged.
S i
4G Owner or Agent
574. so 6 / - 7 -a
The foregoin : instrument was acknowledged before me this _
day of '' L.. , 20b3 , by
who is per ally known to me or � has produced
As ide ij �� and who did take an oath.
NOTARY PUBLI AIr
Sign: 1 1 _ .ti1111-
.. • o 10.x.
Chc6/1 8/03
APPLICATION APPROVED BY:
7
/
Co tractor
The foregoin instrument was acknowledged before me this 2 5"
day of 20 , by
who is ersonally known to e or who has produced
ication and who did take an oath.
SigI a e
NOTARY PUBLICS N N
Sign: Notary
Print: MY
6ezL.1 7(,)--7/72
as id
ERMAN
tate of Florida
• I
c =t A' ,.
„ , p 182405
i •
My Commission E
ires:
Zoning
Print: Notary Public
My comm.
My ConmeR 0}; liPspbes18240
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
JUI 3 0 71103 Plans Examiner
DA TE
Nov. 3,/997
LOCATION MAP sc4/e: /50'
21
/,
22
23
ORDER
9740
%r
24
5'
25
3d ,,
N Ng. —
DRAWN BY
4_C.
,/
27
28
,/
— —9 /rt
•
29
Ii
FLOOD INSURANCE RATE MAP INFORMATION
COIANNITY MO. PANEL NO. SUFFIX DATE OF MA FM ZONE BASE ROOD
120852 0083 J MARCH 2.1884 AE 8A FT.
30
,/
3/
ii
—T RR,
LEGAL DESCRIPTION:
t Lot 25, the East 5.00 feet of Lot 24 and the West 20.00 feet of Lot 26, Block 1,
of "WATERSEDGE", as recorded in Plat Book 9,Page 141 of the Public Records
` y of Dade County, Florida.
PROPERTY ADDRESS: 1201 N.E 91 Terr., Miami Shores, FLorida, 33138
SURVEYOR'S NOTES:
1). TITS IS A BOUNDARY SURVEY.
2). LEGAL DESCRIPTION AS PROVIDED BY OWNER.
3). THIS SURVEY HAS BEEN PREPARED WITHOUT THE BENEFIT OF A TITLE SEARCH,
THEREFOR ONLY THOSE EASEMENTS (IF ANY), DEDICATED BY THE AFORMENTIONED
RECORDED PLAT, AND/OR,LEGAL DESCRIPTION HAS BEEN SHOWN.
4). ALL ELEVATIONS THUS .1 WERE DERIVED FROM DADE COMITY BENCHMARK
No. B-$2, LOCATOR INDEX 3250 S, ELEVATION 8.74 FT., NATIONAL GEODETIC VERTICAL
DATUM OF 1929.
CER T 1 F I ED T0: FRANCISCO CAMPA; SIGNATURE TITLE GROUP, INC.
ARIEL POPLACK, P.A.; ATTORNEYS TITLE INSURANCE FUND;
AMERICA'S WHOLESALE LENDER AMD/OR ITS ASIGNS AS
THEIR INTEREST MAY APPEAR.
FB
/4 -G6
32
If
Revised July 10, 2000
LEGEND OF ABBREVIATION:
C.B.S. = Concrete block structure
Sty. = Story
Conc. = Concrete
Res. = Residence
= Center line
C.L.F. = Chain link fence
O.E. = Overheah electric service
A.C. = Air conditioner
F.F.E. = Finish floor elevation
W.M. = Water meter
F.I.P. = Found 1/2" pipe Zoning
Approved
SKETCH OF SURVEY SCALE: I "= 20'
JJ /24 Fence I• P OW' k -
090
0 20
3
(9yo
O, •
SQ
Cone. 5,66
E,gC•
4.
/Q G4'
•
l y.Y
1
3'
/2,26
O N�
41, III
! O t A
0 /E
75.00'
46 y
1 -5fy, CBs
Re 5. A re. /20/
ffE = 770'
A
/4.5/'
0 6a'
040'
CAMPA & ASSOCIATES, INC.
. LAND SURVEYORS
8013 WEST 16 AVE. HIALEAH, FL. 33014
Ph. (305) 558 -8072 FAX (305) 558 -2153
SURVEYOR'S CERTIFICATE Revised February 27, 2003
1 HEREBY CERTIFY: That a Survey of the property as described in the foregoing caption has been
made under my direction, and meets the minimum technical standards set forth by the Florida Board of
Professional Land Surveyors in Chapter 61 -G-17 of Florida Administrative Rules, pursuant to Section
472027 of Florida Statutes.
FURTHER CERTIFY: That this SKETCH OF SURVEY is an accurate representation of such survey,and is
true and correct to the best of my Ivlowledge and belief, an d that no visrble encroachments exist, except as
shown hereon.
JOSE L. CAf7PA
PROFESSIONAL LAND SURVEYOR # 2936
STATE OF FLORIDA
NOTE: Not valid unless sealed
with an embossed Surveyor's Seal
76,00'
e
.9/ s>
430.00
PERMIT NO. .-
ADDRESS: .
MIAMI SHORES VILLAGE
BUILDING / ZONING DEPARTMENT'
DATE N
SECTION
BY
ZONING' •
ELECTRICAL
MECHANICAL
PLUMBING
FIRE
PUBLIC WORKS
•
STRUCTURAL
BUILDING OFFICIAL
1. Subject to compliancy with eft Federal. State.
County.Ydlage Cites tad regutattons. Wtage assumes
no responsibility for emcee) oflor resutts frost
these plans.
2. This copy of pions must be ayatlab(t ea
buUding site at co Inspection rdt( be conducted.
JOB ADDRESS
CRITIQUE SHEET
APPLICANT
PHONE ft
APPUCATION D/z I (/e4 `, •
SHEET OF.
MISCELLANEOUS
DATE MAW COMMENTS
INITIALS
jAzthi /- c /O /M '5/'s f L/ /J 9 y / ` 5(
�2v /44-X. w,JT!