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DRIVEWAY PERMITMIAMI SHORES VILLAGE� BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Type Insp'n Name Date Approved Correction Re- Insp'n Fee Permit No. 37 d709 3g0 h/g sI- (h) Address Company � �/ ( - Phone # 3 S 7f S �/ 7 Inspection Date 2'6 - bf Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 1/21 /2004 Applicant: BRIAN Owner: WOLSTENHOLME JOB ADDRESS: 380 NE Contractor Local Phone: Parcel # 1132060190200 Fees: FEE2004 -620 FEE2004 -621 FEE2004 -622 FEE2004 -623 FEE2004 -624 FEE2004 -625 FEE2004 -626 Description Building Fee CCF Notary Fee Training and Education Fee Technology Fee Scanning Fee Builders Bond Total Fees: Signed: (INSPECTOR) Signed: (Contractor or Builder) Building Permit Permit Number: BP2004 -52 WOLSTENHOLME BRIAN 91 ST Contractor's Address: Legal Description: EL PORTAL Amount $110.00 $1.80 $5.00 $0.60 $2.75 $6.00 $300.00 $426.15 Permit Status: APPROVED Permit Expiration: 7/13/2004 Construction Value: $2,500.00 Work: INSTALL BRICK PAVER DRIVEWAY AND SIDEWALK BY: Page 1 of 1 PB 9 -101 LOT 3 & W1/2 LOT 2 BLK 2 LOT SIZE IRREGULAR Total Fees: $6.115 # Total Receipts: — V.0 ' 0 ') , 2 v 3 9 6, LS JAN 2 1 PAID 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. a J • BUILDING PERMIT APPLICATION FBC 2001 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. OP 4 -7SZ Master Permit No. Permit Type (circle • Building ) Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) : X i T r, )• LUo , S4' 1`. il. D 1 ° �i Z Phone # 36 • ' i ST ,S 9 ') 7/ S %- t -7 Owner's Address :Sc [) 'iVf ') / S City / d. c.mr cis r, "P.- State FL" Zip . 1, Tenant/Lessee Name Phone # Job Address (where the work is being done) • c S (' A/ � / ,..)/: City Miami Shores Village County Miami -Dam- Zip Is Building Historically Designated YES NO Contractor's Company Name (`7C sLy-7E' C • Phone # Contractor's Address City State Qualifier $ Value of Work For this Permit ` v Z 0 0 Submittal Fee $ .CTO Notary $ Code Enforcement $ (Continued on opposite side) Training/Education Fee $ Scanning $ Radon $ Total Fee Now Due s T ' • 1 S C. et 0 Structural Plan Review. $ Zip Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: ❑ Repair/Replace Type of Work: ['Addition ['Alteration [ Cw Describe Work: '\ J C C> S<-1 7 ,srN aNn L c -t' 0 u � 1 ✓ O"A vd ra/� f ( �rrn� (try rt $� '�'P..'l/n tJ ��l Z -1 �•��s' /L I ✓�.� ✓' � - I � I�bt /f1. � / �'• ��1 �1 r,t "\P! > *IA n 3 J g1rA,tL-V / \ •P4f E )S P�°f •)n-CP I)l�� / /iSST"�r_n t1J! 7)(4, . /r '/ %L v` ) 0- t 1a e-. 4 �Z ( .01 dr l r /e C aa3 * * * * * * * * * * * * * * * * * * * * * * * ** ** * ** Fees** * * * * * * * * * * * * * * * * * * * * * * * *** * *** Permit Fee $ 6 L CO CCF $ 1,60 Technology Fee $ Bond $ Demolition Bonding Company's Name (if applicable) 4 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 CONDMONERS, 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 constriction 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. Signature The foregoing instrument was acknowledged before me this 15. The foregoing instrument was acknowledged before me this day of 20 by P( inn I iC )\ Skn r d of , 20 by who is personally known to me or who has produced who is personally known to me or who has produced • As identif diT ,& ti<ld t NOT . . , aa ' = Olig oioti i d Y : IC: ^�. '.. Ex Jul 13, 2007 � � . : , � r� ru Sign: � 1 �J ._��l1>Ta�, : � ,,, � . �. Prin 1, ra� '7IIMI J 4. My Commission Expires: 14 111, My Commission Expires: . Owner or Agent (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * *f *********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 10/14/03 Signature Contractor as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: t/ JAN 2 0 2004 Plans Examiner Engineer Zoning i • STATE OF FLORIDA) . . COUNTY OF DADE) attached survey, performed by Witness(sign and print) / iami Shore� VLag The undersigned Affiant, ter / & It lSJt' toes hereby attest that the (property owner) 17 •-■/ 0 ^. (name of surveyor's company) performed on ' ' � , is an accurate representation of the existing conditions and (date of survey) 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 building permit for the property 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 further understands that the existence of any such structures may affect final inspections as applicable to this or other permits.. Further, Affiant sayeth naught. SWORN TO AND SUBSCRIBED before me this t 6 day of � Affiant is personally known to me, produced ` iyitam- Vargas Comm #DD23198 • es: Jul 13, 200 1 i s Affiant/Property owner as identification. tr _ 9yo F• Oi s :s- Bon " Atlantic Bonding Co., Inc. t, Owner Owner VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT OWNER BUILDER DISCLOSURE STATEMENT (q1d /s4-n kt/ being the legal property owner, for the property Located at: J c2) /Z? 9 ( S l r i � ✓ ec ) �' L �, Legally described as Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S. 489.103(7), qnd I have read and understand the following disclosure Statement, which entitles me td cork as my own contractor, I further understand that I as the owner must appear in person to complete all applications. DISCLOSURE STATEMENT State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the constriction yourself. You may build or improve a one - family or two- family residence or a farm out - building. You may also build or improve a commercial building at a cost of $25,000.00 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is completed, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who Is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A. and with- holding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes and zoning regulations. Proof of ownership provided ( ) initial of reviewing clerk. The foregoing instrument Was acknowledged before me this 15 day of , 20 c u who is personally known to me or who has Produced • as identification and who did take an oath. • Vta Commission #DD2 984 .:. Expires: Jul 13, 2 t 1 7 'oo�o Bonded Thro antic Bonding Co_ 'nc. 1 Miami Sjor ? ,a e ronowing described property: Legal description/folio #: Lot Block Subdivision Tax Folio #: requests permission to install: T OF CONSTRUCTION WITHIN RIGHT OF WAY a I Stijl/11/0 / ereinafter referred to as the Owner of the —Jer) [ ,Asphalt, concrete, brick pavers [1 Landscaping [] Other within the public road right of way of (address) 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 item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade 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, such expense shall be paid by the Owner or shall constitute a Ilan against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 3. The Owner does hereby 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 all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligation has been canceled by an affidavit filed in the Public 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 day SIGNED. SEALED AND DELIVERED in the presence of: 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 -2382 Telephone: (305) 795 - 2207 Fax: (305)-756 -8972 rs. LKJ I y APPRo tf owner) N.W. Ad STREET. SLNTE 202 R.ORICA S3126 TELEMONM 0305) 2844E60 RIM 005)20442229 ,N11, ?./,--4"/(}:i , crs ova pem3Joldv 3almoz Loro eve„cie--2 , , „ * / - t , -fre-om. Nova CC- *umpire Jim. 4 t LAND SURVEYORS 1 Scale 1 0 ' SURVEY NO SHEET NO O2- , E 3 4-0C4-- ‘, • ANA MARIA WOLSTENHOLME BRIAN D WOLSTENHOLME 380 NE 91st Street Miami Shores, FL 33138 -3130 305 - 758 -3477 LIE WACHO Wachovia Bank, N.A. H R/T 067006432 For Y 1 ?aA,L-V) )7 1:06 70064 3 2i: LO LOO L8 58 38090 L 3 7 7 1.)t 10V. Date Pay to the `- )1' . vw%- �S t,U M j I l' 4.ce 3 `� !o / S order of ,--)1S$ 1377 63- 643/670 BRANCH 03044 n? MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Bu Inspection spection Request Date I a2► 9104 Type Insp'n r�C I DO lu.-Q Permit No. c3 4 Name &o r. . 6001 Si-e( J'- y Address 3O �� ct s� • Company 1Lr Phone # Inspection Date 12010 q Approved ❑, j Correction Re- Insp'n Fee �❑ (frtafteAdeAze, 62-- 1 Date 1/ G/Z Job Address ..30 .64:1 97 c Tax Folio // Zt/p /9 e ga f Legal Description WA d', Z ,QLL6J£w ,ic ' crFei .�7Z3 Owner / Lessee / Tenant 9iPLc�S zge,e Master Permit #_, Z4 4 Owner's Address c.', .�/.4- '/ Phone Contracting Co. �',9�lJ� .#0, "At Address 7�S /�•(v • �� Qualifier / 04,,expe �.7 i. SS# Phone X 6'0' - 2FeD ,p State #'=O /44,2?Iunicipal # Competency # Ins.Co. Architect /Engineer ■41'.f/�YG,ti Address ,a4-7 f. Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN WORK DESCRIPTION �T•�' -e- C%o.�.E' 2e � .Pi!/�l�//�� .�� ,4-,e/.P y,c-.4.7 _/ Square Ft. /2.3 ' Estimated Cost(value) �: c-g,.. WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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 zoni Furthermore, I author t e above - / gamed contractor to do the work stated. D A Signature of owner and /or Condo President Date• • 4 .4 _1L1 Not i ay''kto Ownr g e • . /6 My Commission Expires: APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE President Fire Zoning Building ro� -Bui der Signatur o ontractor o;' Owner- Builder Date: /W 4„.„ /, 1 •ta y as to Co My Commission E /*;;"'" JOSEPHtNE CHURCH Notary Public. State of Fk nda Print type or stamp name of Notary Public Personally known 0OR Produced I.D., "iype arJ iiumb I. roc�,u , , * ** * * * * * * * * * * * 1 �J DID take an oath, or FEES: PERMIT :1 /'6� RADON C.C.F � �42 2 NOTARY,��� non NOTQ I Other y 11/ Electrical Mechanical Plumbing Engineering PERMIT* TAX FOLIO NO./Z,W0 / /op /o " rte e DU State of Florida r County of Dade NOTICE OF COMMENCEMENT �, THE UNDERSIGNED hereby gives notice that Improvement will be made to certair2 real property, and in accordance with Chapter 713, Florida Statutes, the CA following Information is provided in this Notice of Commencement. - G 1. Description of property:(legal description of the property, and street a 4' , address If available) 4347444 e a ei /44h :7 Oa 4 k. g go 7 9/ x . 0 CC 2. General description of improvement: T'1,' � ( CIN 3. Owner information: � a. Name and Address: 6 /c-S . ova 380 A/44`: b. Interest in property: 46 c. Name and address of fee simple titleholder (If other than owner): 4. Contractor: (name and add ress) S;; l ..✓c. 7a5 5. Surety: a. Name and Address b. Amount of bond $ 6. Lender:(Name and address) Q,e'Gs. e,' �73 -3 A s" . C . 33■ a 7. Persons with 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) 8. In addition to himself, Owner designates to receive a copy of the Llenor's Notice as provided In Section 7.13.13(1)(b), Florida Statutes. 9. Expiration date of notice of commencement (the expiration date Is 1 year from the date of recording unless a different dae Is specified) Sworn to and subscribed before me this S rid 2 ' Notar••Pvblic May Commission Expires .1 L I d Fe e - d. 2 of ure of Owner day of ©cam"' 1992, t.. • Zv Clark CUcul STATE OF FLORIDA COUNTY OF DADE •, ti HEREBY CERTIFY that this I`3 a a 33.013Y of ttta 9 A v V) this -Y) l ei on A 0 9 of A 0 19 WITNESS my hand and Official Seal. DC