Loading...
BUILDING PERMITBUILDING PERMIT APPLICATION FBC 2001 c Permit Type (circle):. Building Tenant /Lessee Name Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO State Certificate or Registration No. C at c,42 0 Architect /Engineer's Name (if applicable) $ Value of Work For this Permit Describe Work: tve 1,0 cidowsne..0C-71 Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Master Permit No. Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) Ql7Ia hone # t/ ° % "' ' g y Owner's Address NCO i, Rea ' , E � - �� . � ` t k L 1. ) (JJ 30s- - Zeta - `j City M1°trA t - -- — — State ELA A Zip 3 2 713 - Phone # Zip Contractor's Company Name LM _ o/.J i 4b3 It Phone # (') Contractor's Address (100 5. SA } - i2E tle t City \I{ u- s 4 State FLalei tArn Qualifier AIM N I PAL, Zip `3 Certificate of Competency No. Phone # )I ****************************Fees****************************** 4W) 3 Square Footage Of Work: .✓ Type of Work: ['Addition ['Alteration New ❑ Repair /Replace ❑ Demolition Submittal Fee $ Permit Fee $ CCF $ CO /CC Notary $ Training /Education Fee $ Technology Fee $ Scanning $ Radon $ Zoning Bond $ Codc Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if applicable) Mortgage Lender's Address City 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: 1 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. Signature chc 05/13/03 Owner or Agent The foregoing ins rument was acknowledged before me this 31 day of 4 , 206‹ by M4T� I � , Th j is ersonally known to me or w As identifcati NOTARY PUBLIC: Sign e Print: [ • • . . My Commission Expires: - - APPLICATION APPROVED BY: State State Zip Zip_ - Contractor The foregoing instrutnent was acknowledged beforgme this_ SD day of J ill , 20 , by r> ra � .,..�„ „� who isyer onally known to me or who has produced JANE - rrw uwrnrrrrmrrrr�rrr� 0 dide t,i1Doo3adt2 �G�� as identi at 'wh the bows 5/5/2009 sir NNW thre0190µ32.2SJJ PUBLIC: Florida Nobly NrNN}NrrrNrNrl Assn.. tom' Sign: , � �.� u Print: r- , t My Commission Expires: - .,� /' Expires 5/512ra: pc P. Banded tiro t ^� rrtirls\i.wnnt x. .. ************************************************************************,. it*** * * *8 * * * * * * * * * * * * * * * * ** * * ** * * *** **4* * 8 ** 48 ** * *** 44 **** *** ****** 44 4* 4******** * *4 ** * * * * * * * * * * * * *88 * * * *8** * * ** * 4 * * * * **** * * 4 * * * *8* Plans Examiner Engineer Zoning Change of Contractor Permit No. Owner's Name (Fee Simple Titleholder) IQ;1 An g' ,C bkT- UnziPhone # Contractor's Company Name Contractor's Address City , Q Qualifier, Signature NOTARY PUB Sign: Prin My Commission Expi¢ Rev. 09/19/03) Miami Shores Village Building Department Owner's Address City ;% I . State ° Tenant/Lessee Name Phone # C) — S1 0 ° "6 Job Address (of where the work is being done) 64' E q \ • City ' ot �? Count ‘bAei Legal Description RO Owner or Agent U, -i-..: � . .hY � +I. (/E�/ SIL AA S; u1 IERt.1AN S Zip) 13 ° this day of who i pers . u ally ylown to me or who has produced As identification and who did take an oath. Signatur OOO,byele D s _Fod Er day of Zip `3,7, (In Z "1 49 NOT ' J UBL C: Sign Print: Phone 0o k Contractor My Commissioq exxires: 550 I hereby certify that the work has been abandoned and /or the contractor is able or unwilling to complete the contract. I hold the Building Official and the Vill., of Miami Shores harmless from all legal involvement. `Vr The foregoing instrument was acknowledged before me this 771 The foregoing instrument was acknowledged before me who is personall known t me or who has produced as identification and who did take an oath. r �y i1 p COM MISSION NUMBER u , DD136368 MY COMMISSION EXPIRES * * * * * * * * * * * * * * ** *Ri:pw..* * * * * *mv*f 6 * * ** ********************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *stet * * ***** ** BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Owner's Name (Fee Simple Titleholder) ) Owner's Address City Tenant/Lessee Name <:. State Zip Job Address (where the work is being done) �: ._c r � ; = ' City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name Contractor's Address City Qualifier Submittal Fee 8— Notary S� Scanning $ Code Enforcement $ Total Fee Now Due $ (Continued on opposite side) Building t . Architect/Engineer's Name (if applicable) S Value of Work For this Permit Type of Work: [1] Addition Describe Work: wrenn. w * * * * * ** Training/Education Fee $ Radon $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 f . EAlteration Electrical Plumbing Mechanical State 1 3 4-T Permit Fee $ 1ew ❑ Repair/Replace ❑ Demolition Phone # Square Footage Of Work: Permit No. Master Permit No. Phone # Phone # Zip Fees* ****** ******d:: **1..1 ** :F:tt** ** CCF Technology Fee S Zoning X' ,. Bond $ Structural Plan Review. $ / • :1/ ,) Roofing co/cc LS? 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 < nd 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. 3tg11dtLLrC " Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this 2.,=. The foregoing instrument was acknowledged before me this 2.. day ofqu , 20d, by zi.t. P1 06 ‘ i$`iu -- , day of 11,41.. , 20 ( %'' , by ,. t who is personally'k4own to me orinaiteittisirertiriced who is personally kpw to me car who-ltas-prorfuced As identi ation ice identification cation and who did take o\ P,�1DA t t T/ �i ®�9 ✓i as i NOTARY d who d UBL # P�:•• lssio •. IC: �sNO111noiean ttt oath. Sign: ` 'b F : i sign:, _O P A�`�� ��'���`' c e ` � ®.� : * w Print: t J j L . _ �� • p� a #CC 940132 •;,_,C),:: Q y ° g N >�q•..aenlnN ��;: ° My Commission Expires: = *; o•• ?* ° ° +".•��� o #CC 9401 (Ce#(4YIetati 1° 'competency Holder) %, 3 ;: �� ° ems State Certificate or Registration No. .; 6i 0, : s ; . - Z -j Certificate of Competency No. /* f11 ®\ Print:a. ►`' 3 My Commission Expires: . **********************************. , r , t************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 12/15/03 /1 Plans Examiner Engineer Zoning B4. MAP AND PANEL B7. FIRM PANEL 89. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTIVE/REVISED DATE B8. FLOOD ZONE(S) (Zone AO, use depth of flooding) 12025C-0093 J 7 -17- 1994 3-2 -1994 X N/A Process # Folio # 30- Crown of Road: 8.82 ft. NGVD FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1-7. SECTION A - PROPERTY OWNER INFORMATION BUILDING OWNER'S NAME Talisman Investments, Inc. BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 465 NE 91 Street CITY Miami STATE FL PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 21, Block 49, Plat Book 10, Page 27, Miami -Dade County, Florida BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.) Single Family Home LATITUDE/LONGITUDE (OPTIONAL) ( ##° - ##' - ##.##" or ##.#####°) HORIZONTAL DATUM: ❑ NAD 1927 0 NAD 1983 SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER Unincorporated 120635 B2. COUNTY NAME Miami -Dade B3. STATE Florida B10, Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ►Z1 FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in 89: ►5 NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the building located in a Coastal Barrier Resources S stem CBRS area or Otherwise Protected Area OPA ? ❑ Yes ►Z1 No Desi. nation Date o a) Top of bottom floor (induding basement or endosure) 9. 98 ft(m) o b) Top of next higher floor 18.73 ft.(m) o c) Bottom of lowest horizontal structural member (V zones only) N/A . _ft.(m) o d) Attached garage (top of slab) 9. 32 ft.(m) o e) Lowest elevation of machinery and/or equipment servicing the building (Describe in a Comments area) _. _ft.(m) o f) Lowest adjacent (finished) grade (LAG) 8.20 ft.(m) o g) Highest adjacent (finished) grade (HAG) 8. 50 ft.(m) o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade WA o i) Total area of all permanent openings (flood vents) in C3.h N/A sq. in. (sq. cm) CERTIFIERS NAME ROLANDO ORTIZ TITLE PRESIDENT ADDRESS 9350 S.W. 22 Terrace FEMA Form 81 -31, January 2003 ZIP CODE 33138 SOURCE: ❑ GPS (Type): ❑ USGS Quad Map i~i Other. Level cn 0, 00 a E °c w co a Y E c z N J SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. LICENSE NUMBER 4312 COMPANY NAME Gunter Group, Inc. O.M.B. No. 3067 -0077 Expires December 31, 2005 For Insurance Company Use: Policy Number Company NAIC Number SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction* ® Finished Construction °A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 1 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations — Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 -A30, AR/AH, AR/AO Complete Items C3. -a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum NGVD Conversion/Comments Elevation reference mark used G53R Does the elevation reference mark used appear on the FIRM? ❑ Yes ►.1 No PLS 4312 5-18 -2006 CITY STATE ZIP CODE Miami FL 33165 DATE TELEPHONE 5-18- 2006 305- 220 -0073 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 465 NE 91 Street CfTY STATE ZIP CODE Miami FL 33138 COMMENTS ADDRESS SIGNATURE COMMENTS LOCAL OFFICIAL'S NAME COMMUNITY NAME SIGNATURE COMMENTS FEMA Form 81 -31, January 2003 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community offidal, (2) insurance agent/company, and (3) building owner. For Insurance Company Use: Policy Number Company NAIC Number ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR-F, Section C must be completed. El. Building Diagram Number _(Select the building diagram most similar to the building for which this certificate is being completed — see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or endosure) of the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is _ ft.(m) _in.(cm) above the highest adjacent grade. Complete items C3.h and C3.i on front of form. E4. The top of the platform of machinery and/or equipment servicing the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA4ssued or community - issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are coned to the best of my knowledge. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: G9. BFE or (in Zone AO) depth of flooding at the building site is: CITY DATE TELEPHONE TITLE TELEPHONE DATE - _tt•(m) _ ft.(m) STATE ZIP CODE ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. ❑ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO. G3. ❑ The following information (Items G4-G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED Datum: Datum: ❑ Check here if attachments Replaces all previous editions B4. MAP AND PANEL B7. FIRM PANEL B9. BASE FLOOD ELEVATION(S) NUMBER B5. SUFFIX B6. FIRM INDEX DATE EFFECTIVE/REVISED DATE B8. FLOOD ZONE(S) (Zone AO, use depth of flooding) 12025C-0093 J 7 -17- 1994 3-2 -1994 X N/A Process # Folio # 30- Crown of Road: 8.82 ft. NGVD BUILDING OWNERS NAME Talisman Investments, Inc. FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1- 7. SECTION A - PROPERTY OWNER INFORMATION BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 465 NE 91 Street CITY STATE ZIP CODE Miami FL 33138 PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 21, Block 49, Plat Book 10, Page 27, Miami-Dade County, Florida BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.) Single Family Home LATITUDE/LONGITUDE (OPTIONAL) ( ##° - ## - ##.##" or ##.### TITLE PRESIDENT FEMA Form 81 -31, January 2003 HORIZONTAL DATUM: ❑ NAD 1927 NAD 1983 SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION SOURCE: ❑ GPS (Type): ❑ USGS Quad Map 1 Other. Level 81. NFIP COMMUNITY NAME & COMMUNITY NUMBER Unincorporated 120635 82. COUNTY NAME Mami -Dade B3. STATE Florida 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ►Z/ FIRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): B12. Is the buildin located in a Coastal Barrier Resources S stem CBRS area or Otherwise Protected Area OPA ? ❑ Yes f / No Designation Date COMPANY NAME Gunter Group, Inc. SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIERS NAME LICENSE NUMBER ROLANDO ORTIZ 4312 ADDRESS 9350 S.W. 22nd Terrace SIGNA � DATE TELEPHONE 5 -18- 2006 305- 220 -0073 O.M.B. No. 3067 -0077 Expires December 31, 2005 For Insurance Company Use: Policy Number Company NAIC Number SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 1 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations – Zones Al A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 -A30, AR/AH, AR/AO Complete Items C3. -a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum NGVD Conversion/Comments Elevation reference mark used G53R Does the elevation reference mark used appear on the FIRM? ❑ Yes ►I No o a) Top of bottom floor (induding basement or endosure) 9. 98 ft.(m) o b) Top of next higher floor 18.73 ft.(m) o c) Bottom of lowest horizontal structural member (V zones only) N/A . _ft.(m) o 0 o d) Attached garage (top of slab) 9. 32 ft.(m) E al o e) Lowest elevation of machinery and/or equipment w 6 al servicing the building (Describe in a Comments area) —. _ft.(m) a w o f) Lowest adjacent (finished) grade (LAG) 8.20 ft(m) z o g) Highest adjacent (finished) grade (HAG) 8. 50 ft.(m) o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade N/A 8 J o i) Total area of all permanent openings (flood vents) in C3.h N/A sq. in. (sq. cm) CITY STATE ZIP CODE Miami FL 33165 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. BUILDING STREET ADDRESS (Including Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 465 NE 91 Street CITY STATE ZIP CODE Miami FL 33138 COMMENTS ADDRESS SIGNATURE COMMENTS LOCAL OFFICIAL'S NAME COMMUNITY NAME SIGNATURE COMMENTS FEMA Form 81 -31, January 2003 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR -F, Section C must be completed. El. Building Diagram Number _(Select the building diagram most similar to the building for which this certificate is being completed – see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (induding basement or enclosure) of the building is _ ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is _ ft.(m) _in.(cm) above the highest adjacent grade. Complete items C3.h and C3.i on front of form. E4. The top of the platform of machinery and/or equipment servidng the building is ft.(m) _in.(cm) ❑ above or ❑ below (check one) the highest adjacent grade. (Use natural grade, if available). E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. - SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA4ssued or community- issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the best of my knowledge. PROPERTY OWNERS OR OWNER'S AUTHORIZED REPRESENTATIVES NAME G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (induding basement) of the building is: G9. BFE or (in Zone AO) depth of flooding at the building site is: CITY DATE TELEPHONE TITLE TELEPHONE DATE For Insurance Company Use: Policy Number Company NAIC Number STATE ZIP CODE ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. ❑ The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA - issued or communityassued BFE) or Zone AO. G3. ❑ The following information (Items G4-G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED Datum: Datum: ❑ Check here if attachments Replaces all previous editions DATE: PROPERTY ADDRESS: LEGAL DESCRIPTION: according to the at Page 27; of the FOR: TALISMAN INVESTMENTS, INC. LOCATION MAP (N.T.S.) 465 N.E. 91st Lot 21, Block plat thereof, Public Records SURVEYOR'S NOTES' 1) The survey was conducted tar the purpose of a 'Boundary Survey only and is not Intended to deilneate the regulatory jurisdiction of any federal, saes, regional or local agency, board, camlmSsion or Other on7ity. 2) The accuracy obte:ned by measurements and cafalo th re on e survey, meets end exceed3 the Minimum Iodated Standards requirements for a Suburban area (1 toot in 7,500 feat) es specified In Chapter 61017 -6, Faroe Administrative node. 3) TM Survey rvey does not ref ed or determine ownership. 4) Log: i description subject to any , limitations, restridion3 ras6rvs one or easements of record. 5) Exemtrtet on of t � o Abetrect of Tee will have to be made to Bnntrtw recorded Dt d In9snenta, R any affecting the property; s of Pubic Records not performed by Ste office. 6) No anon was made by this otfwe lD locate any underisoUn 0 t; d ti s end/or within or cti»m el lng the ect pit:c ty. at 0) Thy survey hes be prepared fa the wee:L.ve use 07 the rialtos named hereon ally and the hereon do not extend to any unnamed parties. 9) Thy survey was prepared for a Mat9age Tren�tiat only; Not to be Used for design and/or construction purposes without the Consent of 6118 Once. l0ty 10) U teeth y es within UCi Easements not noted as vl01aterta. 11) Driveways Cr potions thereof whin Roadways not noted es *Worm or encroachments. 12) Fc , oars ed/or footings undemuabt the ground surface that may cross beyond the bounduy linos of the herein deserted parcel ere not shown. 13) All Iron Pipes a Re -Bard found end shown on the sketch of survey have no caps unless otherwise stetsd. 14) Ferree ownership determine by visual moans only (L1 any'); Lag awnerehip not determined. 1 5) No ee h ene of =cede was made by this firm beside the record pet therefore we do not Imply or accept resporrsUly for any an a Easement, Derfeatl Limitation for which information wee not hrNahed. Contact Cor the eWprtrpriete authorities prior to any desgn work an the hereon -described pared for Building and Zoning intornteSon. 17) Pro':keto ne! Land Swayer end Mapper in responsible charge: Rolando Ortiz LS 4312, State of Fonda. 1 B) The survey b not valid without the elgrud re end the raked seed of a Rorke Warmed Lard Surveyor d Mapper. JOB M R SKETCH NUMEER DRAWN BY: Remote o r 5— 27 �. 20© 44-6, Street, Miami, Florida 33138. 49, "MIAMI SHORES SECTION 2 ", as recorded in Plat Book 10, of Miami -Dade County, Florida. f o1 re ►o -0 3°L4 C I hereby catty to th to the above named fir end/ r persons that e Sketch of Survey d the described property is true and correct 10 the best d my knowledge and belief, as rec env an y surveyed d platted under my direction; ease tat meets the Mlntrmmrn Tecrnbel Standards Bet in Chapter 61017 -6, Ronda Administrative Code, pursuers to Seawn 472.027 Ronde Siatuteo. 4 p ioc React) saver': 5/ '�1' 6 -d - Z 5 t/P - ®1176 - Tv/everry -4z oe ' 7- fS -?oor u/ - a4 re £ d ale AB ATtON& R/W RIGHT OF WAY INC. (Mem.) MEASURED C.LF. (R) RECORD W.F. (Coe.) CALCULATED CONC. F.I.P. FOUND IRON PIPE C.P. FRB FOUND RE -BARD r FD/H FOUND DRILL HOLE W M F. N1. N D FOUND NAIL & DISC W P C.B. CONCRETE BLOCK LP. AND STUCCO P.C.P. C/B CATCH BASIN P.I. (Tt ) TYPICAL P.C. CENTER UNE P.T. g NONU9ENT UNE U.E e PROPERTY 1.1,E D.M.E. CL CLEAR ENCROACH CHAIN UNK FENCE GOOD FENCE CONCRETE CONCRETE POLE FIRE HYDRANT MAN HOLE WATER METER WOOD POLE UGHT POLE PERMANENT CONTROL POINT POINT OF INTERSECTION POINT OF COMMENCE POINT OF TANGENCY UTIUTY EASEMENT DRAINAGE AND MAINTENANCE EASEMENT PREPARED BY; GUNTER GROUP, INC. AN LD SIMEYNG - LAND PLAFR�RJG FLORDA CERTIFICATE OF AUTHDRRA1ION I LB 4507 9350 S.W. 22nd TERRACE t9ANNI, FLORIDA 33165 (305) 220 -0073 BY: ., DO ORT1Z LS 4312 OR: RICARDO OR11Z LS 5629 PROFESSIONAL LAND SURVEYOR & MAPPER, STATE OF FLORIDA. , 0 M /4 1, SKETCH OF SURVEY SCALE 1- o g® 03 2 " 9.99 N' : 5/ cZT ACCORDING TO THE NAT)ONAL ROOD INSURANCE PROGRAM 1 CCMAUNITY Mo. I 1 O.00 AID TIE SUBJECT PROPERTY FALLS IN ROOD ZONE /24652. 53 /6 .D do p' n� 6° r S'UFFLX 10.1 DATE OF R1 7 -/7 -95 RFLM ZONE BASED ROOD ELEV. °• 02/17/2005 08:51 FAX 954 370 5401 FROM :FRY 8. REY 1 h.C. Work To Be Performed At Name: SIMON RODRIGUEZ De BUILDERS INC. 10001 WINDING LAKES RO. #203 SUNRISE, FL 33351 Phone #: (305) 218 -2953 SINGLE FAMILY RESIDENCE 469 NE 91 Street MIAMI, SHORES FL Prapo No. 2003 -114 Sheet No. 1 of 1 Date: 1/3/05 ,RAY & REY, WC. 4 Electrical Contractors 14370 Lake Cundlewood Court rillamf Lakes, FL 33014 CC #19885 with payments to be made as follows: Start: 25% = 31,060.00 Between Start & Rough: 50% a $2.120.00 Final Inspection. 25% 61,060.00 as specified. • Payments will be made as outlined above. Sign Date PROPOSAL pE 61. /(4 -PeP Signature UNITED ENGINEERING CORP. a002 FAX N0. :3 05 -6ES -4090 Mar. 20 2003 0 P1 Phone: (305) 819 -9793 Fax: (305) 685 -4090 We hereby propose to furnish the materials and perform the labor necessary for the completion of THE ELECTRICAL WORK TO BE DONE AT 469 NE 91 ST MIAMI SHORES, FL ALL ELECTRICAL MATERIAL & LABOR & PERMIT FEES FOR ELECTRICAL WORK ARE INCLUDED ON THE QUOTATION BELOW. 1. WE WILL NOT PROVIDE FIXTURES AND /OR APPLIANCES. 2. ALL ELECTRICAL INSTALLATIONS TO BE DONE WITH ROMEX. 3. ANY MATERIAL ANO /OR LABOR TO BE DONE AND NOT STATED IN THE MENTIONED FLANS WILL BE ADDEO TO THE FINAL INVOICE AS AN EXTRA CHARGE All material a guaranteed to be as specified, and the above work to be performed In accordance with the drawings end specifications submitted for above work and completed in a substantial workmanlike manner for the amount of 56,700.00 An/ alter:mos or deviation hcm above saeeMcatiana invotvlta extra costs »ill be 3r®e uted only upaP anitton order, end wilt e•oomn en extol Respectfully submitted: RAY & REY, ONC. charge oust or.d above the wire ate. All agreements tontimpani upon strikes. rteadells. or d.loys beyond our eontro:. Per REINALDO DIAZ, PRESIDENT Note - Tbie prop:eel may to withdrawn by ue f! not 0coept®d within 30 days. ACCEPTANCE OF PROPOSAL The above prices, specificatione and conditions are sal factory and are hereby accepted. You are aulhoriae Fo do the work IMPORTANT: In these spaces, copy the corresponding information from Section A. .BUILDING E� ADDRESS (Including Apt, Unit, Suite, and /or Bldg. No.) OR P.O. ROUTE AND BOX NO. ��61 1 sr Ea r CITY, STATE ZIP CODE ' WWI SttoefS f • 331.50 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) For Insurance Company Use: Policy Number Company NAIC Number Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS Fi Alts H'aD ftooR Et. VA T1 o nI alp PRO Pos ED [tis tpesit4i IS I'2.00 rr. ' Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items E1. through E5. If the Elevation Certificate is intended fcr use as supporting information for a LOMA or LOMR -F, Section C must be completed. I PIA El. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed — see pages 6 and 7. If no diagram accurately represents the building,. provide a sketch or photograph.) • E2. The top of the bottom floor (including basement or enclosure) of the building is L _1 ft. (m) LL1 in. (cm) LI above or II below (check one) the highest adjacent grade. (Use natural grade, if available.) H . E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is 1 1 I ft. (m) 1 I lin. (cm) above the highest adjacent grade. Complete Items C311 and C3 front of form. - (�1 ;1/4 E4. The top of the platform of machinery and /or equipment servicing the building is I I I ft. (m) L Ll in. (cm) L above or LI below (check one) the highest adjacent grade. (Use natural grade, if available.) Q+1�1 E5. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? 1 1 Yes 1 1 No I [Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The owner or owner's authorized representative who completes•Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA- issued or community - issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the best of my knowledge. • PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME PF BUtLDORS INC.. ADDRESS tC0b1 • 1,411401,1461 t.P S gb . •* 2o3 SIGNATURE C S SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B,•C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. LI The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law.to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. L1 A community official completed Section E for a building located in Zone A,(without a FEMA- issued or community-issued BFE) or Zone AO. G3. L The following information (Items G4-G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7. This permit has been issued for. L.j New Construction Li Substantia Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: G9. BFE or (in Zone AO) depth of flooding at the building site.is: LOCAL OFFICIAL'S NAME COMMUNITY NAME SIGNATURE nits Et.EVArf Is PRoposE- . FEMA Form 81 -31, January 2003 CITY SUNRISC DATE • 2-.0 TITLE TELEPHONE DATE , STATE ZIP CODE 033.1 TELEPHONE Check here if attachments . ft. (m) Datum: ft. (m) Datum: COMMENTS 1 Check here if attachments Replaces all previous editions MIAMI SHORES %ILLL GE BUILDING INSPECTION DE TMENT PPLICATION FOR DLEHNO PER R Ir Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. DoieFebruary 2 1966 19 Owner's Name and Address Ml my_._Im_C itty N0.469 BE Street_ __ t Registered Architect and /or Engineer ' %'ke?a1 Name and address of licensed contractor atg' a___ ° s , t ,om.2 26 5— Y, AT. 9.Q- h- S' x,e C ,r' Location and legal description of lot to be built on: Lot___ 22 Block 49 Subdivision D/Iimmi Shores Section #2 2 PP 10 P Page 37 Street and Number where work is to be done Vacant State work to be done and purpose of building (by floors)___ Neu single __family residence and for no other purpose. New Building X Remodeling Addition Repairs No. of Stories 1 To be constructed of CBS Kind of foundation Reinforced Concrete Roof covering Plat Tile Estimated Total cost of improvements 25 e 000 Amount of Permit 0 Iona cubage required_ - -_ - - 1 .000 _Plan Cubage— _ 22_,18 Distance to next nearest building 15 ° _Size of Building Lot 50 X 127065 Maximum live load to be borne by each floor --- II hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to_ Ruatraro Construction-2265 N.If®, 90th Street The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work o be performed under this permit, as are licensed by Miami Shores Village. Remarks - -- — ( Signed )� STATE OF FLORIDA, COUNTY OF DADE. ss • Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared -- _Francis. _r_aro. - - -- — _- -__ — to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the Contractor of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No Date cad, orn to and Subscribed before me. Disapproved Date ____ _________ Notary Public, State of Florida (Signed) - Building Inspector My Commission Expires NOTARY PUBLIC STATF. of FLORIDA rt LARGE MY COMMISSION DtPIRES-- tfrAit.--24;---967 BONDED THROUGH FRFD D17''7"'' LHOR9- PLANNING BOARD DATE Chairman ______ - _ Member Member Member Member ___ Member Council Approved ___- Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improl(Tv ,L,' -e for inspection or faulty materials and /or workmanship. Zone cubage required_ 20_p000 Distance to next nearest building MIAMI SHORES ILL GE BUILDING INSPECTION DES ; T ENT APPLICATION FOR BUIL '86 9 PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date PQbY.__22_ ., 1966_ Owner's Name and Address____. Earl -_L. Chitty ____T No.__4._ __ street_ _91st Registered Architect and /or Engineer N1ar'ke_l_ Name and address of licensed contractor atx' = . ro Construction-2265 N.17. 90th S 'IC'A'O t Location and legal description of lot to be built on: Lot_- ____ -- 20 Block 4 - 9 Subdivision__ litami ---- St@.$_ak ___ae_c_tion - - -2_p YB 10.0 Page Street and Number where work is to be done VaQant State work to be done and purpose of building (by floors and for no other purpose. New Building X. Remodeling Addition Repairs No. of Stories 1 To be constructed of CBS Kind of foundation__ '_Q 'Ce°C°O Cg'_eta__ Roof Covering_.P_lat__ Estimated Total cost of improvements $ 25 t 000 _Amount of Permit $ Maxianum live toad to be borne by each floor II hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to__Q atr ro Construction -2265 N 90th Street The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. d _ / Remarks J����• y %f f Building Inspector flan Cubage__22 —Size of Building Lot_ 50 X 127.81 STATE OF FLORIDA, U COUNTY OF DADE. ss • Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personahy ap- peared F, '1 .Cia- .Quatraro —___ -- to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the Contractor of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No Date Disapproved --_ Date (Signed) orn to and Subscribed befo.e e. Q Notary Public, State of Florida LVOTARy PUBLIC STATE oi r nt LARGE My Commission Expires __Tl,__ M1SSIU1T__E i,IAR. 24, 1367 BONDED THROUGH FRED \V DIE : T' 'naa- PLANNING BOARD DATE Chairman Member Member Member Member ____ _________._ Member Council Approved _ Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by impTorc':: :ii 0 for inspection or faulty materials and /or workmanship. 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. Master Permit No. Permit Type (circle): Building Electrical Plumbing Mechanical i Owner's Name (Fee Simple Titleholder) ''» w } � ' ® ` 4 f f l' / / C 2 e / : Phone # � or - c a , a Owner's Address / ' k ( S �.,_ /— , 4 ) / z -;, o " )., City ` Tenant/Lessee Name State Job Address (where the work is being done) Zip City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO Phone # / Contractor's Company Name f ', I,. iii -' - % r! / ‘ : i Phone # Contractor's Address Zip__ City State Zip Qualifier State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit Square Footage Of Work: Type of Work: ❑Addition ❑Alteration New ❑ Repair /Replace [_1 Demolition Describe Work: C. "r' 11 >.r 1 C_Lv i_ d ,xxXXN9CMXY. X *XXXX %9t **********F Submittal Fee $ �C ` ' - Permit Fee $ 2 25 — ar-- '" a CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ t� , Total Fee Now Due $ (Continued on opposite side) 1 Roofing 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. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of ,20,by , day of ,20 ,by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: My Commission Expires: My Commission Expires: ..1..... ********************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** : * * ** * * * * * * * * * * * * * * * * * * * * * ** *** * * * * * * * * * * * * * * * * * * * ** ** * * * * * ** APPLICATION APPROVED BY: chc 05/13/03 M4 WI Plans Examiner Engineer Zoning Disapproved ____ _ Date (Sigmed) Building Inspecto Chairman _ Member _ Member MLAM SHTIRES \PIL,LME ELM L. LCTBON DEPARYMELVT APPL,MATU FoR UNLDONE PEKMOV Application is herioy made for the approval of the detailed statement of the plans and ,specifications herewith szizar:Ited for the 'DWI& ing or other structr.;:e Lein described. This application is made in compliance and conformity with the IChnii.l.dir_zr lardiriance e Miami Shores Village, Flo:ida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Vage and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein ssrecified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date__ Febo 6 AoJeLee - 469 00E0 91 StoMiami ves Owner's Name and Address Street Orkin Exterminating CoJmo 1960 NoU0 27 Registered Archtect and/or Engineer.. Name and address o iicensed contractor Location and legal description of lot to be built on: Lo Block Subdivision Street and Number whe ze. work is to be done State Wor 7.1 to be done and purpose of building (by floors)._ f1C1/1.._Tent.....i iOric" Vikane 18-2 h and 2. 6000 and for no other purpose. New 3uilding_ Remodeling . Addition Repairs.. No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $._ _ Amount of Permit Zone cubage requfrej _Plan Cubage__ Distance to next nearest building Size of Building Lot. Maximum live load to be borne by each floor__ :: hereby submit all the Plans and specifications for said building. All notices with reference to the building and its construction may be sent to_ The undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer of labor under the :Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be perfacmed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks._ _ _ - (Signed) STATE OF FLORIDA, COUNTY OF DADE. SS. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No ') Date - a ? 17 Read, Sworn to and Subscribed before me. .... 469 M.E. 91 StoNizni to me well known, Notary Public, State of Florida My Commission Expires PL NYNG BOARD DATE Member Member Member Council Approved _ _ _ Date Disapproved Date NOTE: A charge of 81.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re-inspection fee of 81.00 will be charged when such re-inspection is made necessary by improper not"ce for inspection or faulty materials and/or workmanship. Application is hereby made for the approval of the detailsi statement of the plans and specifications herewith submitted for the building or other structure herr•.r described This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village Florida. and all provisions of the Law. of tht State of Florida. all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall br comphec with. whet ha . herein specified or not. A copy of approved plans afld specifications deist be kept at building during progress of the work Owner's Name and Address r i2-A0G I Kloa q Registered Architect and or Engineer 1x ' 11- i�� F>�i?s.t/P4!!!- Name and address of licensed c o n t r a c t o r s � CON S R ) ( Location and legal description of lot to be built on / / Lot_ 7 / Block % Subdivision " 5 ' � R 1 1 206 o Street and Number where work is to be done 14-6 1 '7 E 9 / ST, - - State work to be done and purpose of building Iby floors). state exterior colons (submit samples' ADD ---A 1 c Tzvz- __Z.€JI6GJ .0. 1 1 __ /mss 2 Of Fd_ c z'(' )(50' . t264- 49 / A',r- % STL __ . R€ -• A on JL . e (.(QS `� Th , �C�T = elefb o 'Q , P - P1'!T - SJ kt cet) _yr_� ---. and for no other purl,, 4 s u veo 37 f Z AD, New Building _. —___ - - Remodeling Addition Repairs_ _ --.. _— No of Stories < To be constructed of C 6_ __ ___ _ -. — --- Kind of foundation __C....Me_ - V Roof Covering __6e /4 _Tice _g 14 6 • Estimated Total cost of Improvement, c _t_f fI5L d Amount of Permit g 2 ' °n d _ r ` - -- -- - Tone cubagt• required . -_ — _Plan Cubage __ e r i °' °, °\ . - Distant ( to next nearest building _ _ - ___ _ _ _ _ ........ _ � Size of Building L g m $0(x r z� 7. 7 ' 6 Maximum live load to be born( to each floor - - - -- 1 beret). submit all plans and specifications for said building All notices with referent( u. the building and its construction ma■ be sent I. The undersigned applicant for this building permit does hereby certify that he understands and accepts his-obligatens as an employer of Labor under the Florid., tt.+rktnty. Compensation Act. being Section 5966. Compiled General Laws of Florida. Permanent Supplement gnu ,ias compile., dttith the provisions thereof. and will rev irt s;nu...• compliance from all contractors or sub - contractors employed by him in the work to be performeo under h .ermit e pose u, t:ause to be posted ' asp on the site of the work such public notice or notices as are required by the Act. The undersignedagree •mplo it/p sues subt-ontratoors u • tdi r•i o'yturm( (: under this permit. as are licensed by Miami Shores Village Remarks (Signed STATE OF FLORIDA COt'NTY OF DAD(_ iss Before me the undersigned authority. a notary public. duly authorized w administer oaths and take acknowledgments. personall} appeared JOL /'v - Z.0 and who. being by me first duly sworn, upon oath deposes and says that he is the V(C/ / _C iILA)T of the above described construction. that he has carefully read the foregoing application. and that he did sign the same. and tht r all fasts t' b }.jbim state(? ar.- tra, a - i Date 9 Read. orn � o and and Su cribed before - •, 7 Notary Public';Stete i f Florida. Permit No 1'1_4' Disapproved (Signed. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT i`L -1VUW� Date Building Inspector PLANNING BOARD Chairman _ _ Member Member Council Approved Date Disapproved My Commission Expires DATE Date g- 2 7— g �, $tercet � _� : �• - l-5Sc• I d t1 C Ar?ci -I -r c7j ON IN C- 745 w. Ftixo,lee5 - # 7 33134 J. OTf W CCCO4S s 2 1.: Member Member Member \tl; A liars. ,` 0, w,l' t.. ad• tat' making torr(- :, n• or changes u. thin appbcaut.: btu- app-a.t' hie Neer obtained free tb. 1'i - 1. A re- Inspection of hZ :.(J( wiL b. charged whir. such. re-inspection is made necessar■ b■ improper notice for in- pt•cuon or fault r..atenal- ..nc. • 'r tc mi w ell know h.: (3051 264-6260 JULI ° es Vice CO Co nstruction, Inc. TACO FL`GLER STRECT 74 Mi pt41, FL R ON 33144 Application is hereby made for the approyal of the detailed statement of the plans and specifications herewith suknitt -•.i fur the buil;- ing or other structure herein described. This application is made in compliance and conformity with the uilding Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address Registered Architect and /or Engineer Name and address of licensed contracto Location and legal description of lot to be built on: Lot Block Subdiviision on State work to be done and purpose of building (by floors) 7 c11 Street and Number where work is to be done STATE OF FLORIDA, COUNTY OF DADE. ss Chairman Member Member MIAMI SHORES VILR A UILDING INSPECTION DEPAf VML Mer APPLICATION FOR BUILD J F CI f 10 Date__ Remarks ( Signed ) _ No PLA NING BOARD__ __ _ DATE Member Member Member it Street - -- and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ o°�°� Amount of Permit $ Zone cubage required _Plan Cubage_. Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor___ I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen s Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared — - - - - -- - - to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. , Permit No - - ", 7 � � 2' D ate- ` f_ Read, Sworn to and Subscribed before me. / ._ - - -�- - - -- -- Disapproved __ _ `' Date -- - -- �J ' � � Notary Public, State of Florida (Signed) L _-/ Building Inspector My Commission Expires__ __ _- Council Approved __Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with. whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address A d �Z i Registered Architect and/or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: -_ Lot 41. Block / 9 Subdivision . �T/ 1 // � N 9/ mpl r � • � :=:— 1 State work to be done and purpose of building (by floors), state exterior colors (submit saes P i 7 Q �i� / // .44/.2 � . Street and Number where work is to be done MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT New Building , JY 72/ (, To be constructed of Remodeling Addition Repairs Kind of foundation V Estimated Total cost of improvements S —�(1 � • P Amount of Permit S —� Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons as an employer of Labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the . ork such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors. on work to be performed under this per '. , : s are licensed Miami Shores Village. — ��/ 1 Remarks �r � � �'�t� (Signed) • � 44 12-g ' �> STATE OF FLORIDA COUNTY OF DADE. J 55. Building Inspector Date Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared and who, being by me first duly sworn. upon oath deposes and says that he is the _ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No. Disapproved Date l t f Notary Public. State of Florida (Signed) Read, Sworn to and Subscribed before me. My Commission Expires PLANNING BOARD DATE v 9 Date 19 9 No. / j Street./ l � � f� No. of Stories Roof Covering and for no other purpose. to me well known. Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of 525.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and or workmanship. IDATE cG /-1--X,1 111 76 5 iFeArto..44- «1 to cc; fc.1 ZINING CRITII UE SHEET 9C.7 L IEDE COMMENTS INITIALS 6 / 67e46e- STATE OF FLORIDA ) COUNTY OF MIAMI -DADE ) 73 a ,A, w 1 G reilage (ek,ez (9204e. 10050 Q4< r 0 uce atcagni atoleeo, 9 33138 SATISFACTION OF MIAMI SHORES BUILDING & ZONING VIOLATION This is to certify that previously cited violations of Section 202 and other related sections of the South Florida Building Code have been satisfactorily corrected in connection with the following described property: Legal Description: Lot 21, Block 49, Miami Shores Section Two (2), Plat Book 10, Page 37, Dade County, Florida. Street Address: 469 N.E. 91 Street The County Recorder is authorized to cancel and discharge the Notice of Violation, recorded in the Official Records Book 13835, at Page 2282, relating to the above described property. Dated at Miami Shores, Florida, this 23 Day of December, 2003. Curtis Crai •, Building Offi Miami Shores Viiiage BEFORE ME, the undersigned authority, this day personally appeared Curtis Craig, who did acknowledge that he signed the foregoing for the purpose and intent expressed therein. Prepared and notarized by: My commission expires: gliavze: (305) 7.95 -2207 Barbara A. Estep, NOTARY PUBLIC STATE OF FLORIDA AT LARGE $ G Barbara A Estop My Commis -Ton DD170470 -11 0, Eupfros March 29, 2003 Miami Shores Village 10050 N.E. 2 Avenue Miami Shores, FL 33138 -> C9Ciev.• (905) 756'-8.972 $ Oita a:tela @mia Adiooevvd4o.eom MIAMI -DADE C"' '''v r' Rr" OF COURT RECORDS DEPR 22 N.W. 1ST MIAMI, FL 3 DATE:01 /05 /2„u 1c F RECORDING F Sub. Total AMOUNT DUE: PAID CHECK: Check N: TOTAL PAID: REC BY:RUBENV DEPUTY CLERK 3K/ G:21949/4749 6.00 r $6.00