262 NE 93 St• PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 5- ) -- Address 6,,�, q 5-5r Tax Folio /1- 3 �D — 0/3 3Q°
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Legal Description 107/.// / 44Gc , ) M#0, � 70 Historically Designated: Yes / No
Owner/Lessee / Tenant .e Noc,yi lam. Master Permit # ! g f
Owner's Address 2-4 2 ve 93 ST Phone r) 7.f8 (z 9 ,)
Contracting Co. .1 �2J ��A- S yr j'.c (1 R,/ eft( Address (� �� Z) ��d/
I ( 04 3 23 - 33S
Qualifier Ad L„i ' Phone \ 9 //
State #
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one):
WORK DESCRIPTION 4 cj/ 'F 6269e, /J/ •A iAy AT F r .
Square Ft. em S�!
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.)
4
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 zoning. Furthermore, I authorize the above -named contractor to do the • ted.
Signa
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Notary a
My Co
APPROVED:
FEES: PERMIT
e of owner and/or Condo President
il
�ja..!• - ; • . , n . •u,1nn. JUNCO Da
c'fTonE l ,E * rtr, i m T , � �ISSI O N #CC 85236
,,,, ,. :a: EXPIRES: July 6, 2003
' Rf . Bonded Thru Notary Public Underwriters
RADON
Municipal #
ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
'°_ 27 —t
Date
Competency # 5979 0 /
Address
Address
Address
A-13 4 s7 . gzA3 ftia eon
Estimated Cost (value) >
Signatur
RODOLFO JUNCO
= ��� �; MY COMMISSION -
rai � s N # CC
;: -���.a EXPIRES: Jul 6 2 0�
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ru 'o ary ublic Underwryt
of Contract r or
Notary as t
My Commi
t ntractor or 0 i..-. _�-
on Expires:
Ins. Co.
C.C.F. / 1
► NOTARY O BOND Spa
Electrical
TOTAL DUE
0'
Mechanical Plumbing Structural Engineer
•
Tax Folio #:
requests permission to install:
Asphalt, concrete, brick pavers
[ ] Landscaping
[ ] Other
within the public road right of way of /(1E: 9 ST -
SIGNED, SEALED AND DELIVERED in the presence of:
flh iarni ShoreO Vi��ac�e
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 - 2382
Telephone: (305) 795 -2207
Fax: (305)_756-8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
g,
WHEREAS, 9 g NV. 0 /l k,& b , hereinafter referred to as the Owner of the
(owner)
following described property:
Legal description /folio #: / j, 3)- 496 —0/3 -"WO
Lot -J Block ? Subdivisio PikM/teid 4 7 o M4. S1ut>e; /
(address)
IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows:
I. 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 lien 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 21 11A. day of
(owner)
nppeon
5.- 2
fial 4
��� +�� : MY COMMISSION # CC 852366
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THOMAS J. KELLY, INC.
L.B. #6486
SURVEYORS - MAPPERS -LAND PLANNERS
333 PALERMO AVENUE CORAL GABLES, FLORIDA 33134
(305) 444 -7692 DADE (954) 779 -3288 BRWD
(305) 441 -6494 DADE FAX (954) 779 -3260 BRWD FAX
SHEET 2 OF 2
DATE FIELD WORK SCALE 'SURVEY R NO. I
evd- d4 -2noo 1° _ .2 4 7/