BP2005-1506Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (13A ,04- 1�ax:.(305�.Z56.8972
ti 1 5-CD-(=D 1 Laster Permit No
Permit No.
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
)
(Fee Simple Titleholder) l <
Owner's Name
( P ) � Lys ` jC 14 L11-1 ' 0 Phone # . C 7C6
Owner's Address y7 7 3 LI 11,' 6 1 2— `-) J
cit A') 1 /41v) I ' [rGticz.Cstate F I-- Zip 3 3 .3
Tenant/Lessee Name Phone #
Job Address (where the work is being done)
City Miami Shores Village County Miami- ade Zip
Is Building Historically Designated YES NO
Contractor's Company Name P iC r / e &C ) / v ( - 76 - e Phone # 3 0
Contractor's Address / (' l y A/ ft) % �' m �� / �j / ' 5)/)/
City /11 State 14- Zip 3 -/ ? 0
Qualifier ! � l / /� r 7'/ �✓
State Certificate or Registration No. �— 2 3/r ,) Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
(?c
Type of Work: ❑Addition ['Alteration ['New
❑ Repair/Replace 11 Demolition
Describe Work: ;77jlQf/" (r %/o) .Corte f • 94 till ({' /ot ?/ .
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
pv
Submittal Fee $ Permit Fee $ Z ZS — CCF $ 're?9 1 CO /CC
Notary $ Training/Education Fee $ 0.
Scanning $ 3.CX.)
Square Footage Of Work:
79
Technology Fee $ . . 2.0
Radon $ Zoning Bond $ 30. Op
Code Enforcement $ Structural Plan Review. $
+33. f:O
14042
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 wil .t be approved and atFeinspection fee will be charged.
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 aa.oath.
As identification and who did take an oath.
NOTARY PUBLZ €: 3 , r
Sign: �-�
Print:
STATZOF FLORIDA NOTARY PUBLIC:
1�.", °I`1S Negri11 ')T'YPUBLI OFF ` DA.
Sign: E C rr�ri Ntt
Qomjnission # DD44851 / t _
ffoirty 07 2009 Print: ~ ! �� missi0 # D 9 17
My Commission Extlir a ' �.% ATy uc t7n- C o '. i •- My xpiresi nu - � •.' ' g Inc ("r.° J
t I M CommissiotaE �
r
** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * ** * * ** * ** *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
APPLICATION APPROVED BY:
chc 05/13/03
Signature
/, / OJ
i/1
Plans Examiner
Engineer
Zoning
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, �f... -CC 14 L i , hereinafter referred to as the Owner of the
(owner)
following described property:
Legal description /folio#:
Lot .J
Tax Folio g: //° .32,06 -- O / / /e0
requests permission to install:
SIGNED. SEALED AND DELIVERED in the presence of:
fl Sjor�
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 - 2382
Telephone: (305) 795 -2207
Fax: (3051756 78972
Block b g Subdivision I ` i '�I GL✓vt, / SA& r
Asphalt, concrete, brick pavers
[) Landscaping
[ J Other
within the public road right of way of 5 3 L/ Aj / S i Q, `l
(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 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 r resentative).
SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE •• is 41 day
r (owner)
LJ
.
0.07 VA :10 Ln.E5 cy_e05SE0 vl'"M
SURVEYOR'S SEAL •
REVISED'
ABBREVIATIONS:
Sw4 =50 NALK Cis =CCrICRE:E SICC4 S:,P.C•LRE. CIF =CHAT, _e•E FENCE. X = ?7CPERY t4E. OUE=MANAGE .11LY E?30ME`. :.
IP•I1CN P:FE. 7 =7OLE,O. NC= AR CONO ti.Ch77 PAD. .PIC • PQ0P73.I' CORNER C/H= DRILLED N'lE. W/F= 'OCCEN FENCE.
RE5.7E50ENCE. Cl =CLEPA. RB•RESAR UE =LITutt FASEMEN1. CONC =CONCREES 5003. OW =RIGHT CE WAY. DE =02VNAGE DS?. E•+1
CR- CENTER tRa. 0 =00AME75 :7, IYP....Y.CAL M•51E)5o1350 R.RSCOn6EO. ENCR•ENrC.70ACFMEN1.
WD =NAl B DISC. 5 =5EI. FFE =777033 LOCn ;L- ^ IAi.N. 06 =07 7571. PiP.,'OW3i nth: OHP.CV57hEAL RO.WE Rlh7 v/A: •'N0 l'E :R
WOOD FENCE. ELEVATION BASE ON
MASONRY WALL= -
CON'CRETE= 1...•,:• :'• . : , . ....... CBM // ELV.
VAINIL\ANCE 0 MOUSE Eu�: = tit - •E• LOCATOR INDEX;I
NOTES: UNLESS OTHERWISE SHOWN, THE FOLLOWING NOTES APPLY. .
1) Record and measured cells are In substantial egreement. 2) Bearings, if shown are based on Plat date 31700 Iands
shown hereon were not abstracted for Easements or other recorded emcurnbrances not shown on the plat and 'he Same. it
any may not be shown on his Sketch. 4) Undorground portions of Foolinns. Foundations or ol■ei imams c:7n Is 0 003 re:
located. 5) Elevations are based on Natic.nal Geodetic Datum. 6) Fence Ties are to the Centerline cl 5.o (0.".:e. 71
Tie5 to the face of the Wall fi r' ;1.;C•0 011113 0(1(1(13 O.RE HUMMED 70 AN ASS'T' fill 3ALUE 5d'.0 0B- 1L( C_
tr-
I HEREBY CERTIFY Thal the survey represented
/ereon meets the minimum technical requ,ramCOI
adopted 57 the STATE OF FLOR700 Boe'0 cl Lena
S'ur.eyor pursuant to * Sec■on 472. 027 Florida
Sla:u:et
,here are 0.0 encroacbmenls overlaps. ea semen:s
ap ar.nQ 0n t he 7111 or 7,9 ea5eenis ether
:can pe as 5hoan hereon m
127 34 7.---
4' .- --
(305) 865 -1200
. rl ,•,���, + 01000 zo:
ADIS N. NUNEZ ;PANEL :
REGISTERED LAND SURVEYOR DATE
7T TE CF FInr.ID :. ` ,9 . 3 4— 1
SCALE:
CERTIFIED TO: CAROLYN SCHLAM, 534 N.E. 92ND ST., ML
DANA F. CHARLES, P.A., ATTORNEYS' TITLE INSURANCE
WHOLESALE LENDER, ITS SUCCESSORS AND /OR. ASSIGNS, ATI
LEGAL DESCRIPTION' LOTS 2 AND
OF MIAMI SHORES SECTION NO. THREE
ACCORDING TO THE PLAT THEREOF AS RECO4 :ED IN FLAT BOOK._I
OF THEPUBLIC RECORDS OF MIAMI —DADE 'COUNTY, FLORI':
MZMIEZMVSUCCELZMICES
SINCE
I3r.ANco Su):
Engle ors • Lend,SVrve4O
X SUFFI
0093 C0h7)U
DWN.
7 0
555 NORTH
hMIAMMI BEACH
e xmoier cigiectmi
534 N.E. 92 Street. Miami Shores, Fl. 33138 Email:
Tel: 305-756-9330 Cell: 786-897-2276 Fax: 702-549-5756
REQUEST FOR PERMIT TO PUT IN DRIVEWAY IN FRONT OF
534 N.E. 92 ST.
1-3,1 tkv--
ro
v
tt
FINAL DRIVEWAY
U
Passed
r
Inspector Comments
/ 5
AVA C '
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Number: INSP -5407
Inspection Date: 01/09/2006
Inspector: Grande, Claudio
Owner: SCHLAM, CAROLYN
Job Address: 534 92 Street NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: ARTISTIC CONCRETE USA INC
Building Department Comments
Friday, January 6, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
506
Permit Type: Imported Permit
Inspection Type: Final
Work Classification: Building
Phone Number 305 - 756 -9330
Parcel Number 1132060141180
Lot:
Phone: 305 - 888 -4565
Page 1 of 2
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AlI
/1 l ��.iPvi.iie'. P F. rs.�
100tt'! tJ11' Fig AL
Sold To: l P•1E.1)1.1' 1
Delivery Address:
NE SI
READY MIX CONCRETE • PUMP SERVICE • SIX DAY DELIVERY
Sales
Person
3000 PUMP till.
F.NV.FEE - -I=I F.L::I1
GRACE F 1 Lu
Date:
i
S.
1 SLUMP
THIS DELIVERY TOTAL _ : CU YDS.
OF YOUR ORDER FOR CU YDS.
CUSTOMER OR HIS AGENT ASSUMES FULL RESPONSIBILITY FOR
STRENGTH AND/OR PERFORMANCE OF ANY CONCRETE PLACED
ABOVE DESIGN SLUMP OR WHEN WATER IS ADDED.
WATER ADDED: 0 YES ❑ NO GLS
AMOUNT
TAX
TOTAL
Phone: (305) 887 -3250
Extension
BUYER, OR HIS AGENT, AGREES TO ASSUME RESPONSIBILITY FOR CONCRETE, AND ANY PROPERTY DAMAGE RESULTING
FROM TRUCK MAKING DELIVERY BEYOND CURB LINE. ALL CLAIMS MUST BE MADE ?T
� TIME OF DELIVERY.
IF IT BEOOMES NECESSARY
CO NEGE AR SIS RICURRED BY VENDOR IN SECURING COLLECTIONS. V7S WE NS. BEST AT I1/2% PER MONTH ON OUTSTANDING BALANCES.
FEES AND
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 11/2/2005
Applicant: CAROLYN SCHLAM
Owner: SCH LAM CAROLYN
JOB ADDRESS: 534 NE 92 ST
Contractor ARTISTIC CONCRETE
Local Phone: 305 - 888 - 4565
Parcel # 1132060141180
Signed: (INSPECTOR)
Building Permit
Permit Number: BP2005 ®1506
Page 1 of 1
Contractor's Address: 10099 N. W. 89 AVE, UNIT 8
Legal Description: MIAMI SHORES SEC 2 PB 10 - 37 LOT 2 & 3 BLK 58 LOT SIZE 100.000 X
Fees: Description Amount
FEE2005 -14037 Building Fee $125.00
FEE2005 -14038 CCF $1.80
FEE2005 -14039 Training and Education Fee $0.60
FEE2005 -14040 Technology Fee $3.20
FEE2005 -14041 Scanning Fee $3.00
FEE2005 -14042 Builders Bond $300.00
Total Fees: $433.60
Total Fees: $433.60
Total Receipts: $0.00
R
Permit Status: APPROVED Permit Expiration: 4/16/2006 Construction Value: $2,350.00
Work: STAMP CONCRETE DRIVEWAY
Nov 0 4 PAID
— 3
In consideration of the issuance to me of this permit, 1 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.
Signed: (Contractor or Builder) BY: