725 NE 93 St (14)APPLICATION FOR BUILDING 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
t�-.
Owner's Name and Address.... ' / /✓ 7 41 ,.J) . N `k
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
/4 Y
� i G i /_ (S: G"'l''
Disapproved /
(Signed) i
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Street r✓
4
Notary Public, State of Florida
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
7 Estimated Total cost of improvements $ 5 ✓ eia Amount of Permit $
Zone cubage required Flan 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 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 performed under this permit; and will post or cause to be posted for inspection on the site of the work such ublic 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.
e > LL i , e ' ) // !///4 /6: / /eye i zi
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 Date 1' — Read, Sworn to and Subscribed before me.
Building nspector My Commission Expires
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 improper notice for inspection or faulty
materials and /or workmanship.
6-71094k
Company
Phone #
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
Date
305- 795 -2204
Buildin: ns.ection Request
Type Insp'n
Permit No. v J r d- R0
Name r Yt
Address 2 s !" c q 3
Inspection Date V
Approved
Correction
Re- Insp'n Fee
Inspection Date
Correction
rAIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date 5
144
Type Insp'n
Permit No. B O5
Name ^� q Address ! D-5 10 E q 3 sf
Company nct r
/
Phone # lJ " 1
s l
Re- Insp'n Fee ❑
0
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204 lv)
Buildi g Inspection Re•uest
Date
Type Insp'n
Permit No.
Name
Correction
Address 7 5 '\ e q s Lv
Company " CO/0i t
Inspection Date
Phone # ggp
Re- Tnsp'n Fee ❑
Building Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2005 -286
Printed: 3/16/2005
Applicant: ROLANDO FERNANDEZ
Owner: FERNANDEZ ROLANDO
JOB ADDRESS: 725 NE 93 ST
Contractor SUPER STAMPED CONCRETE Contractor's Address: 5204 S. W. 134 CT.
Local Phone: 305 - 220 -1163
Parcel # 1132060141830
Work: PLAIN CONCRETE DRIVEWAY
Page 1 of 1
Legal Description: 5-6 53 42 MIAMI SHORES SEC 3 PB 10 -37 LOT 29 & LOT 30 LESS E2OFT BLK 65
Fees: Description Amount
FEE2005 -3403 Building Fee $150.00
FEE2005 -3404 CCF $3.00
FEE2005 -3405 Training and Education Fee $1.00
FEE2005 -3406 Technology Fee $3.75
FEE2005 -3407 Scanning Fee $6.00
FEE2005 -3408 Builders Bond $300.00
FEE2005 -3409 Submittal Fee ($50.00)
Total Fees: $413.75
Total Fees: $413.75
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 8/28/2005 Construction Value: $4,700.00 0 -
Signed: (INSPECTOR)
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.
Signed: (Contractor or Builder) BY:
Miami Shores Village
Building Department
10050 N.E.2r1 venue Miami Shores, Florida 33138
Tel: 303 O4 — M O0156.8972
BUILDING ° ` 2 r=' Permit No. e:,tz
PERMIT APPLICATION Master Permit No
FBC 2001
Permit Type (circle):
Tenant/Lessee Name
State Certificate or Registration No.
$ Value of Work For this Permit
Owner's Name (Fee Simple Titleholder) Rol clod o - Fernarcte Phone # 331— 0 2 1 1
Owner's Address a5 me 9 st M. Shores 1F 3313 8
City M 6hores State r L Zip 3313$
Job Address (where the work is being done) E) NE 'I 3 Az
City Miami Shores Village County Miar ' -Dade Zip 33 139
is Building Historically Designated YES NN.
Contractor's Company Name SO PER s +Qmp tr Nenfreina Phone # 305- •a 0- 1 1 (o 3
Contractor's Address 5204 5u) 13 CA
City State F1
Qualifier W i L I i Arri 9115
Architect/Engineer's Name (if applicable) Phone #
Type of Work: ❑Addition ❑Alteration ❑New
Describe Work: PLATS enti Ett 91Zlv5-IN7
4 4100, 0 0 Square Footage Of Work: 11-loo
* * * * * * * * * * * * ****** * * * * * * * * ** F ees * * * *** * * * * * * *** * *A* * * * * * * * ****
Submittal Fee $ Permit Fee $ /S CCF $ �^ CO /CC
Notary $ Training/Education Fee $ ,�'— Technology Fee $ 75
Scanning $ — Radon $ Zoning
Code Enforcement $ — Structural Plan Review. $
Total Fee Now Due $ +0 :7 C e
(Continued on opposite side)
1
Electrical Plumbing Mechanical Roofing
Certificate of Competency No. E 98 1.9 0
Phone #
zip_ 3311.S
Lf F:epair/Replace ❑ Demolition
Bond $ ?eR®
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 82500, 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 comme
for the first inspection which occurs seven (7) days after the building permit is issued. In t
inspection will not be approved and a rei spectio 'e will be charged.
.............. ..............
MAR FRA�@
Comma 8224 atuie
4,4 ! Ih1u (80o)432 -425a
.NN.w.....110•11 O r Y Aasn., Inc
The foregoing instrument was acknowledged beforee this a The foregoing instrument was acknowledged before me this ae
day of Fit- , 20 0E by e 1Q (1O I_SYi'AI et,, day of 1 &r , 20 OS, by [..0i )1;A I - 1 JVS
who is personally known to me or who has produced Di. who is peally known to me or who has produced
Signature
Own r or Agent
As i ication and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
/� /� // ��� /._� Sign: q -eikA t.L Sa..A4.4.--- Sign: �/�i �
Print: a / w! • Print: y t i n -.. S a --. S
My Commission Expires: 'I' I Co I 0 $ My Commission Expires: (013/01
1
Chc 05/13/03
NOTARY PUBLIC:
APPLICATION APPROVED BY:
coo of umtgA
e o sz tice, th
;`r COMMIS...$IO # i t7 g091841 !!
:: ;10147 )
Contractor
de4ey 3 4/d I
Plans Examiner
Engineer
Zoning
STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant,
attached survey, performed by
Witness(sign and print)
(date of survey)
Affiant is personally known to me,
flh iami SJorQ� Vdtcte
Dp'
AFFIDAVIT
�ol ardo erwa t ck2 , does hereby attest that the
(property owner)
(name of surveyor's company)
performed on , is an accurate representation of the existing conditions and
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.
Affiant/Property owner
Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this ag day of C 200 S
as identification.
MARaA FRANCO /SANS ""
Comm# DD0282247
s ilea 451=8
SWIM IAN (800)432-4254
Rata Aron., ••
.....
(ACKNOWLEDGEMENT-INDIVIDUAL)
STATE OF FLORIDA )
) SS.
COUNTY OF MIAMI DADE )
The foregoing instrument was acknowledged before .me by
, who is personally known to me or who has produced
as identification and who did (did not) take an oath.
Signature of Acknowledger:
Name of Acknowledger:
STATE OF FLORIDA )
) SS.
COUNTY OF MIAMI DADE )
Title or Rank:
Serial No.(if any):
(ACKNOWLEDGEMENT - CORPORATION)
The foregoing instrument was acknowledged before me on by
, of
a corporation, on behalf of the corporation. He/She is
is personally known to me or has produced as
identification and did (did not) take an oath.
Signature of Acknowledger:
Name of Acknowledger:
Title or Rank:
(Typed, Printed, or Stamped)
(Typed, Printed, or Stamped)
Serial No.(if any):
m ami Shore liar
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 - 2382
Telephone: (305) 795 -2207
Fax: (305)356 -8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, RO I Cl nd 0 - Fe rns ndez, hereinafter referred to as the Owner of the
(owner)
following described property:
Legal description/folio #: ' 3� 0( - D 1 �{ S 30
Lot Re! d' 3 0 - 2014 Block Co 5 Subdivision
Tax Folio #: 1I-3l0(c - " O)4 - 1830
requests permission to install:
[/fic'sphalt, concrete, brick pavers
[ ] Landscaping
[ ] Other
within the public road right of way of 7a5 1J2 q 3 At
(address)
IN CONSIDERATION of theapproval 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.
?. 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 a day of
SIGNED, SEALED AND DELIVERED in the presence of:
m .,,,,, 3.
pktuEtuhv
f PPRo4ct-f
MAROLA FRANCO /SANS
Comm# DD0282247
Expires
II Bonded Oyu (800}4800)4 32 2
-4254
'inn Oyu Florida Notary Assn., Inc
- ?A5" Ne.q8A-t ALLA,/ po
"II, otazpo
PDW011 3
Zoning
Approved
c.'f'
STATE OF FLORIDA, COUNTY OF DADE
1 HEREBY CERTIFY that thin is t of iho
oriN' filed i n lb' olfica on day of
au< _. A D 24-1 5
VIIITT 'ESS my hcni on - ftrcia!
HARVEY- IN r E County Courts
ey ,/it 1rL,u!1
- D.C.
NOTICE OF COMMEJ CEMEN
A RECORDED COPY MUST BE POSTED ON TIIE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO. 1 � — 3 Q 0 (c -01 - X 5 30
3. . Owner (s) name and address: RC l t n d 0 Felrn and22
Interest in property:
Name and address of fee 'mple titleholder:
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond: $
6. Lender's name and address:
Name and addres
unless a different date in specified)
-.�
SiM gnature otOwner
•
Print Owner's Name
Sworn to and subscribed before e this
Notary Publi
Print Notary's Name
My Commission Expires:
�olando
— — - leoolrax,:
XN
a day of rjJr20 O.
1
CFN 200
OR Bk 23125 Ps 2076; (1P9)
RECORDED 03/01/2005 14:52 :35
HARVEY RUVIN► CLERK OF COURT
MIAMI -DADE COUNTY, FLORIDA
LAST PAGE
STATE OF FLORIDA
COUNTY OF DADE
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance
with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement: '?
1. Legal description of property and street address: 5 N E 93 • �`'� ■ a m I Shora S
Sec. 3 tot aq * ' o - E�,o ¢ ' 66 I Pe, 10 ) P 6- 31
2. Description of improvement: PLATO 0-01\1c r -i.e. d r i ve aAy
1 1. •
4. Contractor's name and address: ! NCrete
5R09 BSI I3 I -t■AMi ei 03176
7. Persons within 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:
8. In addition to himself, Owner designates the following person (s) to receive a copy of the Lienor's Notice as
provided in Section 713. 13 (1) ( b ) 7., Florida Statutes.
Name and address
9. Expiration date of this Notice of Co gj t ( expiration date is 1 year from the date of recording
LA F .................
Canynip
°8 2247
� 4/6/200e
Prepared by: a ro la -F; 6'S
Address: 690 6,1) it 01- M R n.1J i FI. 3irS