70 NE 92 St (5)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date; a f — I Job Address 7& /Ye / Z Tax Folio
Legal Description Historically Designated:
A )1/ "p 4,Y
Owner's Address 2c, Id X 9 2
Contracting Co. ,6 , / / /" Z e
Owner/Lessee / Tenant
Qualifier 6 W / A. bill Cs-€7 PhoneC3oS� ��P � ' S
State # ( 'G. D ( Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFIING
WORK DESCRIPTION `� 4 ? ii/ ads /%�6 71 gew
Square Ft. Estimated Cost (value) k q » ,
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work
will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL
PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
3
ignature of own r and/or Condo President Date
'1
Notary as to Owner and/or Condo President Date
My Commission Expires: t'ic .Y 1
1 RADSHEWON BUTLER
NOTARY PUBLIC STATE OF FLORIDA
O011 ION NO. CC'. 37717
MY COMMISSION MAY 17,2004 _
FEES: PE
APPROVED:
RADON
C.C.F. 6D NOTARY
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Zoning Bmldmg 3f-14 electrical
Mechanical Plumbing Structural Engineer
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Master Permit # ye5
Phone(
Address / 3 / 6 3
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Signatut`e Contr ca for or • - er -Buil te>`
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er- Builder
ELIZABETH AGUILA
COMMISSION # CC 673958
EXPIRES OCT 10, 2001
BOND81D*U
ATLANTIC BONDING CO �+NC
FENCE SIGN
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Date
BOND - 30O. 0 0
TOTAL DUE
Date
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STATE OF FLORIDA)
COUNTY OF DADE)
�CGLYYLL Sliore� VGLLGCG�B
AFFIDAVIT
P1.1 l I IL'�.L'F4 rJ
($roperty owner)
�vAr £, /� / 'f nom: fd S Y trc f� �i f�.
(name of surveyor's company)
performed on 2 - 1 .3 — 6 � is an accurate representation of the existing conditions and
(date of survey)
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the
property without first providing a survey less than six (6) months old. The Affiant, as property owner, further
agrees to remove or obtain permits for any structures which now may exist on the property which are not
permitted or which may violate zoning or building code regulations. The Affiant further understands that the
existence of any such structures may affect final inspections as applicable to this or other permits..
The undersigned Affiant,
attached survey, performed by
Further, Affiant sayeth naught.
Robert G. Parker
MY COMMISSION # CC945142 EXPIRES
June 14, 2004 Notary BONDED THRU TROY FAIN INSURANCE, INC.
, does hereby attest that the
Affiant/Property owner
T�
SWORN TO AND SUBSCRIBED before me this ) 4 Clay of 2,00 1,
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WHEREAS, 7
M iami Sores V/ /aye
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
(owner)
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 -2382
Telephone: (305) 795 -2207
Fax: (305)_756 -8972
, hereinafter referred to as the Owner of the
following described property:
Legal description /folio #:
Lot ,/4-4r';t14%057 2 6 Block / Subdivision I Il' Qj � G ?d
Tax Folio #:
requests permission to install:
[+.]/sphalt, , brick pavers
[ ] Landscaping
[ ] Other T�
within the public road right of way of ,7 U Rn- T2'
pRluiiuf1'/
(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 representative).
SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this 9 day of AL 1
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o wne r)
SIGNED. SEALED AND DELIVERED in the presence of:
OFFX AL NOTARY SEAL
BRAD SON BUTLER
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC 937717
MY COMMISSION EXP. MAY 17,2004
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SKETCH OF SURVEY
Lot 4 and the East 1/2 o1( - Lot 5, B.eoek. 1, AN AMENNEV PLAT OF MIAMI SHORES
SECTION NO. 1, aecond i n.y to the peat .theneo4, ad iteco'tded in Peat Book 10,
at Paae 70, oA the Pubt i.c Recond.s oA Dade County, FLol ida. _
Fon.
MIL_ Stan Mc vain
P/copentu add)cez4: 70 N.L. 92nd. St., Miami. Shonez, F!a.
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2/a 22:
JUAN R. MARTINEZ C ASSOCIATES, /NC.
ENGINEERS PLANNERS LAND SURVEYORS
saw w. FLACLZR sr. AWE •-/Oa thou, rJR1D4 33144 . /Moil twos/ eat -loos
/ HEREBY .:L 'R77FY . That the attached 'SKETCH OF SURVEY - represented hereon is true and correct
to Me best of .)•y Snow/ edge and be/let, and meets the "MiV/Mt'M TECHNICAL STANDARDS" as set forth by the
° FLOR /DA BOARD OF LAND SURVEYORS ; pursuant to Section 472.027 Florida Statutes
JUAN, R.
Prafessano/ Land Surveyor N °2/60
State of Florido
H 5' 6647' 3 0,,
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President
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