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863 NE 92 St (4)MIAMI SHORES VILLAGE • BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 3 Type Insp' n Dl Q, uu Permit No. Name Ca xcAC.A' 9'23 Address c' Company :g 5 s / Phone # Inspection Date Approved f 1/4 Correction ❑ Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE 613 BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Type Insp'n — modal 100 Permit No. I PaS J PP • Name 00y'Cb i Address b( S Iv� q 2-54 Company gory Phone # Inspection Date Approved Correction Re- Insp'n Fee Dat Type Insp'n tomd 1 1 DCW rs Permit No. bRon ° d Name 22 � � 1 1 c Address 453 J 'vE. qa 34 Company R. Phone # Inspection Date Approved MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Bgilding Inspection Request Re- Insp'n Fee 3/a tE?c2. a eta Rez C,71 1 1-1 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 2/24/2005 Applicant: JACK GORDON Owner: GORDON JACK JOB ADDRESS: 863 NE 92 ST Contractor R & R SURFACES, INC. Local Phone: 954/382 -2142 Parcel # 1132060050040 Signed: (INSPECTOR) Building Permit Permit Number: BP2005 -179 Contractor's Address: 4475 SW 96 AVE Page 1 of 1 Legal Description: GOLDEN GATE PARK ADD PB 6 -130 LOT 4 LESS E6.05FT & E1/2 LOT 5 Fees: Description Amount FEE2005 -2421 Building Fee $100.00 FEE2005 -2422 CCF $1.80 FEE2005 -2423 Notary Fee $5.00 FEE2005 -2424 Training and Education Fee $0.60 FEE2005 -2425 Technology Fee $2.50 FEE2005 -2426 Scanning Fee $3.00 FEE2005 -2427 Builders Bond $300.00 FEE2005 -2428 Submittal Fee ($50.00) Total Fees: $362.90 Total Fees: $362.90 Total Receipts: $0.00 PAID Permit Status: APPROVED Permit Expiration: 8/3/2005 Construction Value: $2,500.00 Work: REPLACE OLD ASPHALT DRIVEWAY FOR PAVERS 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: BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) Owner's ddress� I�= , G City (ft �l ©k ! State Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village Contractor's Address � / I UJ q 2 L J Contractor's Company Name City Qualifier Architect/Engineer's Name (if applicable) $ Value of Work For this Permit Type of Work: Describe Work: / IIIf 4I��! ^ State J; ,n14,6 4- Submittal Fee $ SC Scanning $ 3 Notary $ Code Enforcement $ Total Fee Now Due $ Training/Education Fee $ Radon $ (Continued on opposite side) Miami Shores Village Building Department 10050 N.Z.2txd Avenue, Miami Shores, Florida 33138 Tel: (3054 735.2204 Fax: (305) 756.8972 Permit Fee $ Plumbing 4(1 ),7 '� 1 Zip r Phone # C Electrical J'�t�✓ ,J( 6i q ?'mil" ✓ County Miami -Dade Is Building Historically Designated YES NO State Certificate or Registration No.VfdJ ✓J Certificate of Competency No. 666 Square Footage Of Work: - ✓I * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Zoning — Bond $ Structural Plan Review. $ Master Permit No. Phone # Phone # Permit No. 13 PO 2 Phone # Mechanical Roofing Zip (?✓ ( 94)A- cop, Zip ✓, p ✓✓ ,1� CCF $ L o 6 CO /CC Technology Fee $ ii 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien !env brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection • • will be charged. who is personally known to NOTA' iIl:•LIC: Sign: My Commission Expires: APPLICATION APPROVED BY: Chc 05/13/03 Signature Owner or Agent The ere instrumentwas ackno edged before me taus day of _ 20V by w to did take an oath. "YP ;,►� .. finny H. Got?g)TARY PUBLIC: Commission #DD323870 2008 Sign: Bonded Thru Inc Contractor The foregoing instrumenkwas acknowled d bef e me this day of �iJ% 200', by G�" `, � w h ( is personally nor who has produced Print: My Commission Expires: as identification and who did take an oath. **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ************************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * ** 9 V r. A o, E> •s S.p emw 05.2e° pion om m s$ On D034351e Plans Examiner Engineer • ' f' % Zoning Lot Tax Folio #: requests permission to install: Miami Shor� 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 -2382 Telephone: (305) 795 -2207 Fax: (3051756 -8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY WHEREAS, , hereinafter referred to as the Owner of the (owner) following described property: Legal description /folio#: ��� - � . . Block Subdivision SIGNED, SEALED AND DELIVERED in the p pence of: SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this day of n Pf 0 ►4�� - f [asphalt, concrete, brick pavers [ ] Landscaping [ ] Other within the public road right of way of 2•+ .E._. C (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). 'STATE OF FLORIDA) COUNTY OF DADE) The undersigned Afant, does hereby attest that the (property owner) attached survey, performed by ® 9_.c (name of surveyor's company) performed on `C\ at,`'S 4 , 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.. Further, Affiant sayeth naught. Witness(sign and print) Witness(sign and print) SWORN TO AND SUBSCRIBED before me this t/ day of ! `�© Affiant is personally known to me, produced (IC � ( (C Y)as identification. 0 1111P 116 Commission #DD231984 kv9 Q- Expires: Jul 13, 2007 .• NOF•■S)@A BondcdThru Atlantic BcvlirgCu b,d J. B. FORD CO. : ?12 S. W. 1st Street Iv1IAMI 35, FLORIDA Telephones: 9-3508 82 -002 /y .E 9Z' $72 -1 I-5 fy cB5 # 803 32•!05 Public Records of Dade Coui, Florida. For / C 0 %le> I HEREBY CERTIFY th..t the attached sketch represents E. survey made under my direction and is true and correct to the best of my Isnowledge and belief. There are no encroachments as show: REGISTERED LAND SURVEYtik 427 STATE OF FLORIDA - /0 4 'Pe" .5",eE 5C '7 t. ' 1" = /' FT' H'N r a ca /. ,c, ,BL D 'a SE S 4C f,G el/yr • 26 Ft 5/l f3 /o FT A`P'X e4 P i f y/ 4 a> / y/o 54n//7A .3E v%/E,E'-.S .Survey of Lot 5 leas the West 20o605'Ft. & Lot 4 leas the aat 6.05 Ft 5look 1 Golden Gate Park Addition According to the Piat thereof as recorded in Plat Book G , at Facie /3a / 48 ■ a /. a 4 ?.3 V /2 a ^ /1 Q iv ° 1 O '' 8 C4 Lyo ofi a C. h 1' q , . �• . . . ./35 3 Q bGa'vd/ 1 4o•ad' h J. B. FORD CO. : ?12 S. W. 1st Street Iv1IAMI 35, FLORIDA Telephones: 9-3508 82 -002 /y .E 9Z' $72 -1 I-5 fy cB5 # 803 32•!05 Public Records of Dade Coui, Florida. For / C 0 %le> I HEREBY CERTIFY th..t the attached sketch represents E. survey made under my direction and is true and correct to the best of my Isnowledge and belief. There are no encroachments as show: REGISTERED LAND SURVEYtik 427 STATE OF FLORIDA - /0 4 'Pe" .5",eE 5C '7 t. ' 1" = /' FT' H'N r a ca /. ,c, ,BL D 'a SE S 4C f,G el/yr • 26 Ft 5/l f3 /o FT A`P'X e4 P i f y/ 4 a> / y/o 54n//7A .3E v%/E,E'-.S .Survey of Lot 5 leas the West 20o605'Ft. & Lot 4 leas the aat 6.05 Ft 5look 1 Golden Gate Park Addition According to the Piat thereof as recorded in Plat Book G , at Facie /3a ' �1