BP-05-1272BUILDING SEP 1
PERMIT APPLICATIO
FBC 2001
Tenant/Lessee Name
Contractor's Company Name
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel ( 05 756.8972
Permit Type (circle): Building Electrical
r / _ ' mbin Mechanical Roofmg
Owner's Name (Fee Simple Titleholder) l0 �A 7- qL Phone # ' 7, 7
Owner /�'� A J �
City / "l 141/4, JI State
� Zip
Job Address (where the work is being done) : 1�
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO
Phone #
4 2,a6_ Pophone # O5=
Contractor's dress Z/ -/ / 5 5
City 1 4 4 ( State J Z Zip
Qualifier . \ -- >A\
State Certificate or Registration No. C / "f2 (' / 3 Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit (Go ®
Permit No. CB —
Master Permit No. 5 12112
3 3/
Square Footage Of Work:
Type of Work: DAddition DAlteration DNew ❑ Repair/Replace
Describe Work: C / .===,(z l� /2 _L}
* *** * ** * ** * * * * * * * # * * *, *** Fees* *** * * * **** * **** * * * * * * * * * *
Zip
emolition
Submittal Fee $ Permit Fee $ / # ,.� CCF $ CO /CC
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
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,
promise in good faith that a copy of the notice of commencement and construction lien law broc ill be
whose property is subject to attachment. Also, a certified copy of the recorded notice of co
for the first inspection which occurs seven (7) days after the building permit is issue
inspection will not be approved and a reinspection fee will be charged
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
*** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *. * ** * ** * * * * * * * * * * * * * * * **
'A
Wr r APPLICATION APPROVED
BY:
05/13/03
who is personally known to me or who has produced
icant must
to the person
d at the job site
posted notice, the
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 13
day of ,20 , by , day of ,2 by IA.1: £1Prz
LD
NOTARY PUBLI
Sign:
Print:
My Co ission Expires:
* * ** ** * * ** * *** * * **** * ** * *** * * * * ** ** ** * **** *** ** *** **x** * ** * ** * *** rat * ** * ** r*********
identification and who did take an oath.
abet Vargas
• gpgVPU6 n
,) _:- a:COM .0n''D �
ArAE
Zoning
* * * * * * * * * * * **
********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
/ 7:- ® ,.5 Plans Examiner
Engineer
The following pages were
originally attached to plans
with the following permit #
?LOS -Q-7,
7
1 6
S
4
.
a
•
a
1
•
• LAID SUAVEYCAS • PLAt
P.O. BOX 823271 $0UTe 8L08XDA,.•8L. 33082 -3271 (305) 7 72-0784
NE X37•
NE
es .s
LOCATION SKETCH NOT TO SCALE
$ � Ryy
LEGAL DESCRIPTION.
Lot 1 &'the Eastk of Lot 2 in Block 1 of GOLDEN GATE PARK ADDITION,
according to the plat thereof, as recorded in Plat Book 6 at Page 130
of the Public Records of Miami -Dade County, Florida.
SURVEYORS NOTES:
1). Legal description provided by client.
2). Only record plat easements are shown.
3). Right of way information obtained from record pit.
4). In Federal Flood one X, Panel 0093 last revised 3 -2 -94.
5). Benchmark used- Dade County Benchmark *B -62.
6). Elevations are referenced to National Geodetic Vertical Datum'
1929 Adjustment (NGVD29).
BOUNDARY, IMPROVEMENTS& ELEVATION SURVEY
may Fah James =Wahl 899 N.E. 92 St. Miami Shores, F1. 33138 •
cempro&fl aozE. a NOT VALt0 masa SUM al^a apt semoa soaysuoi$ smm.*
1 MBUT C88TI„YY TUT N W 48Y` wus N wZ Tat
=Um TECBNYCdb STANDQ _ Wr T1 MUM sum of summon Ax*
ma : 333 IN CUAPT2* 620 274. nom* memstaTIv$ 000*. P00400/0** TO
se ON 472.027, Florida S°im*stiaa,
4 SEPH L. MARTIN
PRA CNAL LANG $Un inBi * 4368
Tg OF FLORIDA
REVISIONS
BY
DATE
DRAWN WALE
) M , q. 70'
DATE
./PO. JC80
Zoos - -1'30
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle):
City Miami Shores Village
Is Building Historically Designated
YES
Contractor's Company Name �I s �� /467 ic
Contractor's Address L
City OA u l C
Qualifier A:FH - // #0/ O c..._.
$ Value of Work For this Permit
/9oC
Type of Work: ['Addition ❑Alteration
Describe Work: P.p w•■ o e_.
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Electrical
Owner's Name (Fee Simple Titleholder) 13 He,
Owner's Address ,Z,2 z Pe & b, 0 f< e
City /"-J, woo c State /-/ .
Tenant/Lessee Name 10P4
State Certificate or Registration No. (, G /S0203 7
County Miami -Dade
NO
State /= /.
�i0s eu t f i��j fiecr / E
ArPolbiteet/Engineer's Name (if applicable) A�,v -r r ,!
Plumbing Mechanical Roofing
c /1 Miu ye 7 C, Phone # , � O,s -- - 3 )C) — 75.7/
R V
Zip 33 6,20
Phone # /0//2 •
Job Address (where the work is being done) e y e ' / / 0 G am . q2.- J S ' 2 ' 7
Phone # 3c ' 3/0- 7 9 7/
Zip 3
Certificate of Competency No.
Phone # rge0S - 64/9 I'
Square Footage Of Work:', ( 9 0 0® 42
['New ❑ Repair/Replace WDemolition
l� 1 'a - '4rs`-') S � �e$ �il�TGr1a� Le..)
It)HOUTION .01 d A s
****************************F
Submittal Fee $ Permit Fee $ '15
Notary $ Training/Education Fee $
Scanning $ Radon $ Zoning
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite side)
Permit No. 5FtS ° 1 1:72. ,
Master Permit No.
Zip
CCF $ CO /CC
Technology Fee $
Bond $
Bonding Company's Name1if applicable) /A 1/R •�
Bonding Company's Address `! ^ .
City State Zip
Mortgage Lender's Name (if applicable) p ,�
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 will not be 'pproved and a reinspection fee will be charged
NOTARY P
Sign:
Print:
APPLICATION APPROVED BY:
Chc 05/13/03
Rosemarie Jerez
lesion DD198114
au, 2007
My Commission Expires: My Commission Expir
pn'
NOTARY PUBLIC:,;
Sign:
Print:
Owner or Agent W Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ,20by , day of ,20
who is personally known to me or who has produced who is personally known to me or who has produced
As identificati and who did take an oath.
as identification
did take an oath.
/111.44k. Rosem Jerez
114
30.2007
Plans Examiner
Engineer
Zoning
Miami Shores Village
Attn:
Building and Zoning Department
Miami Shores, FL 33138
RE: Property located at 899 NE 92 Street
Miami Shores, FL 33138
Gentlemen:
As legal owner of subject property, I request a Demolition Permit.
Plans signed and sealed are enclosed.
I agree to hold Miami Shores Village, its agents and authorized personnel harmless and relieve
them from any responsibility or liability for any legal action or damage, cost or expense
(including attorney's fee) resulting from the cancellation of this permit.
Very truly yours,
"wner's signature) 4
James Wahl e t
(print name)
STATE OF FLORIDA
COUNTY OF DADE:
HOLD HARMLESS
Prime Contractor
August 29,2005
Frank Hogan
(print name)
The undersigned, being first duly sworn, deposes and says that he/she is the legal owner of
the above property.
Sworn to and subscribed before me this
Notary Public, State of Florida at Large
► f�osemene
' yy�� • My Commission Jerez DD108l14
��i a Expires Mardi 30, 2007