930 NE 92 StMiami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 10/11/2002
Applicant: 'DEBRA
Owner: '-H -i_
JOB ADDRESS: 930 NE 92
Contractor
Local Phone:
Parcel # 1132060060090
Permit Status: Approved Permit Expiration: 4/6/2003 Construction Value:
Work: TILES IN THE KITCHEN FLOOR AND COUNTER
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
MARIA LUISA NEGRIN
1266 NE 94TH ST. 305- 754 -6743
MIAMI SHORES, FL 33138 -2947
PAY TO THE
ORDER OF
�!1 Washington
NOTES
Washington Mutual Bank, FA
Miamlflamiami Financial Center 1724
1901 SW. 8 Street
Miami, FL 33135 24 hour Customer Service
P
Fees: Description Amount
FEE2002 -5711 Building Permit Application Fee $60.00
FEE2002 -5712 CCF $0.60
FEE2002 -5713 Notary Fee $5.00
Total Fees: $65.60
Total Fees: $65.60
Total Receipts: $0.00
1- 800488.7000
x: 26 ?084 L3 LI:8 341 , 100 LSO6 sr0II .
Legal Description: AMD PL GOLDEN GATE PK PB 7 -54 LOT 11 LOT SIZE 50.000 X 140 OR
63- 8413/2670
8340015060
GATE 0 /7
Contractor's Address:
2141
/��( n1.C. c� �'�✓ U/ l/� /
1$ 6,6 6,0
ziceffr aa/b
DOLLARS
PIA Wort,
IA �
� I
az lM"
2L4L
Building Permit
Permit Number: BP2002 -1724
BY:
the equipment or device described in the application herefor in strict compliance with all
with any plans, drawings, statements or specifications that may have been submitted to
is not done in compliance with such ordinances or if the plans are changed without
actor or builder named above assumes the responsibility for a thorough knowledge of the
rings or in the statements or specifications and that he assumes responsibility for work done
BY:
$550.00
Page 1 of 1
in compliance with all ordinances and regulations pertaining thereto and in strict conformity
)res Village. In accepting this permit I assume responisibility for all work done by either
•
PROPERTY OWNER
t
Name y f
Address
r
/
6: '?
4/ 4 l SIT (h
Home Telephone
Cr '_ (i 7 y � / �
Business Telephone
Fax
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'l Attachment
Other
Add', Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: f
Step 1.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department fir processing. During the
processing of your application, you may be asked to submit additional information.
A PPLICATION
Job Address:
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit-
ted along with this permit application.
Address
Apt.
Folio Number
Lot Block
Subdivision
Current Use of Property
Proposed Use of Property
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
PB PG Zoning
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Description of Work
Master Permit No.
Subsidiary Permit No.
PERMIT APPLICATION
r -�
City State Zip
P1 � ' 1 � h 1 i E ► - i #o D r G - 6 4,1,49 " --
Linear Feet
Square Feet
slue of Work
ax Assessed/Appraised Value
Flood Zone Base Floor Elev.
� Units Floors
a- 5 0 • 0 ' 0 Bldg Value
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
License No.
Address
Telephone Fax
Qualifier Name
Page 2
IMPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
STATE OF FLORIDA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE
1
S :,.: to and subscribed before me this
•
SEAL:
Signature of Owner
1 7 2 5/ ?
Pri nt Name _n Print Name
Signature of Contractor / Qualifier
Sworn to and subscribed before me this day of
PERMIT APPLICATION
• �... , r ' /. AAA t I_____
mature of Mary Public - . ta J o srida Signature of Notary Public - State of Florida
r �- oenciai. :. .
O .sP RY p„ 't? ANGC;LA 1 E • I
2 ��� n coT.; , ,;..■,,i SEAL:
OF F vO NC '
Personally known - " OR Produced Identification ' Personally known OR, Produced Identification
Type of Identification Produced: Type of Identification Produced:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 4 /(/' 01 Job Address Q 1 v "i O- Tax Folio
L e g a l Description LOt 11 h1- ai)1 e/' pl or 601610,
Est
Owner/Lessee / Tenant ,)k1 G
Owner's Address Quo N Q2(6
Contracting Co. 6Q0
Qualifier SS# Phone
State # Municipal # Competency # 2 c Ins. Co.
Architect/Engineer iqa,( aarcyri2 — 61 .L Address � J V� c � '' r\ �\ l
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION N (mow W c'c'tq (LC4 6 p bra s;7ku4 424
Square Ft. - DO
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
truction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
swA7`';, 2.10.0
Signature ofpwner an' or Condo President Date Signature of Contractor or Owner - Builder Date
— ? /OA/
Date Notary as to Contractor or Owner- Builder Date
Ao to Owner and/or Condo
.My Commission Expires:
'& Stacy E. Kilroy
Commission # CC 769428
Expires AU6.23, 2002
BANDED THRU
OF OP' ATLANTIC BONDING CO.. INC.
FEES: PERMIT V RADON
APPROVED:
Zariirig , B ' /
o
Mechanical Plumbing
C.C.F. . , D NOTARY °' BOND 3V
TOTAL Dti30 ( b �
l-3w& -ooto -ate
g ted: Yes No V
Master Permit # � .3 ' g
Phone a}"J 754 754
Address
Estimated Cost (value) W / COO
My Commission Expires:
Electrical
Structural Engineer
/ A
uTu7 OE rrZ
.iJILD NG Al -ON: G ;
100E3 N. 7 . 7 " . ?NI
/ 755-2204 X: ( ^35
BUILDING PE PORMIT/CONMACTORS P ISiRATTG_'{
Copy cf STATE' OF FLORIDA CERTIFICATION (DPER) or SZ LLE cREGIS'I ATT_ON
AND DADE COUNTY 03iPEI'ENCY LIC SE_
Copy of current OCCUPATIONAL LICENSE from coin :_. cr mun_ci_a? t_r wh ra
ousiness is located.
Certificate of Insurance for LIABILITY (address to Miami Shores
Village)
C`r`i :icate of Insurance for BR'S COMP (addressed to Miami
ShoresVillage) or if exempt.
State of Florida LES For BCf -204, Construction :nd_ustry Notice of
Election to be Exempt.
PLEASE SUBMIT EVERYTFII.NG OEIE ' n OFF
Permit Application (signed by person performing the work, licensed
contractor and the property owner, both signatures notarized) .
Two sets of plans /drawings signed and sealed by registered architect or
engineer. Occupancies by Group Classification must be on plans and
emit application. All plans must include folio number and property
address.. Amended plans, in addition to the above, oust also include the
permit number.
StruuLuLal Calculations signed and sealed by a_c tect or engineer when
applicable.
Current survey of the property.
C.e_tificate of Elevation signed and sealed by Surveyor.
Substantial Improvements Checklist (contractor or owner).
Four sets of energy calculations, signed and sealed
Two sets of signed & sealed Truss Plans (Engineer).
DADE County or State of Florida Products Approvals for roof materials,
sheds, windows, exterior /garage doors, aluminum cavorts, screen
enclosures, shutters awnings, skylights, french doors and etc.
A_provals from HRS, DADE County Impact Fee Section, Fire Department &
Health Department (when applicable). DERM
V W rranty Deed or Other Proof of Ownership if necessary.
SlamLtutdl Review fee 4 r7 O a
Flood Elevation
Ate /� Notice of Commencement
Date / � ,
�%���� "! � Job Address �C) lle � � r'f, �� s Tax Folio // f&O 0/4 GAO 9
WORK DESCRIPTION F s IL/6, �.
Square Ft.
1 -i ( dC ;
Si nature of owner and/
Date: 9 ;
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
r /
Legal Description // III!/ /4' 4, i /ir i 4 4
Owner / Lessee / Tenant - ZLiV 4 - Wj k ' Master Permit c ,/sz
Owner's Address r\ i°); wwlit,, w � FL w3/ s- Phone 30.c - aaC '(,/
Contracting Co. 0 Q1) y"'
Qualifier Phone __ a4) rL _
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
"pr 94 reside
,•� �'" `°�4 Y JOSEPHINE HURCH
\Notary Pubkc, State of Florida
illy Commission Exp. April 30.1996
Its CC1l45
Address QGe C'.126
r
r, ^ �1 0 3/05
Estimated Cost(value) 5; 000
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.
Signature of Contractor or Owner- Builder
Date:
Not ry to Owner and/ •__._�� Notary as to Contractor or Owner-Builder
My mmission Expires: Print type or stamp name of Notary Pub My Commission Expires:
Personally known OR Produced I.D
Type and number of I.D. produced:
** * * * * 117 I * * * * * * * * * * **
ii__ ❑ DID take an oath, or
DID N
FEES: PERMIT p 1 . / I 1, gRAD take an oath. C . C . F . fl NOTARY 5. TOTAL DUE ) /
APPROVED: Fire 1 Other
Zoning Building )1) /, Electrical
Mechanical Plumbing Engineering
Bill of Sale
Know All Men By These Presents, That this 1st day of
Kenneth Shaw, individually and as trustee,
of the County of Shelby
John Hauter, a single man,
whose addressis: Box 351323, Miami, Florida 33135
of the County of Dade
In t Witness \1 Whereof,
Signed, sealed de vered i
Printed Na
Witneqs .s
P - ntet3 ame • - .b z s 1> 4
itness as to Both
State of Tennessee
State of
Witnesseth that the FIRST PARTY, for and in consideration of the sum of
DOLLARS,
and other good and valuable consideration to FIRST PARTY in hand paid by SECOND PARTY, the receipt whereof is hereby
acknowledged, has granted, bargained, sold, transferred and delivered to the said SECOND PARTY and SECOND PARTY'S heirs
and assigns forever, the following goods and chattels:
Refrigerator, disposal, ceiling fans, boxed lighting fixtures,
all building materials on site, all fixtures and all permits in
place.
To Have and to Hold the same unto second party, and the second party's heirs, personal representatives, successors and
assigns forever.
AND the first party covenants with the second party, and the second party's heirs, personal representatives. successors and assigns
that the first party is the lawful owner of the said goods and chattels; that they are free from all encumbrances; that the first
party has good right to sell and transfer said property, goods and chattels; and that the first party will warrants and defend the
sale and transfer of the said property, goods and chattels hereby made to the second party. and the second party's heirs, personal
representatives, successors and assigns, against the lawful claims and demands of all persons whomsoever. This covenant shall be
binding upon the first party and the firs: party's heirs, personal representatives, successors and assigns.
first party has hereunto set his hand and seal the day
nce:
STATE OF Tennessee
COUNTY OF Shelby
The foregoing instrument was acknowledged before me this 1St day of
Kenneth Shaw, individually and as trustee,
ut.{z- Kenn th Shaw
who is personally known to me or who has produced his Florida driver's
take an oath.
This Document Prepared By
Julie Harris
IntuoosWal Titk 930 Washington Avenue
Suite 300
Miami Beach, FL 33139
June , 1992 A. D., That
Florida , second party.
L..11 Al
4A
license as identification and who did
Printed Na tf>�: C�gr?_,z. -� �'1•YV��sl.rs�
NOTARY PUBLIC
My Commission Expires: Z " S-9
Hauter
, first party, and
year first above written.
June, 19 9 2 by
(Seal)
(Seal)
(Seal)
(mil)
Warranty Deed
Parcel ID Number. 11- 3260 - 6009 -0
Grantee #1 TIN:
This Indenture, Made this 1st day of June, 1992 A.D. , Between
Kenneth Shaw, individually and as trustee,
of the County of Shelby
John Hauter, a single man,
I Witne
St ned, eat
pfanted
Witness as to Both
ranted N
Witne
state of Tennessee
whose address is: P. O. Box 351323, Miami, Florida 33135
of the County of Dade , state or Florida , grantee.
Witnesseth that the GRANTOR, for and in consideration of the sum of
TEN & NO/ 100 ($10.00) - - DOLLARS,
and other good and valuable consideration to GRANTOR in hand paid by GRANTEE, the receipt whereof is hereby acknowledged, has
granted, bargained and sold to the said GRANTEE and GRANTEE'S heirs and assigns forever, the following described land, situate,
Tying and being in the county of Dade State of Florida to wit:
Lot 11, amended Plat of GOLDEN GATE PARK, according to the
Plat thereof, as recorded in Plat Book 7, Page 54, of the
Public Records of Dade County, Florida.
Subject to restrictions, reservations and easements of record,
if any, which are not reimposed hereby, and taxes subsequent to
December 31st, 1991.
Subject to existing mortgage held by Principal Financial Group
in the approximate amount of $45,058.12 which Grantee herein
specifically assumes and agrees to pay.
Subject to a Purchase Money Mortgage Second held by Kenneth
Shaw, Trustee, for approximately $16,500.00 which Grantor hereby
has given.
and the grantor does hereby fully warrant the title to said land, and will defend the same against lawful claims of all persons whomsoever.
Whereof, grantor has hereunto set his hand and seal the day and •r first above written.
vered y t o pt•e
im.e. Kenn th Shaw
P.0. Ad 3878 Otter Drive, Memphis, TN 38128
STATE OF Tennessee
COUNTY OF Shelby -
The foregoing instrument was acknowledged before me this iSt day of June, 1992 by
Kenneth Shaw, individually and as trustee,
who is personally known to me or who has produced his Flor driver's 1 icense as identification and who did
take an oath.
This Document Prepared By.
Printed N e: �w x ►A, Ako;t a.,
NOTARY PUBLIC Q /
My Commission Expires: '7 -S- 7 Z
Hauter
, grantor, and
(Seal)
(Seal)
(Seal)
(Seal)
OWNER'S AFFIDAVIT
NON - FOREIGN CERTIFICATE
AND
REQUEST FOR TAXPAYER IDENTIFICATION NUMBER
STATE OF Tennessee
COUNTY OF Shelby
BEFORE ME, the undersigned authority, personally appeared
Kenneth Shaw, individually and as trustee, (the "Seller "), ( "Seller"
refers to singular or plural as context requires) who, first being duly
sworn, deposes and says:
A. OWNER'S AFFIDAVIT
1. Seller is the owner of the following described property (the
"Property "):
Lot 11, amended Plat of GOLDEN GATE PARK, according to the
Plat thereof, as recorded in Plat Book 7, Page 54, of the
Public Records of Dade County, Florida.
Street Address: 930 N.E. 92nd Street
Miami Shores , Florida 33138
2. There is no outstanding contract for the sale of the property
to any person or persons whomsoever, nor any unrecorded deed, mortgage
or other conveyances affecting the title to the Property.
3. There are no liens, encumbrances, mortgages, claims, boundary
line or other disputes, demands or security interests in, on or against
the Property or any goods, furnishings, appliances, fixtures or
equipment now installed in or which are to be affixed to the Property;
(except for mortgages described in the deed given by the undersigned);
that there are no unpaid taxes, levies, assessments, paving liens or
utility liens against the Property (other than real estate taxes for
the current year).
4. There have been no improvements made upon the Property within
the past ninety (90) days for which there remain any outstanding and
unpaid bills for labor, materials or supplies for which a lien or liens
might be claimed by anyone.
5. There are no matters pending against Seller which could give
rise to a lien that would attach to the Property during the period of
time between the effective date of the title insurance commitment and
the time of recording of the instruments evidencing the Buyer's fee
simple or other interests in the Property; and that the Seller has not
executed and will not execute any instrument that would adversely
affect the title to the Property from the date of this Affidavit
forward.
6. There are no judgments, claims, disputes, demands or other
matters pending against Seller that could attach to the Property.
Seller has complied with the Florida Sales Tax laws where applicable.
Seller acknowledges responsibility for water, sewer and electrical
consumption charges through date of closing or occupancy by Buyer,
whichever first occurs.
7. Seller is in sole constructive or actual possession of the
Property and no other person has any right to possession of the
Property, or asserts any claim of title or other interests in it.
8. Seller represents there are no violations of governmental
laws, regulations or ordinances pertaining to the use of the Property.
B. NON- FOREIGN CERTIFICATE AND REQUEST FOR TAXPAYER IDENTIFICATION NUMBER
Section 1445 of the Internal Revenue Code provides that a
transferee ( "Buyer ") of a U.S. real property interest must withhold tax
at a rate of 10% of the amount realized on the disposition if the
transferor ( "Seller ") is a foreign person. To inform the Buyer that
withholding of tax is not required upon the disposition of a U.S. real
property interest by the Seller, the undersigned hereby swears, affirms
and certifies the following as or on behalf of the Seller:
1. Seller's Legal Name Is: Kenneth Shaw, individually and as
trustee,
[Space Above This Line For Recording Data]
THIS IS A BALLOON.. MORTGAGE AND THE FINAL PRINCIPAL PAYMENT OR THE
PRINCIPAL BALANCE ! DUE UPON MATURITY IS $ 16 21 R F, 3 , TOGETHER WITH
ACCRUED INTEREST, IF ANY, AND ALL ADVANCEMENTS MADE BY THE MORTGAGEE
UNDER THE TERMS OF THIS MORTGAGE.
THIS MORTGAGE made this 1St day of
John Hauter, a single man,
REAL ESTATE MORTGAGE
June A.D. 19 9 2 , between
herein called Mortgagor, in consideration of the sum named in the promissory note herein described received from
Kenneth Shaw, individually and as trustee,
herein called Mortgagee, (the terms "Mortgagor" and - Mortgagee" include all parties in each capacity to this instrument
and their respective heirs, personal representatives, successors and assigns; the term "note" includes all promissory
notes described herein) Mortgagor hereby mortgages to Mortgagee the real property in Dade
County , Florida , described as :
Lot 11, amended Plat of GOLDEN GATE PARK, according to the
Plat thereof, as recorded in Plat Book 7, Page 54, of the
Public Records of Dade County, Florida.
TOGETHER with all easements connected therewith, improvements now or hereafter made thereon, fixtures attached thereto,
any furniture or furnishings located thereon or therein and any reversions, remainders, rents, issues and profits thereof as
security for the payment of the promissory note, a copy of which is attached.
AND Mortgagor hereby covenants :
1. That Mortgagor is in actual possession and seized of said real property in fee simple with full power and
lawful right to mortgage the same; that said property is free from all liens and encumbrances except as set forth
herein; that Mortgagor fully warrants the title to said real property and will defend the same against lawful claims
of all persons whomsoever.
2. To pay all money required by said note and this mortgage, or either, promptly when due.
3. To pay all taxes, assessments, levies, liabilities, obligations and encumbrances of every description now on or
which may hereafter accrue on said property, this mortgage and the debt secured hereby, or any of these, when due. If
any part thereof is not paid when due, Mortgagee may pay it without waiving the option to foreclose this mortgage or
any other right hereunder.
4. To pay all costs and expenses together with reasonable attorney's fees (including appellate proceedings)
incurred by Mortgagee because of any default by Mortgagor under this mortgage and said note, or either.
5. To keep the improvements now or hereafter on said property insured against loss by fire or other hazards
included in the terms "extended coverage" and "other perils" in the amount secured by this mortgage by an insurer
approved by Mortgagee. The policy shall be held by and made payable to Mortgagee by standard New York mortgagee
clause without contribution as Mortgagee's interest may appear. If any money becomes payable under such policy,
then all checks for said money will be made payable to Mortgagor and Mortgagee and the proceeds shall be first applied
to restore the mortgaged property to the condition it was immediately before the loss occurred and if there be any excess or
if the property not so restored then Mortgagee may apply the same to the payments last due on the debt secured hereby or
may permit Mortgagor to use it, or any part thereof, for other purposcs without waiving or impairin* any lien or right hereunder.
If Mortgagor fails to obtain such policy, Mortgagee may procure it and pay therefor without waiving the option to foreclose
this mortgage or any other right hereunder.
- Page 1-
MORTGAGE NOTE
$ 16,500.00 Memphis, Tennessee
June lst, 1992
For value received, the undersigned agrees and promises to pay to the order of:
Kenneth Shaw,
the principal sum of $ 16,500.00 with interest thereon at the rate of 8.500 per centum per
annum from the date hereof until maturity, the interest being payable as set forth below in lawful
money of the United States of America at:
3878 Otter Drive
Memphis, Tennessee 38128
or such other address as the holder from time to time may specify by written notice to the maker, the
principal and interest to be paid as follows:
This note with interest is secured by a mortgage on real estate, of even date herewith, and shall be
construed and enforced accordingly.
If there is a default in payment of any of the sums or interest or in said mortgage, or in the
performance of any agreements contained herein or in said mortgage, and it continues for a period of
days then, at the option of the holder of the note, the principal sum then
remaining unpaid with accrued interest shall immediately become due and collectible without notice,
time being of the essence of this contract, and the principal sum and accrued interest shall both bear
interest at the highest rate allowable by law from the date of default until paid. All sums paid under
this note shall be credited first to accrued interest and then to principal. Failure to exercise this option
shall not constitute a waiver of the right to exercise the same in the event of any subsequent default.
Each maker and endorser waives presentment, protest, notice of protest and notice of dishonor
and agrees to pay reasonable attorneys' fees and expenses in the enforcement of this note prior or
subsequent to judgment and in any and all trial and appellate tribunals, whether suit be brought or
not if, after maturity of this note or default, or under said mortgage, counsel shall be employed to
collect this note or to protect the security of said mortgage.
The indebtedness evidenced by this note may be prepaid in whole or in part at any time without
penalty or premium.
MAKER'S ADDRESS:
P.O. Box 351323
Miami, Florida 33135
SEAL)
(SEAL)
(SEAL)
(SEAL)
MORTGAGE NOTE
S 16,500.00
FOR VALUE RECEIVED, the undersigned, (jointly and severally, if more than one) promises to pay to
Kenneth Shaw,
Memphis, Tennessee
June 1st ,19 92
, or order, in the manner hereinafter specified, the principal sum of
SIXTEEN THOUSAND FIVE HUNDRED AND XX /100 DOLLARS
($ 16, 500.00) with interest from date at the rate of 8. 500 per cent per annum on the balance from time to time remaining
unpaid. The said principal and interest shall be payable in lawful money of the United States of America at 3878 Otter Drive,
Memphis, Tennessee 38128
or at such place as may hereafter be designated by written notice from the holder to the maker hereof, on
the date and in the manner following:
This Loan is a three year Balloon for 16,500.00 Based on a
30 year amortization schedule at 8.5 percent, with payments of /a?G •f'7
Payments start July 1st 1992. Balance due at the end of
36 months.
This note with interest is secured by a mortgage on real estate, of even date herewith, made by the maker hereof in favor of the said
payee, and shall be construed and enforced according to the laws of the State of Florida.
If default be made in the payment of any of the sums or interest mentioned herein or in said mortgage, or in the performance of
any of the agreements contained herein or in said mortgage, then the entire principal sum and accrued interest shall at the option of the
holder hereof become at once due and collectible without notice, time being of the essence; and said principal sum and accrued interest
shall both bear interest from such time until paid at the highest rate allowable under the laws of the State of Florida. Failure to exercise
this option shall not constitute a waiver of the right to exercise the same in the event of any subsequent default.
Each person liable hereon whether maker or endorser, hereby waives presentment, protest, notice, notice of protest and notice of dis-
honor and agrees to pay all costs, including a reasonable attorney's fee, whether suit be brought or not, if, after rnatunty of this note or default
hereunder, or under said mortgage, counsel shall be employed to collect this note or to protect the security of said mortgage.
Whenever used herein the terms "holder ", "maker' and "payee" shall be construed in the singular or plural as the context may
require or admit.
P.O. Box 351323
Maker's Address
Miami, Florida 11135
(Seal)
(Seal)
(Seal)
Hauter
(Seal)
ff f - ''if
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date Y/5/9/ Job Address ego
Legal Description // by; Master Permit #
Owner / Lessee / Tenant &1J1 -o Sh(A l t)
Owner's Address 9,30 /Ve / 0 2 Np S *eeP Phone 8595 - (7 039
Contracting Co. °boner- Address
Tax Folio2'/ LioW a,n91J
Qualifier SS# - - Phone
State# Competency# Ins. Co. /
Architect /Engineer m O rd 0 C a Z D Address 35 0 / 5 , 4 • , "'' L _ a 0L1
MiG+mw — 3.2j/J. /35`
Bonding Company Address
Mortgagor Address
Permit Type (circle one : BUILDIN ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION C' ndd h — 7 Pi-. pordi 0rya' hall (0 - 4) a.nd
356, 5 oir'a. used 65 kilalen and bete rovrm bac%
Square Ft . � Estimated Cost - / ? 5'D
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.
Furtherm9e, I auth• the above -named contractor to do he work s ed.
f
Sigratu
Date: � 3 a er d /or Condo President
�
N( ary,rs to Owner and /or C ndo President No ary fas to ontractor or Owner - Builder
M Commission Expires: /i/ / /e /f,i My Commission Expires:
PERMIT FEE: APPROVED:
Zoning
Mechanical
Fire
Building
Plumbing
Signat re of C tor or Owner - Builder
Date:
Other
Electrical
Engineering
m:›c2N
1, DQ ° Ei - / Q b,0 r D
ELECTRICAL
TYPE
Minimum Fee
QTY
TYPE
Dryer
QTY
T\'PI:
Outlet, Appliance
QTY.
'11 PE
Service Repair
Q
A/C Central 1 -3 Ton
Fan
Outlet, Wall
Service, Temporary
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Domestic Well
Demolition
Laundry Tray
Low -volt, Intercom/Teleph.
Septic Connection
Repair Circuits
Water Heater
Drainfield, 4" Tile/Res.
Dishwasher
Lavatory
Low -volt, Television
Septic Tank
Service, Number of Amps
Water Heater New
Drains, Area
PLUMBING
T1'P1{
A/C Condensate
QT1'.
TVI'F.
Drains, Roof
QTY.
Typv
Miscellaneous Fixture
QTY.
'1'1'1'1?
Soakage Pit
Q'I'1'.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
MECHANICAL
TYPE
Q'I'V'. TYi'li
QT1'. Yuri:
Q'I'1'. TYPE
QT1'.
Minimum Fee
A/C Central, Tons
A/C Wall/Win. Tons
Air Handler, Tons
Barbecue
Bath Fan - Vented, #
Condensate Drain
Cooling Tower
Dryer Vents, Number of
Ductwork, Cost of
Fire Sprinkler System
Fireplaces, Number of
Generator
Heating Strips, each
Paint Booth
Piping, Flammable Liquid
Process/Pressure Piping
Pressure Vessel
Refrigeration, Tons
Vent Hood, Cost
Ventilation, Cost
Periodic Inspections
RECEIVED AND REVIEWED BY: DATE:
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee) $
Miami Shores Village
Bond j�
Metropolitan Dade County (C.C.F.) $ Z 6 v (xq 0.60) . x/1000
Inspector State Educational Fund $ (¢.005 /sq.ft.)
State DCA (Radon) $ (¢.01 /sq.ft.)
Code Enforcement Fine $
Zoning Review
Notary
$ 0
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
D 11
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERNIIT FEES
TOTAL $ 6_S . b U
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
MIAMI SHORES VILLAGE, FLA. N° 24297
JOB k ti c 1
ADDRESS 1 3 0 /V Z S �
INSPECTION 11- 12 ►' 1 \ 1
TIME READY 1 3 -GI 4f
REMARKS: uo741
INSPECTOR
? /U
75e-/ cM S/
``
'5 9 DATE 7-G( �\
MIAMI SHORES VILLAGE, FLA. N? 24338
JOB 9.L■ c"V't) =-- A' t-c -il
4 Li N E .
ADDRESS 2
INSPECTION � v&\
TIME READY ' 1
REMARKS:
Ve_y\ - gqS-
INSPECTOR Z ^
A `, Z.L `
DATE
INSPECTION
TIME READY
REMARKS:
'MIAMI SHORES VILLAGE, FLA..
-//j/ r
608 E �� - '1 2 v f �:
ADDRESS 2i
(7/
/:14-77/7 ik-(41
2 g -
INSPECTOR DATE
fec-eijf
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
/ (OWNER TO RETAIN COPY)
Date .0 c // Job Address 910 7 i�/� ^ Tax Folio J6Z p6#'#'/J
Legal Description// ,4Ljj rigehlif ik
Owner / Less a / Tenant f' j tJ JJJ ? )
Owner's Address 9_6o, A/c C.,2 ILA" Etreef Phone - ii 039
. *
Contracting Co. 0 bone r Address
Qualifier SS# - Phone
State# Competency#
Architect /Engineer firrri G, nd v C O Z c Address 3501 / S1/J VI Si ki o?G'L/
di i c'rrrw — 33/35
Bonding Company Address
Mortgagor Address
Permit Type (circle one • BUILDIN ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION CGS 74_1 }- • — 41 3( j
56 Ssez lfi. nr& %61 oeci ?s .Ichcn c>>a
Square Ft. 474'6" Ut Estimated Cost - / 5
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.
?WNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work
:ill be done in compliance with all applicable laws regulating construction and zoning.
wurthermore, I auth zj the above -named contractor to do he work s : ed.
'ERMIT FEE: APPROVED:
(9
fl2U
'ate: I j
g J/7
a : I / /9
ary /os to Owner and /or C ndo
Commission Expires: /04/P
* * *
d /or Condo President
di
No ry s to ontractor or Owner- Builder
My Commission Expires:
* * * * * * * * *
President
Fire
i " %1
Ins. Co.
bctfArc2rn5 � n h�icic
7
Master Permit # 1) G-577
Signat re of Co tr. tor or Owner - Builder
Date:
Other
Zoning Building " ' /! Electrical
Mechanical Plumbing Engineering
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
/3- l
Job Address � ! , j L j L % L f � . Tax Folio //
n� / ,# In S L /J�'M er Permit. # 9 � Jr
Date.///9 Legal Descriptio
Owner / Lessee / Tenant
Owner's Address
Contracting Co. L j /- 77.77'
State/
PERMIT FEE:
Signature of
Date:
, ?fir! "Lc lc et ! L
Notary as to Owner and /or
My Commission Expires:
* * * *
j C-Cf ��. b
Architect /Engineer
Bonding Company
Mortgagor
APPROVED:
Zoning
Mechanical
f
:r
/'/ F 7,4
.
Qualifier /Li / !� /-1 E T /�L- -
Competency/ r / k, /C%
Address
Address
Address
®BtFiorida
Comm. Exc. 5/30/93
DTHRU
REGENCY INSURANCE
Condo President
*
Fire
Signature
Date:
Notary as
My Commiss
* * *
Building
Address
fl if .1/ Phone
Phone
J
Ins. Co. /JLTTf ./-'-
Permit Type (circle one): BUILDING ELECT IC PLUMBING MECHANICAL PAVING FENCE SIGN
� C �
WORK DESCRIPTION • - /A4i� ,oiu — / e/—
i iiii 1 ■ ( 4 Ar&ti — pitiltf - , -1
' L'A;(.1
Square Ft. Estimated Cost (
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 AFFIDAVI � ` i tify that all the foregoing information is accurate and that all work
will be do •e i mpli nce with all applicable laws regulating 'construction and zoning.
Furthermore, I a t •raze he above -named cont o rr y�otk sta
Other
El
Plumbing .11. g n tq peerin
of c ontractor Q �p S RAS
/ r� State of Florida
Pue`c' �yty Comm. E. 5/30/93
\� e.. � D TH
( e /let l : / CC / t REGENCY INSURANCE
to Contractor or Owner- Builder
ion Expires:
* * * * *
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date + ` Job s � — Tax Folio / gd Z/H C; Cn
Legal Description
h. �L • l C -��. , PK f I3. — 7 --
Owner / Lessee / Tenant V ! "I - T7 - t DIY Master Permit # jc
Owner's Address 6-RA `,1 if � 41- Phone d -15
Contracting Co. E 7 ,tc-N INcAddress 1116 vI 5 ► 1 PL• t4 tt 33G
Qualifier 4j /J J/eZW!G0' ss # - - Phone �3 6:5-9-08.24/
State # OQQ gr U Municipal # Competency # /42 Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIG
WORK DESCRIPTION 'iv a -S-e **- eeZ h /1 f ` ! A5-4111 5 -1 r'• [e y � c t�•l /c f 4 ft
n ,1 A /c cam. 'f— f v , , ec,�J t. / . w, (/ %x
Square Pt. T Estimated Cost(value) 3,-ae as
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DC
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEN:
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU:
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, an
on the attached addendum (if applicable). I certify that all work will be performed to meet th
standards of all laws re: lating construction in this jurisdiction. I understand that separat
permits are required or ECTRICAL, PLUMBING, SIGNS, POOLS, ROOPING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: er
be done in com.lian.j it
authorize the :bor= .v.med
Signatare of ner ca / or Condo President
Date: 1 7 1 /23/q a, Date:
Notary as to Owner Ofd /or Condo President_____ Notary as to ContraQtor .• _ p_ �er7 _ 5. ' d
My Commission Expir s. NOTARY PUBLIC My Commission Expir 'TRRY or PUBL;�SU``�1'OR!��AT
b ISSION EXP JUN FLORIDA k �Q MNII�SI0�1 �,P1RES� SEP ?, 25,
THRU GENERAL INS UNO
* * * * * * * * * **
y that all the foregoing information is accurate and that all work wil
11 applicable laws regulating construction and zoning. Furthermore,
ntractor to do the work stated.
Signature of Co
or or • -r-Buiider
FEES: PERMIT 1 '7 5 RADON C.C.F. NOTARY TOTAL DUE ) 5
APPROVED: Fire Other
Zoning Building Electrical / PI M 1 0 x
Mechanical Plumbing Engineering
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
A
Date //0/‘1_ Job Address � 3O rVE ga. 4 .d 51 (4 Tax Folio // irda 9j e,93
A/41? / 44k‘1,)a10: - a
Owner / Lessee / Tenant - w�� /�' - , / tref, Master Permit #1 7s
Owner's Address .(1 �, k 7 Si (($ IAA: FL . 3/3 . - Phone 4 30c-
Legal Description /1
Contracting Co. Oki) fA t.,{ ' Address ' 2 ICI _ �Q
Qualifier SS# ?/ Phone_ (j_ Cahl -c■Q
State # Municipal # Competency 4i Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGD
WORK DESCRIPTION
Square Pt.
- PPROVED:
'1q - Cr 4 di 4 (•
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 INTENr
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, anc
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 - naiged contractor to do the work stated.
Z
'ig1 Lure of owner and pq q..rrree SINE n r. Signature of Contracto or Owner- Builder
'gate: G / /C' `C� C ' :4": Notary Poblic Flond� Date:
• / )
to • ry to Owner and / "' J Notary as to Contractor or Owner-Builder
ly mmission Expires: Print type or stamp name of Notary Public My Commission Expires:
Personally known OR Produced I.D.
Type and number of I.D. produced:
* * * * * — L * * * * * * * * * * **
[1 DID rake an oath, or
'EES : PERMIT 1 3 RADON take an oath. C.C.F. 0
DID N
NOTARY 5' r TOTAL DUE /
Zoning
Building
Estimated Cost (value) 4or.)o
Fire Other
,61)oigx/
Electrical
Mechanical Plumbing Engineering
- PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Legal Description Z f //
Job Address T Tax Folio c to G� O��G
/ Al nAlsP FA L 1 m
Owner / Lessee / Tenant �� cpys, f , �._Akrz Master Permit # 3? ) SO
Owner's Address c l �d . �. c 2.. J + Phone
Contracting Co. S A F�cc� L 2_ Address ?. 2 O - 3 N. (-1.) 2 3 AV.
Qualifier �. tee_ ss# Phone 6 i Zg,
State 4i A Municipal 4P Competency #G9c..0 /42- 347Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE ,, SIGN
WORK DESCRIPTION (tom . �
k C e .•. �P.a c (� t- �� S 1 L{ . /e (`G'
L v e-, k2 -0 S z ` - 6 A/c.. oL t t- AsAkt. yf„ 1 tc
Square Ft. 12. � Estimated Cost(value) W2 g'U
‘)
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 underst that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING WO .
OWNER'S AFFIDAVIT: I certify that all the foregoing information is
be done in compliance with all applicable laws regulating construct
authorize the above -named contractor to do the work stated.
Signature of owner and /or Condo President
Date:
Signature o
Date:
1 work will
rthermore, I
'nr n•pe or cramp name of \o r.,n•
� • h.e. k . n p� I: -eel Luvs
Notary as to Owner and /or Condo President No ry as to Cont , ractor } r u m
My Commission Expires: My Commission Expires:
I)ID rake an oarh, or
DID NOT take an oath,
** * * * * * * * * * * * * * * * **
FEES: PERMIT -6 / RADON C.C.F. /, ..5 NOTARY /Ge TOTAL DUE --6 a .S
APPROVED: Fire Other
Zoning Building `'"' frIInfrld Electrical
Mechanics / Plumbing Engineering
Date to - /2'9.2 Job Address *� --?41/16 P,Z — , Tax Folio 1/ .1 Li e6 4i*,
Legal Description �� %'p / W
/ Tenant 7 1 - 04),k 4),k /' 1. '4 a ` PP
Owner's Address P O r �� k 2,�� IIj? tIC11,(44' Phone .0 0 T° V ^'( /
Contracting Co,gLi4611 DCV;T2:/Af . Address 'Z! 4?4e i"
Qualifier e - Sept. l ve Phone "V — / 7 75
Owne / Lessee
State t / Municipal # Competency 00 Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
k6RK DESCRIPTION r w /,' /laus' d /4/ L x/ Cc} ,a6c a P
Square Pt. Estimated Cost(valueG) "''
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, anc
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, ROOPING 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, 1
authorize the above game• ant, erni to do the work stated
Signaturf o Conttactor or owner - Builder
Date: 9AZo/
40 JOSEPHINE CHURCH
: Notary Public, State of Honda
Si te _ : 7 ur9 ' / ow ner
ar
** *
FEES: PERMIT b • d RADON
PERMIT APPLICATION FOR K NICIPALITIES OF DADE COUNTY
(OWNER TOETAIN COPY)
ti
•T as to Owner 4g� � ndo , • r a %
c C
"ly Commission Expires:
APPROVED:
❑ DID take an oath, or
. • DID NOT take an oath.
* * * * *
Zoning
and
�� 1 _i„�•' ``re:„: JOSEPHINE CHURCH
:Notar Publi Florida
t @B4F@n ExD• ADM 30,1
No CC197545
pc o; cramp name of Ncrary Public
Mechanical
Print typ. Qta ' nQ& d£a
Personal! oC,pt$Il'gp'
Type ar . oi I.D. produced.
* • p D take an or *
C.C.F.
r _D_ NOT take an oath.
NOTARY '6 r O0
4a7 C(—
Master Permit 7s0
7'!3f3ia0
* *
TOTAL DUE $ r50
Fire Other
Q�
i� r
Electrical N D `� - V)� 1�
Building
Plumbing_ Engineering
TO: MIAMI SHORE VILLAGE
REF:
ELECTRIC PERMIT # 32580
939 NE 92 STREET
MIAMI SHORE
B & 8 ELECTRICAL INC
1115 WEST 50TH PLACE
HIALEAH FLA 33012
TEL : ( 305 )557 -0824
FAX:( 305 )821 -2699
WE HEREEY ASK THE MIAMI SHORE VILLAGE TO
CANCELL THE ABOVE REFERENCE ELECTRICAL PERMIT. WE DID NOT
PERFORM ANY WORK AND IN CONSECUENCE DO NOT ASK ANY COMPEN-
SATION.
RESPECTFULLY
EULALIO BERUVIDES
6 AND E ELECTRICAL PRESIDENT
BUILDING
ELECTRICAL
PLUMBING
Architect
j Contractor
or Builder
Legal Lot
Description
MDAMO SH RESS VDLLLQGC FL D G°3ODA
PER° M/I Ir
Bl.
0
N9 612
Work to be performed under this Permit
Owner of
Building
Subdi-
vision
DATE
194_
Contractor
License No.
Address of Value of II Amt. of
Building Project I Permit .i
This permit is granted to the contractor or 'builder named above to construct the building or to install \ t•e equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed • By
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 responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Address of
Building
Owner of �
Building V 1?-1/ I' i 1 4-P "1
Architect
MIAMI SHORES VILLAGE, FLORIDA,,
DATE `/ /ZVI _` � 194 i .
Contractor's
License No.
PERMIT N? 6129
Work to be performed under this Permit
)
Contractor y
or Builder
Legal Lot Bl.
Description
This p e r , i is gran e. To"The"TVEMeffrderuld'etrnarrre'ditellovgitoiconstruct the building o to install .' e equipment or evice described in the appli-
cation herefocim strict compliance with all ordinances pertaining thereto and w'th the understanding that the w k will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulsAons pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed • By
C 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 authonfi Eof Miami Shores. Village.
In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
41 ?
CONTRACTOR BUILDER
v
Subdi-
vision
Value of
Project
BY
(4 fit' ,(a k -Ler "
J c)6
Amt. of
Permit
AUTHORITY
1
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of f
Building
1 /
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT IT? 13748
in Work to be performed under this Permit
Architect
Contractor }I
or Builder °
Legal Lot
Description
Address of
Building � �0 9 `
BL
Signed •
Subdi-
vision
Value
Project
BY
Amt. of
Permit $
DATE i "' ` -� �=�-- 195
Contractor's
License No
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
BY
AUTHORITY
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 responsibility for all work done by either, myself, my agent, servant or employee.
.
Owner's Name and Address
Estimated Total cost of improvements
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authorit
peared
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed sty tement of the plans and specifjcations 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.
a..
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
r / 2 /2 Date
Street and Number where work is to be done `—
State work to be done and purpoF of building (by floors)______ - -P X4_2 -4'
New Building Remodeling Addition fi Repairs No. of Stories
To be constructed of ^- _�= '- °_'_ Kind of foundation e Roof Covering
Amount of Permit $
Zone cubage required _Plan 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 permit 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 public notice
or notices as are required by the Act. The undersigned agrees to employ only such sub ntractors, on work to be performed under this
permit, as are licensed by Miami Shores Village. / / ;7
Remarks (Signed)_
No
a notary pub,, duly autho f d_ ter o the and ake acknowledgments,,�ersonal
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 Date Ready Sworn to and Subscribed before me.
11 // r
Disapproved Date
( Signed)
Notary ublic; State of Florida
y Commission Expires (Or' . , f ` 1. `
PLANNING BOARD ' /' L, _� DATE
Chairman � ' a — Men'iber
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.
Stree
fib (- -sue • 2L
fir
7
- and for no other purpose.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N° 4470
Work to be performed under this Permi
Architect
Contractor
or Builder
Legal Lot Bi.
Description
Address of
/; ,��..+ Vin► ,
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described he appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawing. or *the tements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed: "x ° By '"
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 th reto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting his permit I Mme ri sibility for all work done by either myself, my agent, servant or employee.
Subdi-
vision
Value of
Project
CONTRACTOR OR BUILDER BY
DATE
Contractor's --^
License No.
Axnt. of
Permit
L er
S
AUTHORITY
1 94L
BUILDING
ELECTRICAL
PLUMBING
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 3516
Work to be performed under this Permit a .�
Owner of
Building
4
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
This permit-is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the
application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance
with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may
be revoked at any tithe if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition
upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and lip P assumes responsibility for work done by his agents, servants or employees.
Signed: By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with ailimplinances and "�ee
tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper aunt ies of Miami3h ess
Village. In accepting this percpit I assume responsibility for all work done by either myself, my agent, servant or employee.
Bl.
Subdi-
vision
Value of
Project
DATE 194_
Contractor's
License No.
Amt. of
Permit
BY AUTHORITY
1
lUILDING
LLECTRICAL
PLUMBING
Owner of
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 3516
Work to be performed under this Permit
Building
Architect
Contractor
or Builder
Legal Lot Bl.
Description
Address of
Building t vu
■
Subdi-
vision
Value of
Project
DATE 194
Contractor's
License No.
WfRNtN' : T ".s rnnstruoion may he in irotarfan of
via P,oau'.two:t Lirmtatians G tier 41
ie cansfi t your War Produc.ion
8.ard c'fce betor• starting the work authorized in
ttefi period_
Amt. of
Permit
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the
application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance
with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may
be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition
upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and
that he assumes responsibility for work done by his agents, servants or employees.
Signed• By
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 regula-
tions 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 perg�iel assume responsibility for all work done by either myself, my agent, servant or employee.
BY AUTHORITY
` M 1AA11-yS rI QdRES VI LLAG E
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building
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 regula-
tions 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___DQ_o )Or 2a_ __, 194.4__
Owner's Name and Address BERNARD GERTLER No KO I? at
Registered Architect and /or Engineer
Name and address of licensed contractor Day Work
Location and legal description of lot to be built on:
Block___ _ _ - -__ Subdivision GOl_tl_(a'a _ait r
Street and Number where work is to be done _930 N.
State work to be done and purpose of building (by floors) 1- S t_Qrx__Gii-ra g&_ 14 t x24.
_---- -`�� -- _and for no other purpose.
New Building____e_!L________ Remodeling______ __ Addition_______________________ Repairs No. of Stories__
To be constructed Kind of foundation___ _____ CSAIIC r t: A Roof Covering__$1ite__S_uTf a c.!!
Estimated Total cost of improvements $ _.1S0 - 00 — _—_Amount of Permit $
Zone cubage required— — ____Plan 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 permit 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 public notice
or notices as are required by the Act. The undersigned agrees to employ only such subc actors, on work to be e under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA, 8
ss.
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
and who, being by me first duly sworn, upon oath deposes and says that be 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 Date Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Building Inspector My Commission Expires_
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved
Notary Public, State of Florida
to me well known,
—mate
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.