1220 NE 94 St (7)Page 2
MPORTANT 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.
AFFI DAVIT' - 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 / , RIDA, COUNT OF MIAMI -DADE
62
Signature of caner
A1yTb
Print Name
Swom to and subscribed before me this
Z Z.
Signature of Notary Public - State of Florida
SEAL:
Type of Identification Produced:
o�ppOQpOo
0 %
Personally known OR, Produced Ident;ific c ,114"1 111 11 :- '. $
r
. < 6. .a00 0e� ✓ ` °o
OFFICIAL NOTARY SEAL
TOMAS A BAER
COMMISSION NO. D0038023
MY COMMISSION EXT. JULY 12,2005
STATE OF " ��' IDA, MIAMI -DADE
Signature of Contractor / Qualifier
9N ar, 1.
Print Name
Sworn to and subscribed before me this 3D day of ` ., C
aCc.
Signature of Notary Public - State of Florida
SEAL:
Personally kn
PERMIT APPLICATION
OYANYSti
MARTHA COREA
NOTARY PUBLIC STATE OF FLORIDA
COMMISS ON NO. CC944701
11Y
Type of Identification Produced:
CONTRACTOR
Name IS lo id Fe ice 6 ,p FL
License No.
aR' gs — rm
Address X111 e OKecho be Ed
14 = 3300
Telephon $ -9oCh Fax Psm
(( l
` ; d
Qualifier Name f
r iCt'c t h o e2
/PROPERTY OWNER
Name n ion Sm f.
Address )O 1 nc 9
Fri Q'lli 1 &hones, FL
Home Telephone a r , p w 4a5 rl
y
Business Telephone
Fax
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
A Iteration Exterior
Repair
A Iteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'I Detachment
Other
/.
Step 1.
N ob Address:
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
Master Permit No.
Subsidiary Permit No.
INSTRUCTIONS - The following steps must be taken to obtain a p rmit from the Miami Shores Village:
Complete the attached permit application which must be signed by the property owner and qpalifier. 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.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
AI'I'LICA'1'ION
101.R n ?L) Sf" 7-{ '01.6 Shots FL
Address Apt. City State
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
PERMIT APPLICATION
Zip
Folio Number description of Work (p91 x St 11,- A l (min um
Lot 1 Block o, 1 `;V P G' C3
5 3i is on 1 _ bvY\Sht PS3 PB 5 PG Q1 Zoning Linear Feet a a t
P
Current Use of Property s ► Ci P(A-i Q Square Feet Units Floors
Proposed Use of Property , ; (A P( - - i i 4i e\alue of Work, ' aQf .00 Bldg Value
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 11/14/2002
Applicant: MARTIN BOUTOT
Owner: BOUTOT MARTIN
JOB ADDRESS: 1078 NE 94 ST
Parcel # 1132050070190
Signed:
Building Permit
Permit Number: BP2002 -1948
Contractor ISLAND FENCE OF FLORIDA INC Contractor's Address: 711 E OKEECHOBEE RD
Local Phone: 305 - 888 - 9090
Permit Status: Approved Permit Expiration: 5/13/2003 Construction Value:
Work: 22' X 5' ALUMINUM DRIVE GATES
Page 1 of 1
Legal Description: 5 -6 53 42 .19 AC M/L PL OF GOVT LOT 4 PB 5 -90 PORT OF TR K DESC BEG SE
Fees: Description Amount
FEE2002 -6430 CCF $2.40
FEE2002 -6431 Building Permit Application Fee $60.00
FEE2002 -6432 Buildier's Bond $300.00
Total Fees: $362.40
Total Fees: $362.40
Total Receipts: $0.00
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.
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.
(INSPECTOR) BY:
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:
r
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 11/14/2002
Applicant: MARTIN
Owner: BOUTOT
JOB ADDRESS: 1078 NE 94
Contractor ISLAND FENCE OF FLORIDA INC Contractor's Address: 711 E OKEECHOBEE RD
Local Phone: 305 - 888 -9090
Parcel # 1132050070190
Fees:
FEE2002 -6430
FEE2002 -6431
FEE2002 -6432
Description
CCF
Building Permit Application Fee
Buildier's Bond
Total Fees:
Amount
$2.40
$60.00
$300.00
$362.40
Total Fees: $362.40
Total Receipts: $0.00
Permit Status: Approved Permit Expiration: 5/13/2003 Construction Value:
Work: 22' X 5' ALUMINUM DRIVE GATES
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.
This Permit is granted to the contractor or builder named above to construct the buil
ordinances pertaining thereto and with the understanding that the work will be perform
and approved by the proper municipal authorities. This Permit may be revoked at any
authorization. A further condition upon which this permit is granted is the understandin
ordinances and regulations pertaining to the work covered hereby whether shown on th
by his agents, servants or employees.
Signed: (INSPECTOR)
In consideration of the issuance to me of this permit, I agree to perform the work cov
with the plans, drawings, statements or specifications submitted to the proper authoritie
myself, my agent, serva . r employes.
Signed:
/� - e 4; ', (Contractor or Buil
Building Permit
Permit Number: BP2002 -1948
BOUTOT
MARTIN
ST
Page 1 of 1
Legal Description: 5 -6 53 42 .19 AC M/L PL OF GOVT LOT 4 PB 5 -90 PORT OF TR K DESC BEG SE
EVELYN L. PASCAL o3-99
ARTHUR J. PASCAL
954 - 438-7843
359 S.W. 164TH AVE.
PEMBROKE PINES, FL 33027 -1085
Pay to the
Madera
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BankofAmeriCa®
ACH R/r 063100277
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For
1:063 LOO 2771: 0034375 28 5 L811'
Bate /0.51° 2.
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6 r 1, � , 1 it y\ r -
\''" .1'; Bank of America Ad ' '', i C [
1.
1514
63- 27/631 FL
773
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OF THE PUBUC RECORDS OF MI MI -DADE COUNTY, FLORIDA, BOUNDED AS FOLLOWS:
STARTING AT THE INTERSECTION OF A LINE PARALLEL TO AND 80 FEET NORTH OF
THE SOUTH LINE OF TRACT K AND THE WEST UNE OF EAST DIXIE HIGHWAY,
RUN NORTHEASTERLY ALONG THE WEST UNE OF EAST DIXIE HIGHWAY A DISTANCE
OF 76 FEET; THENCE WEST PARALLEL TO THE SOUTH UNE OF TRACT K, A DISTANCE
0F133 FEET TO THE POINT OF BEGINNING OF THE TRACT HEREIN DESCRIBED, THENCE
CONTINUING WEST PARALLEL TO THE SOUTH UNE OF TRACT K A DISTANCE OF 117 FEET;
THENCE SOUTH AT RIGHT ANGLES TO THE LAST MENTIONED LINE, A DISTANCE OF
74.28 FEET; THENCE EAST AT RIGHT ANGLES TO THE LAST MENTIONED LINE, A DISTANCE
OF 11.7 FEET; THENCE NORTH AT RIGHT ANGLES TO THE LAST MENTIONED LINE A DISTANCE
OF 74.28 FEET TO THE POINT OF BEGINNING.
' PROPERTY ADDRESS °
1078 NE 94th Street
Miami Shores, Fl 33138
▪ CERTIFY TO ' :
German Molina & Alan Smith.
C & C Title Agency, Inc.
Attorneys Title Insurance Fund, Inc.
Chase Manhattan Mortgage Corp., its successors
and /or assigns as their interest may appear.
BOUNDARY SURVEY
•
I Herby Cs1I : TIM its atlect ed Story we nude weer
mF rarponihe dreevrd stropyAriy nuts b. Meow
Idrid MNleb es me I°rW Ll, 1Ie *R.ORIDA BOARD
OF LANG SURVEYORS• tiCrueler 8103174, Rorke Ned
-
renew) ene) Cod , P ID - CTITET. Rorke Seeing.
TOR Y. PINERA
Land Surveyor 8 Mapper No. 5687
State of Florida
Mid Valid without the Sianetwe anq
ORION SURVEYORS
& MAPPERS , INC.
t( 15036 S.W 140th TERR.
MIAMI, FLORIDA 33196.
305) 232 -1109 - 2324659
LOCATION SKETCH
( N.T.S.)
JOB No: 02 - 08452 I DATE: 8 - 2002 I DRAWN BY: H.Y.P I REVISED:
TUNS SURVEY WAS CREATED FOR TITLE INSURANCE PURPOSES ONLY.
NOTES:
-1145 SURVEY DOES NOT RB .ECT OR OETERIBE OWDERSHP.
-AIC8 SHOWN HEREIN HERE NOT ABSTRACTED FOR EASBENTS
ANC/OR RIGHT OF WAYS OF RECORD.
-LEGAL DESCRIPTION PROVIDED BY CUBIT.
-BEARINGS IF SHOWS. ARE BASED CRAMMED MERIDIAN BY PLAT OF RECORD.
-IF SHOW ELEVATIONS ARE REFERRED TO NO.V.D 1929.
4J06tGROUPD ENCADPCMIBIt8 NOT LOCATED.
- DISTANCES ALONG BOUNONR OF SuEuECT PROPERTY ARE
RECORD AND MEASURED UNLESS OTIERIMSE STATED.
- THS SURVEY I NAS PREPAR® FOR THE D ICLUBIVE UIBE OF
DE ENTITY NAMED HEREON E ATTACHED CERTIFICATION
DOES NOT BRED TO ANY UNNAMED PARKED.
THE FLOOD INSURANCE RATE MAP, DATED 3-2-94 , PUBLISHED BY THE FEDERAL EMERGENCY MANAGEMENT
AGENCY (F.E.MA) , DELINEATES THE HEREON DESCRIBED LAND TO BE LOCATED WITHIN :
COMUNITY No: 120852 PANEL No: 0093 SUFFIX: J FIRM ZONE: AE BASE FLOOD ELEVATION: 8.0'
= CHAIN UNK FENCE = CONCRETE BLOCK
--# - --IH = WOOD FENCE /-- e - - --R— or WIRE FENCE ® STRUCTURE
ENRO
C.B.S
C.LF
W.F
(M)
(PI
IC)
OlS
F.I.P.
HO
S.I.R
ENCROACHMENT
CONCRETE TE BLOCK STRuCTIRE
CHAIN UNK FBA
WOOD FBCE
MEASURED
PLATTED
CALCULATED
OFFSET
FOUND IRON PIPE
NAIL L DISC
BET IRON ROD
P.R.M
P.C.P
P.I
P.0
D M
U.E
0.M.E
P .P
O.P.L
AD.R,T
F.I.R
PERMANENT REFERENCE MGNMENT
PERMIVENT CONTROL POINT
POINT OF INTERSECTION
POINT OF CURVATURE COMMENCE
DNU . HOLE
URLRY EASEMENT
DRAINAGE MAINTENANCE EASEMENT
POWER POLE
OVBtlfAD POWER UNES
ARC. OB.TA RADIUS TANGENT
FOUND IRON ROO
WILL
F.H
C.B
OONC
SAW
MC
F.F EL
P.O.B
NT.S
ELM
EO.W
• WATER METER
• FIRE HYDRANT
• CATCH BASIN
• CONCRETE
• a1DBAWUL
• NR coternODER
• FIMSH FLOOR ELEVATION
• POINT OF BECKWINl
• NOT TO SCALE
• BFIL:H MARK
• EDGE OF WATER
' LEGAL DESCRIPTION °
ALL THAT PART OF TRACT K OF PLAT OF GOVERNMENT LOT 4, OF SECTION 5,
TOWNSHIP 53 SOUTH RANGE 42 EAST AS RECORDED IN PLAT BOOK 5 PAGE 90
F.I.P 3/4"
(No I.D)
F.I.P 3/4"
(No I.D)
N.E 94th STREET
N 90 °00'0" E
117.00'
S 90 °00'0" W
117.00'
0
i o i i i i i it ii i ii i i i i i iiio loll i i i i i i i o i �i i i J
P.O.B.
F.I.P 3/4"
(NO LO)
bl
F.I.P 3/4'
c (No I.D)
20
1 " =20'
40
ELECTRICAL
TYPE
Minimum Fee
(in'.
'I•ypE
Dryer
QTY.
Typl.-
Outlet, Appliance
Q"I Y
Tvp :
Service Repair
QT1r.
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
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL
nil:.
Minimum Fee
QTY
TYPE
Condensate Drain
QTY.
TYPE
Generator
QTY
TYPE
Refrigeration, Tons
QTY
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinlder System
Process/Pressure Piping
Supply, AC Well
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Temporary Toilet
PLUMBING
TYI'I{
A/C Condensate
QTY.
TYPE
Drains, Roof
QTY.
TYPI.
Miscellaneous Fixture
Q"I'1'.
'I'YI'I?
Soakage Pit
I
Q'I1
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.
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
DATE
VS /(}Z
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
j
,
Building Official
,
I
`1.1--
ti /
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
O FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
Notary
Cl PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
$
( s .ftt. = x/1000
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
O CONTRACTOR REGISTRATION
(On File)
TOTAL $
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