1270 NE 94 St (5)MIAMI SHORF VILLAGE .\
BUILDING DE ARTMENT
305- 795 -2204
Building Inspection Request
Date \\ '1 'C)
Type Insp'n € CL c/
Permit No. ? Q
Name C�C�� C A-V
Address \ 22i � _ q - --
Company
Phone # S �5�` - �46 2
Inspection Date \\ ' c�v OH
Correction ❑
Re- Insp'n Fee ❑
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): a: uildin a, Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) B � i)- .R. } Phone # 3 0 f r. ), --r )— 6 6 8 - 3
Owner's Address V ) - 1)0 NE. R .
Cit \ I Prf \ S14-012L...1 State pt- Zip 33132
Phone #
Tenant/Lessee Name
Job Address (where the work is being done)
City Miami Shores Village
is Building Historically Designated YES
Contractor's Company Name
Contractor's Address
City State Zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable)
$ Value of Work For this Permit LA 000
Type of Work: ❑Addition
Describe Work:
dosiml mud a STdE. ()Jo) t
5563
Submittal Fee $ —5
Notary $ Training/Education Fee $
Scanning $ Radon $ Zoning Bond $
Code Enforcement $
Total Fee Now Due $
(Continued on opposite side)
CZ 6- s LOA ti t F i -c-e2-.1 w Lc
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Permit Fee $
g(fd (
Miami Shores Village
Building Department
I
,�� � Florida 33138
Te (RE/a0 ' �tl+\ 1. �'1 I 756.8972
' • Master Permit No.
10050 N E 2n
V)- t) F, ck Lt
County Miami -Dade
NO
/a5 —
0,e0
Structural Plan Review. $
Phone #
Permit No. tPO4 ( U 53 -
Phone #
Zip 33t3'
Square Footage Of Work: Pree/Z0A. q 0 0
❑Alteration ❑New ERepair/Replace ❑ Demolition
CCF $ r 40 CO /CC
Technology Fee $ 3
'3
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien 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 approved and a reinspection fee will be charged.
Signature
Owner or Agent
APPLICATION APPROVED BY:
Chc 05/13/03
The foregoing instrument was acknowledged before mee tt is 5 he foregoing instrument was acknowledged before me this
day of N\00 , 2&4 , by 36 OUP A Vole iM The
of 20 , by
who is personally o to me or who has produced 6074 who is personally known to me or who has produced
s identification and who did take an oath. as identification and who did take an oath.
NOTARY P : IC: NOTARY PUBLIC:
Sign: 45!r.l�"i��iZIL0 r • : , Sign:
Print: :4_ Co fission Dh2319Z34 Print:
, ii -
ed Thtu
My Commissio xpires: Atlantic Bending Co., Inc
*******************************************************************/ n9***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Signature
Contractor
My Commission Expires:
NOV 0 9 200
Plans Examiner
Engineer
Zoning
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, e%'R- di (41- • , hereinafter referred to as the Owner of the
(owner)
following described property: �1 n
Legal description /folio #: \''1..' ! 0 (J 6 - R '1 .& i i
Lot Block Subdivision
Tax Folio #:
requests per to install:
Asphalt, concrete, brick pavers
[] Landscaping
[) Other
zrQ •t S9 . T .
(address)
IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows:
I. To maintain and repair, when necessary, the above- mentioned item(s) installed within the dedicated right
of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said
items within public right of way including restoration of street by reason of the Owner's failure to do so,
such expense shall be paid by the Owner or shall constitute a lien against the above described property
until paid.
2. The owner does hereby agree to indemnify and hold Miami Shores Village or dade County harmless from
any and all liability, which may rise by virtue of permitting the installation of these items within the public
right of way.
3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days
notice by the Village to do so. Failure to comply with this notice will result in the Village causing the
item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all
costs incurred in the removal and disposal of the item(s).
4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and
shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such
time as this obligation has been canceled by an affidavit filed in the Public records of Dade County, Florida
by the Village Manager of Miami Shores Village (or his fully authorized representative).
within the public road right of way
SIGNED, SEALED, EXECUTED AND ACKNOWLED,
SIGNED. SEALED AND DELI VERED in the presence of:
M uni SIlorQ� l/iLLcr.�e
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 -2382
Telephone: (305) 795 - 2207
Fax: (305)-756 -8972
ay of r i 200N
f} PPR o4-ct-f
attached survey, performed by
'STATE OF FLORIDA)
COUNTY OF DADE) ,�,�� �,
The undersigned Affiant, ,K e)./4.) cr1/4 fi'"° tmdoes hereby attest that the
(property owner)
ry (name of surveyor's company)
performed on - '1 is an accurate representation of the existing conditions and
a.. ,f 012.s I
(da of s • ey)
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the
property without first providing a survey less than six (6) months old. The Affiant, as property owner, further
agrees to remove or obtain permits for any structures which now may exist on the property which are not
permitted or which may violate zoning or building code regulations. The Affiant further understands that the
existence of any such structures may affect final inspections as applicable to this or other permits..
Further, Affiant sayeth naught.
Witness(sign and print) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this S day of 1VO v V
Affiant is personally known to me, produced
as identification.
40!`7.17 �1abek argas
` C om #DD231984
U, Expires: Jul 13, 2007
9 P Bonded Thru
i�OF F10
'' Atlantic Bending Co.. lit;
I (3guck. A-- R.o.s , .being the legal property owner, for the property
Located at: \ 2'7 o L t 5 Pir•1 ' 1 S Woreixf FL 33 13 - 3
Legally described as fat ' p
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the
State of Florida, F.S. 489.103(7),,.nd I have read and understand the following disclosure
Statement, which entitles me to work as my own contractor, I further understand that I as the owner
must appear in person to complete all applications.
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor
even though you do not have a license. You must supervise the construction yourself. You may build or
improve a one - family or two-family residence or a farm out - building. You may also build or improve a
commercial building at a cost of S25,000.00 or less. The building must be for your own use and occupancy. It
may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the
construction is completed, the law will presume that you built it for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure
that people employed by you have licenses required by state law and by county or municipal Iicensing
ordinances. Any person working on your building who is not Iicensed must work under your supervision
and must be employed by you, which means that you must deduct F.I.C.A. and with- holding tax and
provide workers' compensation for that employee, all as prescribed by law. Your construction must comply
with all applicable laws, ordinances, building codes and zoning regulations.
Proof of ownership provided ( ) initial of reviewing clerk. The foregoing instrument
Was acknowledged before me this n day of N O`f , 20 0.-1
�B b-CX')e_ a5.2,r)-1
Produced
OWNER BUILDER DISCLOSURE STATEMENT
Owner
Owner
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
DISCLOSURE STATEMENT
who is personally known to me or who has
as identification •ii who did take an oath.
,vfauei v
'omm ission I D D23
.�. E fires: Jul 13, .07
Atlantic Bonding Co:, Inc.
LEGAL DESCRIPTION: LOT 18
SUBDIVISION MUAW SHORES BAY VIEW
Aar1 DING TO THE PLAT THEREOF AS RECCRDFI) IN PLAT
OF THE'POBLIC RECORDS 6 OF nADE COOKY,
CERTIFIED TO: Chase Manhattan Mortgage Corporation, !Its
Assigns, As Their Interest May Appear,
B uoe A. Rosenthal and Anna M. Chan,
Attorneys Title Insurance Fund, Inc.,
- Garry Nelson, Attorney At Law
Fautslc:7) o� \ li_
■-■ ot.E c:,%•4 Cora c
.■L1.r
•LEGEND; Centerline,
Plt = Planter,
No = Number
Clr = Clear,
Typ = Typical,
M = Measured,
P = Plat,
A/C = Air Conditioner,
Conc = Concrete,
'scALt: 1" = 201
D
1..3 .e__ 94
- APPROVED If:
40 PAGE 16
Successors and /or
15
co
;
scAvKIE
LOCATION SKETC
SCALE: 1 " Notj To Scale
WE HEREBY CERTIFY: that the attached BC44DARY SURVEY of the above described
property is true and correct to the test of air krcwled9e and belief as
recently surveyed under our direction meets minimum tedinical standards
set forth by the rum.= EOM D ow , Pursuant to chapter 61 G17-6
Florida Administrative code, 1>smdcatich of the abstract of title will have to
be amide to determine recorded instruments, if any, affecting the property.
Location and identification of utfliti ' an and/or adjacent to the property
were not secured as such information waS not requested. Ownership is subject
to Opinion of Title. This survey is performed or PLUM A 'R:se>t17a1 &Arra CYErl,
for the similar p rip e s of obtaining fiortgagezi4t4 I u ance'and does not
extend to any ►moaned party,
' " NAPFERAND:S019;
}9t)Yaii{3 e{bossed seal.
PREPARED BY: B.P.Y. LAND SURVEYING, INC.
11330 S.W. 56th Street Miami, Florida 33165
(305) 274 -4292 Fax (305) 274 -3857 LB #: 4742
kB: 92
2 -17 -99 Pb: 27
PREPARED FOR: BRUCE A. ROSENTBBAL and ANNA M. CHAN
ADDRESS: 1270 N.E. 94th Streeq Miami Shores, Florida 33138
Flood Zane 120652 0093 J 3 -21,94 "AE" Et,: 9
r7,',c,.rc of 1 ..cf 1.
DRAWN BY
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31 2. 42 CP)
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 11/16/2004
Applicant: ANNA
Owner: ROSENTHAL
JOB ADDRESS: 1270
Contractor
Local Phone:
Parcel # 1132050100160
NE 94
Signed: (INSPECTOR)
Signed: (Contractor or Builder)
Building Permit
Permit Number: BP2004 -1457
ROSENTHAL
ANNA
ST
Contractor's Address:
Legal Description: MIAMI SHORES BAY VIEW PB 40 -16 LOT 18 LOT SIZE 75.000 X 138 OR
BY:
Fees:
FEE2004 -11371
FEE2004 -11372
FEE2004 -11373
FEE2004 -11374
FEE2004 -11375
FEE2004 -11376
Description
Building Fee
CCF
Notary Fee
Training and Education Fee
Technology Fee
Scanning Fee
Total Fees:
Amount
$125.00
$2.40
$5.00
$0.80
$3.13
$6.00
$142.33
Total Fees: $142.33
Total Receipts: $0.00
g- 33
.5
Permit Status: APPROVED Permit Expiration: 5/4/2005 Construction Value: $4,000.00
Work: DRIVEWAY
Page 1 of 1
NOV 17 PAID
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.
3
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. ?` CO (:)%. t‘k0C TAX FOLIO NO. \A -32-OS --OHO -OIIOO
STATE OF FLORIDA
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
111111111111111111111111111111111111111
2. Description of improvement:
CFN 200480993021
OR Bk 22812 P9 0389; (1139)
RECORDED 11!10/2004 10:
HARVEY RUVII'ar CLERK OF COURT
MIAMI -DADE COUNTY, FLORIDA
LAST PAGE
1. Legal description of property and street/address: M \ Pt 1 - HR6-f $ I -- t v I RA.) Vis -10 " `
L.0Z' 1
yx .rI 0 r J 6. 9 K S'7`. �"` 1 g, I
DRS ' f , g ,,,,
s (+o RA J
3. Owner(s) name and address: 2) l P 20 5.'"
N)6 c141 1�r. MBA -^^( SH- OQ 33t3R
Interest in property: 0 W r
Name and address of fee simple titleholder: (5 Pr+r .& Pr A,00/6:)
4. Contractor's name and address:
5. Surety: (Payment bond required
Name and address:
Amount of bond $
6. Lender's name and address:
P.O. 28 83 0 govt-1", 0R_C j M �
7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided
in Section 713.13(1)(b), Florida Statutes.
Name and address: ~'
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
differ:; • . e 's spe;;ed)
•'Si nature of Owner
Print Owner's Name 0 • 1 ' J o< enTM'
Sworn to and subscrib:. befo
Notary Public
Print Notary's Nam
My commission e
123.01 -52 PAGE 4 8/02
Tres:
me this n day of 0 , 2
1' .. . •
omtniss►On li 1
Expires: Jul I "i (107
YP
s
o4
28 3 - 00\
Prepared by e"&" A P.P m"
Address:
0 Al ri_ 9, (47
.
FL- 33/ 3