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FENCEMIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date / Time Type Insp'n_iJ r/ 1 l� ��►^ ��� Permit No. Name Address — 135 5—t Compan - ?). Phone # C30c) /59 J 0/ For Inspector: la Correction Re- Insp'n Fee Name & Date v • N 37.50' (7 REMAINDER OF LOT 18 L_ - - NO ID. 0 15 ALLEY 3 an 128.75'(P8M) �� " F. r 0 I F LP 1/2" / 80.00'(P) 80.12'(M) F.I.P 112" �s cP• 25.00' IC. v �+ p N 4 w o n 1 1 fi 30.00 o °- - r+v iv. ASPHALT DRIVEWAY 80.00'(P &M) 9' ASPHA1lf I / o] „ rn o v • "r m 86.00' — u+ o 32.90' Q u ° vD v- v m D > -I 18.10' fl ! m 11 y " D " g c� 1 D � I �(7 p -i — 38.30' — W ;o ' - (.1l � m a o) o oo m \ / \ Ta i /A / \ \ `i WOOD F. O p 0.10' \ I/1 c, \ CL 1 o o \ I! 1 yo 7C n ao ii > m xi 45.10' — U S 12.60' = v ' 8.95 D N 6)O u. o OT o 36.55' •, � \ v 0 oC \ G _ • 1 I co n 4 8 s o, VV.rvvl /7 128.75'(P&M) LOT 20 4' WIRE F. a O -n SCALE:1 "= 20' BOUNDARY SURVEY REVISED: I HEREBY CERTIFY Thal the survey represented Hereon meets the minimum technical requirements adopted by the STATE OF FLORIDA Board oI Land Surveyors pursuant lo Section 472.027 Florida Statutes There are no encroachments. overlaps. easements appearing on the plat or visible easements other Chan as shown hereon ADIS N. NUNEZ Pegis :erecLand Surveyor No. S :ate of Florida DWN. BY: F. likOco DATE: (3 — 01 SCALE: 1 "= 20' JOB No. 01- / /8S NOT VA up UNLESS EMBOSSED We SURVEYOR'S SEAL • SUFFIX: :J 'ABBREVIATIONS: SWK =SICEWALK. CBS =CONCRETE BLOCK STRLCTURE. CLF =CHAIN LINK FENCE. PI= PROPERTY UNE. ME =CRAJNAGE UTILITY EASEMENT. IP =IRCN PIPE. F= FOUND. A/C =AIR CONDITIONER PAD. P /C= PROPERTY CORNER D/H= DRILLED HOLE. W/F= WOODEN FENCE. RES= RESDENCE. CL =CLEAR RB =REBAR UE =LMUTY EASEMENT. CONC = CONCRETE_ SLAS. R/W =RIGHT OF WAY. DE= DRAINAGE EASEMENT C/I= CENTER LINE. O= OWMETER TYP= TYP.CAL M= MEASL;RED. R= RECORDED. ENCR= ENCROACHMENT. COMP =COMPUTER. ASP`+ =ASP) ALT N/D=NAJL & DISC. S =SE1•FFE =FINISH FLOOR ELEVATION. O/S=OF.FSEL P/P =POWER POI.c. OHP= OVERHEAD POWERLNE. WM='NATER METED W000 FENCE I E:?v2:iors t z.e� cn MASONRY WALL- ----- - - - - -- CB CONCRETE= S:. :• • � E NGV D:ty - MAINTENANCE & DRENACE E. = H & NOTES: UNLESS OTHERWISE SHOWN. THE FOLLOWING NOTES APPLY.: Locator Inc ex T 1) Record and measured calls are in substantial agreement. 2) Bearings, if shown are based on Plat data. 3) The lands shown hereon were not abstracted for Easements or other recorded emcumbrances not shown on the plat and :he same, if any may not be shown on this sketch. 4) Underground portions of Footings. Foundations or other improverner.ts were not located. • 5) Elevations are based on National Geodetic Datum. 6) Fence Ties are to the Centerline of the fence. 7) Wall Ties to the face of the Wall. 8 g ,ql iv^T 1 - SHOW - ARE _ RErERED TO AN ASSLhtiD VALUE •SAID FB PAGE_ rA L O C A T I O N S K E T C H SCALE : N T S N.E 1st AVENUE 0) n 128./5 cn 128.75' 0 0) 128.75' 0) 128.75' 0 15' (-n rJ 37 5' CERTIFIED TO: FLORENCE BLACK- GORDON AND CORDINEL GORDON,135 N.E. 94TH ST., MIAMI SHORES, FLORIDA 33138., DANA F. CHARLES, P.A., ATTORNEYS' TITLE INSURANCE FUND, INC., SIB MORTGAGE CORP., ITS SUCCESSORS AND /OR ASSIGNS, ATIMA. LEGAL DESCRIPTION: LOT 19 AND THE FAST 30 FT. OF LOT 18 BLOCK 21 OF AMENDED PLAT OF MIAMI SHORES SECTION NO. 1 SUBDIVISION ACCORDING TO THE PLAT THEREOF AS RECOFD_D IN PLAT BOOK 10 AT PAGE 70 OF THE PUBLIC RECORDS OF MIAMI -DADE (COUNTY. FLORIDA. SINCE 1987 BLANCO SURVEYORS Planners INC � 0007059 Engineers • Land.Survevors • 555 NORTH SHORE DRIVE MIAMI BEACH FL. 33141 (305) 865 -1200 1 , PROPERTY OWNER New Construction Name /f 9 o r J e ,( �� r ed 0 � C '13 Address 5 f � r 4 P. a c►1 i' S i•,wr-GS Alteration Exterior s i- FL- 1313c Home Telephone 3 J 5 7 7 ` q 5/01'4 Business Telephone Demolish Fax Shell Only TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ 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 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ n o $ (¢.005 / sq.ft.) S. ISSUING OFFICIAL REVIEWED AND PREPARED BY: SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official DATE 74 / 6 (sq.ft. = x/1000 x ¢.60) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ S, b 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 INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which print or type to allow for a more accurate processing along with this permit application. Step 2. Submit the completed application with all necessary processing of your application, you may be asked to APPLICATION Job Address: 135 NC- q f`' 3t Address Apt. Folio Number,) 3" r q h o1, Lot 17 6-t14-. 4 /Block ,..c.. 1 Subdivision f llil. K LAT drn _i_o_ PG 76 Current Use of Propert xl�Az_� Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax PERMIT APPLICATION Master Permit No. Subsidiary Permit No. 'i g '7 must be signed by the property owner and qualifier. Both signatures must be notarized. Please of your application. If roofing work will be done, a roofing application must be submitted documents to the Building, Planning and Zoning Department for processing. During the submit additional information. rY 4 , k0' City Description of Work Jo ' e- ' ?Q/)C e S' Zoning Square Feet Units Value of Work LI O t) 33 /g$ Zip IZ-e �1 F evl c e. o r ,// '� j.� Linear Feet /' ('0 'g fL State Bldg Value Floors ENGINEER Name License No. Address Telephone Fax CONTRACTOR I )f Name License No. Address Telephone Fax Qualifier Name ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. 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 TYPE 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 Sprinkler System Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. 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 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. STA O' FLORIDA, CO OF -DADE oA •iX 1.c_. � /A ) Signature of Owner /v�nce 13/9c, . Print Name Print Name day of • ignature of .: , :' i . tr. r '91 IFM .T,: TAR • 0 ' ANGELA M BECKER Z -,,,---\ r i i cotamm o NUMBER u, q�p. . 'e C 9I ci MY COMMISSION EXPIRES ` O FL NOV. 15,2 S : to and subscribed before me thi SEAL: Signature of Contractor / Qualifier PERMIT APPLICATION STATE OF FLORIDA, COUNTY OF MIAMI -DADE Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Personally known OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produce b 35 v Type of Identification Produced: 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: ** * APPROVED: * * * PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date ?-- \ \ - R3 Job Address V --;774; j0 %C 444 \ l ' S Tax Folio Legal Description ,g:4 _ Lessee / Tenant f f A � �Q"\atr4 Vfvvy-er Master Permit Owner's Address \ W ( E g q" S { '5 Phone q � Contracting Co. (3W VN Address Qualifier SS# - - Phone State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): s ILDI ELECTRICAL PLUMBING MECHANICAL ROOFING PAVIN// ENCE SIGN �' WORK DESCRIPTION S 1.0 D 7� � vc, Square Ft. Estimated Cost(value) 6 Cad 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 a hor the above -named contractor to do the work stated. Signat e of owner and /or Condo President Signature of Contractor or Owner- Builder Date: g ///4 Date: /40, C IMIPWW11 Not =(y'a to Owner a ±; cy�,gApn73p,1 i Notary as to Contractor or Owner- Builder My ommission Expires ��; No.CC197545 My Commission Expires: * * * * * * * * * * ** FEES: PERMIT 4 � ®" RADON C.C.F. © NOTARY S C ®K/ TOTAL DUE�3 3 - Fire Zoning din Other Electrical Mechanical Plumbing Engineering / / ^ * Mb. vs-vi - .1(. dQ HL d v 1 ( ri ••, a 1 I \ ri 1 ; n Knci 1 • ? • J.i.d , • • •■% S'• 7‘■ V't - •Vla. .e