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230 NE 94 St (7)S Notary as to Own My Commission PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date I r 9 Job Address Legal Description Historically Designated: Yes No Owner/Lessee / Tenant s- !/fie 6 .4• .74 Master Permit # 9 . 3 3 s c Owner's Address 02 3 0 N- C . 9 •s' /7 . Phone - 7 5 °- 0 y ') (, Contracting Co. Ar i on , Inc . Qualifier Richard Wynne ; SS# , ph 251 —1279 State # ‘hunicipal # 00013371 Competency # Ins. Co. Ko 1 i s c h Architect/Engineer Address I Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Install of Rain Gutters and Downspouts Square Ft. ,r2 00 .� .,, f" e- ° � Estimated Cost (value) 99'Y 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 •nstruction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. e o owner and/or Condo President Date or Condo Presi es: FEES: PERMIT RADON APPROVED: Zoning Buildin Mechanical 0 2 30 Ai 6 9 `F l r. Tax Folio . P6/95 Date NOTARY PUBLIC . STATE OF FLORIDA JENNIFER NAFTAL -PEREZ COMMISSION # CC588692 EXPIRES 10.11.2000 BONDED THRU ASA 1 .888 - NOTARY -1 C.C.F. Plumbing „t(adress 8723 Sw 129th Terr . <l Date Signature of Contractor o otary as o Contracto My Commission Expires: NOTARY Electrical er- Builder _ Date NOTARY PUBLIC - STATE OF FLORIDA JENNIFER NAFTAL -PEPEZ COMMISSION # CC588 EXPIRES 10.11.2000 BONDED THRU ASA 1.888-NOTARY -1 BOND TOTAL DUE Engineering ADDRESS e3U N• IS• y4Lia UZ• LEGAL ) do 0 ( ki ii RECORD GARBAGE TAX 11 1ory 9 PAID BY #11279 ��1V�5 Iiunderfor YEA ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT NUMBER .. /7 14.4.. r r e l c c ® r'1 / 9 \ r / / P ` c'---L'- /; -..7/-s7 j/. - - _ s r - /s-00, BUILDING ELECTRICAL PLUMBING ROOFING , Owner of t Building `.i Lot r .• PERMIT 10 11279 f] Work to be performed under this Permit rt Architect i J i ��,, , L. ' 1 I) Contractor or Builder Legal Description Address of Building w This permit is granted to the contractor or builder named above to construct the b herefor in strict compliance with all ordinances pertaining thereto and with the un cr drawings, statements or specifications that may have been submitted to and approve time if the work is not done in compliance with such ordinances or if the plans are granted is the understanding that the contractor or builder named above assumes pertaining to the work covered hereby whether shown on the plans or draw done by his agents, servants or employees. INSPECTO In consideration of the issuance to me of this permiiI agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the place, drawings sta ments or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done byher, myself, my agent, servant or employee. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA r'l BL J Subdi- vision ll\ Value of ` Projec � '�,{ BY r= DATE 4 ; : ; : _ 195_1.__ Contractor's License No, • • Amt. of "‘ ► Permit $ old- or to install the equipment or device described in the application hat the work will be performed in compliance with any plans, Ap oper municipal authorities. This Permit may be revoked at any thout authorization. A further condition upon which this permit is sibility for a thorough knowledge of the ordinances and regulations tenleiyts or specifications and that he assumes responsibility for work 4; BY AUTHORITY ' .. N9 1478 CERTIFICATE OF OCCUPANCY Street Address MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Miami Shores Village, Fla , Owner, Agent or Tenant of Building Lot Block Subdivision Approved use by occupancy Remarks: This Certificate of Occupancy is issued to the above named for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known ss the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildings or structures. BUILDING DIVISION INSPECTIONS/ DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION 4-15-11 DATE FEE TEMPORARY SERVICE / !�' BEAMS & LINTELS f ? -,S I $ SEWER FRAMING / .4'f/ w A SOLAR HEATER $ GAS $ FINAL INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT CLEAN -UP ROUGHING V.—/f G— 9-' i CONTRACTOR „ /,'; i 1 I PHONE PERMIT NO. /f alp S DATE - 02 4 - 4 . . ,..-- / FEE $y `,-- NEW BLDG I ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE / !�' y.--=,- •---" /.4'. -r $ SEPTIC TANK $ SEWER $ SOLAR HEATER $ GAS $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING V.—/f G— 9-' i GAS _! H. W. HEATER CONN SEWER RANGE CONN. SEPTIC TANK pp ,�-.. r *" ./ M C� SOLAR HEATER FIXTLRES & FINAL p.oa. FIXTURES CONTRACTOR PHONE / n PERMIT NO. //� DATE - a2f'k FEE $ He f NEW BLDG. 1 ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE / !�' y.--=,- •---" /.4'. -r $ �___ H. W. HEATER CONN. $ RANGE CONN. $ MOTORS $ FIXTURES $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE V.—/f G— 9-' i RCVGHING . _! H. W. HEATER CONN RANGE CONN. FIXTLRES & FINAL 6 p.oa. � �i i ii % /. / . S $ ' ' �• . �: i� ✓ Pe l ✓ ��/ ��,�L.l�- UILDING INSPECT ' r PLUMBIC, PERMITS & INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL. TO POWER CO. FOR SERVICE DATE BY a�r -S BY a.L /• OWNER•S NAME J: A. HUNDERFORD` PRESENT ADDRESS 230 L. E.. 94th STREET LICENSE NO. PHONE NO. • .0-..,,,, JOB LOCATION (ST. OR AVE.) 230 N: E. 94th STREET' LOT 5 & 6 BLOCK 27 SUBDIVISION MSS #2 "- A GENERAL CONTRACTOR JOl RI'1mH & SON ADDRESS PHONE NO. ' LICENSE NO. BUILDING PERMIT NO. 11279 DATE 410 5 PERMIT FEE $ 21 BUILDER'S BOND NO. DATE ZONE REQUIREMENTS 18,500 CU. FT. PLAN CUBE 19,500 CU. FT. EST. COST $ 7.000 PETER GAETA DRAWINGS, SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY:" DATE 4 -10 -51 �C Z NEW CONSTRUCTION TYPE STORIES ., ROOF CONSTRUCTION INTERIOR CONSTRUCTION REPAIRS DESCRIPTION Liv Area Din Area -Kit -2 Bedr• •v,, - • : • ; - • _ • . • ' -. _ ALTERATION _ _ _ DESCRIPTION , Porch- screened patio car port ADDITION SUBMITTED TO PLANNING - BOARD APPROVED REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING'BOARD SUBMITTED TO VILLAGE COUNCIL REMARKS CERTIFICATE OF OCCUPANCY NO./ ' 7 ISSUED 70 / S BY A __ TO BUILDING PERMIT AND INSPECTION RECORD - MIAM.I SHORES VILLAGE N9 1478 CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Miami Shores Village, Fla , Owner, Agent or Tenant of Building `T Lot Block `) S d Street Address ,(= r Approved use by occupancy Remarks: This Certificate of Occupancy is issued to the above named Y a for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildings or structures. �_ - "N, BUILDING DIVISION YiYAY OF FLORIDA COUNTY OF DADE 0 HEREBY CERTIFY that this Is a true copy o4 the origin filod In this office% on / (j+ da of , A.D. 1 WITNESS my hand and Official Seal, •PEPP,rI T* ,-a .-a 'O CV THE UNDERSIGNED hereby gives notice that Improvement 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. State of Florida County o f Dade NOTICE OF COMMENCEMENT Co o NO dti 2. Genera 1 descr i pt ion of Improvement : �� �/4 .Sc �',�/J -vC / / p� A• �G21,tL•d / - • CE-14 / (JG- O F -5-6P6'E h- i9 6. 9d4 2 .0 ►— �-� ,rz /47 4 J..o /J<,7 /ee/4°9J a /94 :' '- o.c f�vr'E 3. Owner information: .2.30 NE a. Name and Address: Ox, /24[/,/ _5EX7 - r).v 0/'7) S'/ / b. Interest in property: c ep,z,AjEi2 .x/ 1. Description of property:(legal description of the property, and street address If availabi 4 7; 9 /&r c. Name and address of fee simple titleholder (If other than owner): 1 4. Contractor: (name and address) # 4 9 7" , e.,,i dQ,1 /e) c- 5. Surety: a. Name and Address b. Amount of bond $ 6. Lender:(Name and address) / 0 TAX FOL IO NO . / /' ...K7 /3 07a 5 2. Vi // , 7 5 -c.// - 4 v-9 7eo , " d 7. Persons with 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) 9. Expiration date of notice of commencement (the expiration date Is 1 year from the date of recording unless a different date is specified) �Q� // ✓ 7 l<-J - e---1- I 0 - / SI / gnature of Owner 6c Sworn to and subscribed before me this /4 ity day of .y y2/j6r 1991. t" C NOTARY PUBLIC, STATE OF FLORIDA. ( } /}')J}"� %\ /l/.�'/ I) � (� MY COMMISSION EXPIRES: Dec. 29, 1995. Notary Pubric N>\V ' 4/1 May Commission Expires ra:.0 NOTARY r:ai is uti>7r tir^ . -s. f�. 'M Y 4 P 1, ,; �: � :� ^ Gi - ' /ti 'd i . rl ,. , _ s / NU �l � r ryLi ^ R< / ,. S ,may \, 8. In addition to himself, Owner designate to receive a copy of the Llenor's Notice as provided In Section 7.13.13(1)(b), Florida Statutes. of 'PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) -2,30 ,577 Date/'Z- /2 —9 Address Legal Description\ j Owner's Address c,Z 3O %" , P J2 Contracting Co. Qualifier ,v 99 7 SS # / '? Phone State# e742 6 ® Competency# Ins. Co. Architect /Engineer / Address Address Address Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION S°7 —�•e ? J�/�r��9G� Ep�f9 G.� ,Sc ����c/ .e ®o M 8 - 5 - c. ,?F ,,,Ef" e X 4r AVo.0 D i=-2 A7� / !7:' Square Ft. — Estimated Costp 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 Proper Date: /a? F Lessee / Tenant T.��. 4;x4:5 /a/(, Address PERMIT FEE: APPROVED: Zoning Mechanical 4/7 -- 'm4f1i/ 27 Notary as to Owner a • • on o resi•ent My Commission Expires:.d)-9 * * * * * * • 9 "" EXPIRES: March 2, 1996 ' PF moo?•' Bonded Thiu Notary Public Underwriters * Fire Plumbing in/n Jh' Notary as to My Commission * * Tax Folio / / /J3 io5 33W Master Permit # Phone ,p7 „51”, 94C . — Other Electrical Engineering Signature of Contractor or Owner- Builder Date: (2,,„ez ontractor.or Owner -Bty • lder Exp i re s : NOT AP3 pp � ����yTyrrUBIL7C,g TAM' snmA * 46, @F1 EI U I alre b` MRS Vii k • C;' ",. 6o g5 6 MIAMI SHORES VILLAGE 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 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. Date_ _7 f _� , 19 Owner's Name and Address ' ,, ,; No Street Registered Architect and /or F ineer .0 Name and address of licensed contractor -4 i ' /\ C- Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done a__ 1 r. ^ State work to be done and purpose of building (by floors) ___. , and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering , + ' _Amount Estimated Total cost of improvements $ of Permit $ �1 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 '9l 1 be sent to____ L ., „ c - - — "v ■ 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks � .,:. , .. (Signed) r_•._-- �------ �-- --- -------- -- - - -- - -- -' ' • STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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. Building Inspector NOTE: A charge of $1.00 will be made for the Planning Board. A re- inspection fee of $1.00 will be charged materials and /or workmanship. Permit No Date Disapproved Date (Signed) Chairman Member Member Council Approved Date Read, Sworn to and Subscribed before me. PLANNING BOARD DATE Notary Public, State of Florida My Commission Expires Member Member Member Disapproved Date making corrections or changes to this application after approval has been obtained from when such re- inspection is made necessary by improper notice for inspection or faulty MIAMI SHORES VILLAGE BUILDING DEPARTMEN , 305- 795 -2204 Building Inspection Request Date (Q/ l lq Type Insp'n Of P1 pa" Permit No. P1 (Y - l Z- Name N Address N 2 O 94 Sf Company IlC �/ HiILiJ'C� Phone # Inspection Date , Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT Q\ 305- 795 -2204 t� ■Building Inspection Request J'� Date E�!/ / Type Insp'n FOCI!! P1 '66/ Permit No. P1 ( V Name '5`11/4 , ,tom Address 6' ' ° J �� Qi/ l Company Phone # Inspection Date f Approved Correction Re- Insp'n Fee iIT • • • before me. Florida 19 : herewith submitted for the build- he Building Ordinance of Miami Shores Village and all rules and ::cified or not. A copy of approved Street and for no other purpose. No. of Stories building and its construction may, uts his obligations as an employer ,f Florida, Permanent Supplement, sub - contractors employed by him site of the work such public notice cork to be performed under this acknowledgments, personally ap- to me well known, sign the same, and that all facts Date approval has been obtained from er notice for inspection or faulty MIAMI SHORES VILLAGE BUILDING DEPARTME r T 305- 795 -2204 Bu Iding Inspection Request Date 1 S Type Insp'n OCD pipo. Permit No. \ 1 1 L Name l ( (� /� Address 3 V U�� "1 4 Company Phone # Inspection Date Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Bufidin_ Inspection Re Date q Type Insp'n f w piping Permit No. Pi 2.O(Y'i —i Name gcJ2Q Address Z30 q-- Company I =C.ryyJ 4" Phone # Inspection Date q 1 Approved ❑ Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPART EN 305- 795 -2204 Building Inspection Request Dat Z 0 -I Type Insp'n Permit No. Name��/Y�n Address Inspection Date Approved Correction Re- Insp'n Fee Inspection Date Approved Correction Re- Insp'n Fee MIAMI SHORES VILLA BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Type Insp'n, _Q PermitNo.B Name ��►1� t/\ `� Address O Company PNA Phone # U 6- S o ^ 7s 1 V T MIAMI SHORES VILLAGE�� BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ) J A Y Type Insp'n/i jk / , Permit No. P 0 N P 1 - 1 A Name , / Address ) 0 l 1 Company ti (N ` � PNI P Y Phone # :) 6 ` 3 C) '� ) J Inspection Date Approved Correction Re -Insp' n Fee M A MI SHORES VILLAGE B ILDING DEPARTMENT 305- 795 -2204 1: uilding Inspection Request Date 101 l • pelnsp'n Pool born2r rmit No. 50 PO — 8---)D- . me 5 , 1 h• [dress i 30 NIL `� 4 sI- mpany ' t ' O 1 J . one # ;pectionDate )proved ■rrection - Insp'n Fee (0) . ‘ ❑ ❑ Ty Pe N A c Ph In A c R ,. MIAMI SHORES VILLAGE , BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 10 is Type Insp'n Pa) (. r( y • Perm it No. ,(?)/710`i o 8-7 � • Name 5 1i/ - ' Address 2 & q s- Company / !cr Phone # Inspection Date (0/ 1? Approved Correction ❑ Re- Insp'n Fee ❑ Company Phone # Inspection Date Date' Approved Correction Re-Insp'n Fee 1 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305-795-2204 Building Inspection Request f') Type Insp'n - Ai ■ 1, ;:..\ .._ N C.C) p Permit NO. B 0 ----.):(:.(--.,. ,, - Name 'U Address ;‘,. • (;:, - MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date \\ \ Z • ©t'1 Type Insp'n nak q03 CO U l 0. Permit No. ,3p cOOt Z. Name `A)1 Lt 1 d '1S Address �� 6 • L� Company Phone # Inspection Date \\ • \ G > 0 t Approved Correction Re-Insp'n Fee BUILDING PERMIT APPLICATION FBC 2001 Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) alit (../4.1. Kt i/c 7 !% f► Phone # ° ( /%'E Permit Type (circle): Owner's Address 2-_:-Y9 A jE 91/ `•/ • City /I/ %4' (.5. State t Tenant/Lessee Name Miami Shores Village Building Department ,L04 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 'C *. Building Job Address (where the work is being done) . / J . 9/ . / Permit No. Master Permit No Zip .1 ° Phone # City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO ass Contractor's Company Name /I K . /0,7//9 Phone # 9),0 /0 ? 2.2 7 / 6 Contractor's Address ' ;' /Q / , S ' /� e 7--/ J 7 �J , j 7 City /7i r i / 5 /,/'c Z State Zip k Qualifier /2 // /V 5/ 6 !✓ 7 lD R.._ ( 3 Phone # �y GL' Architect/Engineer's Name (if applicable) Vaf Jd -- (- 5z. Square Foot ge Of ear ,I .J170 9' 6 '; $ Value of Work For this Permit r ` �G'Z') Type of Work: ❑ Addition ❑Alteration New ❑ Repair/Replace Describe Work: - •,-•// ' ".'- ' Oc J ) `• 3 l Submittal Fee g. _oo n Permit Fee $ * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** CCF $ q CO /CC ❑ Demolition Notary $ "'— Training/Education Fee $ Technology Fee $ B/ e /0 Scanning $ I Radon $ % Zoning Bond $ e ) Code Enforcement $ Structural Plan Review. $Sa ,`f 21 '; '-' • '' s =' Total Fee Now Due $ n4 6 G, ,. 1 b (Continued on opposite side) if Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name-(if applicable) /(lc2,?'f 6 /2,.J 7/2 0.5 Mortgage Lender's Address City I /M / `200 _84, /a 1 a A 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. n the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Chc 12/15/03 Signature Owner or Agent The foregoing instrument was acknowledged before me this 10 The foreg instrument was acknowledged fore me this.f day of i'14• , 20 04, by j,U/t uangi / $,rry srrr 4L day o // , 20 6 G /by re."' who is personally known to�or who has produced who is persona y known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: • ;p ...•P BondedThru Notary Public Underwriters My Commission Expires: APPLICATION APPROVED BY: State re, Zip 3.3/_3F Contractor NOTARY PO IC: A � _ -'- ; '- r R D'-' yJ�� I 711,` h1Y CO' P i t: � ., : , ra i .0 5. ::6, 20G7 rfters I: an My Co �� Plans Examiner Engineer Zoning ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** NOTICE OF COMMENCEMENT , A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. 9 — 874 TAX FOLIO NO. 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. £ 7S 3 9- 6 / &.Oc..,r 7 , '4AJ ,oft 6AJD6 2) �G 9T or /fhvii / Sf024S SSG i /onJ /vo . / " PeAr Acae 10 g4667 r), 13� Coca/v y Fcon.. r 2. Description of improvement: 1r iMJwwC T®a 4! e 3. Owner(s) name and address: J gi- tA/k) / O, 12.T S/h Tfl 3o A-) X 36' ST . 44/4777/ S'/y1 s re_ 33/3 R Interest in property: - c.2NE./2-- Name and address of fee simple titleholder: ■5' ' i E As 1. Legal description of property and street/address: 4. Contractor's name and address: /<, / l D //a,, c.. ' h C 951 a .its c, n e (,,-ct_ r rile -r F jn iw 1 - 7. 33( 5. Surety: (Payment bond required Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the state of Florida designated by Owner upon who notice • 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 different d is specified) Sigpature of Owner Print Owner's Name Sworn to and subscribed before me this `0 day of Notary Public ',/(-( " Print Notary's Name My commission expires: 123.01 -52 PAGE 4 8/02 apee.m7r) p. ineitY MY COMMISSION 4 CC 922649 EXPIRES: July 25, 2004 Bonded Thru Notary Public Underwriters s1TW SS n•,% HARVEY Pt V;a t3, , 200 1Jsi:rlCr, 111111111111111111111111111 111111111111111111 CFN 2004R0630727 OR Bk 22517 Ps 3192; (ips) RECORDED 07/27/2004 11:56:50 HARVEY RUVIN, CLERK OF COURT MIAMI -DADE COUNTY, FLORIDA LAST PAGE by owner from contractor, if any)STATF OF FL O:MA: COUNTY Cv, DP.DE 1 tics ?EBYC_R7;',:;' that ?Oisis o tr:,, "DVof r,a20 aur %Cc_ri„ . . Prepared by Address: q -, 7cc rn //q/27/, 33/3/ ' PROCES # FOLIO # 30- CROWN OF ROAD 10.40 Ft NGVD CITY MIAMI SHORES, FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1- 7. SECTION A - PROPERTY OWNER INFORMATION BUILDING OWNERS NAME WILLIAM ROBERT SMITH, III. BUILDING STREET, ADDRESS (Including pt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 230 N.E. 94TH STREE HORIZONTAL DATUM: ❑ NAD 1927 aI NAD 1983 For Insurance Company Use:.. Policy Number • Company, NAIC Number. STATE ZIP CODE FLORIDA 33138. PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) I(7IS 5 & 6, BLOCK 27, PLAT BOOK 10, AT PAGE 70, OF THE PUBLIC REOORD8 MIAMI DADE COUNTY. FLORIDA. BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.) SINGLE F AMILY HOME. LATITUDE/LONGITUDE (OPTIONAL) ( # #° - ##' - # #.#r or # #.#####°) SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION O.M.B. No. 3067 -0077 Expires December 31, 2005 SOURCE: ❑ GPS (Type): ❑ USGS Quad Map 810. Indicate the source of the Base Flood El evation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ® RRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): _ B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date W SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER ROLANDO ORTIZ 4312 TITLE COMPANY NAME PRESIDENT GUNTER GROUP, INC. ADDRESS CITY • STATE 9350 SW 22 TE . c . MIAMI FLORIDA SIGNATURE ! / ., DATE TELEPHONE 5/21/2004 305- 220 -0073 FEMA Form 81 -31, January 2003 ® Other: AUTOMATIC LEVEL C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' © Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 1 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations — Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 -A30, AR/AH, AR/AO Complete Items C3. -a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. DatumNGVD Conversion/Comments Elevation reference mark usedJ243 Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No O a) Top of bottom floor (including basement or enclosure) 68 ft.( O b) Top of next higher floor N/A _ft (m) c O c) Bottom of lowest horizontal structural member (V zones only) N/A f .(m) y 0 d) Attached garage (top of slab) N/A _ft(m) E 2 O e) Lowest elevation of machinery and/or equipment servicing the building (Describe in a Comments area) 10 60 ft(m) cl O f) Lowest adjacent (finished) grade (LAG) 9 50 tt.(m) 2 m 0 g) Highest adjacent (finished) grade (HAG) 9 70 ft.(m) °' N O h) No. of permanent openings (food vents) within 1 ft. above adjacent grade N/A J O i) Total area of all permanent openings (flood vents) in C3.h N/A sq. in. (sq. cm) PLS 4312_ 5/21/2004 ZIP CODE 33165 See reverse side for continuation. Replaces all previous editions 81. NFIP COMMUNITY NAME & COMMUNITY NUMBER MIAMI SHORES 120652 82. COUNTY NAME , MIAMI —DADE B3. STATE FLORIDA B4. MAP AND PANEL NUMBER 12025C -0093 B5. SUFFIX J 86. FIRM INDEX DATE 7/17/1995 87. RRM PANEL EFFECTIVE/REVISED DATE 3/2/1994 B8. FLOOD ZONE(S) "X" 89. BASE FLOOD ELEVATION(S) (Zone AO, use depth of flooding) N/A ' PROCES # FOLIO # 30- CROWN OF ROAD 10.40 Ft NGVD CITY MIAMI SHORES, FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1- 7. SECTION A - PROPERTY OWNER INFORMATION BUILDING OWNERS NAME WILLIAM ROBERT SMITH, III. BUILDING STREET, ADDRESS (Including pt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO. 230 N.E. 94TH STREE HORIZONTAL DATUM: ❑ NAD 1927 aI NAD 1983 For Insurance Company Use:.. Policy Number • Company, NAIC Number. STATE ZIP CODE FLORIDA 33138. PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) I(7IS 5 & 6, BLOCK 27, PLAT BOOK 10, AT PAGE 70, OF THE PUBLIC REOORD8 MIAMI DADE COUNTY. FLORIDA. BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area, if necessary.) SINGLE F AMILY HOME. LATITUDE/LONGITUDE (OPTIONAL) ( # #° - ##' - # #.#r or # #.#####°) SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION O.M.B. No. 3067 -0077 Expires December 31, 2005 SOURCE: ❑ GPS (Type): ❑ USGS Quad Map 810. Indicate the source of the Base Flood El evation (BFE) data or base flood depth entered in B9. ❑ FIS Profile ® RRM ❑ Community Determined ❑ Other (Describe): B11. Indicate the elevation datum used for the BFE in B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe): _ B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date W SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER ROLANDO ORTIZ 4312 TITLE COMPANY NAME PRESIDENT GUNTER GROUP, INC. ADDRESS CITY • STATE 9350 SW 22 TE . c . MIAMI FLORIDA SIGNATURE ! / ., DATE TELEPHONE 5/21/2004 305- 220 -0073 FEMA Form 81 -31, January 2003 ® Other: AUTOMATIC LEVEL C1. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' © Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 1 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations — Zones Al -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 -A30, AR/AH, AR/AO Complete Items C3. -a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. DatumNGVD Conversion/Comments Elevation reference mark usedJ243 Does the elevation reference mark used appear on the FIRM? ❑ Yes ® No O a) Top of bottom floor (including basement or enclosure) 68 ft.( O b) Top of next higher floor N/A _ft (m) c O c) Bottom of lowest horizontal structural member (V zones only) N/A f .(m) y 0 d) Attached garage (top of slab) N/A _ft(m) E 2 O e) Lowest elevation of machinery and/or equipment servicing the building (Describe in a Comments area) 10 60 ft(m) cl O f) Lowest adjacent (finished) grade (LAG) 9 50 tt.(m) 2 m 0 g) Highest adjacent (finished) grade (HAG) 9 70 ft.(m) °' N O h) No. of permanent openings (food vents) within 1 ft. above adjacent grade N/A J O i) Total area of all permanent openings (flood vents) in C3.h N/A sq. in. (sq. cm) PLS 4312_ 5/21/2004 ZIP CODE 33165 See reverse side for continuation. Replaces all previous editions Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. For Insurance Company Use: Policy Number Company NAIC Number IMPORTANT: In these spaces, copy the corresponding information from Section A. BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and /or Bldg. No.) OR P.O. ROUTE AND BOX NO. 230 N.E. 94TH STREET CITY STATE ZIP CODE MIAMI SHORES, FLORIDA 33138. SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) COMMENTS 1 1 Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items El through E4. if the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR -F, Section C must be completed. El. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed – see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is 1 -1 -1 ft•(m) I_I_lin.(cm) L_I above or 1_1 below (check one) the highest adjacent grade. E3. For Building Diagrams 6 -8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is 1_I_I ft•(m) I_I_ lin.(cm) above the highest adjacent grade. E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance?' 1 Yes 1_I No 11 Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA- issued or community- issued BFE) or Zone AO must sign here. PROPERTY "OWNER 'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME ADDRESS SIGNATURE COMMENTS CITY DATE STATE ZIP CODE TELEPHONE 1 1 Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. I I The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation in the Comments area below.) G2. II A con munity official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO.- G3. 1 I The following information (Items G4 -G9) is provided for community floodplain management purposes. G4. PERMIT NUMBER G5. DATE PERMIT ISSUED G7. This permit has been issued for 1I New Construction 1I Substantia Improvement G8. Elevation of as -built lowest floor (including basement) of the building is: . ft.(m) Datum: G9. BFE or (in Zone AO) depth of flooding at the building site is: ft.(m) Datum: • LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME TELEPHONE SIGNATURE DATE COMMENTS G6. DATE CERTIFICATE OF COMPLIANCF.'OCCUPANCY ISSUED . 1I Check here if attachments FEMA Form 81 -31, AUG 99 REPLACES ALL PREVIOUS EDITIONS Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2004 -872 Printed: 8/4/2004 Applicant: WILLIAM ROBERT SMITH Owner: SMITH WILLIAM ROBERT JOB ADDRESS: 230 NE 94 ST Contractor MK ROLLAND Local Phone: 786- 306 -9510 Parcel # 1132060133630 Building Permit Contractor's Address: 9510 BISCAYNE BLVD. Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 5 & 6 BLK 27 LOT SIZE SITE Fees: Description Amount FEE2004 -7816 Building Fee $444.00 FEE2004 -7817 CCF $9.00 FEE2004 -7818 CO /CC $50.00 FEE2004 -7819 Training and Education Fee $3.00 FEE2004 -7820 Technology Fee $11.10 FEE2004 -7821 Scanning Fee $15.00 FEE2004 -7822 Radon $4.50 FEE2004 -7823 Builders Bond $300.00 FEE2004 -7824 Structural Fee $50.00 Total Fees: $886.60 Total Fees: $ Total Receipts: $0.00 VC 0 5 PAID Permit Status: Approved Permit Expiration: 12/21/2004 Construction Value: $14,800.00 Work: SWIMMING POOL AND DECK Signed: (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 responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: