27 NE 94 St (13)V
Si
PE IT APPLICATION FOR MIAMI SHORES VILLAGE
10050 N.E. 2nd Av nue • Miami Shores, Florida 33138 • Phone: 305- 795 -2204 • Fax: 305- 756 -8972
Date / Lress 2 7 /"6'"/4 17 6777 Tax Folio
4 egal Description p Historically Designated: Yes No
t wner /Lessee/Tenet II4 2 7 ` . 44/1 .- • 1 Master Permit # P Zt)03 6 6
� '/ 1
Litner's Address 2 ,p/E 777 $7 d4 7 Phorfe J b -S-- r) S I - 6 , ;
Contracting Co. Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one)
WORK DESCRIPTION:
Square Ft. 3 0 Estimated Cost (value)
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 ANY 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 all disciplines.
OWNERS 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.
ature of owner d/or Co do President
it Alb _ �.�
3
I s -∎ 1
Not. � � t o Owne' and/or C s do Presi
M-y Commission Exp rg,s Angela M Becker • �'• 4,4si � M Commission D0150048
• A November 15, 2008
F ES: PERMIT/ ■ .RADON
VW:
Zoning A ,b 7 /Buildin
Mechanical ,L4 r/4-.0 3 - Plumbing
2
Date
-Oy,6D
ELECTRICAL PLUMBING MECHANICAL ROOFING
Date Notary to Contractor or Owner Builder
.. My Commission Expires
C.C.F
' - r- - -*- '
Structural Enginee
Signature of Contractor or Owner Builder
), S
DUE
Date
Date
NOTARY S - 0 v BOND
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ACCOUNT
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PAYMENT
7 ( O O a
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DATE
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ONEY BY
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A
200 3-6Z
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•
No. 197706
$q50, o a
�B6 ±ARS
1182
PRINT TIME 06/03 '03 16:35 ID :MIAMI_SHORES_VILLAGE____ FAX :3057568972
TIMER=--:--
FILE START MODE
No. TIME
130 06/03 16:34 TX
ERROR PAGE=
LOCATION
TRANSMISSION REPORT
93057598561
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•
Pedro Relg and AMsoolsier. PA
901 Peace de Leos Blvd, Seile 900
Card Gables, Florida 33131
File Memel: 2001111
State of Florida
°may ofMiiW: Dade
(Neter'
Closing File M 7002121
_ '+ t3se�m Reee
•�4act
Eroiraspordalsa.sotet
t:uwc.a %4:c i
Above Ills LW Por RecarBint
4 2x3327$6 2002 MAT 30 13119
Warranty Deed
! between HARVEY T RIAlti CLI3 t ME COUNTY, F
di. .2 day i _ 2002 is � sea 151. Okope�,
This Warranty
%U se Deed is 597 SW 15 wey Flocs, FL 33027 Bra and Maras Santos aad Leah
Sin airs s wi post o p � address is 27 NE 94 Street Mind, 1 33138, puree: $salsa, his �ri6e. whose post
tow boon iht Ns= 'Braid end "pone iselsds al me Vida •D ilia isarennt and the leia legal rgpnsnntlaes. sad NAM of
iedi•idn6. aid due swum and DDS are° K9s60 ntee led iiiMem)
WMnessdbn that grid erplitee, Gtr and in ecosidowion of the smn of TEN AND NO/100 DOLLARS (510.00) and other end valuable dil l. . m said �r io hand paid * odd gam. � whereof is beleby acknowledged,
� bargained, and sold to the said Banta, and grrotsc s bras Lod ads forever, the iofawieg dca tibed land,
situate, lying and being in MiaotDade County, f1 /o-wit ONE A/IMBED, according to the Plat
Lots 1 3$ beta rded Plat Beek 10, at Page �th • N Public Records of M1.aai-Bade qty
Mao known as 27 NB- 94th Street Miami, P133131
This conveyance is subject to the foJJ0 IU
1. Taus and assessments for the year 2002, and aubsequent ywts.
>imttal, deftenions, existing g ordinances and easements ck of record, i bz g bur
Canes, ° �' ofrecotd. er offer xstrideons loon Ore me of
not limited m pacer, sows, g>=, electrical and off' �' applicable roving Ism. atdionoes.
dl° propety as may >�d by the afl tides having app
and reguhuienW
Parcel Identification Num1142464134540
Together with all the tenements, be and appurtenances thseeD belonging
or in anywise 3pp:staking.
To Have sad to Hold, the tante in fee simple forever.
Mid the groans duchy pDieD®°o with said grantee t the graasot is lawfully seized of said land in fee simple: dim tOse
and lawful ■ettaity to sell and convey said laud: that the rotor hereby fully watesm titl
s dle e to said
lan a has good tied Oec lawful deism of all pessaza whomsoever; and that said hod is faec of all
esscomblences. =apt axes scenting subsequent to Deceasber 31, 2001
12 Aquas whereat pante has L nset gesomes kali 2 nd : = vied par hex dune watts.
»Leer a'.t.laa
Ili'
below sex tiffs day af
1!: molar hen gsoeksad Alm Drivers Lissome as ideadficritert
mad 1�a tZ+C,p�.
PsimadNlame
My Comttlistion Expires:
BIM by
t>osbtn?ttew � ,.
Attorneys' Title insurance Ewa, Imes
TO THE EXCLUSIONS FROM COVERAGE, THE EXCEIMONS FROM
0 E CONTAINED IN SCHEDULE B AND THE CONDITIONS AND STIPU-
LATIONS, IONS, AT"TORNE S' TITLE INSURANCE FUND, INC., a Florida corporation,
herein called The Fund, insures, as of Date of Policy shown in Schedule A. against loss
or damage, not exceeding the Amount of Insurance stated in Schedule A, sustained
or incurred by the insured by reason of
1. Tide to the estate or interest described in Schedule A being vested other
than as stated therein;
OWNWRW IT TIE INSMANCE POLICY
ORLAAIDO, FLORIDA
2. Any defect in or lien or encumbrance on the tide;
3. 11nmarketability of the tide;
4_ lack of a right of access to and from the land
The Fund will also pay the costs, attorneys' fees and expenses incurred in defense of
the title, as insured, but only to the extent provided in the Conditions and Stipula-
tions.
in Witness Whereof, ATTORNEYS' TITLE INSURANCE FUND, INC. has caused this
policy to be signed and sealed as of Date of Policy shown in Schedule A, the policy to
become valid when countersigned by an authorized signatory.
tam FORKI ta-
Ry
Attorneys' Tito Insurance Wined, Inc.
.40‘zey'
Charles J. Kv
Presidant
SERDAL
2262894
FUND OWNFK' N !VIM
Schedule A
POLICY NO:- 2262894 FILE NO: 0216018
EFFECTIVE DATE: May 30, 2002 Agent's File Ref: 2002121
at 1:19 P.M.
Amount of Insurance: S 275,000.00
1. Name of Insured:
MARC OS SAMO6 and LEAH SANMOS
2. The estate or interest same) in aannd described i vested in t named insured as shown by simple is covered by this policy is a fee
(ifother, specify �) Page 227 of the Public
instrument recorded in Official Records Book 20429
Records of MIAMI -DADE County, Florida.
3. The land referred to in this Policy is described as follows:
Lots 15 and 16, in Block 4, of MIAMI SHORES SECTION ONE AMENDED, according to the Plat
thereof, as recorded in Plat Book 10, at Page 70, of the Public Records of MIAMI -DADE County,
Florida
Issuing Agent: 90 P Roig and
de Leon Boulevard Suite 200
Coral Gables, Florida 33134
305-448-1965
Agent No.:
FUND Form OPMSCH.A (rev.12/92)
•
r wvv uwtvaic •a ru.aun
Schedule B
Policy Number: 0P M-2262894
- 2262694
File No: 0216018
This policy does not insure against loss or damage by reason of the following:
1. Taxes for the year of the effective date of this policy and taxes and special assessments, which are not
shown as existing liens by the public records.
2. Rights or claims of parties in possession not shown by the public records.
3. Encroachments, overlaps, boundary line disputes, and any other matters which would be disclosed by
an accurate survey and inspection of the premises.
4. Easements, or claims of easements, not shown by the public records.
5. Any lien, or right to a lien, for services, labor, or material heretofore or hereafter furnished, imposed
by law and not shown by the public records.
r�roos A. Santos and Leah B. Santos, husband and wife,
in favor of f America's Mortgage Choice;
6 • o in the principal sum of 5261,250.00;
aae
d may 17, 2002, recorded May 30, 2002 in Official Records Book 20429,
Page 230; and assigned to Chase Manhattan Mortgage Corporation by instrumrit
recorded May 30, 2002 in Official Records Hook 20429, Page 247; both of
the Public Records of MIAMI County, Florida.
7_ Any rights, easements, interests or claims rich may exist r son oo f ,
or reflected by, the facts shown err survey prepared t by f,yes &
Associates, Inc dated on 4/16/02 bearing job no. 02 -7046.
TOTAL P.07
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Dom• */x/03
PLAN REVIEW COMMENTS
PROJECT NAME: .5;41
- 17D S
PROJECT. ADDRESS: 21L rse/ C �4"S
REVIEWER:
SHEET NUMBER:
COMMENTS
s
Cc
DATE:
s *r 3. 63 .
�,
s ni
Ai u tr\ A t b &J(s1 1
Signa ure of Inspector
tr-c& d-f(7e
Title
Date Signed Total Number of Hours
(PLEASE TURN•IN A COPY OF THIS FORM AS YOUR TIME SHEET: FOR ALL PLAN REVIEW)
DEVELOPMENT ORDER
CASE # PZ03- 0320 -11
APPLICANT: Marcos and Leah Santos
SITE ADDRESS: 27 N.E. 94 Street
iarni SIiorei Vi��ccc�.e
Whereas, the applicant has filed an application for site plan approval before
the Planning and Zoning Board on the following described property:
Lots 15 and 16 of Block 4 of " MIAMI SHORES SECTION ONE
AMENDED" Plat Book 10, Page 70 of the public records of Miami -
Dade County, Florida
The applicant sought approval as follows: site plan — garage enclosure.
Whereas, a public hearing was held on March 20, 2003, and the Board, after
having considered the application and after hearing testimony and reviewing
the evidence entered, finds:
1. The application was made in a manner consistent with the
requirements of the Land Development Code of Miami Shores
Village
The conditions on the property and the representations made at the
hearing merit consideration and are consistent with the requirements
of the Land Development Code.
The Board requires that all further development of the property shall be
performed in a manner consistent with the site plan, the drawings, and
conditions agreed upon at the hearing. The applicant must satisfy all
applicable Miami Shores Village codes, Miami -Dade County Codes, and the
applicable building and life safety codes required for development. Action
taken today does not constitute a final development order and one or more
concurrency determinations will subsequently be required. In addition, the
following terms and conditions are imposed: compliance with Dade County
and FEMA flood requirements.
Passed and adopted this 20 day of March, 2003 by the Planning and Zoning
Board as follows:
Member Crutchfield
Member Sastre
Member Abramitis
2.
Yes
Yes
Yes
Chai .I Fe - • ez Yes
►�e , 00y
r
/hairman, P ' ing an• ning Bd.
PLAN REVIEW COMMENTS
PROJECT NAME: �y S%
PROJECT ADDRESS: Z5' �
REVIEWER: / L1G `6y h /
SHEET NUMBER: /
DATE : / /�ffc
COMMENT e/ jLGef/ y , G4/ 1 Nei2 ` �
/ r
; /)0 tLa4 7.0z6,/
%`/0 ► / `,offer �PGi.�2�
ature opt nspector Title
Date Signed
Total Number of Hours
(PLEASE TURN A COPY OF THIS FORM AS YOUR TIME SHEET. FOR ALL PLAN REVIEW)
PLAN REVIEW COMMENTS
PROJECT NAME:
PROJECT ADDRESS: �4 p ,/ e t- --
,/ j4'S
REVIEWER:
SHEET NUMBER:
COMMENTS
Signa ure of Inspector
1 -0c > 3
Date Signed
(16-s Co 0
/I) v /de - 7 b:2
',.
DATE: S 13.
•
Ck iC,4-L (7 1C 7 af t—
Title
Total Number of Hours
(PLEASE TURN A COPY OF THIS FORM AS YOUR TIME SHEET: FOR ALL PLAN REVIEW)
PLEASE steer e.... • C.'FI CD OFF
Permit Agolication (signed by person perforating the work, licensed
=ntractor and the property owner., bath signatures notarized).
3tao sets or p l�ss� 41�
dr wings sicced and se= ed by : giszer d arthitect or
Occupancies by GG•cc C?zs, - ific t'cn must be on plans and
ce .it appli All plans must include folio lumber and
address.. Ascended plans, in addition to the ab0 2, mist also include the
Pclperty
permit number.
Sthic ral CalwLztions signed and
applicable.
V '
/ elm -tent survey of the property.
Eq
AltD DADE calm LI ,-.t '�'ICN (��ER) := "'r ISL''.AZ'I'CN
Czcy of current CCCUPATICtraL DICES, -
L .
.business is I c � t' d. -�:5� CrL.:. b- 3+1:.x:; Z t'/ TZ:aY
�_ Z
•
Certificate of Insurance for L URILITg
_
Certifi of Instrmince for ACF. .'S oho (addressed tc -Mimi?. •
ShorasVillage) or if exempt.
State of Florica LES, Foza BCf - 204, Corstzc .°on I.^ ;s`/ biotic of
Election to be Exempt.
,Certificate of Elevation signed and sealed by Szwevor..2
Substantial Trrpr. z. e■ eddist (coat-actor or owner). •
sets of energy alculations, signed and sealed
ets of signed « sealed Truss Plans (atgi ` -).
A3A,DE Camnty or State of Florida Products p rats for roof materials,
Sheds, triMgg exterior/garage doors, aT'31:nt`n r. c ch s skylights, doors and e pan
Enclosures, shutters as -int
� mac'. doors .e�c.
ovals f,an FIRS, D A D E C o m i t y I act F e e Section, F .re De
at Department (%4he.•1 aCO1IG^_e) • DM(
ty Dew or Other Proof of Cwm=hip i = rec_ssazy.
Structi al R -vies,
- Th+
Notice of Cotdmencement
sealed
y azc . t_ct o_ engineer when
l)1AiA"-k
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B4. MAP AND PANEL
B5. SUFFIX
B6. FIRM INDEX
B7. FIRM PANEL
B8. FLOOD
B9. BASE FLOOD ELEVATION(S)
NUMBER
DATE
EFFECTIVE/REVISED DATE
ZONE(S)
(Zone AO, use depth of flooding)
12025C 93
J
7 -17 -95
3-2 -94
X
N/A
4 - 24 - 03
BUILDING OWNER'S NAME
MARCOS SANTOS
BUILDING STREET ADDRESS (Including Apt., Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
27 NE 94 STREET
CITY
MIAMI
PROPERTY DESCRIPTION (Lct and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT 15 & 16 BLK 4, MIAMI SHORES SEC. 1 AMD PLAT BOOK 10 PAGE 4
BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use Comments section if necessary.)
RESIDENTIAL
LATITUDE/LONGITUDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: ❑ GPS (Type):
( iYtt -1#P - ##.##' or ##. ) ❑ NAD 1927 ❑ NAD 1983
B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER
VILLAGE OF MIAMI SHORES 120652
TITLE PROFESSIONAL LAND SURVEYOR
ADDRESS
3742 WEST 12 AVE
QV]10ATI ID=
C . O . R . 1 1 .4 0 FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1 - 7.
SECTION A - PROPERTY OWNER INFORMATION
ORDER NO. 0304-104
STATE
FL
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B2. COUNTY NAME
MAIMI -DADE
Elevation reference mark used DC Does the elevation reference mark used appear on
o a) Top of bottom floor (including basement or enclosure) 13. 24 ft.(m)
o b) Top of next higher floor N/A . _ft.(m)
o c) Bottom of lowest horizontal structural member (V zones only)N /A . _ft.(m)
o d) Attached garage (top of slab) 11. 21ft.(m)
o e) Lowest elevation of machinery and/or equipment
servicing the building 10 . 84ft.(mr
o f) Lowest adjacent grade (LAG) 11 . Oft.(m)
o g) Highest adjacent grade (HAG) 11. 3ft.(m)
o h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade N
o 1) Total area of all permanent openings (flood vents) in C3h N/A sq. in. (sq. cm)
ZIP CODE
33138
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
the FIRM? ❑ Yes
E 2
w Ho
z '
in
3
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
COMPANY NAME CARIBBEAN LAND SURVEYORS, INC.
CITY
HIALEAH
naT=
STATE
FL
TFI FDI -11110=
4 -24 -03 (305) 824 -0040
O.M.B. No. 3067 -0077
Expires July 31, 2002
For Insurance Company Use:
Policy Number
Company NAIC Number
USGS Quad. Map ❑ Other.
B3. STATE
FL
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in 89.
❑ FIS Profile ® FIRM ❑ 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
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 accuratc;y represents the building, provide a sketch or photograph.)
C3. Elevations - Zones A1-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 C3a -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.
Datum NGVD Conversion/Comments
® No
3106
4 -24 -03
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.
CERTIFIERS NAME WALTER E. VENEGA LICENSE NUMBER 3106
ZIP CODE
33012
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.
27NE94
CITY STATE ZIP CODE
MIAMI FL 33138
COMMENTS
SIGNATURE
COMMENTS
LOCAL OFFICIAL'S NAME
COMMUNITY NAME
SIGNATURE
COMMENTS
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
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 _ ft.(m) _in.(cm) ❑ above or ❑ 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
_ ft.(m) _in.(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? ❑ Yes ❑ No ❑ 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 CITY STATE ZIP CODE
DATE TELEPHONE
S• SECTION G - COMMUNITY INFORMATION (OPTIONAL)
For Insurance Company Use:
Policy Number
Company NAIC Number
❑ Check here if attachments
❑ Check here if attachments
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. ❑ 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 data in the Comments area below.)
G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA - issued or community- issued BFE) or
Zone AO.
G3. ❑ The following information (Items G4-G9) is provided for community floodplaia management purposes.
G4. PERMIT NUMBER
G5. DATE PERMIT ISSUED
G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY
ISSUED
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building is: _
G9. BFE or (in Zone AO) depth of flooding at the building site is: _
TITLE
TELEPHONE
DATE
_ ft.(m)
_ _ft.(m)
Datum:
Datum:
❑ Check here if attachments
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Schedule B
Policy Number. OPM- 2262894
File No: 0216018
This policy does not insure against loss or damage by reason of the following:
1. Taxes for the year of the effective date of this policy and taxes and special assessments, which are not
shown as existing liens by the public records.
2. Rights or claims of parties in possession not shown by the public records.
3. Encroachments, overlaps, boundary line disputes, and any other matters which would be disclosed by
an accurate survey and inspection of the premises.
4. Easements, or claims of easements, not shown by the public records.
5. Any lien, or right to a lien, for services, labor, or material heretofore or hereafter furnished, imposed
by law and not shown by the public records_
executed by memos A. Santos and Leah B. Santos, husband and wife,
in favor of America's Mortgage G memos mice in the principal sum of $261,250.00;
dated may 17, 2002, recorded May 30, 2002 in Official. Records Boric 20429,
Page 230; and assigned to Chase Manhattan Mortgage Oozporatian by.instrurasnt
recorded May 30, 2002 in Official Records Boric 20429, Page 247; both of
the Public Records of MThMY -D DE County, Florida.
7_ Any rights, easements, interests or claims %Mich may exist by reason of,
or reflected by, the facts shown on survey prepared by Alvarez, Alguesvives &
Associates, Inc dated an 4/16/02 bearing jab no. 02 -7046.
TOTAL P.07
I --1 Ai .CoS �A�1ll� being the legal property owner, for the property
Located at: 2
Legally described as 21 r S iKt t S651-2-3,
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 cork 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 525,000.00 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 licensing
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 1 day of rah , 20 06
By
Produced UjA?Q
OWNER BUILDER DISCLOSURE STATEMENT
Owner
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
vg5533
DISCLOSURE STATEMENT
who is personally known to me or who has
as identification and who did take an oath.
liAh MONICA u
= ia
MONK SSETH DIAZ
MY COMMISSION # DD 483995
9f 4 Bonded Pm EXPIRES: sober 2o, 2009
Notary Public Underwdtere
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date 7 Bu`Rq // Q Time �,,
Type Insp'n /j !(G<�- �.XJ��el
Permit No. 6P R003 a
Name ?c Slays
Address
;2 "7 itifX 9f j7
Company DWyk/4A-
Phone # 30 16r(
For Inspector:
Approved
Correction
Re- Insp'n Fee
Approved
Correction
Re- Insp'n Fee
1 �
MIAMI SHORES VI LAGE
BUILDING DEPARTMENT
305 -795 -2204
Building Inspection Request
Date Time
Type Insp'n r /" d - `j e 5
Permit No. SP Qo3 - 166
Name d p C. S 1 S 6 1
Address 62 Ili $ YR
Company
Phone # 30
5' 759 ° (Y ' ST
For Inspector: 7\3 Name & Date ' C ‘:\
MIAMI 1-101?,E,S34iLLA,GE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date VZO3 Time
Type.Insp'n l
Permit No. BP 0 3-
Name
Address gy*
Company
Phone #
For Inspector 73\0 Name & Date
Approved
Correction
Re- Insp'n Fee
7
ficu
BUILDING
PERMIT APPLICATION
FBC 2001
Job Address (where the work is being done)
City _ Miami Shores Villaue
Is Building Historically Designated YES
$ Value of Work For this Permit f 2O
Miami Shores Village
Building Department
Electrical Plumbing
Mechanical
Permit Type (circle):
Owner's Name (Fee Simple Titleholder) f'//2C0 _ / I
Owner's Address 29 ,1- ' 4i I 3
Cit 7' 4 ( /. 4S State FL
Tenant/Lessee Name
-54:47492— AB V.
County Miami -Dade
NO
Minus Plans Check Fee $ Total Fee Now Due $ 60
Permit NoP 'j - ) a�
Master Permit No. 26
Phone #
Zip 33/ °
Phone #
Phone #
Zip
•
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Roofing
C
Contractor's Company Name
Contractor's Address
City _
State Zip
Qualifier
Architect/Engineer's Name (if applicable)
Phone #
Architect/Engineer's Address
City _
State
3-
Number of: Bays
Stories Families Bedrooms Baths
Type of Work: ❑Addition
['Alteration ❑11ew ❑ Repair/Replace ❑ Demolition
� �. � � 0/1///T a/1/// LG 4i/Z Go i T
Describe Work: iN.Sf C��' /�� /o -
» L- Gfioi 7 ?./1 / /LL -- FU/0G. y4 5i ;; 4k- ` _
� �
a t r02 , /e7c�/ ,o, / 4„ /zb,- / ��/ -
Permit Fee $ �J 0 7 Notary $
County Escrow Fee $ r Radon $
Education/Training
Fee $ Tech $ Scanning $
Code Enforcement $
Bond $ Struct. $
J
(Continued on opposite side)
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 in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... FIDAVI I tify g
OWNER'S AFFIDAVIT: certify '
rtify that all the the foregoing information is accurate and that all work will be done in compliance with all
applicable laws IDAVI 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 FINANC
CONSULT WITH YOUR LENDER OR AN ATTORNEY NOTICE G
NEY BEFORE RECORDING YOUR OF
Notice to Applicant: As a condition to the issuance of a of posted. notice, the
buildin g 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 o the recorded notice of commencement must be posted at the job
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence o such p
inspection will not be approved and a reinspection fee will be charged. > site
Owner or Agent
The foregoing instrument was acknowledged before me this
day of 20 by
who is personally known to me or who has produced
As identification and who did take an oath.
VOTARY PUBLIC:
Sign:
'Tint:
Ay Commis Expires:
(Certificate of Competency Holder)
Certificate of Competency No.
******** s***'****#******************* * * * * * * * * * * * * * * * * * * * * * * * * * * * *..r ********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
AUG - 8 2003 Plans Examiner
Engineer
Zoning
•tate Certificate or Registration No.
PPLICATION APPROVED BY:
c7/7 /03
Bonding C •
g mpany'� Name (if applicable) _
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
Signature OM/4 - CJ/ L r2
Contractor
The foregoing instrument was acknowledged before me this
day of 20 , by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
CERTIFICATE OF RE- OCCUPANCY
On behalf ofMiami Shores Village, Florida, the undersigned certifies that the ro erty
described in the above application has been inspected for p p
Sections 901 and 902 of the Miami Shores
purposes of re- occupancy pursuant to
ores Land Development and Zoning
property may be re- occupied by the above applicant for lino a -f �y resid Code and that such
ential purposes:
PAGE 2 OF 2
SHORES VILLAGE, FLORIDA •
Date of Certification.
THIS CER I k ICATE VERIFIES THAT THE REFERENCED
PROPERTY HAS BEEN INSPECTED BY M SHORES
'VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY
COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE
MIAMI SHORES LAND AND DEVELOPMENT CODE
PERTAINING S OLEL Y TO THE RE ,
ONE— FA.l�IlLY DWELLING IS USED AND �� THAT EACH`'' <s.;
USED FOR A ONE — FAMILY DWELLING PURPOSE TO BE
HOWEVER, THIS CERTIFICATE DOES NOT CONSTIITEJ
REPRESENTATION OR W CONSTITUTE ANY
OF THE DWELLING OR OTHER STRUCTURES CONDITION
L
PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF
CONDITION, AND INTERESTED PERSONS ARE ADVISED H
ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE AND
• PREM. IN ORDER TO DEER I TE THE CONDITION,
THEREOF.
I,
to re- occupy the single family residence known as : (address)
Legal Description:
Lot: Block PB & PG:
I hereby certify that I that the zoning of the property is for single - family residential use
and that it is unlawful for more than one family to reside therein. I also understand that any
Certificate of Re= Ocbupancy that may be issued by Miami fibres Village, certifies only that the
referenced property is being used for single - family purposes and that such Certificate does not
constitute any representation, warranty or certification as to the condition of the dwelling or other
structures on h property.
Applicant
Print Name
* * * * * * * ** * * * * * * * * * * * * * * * * * * * ** . * * * * * * * * * * * * * * **
For purposes of conducting the inspection required by Section 902 of the Miami Shores Land
Development and Zoning Code, please contact:
4\—e,f 41
Contact Name:
Buyer
Application Fee (S50) paid: Cash
APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY
4)-6664,0r/
Seller Realtor V CompanY Name
Approved
PAGE 1 OF 2
, Miami Shores, Florida.
, hereby apply for a certificate
Telephone:
Check No. 1
enied
Sd
7c.
Date )� �� Zb
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 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.
L4. ner's Name and Address
Registered Architect and/or Engineer
ame and address of licensed contractor YraL/1
Location and legal description of - lot to be built on:
Lot, ti . ` ) ` 7 6 Block q
C.--Street and Number where work is to be done
a e) d512
r ,Ste el!work to be done and purpose of building Iby floors state exterior colors 1
l ig for no other purpose.
New Building Remodeling e.----"*" e.----"*" Addition « Repairs No. of Stories )
�%
To be constructed of e. ,I s t Kind of foundation Roof Covering
*Lye- ' ering
mated Total cost of improvements S v / f 0 Amount of Permit $ 7 S
� C �J
Zone cubage required Plan Cubage 1 32. 2 z_ ' ` � / ' V Q L..,-
Distance to next nearest building Size of Building Lot /2 0 0
Maximum live load to be borne by each floor
I hereby submit all 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 obligatons 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.
` �i,
Remarks _ (Signed) CCC �.(
STATE OF FLORIDA
COUNTY OF DADE.
1 SS.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
t samples)
i
Before me. the undersigned authority, a notary public. duly authorized to administer oaths and take acknowledgments. personally appeared
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 foregoin application, and that he did sign the same. and that all facts therein by him stated are true.
Date / Read. Sworn to and Subscribed before me.
Permit No.
Council Approved
3 /3
. Date 0 q — 1 1 19!d/ .
No. l Street A/ E qy 6 ^
Subdivision d/ 5 sr .,J`oA i ' / /' b i/320 113 o S"yo o
27
X //S, 75-,
Disapproved Date
(Signed)
(/4-\ PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Date Disapproved Date
Building Inspector
Notary Public. State of Florida
My Commission Expires
NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anchor workmanship.
OWNER'S NAME
mw. 4 I.l R. M. k LE* ..1E rz...
JOB LOCATION (ST. OR AVE.)
- L1 f1 . t • 9 4 Th STILEeT .
ENERAL CONTRACTOR
Gar 1-e. A 4
PRESENT
2'1 N E •
LOT
If k i c.
ADDRESS
1 o 3 s P4 , E
ADDRESS
' ct ST.
BLOCK
• $ 5 ' '
AA IC%
S rrt a•l
1
LICENSE NO.
S BDIVISION
ivy.. hale•t$
PHONE NO.
PHONE NO.
)e '. * 1
LICENSE NO.
0119,
G a
BUILDING PERMIT NO. Q Z I Z ^
DATE 1-13 `7
OM
PERMIT FEE $ ' �
BUILDER'S BOND
NO. DATE
A. on CU. FT.
ZONE REQUIREMENTS ^
PLAN CBE 1 L
U 1 CU. FT.
•+
EST. COST $ Z a 00 •---,
,�{+
DRAWINGS. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: L•.) • • 3r� •4. -
DATE
j. ! 3. 4i'
NEW CONSTRUCTION
TYPE
STORIES
ROOF CONSTRUCTION
INTERIOR CONSTRUCTION
REPAIRS
l DESCRIPTION
SG L -.PC.6 ' id. .4..1., — .. F ,. MC, -
I
ALTERATION
_ ..
1/I DESCRIPTION r
SC�`taAsn . C+J ID L ♦l.�w 4 am. - t - CX iJoa.0 C ; (1:n
ADDITION
SUBMITTED TO PLANNING BOARD
APPPIOVED
REJECTED
REFERRED TO COUNCIL
REASONS J
RE- SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE_ COUNCIL
/ / J t9- a
n REMARKS
�re.e..1 f. .," 4 - 5 $g - SG 2 .E` 4 � A lp s y 26" A:yt
CERTIFICATE OF OCCUPANCY NO. f C ` ISSUED Z.. 20 6
BY le- I .
TO �- L
i �-(_ it.
BUILDING PERMIT AND INSPECTION RECORD —MIAMI SHORES VILLAGE
INSPECTIONS
DATE
BY
INSPECTIONS
DATE
BY
FOUNDATION
$
SEWER
ROOF
ROUGHING
$
BEAMS & LINTELS
H. W. HEATER CONN.
TUB & TOP OUT
POOL
GAS
FRAMING
AIR COND.
$
FINAL
CLEAN UP
+ I
SLAB
SEPTIC TANK
SLAB
S
FIXTURES & FINAL
TEMPORARY SERVICE
DATE
BY
$
SEPTIC TANK
RE- INSPECT
BY
$
SEWER
TEMPORARY SERVICE
ROUGHING
$
SOLAR HEATER
H. W. HEATER CONN.
TUB & TOP OUT
$
GAS
RANGE CONN.
$
$
SEWER
e
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
FEE
TEMPORARY SERVICE
ROUGHING
$
H. W. HEATER CONN.
TUB & TOP OUT
H. W. HEATER CONN
$
RANGE CONN.
$
SEWER
$
FIXTURES
SEPTIC TANK
S
FIXTURES & FINAL
SOLAR HEATER
FIXTURES
GAS
CONTRACTOR
PHONE
PERMIT NO. 1 DATE
FEE $
NEW BLDG. 1 ALTERATION I ADDITION
REPAIRS
SPECIAL PERMITS PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
ROUGHING
$
H. W. HEATER CONN.
H. W. HEATER CONN
$
RANGE CONN.
$
MOTORS
$
FIXTURES
$
S
INSPECTIONS
DATE
BY
RE- INSPECT BY
RE- INSPECTI BY
TFMP SERVICE
ROUGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL
BUILDING INSPECTIONS 2,t L"7"- ar � a -r
CONTRACTOR
PERMIT NO.
NEW BLDG.
PLUMBING PERMITS & INSPECTIONS
DATE
1 ALTERATION I ADDITION
SPECIALS PERMITS PERMIT NO.
DATE
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL TO POWER CO. FOR SERVICE DATE
PHONE
FEE $
REPAIRS
BY
FEE
OWNER'S NAME
MT. & WS • Wlllian Ihnen
f PRESENT ADDRESS
1 210 N. W. 84th St.
LICENSE NO.
PHONE NO. g
IV/
JO A,G -C TION (ST. OR AVE.)
Z N: E.. 94th. Street
i LOT
15" & 16
BLOCK
4
SUBDIVISION
Seat. 1
GENERAL CONTRACTOR
Wm. B.. Peterson
ADDRESS
166 N. E. 93rd St.
PHONE NO.
LICENSE NO.
5024
ww�7,,
BUILDING PERMIT NO. L0 2
r� '• C
DATE 12 -lt•50
�p
PERMIT FEE S 18.00
r BUILDER'S BOND
NO. 11'7.0 DATE 12∎440 ..
ZONE REQUIREMENTS 20,000 CU. FT.
PLAN CUBE 216282 CU. FT.
EST. COST S `1 1600000
DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY
DATE
1
NEW CONSTRUCTION
TYPE
OBS
STORIES
L
ROOF CONSTRUCTION
T ILE
INTERIOR CONSTRUCTION
Oak floors- plaster walls
REPAIRS
ALTERATION
DESCR IPTION
n. • . • . • 2 ,�...1. ,, y
2 ° c' ." •A u : .b$th_earp ___-at bath
,_ 1...gan�
DESCRIPTION
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.f ///
ISSUED' 07 � � !
BY ;
�
!/ `
TO Art Y - . /.///
BUILDING PERMIT AND IN(SPE¢TION RE
RD -MIAMI SHORES VILLAGE
INSPECTIONS
DATE
PERMIT NO. 1 0491
RE- INSPECT
BY
RE- INSPECT
BY
FOUNDATION
/2.10e
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$ 1.00
BEAMS & LINTELS
$
I
X 21
�r�
12_9 -50
$ 1.00
SEWER
FRAMING
MOTORS
$
SOLAR HEATER
$
FIXTURES -
$
GAS
$
--
$
$
INSPECTIONS
FINAL
INSPECTIONS
j'
BY
RE- INSPECT
BY
RE- INSPECT
CLEAN. -UP
ROUGHING
/
f'
ROUGHING
CONTRACTOR ATLANI= PLI III.004a.
PHONE
PERMIT NO. 1 0491
DATE 12 -11 50
FEE $ 9.5
NEW BLDG. ALTERATION
ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
$ 1.00
H. W. HEATER CONN-
$
SEPTIC TANv arso a
X 21
�r�
12_9 -50
$ 1.00
SEWER
$
MOTORS
$
SOLAR HEATER
$
FIXTURES -
$
GAS
$
--
$
$
INSPECTIONS
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
ROUGHING
/
f'
ROUGHING
�o t at
GAS
H. W. HEATER CONN
SEWER
/
SEPTIC TANK
42.,._./1-- /i- rniF
SOLAR HEATER -
FIXTURES & FINAL
2. A.. 9 -
A: .44,
FIXTURES
CONTRACTOR H & H 1 +' . T . . TRT(;
PHONE
PERMITNO. /6 ? 1DDATE /••/ 6 /
p
FEE $ /3' 336'
NEW BLDG. (t+ ALTERATION I ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
10390
1250.50
$ 1.00
H. W. HEATER CONN-
$
RANGE CONN.
$
MOTORS
$
FIXTURES -
$
--
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
TEMP. SERVICE
(2_ t
1
ROUGHING
�o t at
H. W. HEATER CONN
"....,
RANGE CONN.
FIXTURES & FINAL
2. A.. 9 -
A: .44,
BUILDING INSPECTIONS
PLUMBING PERMITS & INSPECTIONS
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL TO POWER CO. FOR SERVICE DATE e 7 - BY A 8 ri
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building_
Architect
Contractor
or Builder
Legal
Descripi:ion._
Address of Q
Building
PERMIT N° 10382
Subdi-
vision
Amt. of
Permit
Wo to be p
MIAMI SHORES VILLAGE, FLORID
med under this Permit
Value of
Project $
This permit is grant e to the contractor or builde named above to %onstruct the buildi
herefor in strict compianc with all ordinances pertaini thereto and with the understand
drawings, statements or specifications that may have been submitted to nd approved by th
time if the work is not dot in compliance with such ordinances or if th- .lans are changed
granted is the understanding that the contractor or builder named above ssumes the resp
pertaining to the work covered hereby whdther shown on the plans or dr . ings or in the s
done by his agents, servants or employees.
t Signed:
DATE
AUTHORITY
Contractor's
License No
INSPErCTO
In consideration of the issuance to me of this pern the wor oyirid hereuatletjh compliance with . .inances an regulations
pertaining thereto and in strict conformity with titie drawings, statements or-fpecifii , ons,stibiaittedlto the proper autho s of Miami Sh es Village.
?
In acce this permi I assume respdgsibili ,work done by either, elf, r y' agent, sexy At or employee.
CONTRACTOR OR BUILDER
19
instal the equipment or devicecribed in the application
work will be performed in compliance with any plans,
cipal authorities. Termit may be revoked at any
rization. A further condltiari upon which this permit is
r a thoroug knowledge of the ordinances +n• regulations
nts or specifi . o • • _' ? • work
BUILDING 4 MIAMI SHORES VILLAGE, FLORIDA
Date w , ,
ELECTRICAL ❑
PLUMBING ❑ PERMIT N9 8393
ROOFING ❑
❑ Wo rk to be performed under this Permit
RA ,. or". g•�• k L,Ne,€ t t>
Owner of �r•.•.+••►
Building •+ -•i y,: t= s.
Architect
Contractor
or Builder - 't -- — -'.7 i + .. .L ,
Legal Lot
Description �I J31
Address of
Building
CONTRACTOR or BUILDER BY
f
Contractor's
License No.
AUTHORITY
19 =
;rr . N• + � : +L:5 4.30 e � . S d Ory � CeA� 4.41
0 .,
Subdi-
no 8 t 4 Z
vision
Sq Ft
Value of 11 Amount of 0.
Project $ ° ' ` sue II 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 applica-
tion 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 respon-
sibility for work done by his agents, servants qr employees.
Signed• j..4110 4 � * -•. -� � -� � - ( INSPECTOR) BY 41
In consideration of the issuance to me of this per I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plagk 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.
"
• j
fJt � 9. '! Celaitit
PAID BY
YEAR
ANNUAL TAX
PERIOD USED
AMOUNT PAID
DATE PAID
NECEIET
NUMBER
-/ -si
Iq51
/ ,S
41.00
/r
/0
/. 05 / &<A
jr /gD
oc
/A
/ / -A ? -V
62 '//s‘ 2 °
o2t /f
6L f
7- iuru E /4
ADDRESS 27 N. E. 94th Street,
Lot 15 & 16, Block 4
LEGAL S hores
EC
11;
RD GAR
AGE TAX
c-
4
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.
Dat Nov . 15th 19
owner's Name and Address • & Mrs. Wm. I hn e n c j 2 10 street N • W. 8 St.
Jo J. Di ita, 7625 BiscayneyBly .., !liana.
Registered Architect and /or Engineer 7
Name and address of licensed contractor • (AI' Ai ___
Location and legal description of lot to be built on:
Lot 15 & 16 Block 4 Subdivision Section 1
Street and Number where work is to be done 2-1 _ N • E • 94th St.
State work to be done and purpose of building (by floors) 1 Family Dwelling
New Building New Remodeling X Addition x
To be constructed of CBS Kind of foundation
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Building Inspector
MIAMI SH ® RES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Estimated Total cost of improvements $ 13, 5 00 _Amount of
Zone cubage required N ® C •
Distance to next nearest building Approx. 100
and for no other purpose.
Repairs x No. of Stories 1
Cement Block Roof Covering Tile
Permit $ ® c1 __
____________ �
flan Cubage 2 P1WINIO = kfirt0X.
Size of Building Lot 100 X 128.75
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 Mr & Mrs. Ihnen,____eLQ__ _210_ -IT. W.._ 84th fit._, Mism _i,____F1 _.
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 t� 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 o be performed under this
permit, as are licensed by Miami Shores Village.
Remarks _ ' (Signed) _
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared I� /a Z - -�'11 � � � L 1 14 2li- ('f u d A r /)
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the___4_l,y_ p/__t2l
of the above described construction, that he has carefully read the foregoing applicati and th i
therein by him stated are true.
Disapproved Date Rea o,j/ o ub, . e.
A ir
Permit No Date
otar P►i / State of Florid
( Signed)
sign the same, and that all facts
efor me.
My Commission Expires
I �3
7
,„
PLANNING BOARD DATE � y,,+ „� Ka a +tc, ctdt^ c4 E t^iTi..,
ri,,
Chairman Member ;YAP
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.