749 NE 95 St (4)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date ? Job Address 7 VI ik ` I Q Tax Folio
L egal Description Historically Designated: Yes No
r/Lessee / Tenant A f L . V e ( cao
t ( Master Permit # � 9 -/ 8 2)
(�
OOwner's Address 1 47 I" � I � , P �� I � ►1n� SVW V? S � � �— `� �l / �/ 8 Ph `� one � 0.� 57 °6 `t- 1 }�
Contracting Co. fWlica,k) Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING . ELECTRICAL PLUMBING MECHANICAL ROOFING PAVIN
p"e jAvac /1
WORK DESCRIPTION
Square Ft. 7 c
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
C.C.F.
FEES: PERMIT RADON
APPROVED:
Zoning ..(6 Yh ' Bui di
E stimated Cost (value) t 0'0 , d C
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.
otary as o Contra . ' r or
My Commission Expires:
NOTARY S 0 BOND
Electrical
Mechanical Plumbing Structural Engineer
3 -1 y7 -
O1 p RY
p, OFFICIAL
u ^r t ANGELA lul BECKER
'w' Q30k1SMON NUMUER
o CCresssr
pF f l t4), COPAOSSION E>1pIR ES
NOV. 1 S
= 200
, :r..... ,�
TOTAL DUE
IGN
t I
Date
.. 1 7- oy
0
STATE OF FLORIDA)
COUNTY OF DADE)
AFFIDAVIT
AL0 I v L r � � S does hereb attest that the
The undersigned Affiant, , hereby
(property owner)
L attached survey, performed by °� $ �� a c` c c._
attached
(name of surveyor's company)
performed on q 1 0 ° , is an accurate representation of the existing conditions and
(date of survey)
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the
property without first providing a survey less than six (6) months old. The Affiant, as property owner, further
Further, Affiant sayeth naught.
agrees to remove or obtain permits for any structures which now may exist on the property which are not
permitted or which may violate zoning or building code regulations. The Affiant further understands that the
existence of any such structures may affect final inspections as applicable to this or other permits..
Oa, 4)
AffiantlProperty owner
Witness(sign and print) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this ) ) day DO
Affiant is personally known to me, //Produced F.4 U) v \a D"Di a -73- ("12; identification.
r--
P(ZY Pt, OFFICIAL NOTARY SEAL
61 e ANGELA M BECKER
fi r"• + n COMMISSION NUMBER
•
* CC786697
9f �c QU MY COa4MISSION EXPIRES
OF f\.. NOV. 15,2002
STATE OF FLORIDA
COUNTY OF MIAMI DADE )
SS.
e foregoing instrument was acknowledged before me o
,/
FL))L V y 0 —o y7- b as ident a tion and who did
Signature of Acknowledg
STATE OF FLORIDA )
) SS.
COUNTY OF MIAMI DADE )
(ACKNOWLEDGEMENT - INDIVIDUAL)
, who is personally known to me or who has produced
Title or Rank:
Serial No.(if any):
RV P OFFICIAL NO AHr •EAL
0 0, -6 ANGELA M BECKER
COW &S,ON NUMBER
(ACKNOWLEDGEMENT - CORPORATION)
Name of Acknowledger:
(Typed, Printed, or Stamped)
NOV. 'IS,200
The foregoing instrument was acknowledged before me on by
, of
a corporation, on behalf of the corporation. He/She is
is personally known to me or has produced as
identification and did (did not) take an oath.
Signature of Acknoweedger:
Name of Acknowledger:
(Typed, Printed, or Stamped)
Title or Rank -
Serial No.(if any):
•1. • „1
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N71' VAUJD WI 1 iullrr nu SIUMA'n I11E
41.10 THE IINIt?'sM. tt.0 t D SEAL Ur•
►IJ)RtWA IJ('ENS D SIim'Event
av u nl.411M
S //e) 5 LA NO
L0c,4T /ON MAO.
This property described as:
All of Lot 14, and the East 1/2 of
Lot 13, Block 68
MIAMI SHORES SECTION-NO. 3,
according to the Plat
thereof, as recorded in
Plat Book 10, Page 37
of the Public Records of
Dade County, Florida.
PTgador, Reggie R., and
A BOUNDARY SURVEY
I hereby certify that the survey repre-
sented hereon meats the m.rwm4T
teetsmcai standards set forth by the Board
of land Surveyors es dtaprer 610.7 -4
Florida Adrtunrvranve Code pursuant to
Section C2.0a. Fla. Seaman. The are no
encroachmetm. oeertaes, easements
lamming on. the Plat. ocher rhan as
sho..n hereto. (
PC.; i .rru _ c- s
FL, nor. swet,o, A1» manta run
FIELD DATE
SCALE
20'
4�0
PROPERTY OF:Velasco, Alvin L., 749 N. E. 95th Street, Miami Shores, Florida
L...NNES .AND (;ARC IA. INC.
1..11. 4 209N
sl;RN EY()IZS- :N1 1...N,) PLANNERS
!✓ P,IJ E Sr(2 E. 5 299
1)ffice .tldrrss: 359: \Icatar. \venue ('oral tables. Florida .33 I J4
IJU5)ou4.79U9 1951)52J -8663
DRAWN BY
Page 1 of 2
33138
1
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N71' VAUJD WI 1 iullrr nu SIUMA'n I11E
41.10 THE IINIt?'sM. tt.0 t D SEAL Ur•
►IJ)RtWA IJ('ENS D SIim'Event
av u nl.411M
S //e) 5 LA NO
L0c,4T /ON MAO.
This property described as:
All of Lot 14, and the East 1/2 of
Lot 13, Block 68
MIAMI SHORES SECTION-NO. 3,
according to the Plat
thereof, as recorded in
Plat Book 10, Page 37
of the Public Records of
Dade County, Florida.
PTgador, Reggie R., and
A BOUNDARY SURVEY
I hereby certify that the survey repre-
sented hereon meats the m.rwm4T
teetsmcai standards set forth by the Board
of land Surveyors es dtaprer 610.7 -4
Florida Adrtunrvranve Code pursuant to
Section C2.0a. Fla. Seaman. The are no
encroachmetm. oeertaes, easements
lamming on. the Plat. ocher rhan as
sho..n hereto. (
PC.; i .rru _ c- s
FL, nor. swet,o, A1» manta run
FIELD DATE
SCALE
20'
4�0
PROPERTY OF:Velasco, Alvin L., 749 N. E. 95th Street, Miami Shores, Florida
L...NNES .AND (;ARC IA. INC.
1..11. 4 209N
sl;RN EY()IZS- :N1 1...N,) PLANNERS
!✓ P,IJ E Sr(2 E. 5 299
1)ffice .tldrrss: 359: \Icatar. \venue ('oral tables. Florida .33 I J4
IJU5)ou4.79U9 1951)52J -8663
DRAWN BY
Page 1 of 2
33138
1
1