1041 NE 96 StN i
Date Job A d d ( / ( A) 'E 9 67 SCh Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant,/ 1,0 PrS r ► l / e-1 612- -
Owner's Address
Contracting Co. MMtel 0 rz i, VF W 4
Qualifier \/ V� t !. t L ` Mc‹,_ ss# ✓ � - — L 5
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BU DING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
. / a ,.� ,gam, G/' L%C /L ti rfi 14) 1 / l
a lp ��',1 x 6
WORK DESCRIPTION
Ad ha,bi
Square Ft. Estimated Cost (value) 600
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.
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.
■
Signature of owner and/or Condo President
r
- ' �.,+'to.b ✓r.
Notary as to Owner and/or Condo President
My Commission Expires:
•+� ?-, Nicole Stewart
�'' %Commission # CC 932667
o:1? Expires June 9, 2004
,
Bonded Thru
: `'Atlantic/ending Co., Inc.
FEES: PERMIT: ® RADON C.C.F.
APPROVED:
/02 ®/d/
Zoning d Building
Mechanical Plumbing
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date,
Date
C
otary as to Contractor or Owner- Builder Date
My Commission Expires;, ,,,,,, j
' Nicole Stewart
�
$..
ea Commission # CC 932667
ca; n . I Expires June 9, 2004
••? iu PI Bonded Thor
Atlantic Bonding Co., Inc.
NOTARY BOND i o
Master Permit #
Phone
Address 16 6/0 ` ( A ) . / '
Electrical
JAL
Signature of Contractor or Owner- : uilde Date
TOTAL DUE
99) V
Structural Engineer
.
e
Lot /V
Tax Folio #:
requests permission to install:
SIGNED, SEALED AND DELIVERED in the presence of:
Y/ SIiorei (/iCL"ccc�e
[TAsphalt, concrete, brick pavers
[ J Landscaping
[ J Other
within the public road right of way of /D
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 -2382
Telephone: (305) 795 -2207
Fax: (305)_756 -8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, ' "70-4..e, B are, a-T hereinafter referred to as the Owner of the
(owner)
following described property:
Legal description /folio #: //32.06 fif 3I' 2.c
Block Subdivision jec,
(address)
IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows:
I . To maintain and repair, when necessary, the above- mentioned item(s) installed within the dedicated right
of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said
items within public right of way including restoration of street by reason of the Owner's failure to do so,
such expense shall be paid by the Owner or shall constitute a lien against the above described property
until paid.
2. The owner does hereby agree to indemnify and hold Miami Shores Village or dade County harmless from
any and all liability, which may rise by virtue of permitting the installation of these items within the public
right of way.
3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days
notice by the Village to do so. Failure to comply with this notice will result in the Village causing the
item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all
costs incurred in the removal and disposal of the item(s).
4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and
shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such
time as this obligation has been canceled by an affidavit filed in the Public records of Dade County, Florida
by the Village Manager of Miami Shores Village (or his fully authorized representative).
SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this _ day of brit �
J / /n/ /, A ✓ ` J
(owner)
at(
A'p z,, Nicole Stewart
??• 11?; Commission # CC 932667
i v, � �. Expires June 9, 2004
%vi;••...;V Bonded T ru
° 'n „�„tt%`�� Atlantic Bonding Co., Inc.
PR[uECu/1'/
APPe °1-ti
fl 7/iami Shoreo Vi��ccc�e
COVE l ANT OF CONSTRUCTION WITHIN RIGHT OF WAY
r
WHEREAS, ?Pt r _— G hereinafter referred to as the Owner of the
(owner)
following described property:
within the public road right of way of
Legal description /folio#: / /,3Z 06 o /if 3 p
Lot /y Block Subdivision
Tax Folio #:
requests permission to install:
[LrAsphalt, concrete, brick pavers
[ ] Landscaping
[ ] Other
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 -2382
Telephone: (305) 795 - 2207
Fax: (305) -756 -8972
ORtuEtw -V
f� PPRo 4 t
(address)
IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows:
1. To maintain and repair, when necessary, the above- mentioned item(s) installed within the dedicated right
of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said
items within public right of way including restoration of street by reason of the Owner's failure to do so,
such expense shall be paid by the Owner or shall constitute a lien against the above described property
until paid.
2. The owner does hereby agree to indemnify and hold Miami Shores Village or dade County harmless from
any and all liability, which may rise by virtue of permitting the installation of these items within the public
right of way.
3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days
notice by the Village to do so. Failure to comply with this notice will result in the Village causing the
item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all
costs incurred in the removal and disposal of the item(s).
4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and
shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such
time as this obligation has been canceled by an affidavit filed in the Public records of Dade County, Florida
by the Village Manager of Miami Shores Village (or his fully authorized representative).
SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this day of (.
br ua
g ad
SIGNED. SEALED AND DELIVERED in the presence of:
:�11A p VB'
Nicole Stewart
??g•' • ••• ;
Commission # CC 932667
%�
:�I: jai: Expires June 9, 2004
Bonded Ttw
moo
, ,,, „,a Atlantic Bondinn Co., Inc.
#E1314
•
WILLIE MOSEY RUBYE MOSIEY
Soles Rep. /Supervisor
Owner
535 -8435
Fox: 252 -3693
Mosley Driveway Maintenance
, 10610 S.W. 149th Street
Miami, Florida 33176