1219 NE 96 St (3)IOCT LL Q 2003
C,
BUILDING i :
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building
Owner's Name (Fee Simple Titleholder)
Owner\'s Address tt 211 tJ
City 0 ■ 3 \ '.'" &N State
Tenant/Lessee Name
Contractor's Company Name -
Contractor's ddres
City • 4
Qualifier a g A c9--
$ Value of Work For this Permit
Miami Shores Village
Building Department
{ CI WED
Job Address (where the wurk is being done)
City Miami Shores Village
Is Building Historically Designated YES
Architect/Engineer's Name (if applicable)
Architect/Engineer's Address
City State
V
0,6o
Electrical Plumbing
Ao c..._
`I 6 sA
�-- Zip
Phone #
State
Number of: Bays Stories
Type of Work: ['Addition ['Alteration
Describe Work:
Count
Families
1pNew
Miami -Dade
County Escrow Fee $
Education/Training Fee $
Code Enforcement $ Bond $ jOO' OD 4-9oa lStruct. $
Minus Plans Check Fee $ Total Fee Now Due $ 3 A
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Permit No. 6 / -1
Master Permit No.
echanical Roofing
P hone � �A •
Phone # g0 S 26 -4 4- f
Zip 1-
Phone #
Zip
4 o
Square Footage Of Work:
O * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Zip 1 S
Bedrooms Baths
❑ Repair/Replace ❑ Demolition
Permit Fee $ /00 Notary $
Tech $ 2,5 Scanning $ 3 "— Radon $
(Continued on opposite side)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State 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
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. In the .'sence .). uch posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
NOTARY P UBLI
Sign:
Print:
My
* * * * * * * * * * * * * * * *
chc7n /o3
Owner or Agent
The foregoing instrument was acknowledged before me this
day of t .e , 20 b
who is personally known
)
t
e or who has produced
s identification • . . d w ' - •t d tak
• y
A‘AA“
ommission Exp
a
APPLICATION APPROVED BY:
Signature
who is personally known to or who has produced
as ntification and wh• id
PUBLIC: -
A
r.���fi.Z .'.,:1�7tTT
Sign:
Print•
* * * * * * * * * ** * * * * * * * * **
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
lt�3 \to3
Contractor
The foregoing instrument was acknowledged before me this
day of 3—O 03
, 20
r
1 11
d tak: 1 .:11111
1014- ' p g'' , �� � �3 fi.ORID►A
M'' COMMMISSiON4 EXP. FEB. 19, 2005
Co
* * * * * * * * * * * 4141 * * * * * * ** *4141 ** *4141* *4141 *** * * * * * * * * ** * **
Plans Examiner
Engineer
Zoning
WHEREAS,
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
c O'R` D v ' ', hereinafter referred to as the Owner of the
(owner)
following described property:
Legal de ription/foliolr:
� ��
2S 2& 1 12.E
Lot ' `� V n lA Block g v Subdivision
Tax Folio #:
requests permission to install:
[4 c • rick pavers
[ ] Landscaping
[ ] Other
within the public road right of way of i 1 1 t. E • qG 41\11.01'
?
(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. I f 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/
SIGNED. SEALED AND DELIVERED in the presence of:
Yl /hami S/iorej (/iC�ccc�e
OFFICIAL NOTARY
FIDIAS JOSE LOP
NOTARY PUBLIC STATE OF FLOR1
COMMISSION No. Dd2628
MY COMMISSION EXP. FEB. 19,
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 -2382
Telephone: (305) 795 -2207
Fax: (305).756 78972
4,) \ ° N-Ni\•,
pRL i /i-v
APPEori-ctf
'STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affian
attached survey, performed by
performed on
t,
(date of survey)
rther, Affiant sayeth naught.
and print)
(property
a
, does hereby attest that the
(name ofleyor's company)
, is an accurate representation of the existing conditions and
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
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..
SWORN TO AND SUBSCRIBED before me this 30 day of
Affiant is personally known to me, produced
Witness(sign and print)
e •
IAh OT rt
Ri ®iAl JOt' h�P
NOTARY Pill M YAW t P U
6 ®!!1®A
O@MMIGION Ne, NM
MY % %MM I�t ►f�P� f R FEB, 10, 0008
4:/
as identification.
/2 H t /4c /idea
le' / 33.25 '
f
r
/2
A9,60'
/2.40 / .
z
s
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fio4 ter
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4,e0
141
400
32.80'
29. /0
1
89'55'5r
• 1
•
FoR DI GIACOMO SKETCH OF SURVEY
TYPE OF SURVEY' BOUNDARY JOB * 93 -16903 DATE'10 -25 -93
ADDRESS' 1219 N.E. 96TH STREET, MIAMI SHORES, FL. 33138
o FL000 ZONE' X BASE FLOOD ELEVATION'
C.P.N.# 1206520093 G 1/20/93
LEGAL DESCRIPTION'
22.3'
W 25.00 FEET LOT 12, ALL OF 13 AND 14, BLO
OF MIAMI SHORES SECTION ACCORDING TO TH
THEREOF, RECORDED IN PLAT BOOK 10 PAGE 37
PUBLIC RECORDS OF DADE COUNTY, FLORIDA.
CERTIFIED TO:
SCALE 1" = 2(
LOWEST FLOOR ELEVATION'
GARAGE ELEVATION'
EDWARD DI GIACOMO AND
ANNA MARIA DIGIACOMO, HIS
CHRISTOPHER P. KELLEY, ES(
ATTORNEYS TITLE INSURANCE
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 10/31/2003
Applicant: ANNA MARIA
Owner: MARIA ANNA
JOB ADDRESS: 1219 NE 96 ST
Contractor ICOA CONSTRUCTION
Local Phone: 786 326 - 4041
Parcel # 1132060143810
Building Permit
Permit Number: BP2003 -1726
Contractor's Address: 1101 S.W 18 COURT
Page 1 of 1
Legal Description: MIAMI SHORES SEC 3 PB 10 -37 W25FT LOT 12 ALL LOTS 13 & 14
Fees: Description Amount
FEE2003 -6698 Building Fee $100.00
FEE2003 -6699 CCF $1.80
FEE2003 -6700 Scanning Fee $3.00
FEE2003 -6701 Technology Fee $2.50
FEE2003 -6702 Training and Education Fee $0.60
FEE2003 -6703 Builders Bond $300.00
Total Fees: $407.90
Total Fees: $407.90
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 4/27/2004 Construction Value: $2,400.00
Work: PLAIN CONCRETE DRIVEWAY
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:
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date i i -20.( : )-5 Time
Type Insp'n 1L�2AA�C
Permit No. r P • D3 - V? 2.00
Name i 9 i O2YYY C) 14
Address 1 kLE RL2 'T •
Company l 01 Cic J
Phone # i _ 52(o- LW j
For Inspector: i I L ZI) 03
Approved
Correction
Re- Insp'n Fee
Name & Date
Date 11 -20 ' 0-5 Time
17
MIAMI SHOVNILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Type Insp'n "' ,u1 f..4,11.0.1
Permit No. ('?) P • 0,5 _ 17 2
Name () t 9 I 0 Ovn O rka kt •
Address 12-\ o ME Flo
Company 01 (033--Antjb
J
Phone # • 1 � 2( 9 o -9
For Inspector: I 445 Name & Date
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date Z 0-5 Time
Type Insp'n
Permit No. be 2003 — I - 12 0
Name 14-1
Address (1219 N 6 q (o �T
Company c�V0:Zo at •
Phone # 'j Flo — 52:6-4 0` +
For Inspector: t \ ?.5` 8(19 'Name & Date
Approved
Correction
Re- Insp'n Fee ❑
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305 -795 -2204
Building Inspection Request
Date 1l fz(c_
-5
Type Insp'n f
Permit No. PJ P 2003 " d 72- t'
Name A-14 a nkQ 0:-
Address 1 219 N E Q to 5
Company 60 at •
Phone # 'j d to '3270- 4°4
For Inspector: 1 kZ5103 3iP 'Name & Date
Approved
Correction
Re- Insp'n Fee ❑
Time