638 NE 97 St (8)CONTRACTOR
Name
/�1S Qi.,./
Name ? , ,:‘r--; (4 ; :
T
License No. c N !ge aS7 47
Home Telephone
Address
(27s 446 'a "� 17 */ ;-, P
Telephonejos_ 75-6 9�,,z/ Fax j®s. 7s7—/5,
.v60.
Qualifier Name r 0, c ,4974,,..„
PROPERTY OWNER
Name
/�1S Qi.,./
T /+
r QeorJ F
Address
63V /L e Q?
f r6 /n, 1. fIfr q A- ,11,F
Home Telephone
Business Telephone
Fax
r
Step 1.
Job Address: K 3 P / ?? 1 117 r 6
Folio Number
Lot
Subdivision PB PG
Current Use of Property / ?r' r1
Proposed Use of Property
Tenant Information
Block
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
RooSng
Fence
Other
Address , Apt.
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
einspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No.
Subsidiary Permit No.
r INSTRUCTIONS - The following steps must be taken to obtain a permit 'from the Miami Shores Village:
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted
along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
A PPLICATION
City
Description of Work CX..
Telephone
Fax
/G
State
PERMIT APPLICATION
de ss.
Jfice
Zip
Zoning Linear Feet
Square Feet Units Floors
Value of Work /C O° Bldg Value
Tax Assessed/Appraised Value
Flood Zone
[7 ,67 5fr
V
7156 vc 5-
Page 2
IMPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1S Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
STATE F FLORIDA, COUN Y OF MIAMI -DADE
NOTARY SEAL
JULIE A DAVIES
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CCR3601
MY COMMISSION EXP. MAY 11 003
Signature ff Owner
iA-1 �J Gred
Print Name
Sworn to and subscribed before me this day of
Si o Notary Pub c
SEAL:
Personally known
OR, Produced Identification
Type of Identification Produced:
STATE 0
S gnature of Contractor / Qualifier
67 ,r4A
Print Name
Sworn to and subscribed before me this
PERMIT APPLICATION
A, COUNTY OF MIAMI -DADE
day of
of Notary Public - State of Florida
OFFICIAL NOTARY SEAL
SEAL: JULIE A DAVIES
NOTARY PUBLIC STATE OF FLORIDA
C MMISSION NO. CCi°
M . OMMISSION EXP. MAY 11,2003
Personally known OR, Produced Identification
Type of Identification Produced:
i ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
A/C Central 1 -3 Ton
Fan
Dryer Vents, Number of
Outlet, Wall
Ventilation, Cost
Service, Temporary
Air Handler, Tons
A/C Central 4 -7 Ton
Piping, Flammable Liquid
Fire Pump
Outlet, Switch
Fire Sprinkler System
Signs
A/C Central 8 -15 Ton
Bath Fan - Vented, #
Fixture - Fluorescent
Pressure Vessel
Oven
Space Heater (kw)
A/C Central 16 -20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL
TYPE
Minimum Fee
QTY. TYPE
Condensate Drain
QTY. TYPE
Generator
QTY. TYPE
Refrigeration, Tons
QTY.
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Solar Water Heater
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Cap - Fixture
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Pump and Abandon
PLUMBING
TYPI.
A/C Condensate
QTY.
TYPE
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTY.
TYPE
Soakage Pit
QTY.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
DATE
07/94
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
Il l `1 'L.s'Z
Page 4
OFFICE USE ONLY
CTRYtiLisT
LI OWNER - BUILDER FORM
(Attach)
ID FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
CONCURRENCY
(New Construction)
L1 OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.)
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
LI PROOF OF OWNERSHIP
(Attach)
HRS / DERM APPROVAL
(Septic / Sewer)
IMPACT FEE
(New Construction)
LI OTHER
(Specify & Attach)
PERMIT FEES
$300
(sq.ft. = x/1000
x ¢.60)
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
REVIEWED AND PREPARED BY:
PERMIT APPLICATION
U CONDO ASSOCIATION APPROVAL
(Attach)
BPR APPROVAL (Restaurants)
LI CONTRACTOR REGISTRATION
(On File)
TOTAL $3t t ko
ISSUING OFFICIAL
DATE:
`'CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL o (305) 795 -2207 o FAX (305) 756 -8972 http : / /www.miamishoresvillage.com
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305-795-2204
Printed: 4/19/02
Applicant: GAIL
Owner: GEORGE
JOB ADDRESS: 638 NE 97
Contractor BLUM BUILDING CONTRATORS
Local Phone: 305-751-1546
q3 Parcel # 1132060171660
Fees:
FEE2002-2257
FEE2002-2258
FEE2002-2259
Description
Building Permit Application Fee
CCF
Buildier's Bond
Total Fees:
Amount
$60.00
$1.20
$300.00
$361.20
Total Fees: $361.20
Total Receipts: $0.00
ermit Status: Approved Permit Expiration:
Work:
Signed:
EXTEND DRIVEWAY TO STREET
If there is no permil
fee is $50.00, which fr
This Permit is granted to II
ordinances pertaining thereto
and approved by the proper r
authorization. A further cond
ordinances and regulations p
by his agents, servants or err
In consideration of the issu
with the plans, drawings, stat s,^
myself, my agent, servants o
Signed:
PAY TO THE
ORDER OF
MEMO
10/15/02
5
ermit Number: 8P2002-787
GEORGE
GAIL
ST
Legal Description: MIAMI SHORES SEC 4 AMD PB 15-14 LOT 6 & E1/2 OF 7 BLK 100 LOT SIZE
BLUM BUILDING CONTRACTORS, INC.
275 NE 92 STREET
MIAMI SHORES, FL 33138
ong Permt
Contractor's Address: 275 NE 92
Construction Value: $1,500.00
711,040,t, 4geez
1
onn 111. ,.flr,p,flnq
nn
Page 1 of 1
•
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TOTALBANK •
CORAL WAY BRANCH
MIAMI, FLORIDA 33145-3271
63-915-660
1 5 Poor,
r,t41
rs,
DOLLARS
M.
0
STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant, - V • ".-f 8 %does hereby attest that the
(property owner)
attached survey, performed by
(name of survey 's company)
performed on /C / 7 ,// 7 , 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
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..
Further, Affiant sayeth naught.
FI Y SEAL
JULIE A DAVIES
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC836040
MY COMMISSION EXP. MAY 11,2003
SI Loj ^e3
AFFIDAVIT
Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this f i' day of
Affiant is ✓personally known to me, produced as identification.
Th iami SIlorQ� (/iLLcr.�e
Lot
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, r#,-, � VJ' CT e`-'?6 hereinafter referred to as the Owner of the
following described property: (owner) h _ P L O I M l (` u a12e-
ll 1 1 Ll 1 J
Legal description /fol L T f Lo 1 I3 ( C i � I G Q
Block Subdivision
Tax Folio #: H 3 a L 0 ILL90
requests permission to install:
[ ] Asphalt, concrete, brick pavers
[ ] Landscaping
[ ] Other
within the public road right of way of
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 - 2382
Telephone: (305) 795 -2207
Fax: (3051756 -8972
1\I E,
R[UECv/1
� P PR o ri-c(
(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 t /b day of
SIGNED, SEALED AND DELIVERED in the presence of:
OFFICIAL NOTARY SEAL
JULIE A DAVIES
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC836040
MY COMMISSION EXP. MAY 11,2003
EXTEND CONCRETE
----- STEPS TO EDGE OF
-EXISTING PORCH &
RE -TILE ENTIRE STEP
:DOWEL NEW STEPS
PINTO EXISTING W/ r - - -
( # BARS 1012 "04
'6" EMBEDMENT IN
:EPDXY
rn
I
N
Tom/
-------
FACE OF EXISTING WALL
EDGE OF ROOF OVERHANG
FACE OF PROPOSED WALL
EDGE OF PROPOSED ROOF OVERHANG
PROPOSED STEPS
1
1
9
� v
/ _ - --; —.
' r 1
/ t i
^` t
0
r10 Q
I .-
:Q 11 12. 1•5
Lot 6 and the Ecus-t 1/2 v Lc-t 7, Stocf:. 100, AMENDED PLAT OF ,MIAMI SHORES SECTION
NO. 4, aceo' d.i.ng to :the_ pfa.t -thi 2eo4, as &e.ec'tded in P.ea.t Bock 15, at Page 14, o�
the Pubf f.c Records o,S Dade Caur. tt', Ft o•tidu.
Fie /d Boot : 194
Dols : 10 -7 -87
NOTE: Not vo /id unless sealed with on
embossed sum-line's SEAL
S C A L E
-PI o St SWEVO
I r e :rJ
14 Ir--, \co
. -
1 c
SKETCH OF SURVEY
Fn^
A1•z. David (ie--i'ci.ts
100
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1e.
P'tapeAtu add'ct'4s: h3 N.F. 97th. S.t .0, Maul( Shnze,s, FQ.a.
n
•
Tile Na,ti_onatif'. F.t ood In °c.e Rate. Map, puheL6hed hit the U.S. Depc:.'c.tmc. ;_t oA 11cu5
and l;nhan Development, efeLi.;:e.a.tes the he'tc : dese.t,ibed band to he situated within
Zone "A -14 ". Th.i:s •is a Ff__c+od haz1Lid Zone.
JUAN R. MARTINEZ a ASSOCIATES, INC.
ENGINEERS PLANNERS LAND SURVEYORS
0500 W. FL•iL!R sr.. SUITE •-105 IIAMI. PLOR /OI 33144 . I1I0*( /soul s93-r00r
/ HEREBY CER77FY .' That the attached "SKETCH OF SURVEY" reAresented hereon is true ono correct
to the best of my Arnow /edge and belief, and meets the "MW /A}UM TECHNICAL .STANDARDS as set loth by the
"FLORIDA BOARD OF LAND SURVEYOR'S': pursuant to Section 472.027 Florida Statutes.
blob Number . 23679
Sco/es os shown
f
/ i /! � '�' ",
" -- JUAN R. MAR77NE7 Presider/
Professiono/ Land Surveyor N °2/60
Stole of F/orido
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