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49367Date Legal Description Historically Designated: Yes No Owner/Lessee / Tenant No as to a9; , My Commission Expires: State # FC00,0 1058 Architect/Engineer Address Bonding Company Address OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and construction : ; r oning. Furthermore, I audio ' the abpve- , er an. • Con. d+ President FEES: PERMIT ' e 7 RADON APPROVED: Zoning Mechanical PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address CO? 4/, ,, ? S e Tax Folio fl Yht �GI1(� 6 7 ;ev4 j -)erl C Y\ Chu1G1'astkPermit# t g Plumbing t ork stated. tore of Contra or or 002 otary : (to Con ' tor or My Commission Expires Building Electrical Phone �rr 5 C Address 3 V V- E ( O st SS # / 4Phone30 — 737/ Municipal # Competency # Ins. Co. l a( Y C 1 Mortgagor Address Permit Type (circle one): BUILDIN ► ELECTRICAL P i INC MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 4- Square Ft. Estimated Cost (value) /,, ®,06 c d2 c2 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. Si er an C.) I ,, , do the all ►' 2/ er Buil r • / Date / , rk will be done in compliance with all applicable laws regulating er- Builder te �� P ie GELA M` 4�«s wy t 2 �^ ,T ooM nassiora r.;u2E;a ice. <c CC7d5SW? .3l 4., Fl �4'. MY CEIN {IS49ON rr' R s • C.C.F. NOTARYS >C • BOND TOTAL DUE 3 R.,•476 ate Structural Engineer KNOW ALL MEN BY THESE PRESENTS: KE 19570 P6. 4376 CERTIFICATIONS AND DECLARATIONS OF RESTRICTIVE COVENANT WHEREAS, Miami Shores Presbyterian Church, a Florida non -profit corporation (the "Owner" or "Declarant") is the owner of the following described property (the "Property") situated and being in Miami Shores Village, Florida: Lots 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10, Block 61 and the 15 -foot alley Running east and west through said Block 61, Miami Shores, Section 2, According to the Plat thereof, recorded in Plat Book 10 at page 37 of the Public Records of Miami -Dade County, Florida, and WHEREAS, the Owner, together with Omnipoint Holdings, Inc. a Delaware corporation (hereinafter "Applicant") with the consent of the Owner, has applied to Miami Shores Village, a Florida municipal corporation ("the Village ") for a wireless personal telecommunications services antenna permit, pursuant to Chapter 22 of the Miami Shores Village Code, and otherwise; and WHEREAS, the Owner and Applicant desire to provide certain assurances and certifications to the Village; NOW, THEREFORE, the Owner and Applicant each jointly declare and certify as follows: 1. Title. Owner and Applicant have provided evidence as to the status of title to the Property to the Village. 2. Continuous Compliance. The Owner and Applicant hereby covenant and certify that the wireless personal telecommunications services antenna proposed for the Property will be made continually compliant with all present and future promulgated by governmental authorities having jurisdiction over the Applicant and the operations of the antenna facility, or similar safety standards for other wireless communications media transmissions. The Owner and Applicant hereby acknowledge the right of the Village to require immediate removal of any wireless personal telecommunications services antenna upon the Property which does not meet such safety rules and regulations. 3. Non - Interference. The Owner and Applicant also covenant and certify that any wireless personal telecommunications services antennas proposed for the Property will not interfere with public safety communications, and further, will not unreasonably interfere with the reception or transmission of television, radio, microwave, telephone, digital or similar communications signals or receipt of signals of nearby residential or business residents. The Owner and Applicant acknowledge the right of the Village to require, if necessary, frequency relocation agreements. 4. Multiple Accommodations. The Owner and Applicant covenant and certify that the design, structure or installation of the wireless personal telecommunications services antenna facility proposed for the Property will be such as to accommodate at least two wireless personal telecommunications services antenna facilities of other providers, on a non - discriminatory basis, after applicant's installation, in the manner depicted on Exhibit "A" which is attached hereto and made a part hereof, to avoid duplication of the erection of wireless personal telecommunications services antenna towers throughout the Village. Applicant and Owner undertake no obligations hereby to assure utilization of the structure by other service providers and Applicant and Owner expressly disclaim any right of power to control or dictate any other service providers' choice or design of REC 195'79 PG. 4377 proposed facilities for this structure. The Applicant will not oppose and Owner covenants and certifies that it will permit co -use of the wireless personal telecommunications services antenna structure upon the Property by at least two wireless personal telecommunications services providers, in addition to Applicant, on a non - discriminatory basis. Owner and Applicant acknowledge and agree that unreasonable refusal to permit co -use shall constitute a violation of Section 22-42 of Miami Shores Village Code and may result in the Village revoking any wireless personal telecommunications services antenna tower approval and seeking a mandatory injunction to compel removal of any wireless personal telecommunications services antenna, in addition to all other remedies available to the Village for violations of its code of ordinances, and any other remedy available under the law. 5. Attorney's Fees. The Owner and Applicant hereby covenant and certify that the prevailing party shall be entitled to recover its reasonable costs and attorney's fees in the event any litigation is brought to enforce the provisions of this Declaration and Certification. 6. Binding on Successors. The Owner and Applicant covenant and certify that this Declaration and Certification shall be binding upon the Owner, the Applicant, and each and all of their respective successors and assigns and that they shall faithfully observe and perform hereunder, for so long as Applicant operated its antenna facility on the Property. IT WITNESS WHEREOF, the undersigned have caused this instrument to be executed and delivered on this Z le day of N i n a. , yi , 2001. WIFIESSES: J ` OWNER MIAMI SHORES PRESBYTERIAN CHURCH BY: /✓ GUf'rn -w as BUSINESS MANAGER 4,e4.../(ATTEST) Clerk of Session .s 'al 19570 PG. 4378 STATE OF FLORIDA COUNTY OF MIAMI -DADE) The fo egoing instrument was sworn to and subscribed before age this Z day of January 2001 by (1\1))d Q \N 7 as Business Manager and E/ jzt.17� - J4 a c.1i as Clerk of Session ofiami Shores Presbyterian Church, on behalf of the corporation for the purposes therein expressed. T mtlrre nersona11 known tom ) or have produced and as identification and did take an oath. DEBRA J. McCLUNE MY COMMISSION * CC 830214 EXPIRES: Apr 28, 2003 Fla Rotary Service 13, Bonding Co. My commission expires: COUNTY OF MIAMI-DADE) STATE OF FLORIDA APPROVED: ss: for Miami Shores Village this day of BY: NOTARY PUBLIC APPLICANT: OMNIPOINT HOLDINGS A Ton nn BY: D MK. A4 c,�r'� As J TacrlN tc.,40._ D ( Re� id e foregoing instrument was sworn to and subscribed before me this day of,Tanuary 2001 by a,t, ' / L)f t711) Og ,as Developer of OMNIPOINT HOLDINGS, a Delaware Corporation, on behalf of the $ . . . tion for the purposes therein expressed. They are personally known to or have produced and as identification and did take an oath. �. r f k 0-e- Teresa Blackwell MY N # CC965/60 E!(P6tES Septembers, 2004 i y Q' so menfloY FAIN Risumeat e4c y commission expires: NOTARY PUBLIC BUILDING OFFICIAL RECORDED IN OFFICIAL RECORDS BOO< OF DACE COLN7Y, FLORIDA. RECORD VERIFIED HARVEY RUVIN CLERK CIacurr ccIurT ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHARGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING • INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY 4.. OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 004 MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECT ION WATER SUPPLY TO: AIR CONDITIONERS . A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS • HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SW I W I NG POOL OUTLETS COM,IERC I AL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS GRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION . W. FT. C ATCH r r)l � p (-49 Y1 Cif$ BASIN j DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL PERMIT NO. . ADDRESS: MIAMI SHORES VILLAGE BUILDING / ZONING DEPARTMENT' SECTION BY DATE ZONING ELECTRICAL MECHANICAL PLUMBING FIRE " PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL 1. Subjad to cornpflanei with att Federal, State. Cotx%ty. VIttage Miss and regctfattc;ts. Yitlage assumes no re:panstb11(1y for accvrtcy oflar rents from those flans. 2. Thls copy at plans most be a.Yatlabte on buftding site cc no Inspection wtft ba c3ndccted, JOB ADDRESS • CRITIQUE SHEET aa ivel4 s� APPLICANT PHONE # APPUCA'fION 4- SHEET OF MISCELLANEOUS DATE COMMENTS INITIALS • NOTICE OF COMMENCEMENT 'A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Le . al description of property and street address: 2. Description of improvement: 3. Owner(s) name and address: 0'0 a 4) , E, Interest in property: Name and address of fee simple titleholder: 4. Co tractor's name and address: 5. Surety:(Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as irovided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different d e is specified) Signature � l a" /� �"�� �'° �� ) Sworn to and subscribed before me this q/ day of J DEBRA J. McCLUNE MY COMMISSION # CC 830214 EXPIRES: Apr 26, 2003 1-800-3-NOTARY Fla Notary Service & Baring Co. re a e Owner Print Owners Name Print Notary's Name .,S P. J Al `rCAA e. .Notary Public • 4 ^ E ;49" Z.00 STATE OF FLORIDA, COUNTY OF DACE I HEREBY CERTIFY that this is a ti (cowrie d in th office on P day of , AD 20 WITNESS y hand end Official Seal. . HARVEY RUjVIf�LER .. of cir� ! a ^ unty Courts D.C. By a 1R3 15.220 2001 .JUL 17 10 :43 .5o n55 Address: i 6 /(0 /i , . `GOSH Iva iG�1 vn n FL„ •3)) ACCOUNT PAYMENT (Q BAL. DUE DATE RECEIVED FROM QFOR RENT FOR O CASH F Q CHECK n MONEY ORDER .. No. 155755 s( 0- DOLLARS 7680A200 O'Wi0 /OlTOTL 60.0( 1182