800 NE 97 St (9)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bui ding Inspection Request '}. 0�
\
Date
Correction
Type Insp'n i o (cd DI(
Permit No. ABP 05 224
Name L\ nd
Address !I •+ 04 S
Company OCO1
Phone #
Inspection Date 4
Re- Insp'n Fee ❑
MIAMI SHORES VILLAGE
,- BUILDING DEPARTMENT
305- 795 -2204
Building inspection Request
Date h
Type Insp' n C, , ( `PryjeCJq, 'r' r)
Permit No. P' CS ° D
Name nci
Address t (0 4
Company
` � i
Phone # i '759 — '9C>19 � ,v
Inspection Date
C2 co pi
Approved
Correction ❑
Re- Insp'n Fee ❑
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED 0 THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO.
STATE OF FLORIDA:
COUNTY OF MIAMI -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. Legal description of property and street/address: L0T 1 &LOC 1 eve N / 06 S 1 a
.5uP.,a 'Os (ox) AGcv, -A/ J6 To i4iE ,°L,4i r 9 ' Ffs ecce JET I N
PUT LOOK Lfy- /-T P,46C 5 OF 7NC Purauc ;ecooJs c9I
2. Description of improvement: 1 Lie 14 1- 1A L-T l2.t PP.A L4 W (i2x 4 �N
(a x(.9 Pig ✓ E - i Z s , D D 3 ' v.) t1 L-K w A y OIL) WEST c2-10E
3. Owner(s) name and addres 021_424 1 A L/ DE Ma S lu E (o4 ( f
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address: 0 W iU I
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
provided by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, Owners 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
differ erj( date is Specifi
Sign+§ture of 0 er
Print Owner's Name fS'Loi. ► A
Sworn to and subscribe
Notary Public
Print Notary's Nam
My commission ex
123.01 -52 PAGE 4 8/02
FOLIO NO.
L I p P F iJ 11��--,, dos re me this(/ / day of To? , .
4 Address: / / & A/C/o4 S/
Tres:
: Commission - DD2319
Expires: u, - , 0
Bonded That
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CFN 2005RO1179848
OR Bk 23106 P9 3914 °? (1ns)
RECORDED 02/23/2005 12:05:22
HARVEY RUVIN? CLERK OF COURT
MIAi1I -DADE COUNTY? FLORIDA
LAST PAGE
Prepared by C,"�' /l / � /-) CA
BUILDING
PERMIT APPLI CATION
FBC 2001
Permit Type (cirr):
7 .- -
uilding" Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) 4- .0 it 1 A L i ?k: DE t- Phone # 305 - 7 5 ` 01
Owner's Address ! 1(015 i v e 1 014. J i
City 11 5 440 &S State FE Zip .3 )3F 2 .,(0 5 - 7
Tenant/Lessee Name Phone #
Job Address (where the work is being done) I ibc tjC 0 S 1
Citv Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO vc
Contractor's Company Name 0 WPC 12 Phone # 3 0 ' 7 59 — q (2
Contractor's Address A v'b1 C
City State
Qualifier
State Certificate or Registration No.
$ Value of Work For this Permit ` ' f C 00: c c�
Notary S
Scanning $
3
Code Enforcement $
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida,33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Fee $
Architect/Engineer's Name (if applicable)
Training/Education Fee $ r r 1 1 - G
Permit No.
aster Permit No.
Zip 33 i ?� S ' — ( L 3 - 7
Square Footage Of Work: Pt'k r X , 1 L Cam'
Type of Work: ❑Addition ❑Alteration ❑New [!' Repair/Replace ❑ Demolition
Describe Work: e v i v 1. E : 7 " 4 S P 1 4 ) LT j ? t VCW',, \/ F C_ A 4 : 1 1 1
(.0 X 9 (.0 to PAvc LKLA) y e ►rte' iu r
j6)C
* ** * * ** * *** * * * * * * * * * * * * * * * ** F ees * * * * * ** ** * * * * * * * * * * * * * * * * * ** **
Submittal Fee $ )
CCF $ y-c CO /CC
Technology Fee $ 7
Radon $ Zoning "° Bond $ 3e
Structural Plan Review. $
V
• ;y
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip 4
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 absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature �i Signature
�( a
Owner or A ent Contractor
The foregoing instrument was acknowledged before me this 15 The foregoing instrument was acknowledged before me this
day of 1 , 21;CL, by (Q lG‘ ( L1 Ct -' d9y of , 20 _, by
who is personal own to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY
Sign:
Print:
My Co ssion Expires:
APPLICATION APPROVED BY:
Chc 05/13/03
NOTWV PUBLIC:
Sign:
Print:
* * * * * * * * * * * * * * * * * * * * * * * ** * * * ** ******************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
*************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** f ************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
FEB 17 SO
My Commission Expires:
Plans Examiner
Engineer
Zoning
'STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant,
attached survey, performed by
performed on
( to of survey)
6 l.0Al L NDE/" , does hereby attest that the
(property owner)
V1 S c yA LJNb 5 YOu2S, � 61�C-
(name of surveyor'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..
Further, Affiant sayeth naught.
Affiant is personally known to me, produced
Witness(sign and print) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this 0 S day of o
as identification.
Produced >
Owner
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE .STATEMENT
I LA
ICI L1 being the legal property owner, for the property
Located at: 61(e5 NE 104 S I
Legally described as Lai 1 BLK 1 EVE I N &SWD6.508 1V SIOAI PLA T q4 PA &
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the
State of Florida, F.S. 489.103(7),sgnd I have read and understand the following disclosure
Statement, which entitles me to' allork as my own contractor, I further understand that I as the owner
must appear in person to complete all applications.
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor
even though you do not have a license. You must supervise the construction yourself. You may build or
improve a one - family or two- family residence or a farm out - building. You may also build or improve a
commercial building at a cost of $25,000.00 or less. The building must be for your own use and occupancy. It
may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the
construction is completed, the law will presume that you built it for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure
that people employed by you have licenses required by state law and by county or municipal licensing
ordinances. Any person working on your building who Is not licensed must work under your supervision
and must be employed by you, which means that you must deduct F.I.C.A. and with- holding tax and
provide workers' compensation for that employee, all as prescribed by law. Your construction must comply
with all applicable laws, ordinances, building codes and zoning regulations.
Proof of ownership provided ( ) initial of reviewing clerk. Tlie foregoing instrument
Was acknowledged before me this _ day of _.mow! 20
L .% j 13y _�� � • � rho is personally known to me or who has
DISCLOSURE STATEMENT
may— • as identificati- - : d who did take an oath.
I
1i i
Notary
' - commis ' on DD g lg /� g y 4
9: C � Expires 1 , 2(10 /
'bonded Thru
Atlantic Bonding Co Irr
WHEREAS, & LNG / , L I AU E , hereinafter referred to as the Owner of the
(owner)
Tax Folio T:
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
following described property:
Legal description/folio#:
Lot 1 Block I Subdivision C /e 1J l ,U S
requests permission to install:
[t�Asphalt, concrete, brick pavers
[ ] Landscaping
[ ] Other
M iami S/jorej W/
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 -2382
Telephone: (305) 795 -2207
Fax: (305)_756 78972
within the public road right of way of 1 I(0 N E 1 014 S 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 s d day of
SIGNED. SEALED AND DELIVERED in the presence of:
APPRo4cH-
Pik (306) 223 -8050
FAX: (305) 223 -4007
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1165 N.E. 104th ST., NM. FL.
umgatEscgingt LOT 1 8U( 1. EVENTNGSIDE SUBDMSIN ACCORDING TO THE PUT THEREOF.
AS RECORDED 04 RAT 800K 44 AT PAGE 53 OF THE PUBLIC RECORDS OF MIAMI -DADS COMM', Fl.
RTIF1ED TD; DANA AND GLORIA UNOEN
SKETCH OF BOUNDARY SURVEY
SCALE: 1• = 30'
21.70 RESIDENCE
No. 1165
F.F. Elev. 9.60
Geroge
Elev. 9.20
38.50' 1
............................
CANAL
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DATE 02 -02-08
JOB. No.
004r
R TOhoc
P.LS.N. No.3102
STATE OF FLORIDA
RESSM 01(
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: BP2005 -224
Printed: 3/2/2005
Applicant: DANIEL LINDEN
Owner: LINDEN DANIEL
JOB ADDRESS: 1165 NE 104 ST
Contractor
Local Phone:
Parcel # 1122320290010
Legal Description: EVENINGSIDE PB 44 - 53 LOT 1
Fees: Description Amount
FEE2005 -2696 Building Fee $150.00
FEE2005 -2697 CCF $0.60
FEE2005 -2698 Notary Fee $5.00
FEE2005 -2699 Training and Education Fee $1.40
FEE2005 -2700 Technology Fee $3.75
FEE2005 -2704 Scanning Fee $3.00
FEE2005 -2708 Builders Bond $300.00
FEE2005 -2713 Submittal Fee ($50.00)
Total Fees: $413.75
Total Fees: $413.75
Total Receipts: $0.00
NAIL U 2 PAS
c.c.
Permit Status: APPROVED Permit Expiration: 8/15/2005 Construction Value: $7,000.00
Work: REMOVE ASPHALT DRIVEWAY & REPLACE WITH PAVERS AS PER SURVEY ATTACHED
Signed:
(INSPECTOR)
Building Permit
Contractor's Address:
Page 1 of 1
BLK 1 LOT SIZE SITE VALUE OR
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: