BP-03-1404i
. c 1 -1 -0
305-- '\\' ° PERMIT LIGATION FOR MIAMI SHORES VILLAG 1
*LIGATION
Date 8 I I Job " - 2 tt %' S +r 4- 4 Tax Folio
[v' I i it - ice _F
Legal Description
Owner/lessee / Tenant PV
Owiier's Address 1\1 6 r� VS 11
Contracting ColsoailiiucTtot Cottc b ' tD c. Address 2 1b � V1 4 2 Qz_
Qualifier 4Mv-,tn.
sue # CCxG 0 3 I 13 Municipal #
A r c h i t e c t / E n g i n e e r ARcl.e. _ r c L44 r:�V k ( ry
Bondin Comp K ( A
Mortgagor 1 IA-
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING
WORK DESCRIPTION /id-7 � / -~ c , ,- - '' '40 0
Square Ft.
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 F,I P.CTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK
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. Furthermore, I authorize the above -named contractor to do the work stated.
Signature o or Condo President ate
e ac&b9A
Notary as to'O veer and/or Condo President
My Commission Expires: _
BEYERLYA COWAN
ft% ' MY COMMISSION # CC 927880
• EXPIRES: April 13, 2004
!Ondetihiu Notary Public Undeiw ,s
FEES: ,PERMIT' cO . • RADON
APPROVED:
F/
Historically Designated: Yes No
PA-4 641 � Phone c91) ■ 32 - 6S2.1
3 02
ss#
Co. DNS G�R"� .
Address 429 L G7[/VG\ , r:,2,4 4s'
Address
Address
Estimated Cost (value)
Ct.
Signature of Contractor or er -Buil
�- as to Contra • /r or Own
y Commission Expires:
C.C.F. . \I 0 NOTARY
SEP 112003
11 -3 - 01 '- 1`1
Master Permit # l J P d 3. 1'1'Q''I'
BOND
TOTAL DUE
FENCE SIGN
12
2/0 2./o
Date
m+3
JANETRYDER
IA) x MY COMMISSION S CC 908718
'0 P EXPIRES: April 23, 2004
;COP Bonded ThrnNoffiry Underwriters
j. electrical
Mechanical Plumbing Engineering
3O.00flpp Fee MC
I= LOTT
COMPANIES
LOTTERMAN Deve�ovnei
COMPANIES
LOTTERMAN DEVELOPMENT COR. . CGC#5807
CONSTRUCTION MANAGEMENT /OWNERS REPRESENTATION
CONSULTANTS /GENERAL CONTRACTORS/ENGINEERING
C4 0 CHARLIE ADAMS
SITE DEVELOPMENT MANAGEMENT
305 - 446 -8002 EXT. 103
FAX 305 -446 -0840
EMAIL- cadams @lotterman.com
2511 PONCE DE LEON BOULEVARD
SUITE 200
CORAL GABLES. FL 33134
MIAMI SHORE IJ1 LAG
BUILDING DEPTMENT
305 - 795 -2204
Building Inspection Request
Date 1 r' 0 3 Time AA1
Type Insp'n i--t r0-I , /`P t,(c
Permit No. EP 0 3 14
Name Cure le)
Address Ian '4- l4 E Q6 5T '
Company
Phone# 9S� - 3; S
For Ins
Re- Insp'n Fee
Won (�j� I 0 -20- 0 —Name & Date
on:ection ❑
0 I
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON .THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. SP S4 to
STATE OF FLORIDA:
COUNTY OF DADE:
2. Description of improvement:
4. Contractor's name and address: 5
6. Lender's name and address:
TAX FOLIO NO. l)''J` .c Co - 01 L-14t0
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: (p n a kJ qui 1 ‘,5 1 a - I
3. Owner(s) name and address: Pa T S2 )' (—Q
t i c tO fit- ve.. 14\ \v + v� If F L. bN
Interest in property: Lej YvL\
Name and address of fee simple titleholder: M 6
0 02. P7 E q. L9' St r-e r t 1 �•
S1Arhh OF q-(' OF
5. Surety:(Payment bond required by owner from contrgiebe,Wilair Y that tins is a tru.o or the
da OP
original fade fhas o Pica on
Name and address: L .�
Amount of bond $
WITNESS my hand and Official Seal.
HARVEY RUVI ' Ric, or c'r . as
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:
6. 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 date is specified)
7
Signature of Owner
Print Owner's Name S t- cX, 1, �P, s e-
Sworn to and subscribed before me this A day 20 03
REGA
/�� _., MY COMMISSION M. CC 999115
Notary Public [�..T►.L I *. 25 2005
Print Notary's Name U ZPt-A if RC
My Commission Expires 5740 6
te
0038203 827 2003 LIAR 27 14:41
." TL,
E:A
Prepared by IA.t\s'1
Address: H2O \ iD' Ctsr L i
Removal
ve ' I
er
ecIdng Sal I
w e t M ethod
I I
*Dry Method Ii --- �'
Bu m Dolan
OTHER
•
Florida Department of
Environmental Protection
Division of Air Resources Management
vamoriffivair
NOTICE OF ASBESTOS RENOVATION OR DEMOLITION
TYPE OF NOTICE (CHECK ONE ONLY): • ORIGINAL
TYPE OF PROJECT (CHECK ONE ONLY): 0 DEMOLITION
IF DEMOLITION, IS IT AN ORDERED DEMOUTION?
IF RENOVATION:
IS IT AN EMERGENCY RENOVATION OPERATION?
IS IT A PLANNED RENOVATION OPERATION?
VII. Asbestos waste Transporter. Name c&c waste co.
Address 15447 n.w. 97 ave.
city miami state florida
VIII.
Waste Disposal Site: Name C &C waste co.
Address 15417 n.w. 97 ave.
city miami tate o florida
1 "^ount of RACM or ACM - ' /7
square feet surfacing material
linear feet pipe
cubic feet of RACM off facility components
square feet cemerditious material
square feet resilient flooring
420 square feet asphalt roofing
0 REVISED 0 CANCELLATION
■ RENOVATION
0YES NO
0 YES
0 YES
`MUST OBTAIN PRIOR DEP APPROVAL. BEFORE USING A DRY METHOD
VI. Procedures for Unexpected RACM: wet method
■ NO
■ NO
zip 33014
Cass
o r m DEP F m6225r.soo(1)
Effective 2 -9-99
Page 1 of 2
0 COURTESY
I. Facility Name Miami Shores Presbyterian Church
Address 602 NE 96 Street
city Miami Shores state Florida zip 33138 County Dade
Site Consultant Inspecting Site
Building Size 420 (Square Feet) # of Floors 2 Age in Years 21
Prior Use: 0 School/College/University 0 Residence 0 Small Business IN other Church
Present Use: 0 SchoovCollege/University 0 Residence 0 small Business ci other Church
II. Facilittyowner Miami Shores Presbyterian Church Phone ( 305 )
Address 602 NE 96 Street
city Miami Shores state Florida zip 33138
111. Contractor's Name John Busta Roofing, Inc. Phone (305 ) 219 -9699
Address 300 NE 91 Street
city Miami Shores state Florida zip 33138
Florida License No. CCCO58048 Is the contractor exempt from licensure under section 469.004(7), F.S.? ❑ YES • NO
IV. Scheduled Dates: (Notice must be postmarked 10 working days before the project start date)
Asbestos Removal (mm/ddyy) Start:01 /04 /2005 Finish: 01/05/2005
Demo/Renovation (mm/ddyy) Start Finish:
V. Procedures to be Used (Check M That Apply):
Phone (305 ) 823 -1125
Zip 33014
X. Fee Invoice Will Be Sent to Address in Block Below: (Print or Type)
I cerldy that the above information is correct and that an Individual batted In the provisions of this regulation (40 CFR Fart 61,
Subpart M) wit be on-site during the demolition or renovation and evidence that the required baiting has been accomplished by
A7/77 wilt variable for inspect during normal business hours.
(Signature of Owner /Operator) (Date)
I DEP USE ONLY
Postmark/Date Received
ID#
r
—
, • • • ; Ar4, "IA*7 Amak-wmf.kareporoom.....ann.,mma, xtudt . • rigt
7 , 1 i & "T
1
1 -V '. '
PLAN REVgiEW c'ErPON
APR 11,
-1
This is to certify Vint th e. re,q;nired notification(s)
regarding asPoeVos txave bs?,n tyabraqted ki
compliance with app!iezWe reguladons
Reviewed By:
Signature:
SP
dve
Date.
Iriaz L Z 33
3A03031,6;
DATE:
TO:
FROM:
10050 NI 2'l Ave
Miami Shores 33133-2332
305 -795 -2209
Skoara 4/tP.P.ag.e
FAX TRANSMITTAL
Number of Pages Including Cover
MESSAGE:
•
FAX tvS) ' &‘ y . 0.
•
FAX: (305)756 -8972
1•i
Miami Shores Village
Building Department
BUILDING CRITIQUE SHEET
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel:(305) 795.2204
Fax: (305) 756.8972
Permit Noy 0 6,09 —/ Of
•`Job'Name
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. 1??2_0673 —1 9 G':-I
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
ST^ TF OF FLORIDA, COUNTY OF DADE
n�� Y GE/II-AY/Nat thi y • hp apr of the
a -;lwat *lard et Ube office en 161
day car
--- et4.6440- , AO 20 0 _.
TA'ESS ray hand and Othc;e/ Seat.
HAAVEY RIMro, CUM, aore* cowgCam*
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: (' () t C (0 +-1- ' - f • s et 11c /v. i r
iNi 1 i f t> >-z c Z I�L� (O -3 7 L-v-f l• r JJ , L-1c. ® C l
2. Description of improvement:
TAX FOLIO NO. I[ Z — '/ - (LI (0
3. Owner(s) name and address: /' 7 T 7 fi✓r /e /ccs .- - i'e "s '
.2 • - • Y O f" / Ii " i y 2: 5 �- 5
Interest in property:
Name and address of fee simple titleholder: /L/r, - k - ¢ '/-e• tev A
4. Contractor's name and address: [ r ./ s Div c 7 //04 . � v/' t e S' o 1 ' ' ' f/ G 1
r
x /70 - /7e' 74- . �--
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address: A-; `A
Amount of bond $
6. Lender's name and address: /V
7/9
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
different date is specified) ' Z- /c, /
Signature of Owner
Print Owner's Namel ter/
Sworn to and subscrib- - .efore me this /Cday of
Notary Public
Print Notary's Na
My commission expires:
123.01 -52 PAGE 4 8/02
c01
3 1/57 a-t>06:
D.C.
d j / A./
IIIIIIIVIIIVIIIVIIIVIIIIIIIIHIIIIIIIII I'
CFN 2003R068? 93
OR Bk 21652 Ps 3951; (1Ps
RECORDED 09/16/2003 13:35:35
HARVEY RUVII'dr CLERK OF COURT
MIAMI-DADE COUNTY, FLORIDA
LAST PAGE
f ) Prepared by
20 03.
a
"r'' ARTHUR WEBER Ad•.eSS: 2J'/ � y✓Le ��= `1 avo
'It Notary Public - State of Florida l,441_ ‘464471 �. , L ) 3 /3 y
•= mvCommi , F, .,. ue. ar
Commission if DO 097524
iy Assn