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822 NE 96 St (5)MIAMI SHORES VILLAGE BUILDING DEPAIVIMENT .> 305-795-22647 Building Inspection Request Date Time Type Insp'n Permit No. i.9(..9-(2)63 . N Name 5 Address g L2 Company ff>7 Phone # For Inspector: Approved Correction Re-Insp'n Fee /7 c Name & Date j 1/ /5 , A/Ct/ M N i:5= MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Bui ding Inspection Request Dateis Time Type Insp'n I `nal Dr uQ Permit No. 6P0 Name Address Company Phone # For Inspector: Approved Correction Re- Insp'n Fee tiv5/ Name & Date 0 bnai:72, 5/dei,m4/K ® ' / ,:;)A-1( ����� VA- BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): wilding Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simplelitleholder) 1- 7,r ) L 1r 1 14 / L ■ � - t Phone # ( e z } , ° i.: Owner's Address _ --a ''j (. > - City / : ", �_. - ) ,1 , State / — - _ Zip Tenant/Lessee Name ' / ' Phone # Job Address (where the work is being done) L iU City Miami Shores Village Coun Miami -Dade Zip Is Building Historically Designated YES N Contractor's Company Name Phone # Contractor's Address ' U ■ ` ' ..„ . t `' - 2 � City -=E\ . 'lc.) L - Q 9:0AQ Qualifier 1 12 , i � cr. '0 c . r Architect/Engineer's Name (if applicable) Phone # 2, •J CC $ Value of Work For this Permit Square Footage Of Work Type of Work: ❑Addition Describe Work: CMS 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 State ` Zip �' . '� ❑Alteration ❑New Permit No. g2003 Master Permit No. ❑ Repair/Replace ❑ Demolition * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ COQ Permit Fee $ /00 ' O Notary $ Training/Education Fee $ (. 6 0 Technology Fee $ Scanning $ 3 Radon $ Bond $ YO0 CCF $ 1, 8C Code Enforcement $ Structural Plan Review. $ • 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 ab p ence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent ontractor The foregoing instrument was acknowledged before me this y The foregoing instrument was acknowledged before me this y day of 1 -.. day ,20 by , day of /C ,20 3b who is personally known to a or who has produced who is personally known to or who has produced identification and riL did • : - - .�*:ath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: / � Sign: Print — P � My Co ssion E it OFF1� IA�NOTARY S AL **************** ******09 * *2* * * * * * * * * * ** * * * * * * * * * * * * * ** NOTARY PUBLIC STATE La rLu � COMMISSION No. Dd26(kertificate of Competency Holder) MY COMMISSION EX B 19, 2005 W State Certificate or R alio itI"To. APPLICATION APPROVED BY: Chc 10/14/03 Certificate of Competency No. ***************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 41 7/63 y Commission * * * * * * ** ************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** DEC 17 2003 ntification and vho AL NOTARV SI AL AS .inset. i.CP.7 COMMISSION No. Dd2623 MY COMMISSION EXP. FEB. 19, 2005 Plans Examiner Engineer Zoning WHEREAS, Dw' R following described property: Legal description/folio #: Lot Block Subdivision Tax Folio #: requests permission to install: [1]/Asphalt, concrete, brick pavers [ Landscaping [ ] Other (owner) within the public road right of way of SIGNED. SEALED AND DELIVERED in the presence of: M iami _ Choreo (/iCCac�e 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 -2382 Telephone: (305) 795 -2207 Fax: (305) -756 -8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY , hereinafter referred to as the Owner of the 1.Ji tvt 7 n PPR 0 r4Cf - 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 pbligation 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 repres ntative). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this d /0-0°3's =STATE OF FLORIDA) COUNTY OF DADE) The undersigned Affiant, attached survey, performed by ®q performed on gn and print) ' /' 4 [iumi SIlor?� 8 C tipqa 0.S ` ..) ' , does hereby attest that the n (prope owner) vo- R . Gib 1,1,12 p a s5- c (name of survey Affiant is personally known to me, produced mPanY) is an accurate representation of the existing conditions and Affiant/Property owner Witness(sign and print) SWORN TO AND SUBSCRIBED before me this 1 1 day of C/ ,2dd" (date of surve 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.. er, Affiant sayeth naught. I" as id cation. .7i / AA. v vi.l���A , '. e Vi i' . *`' ', ,:', ;. J. ` ..)i c.Cu.J NOTE: The Nationat Ftood 1)14(1/Lance Rate Map, pubtizhed by the U.S. Department o6 Houzing and Urban Vevetopment, de.Uneate4 the henein ducnibed tAnd .to be 4ituated Zone "6". Vi f e41 Side (OCAK, I , -- • — ; PA WI k ri „. 4°- -- eS" t 0 3 izt) IS GO O rY7.7... r. r u- icb '55' ■ A ' One 822 .er 0 • crearla bt 1 1;7 o Pc.,J to . . . . A 9(0/L1 f . • • I V. poo 4 1 I I 4 • rr) 191 4:00' !"). 8 .40• r 414 8 ..ri' ii8, 9 . I -ts . 0. - c., i IN I M :4 0 • IT* 1:10t() r•tV • c. 44 ' 4 "" . . AsPhca- t,oke.,e PERMIT NO. ADDRESS: MIAMI SHORES BUILDING / ZON VILLAGE NG DEPARTMEN SECTION BY DATE ZONING ELECTRICAL MECHANICAL PLUMBING FIRE PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL 1. Subject to compliance with all Federal, St County, Wags miss Ind regutationsr. Vtaage us;s- no responslbtl(ty for accuracy offoc mutts If these plans. 2. This copy of plans most b• `Yalltbte biding site or no Inspection wtfl be condcrci JOB ADDRESS r,p2„1 iu,g.?a, 5 r CRITIQUE SHEET APPLICANT PHONE # APPUCATION SHEET OF MISCELLANEOUS DATE ZONING COMMENTS 63 . /R-05 ire z- - -- C- - - ) 5-e7 1) f&1 !\•0 \f) - S - 1\)... I.\ �pp fc:1,6,.,30.,„ (Al.sk .:(s-s.szes. _ v co ,zu . 1 Cav, C� l ac ; .r A - 4 - 'V cR._o ra_ g____ cY al,::,.. . .,', r‘ss. -s 1-1 , 51 03 0 Arm E1`75t0 (=0'2 ia/Lo is ot.4 r of 5CAt - TO t. at` (2 i °) /6c r c wax-5 neP/QoJrrc. kv cv .Q F9g c! u ecv . 0 login El-- is inJ 5 the sr l''Anck. 014" 61v iq.0-4 • 111 lNflTl LS Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12/18 /2003 Applicant: THOMAS Owner: HURST JOB ADDRESS: 822 NE Fees: FEE2003 -8425 FEE2003 -8426 FEE2003 -8427 FEE2003 -8428 FEE2003 -8429 FEE2003 -8430 96 Description Building Fee CCF Training and Education Fee Technology Fee Scanning Fee Builders Bond Total Fees: Signed: (INSPECTOR) Building Permit Permit Number: BP2003 -1912 HURST THOMAS ST Contractor ICOA CONSTRUCTION Contractor's Address: 1101 S.W 18 COURT Local Phone: 786- 326 -4041 Amount $100.00 $1.80 $0.60 $2.50 $3.00 $300.00 $407.90 Permit Status: APPROVED Permit Expiration: 6/6/2004 Construction Value: $2,380.00 Work: STAMPED CONCRETE DRIVEWAY Page 1 of 1 Parcel # 1132060142910 Legal Description: MIAMI SHORES SEC 3 PB 10 - LOTS 7 & 8 BLK 75 LOT SIZE 100.000 X 142 OR Total Fees: $407.90 Total Receipts° Go 3.s1 V 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: