DRIVEWAYInspection Date: 07/03/2006
Inspector: Grande, Claudio
Project: <NONE>
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POP ...:.
Owner: DUMAS, YIANNIS & VERONIC
Job Address: 1179 98 Street NE
Miami Shores Village, FL 33138-
Contractor: HOME OWNER
Building Department Comments
Friday, June 30, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
JUL 0 6 ENT
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Block:
Phone Number
Parcel Number 1132050180290
Lot:
Page 1 of 2
1
Passed
1 j D A P
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Inspection Date: 07/03/2006
Inspector: Grande, Claudio
Project: <NONE>
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...................
...................
POP ...:.
Owner: DUMAS, YIANNIS & VERONIC
Job Address: 1179 98 Street NE
Miami Shores Village, FL 33138-
Contractor: HOME OWNER
Building Department Comments
Friday, June 30, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
JUL 0 6 ENT
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Block:
Phone Number
Parcel Number 1132050180290
Lot:
Page 1 of 2
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Issue Date: 6/5/2006 Expires: 11/20/2006
Owner's Name: YIANNIS & VERONIC DUMAS
Permit Type: Driveways /Sidewalks /Slabs
Work Classification: New
Job Address: 1179 98 Street NE
Miami Shores Village, FL 33138-
Contractor(s) Phone Primary Contractor
HOME OWNER
Yes
Comments:
CHANGE TILE OF FRONT STEPS TO COROLINA STONE
Additional Information
Type of Work: FRONT STEPS Additional Info:
Bond Return :
Classification: Residential
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 responsibility for all work done by either myself, my agent, servants, or
employes. I understand that separate permits are required for ELECTRICAL,
PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING
POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work
stated.
Fees Due Amount
CCF $0.60
Education Surcharge $0.20
Notary Fee $5.00
Permit Fee $100.00
Scanning Fee $3.00
Technology Fee $2.50
Total: $111.30
Building Department File Copy
Applicant Signature
Permit Status: APPROVED
Permit Number: DS -5 -06 -1397
Phone:
Parcel #: 1132050180290
Block: Lot:
Section: PB:
Total Square Feet: 70
Total Valuation: $ 600.00
Required Inspections
Foundation
Sidewalk
Landscaping
Final
Invoice Number
DS - 6 - 06 - 25068
Total:
Amt Due
$111.30
Amt Paid
M 0 6 P
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
BUILDING
PERMIT APPLICATION
FBC 2004
Owner's Name (Fee Simple Titleholder) t.,
Owner's Address 7/7 /1-) 9a' 4
City iY(Ai4/ Sr'D4t 5 State GL
Tenant/Lessee Name
Architect/Engineer's Name (if applicable)
Type of Work: ['Addition ❑Alteration
Bond $
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel (305) 795.2204 Fax: (305) 756.8972
BY:
,5 7 .
•
f
Is Building Historically Designated YES NO
Submittal Fee $ Permit Fee $ 6 OD '
Notary $ ' co Training/Education Fee $ • 2-7
Permit No.b . 12 11
Master Permit No.
Permit Type (circle)/Building• Electrica Plumbing Mechanical Roofing
Phone #
Zip .3.51
Phone #
Job Address (where the work is being done) 5 , ;'7_? S `r !, (--'e._
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Contractor's Company Name (2 //(f .N Phone #
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Code Enforcement $ Double Fee $
Phone #
Value of Work For this Permit $ 6 0 Square / Linear Footage Of Work:
['New pair/Replace ❑ Demolition
Describe Work: C"" d''i/ �' /CJ Q ,47 r� �-; �� S Cc / //�Cr° — 54,t12
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CCF $ 0 .(0 0 CO /CC
Technology Fee $ Z eD
Scanning $ 3 • 00 Radon $ DPBR $ Zoning $
Structural Review. $ Total Fee Now Due $ 1 '�
See Reverse side —)
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 absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature \. - %7 _ Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this :74-_ The foregoing instrument was acknowledged before me this
day of �l :�� , 20(.,•byU VC`l' - 1"i CC .L Y1C). \day of , 20 , by
who is ers nal�'y�cnown to me or who has produced who is personally known to me or who has produced
L C k As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commissi
• Expires: '
* * * * * * ** * * * * * * * * * * * **
APPLICATION APPROVED BY:
(Revised 02/08/06)
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
************************************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
VILLAGE OF MIAMI SHORES
OWNER BUILDER DISCLOSURE STATEMENT
NAME: )eaitJ /G4 /Jt1/W1 S • DATE:
ADDRESS: /J ,I 987
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). And Ihave read and understood the following disclosure
statement, which entitles the to work 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 a licensed contractor. You have applied for a
permit under an exception to the 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. 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 complete, the law will
presume that you built for sale or lease, which is a violation of this exemption. You may not hire
an unlicensed person as a contractor. It is your responsibility to make sure the 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 underyour supervision and must
be employed by you, which means.that.you must deduct F.I.C.A and with - holdings tax and •
provide workers' compensation for that employee, all as prescribed by law. Your construction
must comply with all applicable laws, ordinances, buildings codes and zoning regulations.
Please read and initial each paragraph.
1. I hold title to the above property and I am planning on doing this construction
Initial /8
2. I understand that as an owner - builder I must abide by all zoning ordinances and
building regulations in effect at the time of permit application
Initial KO
3. .I have an understanding of the 2004 FBC & FRC and understand that this
department and its inspectors are there to help enforce and interpret the code.
There is a copy of the code in this office for review.
4. I' understand that the building official
alter or give advice on how to meet
minimum code.
Initial
and inspectors are not there to design,
code —. only if the structure meets the
Initial //C-)
5. I understand that as an owner - builder, that any contractor disputes with sub-
contractors and myself must be handled in a civil court with the advice of an
attorney. The department will not mitigate'any contract disputes.
Initial
6. I understand that if I compensate any person or company for work performed
they are required to have a business license in the county. If for any reason they
do not posses a business license I will be responsible and liable for any wrong
doing from this unlicensed company-or person.
Initial
7. tunderstaiid that if any person.gets injured on my construction project —they are
entitled to workmen's compensation. And if they do not posses a workmen's
policy I could be held liable for all doctor and related cost which could include
loss of wages during recovery from injury.
Initial
8: I. understand that under state and local laws I can not do any Electrical,
Plumbing, Heating, Air & Roof work on my•property with out first obtaining
the proper permits by licensed contractors.
I nitia l
Was acknowledged before 'me this Z4 day of ► 20 (
By \YtDY) C_C2( CL .S who was personally known to me or who has
Produced there License or Lc
as identification.
•
locations of all structures on the property as of this date.
Affiant is personally known to me, produced
'STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant, YE /Ciq , does hereby attest that the
(property owner)
attached survey, performed by A/ e 494r/ac
name of surveyor's company)
performed on 7 , is an accurate representation of the existing conditions and
(date of survey)
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.
Witness(sign and print) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this 2 4day of
Affiant/Property owner
L�
as identification.
Date Time
Type Insp'n
• Permit No. — / , t l / /
1/4--f,j n."----' i
Address ✓ V e ) j"
Company
Phone #
-1/ ,) /1 // 8
For Inspector: 1 0 o Name & to
G r 17/ 12.x_
Name
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Type Insp'n
Permit No.
Compan
Phone #
For Inspect :
Approved 1 /
Correctio
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Time
7
, 0 2 (9Oc
Date
f
r° Name Address/ / N 5 g-/
o
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 11/19/2002
Applicant: RICHARD
Owner: CHATTERTON
JOB ADDRESS: 1178 NE 98
Contractor PERFECT PAVERS
Local Phone:
Parcel # 1132050180400
Fees:
FEE2002 -6583
FEE2002 -6584
FEE2002 -6585
Description
Building Fee
CCF
Builder's Bond
Total Fees:
Amount
$85.00
$3.00
$300.00
$388.00
Total Fees: $388.00
Total Receipts: $0.00
Permit Status: Approved Permit Expiration: 5/18/2003 Construction Value: $4,784.00
Work: INTERLOCKING BRICK PAVERS ON DRIVE WALK WAY & PATIO
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
This Permit is granted to the contractor or builder named above to construct the b
ordinances pertaining thereto and with the understanding that the work will be perfom
and approved by the proper municipal authorities. This Permit may be revoked at an
authorization. A further condition upon which this permit is granted is the understandi
ordinances and regulations pertaining to the work covered hereby whether shown on
by his agents, servants or employees.
Signed:
(INSPECTOR)
Building Permit
Permit Number: BP2002 -1999
(Contractor or BL
CHATTERTON
RICHARD
ST
Contractor's Address: 528 NW 1 AVE
Legal Description: REV PL MIAMI SHORES SEC 8
2
2
5
i
In consideration of the issuance to me of this permit, I agree to perform the work co
with the plans, drawings, statements or specifications submitted to the proper authoril v!
myself, my agent, servants or employes.
A
Q
ijonnw C/ coil
. 964-781 -8082
2d � fb 2O9
2.on /aiw caC4 8806
A
ORDER OF TO THE
WASHINGTON MUTUAL BANK, FA
POMPANO BEACH FINANCIAL CENTER 1765
2401 E. ATLANTIC BLVD
POMPAN! BEACH. FL 33062
1 -800 -7
24 HO OMER SERVICE
Page 1 of 1
PB 43-69 LOT 23
63- 8413/2670
DATE
.: 267'b84 L3 LI:83 L11109 7 2 3 7 111 311' 378 L
BLK 180 LOT
3781
/6 2—
DOLLARS B buSwa
b.
5582 N.W. 7th STREET, SUITE 202
MIAMI, FLORIDA 33126
TELEPHONE: (305) 264-2660
FAX: (305) 264 -0229
DRAWN BY: f ._
Survey of Lot: 23 Block: 180
Subdivision: REVISED PLAT OF MIAMI SHORES SECTION 8
According to the Plat thereof as recorded in the Plat Book No. 43
at Page No. 69 of the public records of MIAMI -DADE County, Florida.
Property Address: 1178 NE 98 ST, MIAMI, FL 39138
For: RICHARD CLAUDE CHATTERTON
A = ARC.
NC = AIR CONDITIONER PAD.
A.E.. ANCHOR EASEMENT.
A/R = ALUMINUM ROOF.
NS . ALUMINUM SHED.
ASPH. = ASPHALT.
B.C.. BLOCK CORNER.
BLDG. • BUILDING.
B.M. BENCH MARK.
8.0.8. = BASIS OF BEARINGS.
C. • CALCULATED.
C.B. = CATCH BASIN.
C.B.S. = CONCRETE BLOCK
STRUCTURE.
CBW = CONCRETE BLOCK WALL.
CH.. CHORD DISTANCE.
CH. B. = CHORD BEARING.
CL.. CLEAR.
C.L.F. = CHAIN LINK FENCE.
C.M.E.. CANAL. MAINTENANCE
EASEMENT.
CONC.. CONCRETE.
C.P.. CONC. PORCH.
C.S. = CONCRETE SLAB.
D.E.• DRAINAGE EASEMENT
D.M.E. = DRAINAGE MAINTENANCE
EASEMENT.
DRIVE.. DRIVEWAY.
o . DEGREES.
E.. EAST.
E.T.P. • ELECTRIC TRANSFORMER
PAD.
ELEV.. ELEVATION.
ENCR. =ENCROACHMENT.
F.H. = FIRE HYDRANT.
F.I.P = FOUND IRON PIPE.
F.I.R.. FOUND IRON ROD.
F.F.E.. FINISHED FLOOR
ELEVATION.
Nona ffitrurvirs Jim
LAND SURVEYORS
LOCATION SKETCH Scale 1" = /Vr,
N.E-
16
98
18
ABBREVIATIONS AND MEANING
F.N.D.. FOUND NAIL 8 DISK
FR.. FRAME.
FT.. FEET.
FNIP. = FEDERAL NATIONAL
INSURANCE'bROGRAM.
F.N. = FOUND NAIL.
H.. HIGH (HEIGHT).
IN. 8 EG.. INGRESS AND EGRESS
EASEMENT.
L.P.. LIGHT POLE.
L.F.E. = LOWEST FLOOR
ELEVATION.
L.M.E.. LAKE MAINTENANCE
EASEMENT.
' = MINUTES.
M. = MEASURED DISTANCE.
MON. = MONUMENT.
M/H.. MANHOLE
M/L. = MONUMENT LINE.
N.A.P. = NOT A PART OF.
NGVD= NATIONAL GEODETIC
VERTICAL DATUM.
N. = NORTH.
N.T.S. • NOT TO SCALE.
4 - NO. = NUMBER.
0 /S.. OFFSET.
OH. = OVERHEAD.
O.H.L. OVERHEAD UTILITY LINES
OVH.. OVERHANG.
O.R.B.- OFFICIAL RECORD BOOK.
PVMT.. PAVEMENT.
PL.. PLANTER.
P/L.. PROPERTY LINE.
P.C.C.- POINT OF COMPOUND
CURVE.
P.C. = POINT OF CURVE.
PT.. POINT OF TANGENCY,
POC. - POINT OF COMMENCEMENT
P08. - POINT OF BEGINNING.
13 1 19
BLOCK
P.R.C. = POINT OF REVERSE
CURVE.
PROP. COR. = PROPERTY
CORNER.
P.B. = PLAT BOOK.
PG.. PAGE. -
PWY = PARKWAY.
PRM . PERMANENT REFERENCE
MONUMENT.
P.L.S. . PROFESSIONAL LAND
SURVEYOR.
R.. RECORDED DISTANCE.
RR.. RAILROAD.
RES.. RESIDENCE.
RAN. . RIGHT- OF•WAY.
RAD. RADIUS OR RADIAL.
R.P. = RADIUS POINT.
RGE.. RANGE.
SEC. = SECTION.
STY.. STORY.
SWK.. SIDEWALK.
SET IRON PIPE L.B. 46044
S.. SOUTH.
S.N.D.. SET NAIL E. DISK L.B.46044.
SP.= SCREENED PORCH.
" = SECONDS.
T. = TANGENT. •
TWP.. TOWNSHIP.
U.E. = UTILITY EASEMENT.
• UTIL . UTILITY.
U.P. = UTILITY POLE.
W.M. . WATER METER;
W.F.. WOOD FENCE. .
W.S. = WOOD SHED. •
D = CENTRAL ANGLE.
W. - WEST.
C - CENTER LINE.
X- = ANGLE.
LEGAL NOTES TO ACCOMPANY SKETCH OF SURVEY (SURVEY):
EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED
INSTRUMENTS, IF ANY, AFFECTING THE PROPERTY. THIS SURVEY IS SUBJECT TO DEDICATIONS,
LIMITATIONS, RESTRICTIONS, RESERVATIONS OR EASEMENTS OF RECORD. LEGAL DESCRIPTIONS
PROVIDED BY CLIENT OR ATTESTING TITLE COMPANY.
BOUNDARY SURVEY MEANS A DRAWING AND/OR A GRAPHIC REPRESENTATION OF THE SURVEY WORK
PERFORMED IN THE FIELD, COULD BE DRAWN AT A SHOWN SCALE AND/OR NOT TO SCALE.
EASEMENTS AS SHOWN ARE PEFC1'LAT BOOK, UNLESS OTHERWISE SHOWN.
THE TERM 'ENCROACHMENT' MEANS VISIBLE AND ABOVE GROUND ENCROACHMENTS.
ARCHITECTS SHALL VERIFY ZONING REGULATIONS, RESTRICTIONS AND SETBACKS AND THEY WILL
BE RESPONSIBLE OF SUBMITTING PLOT PLANS WITH THE CORRECT INFORMATION FOR THEIR
APPROVAL FOR AUTHORIZATION TO AUTHORITIES IN A NEW CONSTRUCTION, UNLESS OTHERWISE
NOTED, THIS FIRM HAS NOT ATTEMPTED TO LOCATE FOOTINGS AND/OR FOUNDATIONS.
FENCE OWNERSHIP NOT DETERMINED.
THIS PLAN OF SURVEY, HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF THE ENTITIES NAMED
HEREON, THE CERTIFICATE DOES NOT EXTEND TO ANY UNNAMED PARTY:
THE FNIP FLOOD MAPS HAVE DESIGNATED THE HEREIN DESCRIBED LAND TO BE
2
OA I.
ST. „
.2i
0.00 X
SHEET NO.
Situated in Zone: X Community /Panel /Suffix: 120652 - 0093 -J
Date of Firm: 07/17/1995 Base Flood Elevation:
Certified to: RICHARD CLAUDE CHATTERTON AND JEAN CLAUDE FRANZ
US TITLE SERVICES, INC.
COMMONWEALTH LAND TITLE INSURANCE CO.
MERRILL LYNCH CREDIT CORPORATION, ITS SUCCESSORS AND /OR ASSIGNS
A.T.I.M.A.
SURVEY No.
Date: 01/31/2000
LEGEND TYPICAL
$URVEYORS'S NOTES: 1) IF SHOWN, BEARINGS ARE
REFERRED TO AN ASSUMED MERIDIAN, BY SAID PLAT
IN THE DESCRIPTION OF THE PROPERTY. IF NOT,
THEN BEARINGS ARE REFERRED TO COUNTY
TOWNSHIP MAPS.
2). IF SHOWN. ELEVATIONS ARE REFERRED TO
B.M.4 ELEV
OF N.G.V.D. OF 1929.
3). THIS IS A SPECIFIC PURPOSE SURVEY.
4). THE CLOSURE IN THE BOUNDARY SURVEY IS
ABOVE 1:7500 FT.
I HEREBY CERTIFY: THAT THIS 'BOUNDARY SURVEY'
OF THE PROPERTY DESCRIBED HEREON, AS
RECENTLY SURVEYED AND DRAWN UNDER MY
SUPERVISION, COMPUES WITH THE MINIMUM
TECHNICAL STANDARDS AS SET FORTH BY
THE FLORIDA BOARD OF PROFESSIONAL LAND
SURVEYORS IN CHAPTER 61017.6, FLORIDA
ADMINISTRATIVE CODE PURSUANT,
TO 472.027, f I,ORIDA STATUTES.
0-0000722
OF 2 -
WOOD FENCE.
CHAIN LINK FENCE.
C.B.S. WALL (C.B.W.)
EXISTING ELEVATIONS.
PROPOSED ELEVATIONS.
PR BY: QQ�� 2 -/ -00
OF A LAND SURVE NO. F .2.53 ¢
STATE OF FLORIDA. (VALID COPIES OF THIS SURVEY WILL
BEAR THE EMBOSSED SEAL OF THE ATTESTING LAND
SURVEYOR).
REVISED ON
REVISEDON
5582 N.W. 7th STREET, SUITE 202
MIAMI, FLORIDA 33126
TELEPHONE; (305) 264-2660
FAX: (305) 264 -0229
Nnua urnrl etc
LAND SURVEYORS
SURVEY NO. &722
SHEET NO. • .2 OF 2
N
BOUNDARY SURVEY scale 1" _
20'
6582 N.W. nn STREET, SUITE 202
MIAMI, PLOH10A 33126
TELEPHONE: (305) 264.2660
FAX: (306) 264.0229
i
HUU - 21 - 211 1:1 ; HL:L:I JUN I 1 NU
Nona
frutttPl3rnL 3Jiu.
5OUNDARY SURVEY scale 1° _
`(P
ti 0
LAND SURVEYORS
SURVEY NO.
SHEET NO.
P . 02
a9- 0712
OF
T ITAI P.GI7
Coverages:
Insurer Affording Coverage
Continental Casualty Company
The policy(ies) of Insurance listed below have been issued to the insured named above for the policy period indicated. The insurance afforded by the policy(ies) described
herein is subject to all the terms, exclusions and conditions of such policy(ies).
Type of Insurance
Certificate Exp. Date
❑ Continuous
❑ Extended
*23 Policy Term
Policy Number
Limits
Workers
Compensation
1 -1 -2003
WC 189165165
WC 189165182
WC 247848874
WC 247848888
Employers Liability
Bodily Injury by Accident
$1,000,000 Each Accident
Bodily Injury by Disease
$1,000,000 Policy Limit
Bodily Injury by Disease
$1,000,000 Each Person
Other.
Employees Leased to: Effective Date: 1/1/02
FL 1 H 058846
12279 Perfect Pavers Inc.
The above referenced workers compensation policy(ies) provide(s) statutory benefits only to the employees of the Named Insured(s) on such policy(ies), not to the employees of any other employer.
Certificate of Insurance
This certificate is issued as a matter of information only and confers no rights upon you the certificate holder. This certificate is not an insurance policy and does not amend,
extend, or alter the coverage afforded by the policies listed below.
Named Insured(s):
Staff Leasing Inc. d /b /a Gevity HR and its wholly owned subsidiaries
including Gevity HR, LP; Gevity HR IV, LP; Gevity HR IX, LP; and
Gevity HR X, LP
600 301 Boulevard West, Suite 202
Bradenton, Florida 34205
INSURANCE IN TOUCH WITH BUSINESS
* If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the
certificate expiration date. However, you will not be notified annually of the continuation of coverage.
Notice of Cancellation: (Not applicable unless a number of days are entered below)
Before the stated expiration date, the company will not cancel or reduce the insurance afforded under the above policy(ies) until at least
30 days notice of such cancellation has been mailed to:
Certificate Holder:
City of Miami Springs
261 Westward Dr Ste 116
Miami Springs, FL 33166 -5207
Trudy Williams
Authorized Representative
St. Louis, MO (877) 427 -5567 12/15/01
Office Phone Date Issued
LEWIS, JOHN C
.PERFECT PAVER INC
528 NW 1ST AVE
FT LAUDERDALE
13 1BUS.:
OVERNO,
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
1940 NORTH MONROE STREET
TALLAHASSSEE FL 32399 -0783
FL 33301
DETACH HERE
4TCENSE NBR
06 / 1 0/ 2 00.' 3' 40911''21 R . CBCO1 79OR.
The. BUILDING. •,.,
}Named below 2S , CERTIFIED' :
Under the provisions of Chapt+er1,
Expiration .date: AUG 31, 2004'.`t
DISPLAY A5 RFOl 1IRFn RY I AW •
(850) 487 - 1395
:STATE OF FLORIDA
DEPARTMENT „OF BUSINESS. +.:
;PROFESSIQNAL'S AREGULATIO
. OFFLORIDA-
PARTMENT OBUSINESS ;AND PROFESSIONAL REGULAT�IO
CONSTRUCTION INDUSTRY LICENSING BOARD '(,�,`::'
s•�
4.
L0,2-0,610.00'03t
BINR S,EYER
SECRETARY „•
4
'.� ''Vt,:/�n1i F 1.0Ur1 ]. — 19 8oai - d'O, County Commissioners, arowurd County Florida
anowAno COUNTY OCCUPATIONAL LICENSE TAX
FOR PERIOD OCTOBER 1, 2002 THRU SEPTEMBER 30, 2003
FORM NO.
401-280/AC 25-061
dRENEvwL CI TRANSFER SEC # 18 / 180
[t NEW DATE BUSINESS OPENED 10/01/88
STATE OR COUNTY CERTIE1EG » CB reCi:
Business Location Address:
528 NW 1 AVE
FT LAUDERDALE 33301-000C
CWSlNESS PHONE: (000)491-2444
THIS LICENSE MUST BE CONSPICUOUSLV DISPLAYED
TO PUBLIC VIEW AT THE LOCATION ADDRESS ABOVE.
gnOWAno COUNTY REVENUE COLLECTOR
115 S. Andrews Avenue, Governmental Center Annex
FORT LAUDERDALE, FL 33301
TAX
BACK TAX
PENALTY
T. C. FEE
TRANSFER
TOTAL
27.00
27.00
�
L
Ci.00OS0000O 0000002700 00000018O0000842 '1001 7
PERFECT PAVERS IN:
LEWIS JOHN C
528 NW 1 AVE
FT LAUDERDALE FL
E OF LICENSE TAX PAID
~=2C""`'' n`yro�r�nn
F . 0 R ... .~,.'`"^.=`
� '�'���
RENEW ON OR BEFORE
SEPTEMBER 30, 2003
PENALTIES IF PAID
OCT. -
^ DEC. 'eo% I After DEC. 31 - 25%
Plus Tax Collection Fee of up to $25.00
.
Based on Cost of License if Paid
On or After November 30, 2002
ACCOUNT NUmBER
10 UNITS
2002 - ��������
^�.�n�^� ^�n�"��� PAYMENT RECEIVED AS VALIDATED ABOVE *SEE BACK FOR TRANSFER INFORMATION
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO. !4 7i Q 50 ? 0 OC
STATE OF FLORIDA:
COUNTY OF DADE: O2R67997 2002 NOV 01 13:3
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 prope and street address: ,< or .43 /lex /JU WhA„ri SNoa,• r Sec-
y
2. Description of improvement: —Z rift Locic (A) a- A.L.icaL . , i/ 4.4 eve 114 to P+91
3. Owner(s) name and address: ?it *ILO 6#4 7 r.E4, To./ // 'E 9j> r
/1/M0 i S NI),e.Er FG .
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address: r �PEitFB�T ?As/s,e.s / , Sag , Li �f r 4c/4---; / r . 144/ o /41-E �—c. 3330
5. Surety:(Payment bond required by owner from contractor, if any) co! r1T� OF �,:,�1
Name and address: that this ;we
" °',.;e
!'•';;;; ji;,o�H r.7 !irr� ran
n -,y n.
Amount of bond $ / , • •0 20 ( 0 ` `•
6. Lender's name and address:
IN, CLERK o
D. •
1111113111111,
ram
7. Persons within the State of Florida designated by Owner upon whom notices or o er documents may be served as provided
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 dat _ is specifie
of Owner
Print Owner ' ame
Sworn to and subscribed before me this ar day of
Notary Pu
Print Notary's Name
L. White
# rx' 946000
:.\:gyres Daly 30,2004
Br'i rd1hru
Atlanuc Co., EQ.
eal.
rcuit and Count C
O.C.
Prepared by: l ELF-- t t P
.
Address: Sae'' A/. rJ- / r. jive
14✓0 et 1-F
3 33 ,31
.7•!n..c, nx3,
CONTRACTOR
Name yer � �V e rs
Lic�sp,N O 1 -' 90
Addres� N. Lo yJrs_4" v
1 / L td f/ 333
Telephone 9.L °� / 2 • y V
/� � l O ax 9 Y �/ q � 7
Qualifier N ame .�- l
I.
PROPERTY OWNER
Name � � Ii1/f J A.
''�
Address
/in /t P4-: *(.__)111/ . �j fer
�'
Home Tele hone J J
Business Telephone3 0 5 S3 b l� a
Fax la 3 0/')
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'I Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Step 2. $ubmit 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.
APPLICATION
Job Address: ,/
//
8s
is) rea
3 2
J
Lot
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 submit-
ted along with this permit application.
Folio Number // 3 a - 01 ? � 0
1
3 Block W
Subdivision m NMI St iO4 a s
53c, p'
Current Use of Property
Proposed Use of Property
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Address
PB
Apt.
Master Permit No.
. Subsidiary Permit N
City
Descr
'on of Wor
1 -
D1A .tee 6» /k
PERMIT APPLICATION
State
Zip
PG Zoning L inear Feet
Square Feet 1.3S Units Floors
Value of Work 7 1. 7 Bldg Value
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
Page 2
1NIPORTAN'I' NO'T'ICES
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, 1" 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
Si ature of Owner
g 76/6 - iV 5249107
Print Name
S . •m to and subscribed before me this / day of1=41A/ ,
000;0 /fib
gnaturFrof
SEAL:
1 N
Y OF MIAMI -DADE
t.tY'!NiF 1.Q JISE Wit KERSON
My Comm Enr. 7/23/2003
/No. CC 0` 50899
r . / r.w y nncvn 11 over to
Personally known OR, Produced Identification
Type of Identification Produced:
STATE OF FLORIDA, COUNTY OF MIAMI - DADE
Signs of Contractor / Qualifier
J d (.�.✓ C, E J/ J
Print Name
Sworn to and subscribed before me this / e' day of a TIP At-
_100 .
Signature of Notary Public - State of Florida
SEAL:
L. White
CC 946O0O
ly ,2004
�q�. �.
Personally kno " ' ��� ,, � ' Ox , t! titification
PERMIT APPLICATION
Type of Identification Produced:
ELECTRICAL
TVPI•.
Minimum Fee
QTY.
'TYPE
Dryer
QTY.
TYPI'.
Outlet, Appliance
Q'rV.
'rv'ri•:
Service Repair
QT y.
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
'rYPE.
Minimum Fee
QTY. •ryPE.
Condensate Drain
QTY. TYPE
Generator
QTY. TYPE
Refrigeration, Tons
Q•I' '.
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
T\PI:
A/C Condensate
Q'rv.
'l'YPr
Drains, Roof
QTY.
TvPI:
Miscellaneous Fixture
Q'FV.
'I'm:
Soakage Pit
Q'FY.
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:
Page 4
OFFICE USE ONLY
C1IECKL1ST
O OWNER - BUILDER FORM
(Attach)
O FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
O CONCURRENCY
(New Construction)
❑ 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
Notary
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
(sq.ft. x/1000
$ (¢.005 /sq.ft.)
$ (¢.01 /sq.ft.)
SECTION
Zonin
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
DAT
if t 9 Z-4z,
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PI:RN1I'I' FEES
TOTAL $ ? A
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
Aillication is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building
or other structure berein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores
Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regula-
tions of the Building Division of Miami Shores Village shall be complied with, whe • . ,erein specified or not. A copy of approved plans
and specifications must be kept at building during progress of the work.
Owner's Name and Address r t)
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot_____________________ —_ Block________________ Subdivisio
Street and Number whare work is to be done
work to be done and pur ose of building oors)
lq
New Building
STATE OF FLORIDA,
COUNTY OF DADE.
and who, being b
of the above desc
therein by him st
Permit No._
Disapproved
(Signed) _
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Remodeling________________ Addition
To be constructed of Kin
Estimated Total cost of improvements $_
Zone cubage required
Distance to next nearest building____________.___ —_
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said b
be sent to
Building Inspector
Chairman
Member
Member
Council Approved
Repairs
Roof Covering__
Amount of Permit $ _ ®
__
Ian Cubage
__Size of Building `Lot
—Ir
uilding. All notices with reference to the building and its construction may
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, compiled) Gensfal Laws of Florida, Permanent Supplement.
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit: and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such su tors, on work to be performed under,,,Ahis
permit, as are licensed by Miami Shores Village.
Remarks ,.4 (Signed)
my sworn, upon oath deposes and says that he
ction, that carefully read thl fore
PLANNING BOARD _ 1__ DATE
Date
Date__ 19 "-
No
My Commission Expires
__ Date �•� '" Q Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Member
Member
Member
Disapproved
and for no other purpose.
No. of Stories
"110441/Keue
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known,
e
application, and that he did sign the same, and that all facts
_Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and/or workmanship.
BUILDING
ELECTRICAL
PLUMBING.
Owner of
Building
Legal Lot
Description
Architect
Contractor
or Builder
MIAMI SHORES VILLAGE, FLORIDA
DATE 16,:, Z. Y 194
PERMIT N° 7450
Work to be performed under this Permit
•
CONTRACTOR OR BUILDER
Bl.
Subdi-
vision
Contractor's
License No.
d eLe..-1.„ N-1,-4.....1
Address of g ��-/ Value of Amt. of
Building �� �° Project Permit
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the state ents or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
t
Signed.
- ‘0 0 -
By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform ie4vork covered hereunder in compliance with all and Aegu, jations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Sho s Village.
Inaept ghis Qermit I assume responsibility for all work done by either myself, my agent, servant or employee.
AUTHORITY
MIAMI SHORES VILLAGE, FLORIDA
0ILUING ir# DATE 6 f° . 194.
t,ECTRICAL PERMIT N? 7450
iUMBING
h oner of
.gilding
rchiteet
i
_30ntractor
Builder
egal Lot 1 Bl.
! escriptiOn
�s of . . s L1 Value of 1 Amt. of
g � Y Project Permit
i
This p 't is granted to the contractor r builder named above to construct the building or to install the equipment or device described in the appli-
ition herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
Tans, drawin s statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
zrmit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
igulations pertaining to the work covered hereby whether shown on the plans or drawings or in the states ents or specifications and that he assumes respon-
bility for work done by his agents, servants or employees. 1 r
Signed. employees. . A � ..c 4
. B 4
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform Ale ork covered hereunder in compliance with all ordinanaeI and regulations
.. taining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
3 pia g "s permit I assume responsibility for all work done by either myself, my agent, servant or employee.
•
CO}
Work to be performed under this Permit
CTOR OR BUILDER
( or;-,/-1- dill... ''.4.....4..."..x--4... ,..
Subdi-
vision
BY
fi
Contractor's
License No
AUTHORITY