1270 NE 98 St (12)Company
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
Building Inspection Request
Date \• \y 04
Approved
Correction
Re -Insp' n Fee
Type Insp'n ��y1 u (n�
Permit No. l " I -I9
Name 2.2..C4..py—..S60(.-
0
Address 'N� q% J
Phone # `- 'I I J L j �-� 4 - 71 Lo9
Inspection Date 'VD- ' \ 5 • O H
),(
X10
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bui ding Inspection Request
Date y
Type Insp'n �t1 U d / (�
( t Gu_
Permit No. CDP I "I -f "L .
Name 1`I "
Address 7-:)0
Company 0 S 8( GlL
Phone #
Inspection Date
Correction
Re- Insp'n Fee
Owner's Address
BUILDING
PERMIT APPLICA
FBC 2001
Permit Type (cir
/27 A -16 9g 7
State
Miami. Shores Village
Building Department
0050 N.E.2nd Avenue • n* Shores, Florida 33138
ar : (305) 756.8972
Electrical Plumbing Meckanical Roofing
Owner's Name (Fee imp e itleholder) tryS DD AP Phone # 305
Permit No. fP -e-D ?' 9
Master Permit No.
Zip 5313/
Tenant/Lessee Name Phone #
City Him % 5f4C45
Job Address (where the work is being done) 12.70 N 4 57
City Miami Shores Village County Miami -Dade Zip 3 Bas
Is Building Historically Designated YES NO
Contractor's Address 2-70/ b
Contractor's Company Name
City
Qualifier
Architect/Engineer's Name (if applicable)
Type of Work:
Describe Work:
371 -r 44.s 1O'vb
State Certificate or Registration No. 4t 05-011,r3"
$ Value of Work For this Permit 292. . sO
Sta Zip 353 /
❑Addition []Alteration ❑New
1 . AZt �.
Submittal Fee $ r. Permit Fee $ 5',
Notary $ Training/Education Fee $ tt er)
Scanning $
l5
Total Fee Now Due $
(Continued on opposite side)
Radon $ Zoning
Code Enforcement $ "" Structural Plan Review. $
Phone #
Certificate of Competency No. ?0 /L L 0
Phone #
Square Footage Of Wort€:
$r/pairfReplace ❑ Demolition
Z" e.0 'g4.$
7 42 — 0o
..�
CCF $ Or ' CO /CC
Technology Fee
Bond
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 w h occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be .ppr ed ad a reinspection fee will be charged.
Signature / �� � Signature 7,/ /
Owner or Agent j Contractor
The foregoing instrument was acknowledged before me this 2- The foregoing instrument was acknowledged before me this 22-
day of ` 2 G , by , day of 1ft- o -r", 20 O`jby
who is personally known 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 PUBLIC:
Sign:
f--d�
Print: / ieli lre 7 49 aw ll"�
My Commission Expires: ( �y� a grgi� � ] My Commission Expires: q /.{ Q �
'Y alpC iP11 a YIY4=6 Expires:
•. 1� /Q icha b ll'�:'fiV
?• Commission #DD28705 ; _�. ��.o Irxpiies: Feb 03, 20
•.= 200€1
Bonded Tiro
Expires: Feb 03, F �OP.; BondedTtuu
APPLICATION APPROVED BY:
Chc 05/13/03
CO44_, Al (OP
NOTARY PUBLIC:
Sign: t——'
Print: !'l ii - N —
NOV 16 2004
01
Plans Examiner
Engineer
Zoning
'STATE OF FLORIDA)
COUNTY OF DADE)
attached survey, performed by
Further, Affiant sayeth naught.
The undersigned Affiant, LW14 ,- ezt'v.Se)a l� , does hereby attest that the
QQ (property owner)
�x A,GB bavolOt . 4- A -556e- , , G
(name of surveyor's company)
Witness(sign and print) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this 22- day of Cb'- -T (3 'g
" 'i Michael Hinman
OS�Y PUe
' �' Commission #DD281054
a• Expires: Feb 03, ZQ08
7 •...• P
°, Bonded Thru Notary
" " "' Atlantic Bonding Co., Inc.
performed on 9h/ , is an accurate representation of the existing conditions and
(date of survey)
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..
Affiant is personally known to me, produced as identification.
IMP
i
Tax Folio #:
requests permission to install:
SIGNED, SEALED AND DELIVERED in the presence of:
m ami Sliore� Vi //aye
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 -2382
Telephone: (305) 795 -2207
Fax: 13051.756 -8972
l✓I N. %. .".. / 7
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, Lir- ieI t'.•dS c i€ , hereinafter referred to as the Owner of the
(owner)
following described property:
Legal description /folio#: 71 3 205 -0 3
Lot Block 3 Subdivision
sphalt, concrete, brick pavers
[ ] Landscaping
[ ] Other
within the public road right of way of /2.4Q .Cr,e 7 -
(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 this day of
Commission #DD287054
A.. -. Expires: Feb 03, 2008
! 9�` ai F�� Bonded Tltru
Atlantic Bonding Co., l '
f� P PR 0 �
NLr1IL:t OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO. 11- 32o 5 0ol -0 310
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: Si .)4v., e_ - 741A. (.
/2-?a N -- 9 tr 5
M •A A4 �` J4-Me -5 , t�c� 3 3 r
2. Description of improvement: 7,2 L.r, ds-44
3. Owner(s) name and address: h.vGrE-- avj
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address: ia 2
2 2 �e s t' '/1 s lc ! 3 3 "3/0
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. Expiratio
differer)Cd�
Signature of Owner
Print Owner's Name I R'
Sworn to and subscribed before me this ' 2 day of , 20
Notary Public
Print Notary's Name
My commission expires:
12101 -52 PAGE 4 8
;7A! 1 f1;-
I Prr 7( f ( -
IL
Cy
H R Z Y F u`f r,
1
I11111
CFN 2004.R 101 I900 !''�il
OR Bk 22821 P9 2535; (fps)
RECORDED 11/15/2+104 12 :33.25
HARVEY RUVIN► CLERK OF COURT
MIAMI -DADE COUNTY' FLORIDA
LAST PAGE
/e/c -E- `'/4•vr,�
ate of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
ee is s ied)
Y "" Michael Hinman
.off = Commission #DUZS i054
E Fob 03, 200R
%1••• 'Cr Bonded Thru
Attanttc Boudu,s Co., Inc
t �s .00 ND
Prepared by v /Cr
A ress: 9 7O I 7� e
1) 1E FL 3 S S /y'
I
Building Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2004 -1499
Printed: 11 /22/2004
Applicant: LUCIE ROGENSDORF
Owner: ROGENSDORF LUCIE
JOB ADDRESS: 1270 NE 98 ST
Contractor US BRICK I& BLOCK SYSTEMS Contractor's Address: 2701 REESE ROAD
Local Phone: 954 - 792 -0076
Parcel # 1132050090310
Legal Description: 5 53 42 EARLETON SHORES PB 43 - 80 LOT 3 LESS E12.5FT & E5OFT LOT 4
Fees: Description Amount
FEE2004 -11667 Building Fee $175.00
FEE2004 -11669 CCF $8.40
FEE2004 -11670 Training and Education Fee $2.80
FEE2004 -11671 Technology Fee $4.38
FEE2004 -11672 Scanning Fee $15.00
FEE2004 -11673 Builders Bond $300.00
Total Fees: $505.58
Total Fees: $505.58
Total Receipts: $0
Permit Status: APPROVED Permit Expiration: 5/14/2005 Construction Value: $13,392.00
Work: REPLACE ASPHALT DRIVE WITH 2" BRICK PAVERS
Page 1 of 1
Signed: (INSPECTOR)
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: