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DRIVEWAY
MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request l ' Name Company Address Phone # Inspection Date S) / S / 0 Approved Correction Re- Insp'n Fee ■ 3 os'_ -- 7.S - 'fky,1 o BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle( Building) Electrical Plumbing Mechanical Rooting Owner's Name (Fee Simple Titleholder) /ii /14-84 z5 ? 5C ii 3C V— ` -- ci v'% Contractor's Company Name Contractor's Address $ Value of Work For this Permit Type of Work: a ,t1,0.ddition '[)Alteration 2-500 . a� ibe Wo k: Miami Shores Village RECEIVED Building Department a .. 1 2004 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Submittal Fee $ SD . Permit Fee $ / l Notary $ Training/Education Pee $ of .60 Phone # Owner's Address City it/113141 5/70 State rL Zip 1 13-9 Tenant/Lessee Name Phone Job Address (where the work is being done) Ne 9 q 4 City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO 1/ City State Zip Qualifier Architect/Engineer's Name (if applicable) Phone # Square Footage Of Wor ©New 0 Repair/Replace 71;71yeAay 1 rp4A, 0.1k * * * * * * * * * * * * * * * * * * * * * * * * * ** *)l * * * * * * * * * * * * * * * * * * ** * * * * * * ** CCF $ /80 eryCO/CC Technology Fee S Scanning $ 3 ""'X Radon $ " ®" \ ' Bond $a00#100 Code Enforcement $ " Structural Plan Review. $ Total Fee Now Due $ 5r4 ( f , (Continued on opposite side) ?Ota et 2�►�- Permit No. 5P2.cDO4 52 Master Permit No. rc, JI D . 0 Demc 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 wich occurs seven (7) day of the building permit is issued. In the absence of such posted notice, the inspection will of be app oved and a reinspettion/�ee will / be charged. 1 Signature APPLICATION APPROVED BY: The foregoing instrument was ac owledg before me thi_ day of i 20 (%) by / 42Z )'1lb o,Jri ez. , who is personally known to me or a -predused As i . • ntifi tion and who did take an oath. NOTAR 'I „IC: off / I Sign: M I / 1 D'O .><I it =. ► i My Commission Expires: - /— O Y ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Chc 12/15/03 Signature Contractor The foregoing instrument was acknowledged before me this day of ,20_,by who is personally known to me or who has produced as identification and who did take an oath. ' Y PUBLIC: Sign: Print: My Commission Expires: *************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** y/j e /c,5- MAY - Plans Examiner Engineer Zoning 7210 S.W. 126th. COURT, ANIANO J. GARCIA, PLSM. PH. (305) 856 -4566 & (305) 595 -2824 MIAMI, FLORIDA 33183 LAND SURVEYOR & PLANNER FAX. (305) 856 -4699 & (305) 595 -1454 PROPERTY ADDRESS: 25 N.E. 99th. STREET, MIAMI SNORES, FLORIDA 33 138 LEGAL DESCRIPTION: LOT 15, BLOCK 5, OF "AMENDED PLAT OF MIAMI SHORES SECTION NO. I ", ACCORDING TO THE PLAT THEREOF, RECORDED IN PLAT BOOK 10, PAGE 70, OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY, FLORIDA. RECORD SURVEY SCALE 1 "= 20' F.N. (B /C) PANEL NUMBER 0093 SUFFIX J A = ARC DISTANCE. A/C = AIR CONDITIONER PAD. A.E. - ANCHOR EASEMENT. ASPH. = ASPHALT. D/C - BLOCK CORNER. BLDG. - BUILDING. D.M. = BENCH MARK. D.O.B. - BASIS OF BEARINGS. C CURVE. (C) AT CALCULATED DIMENSION. C.B. - CATCH BASIN. C.B.S. - CONCRETE BLOCK STRUCTURE. C.O.S.w = CONCRETE BLOCK WALL. A - CENTRAL ANGLE. FK PROPOSED ELEVATION CH - CHORD DISTANCE. CH. B. = CHORD BEARTNC. CL. = CLEAR. CA OR C - CENTER LINE. L.L.F. = CHAIN LINK FENCE. C.M.E. - CANAL MAINTENANCE EASEMENT. CONC. = CONCRETE. C.P. = CONCRETE POST. C.S. - CONCRETE SLAB. O.E. = DRAINAGE EASEMENT. - DEGREES. D.M.E. - DRAINAGE & MA:NTE NANCE EASEMENT. X0.00 - EXISTING ELEVATION. LEGAL NOTES 145' ing Approved !✓, BASED ON THE FLOOD INSURANCE RATE MAP OF THE FEDERAL EMERGENCY AGENCY REVISED ON 07 -17 -95 THE HEREIN DESCRIBED PROPERTY IS SITUATED WITHIN: ZONE X BASE FLOOD ELEVATION N/A COMMUNITY NUMBER 120652 THIS SURVEY DOES NOT REFLECT OR DETERMINE OWNERSHIP. 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 DEDICA TIONS, LIMITATIONS, RESTRICTIONS, RESERVATIONS OR EASEMENTS OF RECORDS. LEGA DES- CRIPTION PROVIDED BY CLIENT. THE LIABILITY OF THIS SURVEY IS LIMITED TO THE CTST OF THE SURVEY. UNDERGROUND ENCROACHMENTS, IF ANY, ARE NOT SHOWN.THIS FIRM •S NOT ATTEMPTED TO LOCATE FOOTING AND /OR FOUNDATIONS AND /OR UNDERGROUND IMPRO EMENTS OF ANY NATURE. IF SHOWN, BEARINGS ARE REFERRED TO AN ASSUMED MERIDIAN. IF SHOWN, ELEVATIONS ARE REFERRED TO N.G.V.D. OF 1929. F.I.P. 03/4" :1 3.3' PORCH ASPHALT DRIVEWAY 50.00 ASPHA T PAVEMEN th. STREET. BRICK F.N. VISUAL ENCROACHMENTS NOTED: 1d - WOOD FENCE, ALONG THE NORTH SIDE, ENCROACHESUP TO 0.45 FEET INTO THE ADJACENT ALLEY'S RIGHT OF WAY. DIST. - DISTANCE IN. & EG. E. = INGRESS & DR. - DRIVE. EGRESS EASEMENT. DR. W. = DRIVE WAY. LB. - UCENSED BUSINESS. E = EAST. LF.E. = LOWEST FLOOR ELEVATION. LLEV. - ELEVATION. L.M.E. - LAKE MNNTEIWITR EASEMENT_ ENCR. - ENCROACHED. LK'. - LANE. E.T.P. = ELECTRIC TRANSFORMER E.P. = LIGHT POLE. E.D.M. - FOUND DRILL HOLE (M ) - MEASURED DIMENSION. F.F.E. - FINISHED FLOOR ELEVATION. - MINUTES. F.H. = FIRE HYDRANT. M/L OR Id = MONUMENT LINE. F.I.P. - FOUND IRON PIPE. NON. - MONUMENT. F.I.R. - FOUND IRON ROD. N = NORTH. F.N. ■ FOUND NAIL NAP.0 - NOT A PART OF. FT. = FEET. >/ // - WOOD FENCE. X —X - CHAIN LANK FENCE. sQa = C.B.S WALL DATE OF FIELD WORK 01 -02 -2004 REVISED ON ( ANIA► ARCIA P.L.S.M 5 NO • Er' ITHOUT THE SIGNATURE AND RIGINAL ,•�� OF A FLORIDA LI_012 AND MAPPER. LEGEND A 1 ABBREUTATtONS 15' WIDE ALLEY N.G.V.D. - NATIONAL GEODETIC PL. _ VERTICAL DATUM. P/L = N.T.S. - NOT TO SCALE. PIS - N0. OR / = NUMBER. PLSM O.E. - OVERHEAD UTI'_1TY LINES. 0.H. - OVER HANG, P.O.B. 0/S = OFF SET. P.O.C. D.R.B. - OFFICIAL RECORD BOOK. P.R.C. P0. ■ PLAT BOOK. P.R.M. P.C. - PONT OF CURVATURE. P.C.C. - POINT OF COMPOUND PROP. CURVE. P.T, _ ASPHALT PAVEMENT e 50.00' L TOTPL R /W) REVISED THI RTIRES THAT THIS SURVEY OF THE PROPERTY CRIBED HEREON WAS MADE UNDER MY SUPERVISION AND THAT THE SAVE MEETS THE MINIMUM TECHNICAL STANDARDS SET FORTH DY THE T1.OR!CA BOARD OF SURVEYORS AND MAPP N. IN CHAPTER 61017 -6, FLORAA ADMINISTRATIVE CO', ' P 'SUANT TO SECF4 172.022. FLORIDA STATUI CERTIFIED TO:I PUNTER OR PLACE. R = PROPERTY UNE. (R) PROEESSIOWL TIM SURVEYOR RAD. = PROEFESSE8M. 1M D RD. SUR.EYM & &AFTER RES. - PONT OF BEGINNING. ROE. = POINT OF COMMENCEMENT. R.L.C. - PONT OF REVERSE CURVE. PERMANENT REFERENCE R.P MONUMENT. R.R. COR. - PROPERTY CORNER, R/W POINT OF TANGENCY. S - PVMT = PAVEMENT. PC. - PAGE. PINY. - PARK -WAY. SEC. AT SECTION. P.C.P. - PERMANENT CONTROL POINT. 0 P LOT 16 BLOCK 9 LAll MASSON RODRIGUEZ. LAW OFFICE OF WALTER A. ANON, P.A. ATTORNEYS' TITLE INSURANCE FUND, INC. fLAGSTAR 3AN, F5D, ITS SUCCESSORS AND /OR ASSIGNS. ORDER NO. 03 -2258 RAOIJS. t.',. P. - SET IRON PIPE RECORDED CiMENS;DN, WITH CAP P.L.S 5105 '5ADUL S.P. = SCREENED PORCH. - ROAD. Sr STREET. - RESIDENCE. SI'Y. - STORY. = RANCE. S.W.K. -- SIDE WALK. . = REGISTERED LAND T = TANGENT. SURVEYOR. 155. - TOWNSHIP. RADIUS PONT. U.E. : UTILITY EASEMENT. = RAIL ROAD. U P. - UTILITY POLE. - RIGHT OF WAY. UTY. - UTRLITY. SOUTI1. W - WEST. SECONDS. w . - WOOD FENCE. WM. WATER METER. W.V. - WATER VALVE. . OWNER BUILDER DISCLOSURE STATEMENT I /1ZZ gittn S I r 1 being the legal property owner, for the property Located at: v2C / V e 9q /4) 44, .z Taxer f< Wit- 351g3 t, VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT Legally described as . 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 I have read and understand the following disclosure Statement, which entitles me td 3liork as my own contractor, I further understand that I as the owner must appear in person to complete all applications. DISCLOSURE STATEMENT 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 .7/ day of 20 Of By /A / l iari pGz Produced . • • as identification and who did take an oath. who is personally known to me or who has .I "A "A'.' LISA RODRIGUEZ , MY COMMISSION # CC 941341 •:,: �,. EXPIRES: June 1, 2004 of ry P` Bonded Thru Notary Public Undamriters 'STATE OF FLORIDA) COUNTY OF DADE) � The undersigned Affiant,l4 -2Z HASSoS- - 4:44 G 2_ , does hereby attest that the (property owneY) attached survey, performed by AP1 A 130 Q accA elk performed on / -07. , is an accurate representation of the existing conditions and (date o 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 that the existence of any such structures may affect final inspections as appli r . le to this or other permits.. Further, Affiant sayeth naught. (name of surveyor's company) SWORN TO AND SUBSCRIBED before me this �� day of, Affiant is personally known to me, produced as identification. USA RODRIGUEZ 4 ; , MY COMMISSION # CC 941341 EXPIRES: June 1, 2004 pF V;Q:` Bonded Thru Notary Public Underwriters 1 PERMIT NO. a , ADDRESS: MIAMI SHORES VILLAGE BUILDING / ZONING DEPARTMENT' SECTION BY ■ DATE ZONING • ELECTRICAL MECHANICAL PLUMBING FIRE PUBLIC WORKS • STRUCTURAL BUILDING OFFICIAL 1. Subject to compliance with 1t Federal, State. Coatty. VUttage Mes aid regutatiens. Wage essuatas no responsibility for accuracy otlor resutts frost these plans 2. This copy of plans mast be aval(tbt, on building site or no Inspection Mil be conducted. JOB ADDRESS APPLICANT PHONE fr APPLICATION /"GC-V(1 9 uKI I IQUE SHEET SHEET OF MISCELLANEOUS DATE ZONING COMMENTS do p Sm.. le ® c. on Scu INITIALS Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 5/4/2004 Applicant: JASON & KELLY Owner: RODRIGUEZ JOB ADDRESS: 25 Contractor Local Phone: Parcel # 1132060131270 Fees: FEE2004 -4502 FEE2004 -4503 FEE2004 -4504 FEE2004 -4505 FEE2004 -4506 FEE2004 -4508 NE 99 Description Building Fee CCF Training and Education Fee Technology Fee Scanning Fee Builders Bond Total Fees: Signed: (INSPECTOR) Signed: (Contractor or Builder) Building Permit Permit Number: BP2004 -528 MADDOX LAZZ MASSON ST Contractor's Address: Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 15 BLK 9 LOT SIZE 50.000 X Total Fees: $4,15 Total Receipts. b.Q9 Amount $110.00 $1.80 $0.60 $2.75 $3.00 $300.00 $418.15 Permit Status: APPROVED Permit Expiration: 10/18/2004 Construction Value: $2,500.00 Work: PAVERS ON DRIVEWAY AND WALKWAY 3.1 x, ?3ge MAY 0 5 ENTD 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. BY: