25 NE 99 St (5)Rev. 10/02/03)
RECEIVED
JA, 0 z 2004
RE- OCCUPANCY
APPLICATION
Date V- `"/
•Signature
Sign:
Print:
My Commission Expires:
Miami Shores Villa
Building Department
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate.
Applicant Name Q' &/
Loc ID
Mabel Vargas
Commission #DD231984
Expires: Jul 13, 2007
Bonded Thni
Building Officials Approval: ° "' Atlantic Bonding Co,, Inc,
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 756 -8972
Permit No. ' 7c
Contact Name /4/a a e c e r ' - J - s L ' s ? Phone # o a f - 7 c1-0Z0
Buyer Seller Realtor I Company Name) EA Raa -P
Property Address 2-5 9 9
City Miami Shores State Fl Zip 3-3 (3 d"
I hereby certify that I understand that the zoning of the property is for single - family residential use and
that it is unlawful for more than one family to reside therein. I also understand that any Certificate of Re-
Occupancy that may be issued by Miami Shores Village certifies only that the referenced property is
being used for single - family purposes and that such Certificate does not constitute any representation,
warranty or certification as to the condition of the dwelling or other structures on the property.
The foregoing instrument ', was acknowledged before me this 2 day of ll �
b A- \C) n JU ie.pe . , who is personally known to me or who has
produced t.,(10 as identification and who did take an oath.
NOTARY PUBLIC:
,20
Re -Occ. $60.00
Notary $5.00
CCF $0.60
Total S . cod
JAN 0 2 PAID
1
Address 7.-5 Ma G
City Miami Shores
BuildinOfficials Approval:
Miami Shores Village
Building Department
Certificate of Re- Occupancy
Permit No.
Date 1 O "1 - 2.07
The folloming residence is issued a Certificate of Re- Occupancy
State Florida Zip 3"
OR ELK 21987 PG 2487
LAST PAGE
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756 -8972
This certificate verifies that the referenced property has been inspected by Miami Shores Village
and has been determined to presently comply with the scheduk of regulations of the Miami Shores
Land and Development Code pertaining solely to the requirement that each one - family dwelling is
used and intended to used for a one-family dwelling purpose only; however, this certificate does not
...constitute any representation or warranty as to the condition of the dwelling or other structures on
the premises described herein, or any aspect of such condition, and interested persons are advised
and encouraged to make their own inspection of the premises in order to determine the condition
thereof.
FILE No .168 06/25 '02 10:45 I D : M I Aft I _SHORES_V I LLAGE____ FAX :3057568972 PAGE 1/ 2
to re- occupy the single family res known as : (address)
g__L: A) E g Q 1A sr , Miami Shores, Florida.
Legal Description:
Lot: /6 Block
PG:_
Applicant
Print Name
Comments:
APPLICATION FOR CERTIFICATE t QCCUPANCY
G ► . hereby apply for a certificate
pat
•
I hereby certify that I understand that the zoning of the property i ; r singly residential us
and that it is unlawful for more than one family to reside therein. i also understand that-any
Certificate of Re:Occupancy that may be issued by Miami Shores Village, certfes only that the
referenced property is being used for sin • a - famiy purposes and that such Certificate does not
constitute any representation, warranty o certification as to the condition of the dwelling or other
structures on j ch property.
ZOO 7,
**, * * * *** * * *. ** ,* **;00#* * * * ***** * *** * * *.' * * * * ** * wpi * **ir *s * * *w* *s ** * * * * * * ** * * **
for purposes of conducting the inspection required by Section 902 of the Nfiami Shores Land
Development and Zoning Code, please contact:
Contact Name:
Piclei44Rice: .305-759 09 3 7
Buyer _ Seller Realtor Company Name
Application Fee (SSO) paid: Cash � 04 Check No.
Inspected by: Approved Denied Date
WITH
Remarks
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein
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 regulations of the Building Division of Miami Shores Village shall be complied with. whether
herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work.
Date APRIL 11th. , 1990 19
Owner's Name and Address LISA AND DANIEL MORGENTHAL = = == 25 N.E. 99 STET, MIAMI ,S FLORIDA
Registered Architect and'or Engineer
Name and address of licensed contrector GOTHELF = == 17630 N . E . 7 PLACE, NORTH MT AMT BRACH ,___FLA . 33162
Location and legal description of lot to be built on:
Lot 45 Block
Street and Number where work is to be done
State work to be done and purpose of building Iby floors). state exterior colors (submit samples)
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories__
lb be constructed of Kind of foundation y Roof Covering
Estimated Total cost of improvements $ 3927 Amount of Permit $ 5Z0
STATE OF FLORIDA
COUNTY OF DADE.
25 ATW IN EXISTING OPENINGS. NO STRUCTURAL CHANGES.
} SS.
Disapproved (., , �� _ Date
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
25 N.E. 99th. STREET, MIAMI SHORES,. FLLORIDA.
REPLACING 11 ATW, 13 JALS AND 1 P/W
/
Subdivision /C 1,9./ f/
(Signed) •
Building Inspector My Commission Expires
PLANNING BOARD DATE
a.o c9
,gg 0 6 / ,1 /te,
Plan Cubage
Zone cubage required
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
1 hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to
The undersigned applicant for this building permit does hereby certify that he understands a_nd accepts his obligatons as an em! .yer of Labor under the Florida \t'orkmen's
Compensation Act, being Section 5966. Compiled General Laws of Florida. Permanent has complied with t 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; an. ill 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 agre. . employ o sub c; _ • - . k to he performed
under this permit, as are licensed by Miami Shores Village. !
(Signed)
SEYMOUR GOTHELF. CBC 9454
Before me, the undersigned authorit , a notary public. duly authorized to administer oaths and take acknowledgments, personally appeared
SEA fO'rk
NAr
Notary Public „State of Florida
to me well known.
and who, being by me first duly sworn, upon oath deposes and says that he is the ‘‘
of the above described construction, that he has carefully read the foregoin application, and that he did sign the same. and that all facts therein by him stated are true.
Permit No. JO 000 Date Rea Sworn to and Subscribed before me.
NOTARY PUBLIC STATE OF FLORIDA
NY COMMISSION- XP-3M 75,T99f
BONDED THRU GENERAL INS. UNO.
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $25.00 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 $25:00 will be charged when such re- inspection is made necessary' by improper notice for inspection or faulty materials and workmanship.
MIAMI SHORES VILLAGE, FLA.
GY 9 3- 37
30 ' 1f-s>
DATE 9enl-c5:7
,?).7
MIAMI SHORES VILLAGE, FLA.
JOB
ADDRESS 77,0 ;9'9 `—
INSPECTION
TIME READY -
REMARKS
it2e,
INSPECTOR
N° 6762
ye)
• if AL._,
DATE 1 - I � " `17
Avi
•
MIAMI SHORES VILLAGE, FLA.
JOB S ZO .ti1 c De E Cd p ' rie 5
ADDRESS t 6, 59
INSPECTOR v DATE 1 — -2 3 rn
RY-
N9 6662
INSPECTION Fo o T t tJ �r
TIME READY >elvYl • ` 73
REMARKS.
P. 0. BOX 1777
t Li
tone rie4
J4, 9i St*,
Miami des} Florida
Gentlemen .
M. G. D'N EAL
am are PROOUCTS
'UOCRIJAf.C, P1.OR *ESA
The Pittsburgh Te s g Labors ►ry rep
concrete 3itders Pis Bea, pour a
Bleck 9) ILt , F].orida, bre
twenty Ys*
Pittsburgh 'Testing Leber rtorg Sm inerrs e
this test the compete should reach a sands'
. erty tine da7s mid. we ll taud behtid this estimate,
•
fie
SAMPLE
372nd
MARK SECTIONAL AREA
SQ. INCH •
PROJECT
LOCATION OF POUR
CLASS OF CONCRETE
SLUMP OF CONCR
CONTRACTOR
ADMIXTURE
rl
co: 3 Client
PITTSBURGH TESTING LABORATORY
3281 N.W. .7th STREET MIAMI 35, FLORIDA
AS A MUTUAL PROTECTION TO CLIENTS, THE PUBLIC AND OURSELVES, ALL REPORTS
ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS. AND AUTHORIZATION
FOR PUBLICATION OF STATEMENTS. CONCLUSIONS OR EXTRACTS FROM OR REGARDING
OUR REPORTS 1$-- RE SERVED PENDING OUR WRITTEN APPROVAL.
K�z(STon» yE ✓� -cpr rc'
REPORT OF TEST OF 6" x 12" CONCRETE CYLINDERS
COMPRESSION TEST
85 28027 36,500 1290 7
85 28.27 36,250 1280 7
85 28.27 36,250 1280 1280 7
85 28,27 28
85 28027 28
Concrete cylinders cast on 1 0/1/57 by PTL Repr. @ Jobaite
@ 2:30 PM
Residence 25 NE 99th Street, Lot 15, B1k 9, Miami Shore
Tie Beam, north side
2500
7'x1/2 Inches
None
SUPPLIER M, G. O'Neal
LABORATORY NO.
FOR
M. G. O' NEAL
11000 N. W. 14th Avenue
Minn.,, Florida
CRUSHING LOAD CRUSHING STRENGTH
LBS. LBS. PER SQ. INCH
JOB NO.
MA 52323
FILE NO.
CUSTOMER'S ORDER
oat. 8, 1957 (7)
OATE
AVER.
FORM 1221 -MA
AGE
DAYS
QUANTITY T 78.
TRUCK NO. 17 Drum
TICKET NO. 10373
. eyatono Developers MIXING TIME 75 min.
BLDG. PERMIT NO.
Cyla. east by : Walsh
Above cylinders were made without prior.' uotioo to Ba•i;oher or Plant concerned.
Note: Above 7 day results give indication of possible
compressive strength failure of concrete at 28 days
for the strength specified.
PITTSBURGH TESTING LABORATORY
Ps f
fi
DISTRICT MANAGER
We are in receipt of Test Reports from
Laboratory which indicate a ( ) failure ( ) possible failure to meet code
requirements for compressive strength for concrete which you placed in -
location in structure
address of structure
Date
CC:
DADE COUNTY PLANNING, ZONING & BUILDING DEPARTMENT
NON - CO1'PLYING CONCRETE
We call your attention to the following paragraph, from Building Officials
Committee of South Florida on Handling and Testing Concrete.
VII
Procedure Where Poured
Where 7 day concrete tes reports under any of the foregoing procedures indicate
possibility of 28 -day failu e of concrete, the BUILDER shall immediately be
notified of such failure in 1 iting by the Building Department concerned.
Criteria for determination of f 'lure shall be as designated in A.S.T.M.
Designation c - 94. If the BUILD elects not to remove such concrete, but to
continue construction, and the 28 - concrete test reports show failure, the
builder is responsible and can core -'-st, re- design to compensate for non-
complying concrete, repour, strengthen or remove any part of the structue in
question. Whatever alternative is chose it must meet with the approval of
the Building Department of the jurisdicti•n concerned.
Unless and until arrangements satisfactory o this Department are made Ito
further inspection on the structure concerned will be made.
Please contact the Building Division. Phone FR 3 -2889