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DRIVEWAYMIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buildin g Inspection Request Date ( /O Type Insp'n CC? S/4 Permit No. v � O' - 39�j Name Address S4')- ME q ST Company Phone # ?:O — 7S7— tp ' {7b Inspection Date (p' 'gib Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date / • , Time Type Insp'n Permit No. Name Address' Company 22 4) Phone # For Ins sector: ( / 4) Tame & Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request ate - Type Insp' Permit No. Name Address Company 1 0 Time Phone # 3 - - 1 S '° ( / i S For Ins ,ecton —S1 t / Name & Re- Insp'n Fee /ci f' S�' Cr ere c f MIAMI Shone: Village Building Permit Permit dumber; 8P2002 -82r } AXTON S42 NE 99 A ULTON DANIEL ST ° a100AAflVE MASONRY INC Contractor's Address: 310 NE 99 ST ' 005) 757.7705 1101100 732050142430 i -do . /- PAY TO THE ORDER OF Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOT 7 & E1/2 OF LOT 8 BLK 72 LOT SIZE Description Amount -2398 Building Permit Application Fee $60.00 = 2 -2399 CCF $1.20 �CCZ -2400 Notary Fee $5.00 Total Fees: $66.20 — NQ Work: REPLACE EXISTING ASPHALT & CONCRETE DRIVEWAY TO INTERLOKING PAVERS Permit Status: Approved Permit Expiration: 10/23/2002 Construction Value: $2,000.00 DECORATIVE MASONRY, INC. PH. 757 -7765 842 N.E. 99th STREET MIAMI SHORES, FL 33138 BANK 0 MERICA BANK OF AMERICA N.A. 9190 BISCAYNE BOULEVARD MIAMI SHORES, FLORIDA 33138 FOR " 3? S 11■ 1 :0 6 30000 4 ?': 00 18 10 48 2 5 211 63 -41630 DOLLA 8 : 3DD I DD otal Fees: $66.20 Total Receipts: $0.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection 0375 or in strict compliance with all ordinances been submitted to and approved by the out aythorization.. A further condition upon es and regulations pertaining to the work 8rvants or employees. Ig thereto and in strict conformity with the work done by either myself, my agent, STATE OF FLORIDA) COUNTY OF DADE) The undersigned Affiant, attached survey, performed by Further, Affiant sayeth naught. Witness(sign and print) • Maini SkoreJ lial AFFIDAVIT , does hereby attest that the (property owner) h (name of surveyor's company) performed on rj , b J , 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.. ii antfPrope Witness(sign and print) SWORN TO AND SUBSCRIBED before me this day of Affiant is personally known to me, produced as identification. Notary SKETCH OF BOUNDARY SURVEY SCALE 1"= 20 AJo2(H 1 ∎ 11-1 1 1 4 . 1 / 4 • SF.G• G - 53- 42 20' 6.5 -r pt-'` ( k 6IJr I„ ; 16r4 1 i ouE sra y 642 T' II•n . GoN , m _ N m ,rr.eu? el. X5.35 (n !8.35 „ - 75, oO' r5' 41,c - ey �9 aSPNaL; 2, 7'x2.7 . 4 kn n \\ `i � A5-(I 2 _ 0.20 Of la c _ v 8 i ..v .•, f 1 9a i O,3 i 1 i ,. lC { t . , 4 O `, ; X _ � / `F7/6 a K1 1 BEARINGS HEREON OF ANY) ARE REFERRED TO AN ASSUMED VALUE OF FOR THE SAID BEARING IS IDENTICAL WITH THE PLAT OF RECORD ACCORDING TO THE N.F.I.P. THE SUBJECT PROPERTY FALLS WITHIN FLOOD ZONE: K LEGAL DESCRIPTION LOT - 7 t >✓ A4 - r I/ Z D 1-0T S SUBDIVISION: L4 tp“( 01J �O ' ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 1 O OF THE PUBLIC RECORDS OF t: LOCATION SKETCH SCALE 'I Q b fi 1 11 110 Hi 4 -- 115 jta '1 LG�2e‘T= S 4-2 tJG q q tN i41 , Glr� u (21 A( UGq fight dl.le,Fte,NJ - fI!t,e, IIJc)�UGe., Ge54.4pAiJc{, SURVEY CERTIFY TO rHE STTACHED SKETCH OF BOUNDARY SURVEY OF THE ABOVE DESCRIBED PROPERTY IS A TRUE AND CORRECT REPRESENTATION OF`A FIELD SURVEY MADE UNDER MY DIP.ECTION AND MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVE"ORS ANO MAPPERS IN CHAPTER 61617 -6 FLORIDA ADMINISTRATIVE CODE, PURSUANT TO SECTION 472.027, FLORIDA STATUTES. FQR: (21ld 4,0 L2 N - JOB NUMBER 0 1 01- DRAWN Br. L . F.3. NO. 4 CHECKED BY: 7 • DATE OF THE FIELD SURVEY - 2 REVISION DATE: SURVEYOR'S NOTES: LEGAL DESCRIPTION WAS FURNrSIN£D BY CLIENT, NCi UNOER0'ROEMD INSTALLATIONS OR IMPROVEMENT 5 NAVE IIF.EN LOCATED, k[I;L't AS NOTEL THE 4 ARE mO v1SIBLE ENCROAGNMENTS OTHER THAN THOSE SHOWN EMAPNATION OF THE ABSTRACT OF TITLE WSJ. HAVE 10 BE MAD£ TO DETEPu..s 'ECORDEO ,NSTRUMENt, IF ANY AFFECTING THIS PROPERTY FENCE OWNERS.IP. BY VISUAL MEANS O►Ly (IF ANY), LEGAL OANERSHIP NOT DETERMINE t EGA.:•ESCRIPT KW SUBJECT TO ANY OEDK:ATK u. LIMITATIONS, RESTRICTIONS, RESERYAT OR EASEMENTS OF RECORDS. 2 AVW C .LF. W.F. RES. F.I.P. S.R.B VENTER LINE = PROPERTY LINE cRWGMT•OF - WAY 204AW OW FENCE =•OODEN FENCE iEESIDENCE IfOtMO /ION PIPE .ET RE -BAR C.B. _ >�7+ORO BEARING MEA4 CURED S.N&O S ET NAIL & MSC F.N. =MUM) NAIL ENC. • C.B.S. W X/ /CRETE BLOCK STRUCTURE CONC. :0344CRETE 6 = OtAMETER O.M.E. =DRAINAGE MAINTENANCE EASMT. S.I.R. =SET IRON PIPE F.O.N. =FOUND DRILL. HOLE A/C =AIR CONDITIONING UNIT REC. 'RECORDED F.N.3O =FOUM3 NAIL a 01 90 F.C.N. =FOUND CUT NAIL ABBREVIATIONS (IF ANY APPLIED) NEAR U.E. = ENCROACHMENT W.M.E. PRop. F.N. EA.SMT. F.R.B. 5.0.N. CALC. F.S. PAD = UT EASEMENT =MILL MA HT. &171F4voGE EASMT. »IONLMENT UNE = PROPERTY CORNER MERE HYDRANT = EASEMENT =FOUNO RE-BAR =SET DRILL HOLE =GILCUUCED =FOUND SPIKE =RAWL JIoIMD (TYP)=TYPiCa& . • BLOCK 7 2 AT PAGE 3 COUNTY, FLORIDA. E. BELTRAN & ASSOCIATES, INC. 12533 S.W. 30th STREET MIAMI, FLORIDA 33175 PHONE: (305) 552 -7450 CERTIFICATE OF AUTHORIZATION NUMBER LB 5233 ERNESTO'BELTR J -: PROFESSIONAL SURVEYOR A MAPPER NO. 4885 STATE OF FLORID, DATE: - 2 _ 2O NOTE: THIS IS NOT A VALID SURVEY WITHOUT THE ORIGINAL RAISED SEAL .AND SIGNATURE OF A FLORIDA UCENSED SURVEYOR AND MAPPER. JOB ADDRESS g'Y..2 /v i 97 5 APPLICANT PHONE # n APPUCATION Dgi UFrw$y SHEET OF :. . MISCELLANEOUS DATE ZU.NINC' CRITIQUE SHEET PERMIT NO. 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 et Federal, State, County. Wage riles end regulations. Village asssi no responsibility for accttrecy olio( results tract t:ass pans, 2. Thls copy of plans mutt be available o0 tR:Rdtng site at no Inspection will be conducted. COMMENTS INITIALS Oct- Aid // t/5/cis oyc/ .4 e o46y 69v6 3 d E e(6 & ` - I' t3 '4) • CONTRACTOR New Construction Name r iil;+e /, 0077 / T,t License No. O4, AZ Address ,99a :? /f/-- / 95—Z -� /_J �J Alteration Interior Teleph 7-- s7-77�iS F s i.� S/ Demolish 7 Qualifier Name � Zdj„ � w Shell Only 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. 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 submitted along with this permit application. Step 2. Submit 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 Address Apt. Folio Number Lot /1 "9 Block 72 Subdivision 4t lcr�/50 3PB /Q PG 37 Current Use of Property Si/ , W'4 s'- Proposed Use of Property — it / , l Tenant Information 3e.4 / Description of Work gro / .rG& Zoning PERMIT TYPE (✓ ) Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax PROPERTY OWNER Name Address Home Telephone Business Telephone Fax Master Permit No. p 'a.noe-g- • Subsidiary Permit No. City State PERMIT APPLICATION Zip Linear Feet Square Feet /7t 2 Units Floors `_" — Value of Work� Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Page 2 I1IPORTANT NOTICES L. 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. ,A F. IDAVIT - 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. IDA, Cjs� I -DADS r _ S'r- tire o i wner Print Name t Sworn to and subscribed before me this) t day SEAL: h rc • Personally known - � F lic - State of Florida -.DIAL • 0 ACTF..I-A Dq B =L. co`S•_'sv"oN fl • CC7d6b9 C R, Prbducedldentification Type of Identification Produced: Notary Pub Print Name Sworn to and subscribed before me this Signature SEAL: Personally known PERMIT APPLICATION tate . CFlorida �p,Cil PUe � 11,� M ®4:. Z •4 � � �c c o : o; „,C'ic t �! ° c a t,u91 OR, Produced Identification Type of Identification Produced: ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE, Service Repair • QTY. A/C Central 1 -3 Ton Dryer Vents, Number of Fan Ventilation, Cost Outlet, Wall Ductwork, Cost of Service, Temporary Periodic Inspections A/C Central 4 -7 Ton Fire Sprinkler System Fire Pump Outlet, Switch Fireplaces, Number of Signs A/C Central 8 -15 Ton Fixture - Fluorescent 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 TYPE QTY. Minimum Fee TYPE Condensate Drain QTY. TYPE. Generator QTY. TYPE QTY. Refrigeration, Tons 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 Air Handler, Tons Ductwork, Cost of - Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel PLUMBING TYPE . A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. 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 ® OWNER - BUILDER FORM (Attach) 01 FIRE DEPARTMENT APPROVAL (Commercial / multi- family) 01 CONCURRENCY (New Construction) 01 OTHER (Specify & Attach) PE RIVIIT FEES $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 ® PROOF OF OWNERSHIP (Attach) • HRS / DERM APPROVAL (Septic / Sewer) ® IMPACT FEE (New Construction) C11 OTHER (Specify & Attach) REVIEWED AND PREPARED BY: SECTION BY Mechanical DATE Zoning Electrical Plumbing Fire Public Works Structural Building Official (sq.ft. = x/1000 x ¢.60) (¢.005 /sq.ft.) (¢.01 /sq.ft.) CONDO ASSOCIATION APPROVAL (Attach) 01 BPR APPROVAL (Restaurants) 01 CONTRACTOR REGISTRATION (On File) PERMIT APPLICATION DATE: Revised July 2001 10050 N.E. 2"fD AVE., MIAMI SHORES, FL 0 (305) 795 -2207 o FAX (305) 756 -8972 c http : / /www.miamishoresvillage.com PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 79/ 9 Job Address 8 4 2 N . E . 99 S t Tax Folio // - 0 .ZO 6 - O / z `{c3 Legal Description ,S6L 2 74 E lz 8 Historically Designated: Yes No Owner/Lessee / Tenant 19 /.7 / ! S Master Permit # Owner's Address A). L • 9C/ 67 Phone 751— 2-71/ Contracting Co. Adco Patch, Inc. Address 3091 NW 129 St., Opa Locka, FL Queer Eddie J. Barnes SS# phone (305) 681-2196 State # Municipal # C o m p e t e n c y # E — 14 0 Ins. Co. T r a v e l e r s Ins. Architect/Engineer Bonding Company Mortgagor Address Address Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Rock & Asphalt Paving Square Ft. 472 Estimated Cost (value) Z-/t/ , DO WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I 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, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work stated. g_a att.41 Signature of owner and/or Condo President 0 Notary as to Owner and/. / ondo President My Commission Expires: . P OFFICIAL NOTARY SEAL O '<i EUNICE INSIONARES « ` I r e % COMMISSION NUMBER ▪ '; -S r Q CC436731 Ti. ^ `O MY COMMISSION EXP. OF FL FEB. 1,1999 FEES: PERMIT RADON Date .1 Date C.C.F. ,20 612 Signature of Contractor or Owner- Builder Notary as to Contractor or 0 My Commission Expires: NOTARY APPROVED: Zoning Building Mechanical Plumbing Electrical 5��6 Date ,Date. , PU OFFICIAL NOTAr,'I fir' • O ,m i <E. BARBARA ANN FUGA .. .. , COMMISSION NUMB:=: ;. a .IIP:s« a CC360191 �� ;:f� MY COMMISSION E. OF FA r 10(4:: TOTAL DUE Engineering 4# 33 M/C5 /4:55e 014D.1 Pelf zecie g c 9g 5-T4-eer' Aj ea) 14-5P/J 472.. .6to- <-0 V , exi :41 1 // 5G MIAMI SHORES? VILLAGE, FLA. N9 12894 JOB ��Sca. t�►f `- -i'l., ADDRESS ‘ ..4471-- INSPECTION• Cd." • TIME READY REMARKS • N •f - g., ,.s AL, r► iiru ¢S Pe ; ¢ - 4/ fay4 dam q ¢o — Sc - ra a47 INSPECTOR DATE • This property described. as: •Lot .7 . and the East 1/2..... . of Lo:8, Block '72,. MIAMI SHORES SECTION NO.3,, according to the Plat thereof, as recorded in Plat Book J.O, Page 37 of the Public Records of Dade County, Florida. it \ PROPERTY OF: �.�• t;J. t0 _i a_ Z 6 to gyp *o' 12 0 • 'J `; • ,,A&-1. P at.t -( ;IAA./ T�-E at✓ r! / rat, 1 '1 . o ro t tJ ► u Plt. y. Ot �L �, St.AP8 1) I ca►1c • 5L g' 1 ° loo Qti�d�vs :. A 44;42E1? I. . Y / G . / `.XI r 4, IN w.- 1 FA • 75.0', g SiGB4L6.1,}! � • Z3S•a• 0 6