DEMO-10-874X
5.20 Miami Shores Village pCMIEWEti
MC,550ef Building Department M YIP ! ?ai
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: BUILDING ROOFING �� �+
Owner's Name (Fee Simple Titleholder) Ct. or) e S id hie, 1 ?%U� q.,� Phone # gB -- 770 O ° yd 7 ,f
Owner's Address 6
City M tg �1 SloreS State Ftc.. Zip 3 fi'b
Tenant/Lessee Name Phone #
Email
Job Address (where the work is being done)
City Miami Shores Village
FOLIO / PARCEL #
Is Building Historically Designated
YES NO K Flood Zone
,. ----- irk
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Contractor's Company Name ' 6a -.,. v c1 Phone # /SK f/-r / ' 3
Contractor's Address `7 g Z./ e
City fV ) I itifit l • -c2 State g I Zip Z/6 6 5
Qualifier Name c . ,_ u a „g Phone # yr& g c;4 '7 & 7
State Certificate or Registration No. ($ C v C.,-7 I Certificate of Competency No.
Contact Phone
Double Fee $
Structural Review. $
gineer's Name (if applicab
Value of Work For this Permit $
Type of Work: DAddition
Describe Work: 9-14AL
Scanning $ yo.=. Radon $
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
County Miami -Dade Zip
Master Permit No.
8
Permit No.tent) [ 0'81 l
may, 3..'1f? 7E -mail �� /�,r�o'6#M A-a - *,ct I a Cc) kild‘4
M A e/AAA,P Phone # D Z' - 3 a 3 — 2
0 Square / Linear Footage Of Work: el / 4
DAlteration ❑New ❑ Repair/Replace Demolition
ak. t 1 ,i /,e`19 Q
******** * * * * * * * * + * * * * * * * * * * ** * *** * * * * ** F ees * * ** **** * *** * * * * * * * *** * * * * * ** * * * * * * * * ** ****
Submittal Fee $ Permit Fee $ /04c9 CCF $ CO /CC $
Notary $ J
Training/Education Fee $ . Ye
Violation date:
Technology Fee $ /6 0
DPBR $ Bond $
Total Fee Now Due $
61-
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.
APPROVED BY
(Revised 07 /10 /07)(Revised 06/10/2009)
Signature
Contractor
The foregoing instrument was acknowledged before me this 1 e 9 The foregoing instrument was acknowledged before me this .
dl •. C i ff ,D day of t)1 A't , 20 0, by
who is perspnally known to me or who has produced w o is person��il! or who has produced
rOQ∎\21:,..4 for Al As identification and who did take an oath.
NOTARY PUBLIC:
Sign: a. d ��� , l � '..1
Print:
INDIA
My Commission Expires: 1, MY DQMMISSION # DD8M93:4 mmission Expires:
° EXPIRES December 15, 2012
MR) ainm � Iortda Notary Sernce.com
* *Rr3r*9e, Y9rdi3eaY9r*, F, F9e*** *****4e9r3e9e3edz*dr*dek ***** e3e3e3ek*3r*9e9e**** sY, Y3ek *: Y4r**3e3ezYdr, Y9e3e3edrde9e3r********** 4e*:Y*9e3e**3a ****9r9rYr*3***
Plans Examiner
Engineer
.�� . •''' s station and who did take an oath.
1O T Yt Infi
0 I19nd AN ON . _ '
5 i 0
Zoning
Clerk checked
Inspection Number: INSP- 143601 Permit Number: DEMO -5 -10 -874
Scheduled Inspection Date: August 24, 2010
Inspector: Bruhn, Norman
Owner: PICKARD, GEORGE SIDNEY
Job Address: 869 NE 98 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: DOUBLE DIAMOND CONSTRUCTION INC
Building Department Comments
DEmo Rear Deck and roof.
Passed i
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
C(-
August 23, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
Permit Type: Demolition
Inspection Type: Final
Work Classification: Building
Phone Number
Parcel Number 1132060142510
Phone: (386)847 -8899
Page 6 of 35
CONC. DRIVEWAY
101.69" (
SW(= SIDEWALK, CBS = CONCRETE BLOCK STRUCTURE, CLF=CHAIN LINK FENCE, PL =PROPERTY LINE, DUE =DRAINAGE UTILITY EASEM ENT, IP =IRON PIPE,
F =FOUND, A/C =AIR CONDmONER PAD, P/C =PROPERTY CORNER, DM =DRILLED HOLE, W'F =WOODEN FENCE, RES= RESIDENCE, CL- CLEAR, RB=REBAR,
UE =UTILITY EASEMENT. CONC= CONCRETE SLAB, RNWRIGHT OF WAY, DE =DRAINAGE EASEMENT, C/L =CENTER LINE, O =DIAMTER, TYP =TYPICAL,
M= MEASURED, R= RECORDED. ENCR = ENCROACHMENT, COMP =COMPUTER, ASH =ASPHALT, N/D =NAIL & DISC, S =SET, FEE= FINISH FLOOR ELEVATION,
0 /S= OFFSET P/P =POWER POLE, OHP =OVERHEAD PO■ERLINE, WN =IMTERMETER
WOOD FENCE— ELEVATION BASED ON LOC. #
MASONRYWALL I I I I I 1 1 I I I
CONCRETE= t i s•'.••I,r.••I 'eV •I .•IN.i
MAINTENANCE & DRAINAGE EASEMENT= M &D.E CBM# ELV. TYPE OF SURVEY: BOUNDARY SURVEY
SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATURE
AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT
COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5)
UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC
VERTICAL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL
RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9)
CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING
INFORMATION. 10) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED
INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY.
BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB PAGE
SURVEY FOR: GEORGE SIDNEY PICKARD JR., 869 N.E. 98TH ST. MIAMI SHORES, FL.
33138.
LEGAL DESCRIPTION: LOT 20 & W. HALF OF LOT 21
OF MIAMI SHORES SECTION 3
ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLA, BOOK 10
MIMI
OF THE PUBLIC RECORDS` -DBE COUNTY FLORIDA
IitJECT is() :'CP "PI_L4P.IC- � m�._._��
n rTl 1 "
r
r' LS 4. - Jfl
Engineers • Land Surveyors • Planners • LB # 0007059
555 NORTH SHORE DRIVE
MIAMI BEACH, FL 33141
(306) 865 -1200 Email: blancosurveyorsinc @ yahoo.com Fax: (305) 865 -7810
91x/09 BASE. N/A
COMMUNITY# 120652
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� �,xr: �t � � 6 - - :-c� - �,s. �.: _ � k ar,�'r-r^ �' "' a - _r?F' �.� .� � � i yr �, r5� .4'" cu a` �� `�.: - ,� '�. _^(Y4 ,^,`i ��.. ^..,,.h;:.:
,.__,-- �r,.r�.,, .._..-•- ,-.<.. -��, „. �. ._.;� c..'�_..:,:� �. -:�.,, �.,_ a�.?x"''i'�,� �- �,.� - -2.� _.a ^�,r,.,7urra._a:x._,s�. �- �,r.�_.. _ .... .. ....... .�� _,__,�k .......: -�. -_ .-
1 HEREBY CERTIFY That the survey represented
thereon meets the minimum technical requirements
adopted by the STATE OF FLORIDA Board of Land
Surveyors pursuant to Section 472.027 Florida
Statutes.
There are no encroachments, overlaps, easements
appearing on the plat or visible easements other than
as shown hereon.
ADIS N. NUNEZ
REGISTERED LAND SURVEYOR
STATE OF FLORIDA #5924
NOT VALID UNLESS EMBOSSED WITH
SURVEYOR'S .SEAL