940 NE 99 St (6)11)
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Ins ection Request
a o, Date (f
Type Insp'n — Permit No. !<J Oct /35L3
Name R ,
Address -/ tQ
Company
Phone #
Inspection Date
Correction
Re- Insp'n Fee ❑
BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department E T V D
10050 N.E.2nd Avenue, Miami Shores, Florida 3318
Tel: (305) 795.2204 Fax: (305) 756.8972 JC1 1 2 Zoo
Permit Nm- -_ -.. �" 43
Master Permit No.
FBC 2001
Permit Type (circle: Building Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Title o er) SOH") 6_44.A-e.g. Phone # 30 6' / 3 - 390?
Owner's Address 9'S/O •ve. 99 a :..
City Mil". r 3/- Io?.eS State Pc- Zip 35/33
Tenant/Lessee Name Phone #
Job Address (where the work is being done) 9 Nf 99 5 T.
City Miami Shores Village County Miami -Dade Zip 33/3 3
Is Building Historically Designated YES NO
Contractor's Company Name V5 B Phone # 956' -0076
Contractor's Address 170/
City DA✓ /E State F Zip 3 33/V
Qualifier SA .'• e S g
State Certificate or Registration No. G 0 SO 8& S
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit 86 O. O O Square Footage Of Work: S0 3
Type of Work: ['Addition ['Alteration ENew 0-- Repair/Replace ❑ Demolition
Describe Work: S7 -2 2. " OG_A C iiGr4GG` Ho
6/0 61 N G PA
Submittal Fee $ JV - Permit Fee $ L p J CCF $ 3 , CO /CC
Notary $ Training/Education Fee $ / , ' Technology Fee $ 3,13
Scanning $ 3 Radon $ Zoning Bond $ 309
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite side)
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
92cic
Certificate of Competency No. 90 -/2 zo.
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
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. 1 the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature � ' Signature
Owner or Agent
The foregoing instnunent was acknowledged before me this
day of J 'g 20 t by
who is personally known to me or who has produced b C®
As identification and who did take an oath.
NOTARY P IC:/
Sign:,
Print:
APPLICATION APPROVED BY:
Chc 05/13/03
ill. Li
' Contr. tor
The forego ent was ackno ledged before me this =J
day of , 2064 by , 411 Q2,0 �l�!
cw ho is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC: S 1
Sign: / /14(1' /
Print:
` ,'1, ,
` Trudy assell Trudy Vassell
My Commission Expires: ?° y My Commission Expires: fi ' ;
Commission #DD323982 . ° 4 Commission #DD323982
* * * * * * * * * * * * * * * * * * * * *,w **
*: ° ' r�26tppg**************** * * * * * * * *,� * *�.okEitpires
' '';'oF F� °�` Bonded Th
Bonded Thru r o
'" ii‘` Atlantic Bonding Co., Inc. Atlantic Bonding Co., Inc.
Zip
************************************************************ r+ k********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ocr 1 3 2001 Plans Examiner
Engineer
Zoning
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, 40140 z , hereinafter referred to as the Owner of the
(o Ci�
0 NE 99
following described property:
Legal deescription /folio#:
Lot (D 4- 7
Tax Folio ::
requests permission to install:
s halt, concrete, brick pavers
] Landscaping
[ ] Other
within the public road right of way of
SIGNED. SEALED AND DELIVERED in the presence of:
fl //iamj S/lorQ� (/i�Ccc�Ce
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 - 2382
Telephone: (305) 795 -2207
Fax: (305) -756 -8972
N���uLw 1 7
J� PPR o tf
Block 30 Subdivision __/f IA-j ( go d• C 70 .'J
(address)
IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows:
I . To maintain and repair, when necessary, the above - mentioned item(s) installed within the dedicated right
of way. I f 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 IS' day of
9546896738
10/26/2004 14:42 9546896738 STATE'4IDE PERMIT SER
Di I I*Ia <.VRIFfICIY‘t /VIE V I
A REC MUST BE POSTED ON THE JOS SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO.
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: 5/i FA^' -Y
940 Ale 99 5-p
2. Description of improvement: �+ r�q -c.� '/ �� O1 G �Q 442/4-44 / v701
3. Owner(s) name and address: C4 z- 4
5W' AVE 99 yr fl 4i' i .5,4474.0S
Interest in property:
Name and address of fee simple titleholder:
/�► «rya r� 3 5i; k
4. Contractor's name and address:' 4' S ,t6,G. t 42fc.Qr,,C
270 //Ze .t.460 ! 33'3d'
5_ Surety: (Payment bond required by owner from contractor, if any)
514r- . 4')P cl_CAl£1A C0 Or mo
4 2,21 ley of
77a7 .
Name and address:
Amount of bond
_ 6. Lender's name and address:
Sig caner
Print Owner's Name .� • ► . _ C
Sworn to and subscribed before
At
me this /5" day of �ePr = 20 !3"rf
Address:
PAGE 01/01
11111111111111111111111111111111111111
CFN 20O4RO8•555:3
OR Ek 22726 Pe 3789; (1os)
RECORDED 10/13/2004 10:48 =31
HARVEY RUVIt1r CLERK OF COURT
I1IAflI -DADE COUNTY' FLORIDA
LAST PAGE
1 l:V i'41 _ Ct. z f
7. Persons within the state of Florida designated by Owner up fo 411.111F m ot or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes,
Name arid 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. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
Notary Public `
Print Notary's Name,
My commission expires:
123.01 -52 PAGE 9/OZ
,q= Expires: 03, 2008 p� (�/ �
.s . a �L':rt by 1 L j u` i_1'
rdia c+ tid Feb ,1
5&nee, P io, 269
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Building Permit
Printed: 10 /21/2004 Page 1 of 1
Applicant: JOHN CACACE
Owner: CACACE JOHN
JOB ADDRESS: 940 NE 99 ST
Contractor US BRICK I& BLOCK SYSTEMS Contractor's Address: 2701 REESE ROAD
Local Phone: 954- 792 -0076
Parcel # 1132060143380
Permit Number: BP2004 -1343
Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOTS 6 & 7 BLK 80 LOT SIZE 100.000 X
Fees: Description Amount
FEE2004 -10362 Building Fee $125.00
FEE2004 -10363 CCF $3.00
FEE2004 -10364 Training and Education Fee $1.00
FEE2004 -10365 Technology Fee $3.13
FEE2004 -10366 Scanning Fee $3.00
FEE2004 -10367 Builders Bond $300.00
Total Fees: $435.13
Total Fees: $435.13
Total Receipts: $0.00
SP
Permit Status: APPROVED Permit Expiration: 4/10/2005 Construction Value: $4,860.00
Work: INSTALL OLD CHICAGO BRICK PATIO AFTER REMOVING EXISTING PAVERS
Signed:
(INSPECTOR)
OCT 26PAID
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:
0