1130 NE 100 StPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 3 V Job Address 0 /T Q ,S"3 Tax Folio
Legal Description Historically Designated: Yes No 1✓
Owner/Lessee / Tenant (jA`e••.. OS . k . Master Permit # T 97
Owner's Address /13 0 NO hod 6 4 - / : aui.I S N d r`.CS Phone ZO S ? S/"' ? S
Contracting Co. 1 2 r"400p cn At k Address fy 7 91 N 117 Igo 11/A lcc4
Qualifier /N i the— "AA:it(( SS# /Phone 3A( 6"5'7o 2
State # Municipal # Competency # 1 720 Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING VING ^ENCE SIGN
WORK DESCRIPTION AS Ad I ` •.ZV 606(,l ci
Square Ft. 4? 6
WARNING T() 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 . all work will be done in com
construction and zoning. Furthermore, I authorize the above -named contract to do the ork stated.
° l
Signature of owner and/or Condo Presi ent Date
FEES: PERMIT
• SHAWN OTOOLE
MY COMMISSION # DD 026739
EXPIRES: July 10, 2005
Bonded Thru Budget Notary Services
otary as to Owner and/or Condo President Date
My Commission Expires:
RADON
APPROVED:
Zoning Building
Mechanical Plumbing
C.C.F.
Estimated Cost (vain /C1gt4
/
Signature of Contractor or Owner-
NOTARY
Electrical
liance with all applicable laws regulating
uilder
— /E 3/0 /
Notary as to Contractor or Owner- Builder Date
My Commission Expires:
Structural Engineer
SHAWN OTOOLE
MY COMMISSION # DD 026739
EXPIRES: July 10, 2005
-t OF Row Thru Budget Notary Services
BOND
TOTAL DUE
014
attached survey, performed by .6
Witness(sign and print
(da /61/
f survey)
STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant, (Dct (E, C. Ch frog» l(,, does hereby attest that the
(property owner)
(name of surveyor's company)
D /f
performed on , is an accurate representation of the existing conditions and
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..
Further, Affiant sayeth naught.
Affiant/Property owner
Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this day of
Affiant is personally known to me, produced as identification.
o` •P. &„ SHAWN O'TOOLE
MY COMMISSION # DD 026739
EXPIRES: July 10, 2005
OF °'c' Bonded Thru Budget Notary Services
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, ( Dc, 1E On-{-COLA.. k t , hereinafter referred to as the Owner of the
(owner)
following described property:
Legal description /folio #:
Lot {.
Tax Folio #:
requests permiss on to install:
m ami ShoreJ
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 - 2382
Telephone: (305) 795
Fax: (305)_756 -8972
Block Pk Subdivision SCCA'tdk ,
SHAWN OTOOLE
MY COMMISSION # DD 026739
EXPIRES: July 10, 2005
�Fno coo' Bonded Thru Budget Notary Services
pRtuEcu/+'/
APPRo tf
['Asphalt, concrete, brick pavers
[ ] Landscaping
[ ] Other
within the public road right of way of 1 13 0 I'V . E , (00 .5-6 r E r-t_
(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. If 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 day of
(owner)
SIGNED, SEALED AND DELIVERED in the presence of //� u
To:
08/24/01 03 :04:00 Stiles Corporation -> RightFAX Page 001
DSTILE5 ■
CORPORATION C onstruc t i on
Ihttp: lwww.stiles.com
From: Name: Mariangeli Lebron
Voice Phone: 954 - 627 -9150
Fax Notes:
Name:
Company:
Fax Number:
Voice Phone:
THIS IS A 2ND REQUEST / REMINDER:
Please see attached invitation to bid for Walgreens at Coral Way in
Miami, Florida. It is important that you mark whether or not you
will be bidding on this project and fax the invitation back as soon
as possible.
If you have any questions, please contact me at 954 - 627 -9150.
Thank You,
Mariangeli Lebron / Preconstruction Manager
Date and time of creation:
Number of pages including this cover sheet: 02
FAX COVER PAGE
Alan Moore
Arrow Asphalt & Engineering, Inc.
305 - 556 -0288
Friday, August 24, 2001 06:58:46
A RightFAX Communicated Document
300 SE 2n Street
Fort Lauderdale, FL 33301 -1907
Main -VOICE (954) 627 -9300
Internet: http://www.stiles.com
FAX: (954) 627 -9174 E- Mail: scc @stiles.com
.(ETCH :OF BOUNDARY * SURVEY
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BEARINGS HEREON (IF ANY) ARE REFERRED TO AN ASSUMED VALUE OF
FOR THE
SAID BEARING IS IDENTICAL WITH THE PLAT OF RECORD
ACCORDING '10 THE N.F.I.P. THE SUIJECT PROPERTY FALLS WITHIN FLOOD ZONE:
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a
LEG'AL DESCRIPTION
•
LOT b
SUBDIVISION: to \JV7fQ pia-( 60, -i I c9ecirtoo
ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 4 '
OF THE PUBLIC RECORDS OF OA96
LOCATION SKETCH
SCALE 1 100 oO IO2TH
F.B. NO.
(11X) IOD ft-+ (2 ?- ( i-{141,41 �t -�D�Fh -l. �r31 38
612A-CAJC.t{ 1-140A-f-00?-49
- (PfLt tozxpatu6 f-000‘ 104
SURVEY CERTIFY TO : - ktAc >1\'EI> y .v 00-164.ciE Cpl/ph.431 i 11 ‘ iof-ci AiJO lop- ayylGr.iy
THE ATTACHED SKETCH OF BOUNDARY SURVEY OF THE ABOVE DESCRIBED PROPERTY IS A TRUE AND CORRECT REPRESENTATION OF A FIELD SURVEY MADE UNDER
MY DIRECTION AND MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS IN
CHAPTER 61G17-6 FLORIDA ADMINISTRATIVE CODE, PURSUANT TO SECTION 472.027, FLORIDA STATUTES.
FOR: SOLI L) pp,,, k
9-(¢ouAL &up t2t44 0 Cac.1,-
JOB NUMBER 1 (/D(o - � DRAWN BY:
- CHECKED BY:
DATE OF THE FIELD SURVEY w -IQj - r�
REVISION DATE:
SURVEYORS NOTES:
LEGAL DESCRIPTION WAS FURNISHED BY CLIENT.
NO UNDERGROUND INSTALLATIONS OR IMPROVEMENTS HAVE BEEN LOCATED. EXCEPT AS NOTED.
THERE ARE NO VISIBLE ENCROACHMENTS OTHER THAN THOSE SHOWN
FXAMINATION OF THE ABSTRACT OF TITLE MALL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENT, IF ANY
AFT ECTING THIS PROPERTY .
FENCE
OWNERSHIP BY VISUAL MEANS ONLY (IF ANY), LEGAL OWNERSHIP NOT DETERMINED.
LEGAL DESCRIPTION SUBJECT TO ANY DEDICATiOu, LM(TATIONS, RESTRICTIONS, RESERVATIONS OR EASEMENTS OF RECORDS.
Q CENTER LNE
• .PROPERTY LINE
WW =RIGHT-OF •WAY
C.L.F. =STAIN UNC FENCE
W.F. .n000EN FENCE
RES. RESIDENCE
I,P =FOUND PON PIPE
S.R.B .><SET RE-841
C.8. =CHORD BEARING
MEAS =MEASURED
S.N &O .SET NAL & DISC
F.N. =FOUND NAIL
ABBREVIATIONS (IF ANY
a BLEAR
ENC. =EfICROACFA/ENT
C.B.S. =CONCRETE BLOCK STRUCTURE
DONC. CONCRETE
=DIAMETER
D.M.E. =ORAINAGE MAINTENANCE EASMT.
S.I.P. =SET IRON PIPE
F.O.M. .FOUND DRILL FOIE
A/C .AIR CONDITIONING UNR
REC. =RECORDED
F.N.&D =FOuNO NAIL & DISC
F.C.N. .FOUND CUT NAIL
APPLIED)
U.E.
W.M.E.
PROP. COR
F.M.
EASILY.
F.A.S.
LOA.
CALC.
F.S.
RAD
F.
= UT*JTY EASEMENT
=WILL MAST. ECfWMGE MT.
� .IONUMENT up
•PROPERTY CORNER
.FIRE HYORNIT
• EASEMEM
.FOUND RE•$AR
=SET MU- ROLE
=CALCULATED
.FOUND SPICE
.RADIAL
•FOUND (TYP).TYPICAL
BLOCK 118
AT PAGE 67
COUNTY, FLORIDA.
E. BELTRAN & ASSOCIATES, INC.
12533 S.W. 30th STREET
MIAMI, FLORIDA 33175
PHONE: (305) 552 -7450
CERTIFICATE OF AUTHORIZATION UMBER LB 5233
ERNESTO BELTR
PROFESSIONAL SUiiVgYOR & MAPPER NO. 4885
STATE OF FLORIDA
DATE: (o- t8 (g518
NOTE: THIS IS NO A VALID SURVEY WITHOUT
THE ORIG AL RAISED SEAL AND
SIGNATURE OF A•FL ORIDA LICENSED
.SURVEYOR AND MAPPER
Disapproved Da
(Signed)
Building Inspector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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.
•
Owner's Name and Address <...i 44 - Gam- (j
Date 1 J e. q p 19
�`�-
No.. . / 1/- Street... /. .O . •r- ..
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors) 6. ..ill C ' f
k g W i v i&. /1 « t.t �-�
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stones
To be constructed of Kind of foundation r
Estimated Total cost of improvements $ `As.) d Amount of Permit $ "...:403aing
Zone cubage required plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
Lhereby submit all the 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 and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the 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; and will 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 agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) — & ' 1 1 -
STATE OF FLORIDA,
COUNTY OF DADE. j ss
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is e.
of the above described con uction, that he ha carefully read the foregoing plication, and that he did sign the same, and that all facts
therein by him stated e. Q ,
Permit No 7 5 Date.- / _ _ _.. , mo t ead, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member
Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and/or workmanship.
0