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120 NE 100 St (11)MIAMI SHOiES VILLAGE ('J\ BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Ip.r1 -03 Time Type Insp'n v\a. (pe (U 2 4 e)ai Permit No. e p- 2065- 15 ) L t Name yi vio rksT Address 17 1klE /!y> �T Company Phone # For Inspector:gP )0-$'03 Name & Dat Correction Re- Insp'n Fee PECEOVED 1 7 2003 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Tenant/Lessee Name Value of Work For this Permit Skim . -Miami Shores Village Building Department City ►1JM i ` r-e ;., State 1 L Zip 3 "3 1 3 Phone # * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. P0 -( )3 (S1 `t Master Permit No. Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder)1 oe,;N' o � � o,�n (.J'(Phone # ( czs 7 j 1 7 7 (0 Owner's Address 160 Ni b E b (00 \ Job Address (where the work is being done) 1 t^,L) NI‘. L . loo St - City Miami Shores Village County Miami -Dade Zip 3 Is Building Historically Designated YES NO X(, Contractor's Company Name .B L C._,CG 7 . \ - RxX1- °(fi) C1PSJ3P I Phone # )off 4 Q J 25 C. Contractor's Address 3(0? t. N, 0 - It t.5 r , City k \q t\ D \ State 4 - Zip 3 30 5 . Qualifier bo N 1 rlt C ((7 - 5 • 1_0 Z Architect/Engineer's Name (if applicable) H)19 19" . Phone # Architect/Engineer's Address City State Zip Square Footage Of Work: ± (DSO Number of: Bays Stories Families Bedrooms Baths Type of Work: ['Addition ['Alteration New ❑ Repair/Replace ❑ Demolition Describe Work: _ CO C Z E v 6 '( - County Escrow Fee $ - d • Permit Fee $ G0 .00 . Notary $ 5 . CEO . Education/Training Fee $ Tech $ Scanning $ Radon $ Code Enforcement $ Bond $ 3cD0 .00 . Struct. $ Minus Plans Check Fee $ Total Fee Now Due $ 3C - . (Continued on opposite side) t=ee5(22 . RIcCQ i n FU11 0.,1Cr 1 081 Bonding Company's Name (if applicable) I I Bonding Company's Address Mortgage Lender's Name (if applicable) 1 City State Zip 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 - applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be deliverer' to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be poste at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of Lich ' .'sted notice, the inspection will not be approved and a reinspection fee will be charged. chc7l7 /o3 NOTARY PUB Sign: Print: Signature " �� Signature Owner or Agent C• , tracto The foregoing instrument was acknowledged before me this AS ---- The foregoing instrument was acknowledged before me day of $ 'p , 2 0 423 by , day of • , 20 U3 by who is personally known to me or who has produced F . who is personally known to me or who has produced pe(// ft x, C As identificati • , and who did take an oath. :MISSION ,..# DD 155424 My Commission Expires: %U 6 p2 } rs�� �O ber 6, Zoos ********* * * * * * * * * * * * * * * * * ***.*.* * **.* * ry s . * • � NOTARY PUB (Certificate of Competency Holder) State Certificate or Registration No. C G C 1 SO SS 5 Sign: Print: My Commission Expires: Certificate of Competency No. is 'J • as idei{'a} • : miss g' xpires: Jul 13, 2007 Boned IMAM 1117471 APPLICATION APPROVED BY: SEP 1 6 NIB Plans Examiner Engineer Zoning STATE OF FLORIDA) COUNTY OF DADE) 0 The undersigned Affiant, t\r\ v al1 anc, q , does hereby attest that the (property owner) r attached survey, performed by Cc_k k LD J�� �y o I n C (name of surveyor's compan 6}) • performed on 03 -0 Z.' S • . , 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.. Further, Affiant sayeth naught. Witness(sign and print) SWORN TO AND SUBSCRIBED before me this ir day of c / . 200 3 Affiant is personally known to me, roduced f%L DP l ✓f■ aC /e • as identification. P h GASPARE MUTOLO y < MY COMMISSION # DD 155424 1h i 0, v‘,4 EXPIRES: October 6, 2006 1-800-3-NOTARY FL Notary Service & Bonding, Inc. 1309 SE 1st Street ACCURATE LAND SURVEYORS, INC. (305) 782-1441 r SG/9LG • / "'' err /VA/L /OS 7.5 NI V1$IOM$ /DUND /L /,PoN ,o/v' W000 F'Wce f�i✓C6" D.6 'mot/ 0-2'w /o//W O /off ,4/ OAT( 1. SHEET Z OF Z 20 / /7I'Ph'r99 T /00 7 S 7 7' ,( /w Pf ✓67n 6W T 75.00' (A' 2_5 •0 C)� (/'V 7,S•D 4" /5 r i94cEy R/w NOTE, BEARINGS SHOWN HEREON ARE BASED ON A BEARING OF /Y /q ALONG TIIE LINE OF PLAT BOOK PAGE COUNTY RECORDS, NOTI 1•1 L••OI IMOW• 94INI0• WINE MOT AIITNAC110 •0• OWN(•1M1• NIGMTI.O• WAY. ON KAI(M(M•/ CERTIFICATE THIS SURVEY IS FOR TITLE AND MORTGAGE PURPOSES ONLY THIS IS TO CERTIFY THAT I HAY( RECENTLY SURVEYED THE PROPERTY DESCRIBED IN TH( FOREGOING TITLE CAPTION AND HAVE SET OR /OUNO MONUMENTS AS INDICATED ON THIS SKETCH ANO THAT SAID ABOVE GROUND SURVEY AND SKETCH ARE ACCURATE ANO CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF, I FURTHER CERTIFY THAT THIS SURVEY MEETS THE MINIMUM TECHNICAL STANDARDS FOR LANG SURVEYING UNDER RULE (oIG17 -6. F.A.0 ADOPTED MY THE LORIDA BOARD OF LAND SURVEYO OCTOElfR 1993 IrAll Il• 11 1•ROFESSIONA.L LAND SURVEYOR NO. 3669 • STATE 0 " FLORIDA ROnEITT L 1 1OMPSON %oL�2L L11C11 • 0 f J.v.0 /,Poi vi, i/. Pompano Beach, FL ><-7 33060 SE AL NOT VALID UNLESS SEALED HERE WITH AN EMBOSSED LANO SJRVICY0R SEAL. r 1(LO .00. 277/3 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Nob Address 0 OE , loo S Tax Folio 1 ) 3 a ©8 0 Legal Description � L 1 / — 1 Historically Designated: Yes No › er/Lessee / Tenant Ow K-Q—/ Master Permit # q �� ,� • er's Address 1 d 0 1 - I1 I OCR Si i S "� "Phone (3 0 ) 51- -94) -94) 7� Contracting Co. • w bw t€ 7 CoK.ST tbb - Address Qualifier VM A-% • iles..w 4 tq SS# Phone SOs) 4 S — f 3 % g State # C C t C Q 3 2$ O I Municipal # I $1 g •o Architect/Engineer NJ . -A- Address NJ . A- Bonding Company N • A- Address N. A. Mortgagor NI. Address J. A- Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION r G&J1 riU Sfi��m � r' J hP 0 tW • a Square Ft. I l x 2. - 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 perfonned 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. FEES: PERMIT APPROVED: Zoning Mechanical RADON C2 71/41 Building 17L ll a ' . F - c".`�:ate_ 1I 2 ia:�r_, fj∎ °. (;.`.. Plumbing s ,z„ C.C.F. I 8 0 NOTARY Competency # - Ins. Co. Estimated Cost (value) ) t sO b Signature of Contractor or Owner- Builder Notary as . ontracto L ; - ;'; = lilt PIR E SS iJra • , C'5 5 221 � '' .; °SIR •`r - t My Commission Expir �..r,, �� ,�N Nar 2002 Structural Engineer . 4. -- ;Q- q -2o - ot Date Date MAP *!# CC 755221 S -. ?92( . • a .. L'ndrrwrite -- rs BOND TOTAL DUE - TJ b L 0 WHEREAS, A yi UceY following described property: Legal description /folio #: requests permission to install: COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY (owner Tax Folio #: ) l Sao 6 / 3 a ) (� a / iami Shor� (/iCLccc�e 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 -2382 Telephone: (305) 795 -2207 Fax: (305)_756-8972 , hereinafter referred to as the Owner of the Lot ) a � Block- ) 6 Subdivision S S( 1 f) rn Asphal concrete brick pavers .p p p2bs ,cL . [ Landscaping [ Other ()) within the public road right of way of )D) (� �, Q 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 10 day of S 2) .pRluicu/+y APP SIGNED, SEALED AND DELIVERED in the presence of: ' ' ` 4 & STATE OF FLORIDA) COUNTY OF DADE) attached survey, performed by The undersigned Affiant, / r1 UG ✓ A , does hereby attest that the (property o µ? r) • . ..* i. ./ . 4. ►' _ _ l 1 ..4.4 _ 4 1 name of surveyor' company) performed on ) 0 / ( (Q y , is an accurate representation of the existing conditions and ( to of urvey) 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. Witness(sign and print) SWORN TO AND SUBSCRIBED before me this lank day of 5& 6M �0 / pe Affiant is l rsonally known to me, produced as identification. OML.P.I,NOTAV a2 C (//N,CNI NOTARY fi x. COMMLSSIoN two. C `"�3`i'i� MY COMMISSION V . -I 6,2(10 Notary SG / "' ,e'O 66r NA/4 (�r.7,9 -9 1V111101411 O.2 1 k 6 e 1309 SE '1st Street ACCURATE LAND SURVEYORS, INC. (305) 782 -1441 6' w0 00 FErvice -- -�� fG`NCG` D. 6 'A./ o. 3' n,; /v• .E. 1- - ,a w,9 COO ( PRopo eel ,._ O" Cow &.) Sti4,1) o 6.O . 943, /O O 7W S Tie Ge .7"" 75' A' /k" zo ' /7rfg ,99 r o,9 v6'rne v 7 - DATI • U / a /6.70 • � � tit j ) ss, k /8 25 V /6.70 r 4.t /20 /a• 0 0 • /0.0 '2 6C e SHEET z OF Z /5TOrey Ceg RE S /.oC cL' W /,'cs l 7-S' ' 4 fiv • /5' t9GLEY R/w NOTE, DEARINGS SHOWN HEREON ARE BASED ON A BEARING OF /Y•,9, ALONG TIIE LINE OF PLAT BOOK PAGE f COUNiY RF•CORDS, NOl( •N( LANG• •..OWN N(MION wing WWI C, E R,T I F I C A T E THIS SURVEY IS FOR TITLE AND MORTGAGE PEES ONLY S' cONC .:, - • 50 r /L1 « � o /6.05 t0 I r • Xi/I/O ' 9' y 6.8 3 /9 /c #.>$7.4, #.>$7.4, 708' /7 0 2' t 1 IOM OWN IP NIGH•••O /.W•• OM S••(N(N•• ••ROrtS!:IoNA1,LAND SURVEYOR NO. 7009. STATE RORERT 1.. Tt10MPSON Pompano Beach, FL >O 33060 Zoning Approved O c5 FD amo /,eo ^i oohee / 'd e4./ ,P0 0 f SE AL IIOT VALID UNLESS SEALED HERE WITH AN EMBOSSED LAND SURVEYOR'S SEAL. TNi5•11< TO C(.TIIV THAT 1 HAVE' RECENTLY SURVEYED THE PROPERTY D(SCwIB(o IN THE FOREGOING TITLE CAPTION AND HAVE SILT OR FOUNO MONUMENTS AS tNOICA•(O ON THIS 514(TCH AND THAT SAID ABOVE GROUND SURVEY AND SKETCH ARE ACCURATE AND CoIP(cT To TH( B(SY OI MY RNOWLEOG( AND BELIEF, 1 FURTHER CERTIFY THAT THIS SURVEY MELTS INC MINIMUM T(' HNICAL STANDARDS FOR LANO SURVEYING UNDER RULE (016174 FAX ADOPTED BY THE LOIIIDA ROAD OF LAND SURVEY ° OCTObeR 1995 Z C PH4,13 k)1 0 FLORIDA 1 Date PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address /a p /1/— /00 sr Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant (7 41 C% 4/4 r Air., Master Permit # 4- /z - / 3 Owner's Address /2e. /O Contracting Co?( D (-) Q-V S Address Phone Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Mortgagor Address Permit Type (circle one) WORK DESCRIPTION)( Cv e , c (k/ , po w T /:1 t 0rn/! /ter a-7 3 Square Ft. Estimated Cost (value Address My Commission Expires: My Commiss FEES: PERMIT RADON APPROVED: Zoning Mechanical Buil ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN C.C.F. NOTARY Electrical 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. Date Signature of owner and/or Condo President Date Signature of ontracto o • er- Builder - 0 � 8�3 e- Y3 6_6 4` Notary as to Owner and/or Condo President Date No : s t o i •ntractdi&'::: `r''�tj':i! "'` G h Mi• Date M}tt{UBUC STATE OF FLORIDA COMMISSION NO. CC714103 MY COMMISSION EXP. MAR. 1,2002_ BOND TOTAL DUE Plumbing Structural Engineer 1elf4t '1(c4