DRIVEWAY PERMIT• PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 11/070 Job Address 13, N /0 S' e-1- Tax Folio
Legal Description 7 2 47&, Sv/ -
Owner/Lessee / Tenant �o H Sarno SoA..
Owner's Address /351) /Q
Contracting Co. Ana/0 Cdx -si c • Address
Qualifier A e ss#
/ Phone - 23-r- 3
Address �/�
// -32o 5 0 -3— oo.x)
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one) BUILDING LECTRICAL PLUMBING MECHANICAL ROOFING ' A FENCE SIGN
Address
WORK DESCRIPTION (7.5c-if
04 e
Estimated Cost (value)
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 w rk.stgted.
o . as to Contract
My C * 'ssion E
Electrical
er- Builder
L
NANCY GOLDl LNG
ARV PUBLIC STATE OF FLC2IDA
COM?J1iSSlON 1!O. CC618357
NOTARY E,p. FEg.1
TOTAL DUE
Date
it 6D
D at
Mechanical Plumbing Structural Engineer
Nvumiit ut LUMMENCEMENT
A "RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. • TAX FOLIO NO. / ! ` - ,()G 3 " v0 Za
STATE OF FLORIDA:
COUNTY OF 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.
/3 5 /U (0 / St �ree1-
1. Legal description of property and street address:
2. Description of improvement: �,(� VVIIJ?vf';(,. - Ofd ChICa�]ol Bjr off,
�J
3. Owner(s) name and address: J/ O -!' sieve, Jaco,1250►i
135 (JE srtI -FE4-
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address: Or )(u C'.ond ruC1iU /l2a ' ,54;✓ /3 S jil r
1/, /26
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address: /'/
8. In addition to himself, Owner 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:
/46
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)
/,7
Si • - ture of • er ���
Print Owners Name L u � J2 co n S lt)'._.
/ 1 an i; Shores 3 / /.3s
Sworn to and subscr • • • me this 1 S day of AM ____
Notary Public i / � alj:
Print Notary's Name • AMU Mit
My Commission Expires:
cONh799ON Nu
W86697
STATE OF FLORIDA, COUNTY OF DADE
1 HEREBY CERTIFY that this is a f u opy of the
on t al filed in this office on
, A 0 20
WITNESS my hand and Official Seal.
HARVEY f VI N, CLERK, pi C,rcuit and County Courts
By
Pi77 G% D.0
008546942 2000 NOV 15
Prepared by:
Address: /62 3 g S /
'ilia i / :/, 1 ) 7/7t
fv /
cam
12101.52 2193
14:58
•
WHEREAS,
following described property:
Legal description /folio #:
Lot
Tax Folio #:
Block r Subdivision /1 ii ii Sh0heS Pay Park eel-cies
permission to install:
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
H . eobsovA
(owner)
i- 3 S o2- 3 -v0ao
[+Asphalt, concrete, brick pavers
[ ] Landscaping
[ ] Other
within the public road right of way of /3 50 NE /0 1
SIGNED, SEALED AND DELIVERED in the presence of:
NANCY COLDP.JNG
3cYI'AI Y FOLK STATE OF FLLOEUDA •
COMMES1ON NO. CC61bx57
fl/hami SIlorQ�
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
S -r!ve� f
(address)
IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows:
1. 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 Miamj -Shres 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 g day of /No -6e, -, Q2rY6
CERTIFIED TO:
STEVEN AND JOHANNAH JACOBSON
JOSEPH R. COLLETTI, ESQ.
ATTORNEY'S TITLE INS. FUND. INC.
NATIONSBANC MORTGAGE CORP.
ITS SUCCESSORS AND /OR ASSIGNS.
FIELD WORIS REVISIONS
DAR: // 4 . 0-98 O
FIELD 50010
MS CFRIIRO 11AT DRS SORRY OF THE PROPERTY
OESCOBED HEmN WAS WOE UNDIES MV RJRAb190N
MID THAT TIC INRE MIS THE SWAM 1[CINR.m.
STD. DARDS 1NT FORM BY INC ROOM BOARD v
SURVEYORS NO WIRERS IN CJIAPITA 01017 -4, FI01SM
AOMNQTRATNE 000. PURSUANT TO =DON 472.027,
Iv
t,6' 4e0/0,6<
STATE OF FLORIDA NOE AGUILAR
P.LS. No.S571 •
NOT 02* maw OED. am MO ODVm 011N OM= •
5035 NW 7TH STREET SUITE 901 •
6. 16, ,5 A.�OZ' f?Z " Ra 216
eDL� OF WA
E31SCAYNJE
ON THE F1.000 INSURANCE RATE MAP OF THE FEDERAL EMERGENT MANAGEMENT AGENCY
ON 3 14 9 4 THE HEREIN DESCRIED PROPERTY 6 SITUATED WITHIN ZONE AE
'1D00 ELEVATION B. DO COMMUNITY 11.0 SZ PANEL NUMBER GPI- SUFFIX `
LEGAL NOTES
AJRVtY DOES NXR REFLECT OR DETERMINE OWNERSHIP.
4A110N OF THE ABSTRACT OF TALE ILL HAVE TO BE MADE TO DETERMINATE RECORDED
JCTYENTS. F ANY, AFFECTING TIE PROPERTY. TITS SURVEY 6 SUBJECT TO DEDICATIONS.
BONS. RESDBCRONS, RESERVATIONS OR EASEMENTS OF RECORD. LEGAL DESCRIPTIONS
0ED 97 CUENT. THE UAAUTY OF IRIS SURVEY 6 LOWED TO TIE COST OF THE SURVEY.
TGROUND ENCROACHMENTS. IF MY, ARE NOT SHOWN. THIS FIRM HAS 1407 ATTEMPTED TO
E FOOTING AND /OR FOUNDATIONS AND/OR UNDERGROUND IMPROVEMENTS OF
WIRE. IF SHOWN, BEARD= ARE REFERRED TO AN ASSUMED MERIDIAN. IF SHOWN.
DONS ARE REFERRED TD N.G.VD. OF 1929. 711E CLOSURE IN THE BOUNDARY SURVEY 6
• 1:10000. MS SURVEY IS NOT PREMED FOR NEITHER DESIGN FOR CONSTRUCTION PURPOSES.
7105E PURPOSES A TOPOGRAPNJC SURVEY 6 REOUJRED.
I FGEND AND ABBREVIATIONS
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HMI. FL 33126
PHONE(30S) 461 -3679 FAX :(
Zone cubage required
Distance to next nearest building
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 mein 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 ... s &'
Registered Architect and /or Engineer ,_,.._1,.
Name and address of licensed contactor
Location and legal description of lot to be buiyn:
Lot
2— Block Subdivision.
Street and Number where work is to be done lv
New Building Remodeling
To be constructed of Kind of foundation
Estimated Total cost of improvements $
Building7nspector
Date... G _..� j ,19. - 7
Street_ /►' — M/ , .. !
T
Amount of Permit $.
Plan Cubage
Size of Building Lot
State work to be done and purpose of building (by floors).0 /_rI7r-e
/e)/4.—.e=/,e6- ��OL ffE E _. /O �/� T.�s//5 7-17 1 5 ..7; S/ Gd . and for no other purpose.
Addition Repairs No. of Stories
Roof Covering
Maximum live load to be borne by each floor
I hereby 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 Gener aws of Florida, Permanent Su eleent,
and has complied with the provisions thereof, and will require similar compliance from all . ra• ors or sub - contractors employe m
by him
in the work to be performed under this permit; and will post or cause to be posted for ins. -ctio on the sit of c wort{ such ublic notice
or notices as arc required by the Act. The undersigned agrees to employ only such su• •trams ors, on � rE,pErforp nder this
pennit, as' are licensed by Miami Shores Village.
Remarks (Signed)....
STATE OF FLORIDA,
COUNTY OF DADE. 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 the.
of the above described construction, that Ile has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No- __.__l.9 - Date Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
Notary Public, State of Florida
My Commission Expires
PL NINC BOARD DATE
Chairman / Membcr
Member Membcr
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 hecn obtained from
the Planning Iloard.
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.
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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.
Date 1-4( g
_„apprro"Owner's Name and Address ........}'.Ill)( 14 R No 0'350 Street.... d I E. o B ( ST.
.
..� 1 >tN
Name and address of licensed contractor R S..04 J
Registered Architect and /or Engineer ... -. CHARLES
Location and legal description of lot to be built on:
Lot Block fl Subdivision IA o M o H o g as -a J AV E .`S a ,� 7415
5
a
Street and Number where work is to be done LS s o2 ik4 a e • B 8 13 , c 1 S
State work to be done and purpose of building (by floors) �. _X.:.le.h6..j) PPS➢ 17.14 A a. E.A)
Ca./Ai-Sr RAI C'T Pia /3S
e 1 N ;';
and for no other purpose.
New Building Remodeling. Addition v Repairs No. of Stories 1
To be constructed of. .G`at 6E Kind of foundation � fl At - 1 '.7�E.. Roof Covering...Par . •5* Q. R am.1E -IL
3 e. 0 c a - p�
Estimated Total cost of improvements $...- .�t72 Amount of Permit $ /, ! -.,,�
Zone cubage required /
a� .Plan Cubage....1.. -S 7
G B
Distance to next nearest building.. � Size of Building Lot �97 X �.3
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to 01.1 Y H ' B LP RTl
The undersigned applicant for this building pennit 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 subcontract s, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. 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 the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true. L
Permit No 7 { r Date 7 r--5 Read, Sworn to and Subscribed before me.
Disapproved
(Signed) ....
Building Inspector
Chairman
Member
Member
Council Approved Date
NOTE: A charge of $1.00 will be made for making
the Planning Board.
A re- inspection fee of $1.00 will be charged
materials and /or workmanship.
PLANNING BOARD DATE
Notary Public, State of Florida
My Commission Expires
Member
Member
Member
Disapproved Date
corrections or changes to this application after approval has been obtained from
when such re- inspection is made necessary by improper notice for inspection or faulty
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