230 NE 100 St (4)Da Time
Type Insp'n
Permit No.
Name
Address
Company
Phone # 3 ?I8' ' (
For Inspector 1 ` 0 3 3 Name & Date
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMEN
305- 795 -2204
Budding Inspection Request
o
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bgilding Inspection Request
Date 7 Io&.YJ Time
Type Insp'n t no I
Permit No. 6P - " i j
Name ��//�� ► rs
Address 9 N 1,00S4-
Company NA-64 1‘°-
Phone #
For Inspector: 91 Name & Date
Approved
Correction ❑
Re- Insp'n Fee ❑
p(w5
147r ro /A-
Date (; -3- 03 Job Address 2 #6 //0 � vr 'Tax Folio
Legal Description 1- 4q 3LK 33 Historically Designated: Yes
Owner /Lessee/Tenet M 8-a 4D3/9 Master Permit # P679003- 9//
Owner's Address )- 3 o 4t1 /Q(/ 5T � Phone 3)J `
Contracting Co. ///1 t)? /^!. � 12 1 l/( - *Address /a / / f x'/7/ 5? .0, #U
Qualifier ()Leh P. 1 - - ih SS# Phone 3 6 ° O /0
, PERMIT .APPLICATION FOR MIAMI SHORES VILLAGE
10050 N.E. 2nd Avenue • Miami Shores, Florida 33138 • Phone: 305- 795 -2204 • Fax: 30
State # Municipal # Competency # Ins. Co.
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE
BEEO$E CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one):
WORK DESCRIPTION:
Square Ft.
Notary . s to
My Com
4
APPROVED;
Zoning
Mechanical
83
wner and/o
ion Expires
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 ANY 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). 1 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 all disciplines.
OWNERS AFFIDAVIT: 1 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, 1 authorize the above named contractor to do the work stated.
ignature of owner and/or Condo President Date
•undo rosi4Jpnt ! Date No
` ` pP YP p�i� Damaris i\egr M y
_Commission # DD 016496
: a� Expires April 9, 2005
, 9 rF
.... .•Ct`e Bonded Thru
` \le Atlantic Iionding Co., Inc.
FEES: PERMIT V RADON
tczdn,P egh6 /i4. Atizabie
Building
ELECTRICAL PLUMBING MECHANICAL ROOFING
Estimated Cost (value) c / o.3, co()
C.C.F .3
X I c?_ .. - I ate..... ....
gn ure of ontractor or Owner Builder
( �/,
to Contractor OwnerUuil¢er / Date
,,,,*.pY 1) amaris Negrin
a z . : , Commission # DD 016496
�`.4.'as Expires April 9,2005
i9�'•.,,,,,,. •n Bonded Thru
' Anru,tir. bonding Co., Inc.
C mission Expir
il
NOTARY BOND /
TOTAL DUE 343
PI DVED
JUN ® 5 200
Date
/15 1V0?(,'tl
°797
Plumbing Structural Engineer
Electrical
THOMAS E. FREDERICK 0'60 - 4
I-ot • .. ,. :�
` t c
S ubdlctsWlt, ... ..
ISIMERNERM
CIVIL EN NEER AND SURVAYOR
No. 83 end 222
HIALEAH FLORIDA
ASSOCIATE
ROY B. PEPPERS
4 10 2 115P12.4 . Phone 88 -5015
Survey of
According to Nat t.hcrcof is recorded. in, plat 1300k
County, Florida
For /
O. IL Scale =' .5 ')
f fiercGV certify' that dte attached plat represents a recent survey made G,y' me or under my
direction and is t.ruo and correct to the Gest of my knowledge and fielief.
Thomas C. Frederick, C. E.
Surveyor's Cert. #83
Encjr. Cert. #22'
!Mock
itA
THOMAS E. FREDERICK 0'60 - 4
I-ot • .. ,. :�
` t c
S ubdlctsWlt, ... ..
ISIMERNERM
CIVIL EN NEER AND SURVAYOR
No. 83 end 222
HIALEAH FLORIDA
ASSOCIATE
ROY B. PEPPERS
4 10 2 115P12.4 . Phone 88 -5015
Survey of
According to Nat t.hcrcof is recorded. in, plat 1300k
County, Florida
For /
O. IL Scale =' .5 ')
f fiercGV certify' that dte attached plat represents a recent survey made G,y' me or under my
direction and is t.ruo and correct to the Gest of my knowledge and fielief.
Thomas C. Frederick, C. E.
Surveyor's Cert. #83
Encjr. Cert. #22'
!Mock
Li
-
Jr.
D RZ W u EtwiN
PPR otict-f
Tax Folio #:
requests permission to install:
['Asphalt, concrete brick pavers
[ ] Landscaping /�
[ ] Other 67 t' 7P (fD)) 1/e7 e
within the public road right of way of
SIGNED, SEALED AND DELIVERED in the presence of:
fl / /iami SIiorej
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 -2382
Telephone: (305) 795 -2207
Fax: (305)_756 -8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, Tom 1:3,07 m , hereinafter referred to as the Owner of the
(owner)
following described property:
Legal description /folio #:
Lot q Block 33 Subdivision
,3o 4/6 ) ®o SIT
(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 cday of
tiPP �6,L Dam is Negrin
# DD 016496
1 c Q Expires April 9, 2005
.;, Bonded Thru
�� 1 sa i et∎ Atlantic Bonding Co., Inc.
'STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant,TOM /3 f� lb/) , does hereby attest that the
(property owner)
attached survey, per
erformed by T () ma .5 E - F tip d p,17 ( i
(name of surveyor's company)
performed on
� 99 q
(date of survey)
, 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.
SWORN TO ACID SUBSCRIBED before me this d day of
Affiant is !/ personally 'mown to me, produced as identification.
.``,• VP'e( / Da aris Negrin
°o .Commission # DD 016496
_ Expires April 9, 2005
� •..
B in T hru
'�i��� A11anlic Bdg CD., Imc.
Applicant: LAUREN BENTON
Owner: BENTON LAUREN
(vl JOB ADDRESS: 230 NE 100 ST
M Contractor ARTISTIC CONCRETE Contractor's Address: 10099 N. W. 89 AVE, UNIT 8
4 Local Phone: 305 - 888 -4565
.1:0\ 0 Parcel # 1132060134480 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 8 & 9 BLK 33 LOT SIZE 100.000
r Fees: Description
FEE2003 -3391 Building Fee
FEE2003 -3392 CCF
FEE2003 -3393 Builders Bond
Total Fees:
Permit Status: APPROVED Permit Expiration: 12/2/2003 Construction Value: $4,483.00
Work: STAMP CONCRETE DRIVEWAY
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 6/10/2003
ACH R1r 083/00277 - • '
- 63-4f630 . ft
8
n d d.ocu en t.•S a e bark
Building Permit
Permit Number: BP2003 -911
fo
,./:." , :/ �/, ARTISTIC;CONCRETE USA INC. • 01 -02
/ \ `, ei \N ` li /�� / PERMITS' ACCOUNT,..
''',/ \'‘'N/ V /I . N.W..89TH AVE: UNIT8`,
` f` / � , 1� ` j ` `.' %�.' MEDLEY; F L - •33178- 1421
,' PAY' .'.`,/,'. /.�;,`.t.i���
TO THE . �` / /, >
.` ORDER OF•
dela ila.
. FOR
bb L14:780 . ' :;i :0,6.30000 4 71: 005480429?
Amount
$60.00
$3.00
$300.00
$363.00
'1
Page 1 of 1
Total Fees: $363.00
Total Receipts: $0.00
is pertaining thereto and in strict
I assume responisibility for all work
OTATE 0 €tOh1DA, COUNTY OP DADE
d and off
CLERK.
I
HOWDY CERTIFY that this is a ,` py of the
engine)/ hlc%m .fsce r
WITNESS my h
HARVEY RUVII
By
its
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SiTE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOUO 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: 30 i G
LoT 3L-t 33
2. De rigtion of improvement: � i� �� L- l�� / -� - / ✓L_i %�.��•i� %�L'
,// , /
. ner(s) name d dress• •
IjiCGlrj� h ' ;/4
Interest in property:
Name and address of fee simple titleholder.
4. Contractor's name and address:
/(o 4J = . 9 v - e-
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIiIIIIIIIIIIIIII
CFN 2003R0359831
OR Bk 21310 Ps 0789; (1ps)
RECORDED 06/05/2003 11:17:28
HARVEY RUVINr CLERK OF COURT
MIAMI -DADE COUNTY? FLORIDA
LAST PAGE
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, Owners designates the following person(s) to receive a copy of the Uenor'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
dIffe rent dot spUcifled)
.A
Sf nature of Owner
Print Owner's Name - r - om_ Ni'17 n Prepared by
Sworn to and subscribed before me thl -. _day Of , 20,0 .
■
Notary Public
Print Notary's Nam ` °,,,, ' .
_ ;*. ,,:, - Commission # DD 016496
My commission ex ireres: ; :. a -` Expires Apnl 9, 2005
%oF �Q Bonded Thru
123.01-52 .ot -sz awes 0102
nnu F � A tlantic Bonding Co., Inc.
a
Address: ' hogq bu 9 1l' /-