246 NE 100 St (11)MIAMI SHORES VILLAGE \'\
BUILDING DEPARTMENT 1
305- 795 -2204
Building Inspection Request
Date
Type Insp'n
Permit No.
Name
Address
Company
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
L
(01
Type Insp'n
Permit No.
Name
Correction
MIAMI SHORES VILLAGE
BUILDING DFPARTMENT�`
305- 795 -2204 V`
Building Inspection Request
Date 1
i Ti) D c e.!
Inspection Date 10/5
�1 �J I►i
Re- Insp'n Fee ❑
Address .2(40 m E 100 3
Company 1(n rC Jo OCIYiny
Phone #
dord haue fey O
BUILDING
PERMIT APPLICA'''IO
FBC 2001
$ Value of Work For this Permit , 7
Miami Shores Village
Building Department
Job Address (where the work is being done) ,-,74' ' 44. /(w 3,L
City Miami Shores Village County Miami -Dade Zip 33/ 3 &
Is Building Historically Designated YES NO ?(
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
-- Permit No. OP 9-on \yq3
Master Permit No.
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder r + 1?O -r )c 10- 6) S rY Phone # 2 )05= 5 7- 8
Owner's Address cQ 1/t, At /C L 14-
City & Yl7 I , Shn f'k S State pC-L Zip 33/3F
Tenant/Lessee Name Phone #
Contractor's Company Name )P0Or6 3+1 v'-- Ma -SOY) r j Phone # 30,5- 757 7 765
Contractor's Address PAoZ NE ?f SW-to ,e
City /l4/a.rIt I -51/2c re 5 State /L Zip 33/3
Qualifier
Architect/Engineer's Name (if applicable) - Phone #
Architect/Engineer's Address
City State
Zip
Square Footage Of Work:
Baths
Number of: Bays Stories Families Bedrooms
Type of Work: ['Addition ['Alteration ['New ❑ Repair/Replace ❑ Demolition
• Describe Work: — PGt-Nt t" Y - P1` 1 N/ . G: (t. e 1' f / /;171
County Escrow Fee $ 2 • `1 Permit Fee $ 10 .00 Notary $ s .
Education/Training Fee $ Tech $ Scanning $ Radon $
Code Enforcement $ Bond $ .00 Struct. $
Minus Plans Check Fee $ Total Fee Now Due $ (Continued on o posite side)
B s nding Company's Name (if applicable)
Bon • Company's Address
City
Signature
NOTARY
Sign:
Print:
Own Tr Agent
The foregoing instrument was acknowledged before me this t
day of } ,20Q3,by WI( IQ £ S
who is personally known to me or who has produced
LIC:
My Commission Expires:
State Certificate or Registration No.
chc7/7 /o3
APPLICATION APPROVED BY:
State
As identification and who did take an oath.
Mabel Vargas
':i #1I 1984'
t 1', 20(17
Bonded Thru
ttavtic Rnming Co Inc.
•
Zip
Mortgage Lender's . e (if applicable)
Mortgage Lender's Addres
City State
Zip
Application is hereby made to obtain a p t to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a pe .•'t and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand : t a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEA RS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the forego , 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 RECO 1 A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR P ` OPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTO Y BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit w an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and cons tion lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded . lice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
e".4//_.
��� Si / /'
Contract
The foregoing instrument was acknowledged before me this IS
day of 7 . , 2& , by
personally ''t Mae
who is ersonall t i
i : += 5illf> nded Thru 1v a"ke an oath.
,:
NOTARY PUB " " "" AU.. Bonding Co., Inc.
My Commission Expire
Sign:
Print:
/Vc 3
(Certificate of Competency Holder)
Certificate of Competency No.
****************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** k************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
SEP 1 2003
Plans Examiner
Engineer
Zoning
'STATE OF FLORIDA)
COUNTY OF DADE)
AFFIDAVIT
The undersigned Affiant, ?a-I-ru / (, + D- -2 ►'T , does hereby attest that the
(property owner)
attached survey, performed by L q,» n es a r7c1 Ga r C /c. Tn C
(name of surveyor's company)
performed on (9 —1 t4 , 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) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this 6 day of
Affiant is personally known to me, produced
as identification.
'' Mabel Vargas
= Commission #DD231984'
a 'Q Expires: Jul 13, 2007
Bonded Thru
Atlantic Bonding Co., Inc.
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DRING 1
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•
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This property described as:
The West 25 .feet of Lot 6 and All' of
' 33,
;; •AMENDED• °PLAT OF MIAMI SHORES SECTION 1 ,
..'ac;cording to the Plat
1 thereof, as recorded in
Plat Book 10, Page 70
of the Public Records of
`.Dade County, Florida.
PROPERTY OF:
0
`NcLt- ya'fie'yrr#js •embossed
ki`tkStity_iY "1 •
rfi
21e';
14
ii fAve/
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13.60•
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15r - J ru'emor
A • BOUNDARY SURVEY
•
I hereby certify that the survey repre-
sented hereon :meets ;the minimum •
technlcal standards, set forth ., by the '
,Su pursualt. to
;.Fla: 5 tes. There are `•
ts, - laps,easerrients
at, other than.
6 -20 -91 "Subdivision Name" revised.
•
DATE •
A
GL
u 3�a
•
Gispert, Tony D., 246 N.E. 100th Street,
.NE loosfr, 47745'
L c toi`) Mo p
,,, . T. c*.
FLOOD : ZONE: X
Zoning
Approved
Note:' Underground'
encroachments and •
utilities, if any,,
not located. 0
Z,.
Certified To: M and M
Title Services, Inc.',
Commonwealth Land
'Title InsuraAce Company,
Gispert, Tony
Margaretten and .Company:,:
Inc., its •.'
and /or assigns.
OE;
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(M )=:, M E=.ra SU 2E�
F - FoulJr" i0.A0 /0lr°E
. (- Oki C.IZEET=
i. p le_ou r ipe.
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Miami Shores, Florida'.
;L''A• E S and G A R.0 I A, I'N
•
ENGINEERS- LAND SURVEYORS - LAND Pj;ANNERS
;Office address: 359'Alcazar Avenue, Coral Gables,florida 33134,'
Mailirig•address +P O, Bo 1`561131,Miam ,Flortda:33156
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