1490 NE 101 St (13)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date J Address J 7 0 V ' o I Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenan , J? Q .0 Master Permit # ag , PO
Owner's Address / I/QONC /o 4 S r gate, flAr 41 Phone 3 as"- 767 / 4
Contracting Co. Address
Qualifier D ' (Y5 SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION �'v im w - -A c,2,Q. A
Square Ft. // /D /
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.
My Commission Expires:
FEES: PERMIT
APPROVED:
Angela M Beck
, MY Commission 00150048
w
EXpireS November 15, 2008
RADON
Address
Estimated Cost (value)
^-�- 2
i� + -Q ,o e
0
Signature of Contractor or Owner - Builder Date
Notary as to Contractor or Owner - Builder Date
My Commission Expires:
C.C.F. 0 NOTARY BOND 0 0 J
TOTAL DUE L O 1 0� 0
///r4
Zoning ? Building k t( Electrical
Mechanical Plumbing Structural Engineer
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2002 -1940
Printed: 11 /14/2002
Applicant: EDGAR
Owner: SCHRAUB
JOB ADDRESS: 1490 NE 101
Contractor
Local Phone:
Parcel # 1132050350030
(J Permit Status: APPROVED Permit Expiration: 5/12/2003
'Signed:
Building Permit
SCHRAUB
EDGAR
ST
Contractor's Address:
Page 1 of 1
Legal Description: DUNNINGS WATERWAY PB 114-46 LOT 3 BLK 1 LOT SIZE 15732 SQ FT
Fees: Description Amount
FEE2002 -6392 Building Fee $100.00
FEE2002 -6393 CCF $4.20
FEE2002 -6394 Buildier's Bond $300.00
Total Fees: $404.20
Construction Value:
$6,916.00
Total Fees: $404.20
Total Receipts: $0.00
Work: driveway resurfacing with pavers
If there is . no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all
ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to
and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without
authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the
ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done
by his agents, servants or employees.
Signed: l `_- (INSPECTOR) BY:
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity
with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either
myself, my agent, servants or employes. REG C01 111402 1412. t C #01 002756 CHARGE $404.20
(Contractor or Builder) BY:
STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant,
Witness(sign and print)
ll cu,n�SIo,e
... AFFIDAVIT
• ^�C A rdu6;-does hereby attest that the
(property owner)
Witness(sign and print)
Notary
attached survey, performed 'y
name of surveyor's company)
performed of � i" ,✓ 0 . , is an accurate representation of.the existing conditions and •
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.
SWORN TO AND SUBSCRIBED before me this day of
Affiant is personally known to me, produced as identification.
APPLICATION FOR BUILDING PERMIT
Application is hereby mode for the approval of the detailed statement or t 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 iuilding Division of Miami Shores Village shall be complied with, whcther 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
Street and Number where work is to be done. `/
Ncw Building
Disapproved
(Signed)
STATE OF FLORIDA, 1 .
COUNTY OF DADE. j ss'
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
Date..l .. c-r
— No.. / 4' ' O . Street-2 e. /97i
Registered Architect and /or Engineer.....el(g¢ B iYh% v t �C ` ' .V. tIt
Name and address of licensed contractor.l 6 4. J 71.-- c -- . / ` f 0 ""'e:. / 3 o u
Location and legal description of to be built on:
Lot t3 Block / Subdivision ._
O YI_f. / 7 .
State work to be done and purpose. (building y ffl000rs
and for no other purpose.
Remodeling Addition Repairs v No. of Stories
To be constructed of Kind of foundation
o,U
Estimate le Total cost of improvements $ 0 Amount of Permit $...
Zone cubage required Plan Cubage
Distance to next nearest building.. Size of Building Lot
Mfaxirnum live load to be borne by each floor
I hereby sub it all a p1, qs and s•ecificat'•ns for said b (ding. All notices with reference to the bu ing and its construction may
be sent to. i`.......� GY !'�C • / PO 71. Q. /Yd
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 s :_ „ntra- • s, on worl o be performed under this
permit, as are licensed by Miami Shores Village.
Remarks ( Signed )..
Date
Roof Covering
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.. 1
Permit No ! `1 Date ' ( Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building Inspector My Commission Expires
PLANNING BOARD DATE
Cirainnan 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 hen obtained from
the Plannir,g Hoard.
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.