358 NE 100 St (11)Date Li - 0 I Job Address
x
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
3 58
Legal Description Historically Designated: Yes
Owner/Lessee / Tenant Q,V e (\ A Y 1
Owner's Address .3 58 /00 c57�
L' , l= _ /eV 5 Tax Folio
Square Ft. Estimated Cost (value)
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
Master Permit # g V T
y Co sion Expire
Phone , 5 1 7 3 L/ 9
Contracting Co. D'j U e i2 / iU r 6 d 1 Address 552 • I €. 1 (eD
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVIN
SIGN
WORK DESCRIPTION / f/S TALL (4.) 0,6) (P /i/ ‘349r r p \ •
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.
tary as t ,P ontracto • IITIA L
O � P ,RY P "4 ANGELA r M r BE CKER
Z 4 0. C� COWISSON NU R
u . c Q CC786697
7r ..a f �jCQ . I:- ?002
BUILDING / ZONING DEPARTMENT"
SECTION
BY
DATE
ZONING• •
ELECTRICAL
MECHANICAL
PLUMBING
FIRE
PUBLIC WORKS
STRUCTURAL
BUILDING OFFICIAL
CRITIQUE SHEET
JOB ADDRESS 715 N ' t • IOO S%
APPLICANT 1311142 r 1 vU r ' fl 1i
PHONE t#
APPUCAIION l `�
SHEET OF
MISCELLANEOUS
DATE
V5/0
ZILNI.NG : de
Sic r i c s N'i cssl f
PERMIT NO.
ADDRESS:
MIAMI SHORES VILLAGE
1. Subject to compute. with alt Federal. State.
County.Viltage rules end regutattoas. VHtage assuute
no respons1b4111y for accurecy otlor results train
these piano.
2. This copy of plans meat be available oe
building site or no Inspection +Mil be conducted.
COMMENTS INITIALS
.k. ' CX c e,O± _ %c 1 VA.€ okite/' 7?--- d f .--
attached survey, performed by
STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant, LA' `l l l7(.l r1'lP la — mU74 does hereby attest that the
roperty o
name of surveyor's company)
performed on 5 00 , 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 !J day
Affiant/Property . / /
0 (
Affiant isv personally known to me, produced as identification.
Ry p OFFICIAL NOTARY SEAL
c' Po, ANGELA M BECKER
1 (ir 0 COMMSSON NUMBER
?-1 - ' CC786697
9 l �� MY COMMISSION EXPIRES
F OF FL° NOV. 15,2002
r' .
•
) SS.
COUNTY OF MIAMI DADE )
STATE OF FLORIDA
The foregoing instrument was acknowledged before .me.on
STATE OF FLORIDA )
) SS.
COUNTY OF MIAMI DADE )
(ACKNOWLEDGEMENT-INDIVIDUAL)
Signature of Acknowledge
as identific
Name of Acknowledger:
by
, who is personally known to me or who has produced
Title or Rank -
Serial No.(if any):
(ACKNOWLEDGEMENT - CORPORATION)
;,• n and who did (did not) take an oath.
OF F ',O
nu V. 16,200_
( � p CIAL N p� AR. Y SFJ'�
,� �� A
= l� r C 001011390N NUMBER
N " ..
* CC786697
4z MY COMMISSION SPIRES
The foregoing instrument was acknowledged before me on by
, of
corporation, on behalf of the corporation. He/She is
a
is personally known to me or has produced as
identification and did (did not) take an oath.
Signature of Acknowledger:
Name of Acknowledger:
(Typed, Printed, or Stamped)
Title or Rank -
Serial No.(if any):
6
.
, e _ 352
0la-
teft Goo 6f
fool, AgEa.
•
SKETCW,OF BOUNDARY SURVEY
SCALE 1 u= '2
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,RE REFERRED TO AN ASSUMED VALUE OF FOR THE
SAID BEARING IS IDENTICAL WITH THE PLAT OF RECORD
iE SUBJECT PROPERTY FALLS WITHIN FLOOD ZONE: g
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U
II
11
10
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11
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:GAL DESCRIPTION
UJt II2 i La“- A.O0 4I-I, OF. la( 5 BLOCK Q-O
SUBDIVISION: 6 0 L Q47 PLA of M,6. 1.A I 0 Z '7 - D IJ
ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 1 AT PAGE - 70
OF THE PUBLIC RECORDS OF
LOCATION SKETCH
SCALE 1 1 Oc-
1
%5v 1J - lopt•i
26 COUNTY, FLORIDA.
14-
11
(
II It
JOB NUMBER 0�4 DRAWN BY. •
F.B. NO. CHECKED BY •
DATE OF THE FIELD SURVEY 5 — k - " 2d-7O
REVISION DATE:
I o o .4
11
ti
SURVEYOR'S NOTES:
LEGAL DESCRIPTION WAS FURNISHED BY CLIENT.
NO UNOERGAOUNO INSTALLATIONS CA IAPROVEMENTS HAVE BEEN LOCATED, EXCEPT AS NOTED.
MERE ARE NO VISIBLE ENCROACHMENTS OTHER THAN THOSE SHOWN
EXMMtNAT)ON OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERWNE RECORDED CNSTRUMENT, i ANY
AFFECTING THIS PROPERTY .
FENCE OWNERSHIP BY VISUAL MEANS OM.Y (IF NO), LEGAL OYYNERSHIP NOT DETERMINED.
LEGAL DESCRIPTION SUBJECT TO ANY DEDICATION, LIWTATIONS, RESTRICTIONS, RESERVATIONS OR EASEMENTS OF RECORDS.
15
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14 ,
e7�l6F �t Oz L
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4or. ICU -(1( LOMpA1Jlq ,
SURVEY CERTIFY TO : 2» a al:240(66 tA a(2t‘ 64 L t UQv')R a c�rus.
THE ATTACHED SKETCH OF BOUNDARY SURVEY OF THE ABOVE DESCRIBED PROPERTY IS A TRUE AND CORRECT REPRESENTATION OF A FIELD SURVEY MADE UNDER
MY DIRECTION AND MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS IN
CHAPTER 61 G17 -6 FLORIDA (( AD / MII � NISTRATIVVE CODE, PURSUANT TO SECTION 472.027, FLORIDA STATUTES.
FOR: 4q60,2, !"�V'L (I 111JO 5�% V �.� f4 Z (I f �.-t'(J @L,k) c)
Q
R/W
C.L.F.
W.F.
RES.
F.I.P.
S.R.B
C B.
LIEA.S
S.NSD
F.N.
=CENTER LINE
=PROPERTY UNE
=RIGHT-OF -WAY
.CHMV LINK FENCE
.KOCOEN FENCE
'RESIDENCE
SOUND IRON PIPE
&SET RE -BAR
.ORORO BEIJING
-SET NAL & DISC
.FOUND NAIL
ABBREVIATIONS (IF ANY
O. =CLEAR
ENC. =ENCROACHMENT
C.B.S. =CONCRETE BLOCK STRUCTURE
CONC. .CONCRETE
6 •DIAMETER
D.M.E. =DRAINAGE MAMENANCE EASMT.
S.I.P. .SET IRON PIPE
F.0.N1 .FOUND DRILL HOLE
A/C =AIR OCNORIONIq UMT
REC. .RECORDED
Fx&D .FOUND NAL & DISC
F.C.N. .FOUND CUT NAL
APPUED)
U.E.
W.M.E.
PROF. COR
Flt.
EASMT.
. F.R.B.
S.O.H.
CAL.C.
RAD
F.
=UTILITY
woximok" van
.MOHMIENT LIE
. PROPERTY CORNER
. FIRE HYDRANT
.EASEMENT
. FOUND RE -SAR
.SET ORLL 110.E
.CALL uTED
=FOUND SPITE
. RADIAL
•FOUND (TYP).TYPICA&
ERNESTO BELT
PROFESSIONAL SU
STATE OF FLORI
DATE: - /(
E. BELTRAN & ASSOCIATES, INC.
12533 S.W. 30th STREET
MIAMI, FLORIDA 33175
PHONE: (305) 552 -7450
CERTIFICATE OF AUTHORIZATION NUMBER LB 5233
R • MAPPER HO. 4$85
Zoc�o
NOTE THIS IS NOT A VALID SURVEY WITHOUT
THE ORIGINAL RAISED SEAL AND
SIGNATURE OF A FLORIDA LICENSED ,
SURVEYOR AND MAPPER.