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DS-05-1145BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical ' lumbing Mechanical Roofing Owner's Name ee Simple Titleholder , 1. (F P ) r`bGte,_ Noahas Owner's Address . /a9 � City i'rr 1. ck State ,2 Zip _ /3 S' Tenant/Lessee Name 4/ , s Phone # Job Address (where the work is being done) •5 / Z 1 4E, City Miami Shores Village County Miami -Dade Zip _ /3R Is Building Historically Designated YES NO Contractor's Company Name /eCor4,‘e Zy f7 / ,4, Contractor's Address ,° ei City Qualifier j State /-� Zip State Certificate or Registration No. $ Value of Work For this Permit Type of Work: ['Addition Describe Work: Code Enforcement $ (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (30 a - - _ � , � 8972 DEC ,Y _4 Total Fee Now Due $ 4477 • ` S Structural Plan Review. $ Permit No. D S C'' - 1 14-5 ter Permit No. Phone # Se .5 7 574 : 3 - 37 Phone Certificate of Competency No. X Architect/Engineer's Name (if applicable) A/°X Phone # Square Footage Of Workt /J TO [New ❑ Repair/Replace ❑ Demolition * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * ** * ** * ** * * * *** ** * * * *** * * * *** Submittal Fee $ Permit Fee $ /c0 / CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Zoning Bond $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AlIFIDAVIT: 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice 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 Signature Sign: Print: Owner or Agent The foregoing instrument was acknowledged before me this ..< day of/1421.4 ( , 20 Os; by A f rt Cl . t19 6/K01.5 , who is personally known to me or who has produced P 41:54. 220 -6'6' 7 674 - 0 As identification and who did take an oath. NOTARY PUBLIC: S 1 f D 4:41 VICTOR A. URREGO ':at PAY COMMISSION # i 4 7301 -...s` EXPIRES: May 30, 2009 Bonded Thru Notary W*Underetere ,► ar aft •����A� --fir, �, � ` :•��i� 1 ' ssion Expires My Commission Expires: Sign: Print My Co APPLICATION APPROVED BY: chc 05/13/03 Contractor The foregoing instrument was acknowledged before me this IS day of T , 2001:51.7 who is personally known to me or who has produced D as identification d who did take an oath. Y PUBL * * * * * * * * * * * ** Yorleny Hernandez Commission # DD476455 * * mss` * * S1P *27;1 9 Bonded Thn} Atlantic Bonding Co., Inc. Plans Examiner Engineer 05 Zoning to (or 41 n►my- M iumi S/jorej COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY WHEREAS, /2 Cia - ) (Al1QS , hereinafter referred to as the Owner of the (owner) following described property: Legal description/folio #: / Lot 3 L v I 4 Block Subdivision q AI / r j /iQEEs f 71F't� / ATI l) P B Id: W Tax Folio #: // - 3 2 04 m 0 /3 - permission to install: [tphalt, concrete [] Landscaping [ ] Other w Mr , by d SIGNED. S A7 rtfetels VERED in the presence of: 10050 N.E. SECOND AVE MIAMI SHORES. FLORIDA 33138 -2382 Telephone: (305) 795 -2207 Fax: (3051756 -8972 Luis A Vlganego , My Commission DD767452 Expires Navember 24, 2006 owner) fj PPg ofi-c t within the public road right of way of 9 (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 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 this ✓ day of 6Vetvi • • ;f2'::,--.44 - : 2-, - ,-.. i'2'-', :' gras '.':-." ,t, "E' : • • 1 7 g.--,it+g! • Mtato 4 rz i*e o rf" . en- • • • • • • • • • • • • •• • • • •• • • • • • •• •• • • • •• •• t ALE 1". 2.0 • • • • • • . ••• • • • • .•.••• •• • • • •• ••• •• • • • • • • • • •• • • • • • ••• •4 00 141240 • • • • • • • • MA' ft§..ue,me • • • • • • • • • • • • • • BEARINGS HEREON OF ANY) ARE REFERRED TO AN ASSUMED VALUE OF 140 PeMX1e* 4 AnoW 4 FOR THE - ----- SAID BEARING IS IDEKICAL WITH THE PLAT OF RECOF 1 • e,e,rtan"■• es, 4 4.1 ■■•.• • a , I , 'V, •v■ " t St, 1..0." 8,P, " G10•."..1•41, , • , , " I 6 1 r, 1 t s • ■ .0", , 17,11 . 1,1• 1 f" • • l• • • • • • • • • - - • • • • • 0 • /4r Vdp • • • • •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 1 • tALE i BEARINGS HEREON (IF ANY) ARE REFERRED TO AN ASSUMED VALUE OF FOR THE SAID BEARING IS IDEZICAL WITH THE PLAT OF RECORD ACCORDING TO THE THE SUBJECT PROPERTY FALLS WITHIN FLOOD ZONE LOT 4.09 44 0 it'Abll 1 T BLOCK 4e) SUBDIVISION: AiSk 'W 1;41k ul 4%6(CV ts- Ar TO THE PLAT THEK-OF 4S RECQRWQ IN PLAT MOK t OF THE PUBLIC RECORDS OF: • • • • • • • • • LOCATION SKETCH ".' SCALE 1 = f iCO • • tki. 0 • 1...Q•1 • • IPA •— •-•-• • -•-• • • ••• • • • • •• • IL 1\120Fee. 214 Lie 10.PC M AtAr ‘,41Dge#0 L SURVEY CERTIFY TO : 412121./ #:701)11100 FOR: JOB NUMBER F.B. O. I It. CHECKED w DATE OF THE FIELD SURVEY — 419 REVISION CIATE: SURVEYOR'S NOTES: 61`Gal. LSICMPTKIN Was fuRNiShED'eri cuENT, tiT ITIsTALLATKINs R iMPROVE1ANTS WE EaN LOCAIM, EA:;EPT WirED THERE MIS N IfisteLe emmAcHT.TETirs 0R4ER 'maw 'z1.40SE EXAMMATICei Of THE ASS:tflaCT O TITLE ML HAVE TO FIE MADE TO OVERIMI•Q Fie;:oRINED iNSTRUMENT, Y AFFIXIYNG TWOS PROPERTY f V.NNEFISHIP Fre v‘r:unt. %TEA.% may (iF ANY), LEGAL OINNIERV4IP NOT DETERMINECL LECIAL CESCRIRNaN SIALIECT TC ANY CEDE:MICR, LIMITATIONS, RESTRICTIONS, AESFSNATIONS Q EWNTS Of RECOMDA DRAWN BY: AT PAGE ItO OUNTY, FLORIDA. OtL RIE 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 V•I CHAPTER 61 o17-6 FLORIDA ADMINISTRATIVE CODE, PURSUANT TO SECTION 472.027, FLORIDA STATUTES. klZf _PA tT. =CENTER LINE 2 .4 ore MT =RIGHT-OF-1W • =CNAIN UM( FENCE • AVAYOTIEN FENCE • 4IENDEN J.P. =t34� MN PIPE SAO RE-RAR • 4:0 TIEARiNG MEA3 =MEASURE() 'SAM =SET NAO. & Desc . 01,140 NALL ABBREVIATIONS OF ANY .4-1.E.Aft EMa. =ENCROACHMENT C.R.S. =CONCRETE EILOCN STRUCTURE CONC. =CLATCRETE .IJIAMETE1 0.M.E. =ORAMAGE MALNTENANCE EAUTT. E.L.R. =SET N14/4 PIPE Mi. =POUND oTatt Hoit Aic =AIR CONCTROTENO %UT REG% =REOORDEET P. NA =moo NAIL & ralse; =ECURIO CUT NA% APPLIED) vi„&cE PROP. COP EASMT. Cott.. F.S. RAO EASEMEN1 =WILL MAW. &CFINNOCE &MC .mtmAtENT LE .FlOPERTY CIIRNER =RAE HVORANT =EASEMENT =MUNE) RE-BAR =SET GRILL HOLE =CJI.LCULAI En S4F OAJOID SAME =RADIX .Fotsno (TYP)=TYFtc.N. E. BELTRAN 4 ASSOCIATES, INC. 12533 S.W. 30th STREET MIAMI, FLORIDA 33175 PHONE: (3051552-7450 CERTIFICATE OF AI-af4091ZATIOORAIBER LE 5233 : OBEL su MP PER NO. MSS SUTO,rf1.:138DA DATE: , NOTE: nits'ES$QTAVALID s trRvE Y WITHOUT THE ORIGINAL LIAISED SEC AND SIGNATURE OF A FLORIDA LIC-ENSED SURVEYOR AND MAPPER. Permit Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Issue Date: 12/9 /2005 Expires: 12/07/2006 Owner's Name: PATRICIA DOUKAS Permit Type: Driveways /Sidewalks /Slabs Work Classification: New Job Address: 374 100 Street NE Miami Shores Village, FL 33138 Contractor(s) Phone Primary Contractor DECORATIVE MASONRY INC (305)757 -7765 Yes Additional Information Type of Work: DRIVEWAY Additional Info: 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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due Bond Type - Contractors Bond CCF Education Surcharge Notary Fee Permit Fee Plan Review Fee (Engineer) Scanning Fee Technology Fee Total: Amount $300.00 $1.80 $0.60 $5.00 $115.00 $35.00 $6.00 $3.75 $467.15 Building Department File Copy 2 Permit Status: APPROVED Permit Number: DS -12 -05 -1145 Phone: Parcel #: 1132060135420 Block: Lot: Section: PB: Total Square Feet: 800 Total Valuation: $ 2,400.00 Required Inspections Foundation Sidewalk Landscaping Final Invoice Number DS - 12 - 05 - 22988 Total: G - - ,- G IS Amt Due $467.15 Amt Paid - 1. ) 5 NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.