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
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BEARINGS HEREON OF ANY) ARE REFERRED TO AN ASSUMED VALUE OF
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FOR THE -
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SAID BEARING IS IDEKICAL WITH THE PLAT OF RECOF
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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
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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.