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BPP-09-960 Inspection Worksheet Miami Shores Village �I 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP 116409 Permit Number: BPP -6 -09 -960 Scheduled Inspection Date: February 08, 2010 Permit Type: Pools/Whirlpools /Hot Tubs Inspector: Bruhn, Norman Inspection Type: Final Owner: ASTRALAGA, IVAN AND MARCELA Work Classification: New Job Address: 254 NE 101 Street Miami Shores, FL Phone Number (305)773 -0577 Parcel Number 113206013462 Project: <NONE> Contractor: NATIONWIDE POOLS INC Phone: (954)227 -7665 Building Department Comments NEW POOL Inspector Comments Passe ? j C e C__ Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. February 05, 2010 For Inspections please call: (305)762 -4949 Page 2 of 14 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: INSP- 134111 Permit Number: BPP -6 -09 -960 Inspection Date: January 25 2010 Permit Type: Pools/Whirlpools/Hot Tubs Inspector: Dacquisto, David Inspection Type: wSurvey Owner: ASTRALAGA, IVAN AND MARCELA Work Classification: New Job Address: 254 NE 101 Street Miami Shores, FL Phone Number (305)773 -0577 Project: <NONE> Parcel Number 113206013462 Contractor: NATIONWIDE POOLS INC Phone: (954)227 -7665 " Building Department Comments NEW POOL Inspector Co ments Pass d S` cr��'�r�.s. C�•1�;„ �n �r �,,%y` Failed Correction Needed i I Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. For !nsrc,,,f; ins olease call: (305)762 -4949 January 25, 2010 Pagel of 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 i nspection Number: INSP- 134111 Permit Number: BPP -6 -09 -960 Inspection Date: January 25 2010 Permit Type: Pools/Whirlpools/Hot Tubs Inspector: Dacquisto, David r^..e Inspection Type: SpvtSurvey Owner: ASTRALAGA, IVAN AND MARCELA Work Classification: New Job Address: 254 NE 101 Street Miami Shores, FL Phone Number (305)773 -0577 Parcel Number 113206013462 Project: <NONE> Contractor: NATIONWIDE POOLS INC Phone: (954)227 -7665 Building Department Comments NEW POOL 11.2 Inspector Co ments Passed �'` �� �n e— Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. For Inspections please call: (305)762 -4949 January 25, 2010 Page 1 of 1 115 POMPANO VD ACCURATE LAND SURVEYORS, INC. TEL. (954) 782 -1441 FLORIDA 33060 L.B. #3635 FAX. (954) 782 -1442 SHEET 1 OF 2 TYPE OF SURVEY: BOUNDARY JOB NUMBER: SU -10 -0069 LEGAL DESCRIPTION: THE WEST 1/2 OF LOT 5 AND ALL OF LOT 6, BLOCK 34 OF AN AMENDED PLAT OF MIAMI SHORES SECTION NO. 1, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 10, PAGE 70, OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY, FLORIDA ADDRESS: 254 NE 101ST STREET MIAMI SHORES, FL 33138 FLOOD ZONE: X BASE FLOOD ELEVATION: NIA CONTROL PANEL NUMBER: 120652 - 0302 -F EFFECTIVE: REVISED: 9/1112009 LOWEST FLOOR ELEVATION: SEE SURVEY GARAGE FLOOR ELEVATION: SEE SURVEY LOWEST ADJACENT GRADE: SEE SURVEY HIGHEST ADJACENT GRADE: SEE SURVEY REFERENCE BENCH MARK: DCBM #3250 N -802 ELEV:8.97'NGVD CERTIFY TO: 1. IVAN ASTRALAGA AND W. MARCELA 2. 3. 4. 5. 6. r7n 1 2 "1 � i"� j nay it Ir IRAF Ot 7; (�l_L F.k:( =SAL g +a JAN 2 5 CID NOTES: s ee so* . • e • so 1. THIS SURVEY CONSISTS OF A MAP AND A TEXT REPORT. ONE IS NOT•YALID NVIjMjU�T -. OT* ER. 2. OWNERSHIP OF FENCES AND WALLS IF ANY, NOT DETERMINED. • •: . • :: :•: '. S E A 3. THIS SURVEY IS MADE FOR THE EXCLUSIVE USE OF THE CERTIFIED HE'� b� VALId QNE NOT VAUD VATHOUT FROM THE DATE OF SURVEY AS SHOWN HEREON. THE SIGNATURE AND A = RCLE C ENTR A L +1 LEGEND OF ABBREVIATIONS_ HE ORIGINAL RAISED A ARC LE •+ • • : • • ENC SEAL OF A FLORIDA CB = CHORD BEARING = • • (• _ • MS@ LICENSED SURVEYOR ELEVATIONS BASEDONN.G.V.D. MAINE. = MAINTENANCE • • • Iy = • LIj j r . AND MAPPER. R = RADIUS SQ. FT. SQUARE FEET B C.R = BROWARD LOURIY RECORD9 • • •CONC. • = • CO—MCRbM R/W - RIGHT OF WAY P.C.P. PERMANENT CONTROL POINT D.C..D.C.R. - DADE COUDR'�I�CORQS� • •D3P _ • •DEDD BOOK. P.C. = POINT OF CURVATURE P.B.C.R PALM BEACH COUNTY RECORDS P _ .PLAT BOOK *so CZF = • CHAIlf LINK FENCE P.T. = POINT OF TANGENCY P = PLAT O.RB. WM = OFFICIAL RECORDS BOOK WF = WOOD FENCE = .WATER METER N &D NAIL & DISC F.F. - FINISHED FLOOR BLVD. - BOULEVARD OH = OVERHANG P.O.C. = POINT OF COMMENCEMENT GAR GARAGE AD .A N - NORTH P.O.B. POINT OF BEGINNING ELEC. = = ELECTRIC *so DATUM • • • •I•P. • • ASSUMED ED S SOUTH A/C = AIR CONDITIONER SEC. = SECTION • • • • •I.R • i " ROD E = EAST FND. = FOUND TWP. = TOWNSHIP • • • •••P.RdY • PERMANENT REFERENCE MONUMENT W = WEST CHATT. = CHATTAHOOCHEE RGE. = RANGE • • • • • •N.G.MD. • •NACIONAL GEODETIC VERTICAL DATUM B.M.. BENCHMARK STA. STATION C/L = CENTERLINE • • • • • • iU.E. • • • blg.Tl'Y EASEMENT PH = FIRE HYDRANT F.P.L. = FLORIDA POWER &LIGHT MH = MANHOLE • • • • • • DT0 • • ! D"AGE EASEMENT o/s - OFFSET ELEV. = ELEVATION ESMT. EASEMENT A.E. = ANCHOR EASEMENT 1150 E. ATLANTIC BLVD. ACC POMPANO BEACH. URATE LAND SURVEYORS, INC. TEL. (954) 782 -1441 FLORIDA 33060 L.B. #3635 FAX. (954) 782 -1442 SHEET ? 2 N _N ..E. 1.01ST STREET NW NE �sR 75 RIGHT OF- WAY W E I ASPHALT " PAVEMENT t 1 06 Sr SW SE I i $ Mj BRICK DRIVE NI I nt j I I BLOCK I t CORNER "WALK' 2 _ ,T� r �• ° . 95.00' ... ... , :.' • ;" ; FOUND 1/2" IRON �j 50 00 pti LL 25.00 25.00' PIPE NO ID g' LL L 5 I FOUND 1/2" IRON ^ L L L g1 PIPE NO ID LL n I vi L L I N LL LL N 6 6 h� _L I I g .. L L I 1p g L gyp. 0.19 :'... 36..... 10.00' LLLLLI b' "" 1.05' ` 'ni':':':FF THIS AREA LLLLL \NfvL :'' ..... ......... .. o� LLLLL� �o: =10;46'NGVD::.,', LLLLTILE_LL �' i N :..LLLLLLLLL .. LLLLLLLL i:::::: o O A/C ..= 11.3..... ............. 0 :� •....... .....ii'i:'i: ;::i ?iS : i:i':ii l : is Q Lo '-::: ::::"'. "." "-.'. ': RESIDENCE O :'::::;' RESIDENCE #2 . 4 `:.:.:::' :::: I �j i:•:r•:::: i Fi:!FF THIS AREA:: •:i'•::::'11.9T.: .07' :.:.. .... ... .............. I - 10.75'NGVD':::.: 0 9.94' Lo LOT 7 ' ...21.52'ii;iiii : ui BLOCK 34 .. ::::: ......:::: :: :.:::. MARBLE 6' WOOD FENCE 1 3.06':i':'i r 4' CHAIN o,• o' E.1 /2 LINK FENCE 25.11' R / W.1 /2 (TYPICAL) o I LOT 5 LOT 5 LOT 6 co O o BLOCK 34 BLOCK 34 N c� P 0 0 L N BLOCK 34 31.56' 25.11' 18.46' ii 0.56' 'N S d 6' WOOD 17.48' SET 1/2 _$JN_ _ ©�� E �. _FENCE �n � 7 IRON ROD G c6 0� WOOD^ io \ LB3635 0 I _ P.P. ° co j ¢ "'"FOl7F7Cl""F1AYL -7 C t i.iF'L3faiD OI G / , 5.00 FENCE NO Ib .' .... 0.3'S 1 0' ASPHALT PAVEMENT (15' ALLEY R /W) 0.3 NOTES: 1. UNLESS OTHERWISE NOTED FIELD MEASUREMENTS ARE IN AGREEMENT WITH RECORD MEASUREMENTS. CERTIFICATION: 2. BEARINGS SHOWN HEREON ARE BASED ON A SEARING OF N/A ALONG THE S. LINE OF THIS IS TO CERTIFY THAT I HAVE RECENTLY SURVEYED THE PROPERTY LOT , PLAT BOOK , PAGE , MIAMI /DADE COUNTY RECORDS, DESCRIBED IN THE FOREGOING TITLE CAPTION AND HAVE SET OR FOUND 3. THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR OWNERSHIP, RIGHTS -OF -WAY, MONUMENTS AS INDICATED ON THIS SKETCH AND THAT SAID ABOVE EASEMENTS, OR OTHER MATTERS OF RECORDS BY ACCURATE LAND SURVEYORS, INC. GROUND SURVEY AND SKETCH ARE ACCURATE AND CORRECT TO THE 4. OWNERSHIP OF FENCES AND WALLS IF ANY NOT DETERMINED. BEST OF MY KNOWLEDGE AND BELIEF. I FURTHER CERTIFY THAT THIS 5. THIS DRAWING IS THE PROPERTY OF ACCURATE LAND SURVEYORS, INC. AND SHALL NOT SUR Y•MIEE7g - MINIMUTA TBCHNICAI• STA"ARDS UNDER RULE 61017 -6 BE USED FOR REPRODUCTION IN WHOLE OR IN PART WITHOUT WRITTEN AUTHORIZATION. FLORIII4 ADMINISTR*Aj14E JOQE, •ADOTEPD BY THE FLORIDA BOARD OF 6. THIS SURVEY CONSISTS OF A MAP AND TEXT REPORT. ONE IS NOT VALID WITHOUT THE LAND SYRVEYQP*S, ��AA� 1 9�jj • • • OTHER. • • • • • • • 7. THIS SURVEY IS MADE FOR THE EXCLUSIVE USE OF THE CERTIFIED HEREON, TO BE • • • • • • • • • • • E Q VALID ONE YEAR FROM THE DATE OF SURVEY AS SHOWN. 6 1 ELEVATIONS BASED ON N.G. V, D. 1929 • • • • • NOT VALID WITHOUT • • • • r• • THE SIGNATURE AND i • • • • • • THE ORIGINAL RAISED REVISIONS DATE By • • • SEAL OF A FLORIDA • � • • • LICENSED SURVEYOR • • • • ., NO PER. ROBERT L. THOMPSON (PRESIDENT) PROFt:SIOI AL SUrVV% AMO•MAPPER o.3869 - STATE OF FLORIDA DATE OF SURVEY DRAWN BY CHECKED BY FIELD BOOK • • • s • M •r�(� SKETCH 01/14/10 QDI MLW SP 10- 0099••. • �A�� •��� BYO NUMBERSU - -0069: 115 POM P ANO N EACH VD. ACCURATE LAND SURVEYORS, INC. TEL. (954) 782 -1441 FLORIDA 33060 L.B. #3635 SHEET 1 OF 2 FAX. (954) 782 -1442 TYPE OF SURVEY: BOUNDARY JOB NUMBER: SU -10 -0069 LEGAL DESCRIPTION: THE WEST 1/2 OF LOT 5 AND ALL OF LOT 6, BLOCK 34 OF AN AMENDED PLAT OF MIAMI SHORES SECTION NO. 1, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 10, PAGE 70, OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY, FLORIDA ADDRESS: 254 NE 101ST STREET MIAMI SHORES, FL 33138 FLOOD ZONE: X BASE FLOOD ELEVATION: N/A CONTROL PANEL NUMBER: 120652 - 0302 -F EFFECTIVE: REVISED: 9/11/2009 LOWEST FLOOR ELEVATION: SEE SURVEY GARAGE FLOOR ELEVATION: SEE SURVEY LOWEST ADJACENT GRADE: SEE SURVEY HIGHEST ADJACENT GRADE: SEE SURVEY REFERENCE BENCH MARK: DCBM #3250 N -802 ELEV:8.97'NGVD CERTIFY TO: 1. IVAN ASTRALAGA AND W. MARCELA 2. 3. 4. 5. 6. � _ - I t a k� L AN 2414 � 2 v r w NOTES: 1. THIS SURVEY CONSISTS OF A MAP AND . . D A .TEXT REPORT. ONE IS NOT: VALID �vlYIaDLCr :'H� b1;lER. 2. OWNERSHIP OF FENCES AND WALLS IF ANY, NOT DETERMINED. •• •; �•� •� S E q 3. THIS SURVEY IS MADE FOR THE EXCLUSIVE USE OF THE CERTIFIED HEREO FROM THE DATE OF SURVEY AS SHOWN HEREON. •TO 19E WALID ONL•YEAR NOT VAUD WITHOUT THE SIGNATURE AND ° CENTRAL ANGLE � LEGEND OF ABBREVIATIONS ENCH. = ENCH. SE �OF I A A FLORDA D A = ARC LENGTH + Rob* ! • *MEASURED LICENSED SURVEYOR CB = CHORD BEARING • • • • • • L $$$$ • _ • LRXST POLE. AND MAPPER. R = RADIUS SQ. FT. = SQUARE FEET B.C.R BROWARD�,C UI�T•Y RF:ORDS • • • ,�TiNC. • _ CO C PERMANEN R/W = RIGHT OF WAY P.C.P. T CONTROL POINT D.C.R. - DADE COUPITY R$CORI DE OK P.C. = POINT OF CURVATURE P.B.C.R — PALM BEACH COUNTY RECORDS P.B. = PLAT BOOK • • • • • Cj� _ • CH I KFENCE P.T. = POINT OF TANGENCY P - _ PLAT O.RB. = OFFICIAL RECORDS BOOK WF = WOOD FENCE WM = WATER METER N &D NAIL &DISC F.F. = FINISHED FLOOR BLVD, = BOULEVARD OH OVERHANG P,O.C. = POINT OF COMMENCEMENT GAR = GARAGE AD ASSUMED DATUM N NORTH P.O.B. - POINT OF BEGINNING ELEC. = ELECTRIC LP. _ MON PIPE E 3 EAST FNCD AIR CONDITIONER SEC. = SECTION 0:9 • • • •f.R.• • • f IR ROD FOUND TWP. = TOWNSHIP 0 • �.R*•��� PE NT REFERENCE MONUMENT B. = WEST ST A. = CHATTAHOOCHEE ROB. = RANGE • • • • • .I'I•G • N IONAL GEODETIC VERTICAL DATUM B.M. = BENCHMARK STA. = STATION CIL CFNTEPLWE • • • • • • •U.E, • • f+T' 1TY EASEMENT PH = PIKE HYDRANT F,P.L. = FLORIDA POWER & LIGHT Mil = MANHOLE • • • • • • D.Bp • • • DR46IINAGE EASEMENT o/s OFFSET ELEV. = ELEVATION ESMT. EASEMENT A.E, = ANCHOR EASEMENT 1150 E. ANO EACH VD. ACCURATE LAND SURVEYORS INC. TEL. (954) 782 -1441 FLORIDA 33060 L.B. #3635 SHEET 2 OF 2 FAX. (954) 782 -1442 N N. E. 1.01ST „STREET . . + NWN E W E i A ,'75 RIGHT OF —WAY ), � I � 6' ASPHALT PAVEMENT I I I et S j BRICK DRIVE �I I MF I I 1 I BLOCK CORNER 1 295.00' FOUND 1/2" IRON �� 50.00' Oti LL 25.00' 25.00' PIPE NO ID 9 ' LLL I FOUND 1/2" IRON L L L cb. PIPE NO ID LL in L N LL LL N LL L L L L LL : z: } I– 10.00' 0.54 LL LLLLL :;is.zs': 5ti ` p3' �� o LLLLL<` LL 1.05' / �' '.' '.'FF THIS AREA: ri: LLLLTILE_LLf ` ' ...:... :::.....:::.::: `'. LLLLLLLLL .................. cr : :.: 0'NG re 0 Lo ONE STORY f. p °`: RESIDENCE:: #214: Lo ............ r . .......... ::;::::::FF THIS Al 9.94' i ... . .. ........it:i( ........... . LOT 7 ::::::.:::::...... : :: : : ::: .............21.5z'i:c: i : cri FTTTE BLOCK 34 :ri;: {i MARBLE p y 6' WOOD N p FENCE 4J CHAIN , . p / LINK 25.11' ^� cc•1/2 LOT 5 (T LOT 6 ui o° I o LOT 5 BLOCK 34 pj 1.56 P 0 0 L I ni BLOCK 34 ' 25.11' 18.46' 30.56' --- 17.48' /� 6' ,WOOD SET 1/2" $ FENCE '-: IRON ROD 9 o6 0 0� WOOD' > \. LB3635 �' P.P. TT FOUND NAIL AND DIS NO ID ..75. 00' :...;...; • FENCE 70' ASPHALT PAVEMENT (15' ALLEY R /W) 0.3'E NOTES; 1. UNLESS OTHERWISE NOTED FIELD MEASUREMENTS ARE IN AGREEMENT WITH RECORD MEASUREMENTS. CERTIFICATION; 2. BEARINGS SHOWN HEREON ARE BASED ON A BEARING OF N/A ALONG THE S. LINE OF THIS IS TO CERTIFY THAT I HAVE RECENTLY SURVEYED THE PROPERTY LOT , PLAT BOOK , PAGE , MIAMI /DADE COUNTY RECORDS. DESCRIBED IN THE FOREGOING TITLE CAPTION AND HAVE SET OR FOUND 3. THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR OWNERSHIP, RIGHTS –OF –WAY, MONUMENTS AS INDICATED ON THIS SKETCH AND THAT SAID ABOVE EASEMENTS, OR OTHER MATTERS OF RECORDS BY ACCURATE LAND SURVEYORS, INC. GROUND SURVEY AND SKETCH ARE ACCURATE AND CORRECT TO THE 4. OWNERSHIP OF FENCES AND WALLS IF ANY NOT DETERMINED. BEST OF MY KNOWLEDGE AND BELIEF. I FURTHER CERTIFY THAT THIS 5. THIS DRAWING IS THE PROPERTY OF ACCURATE LAND SURVEYORS, INC. AND SHALL NOT SURVEY &WET.9.WNIVUW TEGHNIC UNDER RULE 61G17 -6 BE USED FOR REPRODUCTION IN WHOLE OR IN PART WITHOUT WRITTEN AUTHORIZATION. FLORIDA ADMINI9�RATI�E OODTi, IDOPTTiD Y THE FLORIDA BOARD OF 6. THIS SURVEY CONSISTS OF A MAP AND TEXT REPORT. ONE IS NOT VALID WITHOUT THE OTHER. LAND 4VEYOV :, �A".1195: %: •• 7. THIS SURVEY IS MADE FOR THE EXCLUSIVE USE OF THE CERTIFIED HEREON, TO BE • • • • • • • • • VALID ONE YEAR FROM THE DATE OF SURVEY AS SHOWN. • • • • • • • • • E A / 6� NOT VALID WITHOUT ELEVATIONS BASED ON N.G. V.D. 1929 • •• • �•• ••• • THE SIGNATURE AND • • • • • • • • THE ORIGINAL RAISED REVISIONS DATE BY i • • • • • • • • SEAL OF A FLORIDA • • • • LICENSED SURVEYOR • �! ND �I�PER. 1 I( ROBERT L. THOMPSON (PRESIDENT) PROFECIIONAL SLIWEYOR•ANDAMAI&PER W.3859 – STATE OF FLORIDA DATE OF SURVEY DRAWN BY CHECKED BY FIELD BOOK y •At�!• 1 �_ •�O� N SU -10 - 0069 UMBER Ot /14/10 QDI MLW SP 10 —OO6g • • • • • IPERMIT# � , Ton CO NTRACTOR: '�►UI�Ir�I�� . SU BMITTAL DATE: AD DRESS: Q a N AME: �r RESUBMITAL DATES: � G16 PROJECT T S IN1 t tej 00 � ZONING FIRE STRUC IMPACT FE ES ELEC�TR14AL - HRS /DERM IG NOC MECHANICAL BLD Miami Shores Village iIjr� T 7 M Building Department i Jug o 9 zoos , 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 B Y: _ -_ Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit No. lJ PERMIT APPLICATION Master Permit No. FBC 2004 --- Permit Type (circle)• n�ing ' Roofing Owner's Name (Fee Si // older) . ` ,.,Qp. Phone # Owner's Address 1 1:� CitY I w A �- State Pa- Zip gh� Tenant/Lessee Name Phone # Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # '� t Is Building Historically Designated YES NO < �� Contractor's Company Name t �' } ^( i�sl Phone # Contra tor's Address G( ck (� City "G ^, p State Zip z, �O6 L/ Qualifier Name -� (,. ° G4a2�, Phone # �QD State Certificate or Registration No. CJ Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # � � " 6" Value of Work For this Permit $ Square / Lingar Footage Of Work: Type of Work: ❑Addition ❑Alteration X ew ❑ Repair/Replace ❑ Demolition Describe Work: O-A Ag c'�ex t 40a ii d d Submittal Fee $ I S Permit Fee $ 0 � CCF $ 1 C0 Notary $ Training/Education Fee $ q" Technology Fee $ ' Scanning $ f Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee Structural Review. $ 60, Total Fee Now Due $ See Reverse side -4 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 sta 5 wds 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 AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will bt done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 14AY 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 exceedigF $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 Signatur Sig e O er or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me'this day of , 20C, by L n 9 Qp.. , day of , 20 _Qqby who is r y o to me or who has produced who is rsonally to me or who has produced As ide n a we an oath as identification and who did take an oath. NOTARY PUBLIC: (a1307'22S 's NOTARY PUBLIC: 11jores 2W2012 �rronnurnrM l L.rDiLALIA nurx.rr IYGW�IiD.. " p^ +r = flfld CM1/m# QM0 i Sign: ®n f 16®1r wfennor��ai"ror +ir' Sign: a Print: A Prin : g" Notary Aaan., Inc rrrrrr.rrr.rN ®.ar.r My Commission Expires: My Commission Expires: APPLICATION APPROVED BY �f G � Plans Examiner Engineer C) T) ld Zoning (Revised 07/10/07) 1 ' , I HARVEYRtJVIId CR1< rare,, v �a �a OR Sk 269;6 Ps 43774 (Ips) a o , ur ^ e > a B� 21r' 00 RECORDED 9 11:30:56 ,/ '� HARVEY RUVINP CLERK O F COURT Per it # MIAMI -OADE COUNTYf FLORIDA Folio # LAST PAGE NOTICE OF COMMENCEMENT The undersigned hereby Property and in accordance with notice that improvement will be made to certain real is Provided in this Notice of Chapter Florida Statutes, the following information 1 • Legal Description of Property: lot Block_ Unit # Bldg nLengthy legal attached Street Address if available: Subdivision !Condominium: a - 6 Ni I(�ISt S� MtGAn 2. General description of Improvement : t 3. a• Owner name and address: Ian b. Interest in property: -► 1114 t MCFT 130 I Ili c Name and address of fee simple i \ titleholder (if other than Owner): 4. a. Contractor name and address: t b. Contractor's phone number: Nationwide Pools, Inc. Surety 5. a, •�' 3N d y name and address: r� b. Surety's phone number: Pompano Beach, FL 373 c- Amount of bond: 6 . a. Lender name and address: b. Lender's phone number. 7_ a Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as rovided by Section 713.13(1)(a)7„ Florida Statutes: P Name: Address: b. Phone number: 8, a. In addition to himself or herself, the Owner designates b. — �_ P�.�_ to receive a copy of Lienor's Notice per Section 713.13(1Kb), Florida Phone _n of person or entity designated by 0wner 9. Expiration date of notice of commencement : (the expiration dale is 7 year /rum the dale or recording unless a different date is specRed) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713. PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signatu_ rq(s) of Owner(s) or DWQ Authorized Officer /Director /Partner/Manager By Print Name _ A —�— By L4___ Pr_,i Name Title/Office Title /Office STATE OF FLORIDA COUNTY OF BROWAR-D The for _ oin instrurren! c, K — r ' befcre me this day of rk By (,] idiv'dually, or as for _ Personally known, or produoed the following type of ideritifrc'tion: (� Signature of Notary 6 E=A Print ry �( (S L) N T iC -STATE ®p pLopj 40 VERIFICATION PURSUANT TO SECTION 92.525 FLORIDA STATUTES r` Lynn Stuart DA Under penalties of perjury, I declare that I have read the foregoing and L Up DDS$229$ that the facts stated in it are true, to the best of my knowledge and belief. BONDED T MUA eS' MAY BONDING C 2013 T�N1IO, IIVC. Signature(s) of Owner(s) or . wner(s)' Authorized Offic /Director /Partner /Manager who signed above: r By r _ By 9 irecording \forms \noc - notice of commencement revised 7.3.07.doc y4` rf tt untM � 10050 NE 2 ^d Ave gNTE51Ny Miami Shores, FI 33138 F LO'RIDP' Phone 305 - 795 -2204; Fax 305 - 756 -8972 www.miamishoresvillage.com e SWIMMING POOL OWNER'S CERTIFICATION DATE MIAMI SHORES VILLAGE BUILDING AND ZONING DEPARTMENT ATTENTION: BUILDING OFFICIAL I certify that I am the legal owner of the property located at: In accordance with Section 33- 12(f), Code of Metropolitan Dade County, I certify that I understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until a separate permit has been obtained for an approved safety barrier, and such barrier erected, inspected, and approved. I further understand that this certification, however, does not eliminate the need for obtaining a permit and erecting an approved barrier prior to final inspection and use of the pool. Legal Owner v' Note: This certification is to be submitted with a swimming pool permit application in duplicate. f� . toil t t+ 10050 NE 2 nd Ave ��orvA Miami Shores, Fl 33138 Phone 305 - 795 -2204; Fax 305 - 756 -8972 www.miamishoresvillage.com NOTICE OF REQUIREMENTS RESIDENTIAL SWIMMING POOL, SPA AND HOT TUB SAFETY ACT I (We) acknowledge that a new swimming pool, spa or hot tub will be constructed or installed at 1.` _� �;) I –( P– e; 2t —41 Miami Shores, FL, and hereby affirm that one of the following methods will be used to meet the requirements of Chapter 515, Florida Statues. Please in' ' the method(s) to be used: The pool will be isolated from access from the home by an enclosure that meets the pool barrier requirements of Florida Statute 515.29; The pool will be equipped with an approved safety cover that complies with ASTM F1346-91; All doors and windows providing direct access from the home to the pool will be equipped with an exit alarm that has a minimum sound pressure rating of 85 decibels at 10 feet; All doors providing direct access from the home to the pool will be equipped with self - closing, self - latching devices with release mechanisms placed no lower than 54" above the floor or deck; I understand that not having one of the above installed at the time of final inspection, or when pool is completed for contract purposes, will constitute a violation of Chapter 515, F.S. and will be considered as committing a misdemeanor of the second degree, punishable by fines up to $500 and /or up to 60 days in jail as established in Chapter 775, F.S. 1(-.A A -- Jllt4,4, TRACTOR'S SI NA E AND D O B R'S SI N G ATURE ANfl CONTRACTOR'S NAME (PLEASE PRINT) OWNER'S NAME (Pl E PRIN NOTARY PUBLIC NOTARY PUBLIC �� 5HORE.� Gt �,- 10050 NE 2 ^d Ave OR, Miami Shores, FI 33138 Phone 305 - 795.2204; Fax 305. 756.8972 www.miamishoresvillage.com NOTICE OF REQUIREMENTS RESIDENTIAL SWIMMING POOL, SPA AND HOT TUB SAFETY ACT I (We) acknowledge that a ne swim ng p ool, spa or hot tub will be constructed or installed at Miami S `�-- � G � �`�•�'r,� s :�— Shores, FL, and hereby affirm that one of the following methods will be used to meet the requi ents of Chapter 515, Florida Statues. Please i 'tial the method(s) to be used: The pool will be isolated from access from the home by an enclosure that meets the pool barrier requirements of Florida Statute 515.29; The pool will be equipped with an approved safety cover that complies with ASTM F1346 -91; All doors and windows providing direct access from the home to the pool will be equipped with an exit alarm that has a minimum sound pressure rating of 85 decibels at 10 feet; All doors providing direct access from the home to the pool will be equipped with self - closing, self - latching devices with release mechanisms placed no lower than 54" above the floor or deck; I understand that not having one of the above installed at the time of final inspection, or when pool is completed for contract purposes, will constitute a violation of Chapter 515, F.S. and will be considered as committing a misdemeanor of the second degree, punishable by fines up to $500 and /or up to 60 days in jail as established in Chapter 775, F. S. 1 tw A-4,A- I" A A-A -4 6ZjCTOR'S GNATURE AND DATE OWNER'S SIGNATURE A DATE C 4 s� C TRACTOR'S NAME (PLEASE PRINT) OWNER'S NAME (PLEASE PRIPd * ) NOTARY PUBLIC NOTARY PUBLIC Alarr.:r - Poo: Guard Door Aiarrn - Swimming I'oels Etc. Page 1 of 3 why buy from SPE? over 17, 004 click hers tc Ckk Hef e For 4WPWt �. .i Fritmlurrr'warri , suppoft dkk 1 11tro tail! us Ilp 81 ' PR1Vf1GY View Your_Sh P Rt�TCTED. Poolguard D( lorne Pool Filters:: Pool Cleaners:: Pool Heaters:: Pool Pumr)s :- Pool Covers:: Pool Alarms:: Pool Liners:: Site Map APE Site Direc 'r a luick Tech T vial 104 Poolguard Door Alarm - Pool Alarms 'oo_ 1S�a Ca I Poolguard Door Alarm mounts next to any door which gives easy access to your swimming pool. Any \bove Ground i L`l ers allows young children easy and quick access to a pool area is dangerous and should have a door alarn lbove Groun o dar(Trs '• oolguard Door Alarm comes with two magnetic switches, hookup wire and operates on one 9 -volt bi \Iternative S itize ° or Alarm has a delay switch which allows an adult to pass through the door without the alarm soundi lutomatic P hild opens the door, the alarm will sound in seven seconds and continue to sound; the alarm will soun :artridges child should go through and close the door. If for any reason the door is accidentally left open, the alarr ;hoi i�ical Feeder Erosion ;hemical s ;rrtorinators Poolguard Door Alarm ;onlnlercial Cleaners ;urr,rl,ercial Heaters -..` Call Us: 1 -$00 544 -373( ;01'11nler cial Ozon ]tors ;avers MFG # Description Pricing ners Pool Door Alarms Click Here `iv1 ?r,• Boards - _lectronic Controls ti y$ w � For Pricin 9 I Call us for all your Pool Guard needs & ; 'iber Optic Lighting 3 . �.s L�az = � � =liter Cartridges sifter Grids Z ' =iiters PoolGua. rd Door Alarm m =itness Aquatic Style Features :'-is & Dive Masks =ountains • LIL Approved Land Rails a Important Safety Feature - feat Pumps • Complies With Building Codes ;eaters • Simple To Operate oflatabie Beds • Automatic Reset -cars 4andy Controls • Battery Powered .eaf Covers • Easy To Install - irahts s • Affordable Price - otrrlcies > • Pass Through Feature For Adults Aisreflaneous Products . Low Battery Indicator Motors dature 2 Purifiers " :)i1 -Fired Pool Heaters . zonators )caner Builder Supplies ) ooi Fteat Pumps ,� zJ 'ool Tc;vs and Gan1r~s 1, 001 harts lumps; :,ebates eplacament Filter Cartridges >afety Covers Salt Chlorinators >lides Solar Controls iolar Cover Reels iolar Covers tt�:// www .swimmiz�gpoolsetc.com/alarrn doc:r.htm 11/29/2006 -- 1 1111, Alarm CLOD ANT 6 /19 /pl D OOR A LARM installation instructions Model DAPT @2017 Figure 1 1 IM RE AD THOROUGHLY BEFORE USING W AQVI Tnb P h. b-Uwn p .gn d b aU . " p Wi. M MA Y.N. 3b —u WDW.apa— PGDCGUARD RAPT IS A SAFE TY AIAFpI SYSTEM AND NOT A LIFESAVING DEVICC II sn was,, L van In. - 1-111,—nl curanrh +r u. ant snarl rcu u.e .sung saNly pror�Nras. 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INSTALLING DOOR SENSOR are pOOnO11 W n M rmall axl d lM •aMOys rn me W.? or of unr how INIIM NNwyy aglvl you miy i<OO]nylY Sel neunnon wayyon aenp ne sOnsa tyres II nis Npswns P,D na W eY swrN YOu ] e nav reap b cMM[I tyre eOV alarm 10 ne ssnb/ sty Kn TM PWIWwe DOP WVmb,csayOq• wYCn conAAS Or IwOOwls One of M salsa •wren •ro . ... oa.M senav m•Tel Bon ne saYSP mro m m•vnn n,ae dasYC co.w : dau< mp.ae MaanemaYm th saner swan na, ..a cd.narnau b. n• dean Mr cmw evn 11 P -pryre oPx,larm U v I aro ne srnf m� s lee rn np subnaY prll •b'ylm M pryr M rM p/or iverr m POp.rN M s wrrm •ro sensd maP•r meal De cbse bparwr a up>aycfY PWmp n sary b us sorts wwd N m m,daapeo berm ypeOMpr MS•naer ivnlcn v mapylrMtnwe i Y FV Desl ogralvl M swyv swCn ala senfd maps,i sinutl ilrrml rwrcn, WI a Dacvp d W b ID' is •ccePaUa 11 M War fame a mats Or sIM, fy vmzd h one sMV maprel mrsl M sOYCee al Imo r.w a wen Dena i/ Uosa yaraf Oaca Us, PODS OI won daaa[ or O.WNa iwitl barn raps br l'a,IP/r 10050 NE 2 nd Ave Miami Shores, FI 33138 ��ORiDA Phone 305.795 -2204; Fax 305- 756.8972 www.miamishoresvillage.com NOTICE OF REQUIREMENTS RESIDENTIAL SWIMMING POOL, SPA AND HOT TUB SAFETY ACT I (We) acknowledge that a ew swimming . pool, spa or hot tub will be constructed or installed at `, .- Miami Shores, FL, and hereby affirm that one of the following methods will be used to meet the requirements of Chapter 515, Florida Statues. Please initial the method(s) to be used: The pool will be isolated from access from the home by an enclosure that meets the pool barrier requirements of Florida Statute 515.29; The pool will be equipped with an approved safety cover that complies with ASTM F1346 -91; All doors and windows providing direct access from the home to the pool will be equipped with an exit alarm that has a minimum sound pressure rating of 85 decibels at 10 feet; All doors providing direct access from the home to the pool will be equipped with self - closing, self - latching devices with release mechanisms placed no lower than 54" above the floor or deck; I understand that not having one of the above installed at the time of final inspection, or when pool is completed for contract purposes, will constitute a violation of Chapter 515, F.S. and will be considered as committing a misdemeanor of the second degree, punishable by fines up to $500 and /or up to 60 days in jail as established in Chapter 775, F.S. oNTRACTOR'S TE OWNER'S SIGNAT RE A ATE d I CONN " TIKAICTIOR 'S AME (PLEASE PRINT) OWNER'S NAME (P EASE P � NOT � NOT A Y . uaa P I ? ,'0011014 roMm# D00749225 � �•u • C)l LA euaunn 012 3 wurrn, COIT M# OD07�92 e �xp 2(812012 � �1kifl� M . tres I l7tP lsiB.!!!M a irrrrrr.' �rrrrrrrrrrrrrrr++ • FWi Nowq Assn.. MC � Irrirrrrr rrrrrrrirri '1lrl uaA FLORIDA DEPARTMENT OF HEALT Charlie Crist Ana M. Viamonte Ros, M.D., M.P.H. Governor State Surgeon General July 22, 2009 Phillip Ness 1923 NW 40 Ct Boca Raton, FL 33433 RE: Contingency Letter Application Document No: AP929906 Centrax Permit Number: 13 -SC- 996119 OSTDS Number: 254 NE 101 St Miami, FL 33138 Lot: 8 Block: 34 Subdivision: Miami Shores Dear Applicant: This will acknowledge receipt of an application dated 07/20/2009 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. 1. -There is no increase in sewage flow, change in characteristics compromising the integrity or function of the system installation. 2. -This project entails: "INSTALLATION OF A SWIMMING POOL " From a review of your completed application, it has been determined that your existing system is adequate for the proposed use: " APPROVED ". G/P If you have any questions on this matter, please call our office at (786) 315 -2444. Sincerely, Jo p r, ngineer Specialist II Enclosures cc: Miami -Dade County Health Department 11805 SW 26 St, Miami, FL 33175 Phone: (786) 315 -2444 Fax: (786) 315 -2090 5� °R9 Miami shores Village Eggs E � Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 FLORIDA Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No: 09 -C/Gz Job Name: 2009 Page 1 of 1 Building Critique Sheet 2 044A, ! . s Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 I 4 K 9 r IG �� 1d I �O ?t er 2!- i 't4 0 N. E. 101st STREET sT F-T 1 1 TR E �a 96 .x° G • 1 s M h o' �p •0 IT 20' ASPHALT PAVEMENT s ' to t p o .y 8 7 .1 7 ; 0' 23.0' b v. 1 - 1 3 t L ° CON.CRETE o a `' •► 19 1 3 10 +6 11 le 19 ro Z1 zz t3_ D R I V EV1/.A Y• • �' M np N Q 1. n1 x :1 T H IQ c JTR F_ E 0. isp:oo'4M)• - - .- - - — - - 75: 00'(R)(M); S'a 'GONG: - WALK n ,, 1 0 0 •o ao 1 a—�- -- F.I.P1/ /2" 11 F.I.P.1 o ri• n r. M 16111 11 BLOCK o, 9 �� - CORNER a o Le gal Description: - - - -- - LP 0 0 ' /2 The West of Lot 5 It Lot b Block 34 of "AN AMENDED PLAT OF LOCATION SKETCH ((�` r N I M M �. Ln MIAMI SHORES SECTION NO.1 ", according to the plat thereof as NOT To SCALE `_? I,l1 ` N recorded in Plat Book 10, at Page 70, of the Public Records of SE` 1 2001 Miami- Dade County, Florida. GENERAL NOTES _ - ------ -- --- - -- - -- o.io' - 21.45 1 3.00' 1 0.00' Certified to: � a _ O . 77 I MARCELA ASTRALAGA -LEGAL DESCRIPTION PROVIDED BY OTHERS. 3 CONCf7ETr 0 ON PL - EXAMINATION OF THE ABSTRACT OF TITTLE WILL HAVE TO BE MADE TO DETERMINE 0 00 RECORDED INSTRUMENTS, IF ANY, AFFECT THIS PROPERTY. Y " PATIO' (.D -THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENT OR OTHER RECORDED Community Number: 120652 ENCUMBERANCES NOT SHOWN ON THE PLAT. a N LL co Panel: 0093 - UNDERGROUND PORTIONS OF FOOTINGS FOUNDATIONS OR OTHER IMPROVEMENTS WERE j NOT LOCATED. 8.40' 3 ix: J ONLY VISIBLE AND ABOVE GROUND ENCROACHMENTS L ° � ED. ° 20.50' 0 0 S u ffi x: � � oo Y Date of Firm Index R .03 /02/94 -WALL TIES ARE TO THE FACE OF THE WALL CI D ONE STORY O � � U I -FENCE OWNERSHIP NOT DETERMINED. RESIDENCE O LL1 0 Firm Zone: X - BEARINGS REFERENCED TO LINE NOTED AS B.R. ,- ( Q J - BOUNDARY SURVEY MEANS A DRAWING AND /OR GRAPHIC REPRESENTATION OF THE SURVEY l— U #254 Base Flood Elevation: N/A z m WORK PERFORMED IN THE FIELD, COULD BE DRAWN AT A SHOWN SCALE AND /OR NOT TO 0 0 O W F.F.E. =11.36 Date of Completion: 08/03/2007 SCALE. J J O of GAR =9.38 _Q -NO IDENTIFICATION FOUND ON PROPERTY CORNERS UNLESS NOTED. CO -NOT VALID UNLESS SEALED WITH THE SIGNING SURVEYOR'S EMBOSSED SEAL- 0 O 1 1 .BO' Property Address: - DIMENSIONS SHOW ARE PLAT AND MEASURED UNLESS OTHERWISE SHOWN. 1 0.00 W - ELEVATIONS IF SHOWN ARE BASED UPON N.G.V.D. 1929 UNLESS OTHERWISE NOTED. 21. 55 ' LO , � Q 254 N.E. 101 STREET -THIS IS A BOUNDARY SURVEY UNLESS OTHERWISE NOTED. MliWl SHORES, FL 33138 -THIS BOUNDARY SURVEY HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF THE ENTITIES NAMED HEREON. THE CERTIFICATIONS DO NOT EXCEED TO ANY UNNAMED PARTIES. " PRaTC ; Survey: S -4554 6.3f SURVEYOR'S CERTIFICATION: I HEREBY CERTIFY THAT THIS BOUNDARY SURVEY IS A TRUE AND CORRECT REPRESEjDSEAL RALICENSE EY PREPARED UNDER MY DIRECTION.. THIS COMPLIES WITH 1 3.05 THE MINIMUM TE AS SET FORTH BY THE STATE OF FLORIDA BOARD OF C) PROFESSIONAL L HAPTER 61G17 -6, FLORIDA ADMINISTRATIVE CODE A/C SLAB ELEV -9.58 I PURSUAN 7 4 ES. z < �LJ LJ • O CJ � STEPPING U• 0 D LaU C]- STONES " SIGNE ________ FOR THE FIRM El El 11 D N MIGUE PI SA P No.5101 STATE OF FLORIDA � � 0.20 l 9 NOT ALID WITHO CT 0 C SIGNATURE AND AUTHENTICATED CONC. SLAB 7 • r ��Jl '2 ELEC RONIC SEAL S N T LID WITHOUT THE SIGNATURE AND 6.0'X6.0' W a u THE RIGINAL RAI SE URVEYOR AND MAPPER. L] 5.0 ' (R)( M 0.20' _ - - - -- F.I. P.1 F. I. P.1 2 _ - J J - 0 10' ASPHALT PAVEMENT o MIGUEL ESPINOSA - - --{-- - - = LAND SURVEYING, INC. 1 5511 SW 8th STREET - SUITE 202 MIAMI, FLORIDA 33134 PHONE: (305) 262 -2992 NOTES: NO NOTES. FAX: (305) 262 -2995 www.espinosolandsurveying.com L.B. 6463 Miami Shores Village I0t"'t t c M libe 10050 N.E. 2nd Avenue ti Miami Shores, FL 33138 -0000 FW Phone: (305)795 -2204 y ,. caxm� �w Expiration: 02/1412 Mi Project Address Parcel Number Applicant 254 101 Street 1132060134620 IVAN AND MARCELA ASTRALA( Miami Shores, FL Block: Lot: Owne Information Address Phone Cell IVAN AND MARCELA ASTRALAGA 254 N. E., 101 ST. (305)773 -0577 Contractor(s) Phone Cell Phone NATIONWIDE POOLS INC (954)227 -7665 Valuation: 2 0,000.00 Total Sq Feet: 324 Approved: Yes For Inspections please call: Comments: POOL EQUIPMENT CAN NOT BE LOCATED IN 10 FOOT REQUIRED SIDE YARD SETBACK (305)762 -4949 Date Approved: 8/10/2009: Yes Available Inspections: Date Denied: Inspection Type: Type of Work: Swimming Pool Occupancy: Private Fence Additional Info: Bond Return : Final Classification: Residential Pool Deck Wall Steel Fees Due Amount Invoice # Total Amt Paid Amt Due Bond Type - Contractors Bond $300.00 Bpp -6 -09 -35049 $ 1,164.25 $ 150.00 CCF $12.00 CO /CC Fee $150.00 BPP-6 -09 -35049 $ 1,164.25 $ 1,164.25 $ 0.00 Education Surcharge $4.00 Check #: 12338 Bond #: 1885 Permit Fee $600.00 Plan Review Fee (Engineer) $60.00 Scanning Fee $18.00 Submittal Fee $150.00 Submittal Reversal Fee ($150.00) Technology Fee $20.25 Total: $1,164.25 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. August 25, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy August 25, 2009 1 R Es Miami shores Village 9-12 Building Department logo FEW NONNI 10050 N.E.2nd Avenue Miami Shores, Florida 33138 �IORiDA Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No: 09- -fG� Job Name: 0 1,)4 , 2009 Page 1 of 1 Building Critique Sheet 2 64e ! . / . 44.E 4,Z Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 sv �� Miami Shores Village Permit NO. B P P - 6 -0 9 - 9 6 0 F �e 10050 N.E. 2nd Avenue t _ Miami Shores, FL 33138- 0000 � . �� Phone: 305 795 -2204 Fax: 305 756 -8972 ? ` ) ) flff G1$5`$I#1Crf1fl '� ---`' Issue Date: Not Issued Expires: Folio Number) 132060134620 Owner's Name: IVAN AND MARCELA ASTRALAGA Owner's Phone: (305)773 -0577 Job Address: 254 101 Street Total Square Feet: 324 Miami Shores, FL Total Job Valuation: $ 20,000.00 ......... ......... ......... ......... Contractor(s) Phone Primary Contractor NATIONWIDE POOLS INC (954)227 -7665 Yes Planning and Zoning Criteria and Comments Approved: No Date Denied: Comments: POOL EQUIPMENT CAN NOT BE LOCATED IN 10 FOOT REQUIRED SIDE YARD SETBACK A 12.5 FOOT SETBACK IS REQUIRED FROM SIDE LOT LINE TO WATERS EDGE 7/28/09 POOL EQUIPMENT CAN NOT BE LOCATED IN 10 FOOT REQUIRED SIDE YARD SETBACK IDENTIFY LOCATION OF POOL DECK s ` O S ; Miami Shires Village �° i Building Department R` 10050 NE 2 Ave, Miami Shores, Fl 33138 Tel: (305)795 -2204 • Fax; (305)756 -8972 RECEIPT PERMIT #; s � ,... DATE: A�Contraclor • Owner • Architect �.icked up 2 sets of plans and (other)_.' Address: Z4 I t C From the building department on this date in order to have corrections done to plans And /or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged by PERMIT CLEARK INITIAL: RESUBMITTED DATE: M OG PERMIT CLEARK INITIAL: . Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 x 0� Inspection Number: INSP 116417 Permit Number: EL -6 -09 -961 Scheduled Inspection Date: December 15, 2009 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: ASTRALAGA, IVAN AND MARCELA Work Classification Addition /Alteration Job Address: 254 NE 101 Street Miami Shores, FL Phone Number (305)773 -0577 Parcel Number 113206013462 Project: <NONE> Contractor: TBM ELECTRICAL Phone: (954)741 -1004 Building Department Comments ELECTRICAL FOR POOL Inspector Comments Passed Failed n' Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. December 14, 2009 For Inspections please call: (305)762 -4949 Page 2 of 14 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 T Inspection Number: INSP- 11 Permi N PL -6 -09 -962 Scheduled Inspection Date: December 15, 2009 Permit Type: Plumbing - Residential Inspector: Levrock, James Inspection Type: Final Owner: ASTRALAGA, IVAN AND MARCELA Work Classification: Pool - Private Job Address: 254 NE 101 Street Miami Shores, FL Phone Number (305)773 -0577 Parcel Number 113206013462 Project: <NONE> Contractor: NATIONWIDE POOLS INC Phone: (954)227 -7665 Building Department Comments PLUMBING FOR POOL r Irysp ctor Comments Passed Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. December 14, 2009 For Inspections please call: (305)762 -4949 Page 3 of 14 11/10/2009 15:52 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES 9007/012 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP-127057 Permit Number: EL -10 -09 -1685 Scheduled Inspection Date: November 10, 2009 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: ASTRALAGA, IVAN AND MARCELA Work Classification: Addition /Alteration Job Address: 254 NE 101 Street Miami Shores, FL Phone Number (305)773 -0577 Parcel Number 113206013462 Project: <NONE> Contractor: LIGHTGATE INC Phone: 305 -054 -4820 Building Department Comments ELECTRICAL SERVICE REPLACEMENT Inspector Comments Passed % 3/ r Failed f Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. November 09 2009 _ __ For Inspections please call: (305)762 -4949 Page 10 of 29 1 n / stjOP a� Miami Shores Village p� 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 .� o Phone: (305)795 -2204 Ys y "LORtvf' r/ Expi ration: 04118 /201 Project Address Parcel Number Applicant 254 101 Street 1132060134620 IVAN AND MARCELA ASTRALA( Miami Shores, FL Block: Lot: Own er Information_ Address Phone Cell IVAN AND MARCELA ASTRALAGA 254 N. E., 101 ST. (305)773 -0577 Contractor(s) Phone Cell Phone Valuation: $2, 000.00 LIGHTGATE INC 305 - 554 -4820 Total Sq Feet: 0 Type of Work: ELECTRICAL For Inspections please call: Additional Info: SERVICE REPLACEMENT (305)7624949 Classification: Residential Available Inspections: Inspection Type: Underground Rough Final Meter Box Alteration Relocation Fire Alarm Service Change W. W. Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $1.20 EL -10 -09 -36148 $ 164.72 $ 164.72 Education Surcharge $0.40 $ 0 Permit Fee - Additions /Alterations $160.00 Scanning Fee $3.00 Technology Fee $0.12 Total: $164.72 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. October 20, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy October 20, 2009 1 OCT -05 -20019 03:04 PM LIGHTGATE , INC 3 M1c��� ° it i Shores Village OCT � 4 zoo9 Build in.g Ilepa�rt���e.i�t �Y:_I�.,.�� :t 0050 N.E.2nd Avenue, Miami Shores, Florida 3_i f -e- Tel: ('303) 79�.2204 Fax: (305) 756.8972 BUILDING Permit Nuti PERMIT APPLICATION Master Permit M &PP16— q� FBC 2 004 Permit Type: .Electrical Owner's Noun (Fee Simple Tidcholder) q Owner's Address i(1 /L* �`� J .. _ - g� _.. - - - -• Cit /4riJ S tate —, zip l- —-- y� -- • -ham_ s —._._ Tenant /Lessee Name _ � Phone # - -- — -- —~ E -MAIL; s lob AddrCtc (where the work is being clone) < zC / 5 City Mi Shores Village County Miami -bade Zip _,..�. FOLIO /PARCEL # - is Building Historically Designated Y8S NO Contractor's Company Name 7 _�7G, Phone Contctor's Address — _ City _ . � /4 n2 / ---� .� State - — Qualifier Name /27i7G, — Phone # State Certificate or Registration No, C L,2k Cortifrcate or Competency No._ E -MAIL: _ _ ......._ .. Architect /Engineer's Name (if applicable) Phone # Value of Work For this Permit $ / /r e!5 Square / Linear Footage Of Wo► Type of Work; ❑Addition. ❑Alteration []New Re air Re lace p p �] Demolition Describe Work. 6� Il l ! ,)ie, 4G aaNtefe ** ten* n, r*+ eaa aa aaaaaa{*. 4aaaaaaalra� .'eeSa *aaaattae * *frn *4 *xi. # * +t isir��r4a� *aaa>tia>V�+4a *V.NwV� Submittal Fee $ Permit Fee $ ` CCF S MCC Notary $ 'training /Education Fee S Technology Fee $ Scanning $ Radon $,,,,,,- , DPBR S — _ - ___ Zoning $ Bond S Code Enforcement $ Double Fee $ Structural Review. S Total Fee Now Due $ See Reverse side —� 3055592183 P-02 B( lildilig C Nitrite 1'11111(lill C Address City State Zip ------- Mortgage I-alder's Nillie (if applicabl Mortgage Lender's Address City State Application is hereby made to obtain a pernlit to do the w an d commenced prior to the issuance of a permit and that all work histAllations as indicated. I certify that no will be pe to wt)rk or installation 11"'; construction in thisjurisdiction. I understand that a sepal-ate permit meet the standards of all laws regulating must be secured for EI,.L1CTR,ICAL WORK, PLUMBINc SIGNS, WEI.,L,S, RMNACIES, 6C)ILERS, 14 LATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT I certify that all die foregoing infonnation is accurate an that all work will be done it compliance with all applicable laws regulating construction and zoning. a n "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 16 Applicant: .4s a condition to the issuance qf a building 171-0m permit with an estimated value eveeeditrg $2500, the applicant must ise in goodfailh that 4 co of1he notice qf commencemenj and construction lien lam hrochu will be delivered to the perion whose propertl) is subje to a Also, a cart! tad c4up for t he first inspection which occurs y of the recorded notice O'cominencemen( must be posted at the job s it i. . ! . seven M 4Ys after the building perinit is issued 117ibovab i17,V/7414rij0�1 nor ba app- an d a 1+ be e'llarged ql,such hosted notice, thf? Signature Signature 11 l —#W- e OvVn or Agent ge Con actor The fio� I �gi strument was a%wledl f 'e ""t day of � day of me his The fore strunient was acknowledged before me thi G7'�O or who�_ l by who is rsona y kn h I produ lv:!7 2e — - I w me or who Jim proced who is personally known to me or who has produced 'd ntification and who did take an oath, i d e ntif y - NOTA Y URLIC: ...... —. �as en f I and who did take an oath. NO Is 'A7 av ON Sign- Sign: LL Print: Print: My Commission Expires: LUIS FERNANDEZ My collitlli,��io h q W ires: EXPIRES: November 7, 2012 7, OF FLd Bonded Thru Budget Notary, Services APPLACATION APPROVED BY: Plans Examiner Engineer Utcyi,wd 02108106) Zoning Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 P Q — co y Inspectio Number: INSP 126398 Permit Number: PL -6 -09 - 962 Scheduled Inspection Date: October 07 2009 Permit Type: Plumbing - Residential Inspector: Levrock, James Inspection Type: Piping Owner: ASTRALAGA, IVAN AND MARCELA Work Classification: Pool - Private Job Address: 254 NE 101 Street Miami Shores, FL Phone Number (305)773 -0577 Parcel Number 113206013462 Project: <NONE> Contractor: NATIONWIDE POOLS INC Phone: (954)227 -7665 Building Department Comments PLUMBING FOR POOL �nsctor Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. October 06, 2009 For I nspections please call,: (305)762 -4949 Page 10 of 12 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 126398 Permit Number: PL -6 -09 -962 Scheduled Inspection Date: October 07, 2009 Permit Type: Plumbing - Residential Inspector: Levrock, James Inspection Type: Piping Owner: ASTRALAGA, IVAN AND MARCELA Work Classification: Pool - Private Job Address: 254 NE 101 Street Miami Shores, FL Phone Number (305)773 -0577 Project: <NONE> Parcel Number 1132060134620 Contractor: NATIONWIDE POOLS INC Phone: (954)227 -7665 Building Department Comments PLUMBING FOR POOL s ctor Comments Passed Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. October 06, 2009 For Inspections please call: (305)7624949 Page 10 of 12 K . ,, ray 'o e NO ORE - r � 1JII11 Miami Shores Village > ) 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 r ' s r� r t #art staff F' Phone: (305)795 -2204 r , Expiration: 0212 1 201 0 Proje Add ress Parce Number Applicant 254 101 Street 1132060134620 Miami Shores, FL Block: Lot: IVAN AND MARCELA ASTRALM M, Owner Information Address Phone Cell IVAN AND MARCELA ASTRALAGA 254 N. E., 101 ST. (305)773 -0577 Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 NATIONWIDE POOLS INC (954)227 -7665 Total Sq Feet: 324 Type of Work: PLUMBING For Inspections please call: Type of Piping: POOL (305)762 -4949 Additional Info: Available Inspections: Bond Return : Inspection Type: Classification: Residential Final Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $0.60 PL -6 -09 -35051 $ 201.55 $ 50.00 Education Surcharge $0.20 "" Permit Fee - Additions/Alterations $190.00 PL -6 -09 -35051 $ 201.55 $ 201.55 $ 0.00 Scanning Fee $6.00 Check #: 12338 Submittal Fee $50.00 Submittal Reversal Fee ($50.00) Technology Fee $4.75 Total: $201.55 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. August 25, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy August 25, 2009 1 Miami Shores Village Building Department JUN o 9 2009 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 - -__ -- BUILDING Permit NoM q— q i f o p PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type: Plumbing Owner's Name (Fee Simple Titleholder) :Phone # Owner's Address F } q V V �( 1— cit y State Zip _ Tenant/Lessee Name Phone # E- MAIL: Job Address (where the work is being done C % City Miami Shores Village County Miami -Dade Zip r: FOLIO / PARCEL # Is Building historically Designated YES NO Contractor's Company Name "10 t.,1 Phone # �G_ � Contract s Address �. �e A� , ' AO ,� City ` Ij n— State Zip 06 , Qualifier Name 11, �,�� Phone # 6 Y22D 7G�� State Certifi5fte r Registration No. Certificate of Competency No. E -MAIL: Q < _ r Architect/En meer s Name if applicable) �1iCQ g ( Pp ) ti Phone # �j(} Value of Work For this Permit $ �, `� -' C Zquare/ ear Footag e Of Work: Type of Work: ❑A itjon ❑Alteratio Repair/Replace E] Demolition Describe Work: Lj t �-- Submittal Fee j Kj Permit Fee $ / f 3 CCF $ M o n CO /CC Notary $ �� Training /Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ See Reverse side Bonding Company's Name (if applicable) Bonding Company's Address City State Zi Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zi 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 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. "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 approve and a reinspection fee will be charged. Signature Signatur Owner or Agent Contrac or The foregoing instrument was acknowledged be re me this - 6 The foregoing instrument was ackn wledged before me this day of 20rQA by day of 20Q�E'' by A , wh is per no to me or who has produced who' one y to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: rruruurrrrrMARI L� rLAUA rnnroa� rnoruunnnnerausennouarr!!nm '•�� NOTXYPBWCRLL.DIlJ1LLA r'n" Comm# DD0749225 Comrrsl DD074®� i Expires 218!2012 E 2/2012 Sign: Inc Sign: ry „ II1R be a Gleason ene uanar7p a nor! Print: Print: My Commission Expires: My Commission Expires: APPLICATION APPROVED BY: Plans Examiner Engineer Zoning (Revised 02/08/06) k :jyi Nr t, Miami Shores Village 10050 N.E. 2nd Avenue! Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 5� . Ills Expiration: 02/14/2 P roject Address Par cel Number Applicant 254 101 Street 1132060134620 .... � � IVAN AND MARCELA ASTRALA( l Miami Shores, FL Block: Lot: Owner Information Address Phone Cell w..,..,..... _......,.., IVAN AND MARCELA ASTRALAGA 254 N. E., 101 ST. (305)773 -0577 Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 TBM ELECTRICAL (954)741 -1004 Total Sq Feet: 324 Type of Work: ELECTRICAL For Inspections please call: Additional Info: POOL (305)762 -4949 Classification: Residential Available Inspections: Inspection Type: Underground Rough Final Meter Box Alteration Relocation Fire Alarm Service Change W. W. Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $0.60 EL -6 -09 -35050 $ 237.42 $ 50.00 Education Surcharge $0.20 1 $111474 Permit Fee - Additions /Alterations $225.00 EL -6 -09 -35050 $ 237.42 $ 237.42 $ 0,00 Scanning Fee $3.00 Check #: 12338 Scanning Fee $3.00 Submittal Fee $50.00 Submittal Reversal Fee ($50.00) Technology Fee $5.62 Total: $237.42 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. August 25, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy August 25, 2009 _� 1 Miami Shores Village 0 Mc g M 0 9 2009 Building Department g p 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY --------- ------------ Tel: (305) 795.2204 .Fax: (305) 756.8972 BUILDING Permit No. PERMIT APPLICATION master Permit No. FBC 2004 Permit Type: E lectrical Owner's Name (Fee Simple Titleholder) V61A Phone # Owner' Address � � � �' J �j � City State i — ! Zip Tenant /Lessee Narne Phone # E- MAIL: Job Address (where the work is being done) r City Miami Shores Village County Miami -Dade Zip POLIO/ PARCEL # Is Building Historically Designated YES NO Contractor's Company Name &C_ a Phone # Contractor's Address /J CA�rQ'fyt City State Zip - -S wJ j Qualifier Narne 2 Phone # State Certificate or Registration No. L Certificate of Competency No. E -MAIL: Architect /Engineer's Name (if applicable -Lk- - -tW - hone # qJ5(I Value of Work For this Permit $ j C36 Square / Linear Footage Of Work: Type of Work: ❑Addition Wrteration w ❑ Repair /Replace ❑ Demolition Describe Work: CL ax— Submittal Fee S Permit Fee $ 2 2 j�, ®p CCF $ CO /CC Notary $ �� Training /Education Fee $ 0 -94 0 Technology Fee $ :5 Scanning $AOO Radon $ D.PBR $ Zoning $ Bond $ Code Enforcement $ Double Fee Structural Review. $ Total `Fee Now Due $ See Reverse side --> 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. 1 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 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. "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 v exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien I w br chure wi be deli d to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of co enceme ust epos d at the fob site for the first inspection which occurs seven (7) days after the building permit is issued !n the a ene of su posted ice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent Contrac The foregoing instrument was acknowledged before me this The foregoing instrument was acknowladged b fore this day of 20 by day of ' personall , 20b who is po n me or who has produced who a or who has produced As identification and w ce an at . as identification and who did take an oath. NOTARY PUBLIsr •r..••r• ■r ■rrrr ■r•• ° °r ° " " "'O""' • NOTARY PUBj,�( MAI21 L. DILALLA r 01 r L1�l- L�' •••••••••••! anrr = ur+ C13111tn# OD0749225 3 ':. �tnn Comm# OD0740225 Sign : G 'itpinas 2/8/2012` r ry x!'2012 Sign: V Notary Print: 1 4A , i rrru■ ........� PI'lltt: ' r yrlrrrrrtlrrrrrrwur* VVW- My Commission Expires: My Commission Expires: APPLICATION APPROVED BY: Plans Examiner Engineer Zoning (Revised 02/08/06)