441 NE 101 St (2)Date
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant RiC/ieri 2 19 6'/C E410
Owner's Address M 1 !lig jg r ,41' S170
Contracting Co. Z4 gETS
Phone ( ) 754 - o8a 6
State # CRC 05706 / Municipal # Competency # Ins. Co.
0 Address / 2 1 /U) q 2 x"°
Architect/Engineer
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING
WORK DESCRIPTION F,e!/IIe — fry gTaJA , v► ' G ' c 00
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.
'4r
•Off_ .7 �0
ture of owner and/or Con
Presiden Date
9-
• '1 N07ARY S 11 •'
O1 PaY pi: wa, ANGELA M BECKER
- _ o coot sSON NUMBER
N 4IIP - . a CC786697
MAY COMMISSION EXPIRES
r O N 15 2002
My Commission Expires:
go
C.C.F. 4 NOTARY S., 0 0 BOND
Master Permit # 4 ,7f ' y
P(one . 1 S 8 ' 1 o
Estimated Cost (value) Rio
ature of Contractor or Owner - Builder Date
DL � g) DO
a•, o tont tor or Owner- Builder D ate
Electrical
101Y PUee ANl:LI EA BECKER
Z 1= 7 n CO BIIREION NUMBER • ' iI;; 4 J Q CG78869
• MY COMMISSION EXPIRES
OF FA NOV. 1 5,2002 .
TOTAL DUE
Lge-g
SIGN
Plumbing Structural Engineer
NOTICE OF COMMENCEMENT
A, RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF DADE:
1. Legal description of property and street address:
�4T /5 A4 t
.r"/VC
2. Description of improvement:
Interest in property:
/VC- / Ots
Name and address of fee simple titleholder:
5. Surety:(Payment bond required by owner from contractor, if any
) tt
vi,„
Name and address:
Amount of bond $
6. Lender's name and address:
S'1 11C1JD w E b designated Eau>1
7. Persons within the State of Florida desi 9 by Owner upon
p on '
by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
■
Notary Public
Print Notary's Name
MV rnmmiecinn C
//- 32 0/ 7 06 60
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
/
• Gtr . Ai0%f, 161 / 9 LLo cGC
S 072E ' S"
,x4/67/11114 Tery
ner(s) name and address: / - A L e r 6.04.2
S ;r ORES F e 3 l3
C _ name and address: - 74 B o gl. i S /6 > /t> LA,
FL.4 33i2y� '
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different date is specified)
Signature of Owner
Print Owners Name a.2.c=7 Prepared by:
Sworn to and subscribed before me this l 2 flay of ,iJece , A .
ay p OFFICIAL NOTARY SEAL
CKE
• 1 _ /7 n WMIASSION NUMBER
CC786697
4
/Le Can
00R590343 2000 DEC 08 10:04
STATE OF FLORIDA, COUNTY OF DADE
I HEREBY CERTIFY that this is a tru pet the
original tiled in this office on V) day Of
D _c _ , A O 20 "ZS
WITNESS my hand and Official Seal.
HARVEY RUVIN, CLERK, of Circuit and CountyCourl§
bV . "\ - QD.C.
or other documents may be served as provided
Address: /61 ! V io .S'
5 r /WM Fh9
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Locator Index
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2 o' Aput pa“/ i(
LEGEND : FIP= Found Iron Pipe
S.P.0 = SET 1/2" PIN & CAP LB4769
S.PCP= SET PERMANENT CONTROL POINT LB4789
CENTERLINE. P /L= PROPERTY LINE, O /L= ON LINE
M.H.= MANHOLE. WM= WATER METER PP= POWER POLE
FC.= FENCE CORNER, R= RECORD, M= MEASURED
CHAIN UNK OR WIRE FENCE- • -
W000 FENCE= • * -+
MASONRY WALL
CONCRETE= ,. .
MAINTENANCE & DRFNAGE FASEMIN rnrS • •
NOTES: UNLESS OTHERWISE SHOWN, THE FOLLOWING NOTES APPLY.
1) Record and measured calls are in substantial agreement. 2) Bearings: if shown are based on Plat data. 3) The lands
shown hereon were not abstracted for Easements or other recorded emcumbrances not shown on the plat and _he same, if
any may not be shown On this sketch. 4) Underground portions of Footings. Foundations or other improvgmer.ts were not
located. • 5) Elevations are based on National Geodetic Datum. 6) Fence Ties are to the Centerline of the.fen■:e. 7) WO
Ties to the face of the Wall. 8 BF;+.R r i wF SHC%J ARE REFER SD TO AN ASSUMED VALZ E SAID FB F?GE�_
I HEREBY CERTIFY That the survey represented
hereon meets the minimum technical requirements
adopted by the STATE OF FLORIDA Board of Land
Surveyors pursuant to Section 472.027 Florida
Statutes.
There are no encroachments. overlaps. easements
appearing on the plat or visible easements other
than as shown hereon
t
ADIS N. NUNEZ
Regis :erect Land Surveyor NO. 5924
State of Florida
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CERTIFIED TO: MICHAEL R. OBREGON, A SINGLE MAN, 441 N.E. 101ST ST., MIAMI SHORES,
FLORIDA 33138., SCOTT R. JAY, ESQ., ATTORNEYS' TITLE INSURANCE FUND, INC., COUNTRYWIDE
HOME LOAN, INC., ITS SUCCESSORS AND /OR ASSIGNS, ATIMA.
LEGAL DESCRIPTION: LOT 18 AND THE W. 40 FT. OF LOT 19 BLOCK 91
OF AMENDED PLAT OF MIAMI SHORES SECTION NO. 4 SUBDIVISION
ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 15 AT PAGE 14
OF THE PUBLIC RECORDS OF MIAMI -DARE :COUNTY, FLORIDA.
SCALE: ' DWN. BY:
1 "= 20 F.'S /AO CO
FLOOD ZONE:
N
SINCE 1987
BLANCO, DANIAL & ASSOC. INC.
Engineers • Land_Survevors • Planners LB # 4789
555 NORTH SHORE DRIVE
MIAMI BEACH FL. 33141
(305) 865 -1200 Fax (305 865 -7810
00
SUFFIX : :J DATE: 7 -17-95 BASE:olk
T iiRPR • 1 2 n R SZ
JOB No.
00- /.70W
Permit No
Disapproved
) A-57
MIAMI SHORES TILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the 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 Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kept at building during progress of the work.
Date 11..__.. = , 19,
Owner's Name and Address - 7 - 2 1 7P e iW �( e�kP fe .R No 1- P7 4 l Street ___._ 4-71
Registered Architect and /or Engineer ev, a
Name addrem of 'teemed contractor........ , : ............................m ! .� —
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 4.24 ! _._ - l._...__1 G
/. State work to be done and purpose of building (by floors) __._ F E A. C 4 $ !{c __. -- �c� 2 2 - i
2 Z Y ' �° r .�l�.�I Grp �o r j
------ - - - - -- -- � . -1�� � i � � _._� � xl PQats , W °
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ .s • Amount of Permit $
Zone cubage required .Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
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, Pennanent 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 inspectio,�r _• • . e site of e •rk such public notice
or notices as are required by the Act. The undersigned agrees to employ only s subcontr - _ k • . perf•rmed uncle this
permit, as are licensed by Miami Shores Village.
Remarks
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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.
Read, Sworn to and Subscribed before me.
me well known,
Notary Public, State of Florida
Building Inspe .r My Commission Expires
ANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproyed Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice fqr inspection or faulty
materials and /or workmanship. � 1 •
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