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1155 NE 102 St (2)MIAMI SHORES VILLAGE v (,¢i BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date U 0 Time Type Insp'n i C CJ ( Paver Permit No. 6o — l S3 1 Name f) ()f).Q.1 l J - Address ` ` SS 1 ' 102 51- Company O Wn I "U` Phone # /51 S T For Inspector: 101 Name & Date Approved Correction Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 9\3 Time Type Insp'n 4(1) / A Permit No. 4P 03 -1 5 3 C( Name SUC/1046 Address L /ST /1/S iO 37 Company Phone # For Inspector: 16\1\0 \D 3 Name & Date Approved Correction Re- Insp'n Fee • ECLFqv 2003 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Buildin _ Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) E S`1-n��,( l �J co, Phone Phone # J O S - • s) -' ) 1 Owner's Address 1 �� K) L \O a. 2 Cit Air) Yn 1 51') 0 (�e S State Fi Zip J 1 ? g $ Value of Work For this Permit Miami Shores Village Building Department Tenant/Lessee Name Phone # Job Address (where the work is being done) E mv-i City Miami Shores Villaze County Miami -Dade Is Building Historically Designated YES NO Contractor's Company Name Phone # Contractor's Address City State Zip Qualifier Architect/Engineer's Name (if applicable) Architect/Engineer's Address City State Zip Number of: Bays Stories 4A600 Families 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. 5Pda - i s 1 Master Permit No. Zip Phone # Square Footage Of Work: 5 0 Bedrooms Baths Type of Work: ['Addition ['Alteration ❑New ❑ Repair/Replace ❑ Demolition Describe Work: , 4. 1/1 /1 rt & • 1) '1 • . • .1 111 ILA - •_ • - 10 1 X av■ r v e s * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** County Escrow Fee $ Permit Fee $ Notary $ Education/Training Fee $ Tech $ Scanning $ Code Enforcement $ Bond $ Struct. $ Minus Plans Check Fee $ Total Fee Now Due $ (Continued on opposite side) l(Ck $ a0v00 C Radon $ 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 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 approved and a reins section fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this 2 3 day of n% , 20 1 by Lc21Y `Q 6 00•Q who is personally known to me or who has produced As identification and wh c1,d take ap oath. : �pr a o Chcl/7/03 My Commission Expires: (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. APPLICATION APPROVED BY: Contractor The foregoing instrument was acknowledged before me this day of , 20 _ , by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Signature My Commission Expires: Zoning SEP 2 9 2003 Plans Examiner Engineer Pompano Plant P A V APPLICATIONS • Patios • Terraces • Pool Decks • Roof Gardens • Beach Promenades • Sidewalks • Streets • Golf Cart Paths • Pedestrian Malls • Entrance Areas • Driveways • Parking Lots • Gas Stations • Bridge Underpasses • Highway Rest Areas • Shore Fortifications • Median Strips • Industrial Yards • Container Ports E R 1590 North Andrews Avenue Extension (Via N.W.15th Avenue) Pompano Beach, Florida 33069 954/972 -7400 • Fax 954/972 -7433 Y O U R B E S T M O D U L E COMPOSITION AND MANUFACTURE Pavers by PaverModule are made from no -slump concrete mix, manufactured under extreme pressure, high frequency vibration and cured in a controlled environment, which explains their incredible strength and durability. Our Pavers Have The Following Characteristics: • 8000 PSI Minimum Compressive Strength • 5% Water Absorption Maximum • Excellent Abrasion Resistance (method C -418) Our pavers meet or exceed the standard specification for "Solid Concrete Interlocking Paving Units" ASTM Designation C936 -82. TYPICAL CROSS SECTION OF MODULAR PAVER INSTALLATION D F .° O va: � °k .4 DD o °v v ey8 ° D cgv 4W'/ A A - Sub -Base: Existing Compacted Soil B - Base: Leveled And Compacted Material C - Curb Edge Restraint D - Curb: Optional Height E - Pavers: By PaverModule F - Joints: Filled With Builders Sand G - Bedding: 1" Clean Builders Sand Or Screening Refer to the Technical Installation Sheet for detailed instructions. PAVER Moo ULE 16::p i.or i3 s Pav ®r C0 Two Convenient Plant Locations www.pavermodule.com N 11.2 114t 1.4 1980 Marley Drive Haines City, Florida 33844 863/421 -7422 • Fax 863/421 -7433 P A V E R C H O I C E Haines City Plant OCTO C 1114 J-• �r _ <,. - _,—> � r te r _ r- r -- T 1- r a- -7 - , �. -r te __ ��_'�� f ' ��. r�`_.r - -T'--� �+''cr --r7.2-3- - -:4 " - ir ': , P A V E R M OD UL E OCVOCOO SHA ON C BLE PES ECE The Octo Cobble offers two distinct shapes - the octagon and the square - yet simplicity by being a small octagon and square that is a continuious flowing pattern. This stone offersa high degree of interlock and is ideal for small or large areas. PAVERS ARE CCONORUCAL DURABLE AND Ensv msTQILL Pavers are the modern replacement for concrete and asphalt paving. These interlocking stones are visually pleasing, stronger and more durable than any other paving material available today. Furthermore, the multitude of shapes, patterns and colors gives architects, landscapers, contractors and homeowners a host of new design options. When you consider the initial cost of pavers is comparable to a poured concrete surface, the additional advantages of pavers are even more remarkable. COLORS Please contact your PaverModule sales representative for color selections. PaverModule has a complete selection of colors, both pastels and earth tones. These colors are offered as solid colors or color blends. Color blends are a combination of two or three solid colors to give the paver area a variegated appearance. Note: Colors will vary due to the inherent qualities of raw materials used to produce pavers. OC CONSIDER 11 ESE VALUABLE O DURABLE: Pavers are stronger than regular poured concrete surfaces and more durable than black asphalt. They can take more abuse and last for generations with little maintenance. O °Ga( STMILEnC: The beauty of pavers adds value and visual appeal to any property, while the pattern possibilities are virtually unlimited. O REUSABLE: Pavers can be removed and replaced with ease to allow access to existing utilities or placement of new ones — making the paver a reusable system. This procedure is known as the "zip and unzip" concept. O SAFETY FEATURES: Pavers have a non -skid surface even when wet. The color mixes offer many options to perm- anently designate or highlight areas such as pedestrian crossings, school zones and hazards. Furthermore, the use of light colors at night together with a strong surface texture (joints system) improves the overall safety of pavement. O MO SURFACE C(PQC (D'\ G: Pavers are a segmental paving system which allows for expansion and contraction without producing surface cracks, unlike that of mono- lithic concrete surfaces and stamped concrete. O [PRO -( MVaROMi!lJC KT: Pavers are made of local natural aggregates with no petroleum based products. Water percolation through the joints of pavers is another favorable quality of this beautiful product. O EASY TO aSTIaLI: Pavers can be laid in any weather conditions and require no grouted joints, no mortar, no concrete sub -base and no curing time. SHAPES H 9 A C T 7,/ 17 1 9 0 T 4 e SOME POPULAR PATTERNS re t:O•e> 00 •••• r°r••••:.• ®Bmensiions: TMcG r esss: Stones Per Sq. (Foot: CoOou's: Teut res: Nominal measurements 2 For Standard Use 3.55 Colors range from earth tones to pastels. Refer to our product samples or color chart. Smooth, non -skid surface. B ICPI INTERUCKING CONCRETE PAVEMENT INSTITUTE I E ?(1CQLOD being the legal property owner, for the property o Located at: 1155 M E \D 1 $ , • Nt S110 l0 ItoS 3313'8 . Legally described as Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S. 489.103(7),..qnd I have read and understand the following disclosure Statement, which entitles me td .work as my own contractor, I further understand that I as the owner must appear in person to complete all applications. State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two- family residence or a farm out - building. You may also build or improve a commercial building at a cost of $25,000.00 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is completed, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A. and with- holding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes and zoning regulations. Proof of ownership provided ( ) initial of reviewing clerk. The foregoing instrument Was acknowledged before me this c . 1 day ofc (2f - , 20(J By who is personally known to me or who has Produced Owner Owner VILLAGE OF MIAMI SHORES BUILDING DEPARTMENT OWNER BUILDER DISCLOSURE STATEMENT DISCLOSURE STATEMENT as identification and who did take an oath. C ID 3 � en 8 §1 CQQ 11 II 11 0 0 cr w W !- I QQQ � - II F II 0 rJ II LL1 V oui2 OD NOT VALID UNLESS SEALED WITH THE EMBOSSED SEAL OF CERTIFYING SURVEYOR 0 1'H1p eXO EK'1'Y DESCRIBED AS: LOT 8, BLOCK 175, " REVISED PLAT " bF PORTIONS OF THE REVISED PLAT OF MIAMI SHORES, SECTION 8 ", ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 43, PAGE 67, OF THE PUBLIC RECORDS OF DADE COUNTY, FLORIDA. CERTIFIED TO: ESTHER T. BUDEBO. PRIME MORTGAGE INVESTORS, INC., ITS SUCCESSORS AND /OR ASSIGNS. PONCE DE LEON TITLE SERVICES, INC. ATTORNEYS' TITLE INSURANCE FUND, INC. d r tu D o d 6 / i Date: I CERTIFICATE BOUNDARY SURVEY I hereby certify that this sketch of survey of the hereon described property Is a true and correct representation of a survey made under my direction and that said survey is accurate and correct to the best of my knowledge and belief, and unless otherwise shown, there are no visible encroachments. I further certify that the survey repre- sented hereon meets the Minimum Technical Standards as set forth by the Florida Board of Professional Land Surveyors in Chapter 61G17 -6 ,Florida Administrative Code, pursuant to Section 4 027 on Statues. 76 • ey FL. Reg. No: vz (?0 MANI til . LANNIE SCALE: 1 �o 76 - roars. _ ei 37.5 A= 5(0.22 = 25 X 52.24' Z ROMAN M. LANNES PROFESSIONAL LAND SURVEYOR 999 Ponce de Leon Blvd. Suite 510 C. Gables FL 33134 Ph:(305) 951 -5470 I JOB NO. IS 203 O 0 w cr 8 w ID E " N 0 0 W 0 cn a w 0 J PROPERTY ADDRESS: 1 155 NI . 102. N t) • �T , KA �. M ► SHo (Le S , 1-x,0 2 I DA MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby upndc for the approval of the detailed statement tit the plans and specifications herewith submitted for the build • intt 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 / 2.12 r r Owner's Name and Address ........ ... y d � /jJp��� - _ No Registered Architect and /or Engineer ,. Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done ( , G _ State work to be done and purpose of building (by floors) . _ ...t ( 1..15 . 2'.l.!/ +� Name and address of licensed contactor... Disapproved ! s Date (Signed) - Building Inspector t _..__ and for no other purpose. New Bui!ding Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation oo Estimated Total cost of improvements $ Ll..te" . 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 per:nit does hereby certify that he understands and accepts his obligations as an employer of I.tbur under the 'rlonda Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Pennant•nt Sup plcment, and has complied \kith 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 inspection on the site of the work such public notice or notices as arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. / • Remarks (Signed)...._ STATE OF FLORIDA, COUNTY OF DADE. Ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, 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. �(� 1� Permit No... _ __ . _L , Date f� 'VV,L 9...._..___ Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chairman Member Member Member ,tember .. .. Member _.._..... Council Approved Date Disapproved Date NOTE: A charge of S1.00 will be made for making corrections or changes to this application after approval has been obtained fmm the 1'i.i nir.;; Board. A re m.pection fee of 31.00 will be charged when such re inspection is made necessary by Improper notice for inspection or faulty materials and /or workmanship.