1155 NE 102 St (8)7
2003
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle):
Owner's Name (Fee Simple Titleholder)
Owner's Address 1155 N E
CityM1C1M1 9nofP S State
Tenant/Lessee Name
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
Contractor's Company
Contractor's Address `
City 1 Nl
Qualifier
$ Value of Work For this Permit ___ • W
Number of: Bays
Type of Work:
Describe Work:
Miami Shores Village
l Building Department
Stories
CJtvic_
1
awn ■ ❑Alte
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Permit No. SP c )
Master Permit No.
Electrical Plumbing Mechanical Roofing
off;S -BSI- s'71
c� Fir BUd6Dphone
i o a St.
�1 Zip 33158
State
County Miami -Dade Zip 3.3 1
115 NE ti
4
Phone #
NO 7C
L r� ;,k f `lam
Phone #
Phone #
Architect/Engineer's Name (if applicable)
Architect/Engineer's Address
City
Zip
Square Footage Of Work:
Families Bedrooms Baths
tion ❑ Repair/Replace ❑ Demolition
(Q - eA !c I 1 )s, I (ic 'f
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
County Escrow Fee $ • b0 Permit Fee $ (00 . 00 - Notary $ S. 00
Education/Training Fee $ Tech $ Scanning $ Radon $
Code Enforcement $ Bond $ Struct. $
Minus Plans Check Fee $ Total Fee Now Due $ eS • QQQ
(Continued on opposite 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. 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 record: , oti of m encpment must be posted at the job site
for the first inspection which occurs seven (7) days after the building pe sue . t absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged. — 9
X Signature
Owner or Agent
The foregoing instrument was acknowledged before me this 10 The foregoing instrument was ackn wledged before me this
day of (eg) eel , 20 a, by T I , day of , 20 , by
who is personally known to me or who has produced who is personally known to me or who has p • duced
As identification and v f oath, as identification and who di • ake an oath.
NOT • ' Y 'UBLIC: .4: 1 4': Commission #DD231984' NOTARY PUBLIC:
Sign. I (1)
es: Jul 13, 2007
-1' . fit
• :•.. Thni Sign:
�� � tic Bonding Co., Inc
Print: ►�i r Print:
My Commission Expires:
My Commission Expires:
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
APPLICATION APPROVED BY:
chc7nro3
9
ntractor
2 SEP 1 6 2003 Plans Examiner
Engineer
Zoning
PERMIT NO.
ADDRESS:
MIAMI SHORES VILLAGE
BUILDING / ZONING DEPARTMENT'
SECTION
BY
DATE
ZONING
ELECTRICAL
MECHANICAL
PLUMBING
FIRE
PUBLIC WORKS
STRUCTURAL
BUILDING OFFICIAL
1. Subject to compliance with aft Federal, State,
County. Vdttage rotes and regulations. Village assumes
noo espo ss for accuracy otlor results from
these
2. Th s copy of plans meat be available on
building site or no Inspection writ be conducted.
CRITIQUE SHEET
JOB ADDRESS al/ /00.2 S�
APPLICANT ac(
. o
PHONE f#
APPUCAT1ON.
SHEET • • OF
MISCELLANEOUS
DATE
q
ZUJVING
COMMENTS
5o sy oit7
g17€9 R -- Q s / ecicri
INITIALS
Bu
VILLAGE OF MIAMI SHORES
Owner
Owner
BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE .STATEMENT
Located at: S 5 NE E /k D a Sk•
being the legal property owner, for the property
Legally described as YY\ U hDMQ _
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)And I have read and understand the following disclosure
Statement, which entitles me td 31rork as my own contractor, I further understand that I as the owner
must appear in person to complete all applications.
DISCLOSURE STATEMENT
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 ( ) 10 initial of reviewing clerk. Ttie foregoing instrument
(
Was acknowledged before me this ) �1 day of c� p T , 20
By who is personally known to me or who has
Produced as identification and who did take an oath.
1 '1
Ale Adk
otary
tM�?
Mao V argas s
= Commission #D0231984-
9
`: Expires: Jul 13 ,
2007
'1 of �o Bonded Thru
Atlantic Bonding Co., Inc.
'STATE OF FLORIDA)
COUNTY OF DADE) � , /�
The undersigned Affiant, E S`'� i ` i (` U � ' 0, does hereby attest that the
(property owner)
attached survey, performed by ROn ` if‘ann e S
(name of surveyor's company)
performed on a 1 is an accurate representation of the existing conditions and
(date of s ey)
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the
property without first providing a survey less than six (6) months old. The Affiant, as property owner, further
agrees to remove or obtain permits for any structures which now may exist on the property which are not
permitted or which may violate zoning or building code regulations. The Affiant further understands that the
existence of any such structures may affect final inspections as applicable to this or other permits..
Further, Affiant sayeth naught.
Affiant/Property owner
Witness(sign and print) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this \ day of
Affiant is personally known to me, produced
as identification.
44 P
Mabel Vargas
::‘ : Commission #DD23I984
Expires: Jul 13, 2007
,;'e, Bonded Thru
9,i ',,,,,' Atlantic Bonding Co., Inc.
Elevations shown hereon are with reference to the National
Geodetic Vertical Datum (NGVD) unless otherwise noted.
NOTES
THIS
OF
ACCORDING
PAGE
CERTIFIED
ESTHER
PRIME
PONCE
ATTOEY
N
.9
co IP
F
2 d
.
rn°
.
PROPERTY DESCRIBED
PORTIONS OF
TO THE
67, OF THE
TO:
T. BUDEBO.
MORTGAGE
DE LEON TITLE
�
THE REVISED
PLAT
PUBLIC
INVESTORS,
SERVICES,
SURANC
7J
t „
Y
e
¢ �.�
y
c
cVC,
Q
, S
AS:
PLAT
THEREOF,
RECORDS
•
INC.,
E FUND,
% "
i/ O
J1
z
�
P<1,'
S 9 ,
� z a ,
• o.
o �
s 6
/�
LOT 8,
OF
AS
OF
ITS
INC.
INC.
�
R
Q �,'
°
.,0* i
BLOCK
MIAMI
RECORDED
DADE COUNTY,
'
SUCCESSORS
'(
�
�s; °" 4,
y C ON
os
175, "
SHORES,
IN PLAT
FLORIDA.
AND
A
1
N .
REVISED PLAT
SECTION
BOOK 43,
/OR ASSIGN;
1
75 To-rA.`
8 ",
,
i
DATEOFF.I.R.M. 3- 2- 9 4 1
F.I.P. = Found Iron Pipe CL. = Clear P.C. = Point of Curvature CLF = Chain Link Fence CONC. = Concrete D.E. = Drainage Easement '�
S.I.P. = Set Iron Pipe & Cap ENCR. = Encroaching P.T. = Point of Tangency WF = Wood Fence U.E. = Utility Easement RES = Residence
F.N.& D = Found Nail & Disc t = Center Line P.C.P. = Permanent Control Point CBS = Concrete Block Stucco D.M.E. = Drainage & Maintenance Easement R/W = Right -Of -Way
A = Angle of Deflection A = Arc Length T = Tangent F.N. = Found Nail R = Radius F.R. Found Rebar C = Chord Asps . A.srv&L.T P.R.M. = Permanent %Morena Monument
anoaddy
BASE FLOOD ELEV. 8 . O I
n
/< , 4 •
p
/ ��
,
Underground features, if any, not identified nor located except as
maybe indicated hereon.
LOWEST ADJACENT GRADE B' 1' I
6
5 A1. _Vr
0 ,
0
■
t.v
(64..--T--4..
�
Q V
1-'
�
(1-
. L � � �/L b \
�'s n,
V `ry
s. •
�'
:IVNei r21 t# W05
This survey shows platted easements and rights -of -way. There
may exist additional restrictions and/or encumbrances which
affect this property.
, ;Q
Y
Q.
�r QAN
I
1 Y
'�O
M ,
N.1)
\ e..0 �
4q,
2 J t3
A 7. 5(0 .22' ,
Q = 25.o'>
A =128° SI
T :52,24'
PROPERTY ADDRESS: 1155 NI , E . IOZ ND • �T � t\l I �a.M t SH° D 1 Ro 2 (Dt . .
NOT VALID
UNLESS SEALED
WITH THE
EMBOSSED SEAL
OF
CERTIFYING
SURVEYOR
CERTIFICATE BOUNDARY SURVEY
ROMAN N. LANNES
PROFESSIONAL LAND SURVEYOR
999 Ponce de Leon Blvd.
Suite 510
C. Gables FL 33134
Ph (305) 951 -5470
I hereby certify that this sketch of survey of the hereon
desc survey ribed made prope u nder �s a my trudie recti and o n correc tht rep s a se id nta ey i 0s f
a
accurate and correct to the best of my knowledge and
f, n s hewhown, there
encroac d unles I fuotrther r ise certi that the su rvey no repro visible
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 02 on Statues.
Date: 1 0-17-95 *G,� � TPe� •
SCALE: i ., ..,o
JOB NO.
, c l S— 20 -5
FL. Reg. No: 'GZc5 20 MAr.1 M M. IANNE S _
ti'•a' Iowa
2'-O"
r?
• w
Owner's Side
:111
•
•
2" X 4" Wood f?ad
Caicrete
WOOD FENCES
I" X6" or I" X
Wood Plcket5
3'-O"
2915 Fences
Concurred
Wood Posts
4' -0" High or Less = 6' -0" O.C.
5' -0' High or Less = 5' -0" O.C.
2915.1 Wood fences, so located on a property
that by zoning regulations they cannot be used
as a wall of a building, shall be constructed to
meet the following minirnum specifications.
(a) Fences not exceeding 5 feet in
height shall be constructed to meet
the following minimum
requirements: from nominal 4 inch
by 4 inch by 8 feet -0 inch long
posts spaced 5 fee -0 inches on
centers, having a fiber stress of
1200 p.s.i. in bending, and shall be
- embedded 2 feet -0 inches into a
concrete footing 1 foot -0 inches in
diameter and 3 feet -0 inches deep.
Other components shall be
designed to comply with the
provisiogs of this Chapter and
'Chapter 23.
(b) Fences not exceeding 5 feet and 4
feet in height respectively shall be
constructed as provided in
paragraph 2915.1 (a) herein,
except that the spacing of posts
may be increased to 5 feet -0
inches and 6 . feet -0 inches on
centers for these heights.
Date
VOwner's Address
L16Ontracting Co.4.1M4/N
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
L,-- , �!- r �) l � /a.7n d /1 .qmC /1 #,8"o
Folio
Legal Description
1 -‘sn er / Lessee / Tenant �/l Gl � q ,,t/ , T ,/Q /'P �/''
/165 /L' /i7 , .
14
Address
Master Permit #3
5
Phon" e 7
// 5:5"/ / oz S/
Qualifier Phone C, ?O'S)
State # Municipal # Competency #
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING
LX6RK DESCRIPTION
w
Square Ft. / 1 - 6X, J I8 L 1 i
Estimated Cost(value)
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 acc
be done in compliance with all applicable laws regulating construction
authorize the above -named contractor to do the work stated.
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
Signature
Date: 1
otar as to C
y Commission
** * * * * * * * * * * * *
FEES: PERMIT RADON C.C.F. 0 NOTARY -5:0 TOTAL DUE 5. `rte
Zonin
APPROVED: Fire
Ins.Co.
G _ / /C - / /5
f OOp'
SIGN
5, ,,Ii :. FJsEPNgMFifthieWmore, I
1 �' :Notary Public, State of Fiond
;,N ; My C Exp. AO 30.1
i . 4.1 No. CC197545
•
er-
r,a ' ^ r,H
**
Other
Electrical
Mechanical Plumbing Engineering