EL-09-1553 Miami Shores Village �t3nt�a
10050 N.E. 2nd Avenues +
Miami Shores, FL 33138 -0000
Phone: (305)795- 2204
'N
Expiration: 03!2212010
Pro)ectAddress Parcel Number Applicant
347 104 Street 1121360130120
Miami Shores, FL dock: Lot: CYTHIA HORI
Owner Information Address Phone Cell
CYTHIA HORI 347 NE 104 ST
MIAMI SHORES FL 33138 -2017
Contractor(s) Phone Cell Phone Valuation: $ 1,468.00
ADT SECURITY SERVICES, INC (786)331 -3967
_... Total Sq Feet: 0
Type of Work: Alarm For Inspections please call:
Additional Info: !panel 18 devices
(305)762 -4949
Classification: Residential Available Inspections:
Inspection Type:
Fees Due Amount Invoice # Total Amt Paid Amt Due
CCF $ 1.20 EL -9 -09 -35945 $ 154.10 $ 50.00 >'I
Education Surcharge $0.40
Permit Fee - AdditionsJAlterations $100,00 EL -9-09 -35945 $ 154.10 $ 154.10 $ 0.00
Submittal Fee $50.00 Check #: 3007
Submittal Fee $50.00
Submittal Reversal Fee ($50.00)
Technology Fee $2.50
Total: $154.10
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.
September 25, 2009
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
September 25, 2009 1
A
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING ° 2� -
Permit No.'
PERMIT APPLICATION bC Master Permit No
FBC 2004
P ermit Type Electrical
Owner's Name (Fee Simpl Titleholder) hone #
Owner's Address 3
a
City State Zip
Tenant/Lessee Name Phone #
E -MAIL:
Job Address (where the work is being done) _292 -e A 6
City Miami Stwes Villa a °°77 County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name �� V / l
P Y � �« ���
Contractor's Address
City State Zip
Qualifier Name f� ��l -�°�� Phone #
State Certificate or Registration Certificate of Competency No.
E -MAIL:
Arch itect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ ��� =_ Square / Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration New ❑ Repair/Replace
El Demolition
Describe Work: 40 fs
( � l x���xxx�xx��� %��x
Submittal Fee $ —` Permit Fee $ / CCF $ t . Zv CO /CC
Notary $ Training /Education Fee $ Technology Fee $
Scanning $ Radon $ ` DPBR $ Zoning $ �-- --
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ - - °— - - �►ta.I -Fee Now Du $ I 0
KL( See Reverse side �
0)0
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.
uWARN[NG 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is sub'ect to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspectioh which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
Signature Signature
Owner or A Contra r
The foreg g rment was acknowledged before me this /� The foregoi inst ment was acknowledged before me th*
day of 20 0 f� by day of , 200, by
who is personally known to me or who has produced who is pers nally known to me or who has produced
As identification and who did take an oath. as identification and who l �e A
• i��4f ;,u o- ,r,• r rr o`kIDA
NOTARY PUBLIC NOTARY PUBLI Nt��� t , ,� � ;lI
• C: Al a f
1
r ''r 'E, 2011
Sign: na Sign: r- JNLIIvGCO.,INC,
Print: �l /��' Print:
My Commission Expires: My Commission Expires:
sY eYxaY sY do drxdex &Y YatoexxeY iexxxxdrx$e $c oY otxd:xxxe: oYo:xnY nYxxxxusr aYxx$c eYxaexx�xxxz6:xxxxxoYeY 4c oYa;xxxot eYacxdexYxxxetxae oYxoY oY Yxxdc eYxxxxx &uoY de sYsYx
APPLICATION APPROVED BY: iZ2 r' /'® Plans Examiner
Engineer
Zoning
(Revised 02/08/06)
RECORDED 07/30/213139 09:5844
This Document Prepped By and Retrrn to: DEED DOC TAX I r bS13. 00
Brinni Jackson HARVEY RUVINP CLERK OF COURT
Structure Title Services "IANI -DARE COUNTY. FLORIDA
7401 Wiles Road, Suite 114 LAST PAGE
Coral Springs, FL 33067
Parcel M Number 11- 2136 - 013 -0120
Warranty Deed.
This Indenture, Made this 22nd day of July , 2009 A.D., Between
ROBIN KEITH Y. HORI and CYNTHIA M. HORI, husband and wife
of the County of Salt Lake , State of Utah , grantors, and
JOAQUIN L. FERNANDEZ, a single man
whose address is: 347 ME 104 Street, Miami Shores, FL 33138
of the County of Mi i —Dade State of Florida , grantee.
witnesseth that the GRANTORS, for and in consideration of the sum of
---------- - - - - -- -TEN DO
T.T.nR n ($10 ) ----------------- - - - - -- DOLLARS,
and other good and valuable consideration to GRANTORS in hand paid by GRANTEE, the receipt whereof is hereby acknowledged, have
granted, bargained and sold to the said GRANTEE and GRANTEE'S heirs, successors and assigns forever, the following described land, situate,
lying and being in the County of Miami. —Dade ' State of Florida to wit:
Lot 19 and the West 1/2 of Lot 20, Block 117, An Amended Plat of
Section No. 5 of Miami Shores, according to the map or plat thereof,
as recorded in Plat Book 10, Page 47, of the Public Records of
Miami -Dade County, Florida.
Subject to: (1)Taxes for year of closing and subsequent years; (2)
zoning and /or restrictions and prohibitions imposed by governmental
authority; (3) restrictions and other matters appearing on the Plat
and /or common to the subdivision; (4) utility easements of record.
and the grantors do hereby folly warrant the title to said W4 and will defend the same against lawful claims of all persons who ever.
s
In Witless Whereof; the grantors have hereunto set their bands and seals the day and year first above written.
•
Si ; seal and d our ptesenc
Prim Name • (Seal)
-e ROSIN KEITH Y. HO
P.O. Address: 843 Lincoln Street, Salt Lake CIty, UT 84102
Ork (Seal)
Pr
-CY16HIA M. HORI
Wes. times P.O. AddrI 943 Lincoln Street, Salt Lake City, UT 84102
STATE OF Florida
COUNTY OF Miami -Dade
The foregoing instrument was acknowledged before me this 22nd day of July 9 2009 by
ROBIN KEITH Y. HORI and CYNTHIA M. HORI, husband and wife
who are personally known to me or who have produced theirFlori.da er' s hens as id c tiQn.
��, �+CbMM�SS�CN�Gu72zr.�: Print d Name
g,., - EXPIRES: C U. 04,211 Notary Public
•a rgWW AARt1MNOTMYOWn o`*` '2 ,� Gabriel Albelo
— - - -- - My Commission Expires: l ift , 1MIS810N0DD722488
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 133009 Permit Number: EL -9 -09 -1553
Scheduled Inspection Date: January 12, 2010 Permit Type: Electrical - Residential
Inspector: Devaney, Michael Inspection Type: Final
Owner: HORI, CYTHIA Work Classification: Alarm
Job Address: 347 NE 104 Street
Miami Shores, FL Phone Number
Parcel Number 112136013012
Project: <NONE>
Contractor: ADT SECURITY SERVICES, INC Phone: (786)331 -3967
Building Department Comments
Burglar alarm 1 panel 18 devices
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
January 11, 2010 For Inspections please call: (305)762 -4949 Page 13 of 23