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118 NE 102 St (6)7 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE t./ Date ,S' =29 Ah Address //g NE /02 ST Tax Folio Historically Designated: Yes No Legal Description Owner/Lessee / Tenant abtl -D 44A/y) $4d tS Ig LW/ D Master Permit # ( q )-17 Owner's . We' /e, - T' s f I U57 GD733 Phone 3s- e lq — r / 353 Ce Contracting Co. ow J' a r• Address Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING WORK DESCRIPTION ) C (QC ,/, CDiI/(_'ie ' �/!JF CG)/9 6e9(7 Address Square Ft. 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 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. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT APPROVED` \ -- P \°\ ‘.k , ( Zoning L � Building Mechanical as to C ntractor . r Owner- Builder My Commission Expire RADON C.C.F. - ,C 0 NOTARY c 1 0 Q BOND 30 n p. c Electrical . PU e, OFFICIAL NOTARY I BECKER 0 2 co lesan nuMaett 41(94 '455; CC786697 � e Y COMMISSION EXPIRES F OF F'.O NOV. 1S,2002 TOTAL DUE FENCE SIGN L ' —tar' Date S / Zg 1 Da e 1 Plumbing Structural Engineer PERMIT NO. • ADDRESS: MIAMI SHORES VILLAGE BUILDING / ZONING DEPARTMENT' SECTION BY DATE ZONING ELECTRICAL MECHANICAL PLUMBING FIRE PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL I. Subject to compliance with alt Federal. State. County.Wlage totes and tegutatlans. Wage essua no responslbp(ty tor accutdcy aflot resutts from these plans. 2. This copy of plans must b. available ea building site at ao Inspection wtii be conducted. JOB ADDRESS ` l " / 7O - T APPLICANT , t'Z 4 e &WO APPUCATION 0 CRITIQUE SHEET PHONE # «& w/9- f SHEET OF MISCELLANEOUS DATE MlelV • y \o"\ COMMENTS INITIALS 5 / 34 /o / No A tires o w 4eo,672 77 - L € IeEZa? F3 Two t cx At2oP 'ry tio7 0,0 t o-7 - off'- w • 114 e_ t^_to bh vt!} PO'tt i la 5 /V A 1, P Qe_t2. 7// harni ShoreJ 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 - 2382 Telephone: (305) 795 -2207 Fax: (305) -756 -8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY WHEREASE2O .QN TCA.),cl i .444/10 , hereinafter referred to as the Owner of the (owner) following described property: Legal description /folio #: Lot 1 � .� �- � a 13 Block Tax Folio #: I I 3O b 0/3 ID requests permission to install: OR[uiiuify APPeo tf I) Subdivision rn S SQ C 1 (B -4'B TO 7b Asphalt, concrete, brick pavers ()Landscaping [) Other // within the public road right of way of //g ire ./o L sr /)70 �i (vres 24 33/38 (address) IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows: To maintain and repair, when necessary, the above- mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. ?. The owner does hereby agree to indemnify and hold Miami Shores Village or dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligation has been canceled by an affidavit filed in the Public records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this SIGNED. SEALED AND DELIVERED in the presen STATE OF FLORIDA) COUNTY OF DADE) The undersigned Affiant, t, ReiC0 4tZT/ii — /►4fV /v, does hereby attest that the (property owner) d/aASI.A1.-61 0- 4.0--erk (name of surveyor's company) attached survey, performed by AFFIDAVIT performed on 9- 5- 9 « , is an accurate representation of the existing conditions and (date of survey) 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. SWORN TO AND SUBSCRIBED before me this o day of Witness(sign and print) Witness(sign and print) 1 n 16 Affiant is personally known to me, oduced �'/, b).., O °.� ') 6° / o was i entificatioh. 41110 • OFFICIAL NOTARY SEAL nY P06 ANGELA QA BECKER Q St' CI COpIySSION NUYBe. - a' CC786697 9 j 'III ; • to Ov 1SS1 5N2 0 Es ' OFF�0 _ - -- STATE OF FLORIDA ) SS. COUNTY OF MIAMI DADE ) The foregoing instrument was acknowledged before me on Q A h A F k ]) L A Sac'- L 7‘ ° '7a - /6 ], as ident''won and who did (i ' a . ot) take an oath. STATE OF FLORIDA ) ) SS. COUNTY OF MIAMI DADE ) (ACKNOWLEDGEMENT-INDIVIDUAL) Signature of Acknowledger. , who is personally known to me or who has produced Name of Acknow edger: (Typed, Printed, or Stamped) Title or Rank: Serial No .(if any): (ACKNOWLEDGEMENT - CORPORATION) tu 21 The foregoing instrument was acknowledged before me on by , of a corporation, on behalf of the corporation. He/She is is personally known to me or has produced as identification and did (did not) take an oath. Signature of Acknowledger: Name of Acknowledger: (Typed, Printed, or Stamped) by Title or Rank Serial No.(if any): BUILDING ELECTRICAL PLUMBING Owner of - Building ' 1 4 PERMIT N? 7817 Work to be performed under this Permit Architect Contractor or Builder °' - -/ Legal Lot Description MIAMI SHORES VILLAGE, FLORIDA DATE - 4 194 Contractor's License No. CONTRACTOR BUILDER Bl. 4 a 'v t- ..+� Subdi- vision AUTHORITY Address of / � �7 a' , c' Value 011 Amt. Building ., Project ' ,,' Permit ? i /' t .1.'. This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. '. _, Signed•` ` d - — r X a e, u_.1. By J INSPECTOR In consideration of the issuance to me of this permit I agree to perforn( jfie work covered hereunder in compliance with aordirkinces and latjon D pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper autho'rr'ii'ttji`es of Miami SholeS``�Vi1lfAge. In acceptipg this permit I assume responsibility for all work done by either myself, my agent, servant or employee. STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE 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 Mar. 5 19 49 Owner's Name and Address________LLr_ _,___2j? _4___D iclVa No 118 Street W• `02nd St Registered Architect and /or Engineer Name and address of licensed contractor LittleJObbers 9201 N. oa. 4th Ave. Location and legal description of lot to be built on: Lot _ Block Subdivision_ Street and Number where work is to be done _ 118 � J . 10 and. St . State work to be done and purpose of building (by floors )_ Concrete driveway- 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 $ 100.00 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, Permanent Supplement, and has complied with the rovisions 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 are 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. I'i'PLL JOBBERS Remarks_____________________ (Signed) 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. G Permit No._ Date Disapproved ____________________________ _____ Date (Signed) 3 Z - 1)f 00 1 t 1 1_ e_-.e i Building Inspector f t Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BARD DATE Chairman Member Member Member Member Member Council Approved_ Date Disapproved 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.