141 NE 102 St (15)2n SthcLt
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
APPROVED:
/aM 4ilO7l
Zonmg ding
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date L - / - 0 / Job Address Ow N.F.. / Dl s'/ Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant 1/44 /1//l/ ✓f /1 Master Permit # / L1 9/g
Owner's Address /W /t) , f, • /01"Y .51 • 11444 1441 ✓/S
Contracting co .1( Q n / er' Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRI AL MBING M , HANICAL ROOFIN a PAVING FENCE SIGN
WORK DESCRIPTION/ J' Q ✓ { A l / 1 r t . � d vG�d } i � N i r � / . [ S S l i y i c v e f r G E n w a n L G ' r - , ' '
Address
4
Square Ft. ' stimated Cost (valuee)S
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 OF 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.
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. Furthermore, I authorize the above -named contractor to do the work stated.
4744.2t. /livt4VC G• / -D/
ignatur `+ Contractor or Owner- Builder D
M610ss-s " sr) 8720
No as to Co
r / :;rIrirla eil CX SEAL
Contractor
r Owne -: lAg IS J VILtAR
Expire
NOTARY PUBUCST.A`fECFFLORIDA
CO Lss1ON NO. CC 71
CAMMIS6 0' EXP. M' 1 _ !
My Commission
FEES: PERMIT D RADON C.C.F. 6e) NOTARY f
�l7
Phone( jp S - , S $ - t15It S
Electrical
BOND
TOTAL DUE 3
c,-
ate
Mechanical Plumbing Structural Engineer
•
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, ititet.et'dG /1 v(, /1 , hereinafter referred to as the Owner of the
(owner)
following described property:
Legal description /folio #:
Lot Block Subdivision
Tax Folio #:
requests permission to install:
M uni ShoreJ ?L4
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 - 2382
Telephone: (305) 795 -2207
Fax: (3051.756 -8972
DR[uE,u/I-y
f� P Pe 4c(
154 Asphalt, oncre =, brick pavers
[ ] Landscaping
[ ] Other
within the public road right of way of /y/ /U. E. /02. 57t, ILb%2 Lt. -f c IUt.�,'91 33 /33
(address)
IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows:
I . 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.
2. 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 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 / day of Jt4,t
SIGNED, SEALED AND DELIVERED in the presence of:
hAI -
(owner)
STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant, Potue✓14e P . Mtr /, I J , does hereby attest that the
(property owner)
attached survey, performed by (ivi bb,vaDt CA v uv tlPi o✓q 7 o L _
,' ) (name of surveyors com'pany)
performed on /- S - Y , 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 (6) months ol• 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.
Witness(sign and print)
AFFIDAVIT
SWORN TO AND SUBSCRIBED before me this 1411 day of a 0 f
Affiant is personally known to me, produced094 �j'�� S33 2 So F7 dentification.
Ds
GLADYS J VILLAR
• TE OF FLORIDA ,
COMMISSION NO. CC714103
MY COMMISSION EI1P. MML
STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant, m u €✓1 P . Mt 66 I , does hereby attest that the
(property owner)
attached survey, performed by a ✓t b bia b( Lt ttd 5 u v 11 Pr o y ? L
/ 0 /� ) (name of surveyors co
performed on /- S - y , 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 (6) months ol• 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.
Affi. operty owner
Witness(sign and print) , 'itness(sign and print)
SWORN TO AND SUBSCRIBED before me this l4ri day of a a
OS
Affiant is personally Imown to me, produced0945 S SD b 20 rdentification.
M
��F1C!•AY.IL�I'
GLADYS r VILLAR
N A YPU13LIC STATi; OF FWEIDA
COMMISSION NO. CC714103
MY COMMISSION EXP. MA_R A _ 07
4 •
STATE OF FLORIDA
) SS.
COUNTY OF MIAMI DADE )
STATE OF FLORIDA )
) SS.
COUNTY OF MIAMI DADE )
(ACKNOWLEDGEMENT-INDIVIDUAL)
The foregoing instrument was acknowledged before me on by
, who is personally known to me or who has produced
as identification and who did (did not) take an oath.
Signature of Acknowledger:
Name of Acknowledger:
(Typed, Printed, or Stamped)
Title or Rank:
Serial No.(if any):
(ACKNOWLEDGEMENT - CORPORATION)
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)
Title or Rank
Serial No.(if any):
1
i A Cev 1 / 00
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LEGAL DESCRIPTION
LOT BLOCK
SUBDIVISION _FL-: 7 1.
ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK _le? AT PAGE .._ OF THE'
•
PUBLIC RECORDS OF
.
FL
r•r
WE hEREBY
ORDER No _ _
NOT VALID UNLESS EMBOSSED SEAL
COUNTY. FLORIDA.
,; .;
CERTIFY That the attacrs. SKETCH
xne.medge and belief as recently unclog our
n'oPtc Minimum Techtilcat Stanciatcs set ty the !OR
.ind Chanter 21 1--11-i 6. co •he F,c)rict,-1 ..,oci.
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- - - • , • - -
CARIBBEAN LAND SURVEYORS, "qt
7175 S.W. 8th STREET, SUITE 216
MIAMI, FLORIDA 33144
TELEPHONE (305) 264-9151
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LOCATION SKETCH
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SUPAVE`f :he best 01 our
IDA BOARD Or LAND ELjI'vE \JCRS as ;F S
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1 .• .-
10 Side Setback
Street
Circular driveway
CIRCULAR DRIVE (Front)
1. Permitted as required or additional spaces
2. Must meet setback (10'sideyard)
3. Cannot impact or cause existing tree removal
or damage (must be outside driplinc)
4. Paving cannot exceed 50 % of area (frontage)
of yard space: 12' max. width •
5. Must be approved by P&Z Director
PERMIT REQUIREMENTS:
1.Completed permit application
2. Two copies of complete survey dated
within the last 6 months (affidavit
required for surveys over 6 months old)
3. Two sketches of the proposed work '
showing all dimensions(length. width, etc.)
4. Limited paving on the right of way(swale)
may be approved depending on location
of trees and driveway approaches
5. Materials to be used: concrete. asphalt.
or interlocking pavers
TRIANGLE OF VISIBILITY:
All driveway /roadway entrances and exits shall
be constructed so that vehicles may enter and
exit without posing danger to occupants, pedestrians,
or other vehicles. Structures and landscaping shall
not obscure vision above 2.5' within the triangle
commencing at the point of intersection of the driveway
and sidewalk/right -of -way for a distance of 10' along
the driveway and 10' along the right -of way.
_ RESIDENTIAL DRIVEWAY
AND PARKING STANDARDS
• STREET TREES (12' High)
5' Side
Setback
MAY 2001
Concrete ribbons
CIRCULAR DRIVE (swale)
1. Permitted as additional parking to
spaces on property (must have 2
existing parking spaces on property)
2. Must meet required setback 5'(svale)
3. Paving cannot exceed 50% of area (frontage)
where located: 10' max. width
4. Cannot impact exist. trees under drip line
(two street trees 12' high required on swale)
5. Must be approved by P&Z Director
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