410 NE 102 St (8)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Reques
Date 3 Time
Type Insp'
Permit No.
Name
Address
Correction
Re- Insp'n Fee
L ) O M • c
Company l
Phone # f
For Inspectors( 23 l ° a $ Name & Date
0
1 e y vt
G
Date
Type Insp'n
Permit No.
Name
Address -
Company
Phone #
For Inspector:
Approve
Correction
Re- Insp'n Fee
,I a) ae
azx 43Aa%
O
MIAMI SHORES VILLAGE
a UILD DEPARTMENT
ING
305- 795 -2204
Building Inspection Request )'
�IT �,'e r 011
r pr
Time
L1 /
• oc99'0
63 Name & Date
Date
Legal Description r 041 P1- 41) s14 54 « Historically Designated: Yes
J
Owner /Lessee /Tenet (9diAiRek . AldlL Boar A) Master Permit #
Pgwner's Address 410 )QE. i0,)"gf AIIMU ,R.33/18 Phone 305- 759 -O
Contracting Co. _ Address 410 NE. 1 OA A4cIL STREET AA 044/ SNoWS-
Qualifier PAUL. RQ(11'1A
State # p L Ih,4
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING
p t`,1c21( DESCRIPTION: E PLAC.1/UCo £>Cis fiNS STEP sjoo s iltwC.i'7"E
Square Ft. Ir;-5 SF
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 ANY 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 all disciplines.
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.
Notary as to Owner and/or Con
My Commission Expir
FEES: PERMIT RADON
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
10050 N 2ndAvenue • Miami Shores, Florida 33138 • Phone: 305- 795 -2204 •
Job Add ss4/0 /OY"`
or Condo President
e l '4,. Stephane Drolet
TF My Commission CC976498
o Expires October 22.2004
SS# . Phone 30,5" 751 - 007 90
Municipal # Competency # C6C 0569a91ns. Co.,Enll?)RV SOREV /,vC t?o
Date
cat (,s aen3
Date Notary as to
C.C.F ' (t' 0
Es a►x d Cost (value)�a0 o'�
b,
Sig ature of C ' trac or or Owner Builder
� .orf Pu Stephane Drolet
My Commission CC976498
C, R Expires Octo
ontractor
My Commi
xptres
NOTARY
• r uilder
Date
Date
BOND
TOTAL DUE (� /l ' ( O
Electrical
Mechanical Plumbing Structural Engineer
3
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 5/21/2003
Applicant: PAUL BOUTIN
Owner: BOUTIN PAUL
JOB ADDRESS: 410 NE 102 ST
Contractor
Local Phone:
Parcel # 1132060170610
Fees: Description Amount
FEE2003 -3013 Plans Processing Fee (Other) $30.00
FEE2003 -3014 Building Fee $30.00
FEE2003 -3015 CCF $0.60
Total Fees: $60.60
Total Fees: $60.60
Total Receipts: $0.00
Permit Status: APPLIED Permit Expiration: 11/11/2003 Construction Value: $200.00
- .0 Work: REPLACE EXISTING STEPS STONES WITH CONCRETE
Signe
Signed:
Legal Description: 6 53 42 PB 15 -14 AMD PL OF MIAMI SHORES SEC 4 LOT 11 & W1/2 LOT 10
ECTOR)
In consideration of e 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 responisibility for all work
done by either myself, my agent, servants or employes.
Building Permit
Permit Number: BP2003 -784
Contractor's Address:
Page 1 of 1
(Contractor or Builder) BY:
ACCOUNT/
30•
PAYMENT
BAL. DUE
CORENO, INC.
410 NE 102ND STREET
MIAMI SHORES, FLORIDA 33138
(305) 759-0290
ca044
TO THE
ORDER
(t • $P X03.7
000345911' 1:063L094301: 62 825 33911'
DATE
RECEIVED FROM
FOR RENT
FOR
SOUTHTRUST BANK
63-943/631
1 C
0
? S
DATE CC�/j / 6, 0�� A MOUNT ay
i
a r
cI
8
- 7 No. 197736/
/cate.,0 kc,
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CASH
CHECK
MONEY
ORDER
00
$3o -a
vi 712144 t7'io 03- 7 Fy
FROM
B
TO
THORIZED SIGNATURE
DOLLARS
1182
j4��
I
OWNER BUILDER DISCLOSURE STATEMENT
P1 7 q 7 t ,j
Located at: 9/0 A , / 0 2 • ;S'r --
Legally described as pan) p L H.Sh Sc_G `1 1/ — 3o 6 — 7 — e d /a
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 to' .. ibrk 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, build_ g codes and zoning regulations.
Proof of ownership provided (if ) r initial of reviewing clerk. The foregoing instrument
Was acknowledged before me this j'S day of
By
Rl I_ o
fi,t
P uL G 0 ien
Owner
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
being the legal property owner, for the property
DISCLOSURE STATEMENT
20 U 3
who is personally known to me or who has
Produced P itil/gjus , tee /(/ S E as identification and who did take an oath.
Stephan Vold
My Commission
f
ary
8P 02a23- 7 <W
•
5 �
.
0 3 % 1-
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B lab io, o
v
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Q 84 , o ,
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LEDGEND:
o MANHOLE Q4.IL)
▪ CATCH BASIN (CA)
•- ANCHOR & GUY
o MCC{' IRON ROD& CAP /4276
•s WOOD POWER ROLE (WD. P.P.)
O CON2LETE POWER POLE (CONC. P.P.)
• PERMANENT CONTROL POINT (IIC.P) rer
O PERMANENT REFERENCE MOUNMENT
ADDENDUM' DATE
1.07 //
O FIRE HYDRANT (EH.)
O WATER METER (YILM.)
O CABLEEV (C.AtV)
■ TELEPHONE (TELE.)
METAL FENCE
WOOD FENCE
▪ ELECTRIC TRANSFORMER
OVERHEAD POWER
CONCRETE
BY CK'D
d
0
BENCHMARK REFERENCE:
fir /, j
0 .e.5
ELEVATIONS BASED ON N.G.V.D. AND SHOWN THUS
FLOOD ELEVATION INFORMATION:
COMMUNITY / &)352 DATE OF FIRM 3 -94'
BASE FLOOD EL N.A.
LOWEST FLOOR EL NA
HIGHEST ADJ. GRADE A/ A .
LOT SQUARE FOOTAGE: 8 625:
NA.
FIRM ZONE X
PANFI 009
SUFFIX t
SCALE: / " =20 SHEET 2 OF 2 SHEETS
Goza
4570 N.E. 4th Avenue
Ft. Lauderdale, FL 33334
ADJ
NC
ALE
IBO
BM
ILK
NCR
ass
CC)
CFT
BOUNDARY SURVEY
LOT 11, TOGETHER WITH THE WEST ONE- HALF(Wh) OF LOT 10, BLOCK 91,
i 'AMENDED PLAT OF MIAMI SHORES SECTION NO. 4 ", ACCORDING TO THE
PLAT THEREOF, AS RECORDED IN PLAT BOOK 15, PAGE 14, OF
RECORDS OF DADE COUNTY, FLORIDA.
ABBREVIATIONS:
, ADJACENT
•NR CONDRIONFR SLAB
,ANCHOR EASEMENT
•BARBEOUE PIT
- BENCHMARK
•BLOCK
4ROWARD COUNTY
RECORDS
•IULDING SET BACK
- CALCULATED
- CALCULATED FIELD
TRAVERSE
CE -CANAL EASEMENT
CARE -CANAL MAINTENANCE
C - CENTER LINE
CH -CHORD
COL -COLUMN
CONC - CONCRETE
CBS - CONCRETE BLOCK STUCCO
C&G - CONCRETE CURB 1 GUTTER
COR - CORNER
OCR -DADE COUNTY RECORDS
0B -DEED BOOK
DE -DRAINAGE EASEMENT
ADDRESS: .410. N.E. 102ND STREET, MIAMI SHORES,
CERTIFIED TO:
CARPENTER GROUP TITLE INSURANCE AGENCY
• COMMONWEALTH LAND TITLE INSURANCE CORPORATION
PAUL BOUTIN
DESJARDINS FEDERAL SAVINGS AND LOAN, ITS SUCCESSORS
NOTES:
® LANDS SHOWN HEREON WERE NOT ABSTRACTED
FOR EASEMENTS, OWNERSHIP AND/OR
RIGHTS OF -WAY OF RECORD.
® UNDERGROUND OR INTERIOR IMPROVEMENTS
ARE NOT LOCATED EXCEPT AS NOTED.
® THE BOUNDARY LINES SHOWN HEREON ARE BASED ON
THE LEGAL DESCRIPTION FURNISHED BY THE CLIENT.
NO SEARCH OF THE PUBLIC RECORDS HAS BEEN MADE
BY ROBERT L. ALLISON TO VERIFY SUCH.
® BUILDING TIES ARE 90' OR RADIAL TO THE
PROPERTY LINE.
® ALL EASEMENTS SHOWN ARE I:ER RECORD PLAT
UNLESS OTHERWISE NOTED.
I •
® BEARINGS BASED ON RECORD PLAT.
A ALLISON ASSOCIATES, INC.
Professional Land Surveyors
JI!
DUIME -DRAINAGE, UTIUTYI
MANTENANCE EASEMENT
DH -DRILL HOLE
ESMT - EASEMENT
EA' -EDGE Of PAVEMENT
EMT -EDGE OF WATER
EL - ELEVATION
FF - FINISH FLOOR O FRONT
•DOOR
FE 4100E/PLAIN EASEMENT
FND •FOUND
GF - GARAGE FLOOR
HMI - HEADWALL
INV - INVERT
IP 4RON PIPE
IPIC -IRON PIPE IN CONCRETE
INC -IRON PIPE 1 CAP
I,R -IRON ROO
!RAC •IRON ROD & CAP
LME -LAKE MAINTENANCE
EASEMENT
LAE -LIMITED ACCESS
EASEMENT
LF - LOWEST FLOOR
MANT - MAINTENANCE
DATA OF LAST FIELD WORK: 9.30 -9G
I HER E£BVCERTIFYTHATTHE SURVEY SHOWN HEREON COMPLIES
1 H T E. MINIMUM TECHNICAL STANDARDS FOR SURVEYS AS
C NE[R IN CHAPTER 61G17, FLORIDA ADMINISTRATION CODE.
ME
N,O
NGVD
NR
NA
NIC
NTS
OA
ORB
OPT
PG
PBCR
PAVE
PCP
PRM
CP)
PB
ROBERT L. ALLISON
PROFESSIONAL LAND SURVEYC)R •
FLORIDA REGISTRATION No. 4278
REPRODUCTIONS OF THIS SKETCH ARE NOT VALID UNLESS
SEALED WITH AN EMBOSSED SURVEYORS SEAL.
JOB NO: 96 - G29
- MAINTENANCE EASEMENT
- MEASURED
-NAIL 1 DISK
-NATIONAL GEODETIC
VERTICAL DATUM
-NON RADIAL
-NOT APPLICABLE
-NOT INCLUDED
-NOT TO SCALE
-OFF SET
- OFFICIAL RECORDS
BOOK
-ON LINE
- OPTIONAL
-PAGE
-PALM BEACH COUNTY
RECORD
-PAVEMENT
- PERMANENT CONTROL
POINT
-PERMANENT REFERENCE
MONUMENT
-PLAT
-PLAT BOOK
FL. 33138
THE
PCC
PC
PI
PRC
PT
R
RGE
RP
Qi)
RES
RAW
REE
SEC
S,W
STY
TOB
TWP
UNR
UE
UEA
U& ME
rM�a�r• -.�s�u
ES. "G: (.3/ 2
!\ \ \"c Not 5 'F
r MIAMI SHORE
L. -_ • \\ o
GOLF COURSE
I7q AND Q,
I tV TRY;CLUB ' \
1 jPRIVA /S TE)!�
1 191 _ UR. ' ' M SH'IMI'\
a Y'_ I'Lf•I YANK /
_-A N E X1O0
FILE NO: 0 /5-14 1 SHEET 1 OF 2 SHEETS
•
•
Phone (305) 771 -2231
Fax 0305) 771 -0522
PUBLIC
POINT Of COMPOUND
CURVATURE
-POINT OF CURVATURE
-POINT OF INTERSECTION
-POINT OF REVERSE
CURVATURE
-POINT OF TANGENCY
-PROPERTYLNE
-RANGE
- RADIUS POINT
- RECORD
- RESIDENCE
•RIGHT OF WAY
-ROOF ENCROACHMENT
EASEMENT
SECTION
SIDEWALK
STORY
•TOP Of BANK
- TOWNSHIP
- UNREADABLE
- UTIUTY EASEMENT
- UTILITY. EASEMENT
ACCESS
-UTILITY," MAINTENANCE
EASEMENT
AND /OR ASSIGNS
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date p-- ?' Jp Addref /U It!i E ax Folio . �,b b
V_ �'
Legal Description 1 L 1 i 0 L • Historically Designated: Yes No
Owner/Lessee / Tenant/' L /9 ,4 /,/ S 00 / J Div Master Permit # 2L 7 7 yo
Owner's Address ) 7 6 / 0 N, , /b 01 S I- 9
Contracting Co 0 \A) n i V Address
Qualifier SS#
State # Municipal # Competency #
Architect/Engineer Address
Bonding Company
Mortgagor Address
Mechanical
Address
Phone
Ins. Co.
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING( PAVING) FENCE SIGN
WORK DESCRIPTION
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.
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.
Signature of owner and/or Condo President Date Signature of Contrac
Notary as to Owner and/or Condo President Date No as to
My Commission Expires:
6)7 1 / i ve/L >uee'ofi1 14-d 49.5 c 7
4 _ 6
/ /OD S /- Estimated Cost (value) /2 6 0
FEES: PERMIT 4,0 RADON
APPROVED: //4-03'
�Q y o�
Zoning ���i( ® /� /� Building
Plumbing
or or Owner- Builder
a ''dFV— a
r
!_ k.
' G • r L ' • TARY SEAL
ssion .••ues: �G ANGELA M BECKER
* , ( n COMSSION NUMBER
o 4II . a' AB
CC786697
9� j MY COmPA7SSION EXPIRES
O F FA
m NOV. 15,2002
My Comi
C.C.F. / 20 NOTARY, -, C) C7 BOND3O 1
Electrical
TOTAL DUE
Date
D to
Structural Engineer
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 coraptlanc11 with art Federal, State.
County.Village Mos and regulations. Wage MUMS ,
no responstbIllty for accuracy *Mr mutts from
those plans.
2. Th1s copy of plans mutt ba avallabte CO
building rite or no Inspection will be conducted.
JOB ADDRESS WO A 6 / 5- ire
e
APPUCANT 4c,/
PHONE #
APPUCATION
SHEET OF
MISCELLANEOUS
DATE
2-oN/til
CRITIQUE SHEET
COMMENTS
INITIALS
l Co ve`cgk 7' 4e e-c/5 fie 5/74e-el
4t l`t pa rfravet yy ca nno ,7 e ) #yer
th' h F X - (See draw#/ S iea)
/
WHEREAS,
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
, hereinafter referred to as the Owner of the
(owner)
following described property:
Legal description /folio #: 1/— 3 l6‘ -D/7 Q'// �
Lot // f //7 /d Block 9/ Subdivision
Tax Folio #: //- 3'6t — 6/7 - 0
requests permission to install:
4-]"Asphalt, concrete, brick pavers
[ ] Landscaping
[ ] Other
within the public road right of way of y/D /d, /% /OZ
(address)
IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows:
1. 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 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 6 - day of
SIGNED, SEALED AND DELIVERED in the presence of: gl
M iami S4oreo
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 -2382
Telephone: (305) 795 -2207
Fax: (305)156 -8972
1t L
ry-
CLAMS j VILLAR
NOTARY PUBLIC STATE . OF FLORIDA
COMMISSION NO. CC714103
MY COMMISSION EXP. MAR. 1,2002
Pm. •
faISVP
LEDGEND:
Lor /2
End
5
•
o MANHOLE Q4A)
• CATCH BASIN (C.1)
1- ANCHOR • GUY
• MBA' IRON ROD & CAP 14278
▪ WOOD POWER ROLE (WD. P.P.)
O CONCRETE POWER POLE (CONC. P.P.)
• PERMANENT CONTROL POINT (pC.R)
O PERMANENT REFERENCE MOUNMENT (R.M.)
0
0
■
Ti Y
ADDENDUM _ DATE
NE /O2 "° ST
_v,
/5
BY
0 00 i ��y 00
7500
;N
, &c ;is 20.6 .
= so 7 . :..I.3 z .
1_ 11.° � 5 CAS RES.
TY
ii 1N
v 6.4
//.4
LOT //
FIRE HYDRANT (F.H.)
WATER METER RIO
CABLE EV (C.A.LK)
TELEPHONE aELL)
METAL FENCE
WOOD FENCE
ELECTRIC TRANSFORMER
OVERHEAD POWER
CONCRETE
/ 7.
/2.5
i,«yi�riiiu!! �
0
2 5 � /no/ "/./° st
0.25
/0, 0
1
1
L 01
- - J
z;-
BENCHMARK REFERENCE:
T /0
NA
ELEVATIONS BASED ON N.G.V.D. AND SHOWN THUS
CK'D FLOOD ELEVATION INFORMATION:
COMMUNITY /20652 DATE OF FIRM 3
BASE FLOOD EL NA. FIRM ZONE X
LOWEST FLOOR EL N A. PANFI 0093
HIGHEST ADJ. GRADE NA . SUFFIX c T
LOT SQUARE FOOTAGE: 8,025
SCALE: r=20 1 SHEET2 OF 2 SHEETS
/nr9