490 NE 102 St (4)4S71
MIAMI SHORES VILLAGE
BUILDI4G .DEPARTMENT
305- 795 -2204
Building Inspection Request
Date I'
L
Type Insp'n 00 I A
r C �(
Permit No. 1' (J (-)4 -`3S $
Name Q i r" � ]
Address '� l � V L ST
Company k woc R�
Phone #
Inspection Date )L tS
Approved
) 4(
Correction ❑
Re- Insp'n Fee ❑
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circl
Owner's Name (Fee L ,Z )/3� t�c. t'� Phone # 3— 3 6,o - 6,/ 9sz.
Owner's Address 1 N45: /00
City / ef, 7/-l0 6 State ��-
Tenant/Lessee Name Phone #
Job Address (where the work is being done) /9® Ne /0 f2 5 c
City Miami Shores Village County Miami -Dade Zip
is Building Historically Designated YES NO
Contractor's Company Name ( ae't� 2�'z( .4, / lS 27 • .. Phone # 30S/,3 �� J' �
Contractor's Address .2/ (p ® 4c...7 / 0 <
City /i /fa ,C, --.a" State r — e--- Zip 3 o/c'
Qualifier /4 ' i7 / a op. p 4 .s -
State Certificate or Registration No. .. -"7/ 2 oe
Architect/Engineer's Name (if applicable) Phone # 5 ®-' 0'05 ° 6 Eb 0 /
$ Value of Work or this Permit ') ��� Square Footage Of Work: / ° b 6-0
❑ Repair/Replace ❑ Demolition
❑Addition E Alteration
Describe Work: /'-0 . I 0
7',9r -t Cr)/L) e r2 ,Z ( CrE •
Type of Work:
Total Fee Now. Due $
(Continued on opposite side)
Miami Shores Village
Bud,,,ag, jaartment
�
1005 N iic `A iui 4 i cores, Florida 33138
Tel: ) '19422 4 a : 05) 756.8972
Electrical
Certificate of Competency No.
New
Permit No. 3e (9 7' - 135S
Master Permit No.
Plumbing Mechanical Roofing
Zip 33
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ Q A 5— CCF $ ' , CO /CC
L N
Notary $ Training/Education Fee $ ' !
Technology Fec $ -J! 6 3
Scanning $ � '� Radon $ Zoning ---,„ Bond $ 300
Code Enforcement $ Structural Plan Review. $
.71°
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 recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved d a r inspection fee will be charged.
Signature
NOTARY PAM! ** "
Sign:
3 e
Print: ,
s......
"o: .....
My Commission Expires:
Owne or Agent
The foregoing instrument was acknowledged before me this
day of NI • , 20
who is personally known to me or who has produced
As identification and who did take an oath.
•
ERNAN
2
mrnt: 000348149
F " 'r °s 8/190008
Bon "''u (8fv 1 -4254
:: Nnts Y ASSn.. Inc
Signature��
Contractor
The foregoing instrument was acknowledged before me thi
day of o . , 20 (1_3 �by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC 1447 7 FER „'. ""
0
aerp'N DO
: �; Bonded
, Florida No Assn.. me I
4nnp`
My Coinnit MWrIfires'
Sign:
Print:
********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 05/13/03
**
/d /' /f/
* * *>rg* Lmpr * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
10/11/2004 04:37
7515243
Legal Descriptiorn
Lot 1 and 2, Block
SECTION NO. 4, acc
roeorded in Plat Book 1
Records of Miami-Dade
17,11'
taM MAXI PIOT
ON CON S' _ 111.00' AA
f lied 04)
, of M1A•1 SHORES
nit to the plat thereof as
at Page 41. of the Public
unty, Florida.
•
MSPC
Certified To:
WILLIAM CATE AND DENISE CA TS , JERICHO TTTLE
SERVICES, INC., ATTORNEYS' TITLE INSURANCE FUND, INC.,
ABN AMRO MORTGAGE GRO( .INC., ITS SUCCESSORS
AND /OR ASSIGNS.
N.E 5
PAGE 01
aoe ' um
Sufx: 1
Data of Firm Inde:.
Flood Zone: X
Date of Completic
Property Addreu:
490 N.W. 102 STI
MIAMI , PL 3313
•
Survey: M15830
AVENUE
'LW w,a o.'w
tx
t 0.
I .
fl// iami ores L e
following described property:
Tax Folio R:
requests permission to install:
SIGNED, SEALED AND DELIVERED in the presence of:
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 -2382
Telephone: (305) 795 -2207
Fax: (3051.756 -8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, 4_1.3 � /p G • , hereinafter referred to as the Owner of the
(owner)
Legal description /folio #:
Lot / t Block ?/ Subdivision /7 9 A9-
SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this / day 4 �' �'
ili I )1AWAMMT
_- ' moor ••• _
Asphalt, concrete, brick pavers
(] Landscaping
[ ] Other 5c 3'-1? /e_-
within the public road right of way of 6 /l/d fo,v: �T
(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).
ANGEL . UUHI- AS
:OFFICIAL " Notary Pu,lie, State of Florida
m j oe My Comm. expires Sept. 24, 2006
of x `' No. 00153050
Bondednthru Aaron Notary 1-809-350-5161
Z00
— COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, /C(. C clv //S , hereinafter referred to as the Owner of the
(owner)
following described property:
Legal description /folio#:
Lot Block Subdivision
Tax Folio
requests permission to install:
within the public road right of way of
7Pl iami SJor� (/iCLccc�e
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 - 2382
Telephone: (305) 795 - 2207
Fax: (305)-756 - 8972
(J Asphalt, concrete, brick pavers
[ J Landscaping
[]Other ?/ /LPL ` . g VC/S
/ X36 o 46- (61364
n PPR o ti
(address)
IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows:
To maintain and repair. when necessary, theabove- 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). l
d
4
ay of (DUU ' 200
SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this
SIGNED. SEALED AND DELI VERED in the presence of:
(owner)
Vendor Number
Make Checks Payable To:
Mailing Address:
Amount of check:
Budget Account No.
General Ledger No.
Revenue No.
ITEM(S) To be Purchased:
Reason for Purchase:
Check Request By:
APPROVED BY:
CHECK REQUEST FORM
D -e
zn6 /1/E lt2
#11 .541"e
33/36
3
fib, - X00- 3 i- loco° 8z- , Ad =1
oveA_ eJazyrtv
boa fr-e644, 13P de90-1/4-)z
Department Head
Finance Director
Please indicate
Mail Check:
Yes No
If "NO ", give check to:
/O
Date
Village Manager
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 10 /28/2004
Applicant: DENISE
Owner: CATE
JOB ADDRESS: 490 NE 102
Contractor BEVERLY HILLS
Local Phone: 305 - 826 -1001
Parcel # 1132060170550
Signed:
(INSPECTOR)
Building Permit
Permit Number: BP2004 -1358
CATE
DENISE
ST
Contractor's Address: 840 WEST 51 PLACE
Legal Description: AMD PL OF MIAMI SHORES SEC 4
Permit Status: APPROVED Permit Expiration: 4/12/2005 Construction Value: $6,400.00
Work: DRIVEWAY
to 01 ..t:P
6 53-0
Page 1 of 1
PB 15 -14 LOTS 1 & 2 BLK 91
Fees:
FEE2004 -10589
FEE2004 -10590
FEE2004 -10591
FEE2004 -10592
FEE2004 -10593
FEE2004 -10594
Description
Building Fee
CCF
Training and Education Fee
Technology Fee
Scanning Fee
Builders Bond
Total Fees:
Amount
$225.00
$4.20
$1.40
$5.63
$9.00
$300.00
$545.23
Total Fees: $545.23
Total Receipts: $0.00
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. AX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
1. Legal description of property and street/address: C4 90 N a.
/ ' aZ� S . f=c_. / 3 '3
2. Description of improvement: ROY) Gr" ,Qtim ✓✓ro -A. • OocziLi e c-.) q 'V) .
- 07 cow e ;z.- v-e .
3. Owner(s) name and address: DM- / S e . 4 '70 toe. /D a. s 17-.
/T,fo !�yLo RE.s / SeL/
Interest in property: /
Name and address of fee simple titleholder:
4. Contra tor's name and addres
A /e /
di e t date is spec' d)
Notary Public !�
Print Notary's Name
My commission expires:
123.01 -52 PAGE 4 8/02
5. Surety: (Payment bond required by owne
Name and address:
Amount of bond $
6. Lender's name and address:
Sworn to and subscribed before me this
act / . A , //S `7! • G.
33 D /QFfTR OF FLORIDA, COU ?!T`f (. 0.. )E
from contractKfif'-anER TIFY that this is a r c, y cf the
wngrnal filed i his office on _ day f
NITNESS my hand and 0' ' eat. v
IARVEY NUM, CLERI � i and County Courts
D.C.
S g ature o - owner
Print Owner's Name ZN /S a-‘
day of , 20 _.
ANGFI R CORPAS
Notary Public, State of Florida
My Comm. expires Sept. 24, 2006
No. DD153050
Bonded thru Aaron Notary 1-800-350-5161
(C g G"" .
C:FN 200480951975
OR Bk 22772 Ps 1682; (lag)
RECORDED 10/28/2004 09:51:30
HARVEY RUVINr CLERK OF COURT
MIAMI -DADE COUNTY? FLORIDA
LAST PAGE
Prepared by
•
c f"
•
l.0
7. Persons within the state of Florida designated by Owner upon whom notic, s or .ther documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided
in Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
,E`i
Addre s• / .) ,c' c+
� I A /e— / /
9.30/0.
Miami Shores Village
Building Departm t
UILDING C
Permit No.
Job Name
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
TIQUE SHEET
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