DS-08-777 B REW 1 Miami Shores Village Petit DriYe fa�ti balk �
10050 N.E. 2nd Avenue 7 Work
Miami Shores, FL 33138 -0000 ! �d y
APPFtt*tVpn
Phone: (305)795 -2204 n _
V41 A s
Expiration:111 1
Project Address Parcel Number Applicant
140 NW 102 Street 1131010220100
Miami Shores, FL 33150- Block: Lot: MARIE LUBIN
Owner Information Address Phone cell
MARIE LUBIN 140 NW 102 ST
MIAMI SHORES FL 33150 -1232
Contractor(s) Phone Cell Phone Valuation: $ 7 ,000.00
CHAMPION CONCRETE (305)252 -8055 (786)402 -4802
Total Sq Feet 1300
Approved: Yes Available Inspections:
Comments: Inspection Typ
Date Approved: 5/5/2008: Yes Final
Date Denied: Landscaping
Type of Work: DRIVEWAY Additional Info: STAMPED CONCRETE sidewalk
Bond Return: Classification: Residential Foundation
Fees Due Amount Total Amt Paid Amt Due
Bond Type - Owners Bond $300.00
CCF $4.20 $ 0.00 $ 0.00 $ 0.00
Education Surcharge $1.40
Notary Fee $5.00 Payment Type:
Permit Fee $150.00
Scanning Fee $6.00
Technology Fee $3.75
Total: $470.35
MAY 14 2008 ° " k - I n N-4 D.
CK�btiO 1 n 5 C
MIAMI SHORES SILL GE
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
May 12, 2008
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
Monday, May 12, 2008 1
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
`� x ��,•�� Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 06/19/2008 Permit Type: Driveways /Sidewalks /Slabs
Inspector: Grande, Claudio Inspection Type: Final
Owner: LUBIN, MARIE Work Classification: Addition /Alteration
Job Address: 140 102 Street NW
Miami Shores, FL 33150- Phone Number
Project: <NONE> Parcel Number 1131010220100
Block: Lot:
Contractor: CHAMPION CONCRETE Phone: (305)252 -8055
Building Department Comments
NEW DRIVEWAY STYAMPED CONCRETE
I.,
�
Inspector Comments
Passed
Failed E:1—
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid .
Wednesday, June 18, 2008 Page 2 of 2
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Date: 05/15/2008 Permit Type: Driveways/Sidewalks/Slabs
Inspector: Grande, Claudio Inspection Type: Foundation
Owner: LUBIN, MARIE Work Classification: Addition/Alteration
Job Address: 140 102 Street NW
Miami Shores, FL 33150- Phone Number
Parcel Number 1131010220100
Project: <NONE>
Block: Lot:
Contractor: CHAMPION CONCRETE Phone: (305)252-8055
Building Department Comments
NEW DRIVEWAY STYAMPED CONCRETE
Inspector Comments
Passed V0
Failed
Correction
Needed
Re-inspection
Fee
($75)
No Additional Inspections can be scheduled until
re-inspection fee is paid .
Wednesday, May 14, 2008 Page 2 of 2
Miami Shores Village
Building Department °'
10050 N.E2nd Avenue, Miami Shores, Florida 33138 [A�
Tel: (305) 795.2204 Fax: (305) 756.8972 BY . ....................
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
FBC 2001 _
Permit Type (circle)• �ig Electrical Plumbing P Mechanical Roofing
Owner's Name (Fee Simple Titleholder) �461 U Z- 'f' j' j
Owner's Address J"10 /-L"tU e 0 j.
City tjj.AP±41') —�kLA> State Cln Zip
Tenant/Lessee Name Phone #
Job Address (where the work is being done) `
City Miami Shores Village County Miami -Dade Zip _T Is Building Historically Designated YES NO
Contractor's Company Name Phone # ��
Contractor's Address 7-,-
City State Zip d
Qualifier . J &lm 6&nl m e
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
$Value of Work For this Permi ,r�
Square Footage Of Work: 6
Type of Work: ElAddition DAlteration ew Repair/Replace
El Demolition
Describe Work: -4
Submittal Fee $ Permit Fee $ �J ��" o CCF $ CO /CC
Notary $ Training/Education Fee $ i An Technology Fee $ •� S
Scanning $ Radon $ Zonin Bond$3X-T
Code Enforcement $ Structural Plan : $
Total Fee Now Due $
(Continued on opposite side) C W ��
1 17V,35/
MIAMI S ��ILLE
+
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be�osted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued in the absence of s ch posted notice, the
inspection will not be approved and a reinspection fee will be charged
Signature � N Z f1 � L k x ---- Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this 12 The foregoing strument was acknow dged before e thi T�
day of = ! 20 by , r •` , _ :.d day of 20 by • �Q J V
who is personally known to me or who has produced who is onally kno to me or who has produced
As identification and who did take an oath. 0 ' 2 +entification and who did take p'ti�
ZU( NOTA=P!Ct �• ti +
�'" °'sir, JAIME$ HAYI�S, �• NOTAR PUBLI
Sign My OOWASSION # DD396160 `� � i w 13 - 2009 2009 Sign :�
Print: -r 1,3003.NpYpRY F1.1,'1�Y Affioa - r �• .
Print: W
��♦ �,
My Commission Expires: �!3 loci My Commission Expires: $
�o
APPLICATION APPROVED BY: S 7 / , o Plans Examiner
Engineer
T
chc 05/13/03 Zoning
Planning and Zon'ng Criteria
Miami Shores Village Permit NO.DS-4-08-777
10050 N.E. 2nd Avenue :..:::...::•.::. .. .
. .. . .................................... .
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. .... . ........ . ................... ..
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......................
................................ .................
Miami Shores, FL 33138-0000
...................... ..................
fa. . Iffik"'
....................
& %Zf- �-oO Phone: (305)795-2204 Fax: (305)756-8972 ........
..........................................
...................................
........................................
.......................... . ......
Issue Date: Not Issued
ExpiresNot issued
. .. .........
Folio Number:1131010220100
.......... ....................................................................................................................................................................................................................................................................................
Owner's Name: MARIE LUBIN Owner's Phone:
Job Address: 140 102 Street NW Total Square Feet: 1300
Miami Shores, FL 33150-
Total Job Valuation: $7,000.00
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
............................ I .......... - ........................................................ ............................................................................................................................ ...........
Contractor(s) Phone Primary Contractor
CHAMPION CONCRETE (305)252-8055 Yes
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 5/5/2008: Yes
Comments:
a V
tali 11111M ictm! 0A?j
F t0 RIDA
AFFIDAVIT
'STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned A1�ant, ` °�' °Qt'lT� °� ° a� does hereby attest that the
(property owner)
attached survey, performed by
(name of surveyor's company)
performed on 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, finther
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.
A)EVint/Property
Witness(sign and print) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this 21- day of a
Affiant is personally known to me, _p roduced as identification.
- JAMES HAYNES, JR.
MY COWSSION # DD386160
1 V 7 Q&-Tn-n lit
O � 3xoraxY FINomryDlecamtA 6ca
1
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4F�ORIDA 10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138.2382
Telephone: (3Q5).795-2207.
Fax i30.S_1.7t�:8972.
.... :.
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, � �� `Z Z-O �J W , hereina -fter referred to as the Owner of the
'(owner)
following described property:
Legal description/foliog:
Lot Block Subdivision
Tax Folio R•
requests permission to install:
Asphalt, c oncrete , brick pavers
[ ] Landscaping
(] Other
within the public road right of way of
(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 alien 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'tlie 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 tiled 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 Z- day of
(owner)
SIGNED, SEALED AND DELIVERED in-the presence of:
S X YW- N, Jl�.
MY COMMISSION # DD386160 '
�Pc WIRES: Tammy 13, 2009
1$ 0.3 NOTARY FL NataYD I As= cM