BP-03-1729p � ? 1 ZOO
Miami Shores Village e-
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fa • (305) 756.8972
Permit No. ?z ® rag.
Master Permit No.
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle):
Electrical Plumbing Mechanical Roofing
° Phone # o l l� u° V Celt
1
Owner's Name (Fee Simple Titleholder)
Owner's Address /14-11. c14
City State Zip
Tenant/Lessee Name Phone #
(where the work is being 17417 14, 94 (S
Job Address (w g done )
City Miami Shores Village County Miami Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name Phone #
Contractor's Address
City
Qualifier
State
Zip
Architect/Engineer's Name (if applicable) Phone #
Square Footage Of Work: ,. q fl 4 l .
$ Value of Work For this Permit X WO o
Type of Work: ['Addition ❑Alt_eration ❑New '
Describe Work: X Y\ (YO `�! (�� &+ Q
C1 I2
❑ Repair/Replace ❑ Demolition
Submittal Fee $ nc") .(11 .Permit Fee $ CCF $
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $ .-- 2,6 fl/€A %$ e. ?-
�m \v-e. iO& �P,
(Continued on opposite side)
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 FT.F.CTRICAL 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 FQR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCE
Notice to Appli
promise in goo
whose proper
for the first i
inspection wil
As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
ith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
'ect to attachment Also, a certified copy of the recorded notice of commencement must be posted at the job site
which occurs seven ) days after the building permit is issued In the absence of such posted notice, the
ed inspection fee will be charged. •
er or Agent
The f• egoing mstrument was acknowledged before me this 3
day .f �� , 20 $O Q , by Tl
who is pens known to me or who has produced
As identification and who did take an oath.
D231984
7.
Signature
Contractor
The foregoing instrument was acknowledged before me this
, day of ,20 ,by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
My Commission Expires:
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY Plans Examiner
Engineer
r i 9 Zoning
Chc 10/14/03
.egal Description:
he East 22 feet of Lots 21 and 22, of MIAMI SHORES
•ECTION NO.3, Block 67, of MIAMI SHORES
,ECTION NO. 3, according to the plat thereof as recorded
1 Plat Book 10, at Page 37, of the Public Records of
t it
511
3230.
.
ar
04 A
Certified To:
SCOTT J. I3ETTUA, RICHARD GONZALEZ., PA.,
ATTORNEYS' (TOLE INSURANCE FUND, INC.,
WASHINGTON MUTUAL BANK, FSB, ITS
SUCCESSORS AND /OR ASSIGNS.
LOT -21
19
:4
tft
�0.
t
35:00'
LOT - 23
cji BLOCK - 67
734.75 •
° BLOCK- 67
47.28'
54t
Panel Ntunber. 0093
Suffix: J
Data of Firm Index: 3/2/1994
Flood Zone: X
Date of Completion: 07/22/03
Property Address:
747 N.E. 94 STREET
MIAMI SHORES, FL 33138
Survey: M17316
r s
•.,s
i MLLY"
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1)
LEGAL DESCRIPTION PROVIDED HYOTHERS.
2) THE LA DSSHOWN HEREON WERE NOT ABSTRACTED FOR EAsc,. EJTOROTHER
RECORDEDENCUMHERA)ICES NOT SHOWN ON THE PLAT.
3) UNDERORQUND PORTIONS OFFOOTTNGS, FOUNDATIONS OR (Jth .*
IMPR OV E M EN r3 W E RE NOT L OCAT ED-
4) ONLY VISIBLE ENCROACHME ITS LOCATED.
S) WALL TIES ARE TO WE FACE OF ThZ WALL
6) BEARINGS REFERENCED TOLUYE NOTED ASB.R.
7) NO IDENTIFICATION FOUND ON PROPERTY CORRNERS UNLESS NOTED:
S) NOT VALID UNLESS SEALED WITH THE SIGNING SURVEYORS 7. ; • -A, SEAL.
9) DDIDISI ONS SNOW ARE PLITAN0MEASURED UNLESS OTHER .' - • • •
10) ELEVATIONS IF SHOWN ARE BASED UPON N.O.V -D. I929 UNLESS s e L • •
NOTED.
I h IRIS Is AEOWWARYSURVIT r. LESS OTHER NOTED.
I REREBY CERTIFY T THIS BO L ' ' Y EY ATRUE
REPRESENTATION 0F SURVEY
SIGNED
SP1NOS
N 5/01
R OF FLO
CORRECT
ON.
FOR THE FIR)A
THIS SURVEY ISINTENDED OR)4bRTGAGEOR PURPOSEONI.Y.
EXCLUSIVELY FORTBIIS Y THOSE TO WHOM ITN CERTIFIED. THIS SURVEY IS NOT
TO SE USED FOR. CONSTRLC M.P EMLr4 2N3,DESIGNORANYOTHERUSEWfliOLT
WRITTEN CONSENT OF )4IGUELESFD4ISA.
IGUEL ESPINYOSA
LAND SURVEYING, INC.
6494 S.W. 24mSTREET
MIAMI, FLORIDA 33155
PHONE: (30 l 740-3319
LB # 6463