DS-08-15Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 113922 Permit Number: DS- 1 -08 -15
Scheduled Inspection Date: July 30, 2009
Inspector: Bruhn, Norman
Owner: BASS, SIDDHARTH AND KAREN
Job Address: 1257 NE 94 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: CHAMPION CONCRETE
Permit Type: Driveways /Sidewalks/Slabs
Inspection Type: Final
Work Classification: New
Phone Number (300)575 -4085
Parcel Number 1132050100060
Phone: (305)252 -8055
Building Department Comments
DRIVEWAY PAVERS
Passed Qi/e
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP-71130. No plans No permit on
site. NB
July 29, 2009
For Inspections please call: (305)762 -4949
Page 7 of 33
kkaw
ckVek\og
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type (circle):
Roofing
Owner's Name (Fee Simple Titleholder) .P9 be-5
Owner's. Address (1---5-7 N «'t s'r
City l i A1Z44 �%NT/49 State
Tenant/lessee Name
Phone #
Zip 3 373'
Job Address (where the work is being done)
Phone #
City Miami Shores Viilagg County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name x"41. f0 frPtJ 1 Me-.4.7tnti°
633 0 .5-60 t e
Contractor's Address
A-0
City A744,\/
State
Phone # .,3O Z5-2- d °vg
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ '-- --
Square / Linear Footage Of Work: 73
Type of Work: ['Addition DAlteration DNlew Repair/Repiace
Describe Work: )t)-)A �.�.� L ! 6.0 O /24 (%0ti
emolition
******* * * * * * * * * * * ** * * ** * * ** * * * * * * **** ** ************** ** * * * ** * * * * * * *** * ** * *:* * ** * * ***
Submittal Fee $ Permit Fee $
Notary $
Scanning $
Bond $
Structural Review. $ Total Fee Now Due $
See Reverse side -*
Training/Education Fee $
Radon $ DPBR $
Code Enforcement $ Double Fee $
CCF $ CO /CC
Technology Fee $
Zoning $
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,
WET S, 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 de i ered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must b n osted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absen e of h posted notice, the
will not be approved and a reinspection fee will be charged.
Signature Signature
Owner or Agent ,/ Contractor /
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this [t
day of , 20 _, by , day of , 20 , by ?Ult,, A- ?6tllb ,
who is personally known to me or who has produced who is personally known to me or who has produced 1717)410/6/K
As identification and who did take an oath. 6NOg0 as identification and who did take an oa
elAti 995
$0 0 dc0 000
NOTARY PUBLIC:
Sign:
Print:
NOTARY P t LIC:
Sign:
Print:
My Commission Expires: My Commission Expir
****** * * * * * * * * * * * * * * * * * * * * * * * * * * *** ** x****: ** * *** * * * * ***** * * ** x*** **** ** *** * * * *** * * **** ********: ***
APPLICATION APPROVED BY:
(Revised 07/10/07)
Ve
Plans Examiner
Engineer
Zoning
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit NO. DS-1-08-15
Issue Date: 1/14/2008
class
Expires:1 t 1 4/2008
Folio Number:1132050100060
Owner's Name: SIDDHARTH AND KAREN BASS
Owner's Phone: (300)575 -4085
Job Address: 1257 94 Street NE Total Square Feet: 1700
Miami Shores Village, FL Total Job Valuation: $ 11,000.00
Contractor(s) Phone Primary Contractor
CHAMPION CONCRETE (305)252 -8055 Yes
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 1/16/2008 : Yes
Comments: 1/16/08
NEW PLAN OK
i.
ID
MumEVIC
JAN 0 8 2DU�
II . r- rrrarre r
FND I/N'1P
ND )G
FIELD
COPY
THIS MUST BE ON
JOB AT TIME OF
INSPECTIONT
3 {+4
• • ••• • • • ••0
•• •• A 0_ • i� •• •
• • • • .•_ • _0 •„ •_ •_
•
• •
• •
• •
• •
•
setipoulty4 $lj.VEY
• •
.• ••
• - 1111 .-
• -
•
• - - •
••• - 1180
•0
•
•• _
•
• •
• -
• •
• _.••
1111 •_ •
• _• •
! 0 • •
•• • • • •• 000 ••
• • • -♦ • • • • _ _ •
0 0 ••• • _ _• _ -
•• 7C • • -6- ! • •••_j.
x _ 75.Otid�
0.49'
• 5' CI"
VILLAGE
r MIAIVII For Driveways and/or Sidewalks,
5• Wore final inspection and bond can be �,
r
approved for refund; all sod and yard work
p x
must be completed.
>S:
X2.35'
1', ■7
+3.71•
RECEIVED
JAN ;, tH a ',
BY:__L
W
PA
1 p
Si cOtAlt&t .
A;c ell hQ O 1 ;l
S - 19,4c K
K•
o4Vy""'
1P
��.E
UHT
Miami Shores Villa •e
ZONING DEPT
BLDG DEPT
SUBJECT TO COMPLIAN WITH ALL FEDE •AL
STATE AND COUNTY RULES AND REGULATIONS'
GENERAL NOTES*
13 BASIS OF MARINO* ASSUlwEO NERIOIAN
23 ELEVATIONS 90614 HEREON ARE RELATIVE TO TATIONAi.
GEODETIC vERTICC•LL OATUNTN.G.v.0.1
3) LOCATION AND IDENTIFICATION OP UTILITIES ON AND/OR ANOCENT TO
THE PROPERTY v6fRE NOT SECURE AS SUCH INFORMATION HAS NOT
REOUESTEO
41 NOT WA4.10 WIDOW THE SIGNATURE NC THE ORIGINAL RAISED SEAL. OP A
FLORIDA LICENSED SUR•ETOR NC RAPPER.
5T THIS SURVEY 15 NOT INTENDED FOR CONSTRUCTION PuTIPOSES
6l
EICROADAENTS AND vIOLATIONS ON Savers IF AM*
NE 94 STREET 02.0.8• PAVElENT 1— - —
M.0' TOTAL R/V
SKETCH OF SURVEY
$GALE• 1- • 20•
WhMft
PTO • FOUND
CH • CONCRETE TIONUNENT
IR • IRON 100
IP • IRON PIPE .,
RAT • RIONT IV HAY
POB •
POC •
PC •
POC •
POINT CS. EEOI$NIING
POINT OF COIEMENT
POINT OP CURVE
POINT OI A CUM
-s—• DJ's LINK roes
-/— • WOOD FENCE
Pe • PLAT DOW P • PAGE
M • !CAMPED 0 • MO
R •'RADIUS A • ARC
A • CENTRAL alpt.E C • CMDRO
• ELEVATION
-1 -1- .V lfl ULAR 412110 LINE
.•'
•u• • avENIEAO LINE to • TTAIrW1.E
is • CATCH BASIN' • i1'�
LEGAL DESCRIPTION
LOT 7 OF M]AMI SHORES BAY VIEW. ACCORDING TO THE PLAT
THEREOF AS RECORDED IN PLAT-BOOK 40 AT PAGE 16 OF THE PUBLIC
RECORDS OF DADE COUNTY. FLORIDA.
D CO NNTY
NU6ER
Z• PANEL
NAMED
3s SUFFIX
4I DATE OF
FIRM INDEX
$• FIIAI
ZONE
ID BASE FLOOD
ELEVATION
120652
93
J
7/17/95
AE
8.00
1v,
'
— 11.1.'1
SUDJECT TO COMPLIAI Vb'i fN ;At
STATE AND COUNTY RULES A 'D F:
CERTIFICATION OF BOUNDRY SURVEY.
I HEREBY CERTIFY THAT THIS SURVEY WAS MADE UNDER MY
RESPONSIBLE CHARGE AND TO THE BEST OF MY KNOWLEDGE
AND BELIEF. THIS SURVEY MEETS THE MINTML1M ;ECHNIcAL
STANDARDS AS SET FORTH BY THE., BOARD Ul- - PROFESSIONAL -
LAND . -TORS I •'TER 6101/-6 FLORID - -ADMINISTRAT; -VE
CODE P :;NT `ECT1ON X2.027. FLtR1DO STATUTES:'
JULIO . 'ITA. P.L.S.
PROFESSIONAL LAND SURVEYOR
LICENSE NO. PSM 5789 --
STATE OF FLORIDA
JULIO S. PIrA- P.L.S.
LAND SURVEYORS
itto 7821 CORAL WAY. SUITE, 121
MIAMI. FLORIDA 33156
RHONE • (305) 262 -2404
SECTION: 5 -53 -42
1 COUNTY: DADE
CERTIFIED TO:S I DDHARTH BASS
KAREN BASS. HIS WIFE
FLAMER BANK. FSB. ITS
SUCCESSORS AND /OR ASSIGNS. ATIMA
SILVER & SILVER. ATTORNEYS AT LAW
ATTORNEYS TITLE INSURANCE FUND. INC.
1257 NE 94 STREET. MIA't*1 SHORES. FL.
DATE: 8-21-00 l REF: 00-08-45
DWG: GL 2633
\Drawings\gf2633.dgn 03/07/2003 03:30:13 PM
Oct Pqr‘No.
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2004
Permit No. a5 -1
Master Permit No.
Permit Type (circle p wilding Roofing
Owner's Name (Fee Simple Titleholder) 1 d EASS Phone # .3 05 —7S I —4o /30 S % ?S`2939
Owner's Address 12 .S 1 NI e y fk
Cityiaim l' koreS state Fc- Zip 3-3 Li T
Tenant/Lessee Name Phone #
Job Address (where the work is being done) 12S-1 ,t■ E fh S+
City Miami Shores Village
FOLIO / PARCEL #
County Miami -Dade Zip 22 /31-
Is Building Historically Designated YES NO
Contractor's Company Name ChU (r)i)l on ` c)00 Cwt Phone #330 S (Ti 0� L{ 333 (1V 6 4 oa -yS70D
Contractor's Address di e 8 S ( 6. P - cI _ * -j-
City Ai l Gi 61')1 State Zip let 6
Qualifier Name Phone #
LIC,4�N 5 �c OS3SQ0C 5
State Certificate or Registration No. ®s,[.�$ 0 ®�' 1.5 Certificate of Competency No.
Architect/Engineer's Name (if applicable)
Value of Work For this Permit $ /0200
Phone #
Square / Linear Footage Of Work: /,%®D '4f/
Type of Work: ['Addition []Alteration []New ►` >, Repair/Replace ❑ Demolition
Describe Work: _DC t J e c...)q - +C Gt u ef ,„C
lu S tAc.4.) ac.
b,J 5 t cQ e t Iu
Submittal Fee $ Permit Fee $
es°5 CCF $ CO /CC
Notary $ ' Training/Education Fee $ f Technology Fee $ •(
Scanning $ VL '0 Radon $ DPBR $ Zoning $
Bond $CD • 4142Z13
Code Enforcement $
Double Fee $
Structural Review. $ Total Fee Now Due $ 4 G. p 1
See Reverse 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 issu�nce of a perXnit and ithht all „work _will bei_per(orned to meet the standards of all laws regulating
construction in this jurisdictimi 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 A14147 DAVIT: 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 m : _ be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absen of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
Signature
gent
The forego g instrument was acknowledged before me this 0/4)
day of 4 20 D€ , by 5 a 55
who is
'ems ,.i►e.�
to me or who has produced
Signature
Contractor
The foregoing instrument was acknowledged before me this 14
day of CIA , 204 by (\C,W & Sl tU�
who is personally known to me or who has produced
As identificatio
• • "a"••,, KIMBERLY J. MILLER -0UERRA
MY COMMISSION # DD 519137
EXPIRES: June 16, 2010
BondedTm Note/ Pubgc Underwriters
NOTAR PUBLIC:
Si
Print / a -'ni4 ; tt f °G er
My Commission Expires: Co 11 ('j 16
*,*** ******* * ** ** * ** * *** ****** ** ****
APPLICATION APPROVED BY:
(Revised 02/08/06)
as identification and who did take an o
NOTARY PUB C:
Sign:
Print
My Commission Expires:
********************. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
* * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
This Instrument Prepared By:
Name .J�1h�e 6A
Address 15330 c) / —7,e . riA72,49}r', 3 z t!
Permit No.
STATE OF -RA-
COUNTY
111111111111111111111111111111111111111111111
NOTICE OF COMMENCEMENT
CIFN 2008R0038069
OR Bk 26161 Ps 0491; Ups)
RECORDED 01/1562003 12:32.18
HARVEY RUVINe CLERK OF COURT
MIAMI—DADE COUI4TYv FLORIDA
LAST PAGE
Tax Folio No.
THE UNDERSIGNED hereby gives notice that improvement 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. Description of property: (legal description of property, and street address if available)
(2 55 ,vim i Lc sr -A ireAr-y ,i, . 131.
2. General description of improvement:
3. a. Owner
Name
..DL 5 .D �4.ff +r`' '% ttt pp� �� /��
a. Name and address: , /'f1 �� y�
b. interest In property: /2c7 A `
c. Name and address of fee simple titleholder (if other than owner): I N `Z!T'
itVAM i 510t45 44,'"" 33'37
4. Contractor: /
a. Name and address: •L�- Ch 1*./ L®Ar4,07 •C_
b. Phone number: 14 Z 54'. � �+ �J Lf_ ; i9t
3v Zit. —�'r�s s•-- +J
5. Surety
a. Name and address:
b. Amount of bond $
c. Phone number:
6. Lender
a. Name and address:
b. Phone number:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes:
a. Name and address:
b. Phone number.
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section
713.13(1)(b), Florida Statutes:
a. Name and address:
b. Phone number:
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is
specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION. OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13,
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A
NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SiTE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
nature of ""Ty r 0 . • uthorized Officer /Director
P er/Manager
Signatory's Title /Office . //O , 55
hpt /
e foregoing instrument was acknowledged before me is ,e_____ day ,, ?.. k (year) by St. 6j et SS (name of person) as r. _ 1,' -. (type of
authority, ...e.g. officer, trustee, attorney in fact) for (name of party on
'behalf of whom instrument was executed).
AlrY NMBBfLYJ MILLER-0UERRA
MY COMMISSION # DD 519137
e«rd,eti Nosey undam�rs
gnature of No ry blic - : to of Florida
Print, Typ •r ta..p Comm ssioned Name of Notary Public
Commis< on umber • •
Personally Known" or Produced Identification
Verification Pursuant to Section 92.626. Florida Statutes
Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my
knowtedge.and belief.
STATE OF FLORIDA, COUNTY OF DADE
/ HEREBY CERTIFY that This is a true py of the
original Witzthis office on
AD20
Signature of Natural Person Signing Above
WITNES
HARV:
Ef
y hand and Ofir ! Seal.
WAN, CLE ' of C' and County Co
ir°777511,''7
JAN 082
• ..• • . • . • ...
.. • • • .. .
BOON • ly 4gRvEY • • •
....... ..:.
•
• • •
•
• • •
•
••
•• •
• •••
•
• • •
• • • . • • • •
•••••••
•••• ••••
•••• ••••
• •
e •
•
OS • • • •• .•• •.
•
•
• •
•
•• • • 79� �h
NO 0 IP
t
ON
LOT 6
N
isa
N LOT 8
6 A ‘ s `Qps"61<'
ae. (J..)
Sed5i.Ae
AcQ_
66 Git �}c'^ C04 WALKWAY
/vy� 4• CBS WALL
FAD Ii2' IP l )V
EILK CON
No 10
500.79•
- - - - - -� NE 94 STREET (20.0' PAVEFENTI - - - - --
SILO' TOTAL R/1i
/APPROVED
zONING DEPT
Di _DG DEPT
SUBJECT TO COMPLIANC fVV! FHALL FED R..AL
STATE AND COUNTY PULES AND REGULATIOHS
GENERAL NOTES*
11 BASIS OF BFARININ ASSONE0 NERIOIAN
21 ELEVATIONS 9 OHN HEREON ARE RELATIVE TO NATIONAL
GEODETIC VERTICAL OATUNN.O.V.O.1
33 LOCATION AND IDENTIFICATION OF UTILITIES ON ANLVOA ADJACENT TO
THE PROPERTY WERE NOT SECURE AS SUCH INFORMATION WAS NOT
REOUESTE0
4) NOT VA. I0 NITHOUT THE SIGNATURE ANO THE ORIGINAL RAISED SEAL Of A
FLORIDA LICEN9E0 SuRNIYOR AND RAPPER.
8) THIS SURVEY 18 NOT INTENDED FOR CDNETRBCTIOs PURPOSES
0) ENCROACTNENTS AND VIOLATIONS ON SURVEV$IF ANY)•
SKETCH OF SURVEY
SCAL.E • 1- ■ 20'
I
FNO • rape
CR • CONCRETE NONUNENT
IR • IRON ROO
IP • IRON PIPE
Rev • RIGHT OPVAT
POB • POINT OF BEGINNING
POC • POINT OF CONNENCENENT
PC • POINT OF CuRFE
POC • POINT ON A CURVE
-s--• DIAIN LINK PENS
-i— • W000 PENCE
P9 • PLAT BOOK P • PAGE
M • NI4SUREO 0 • OEE0
R•MORS A•ARC
a • CENTRAL ANGLE C • 040110
X.XIC • ELEVATION
- 1— 1- NOA•WEHICuLAN ACCESS LINE
• CONCRETE
•u• • OVEIMAEAS LINE ,0 • HMAICLI
mice • CATCH BASIN () TREE
LEGAL DESCRIPTION
LOT 7 OF MIAMI SHORES BAY VIEW. ACCORDING TO THE PLAT
THEREOF AS RECORDED IN PLAT BOOK 40 AT PAGE 16 OF THE PUBLIC
RECORDS OF DADE COUNTY. FLORIDA.
b CO IUiTY I 2s PAWEL
MAW R MAWR
120652 9.3
13' sumc
14.OATE OF
FAN . EX
S• FAN
z0NE
Ds BASE FLOOD
ELEVATION
17/17/95
AE
8.00
1
1
CERTIFICATION OF BOU ORY SURVEY.
I HEREBY CERTIFY THAT THIS SURVEY WAS MADE UNDER MY
RESPONSIBLE CHARGE AND TO THE BEST OF MY KNOWLEDGE
A•O BELIEF; THIS SURVEY MEETS THE MINIMUM TECHNICAL
STANDARDS AS SET FORTH BY THE BOARD OF PROFESSIONAL -
LAND TORS I • TER 61'G1/ -6 FLCR'IDA -- ADMINISTRATIVE
CODE P i ° NT ECTION 47'2.027. FLUPPT _STATUTES.
JULIO S. 'ITA. P.L.S.
PROFESSIONAL LAND SURVEYOR
LICENSE N0. PSM 5789
STATE OF FLORIDA
JULIO S. PI;A- P.L.S.
LAND SURVEYORS
7821 CORAL WAY. SUITE 121
MIAMI. FLORIDA 33155
PHONE. (305) 262 -2404
SECTION: 5 - 53 - 42 COUNTY: DADE
CERTIFIED T0:SIDOHARTH BASS
KAREN BASS. HIS WIFE
FLAGLER BANK. FSB. ITS
SUCCESSORS AND /OR ASSIGNS. ATIMA
SILVER & SILVER. ATTORNEYS AT LAW
ATTORNEYS TITLE INSURANCE FUND. INC.
1257 NE 94 STREET. MIAMI SHORES. FL.
DATE: 8 - 21 - 00 I REP: 00 - 08 - 45
::\Drawings \g12633.dgn 03/07/2003 03:30:13 PM
/gig DWG: GL 2633-
1
Planning and Zoning Criteria
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit NO. DS- 1 -08 -15
Issue Date: Not Issued
Explres:NOt Issued
Folio Number:1132050100060
Owner's Name: SIDDHARTH AND KAREN BASS
Job Address: 1257 94
Miami Shores Village, FL
Owner's Phone: (300)575 -4085
Total Square Feet: 1700
Total Job Valuation: $ 11,000.00
Contractor(s)
CHAMPION CONCRETE
Phone
(305)252 -8055
Primary Contractor
Yes
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 1/7/2008 : Yes
Comments:
'STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant, ` d- .R G SS , does hereby attest that the
(property owner)
attached survey, performed by
L)L-k-D Sv f 17A.
(name of surveyor's company)
performed on Y-1.- 1-0 L] , 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, 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)
SWORN TO AND SUBSCRIBED before me thisV'6 day of T i..4.c.r 2a ®6
Affiant is p sonally known to me, . produced
as identification.
otary
J
li/lami ores
W/a
10050 N.E. SECOND AVE. //ag
MIAMI SHORES. FLORIDA 33138,2382
Telephone: (305) 795 -2207.
Fax: (30.51756:4,3972 .... .: •
WH EREAS,
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
-5-i et t G- C
, hereinafter referred to as the Owner of the
(owner)
following described property:
Legal description/folio #:
Lot Block Subdivision
Tax Folio #:
requests permission to install:
[ ] Asphalt, concrete, brick pavers
[] Landscaping
[ ) Other
S i N E G ill* S-F. ii" nn, �hotes PC
within the public road right of way of 12 _
(address)
IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows:
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
2 day of o
r
SIGNED, SEALED AND DELIVERED in•the presence of:
I' €✓t /'"` Ct Sr