DS-08-1830Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: December 23, 2008
Inspector: Bruhn, Norman
Owner: SABELLA, ANN
Job Address: 795 94 Street
Miami Shores, FL
Project: <NONE>
Contractor: CHAMPION CONCRETE
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Block:
hone Number
Parcel Number 1132060142040
Lot:
Phone: (305)252 -8055
Building Department Comments
Monday, December 22, 2008
Page 1 of 1
Passed Glid
Inspector Comments
cc
aar'e?
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Monday, December 22, 2008
Page 1 of 1
BUILDING
PERMIT APPLICATIO
FBC 2004
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit No. Q506 'I ""
RECEIVED
OCT 9 2006
Permit Type (circl Roofing
Owner's Name (Fee Simple Titleholder) AM) , / Phone #
Owner's Address .7 q5 a CPI
City State
Tenant/Lessee Name
Building
Master Permit No.
Zip 33);
Phone #
Job Address (where the work is being done) `°,l 1
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO
33) 3
Contractor's Company Name C,,
Contractor's Address G 5331)
City 6/
�
Qualifier Name �r/'�`�
State Certificate or Registration No.
R CoNelfry7.7
It% er
State
e "A
Phone# 305 -z5-1-24,dor
Zip 3 /q6
Phone # 1( 07— v
Certificate of Competency No. 03,65 oO ? 5
Architect/Engineer's Name (if applicable) Phone #
0 "3
Value of Work For this Permit $
Type of Work: ❑Addition
Describe Work:
Square / Linear Footage Of Work: }ems
['Alteration New
W(5
❑ Repair/Replace ❑ Demolition
************* ********** * *:x****** * ** * *** Fees******** ****** **** *** * ******** ** ****** * *****
Submittal Fee $ Permit Fee $ 11-S CCF $
Notary $
CO /CC
Training/Education Fee $ Technology Fee $
DPBR $ Zoning $
Double Fee $
Scanning $ Radon $
Bond $ J .c4 '17S 'Code Enforcement $
Structural Review. $
Total Fee Now Due $
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 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 FLRCTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and MR CONDITIONERS, ETC
OWNER'S AFF H)AVIT: 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 t be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the .bsen of such posted notice, the
inspection will not be appro q and a reinspection fee will be charged.
Owner or Agent
The foregoi g instrument was ac owled
day of 13 c i� , 2QG , by vroa �
who is personally know, • e or who has produced C--- L "
bt- As identification and w o did take an oath.
NOTAT 'UBLI
ed before me this (-i 11i
AIVC
Print=
My Commission
Signature
Contractor
The foregoing instrument was acknowledged before me this i
day of Of , 2001, by crlil"It MOW/0 61.311rq
who is personally known to me or who has produced
Lti 631u 80 as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Exp
* * * * * * * * ***:x ********** ** * *** * *** * ***** *******
APPLICATION APPROVED BY:
(Revised 07/10/07)
Plans Examiner
Engineer
Zoning
=STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiantf4tit) 51644-- , does hereby attest that the
(property owner)
attached survey, performed by fr f. j' ,' A / 4- O 9OA .
(name of surveyor's corn y)
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
Doc -igN
EC.E V , :
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 this P4 JLday of 6
/I-r..;
Affiant is personally known tome, . produced f' t- • as identification..
SAIYED SKABBAR JAWAID
Notary Public, State of Florida
Comml.sIonf 00888388
My comm. expires June 24, 2011
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LOCATION MAP
SCALE 1! = 200'
SKETCH OF SURVEY
SURVEY of Lot 27 and the East 15 feet of Lot 26, Block 67, of MIAMI
SHORES, SECTION NO, THREE, According to the Plat thereof recorded in
Plat Book 10 at Page 37 of the Public Records of Dade County, Florida,
being situated in the Village of Miami Shores.
ORDER NO 7715
F.B. 301, P. 28, 29
DAM: February 22, 1984
SCALE: As shown
WE HEREBY CERTIFY: that the attached SKETCH OF SURVEY is true and
correct to the best of our knowledge and belief as surveyed and platted
under our direction in February, 1984. We further certify that this
survey complies with the Minimum Technical Standards for Land Surveying
in the State of Florida, Chapter 472, of Florida Statutes.
A.R. TOUSSAINT & ASSOCIATES INC.
LAND SURVEYORS
620 NE 126th STREET NORTH MIAMI FLORIDA 33161
phone 305-891-7340 fax 305-893-0325
BY:
PRES.
ALBERT R. TOUSSAINT
REGISTERED ENGINEER NO. 8939
REGISTERED SURVEYOR AND MAPPER NO. 907
STATE OF FLORIDA
FLORIDA CERTIFICATE OF AUTHORIZATION LB-273
ORDER NO, 8882: REVISED THIS 14th DAY OF jULY 1987 TO UP-DATE SURVEY AND TO RE-CERTIFY
THIS SURVEY TO CENTRUST SAVINGS AND LOAN ASSOCIATION.
ORDER NO. -14374: REVISED THIS 26th DAY OF JUNE 2't ; TO UP-DATE SURVEY. FB 301, PG. 28.
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795-2204 Fax: (305)756-8972
Permit NO. DS-10-08-18301
Issue Date: Not Issued
Expires:Not issued
Folio Number:1132060142360
Owner's Name: JAMES KAY Owners Phone:
Job Address: 795 97 Street NE Total Square Feet: 620
Miami Shores Village, FL
Total Job Valuation: $ 3,000.00
Contractor(s) Phone Primary Contractor
CHAMPION CONCRETE (305)252-8055 Yes
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 10/16/2008 : Yes
Comments:
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138.2382
. Telephone: [305) 795 -2207.
l _
Faz,r30�? 7566-$972
VEN f•FC
WHEREAS, `, u�iv SA
(owner)
RU ION WITHIN RIGHT OF W Y
, hereinafter referred to as the Owner of the
following described property:
Legal description/folio #:
Lot
Tax Folio #:
Block
Subdivision
MEWED
OCT 5 2000
requests permission to install:
Asphalt, concrete, brick p� vers
[) Landscaping
[)Other
within the public road right of way of N ' `/r
/11645i070)
(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
away. 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 day of e t'GJ;>vf� C)
MEM
SIGNED, SEALED AND DELIVERED in-the presence of
WAA 0
A7)1 L.,0 irt.:4,..k
SAf4ED SHABBAR JAWAID
Notary Public, State of Flodde
Commission#
My comm. expires June 24, 2011
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MIAMI-DADE COUNTY, FLORIDA
This Instrument Prepared
Address
/a (1
Permit No.
STATE OF
COUNTY OF
NOTICE OF COMMENCEMENT
Tax Folio No.
THE UNDERSIGNED hereby gives notice that improvement wig 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 addresi if available)
-795 qt/ ,1.5 3313??
2. General description of improvement
\4,110 VetVA
3. (NnerTTar : k
A0) 7q5- 4)0 II
a.
Nanadari address
b. Interest in property:
41441 frtiA ,_31610.0
c. Name and address of fee simple titleholder f other than owner):
4. Contractor
a. Name and address:
b. Phone number:
am-Hp kik)
530 ...ste) 144 7r5e
STATE OF CERIIFY FLORIDA, CO
'EBY
5. Surety
a. Name and address:
b. Amount of bond $
c. Phone number:
6. Lender
a. Name and address:
b. Phone number
vrigi
wi NESS fflY
HARVEY R
7. Persons within the State of Florida designated bAwne
provided by Section 713.13(1Xa)7., Florida Statutes:
a. Name and address:
b. Phone number
,TE,N,MGor,
wtS
or other documents may be served as
8. In addltbn to himself. Owner designates the folicrwhig person(s) to receive a copy of the Uenoes Notice as provided in
Section
113.13(1)(b), Florida Statutes:
a. Name and address:
b. Phone number:
0. Expkation date of notice encement (the expiration date is 1 year born the date of recording tmless 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.
.11-Nk C-b4.14
8 Authorized OfficedDirector
Sig TOW/Office
ged before me thb . .„)
LS year) by
trustee, 4,7
(name of pamou),-
,,,., , In fact) for 1
Nuns of party on
(Vie of
*anent was assented).
t
A' A
,Al
ANIMINIMINENIOW
AfflaglinthellatakiitglkalakaliSdrattfigin -- -
Under penalties of petjury, 1 deciaorthat 1 have read the foregoing and that the facts stated ht 11 are true b the best of my
knowledge and belief:
SAIYED SHABBAR J
Notary Publlc, of arid
Commission# DD688386 ;
My comm. expires June 24,20
• ID •••• of R
Type, m Stamp Commissioned , e of Notary Public
Number
Known or Produced kientffbatbn
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: December 16, 2008
Inspector: Rodriguez, Jorge
Owner: SABELLA, ANN
Job Address: 795 94 Street NE
Miami Shores, FL
Project: <NONE>
Contractor: CHAMPION CONCRETE
Permit Type: Driveways /Sidewalks/Slabs
Inspection Type: Foundation
Work Classification: New
Block:
Phone Number
Parcel Number 1132060142040
Lot:
Phone: (305)252 -8055
Building Department Comments
Monday, December 15, 2008
Page 1 of 1
Passed 1
\
Inspector Comments
CC
E'r F 1 Mzi- 3 &DOT 44,E---4E---r-
AA A) ) Ail, v M. � rte-- `% `� c'k. .
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Monday, December 15, 2008
Page 1 of 1