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RC-08-639Mier Inspection Date: 11/03/2008 Inspector: Bruhn, Norman Owner: HALMAN, MARK Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Job Address: 1177 100 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: HOME OWNER Permit Type: Residential Construction Inspection Type: Final Work Classification: Alteration Block: Phone Number (786)251 -7913 Parcel Number 1132050190350 Lot: Building Department Comments BATHROOM RENOVATIONS MASTER AND GUEST ROOM Passed i fx s Inspector Comments h ..:, A. Co/ / Q/L_I't- t c l Failed /7 b All Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid until Friday, October 31, 2008 Page 2 of 2 4,-114tos -Pe cowl App. 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 RE CO EN :u Permit No. f .C.o r 637 AP.', 1 0 20011 aster Permit No. Permit Type (circle): c Electrical Owner's Name (Fee Simple Titleholder) 1..1 ` Phone # Owner's Address / / 7-3 I JVCt e City /!!4 State pk- Plumbing Mechanical Roofing Tenant/Lessee Name Zip /36 Phone # Job Address (where the work is being done) (1 L� City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # // " 9 2-0 c -0/1 - 0 5 Is Building Historically Designated YES Contractor's Company Name Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Phone # Architect/Engineer's Name (if applicable) Value of Work For this Permit $ 17 ' Phone # Square / Linear Footage Of Work: Type of Work: ,]Addition DAlteration ❑New ❑ Repair/Replace Demolition Describe Wor 131Mtierdil f6e7W 144-77 69v- 5 -%4-/A+ % - Submittal Fee $ Permit Fee $ 300 t � CCF $ (p.00 CO /CC Notary $ Training/Education Fee $ Q Technology Fee $ 1.SO Scanning $ (p'QQ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 1 'ED 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 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 and a reinspection fee will be charged. ignature C Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this d V The foregoing instrument was acknowledged before me this day of , 20 Uri, by k 37/,I/%9i/1I9/ , day of , 20 _, by r who has produced As iden 'fication and who did take an oath. NOTARY PUBLIC: Sign: Print: P /'1Ga-�d1��'� My Commission Expires: 17 D DAME, P. DOWER MY COMMISSION # DD463852 EAPIRES: Aug. 21,2009 Parkin Notary 8mvlae.com APPLICATION APPROVED BY: (Revised 02/08/06) 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: P/0 O G Plans Examiner Y Engineer Zoning Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 01/11/2008 Inspector: Levrock, James Owner: RODRIGUEZ, JUAN CARLOS Job Address: 1177 100 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: STATEWIDE SEPTIC CONNECTIONS Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Drainfield Block: Phone Number (786)251 -7913 Parcel Number 1132050190350 Lot: Phone: 305 -661 -6633 Building Department Comments REPLACE DRAINFIELD OS 1( 0L Passed In ` e or Co 1 ments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Thursday, January 10, 2008 Page 2 of 2 01/10/1008 13:05 3055133472 STATE OF FLORIDA DEPARMIENT OF HEALTH ONSITE SEWAGE TREATMENT CONSTRUCTION INSPECTION OSTDS D DISPOSAL SYSTEM D FINAL APPROVAL PAGE 02/02 PERMIT NO.b.t!� DATE PAID: FEE PAID RECEIPT #: APPLICANT: AGENT: PROPERTY ADDRESS: J. I.OT: e r I SUBDIVISION: _ == == a== a=== ==a = = = _= CHECKED [X] ITEMS ARE NOT, IN COMPLIANCE; WITH a == a == a= sad = == Pee = = == = INSTALLATION 1 1 [D11 [ ] 1021 [ ] [03] ( 3 (041 t . ] [053 t 1 PI [ I [07] [ ] [001 1 ] 109] TANK St7,E [1] I1L TANK MATERIAL OU LET DEVICE MULTI- CHAMBEPJ!D 19/ N 1' OUTLrr FIL.TER.r�" LEGEND: WATERTIGHT 20—"' LEVEL DEPTH TO UO (1 1 AREA A [1 [E] , 7 SQFr [10j AREA [1 � a •/ 011 DISTRIBUTION E)X— HEADER ✓ (12] NUMBER OF DFIIJNUNES a+ (131 MAINLINE SEPARATION .SC " [141 DRAINUNE SLOPE r , [181 DEPTH OF cowl a 2, [18] ELEVATION (WYE/BELOW) BM [171 • SYSTEM LOOK; ION [18] DOSING PUMP:; _ W-- (*5] AGGREGATE'sim ID • 0.1, [201 AGGREGATE E <GESSIVE FINES [21] AGGREGATE MEPTI-I Z ++' FILL 1 EXCAVATION MATERIAL 3 [22] FILL AMOUNT ,' Z r' ] t233 • FILL TEXTURE ] (24] , EXCAVATION OITH 1 PSI AREA REPLACED ] [ REPLACEMENT MATERIAL EXPLANATION OF VIOLATIONS/ FtEMARKS: t ] t 1 [ 3 CONSTRUCT! PROPERTY ID #:.�� aa=== == = == == ae== ==== = =� STATUTE OR RULE AND MUST BE COD. 4 =='ate gee = == = = = = = = =a === SETBACKS I 12T) SURFACE WATER — FT ] FT 1 [291 PRIVATE WELLS I 1301 PUBLIC FT 3 1311 IRR►t3A'IH3IYVELLB —.. FT ROI DITCHES .' 1 [22I 1 1331 1 [mil ] 1351 3 ] 1 1 1 1 POTA$L WATER LINES, ei FT BUILDING FOUNDATION :JCS' FT PROPERTY UNES FT OTHER • FT RLI.ED 1 MOUNT' SYSTEM [961 DRAINPIELD COVER ['1 SHOULDERS PI SLOPES 19] STABILIZATION, • ADDITIONAL INFORMATION MATION 1401 UNOBSTRUCTED AREA [41] STORMWATER RUNOFF [421 ALARMS . , [431 MAINTENANCE AGREEMENT (441 BUILDING AREA [45] LOCATION CONFORMS WITH SITE PLAN [48] FINAL SITE 0 F '�" (471 cONTRA�R - [45] OTHER. ABANDONMENT ] . , (48] TANK PUMPED1/11/0-7 1 tom] TANK CRUSHED & RIAD DH 4018 (Pap ft 1087 (Prolous r hms May Bo Used) Suit Number: S7444/02- 4018x4 Pr is /Wow PR totallfriCiiiiriirlar PT * Bub** DePutnent 144. N 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 JU3 2007 J Y: Permit No./PL-1 ` 1� ✓� Master Permit No. Permit Type: Plumbing Owner's Name (Fee Simple Titleholder) (Jal4 1l(ty - Phone # Owner's Address tt ,N it» [` City Y\V1M..\ State AA Zip ').-S l Tenant /Lessee Name Phone # E -MAIL: s fiG %( 44 Job Address (where the work is being done) I M,(L City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # it 17IYSb Th Is Building Historically Designated YES NO Contractor's Company Name 14111-1161 St rt Contractor's Address DkD 4.2, Phone # ' -64-33 4-3 City itIVA),01 State fl Zip "'3- ) 62.3 Qualifier Name 1 o AAA Phone # State Certificate or Registration No. Sal "t tt(o2 E -MAIL: Architect /Engineer's Name (if applicable) PIA Certificate of Competency No. Phone # Value of Work For this Permit $ 2, kob Square / Linear Footage Of Work: 2-66 Type of Work: ❑Addition ['Alteration ❑New Eigli Repair /Replace ❑ Demolition Describe Work: (c,c,- iuttkyt C) * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * ** *Fees * * * * * * * * *„ * * ** ** ** * * *rxx — ww* ** * ** * * * * *** Submittal Fee u Permit Fee $ fIS.Ct) Id Notary $ Training /Education Fee $ Scanning $ Radon $ -'0.! Bond $ •b Code Enforcement $ Double Fee $ ,/ Structural Review. $ Total Fee Now Due $ 444-` 7 7 7 See Reverse side I .G6 DPBR $ Technology Fee $ Zoning $ Co /CC 4,37 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the .first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20 , by day of , 20 , by Signature Contractor who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: My Commission Expires: My Commission Expires: ************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * -.* * * *•- **************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: (Revised 02/08/06) Plans Examiner Engineer Zoning G1° Miami Shores Village �r Building Department ��� 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 6./ Y: 1 Tel: (305) 795.2204 Fag: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit No. 1 7` 1 L3 Master Permit No. Permit Type (circle): Building Electrical lumlin Mechanical Roofing Owner's Name (Fee Simple Titleholder) 'SOa Ma r` c ire+ Phone Owner's Address ( 1N ( too City pkg Po +reS State. Tenant/Lessee Name Zip 330jk Phone # Job Address (where the work is being done) P I—) 1 6J �' 1 eo0 STREET City Miami Shores Village County Miami -Dade Zip 33 ( 32 FOLIO I PARCEL # 11— 3 LC 5 ® �� Is Building Historically Designated YES NO I wC r Contractor's Company Name ST v t c) S'E TIC- C' N Phone # Contractor's Address '3590 S S 1 3 ?$ City 14" V-PS- M ACC State rt., Qualifier Name ¶EOe P - SO' - pJ'k.0 6N1 Zip Phone # State Certificate or Registration No. QC1•09 '1 ( 2-6 2 Certificate of Competency No. Architect/Engineer's Name (if applicable) Value of Work For this Permit $ 2 N Phone # Square / Linear Footage Of Work: Type of Work: DAdditiion []Alteration [New yl Repair/Replace ❑ Demolition Describe Work: ***************************************Fees**** * * ** * * * * * * * * *** * * ****** * * *** * * *** * ** Submittal Fee $ Permit Fee $ I1 D° CCF $ CO /CC Notary $ Training/Education Fee $ a 60 Technology Fee $ 1:31 Scanning $ : 00 Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review, $ Total Fee Now Due $ +1 +1 See Reverse side ---> C -X55 Bonding Company's Name (if applicable) p Bonding Company's Address '� s 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 and a reinspection fee will be charged Signature Owner or Agent The foregoing instrument was acknowledged before me this 31 day of 20 by e1 Rock YZ u , who is personally known to me or who has produced $- ®,fa1' LCD As identification and who did take an oath. NOTARY PUBLIC: Sign: Print My Commission Expires: **4e P49 I rA9 91- i1VO11 MY COMMISSION # DD250137 '�FpFAQ* EXPIRLS: September 16, 2007 1. 800 -3- NOTARY FL No te., Discount Assoc. Co. APPLICATION-MIMED BY: (Revised 02/08/06) Signature- 1� Contractor The foregoing instrument was acknowledged before me this day of Ju .. ,200 -by j S4310 rm. 0,7 who is personally known to me or who has produced D K as identification and who did take an oath. NOTARY PUBLIC: I Print 1 1` 71Cc G Or-r41. r, My Commission Expires: C„` (J i �- 2 evaiTYPN MARIA .11 iiirfteialn. s MY COMMISSION # DO 540994 oFTe EXPIRES: Apjfti etar 1- so0- 3- NOrAAv FL Notary Dlsuoum Assoc. Co. Zoning CONSTRUCTION P [ ]New Systl' [ X ]Repair APPLICANT: R STATE OF FLORIDA • • ••• • • • ••• DEPARTMENT OF HEALTH•• •• • • • •• •• ONSITE SEWAGE TREATMCNT SAND I MPOSAL• SYSTEM CONSTRUCTION PERMIT • • 0048 • • • • l'008 • • • • • • • •• • • • • • • • • ng System nment PROPERTY STRE LOT: 13 BLOCK: 177 • rgaret, • • ••• • ••• •• • • • • • • • • • • • • • • • • • • . • • • • •.• • • • [ ]Holding Tank [ ]Temporary [ NA ] • • • •• ••• •• • • • • • • • • :A VI::: c c?21074, Solomon Teresa CENTRAX #: 13 -SG -33279 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 07 -01794 -R [ ] Innovative Other • • • • • • • • • •• • • • • • ••• •• NE 100 St Miami Shores FL 33138 JU \ 1 3 2007; SUBDIVISION: Miami Shores Sec 8 R %�� [ Section /Township /Range /Parcel: } -r -- OOOOO TAX ID NUMBER] -� - ®- PROPERTY ID #: 11- 3205 - 019 -0350 SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME PERIOD. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. SYSTEM DESIGN AND SPECIFICATIONS T [ A [ N [ K [ D R A I N F I E L D 900 ]Gallons SEPTIC TANK 0 ]Gallons 0 ]GALLONS GREASE INTERCEPTOR CAPACITY 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS [ 200 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM [ 0 ]SQUARE FEET SYSTEM TYPE SYSTEM: [ Y ]STANDARD [ N ]FILLED CONFIGURATION: [ N ]TRENCH [ Y ]BED MULTI - CHAMBERED /IN SERIES: [Y ] MULTI - CHAMBERED /IN SERIES: [Y ] @ [ 0 ]DOSES PER 24 HRS # PUMPS[ 0 ] [ N ]MOUND [ N ] [ N ] LOCATION TO BENCHMARK: EFF El.:9.60'NGVD ELEVATION OF PROPOSED SYSTEM SITE [ 24.0 ] [ INCHES ] [ BELOW]BENCHMARK /REFERENCE POINT BOTTOM OF DRAINFIELD TO BE [ 54.0 ] [ INCHES ] [ BELOW]BENCHMARK /REFERENCE POINT FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 30.0 ] INCHES OTHER REMARKS: 1.- Install 900 gal. category -3 septic tank equipped with an approved filter. 2. -The licensed contractor installing the system is ressp n-ible for installing the minimum category of tank in ac .p,RF — sec. 64E- 6.013(3)(f), AC. , _ 3.-Install 571 sf of s.x�€�� i o 4. - Invert elevation of dr haWs1 =I • - • ' NGVD. 5.- Bottom of drainfiel e evation o be no les than �T5�.10'jNGVD. APPROVED BY THIS PERMIT IS NOT FOR "ADDITI ZONING DEPT IPLDG DEPT PAtri COUNTY meA IECT TO COMPLIANCE WI -ALL FEDERAL SPECIFICATIONS BY: Piverger PU TIONS APPROVED BY: Piverger, Joseph ' *s TITLE: Professional Engin Dade DATE ISSUED: 6/11/07 - EXPIRATION DATE: 9/9/07 DH 4016, 03/97 (Obsoletes previou- ed' ions which may not be used) (Stock Number: 5744 - 001 - 4016 -0) .stds_cons_4o16 -i1 CHD Page 1 of 2 .STATE.OF FL.OaipA :EIEPAETMENT.CIF HEALTH APPLICATION FOR ONSItE SWAG [iIS'OSiet a rYSTEM CONSTRUCTION PERMIT Permit Application Nurrberyt ° ) 0. sPd iT II :SI�"4 P3JjN - — — .. .. 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IMO (Replaces HRS•H Form 4015 which may be used) (Stub Number: 5744-002-401544 Page 2 of 3 Miami Shores Village Building Department 10050 .NE 2 Ave, Miami Shores, Fl 33138 Tel: (305)795 -2204 • Fax; (305)756 -8972 RECEIPT PERMIT #; DATE: � Dg I, f e Docuez tntractor ❑ Owner ❑ Architect Picked up 2 sets of plans and (other) Address: 113-3- tec LoGf° From the building department on this date in order to have corrections done to plans And/or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged by: PERMIT CLEARK INITIAL: RESUBMITTED DATE: PERMIT CLEARK INITIAL: Adam S. Ater ely 730 SW 57 Court lee. Sdm5tO Swth Mme, Florida 33143 This knaitumern Prepaid: Adam S. Zipper Greenwich Title Straka, tee 7301 SW 57 Court Suite 510 South Miami, Florida 33143 es a locoma y incident to the fidfrlln ant of melons contained in a title hsanranoo connItihnent {owed by 11. Property Appraisers Parcel I.D. (Folio) Number(s): 1132050190350 Grantee(s) File No:200811282 WARRANTY D® 11111111 11111111111111111 CFN 20oaR!?2-S7199 OR Bit 262V4 Pus 2392 - 2393; (2oas) RECORDED 03/28l2808 11156135 SEED DOC TAX 4,800.00 HARVEY RUVIHr CLERK OF COURT MIAMI -DADE COMM, FLORIDA Tide Warranty Dad Made the 4th day of March, 2008, by Juan Garb Rodriguez and Margaret Rodriguez, husband and wife, hereinafter called the grantor, whose post office address Is 14737 SW 125 Avenge, Miami, Florida 33184 to Marc A. Halmayl and L. All Hahn, hamlraad and wife, whose post office address We 1177 NE 180 Street, Mhtml Shores, Florida 33138, hereinafter called the grtmtoe, W1TNESSI3TH: That said greaser, for and in canalization of the sum of 810.00 Dollars and other veiuehle considerations, receipt whereof is hereby admow1cdged, hreby gan1a, bargains, silo, elleatl, mhos, releases, oonveye and =Elms IMO the grantee. all that certain shade In Mined-Dade Cotmty. Florida, vim Lot 13 AND 14, Block 177, MIAMI SHORES SECTION tt, according to map or plat thcneof as recorded in Plat Ro*43, Pege 67 alike Public Red of Miarni -Dade County, Florida. The property 11 the homestead of the Orator(s). TOGETHER with all the tome aI , homeliness andapp o hdongtngor b Arta appertaining. To Have and to Hold, the same In fee simple forever. And the grantor hereby covenants with said grantee that she venter Is lawttiuy seized of said land In fee simple; that the grantor hug good right and lawful authority to sell and convey said load; that the .granter hereby drily wananta the tide to said bed and will defend We semo again; the lewfht claims of all persons who r, end that said lend is free of all emembrances, except taxes accruing eubsequeot to 2008, reservations, moieties, and assentents of record, if any. rrns tom armrao " Ind "wears "honer ghat raawtainadvi Wadi ap minx and srs orpiaralea Eke COMM teifirlate4 In Witness whereof, Greeter hes hereunto set grantor's hand and seal the day and year first drove written. STATE OF FLORIDA COUNTY OF Miami Mee The foregoing Instrument was acknowledged before me this 4th day of March, and Margaret Redrlgttrwt, husband and wife who isArepereenallylowort ea Me Ileense(s) as identification. My t%ommissiatt Expires: E4l7AB M• 6i.AP1Cd ofSoriQ vai cam i it vary 5r q0.1 Notary CORM Nek U° Illy �t"- Serial Number Z 'd 5Z95 .°t a14!143!' '9 WV81V01 8002 171'idV ,a6,0g-6 1111111 11111 11111 11111 11111 1111111111111 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT %,/ TIME OF FIRST INSPECTION PERMIT NO. V e, TAX FOLIO NO. �l -•`0 C-791-6957) 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: tl llele% / 3 I Luc / CFN 2008R0303557 OR Bk 26323 Ps 1795; tivs) RECORDED 04/14/2008 11:59:07 HARVEY RUV'INv CLERK OF COURT MIAMI-GAGE COUNTY? FLORIDA LAST F'AGE 2. Description of improvement: / TO s 0/1 V S /1 7L- alr— 3.Owner(s) name and address: nu...L . ÷- ►" 4 �'t #� I , � Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and address: 5. Surety: (Payment bond require by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 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)(*)7 , lorida Statutes, • Name and address: Ar 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), Flori tat es. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a differ t date ie specif ed)1 gna of Owner Print • ner's Name C,.. l l $Tot\ !� day of lAk°-- , 20_ „ Sworn to and subscribed before me this Notary Public Print Notary's Name My commission expires: Prepared by Address: 3O gOirg-W 14iii_vki/ ILL, s3/3f 123.01 -52 PAGE 4 8/02 A HEREBY CERTIFY that this is a ll ' copy of the VILLAGE OF MIAMI SHORES OWNER BUILDER DISCLOSURE STATEMENT NAME: L. � ( Vtti ADDRESS: /% n Aar- DATE: 47 l c goo . t-014-5/1 -3HIS Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor; I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - family or two- family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with- holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. Please read and initial each paragraph. 1. I hold title to the above property and I am planning on doing this construction Initial 2. I understand that as ari owner - builder I must abide by all zoning ordinances and building regulations in effect at the time of permit application Initial 3. :I have an understanding of the 2004 FBC & FRC and understand that this department and its inspectors are there to help enforce and interpret the code. There is a copy of the code in this office for review. 4. I understand that the building official and inspectors are not there to design, alter or give advice on how to meet code —. only if the structure meets the minimum code. Initial 5. I understand that as an owner - builder, that any contractor disputes with sub- contractors and myself must be handled in a civil court with the advice of an attorney. The department will not mitigat&any contractdisputes. Initial 6. I understand that if I compensate any person or company for work performed they are required to have a business license in the county. If for any reason they do not posses a business license I will be responsible and liable for any wrong doing from this unlicensed company or person. Initial 7. I understand that if any person gets injured on my construction project—they are entitled to workmen's compensation. And if they do not posses a workmen's policy I could be held liable for all doctor and related cost which could include loss of wages during recovery from injury. 8. I understand that under state and local laws I can not do any Electrical, Plumbing, Heating, Air & Roof work on my.property with out first obtaining the proper permits by licensed contractors. Initial Was acknowledged before me this 1 r day of Ali€142, 0 06 who was . ersonally known to me Produced there License or as identification. DANIEL P. DOWER MY COMMISSION # DD463852 V.OFt�� EXPIRES: Aug. 21, 2009 (407) 3$8-01$3 Rddda Nomy So e oom Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 01C-431 Inspection Date: 08/13/2008 Inspector: Levrock, James Owner: RODRIGUEZ, JUAN CARLOS Job Address: 1177 100 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: JC PLUMBING SERVICES, INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration eterPhone Number (786)251 -7913 Block: arcel Number 1132050190350 Lot: Phone: 305 - 796 -4663 Building Department Comments 2 BATHROOM RENOVATIONS MASTER & GUEST PLUMBING WORK ( tIS 1 8 Ill Passed Ins ,i e u for Comments cc?c V Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Tuesday, August 12, 2008 Page 1 of 2 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: Plumbing Permit No. PLc ter Permit No.' r —41C1 Owner's Name (Fee Simple Titleholder) LV 1 ` 'Hill (NEUn Phone # -70 5-19-6 Qq� Owner's Address %/ '(%C /() 0 Pi g9 City N 11 (C/ State Tenant/Lessee Name E -MAIL: j kcd MAIN m ) o Iii' C�.�(Y�i o Job Address (where the work is being done) Zip % G Phone # City Miami Shores Village County Miami -Dade FOLIO / PARCEL <C S - - - 0 / —cf/v Is Building Historically Designated YES Contractor's Company Name Zip T0. Plufrfb(n( attcks Phone # Contractor's Address 3500 f` �/�(01 G Polak. ,t i City )6111,e.2_0 State Zip Qualifier Name FUar eado5 �cn Phone # State Certificate or Registration No. e Fe 1 4222 1? . Certificate of Competency No. E -MAIL: Architect /Engineer's Name (if applicable) Value of Work For this Permit $(1° Phone # Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration i ❑New ❑ Repair/Replace El Demolition Describe Work: y 15/417001 ®®e-A/0Y OJIS `—' Hfreiv7 Z r 1 7 xxxxr.* xxxr. xxxxxr. r. xxx xir*i ;xicl;r.xxr.r.r.xr.xr.xx,` x* r. xr.xxr,r.x..* r.r.r.r.xxxr/x�r. r,xr.x xxxr.r.rr.xr.xxxr.x Submittal Fee $ Permit Fee $ /80 CCF $ a'40 CO /CC Notary $ Training /Education Fee $ 0 'J Scanning $ 3 Radon $ Bond $ Code Enforcement $ Structural Review. $ Technology Fee $ 4'SO DPBR $ Zoning $ Double Fee $ Total Fee Now Due $ ITMO 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 andinstallations 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: [ 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 and a reinspection, fee will be charged. (S ignatu Owner or Agent Signature Contractor The foregoing instrument was acknowledged before me this The foregoing /instrument was acknowledged before me this J day of /� /ti'' 20 by I 44- 1 jAfil V day of /`,i% etV. 1/4/4/1)04144116-744) ' Y Y , 20� > by wn o m - s , who has produced As identifica NOTARY PUBLIC: �r DANIEL P. DOWER y�. .N� WY Q..tt11/,ISSIf1P1 /� p .0FF�d° LEA t407l3sao�ss RES: Aug. 21. 2009 Ronda Ngyy n (p l eisPe who did take an oath. h personally known to me o as i� ntifa¢. who has produced Sign: Print: take an oath. My Commission Expires: r/1,-/ i CX % ***** **** * ****XXX***********le* *it* ** r) *****x r.',3 w,'w, „Av.,. APPLICATION APPROVED B (Revised 02/08/06) NOTARY PU Sign: Print: Ji�- rL'�QU� My Commission Expires: *X XY. Y.X Y.XXXXXY.XXX 6, Plans Examiner Engineer Zoning Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 08/13/2008 Inspector: Devaney, Michael Owner: RODRIGUEZ, JUAN CARLOS Job Address: 1177 100 Street NE Miami Shores Village, FL 33138- Project: <NONE> Block: Contractor: ELOHIM ELECTRIC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alarm Phone Number (786)251 -7913 Pa eI Number 1132050190350 Lot: Phone: 305 -635 -7999 Building Department Comments Tuesday, August 12, 2008 Page 1 of 2 km A OW Passed F Inspector Comments CC 0 ,9 . Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Tuesday, August 12, 2008 Page 1 of 2 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATIO FBC 2004 Permit Type: Electrical Owner's Name (Fee Simple Titleholder Owner's Address / City Mg L. 71 10© f't State Tenant/Lesse Name E -MAIL: hi ,(` Job Ad dlr s (where the work is being done) i Permit No. EL o8 -641 Master Permit No. ul! Phone # Zip 13 ra r1 ctiw Phone # City Miami Shores Village County Miami -Dade FOLIO / PARCEL # 1/ 3;/:)&-"---e)1 —Or, ✓ 1' Is Building Historically Designated YES Contractor's Company Name Contractor's Address 60 l6/ A)6 City //t ?/( State Zip C Phone # 7, 25/ ' q077 t'.6 r -- zip 031..2-7 Qualifier Name : osi Ali Goll.z , State Certificate or Registratioq 1 N� --C 0l';/` E -MAIL: or it. 6 m /IC Architect/Engineer's Name (if applicable) Phone # Certificate of Competency No. . CO In Value of Work For this Permit $ Z�L Type of Work: ❑Addition ❑Alteration Describe Work: 2/ /3 y477,41 a1 Phone # 756-06)-3- Square / Linear Footage Of Work: ['New ❑ Repair /Replace ❑ Demolition Pc-it/DM-no-ifs' '_, -tire 6-1a6 I� ****** xxxxxxxxxx*** x****** x x *** xxzxxx x *Feesxxxxxxr * *r. * * * ** * * *** ** Submittal Fee $ Permit Fee $ Notary $ Training /Education Fee $ 0.40 Scanning $_(.5-CO Radon $ Bond $ Code Enforcement $ DPBR $ CCF $ I - Lt I CO /CC Technology Fee $ .13 Zoning $ Double Fee $ Structural Review. $ Total Fee Now Due $ 1(Sc. n 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. 1 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 and a reinspection fee will be charged. ()Signature Owner or Agent The foregoing instrument was ackno ledge before me this day of , 20 Y, by N/' Lid 07(- Signature i sl, it/ iA:i7%1, Contractor The foregoing instrument was acknowledged before me this day of s �'�° -- 20 b \gar -L' who is p ally known to me�rAvho has produced ' who is As identification and who did take an oath. NOTARY PUBLIC: Sign: ,�, ` j� Print: ,Pill it clP6-P,Vt-- My Commission Expires: **x xx xxxxx*xxx**** xxxxx xxx xx x�xxx x%x x:F **x*x x**x APPLICATION APPROVED BY: (Revised 02/08/06) produced as is enti ication and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: 7d /D xxxxxr, wxxxx xxx*** ***** ****xx *Sc r.**j xx xx x*** '7Z-4=g Plans Examiner Engineer Zoning