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BPP-09-236Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 • Scheduled Inspection Date: March 30, 2009 Inspector: Bruhn, Norman Owner: DORSCHNER, JOHN Job Address: 390 NE 101 Street Miami Shores, FL 33138 -2425 Project: <NONE> Contractor: Permit Type: Pools/Whirlpools /Hot Tubs Inspection Type: Final Work Classification: Addition/Alteration hone Number Parcel Number 1132060135260 Building Department Comments APR 0 2 ENT`D Passed g ., fe 9 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- 106789. All previous inspections must be approved. NB 0 Opt -23"1 Cc-- March 27, 2009 Page 11 of 21 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 (circle): Building Permit No. Master Permit No. 23t, bing Mechanical Roofing Owner's Name (Fee Simple Titleholder) Ten' J0'�e�C H iul Phone # Owner's Address ,;3q D A%e Q 0 i s' City !tIAiA ! (-moo' State Tenant/Lessee Name 3 5- 75 R49 6' Zip 3313 ' Phone # Job Address (where the work is being done) 3 9 C b'J C / c / S i City Miami Shores Village County Miami -Dade Zip "3 3 f 3 g FOLIO / PARCEL # 1 3 6 o 13 - X60 Is Building Historically Designated YES NO Contractor's Company Name L S V G OL j i C C Phone # 36' -- ! 1'7 - Co0C) Contractor's Address 1 C Ji' 1 i 1 City k Imo} f 4, \ 1. d`kv+-N, State d° l_ Zip "3 3 I ,6 2 Qualifier Name Q - -'7 Phone # - ° C%6 State Certificate or Registration No. P �. ( Certificate of Competency No. CC l :337 Architect/Engineer's Name (if applicable) ) 1 16 2Q Value of Work For this Pirmit $ Type of Work: ❑Addition ❑Alteration ❑New FY-Repair/Replace Describe Work: ! ' n om G ." r iM, d1i1. ��G per, Phone # Square / Linear Footage Of Work: ❑ Demolition ******** * *C* * * * * * * * * * * * * * * * * * * * * * * ** * ** Fees************** * * ** * * * * ** * * * * * ** * * * * * * * * * * * ** Submittal Fee $ 1 Permit Fee $67 CCF $1 / ' E Notary $ / Training/Education Fee $ i •. (ji Technology Fee $ l_- Scanning $ T _ i.) Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 4 o s See Reverse side -+ Bonding Company's Name (if applicable) Bonding Company's Address ,r , 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 broch i delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice o comb cement must , e posted at the job site for the first inspection which occurs seven (7) days after the building permit rssued.- n the absence. of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Signature Owner or Agent C. actor The foregoing instrument was acknowledged before me this —1 The foregoing mstru I'-nt was ackno ledged before me this day of'20by of , -9 9 y- `�1��,� 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. NOT Sign: Print: My PUBLIC: NO Ih q� 7� S _ 1tl11 '�iI 1' 1 �..L4 °JTL�.,°.' O fL•r,i :. orleny H !no sion Expires: APPLICATION APPROVED BY: (Revised 02/08/06) NOT ' Y PUBLIC: Sign: Cam. Print: M S: 6- 27 , 2009 ,2 ' ssion Ex ALwntig _Rood ,6 Co., Inc. Plans Examiner Engineer Zoning At 7 Inspection Worksheet Miami Shores Village 1 epe 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Scheduled Inspection Date: March 24, 2009 Inspector: Levrock, James Owner: DORSCHNER, KATHLEEN Job Address: 390 NE 101 Street Miami Shores, FL 33138 -2425 Project: <NONE> Contractor: ESSIG POOLS INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Repair tokossooliklipne Number Parcel Number 1132060135260 Phone: 305 - 949 -0000 Building Department Comments Passed Failed I\ Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. 00° March 23, 2009 Page 11 of 43 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 RECEIVED 11111 eV Permit No. R., OR -231 aster Permit No. Owner's Name (Fee Simple Titleholder) J .D I .i 1.1)6C. ROC-A Phone # ,;tom'. ' 7S- it, 6 9 590 Ac- Ic�I $t Owner's Address City (e _0 ( pfrW 5 State Tenant/Lessee Name E -MAIL: Job Address (where the work is being done) Zip Phone # 33 (3 e 3gch C I D ( ST. City Miami Shores Village County Miami -Dade FOLIO / PARCEL # 11 .1:7I C Is Building Historically Designated YES NO Zip 33( 3 Contractor's Company Name 6...-..5 ((-3 ,c �° Lji (fu, Phone # Contractor's Address 1 o/3 . rJ t (� ( j City P. tfr,,, ( ityvk l State Pt— Zip 33 f 6 Qualifier Name i (�'°L EES ( G Phone # ?O -- 91q- C � State Certificate or Registration No. (d C:A- l5O S Certificate of Competency No. CC (3E-7,S-1 E -MAI L: i vm i -r e ,-S� ,,, „F:,,.,r, Architect/Engineer's Name (if applicable) Or Phone # 3��f Value of Work For this Permit $ - °®=1 Square / Linear Footage Of Work: Type of Work: yp ['Addition ['Alteration New Repair /Replace 1=1 Demolition Describe Work 1j 12 ( C E J *** sic****xv************ ****** ******sex **Fees** i*************** ir*******xa**** **** ****** CCF $ O. 6 6 CO /CC Submittal Fee $ Notary $ Scanning Bond $ Permit Fee $ ' T.) Training /Education Fee $ tiaL V Radon $ DPBR $ Technology Fee $ 5. G Zoning $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ r34. See Reverse side -3 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Zip 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: 1 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 $2 00, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law a .chure wi -"be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of .rnmencem''ift must be posted at the job site for the first inspection which occurs seven (7) days after the building permit . is d. In th -1 Bence 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 9 —1 The foregoin: in rument was ac nowledged before me this 1-1 day of T , 2O3 by) D )kTh 1:1=enCylr -• (day of by t r„eall who is personally known to me or who has produced who is personally known to me or who haws p�rodu� Signature ontractor As identification aP ICSIJje Yorleny Con010o +127 J 2009 Go., Inc. NOTY PUBLIC: Sign: Print: M Com ission Expires: as identificatinftl w j, b.'tggR -DA. I' 'Gib 7l. �.f� 1 dez 0 fl47G45S 27, 2009 ingralljeff_ /NM TM. S. Z. Print: y Co Y PUBLIC: ir+ titaiK *se9efex 4rde ***** *ir*ie4e4eo4****unYfYi *****udrir****** ****** **zz zzzz,t**w rrxee mission Expires: 2.7 , Za ®� APPLICATION APPROVED BY: (Revised 02/08/06) z** **°Y/aa:+e,t,txzzz zzz****,est,e,Y** *** Plans Examiner Engineer Zoning NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB Sit% AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. y1- 32_0 3 -sat, 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 prope and street/address: L 1- —.7 111111111111111111111111111111111111111111111 CFN 200990141327 OR St: 26766 Ps 2754 floss RECORDED 02/26 /2009 09:21:40 HARVEY RUVINr CLERK OF COURT MIAMI-DACDE COMM FLORIDA LAST PAGE AA( A ( f -1/45405 ScC l /-H)O1 � C GETS 1 .- 2- 2. Description of improvement ��5 `} Q� 5+� ,�� ad(, OL- 3.Owner(s) name and address: .c.�rt7u q 3 b s sL Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and address: 1�0 5. Surety: (Payment bond required owner from contracto F FLORIDA, C • Amount of bond $ $T�1�� this ise,r :...ry ...... I NERE Y CERTIFY t� Name and address: 6. Lender's name and address: HARV 7. Persons with the state of Florida designated by Owner u! Section 713.13(1)(a)7., Florida Statutes. Name and address: n ents may be served as provided by 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specifi j1) / F-1,44.../4:=h I ✓.- 1 , 2 0 t .O , Print owner's Name ..y-o O Sworn to and ' b -I. Notary Public Print Notary's Nam My commiss. n e (seal) I- day of Prepared by V 1 Gr'�- j J4 ✓ -Q'n Z. 20 � {'7d=1 L S , 1 v� L LIC -STATE OF FLORIDA �deny Hernandez M r ar mission # DD476455 ,-� . T ong2009 331 Aslennr Bonding Go., Inc. Ronde REC ND FEB , , 7 2i1D3 A OP •• •••• • • • • • • • • • • • • •••• • •••• • • •• • • • •• • • • • • • • • o APPROVED • •• • • • • • • • • • • BLDG ilEPT DATE 94 1111111P111141 1111111111111110 SU: ECTTOIeO ST, TE AND COU •• •• • • •••• • • •••? • •••t•• • •• • • • 4_ C.-74 16- ALLEY DETAIL. JeAL$: tie20. 14E 4 • LocArnom SURVEYOR'S CERTIFICATiON7 We herc»y certify that the attached "Sketch of Sur- vey" of the above described property Is true and correct to edge and belief our direction. �,, sit Batt our Il Ak. nowl- wiw 5 yl n.�� DONALD W. Mc1NTOSH ASSOCIATES. INC. Rea. Surveyor .286-3 State of Florida 13013(41`0 W. Mc\t3TO64 mbbec\ATe13 INt. �a91 Itockmet. eT ft% S- I T , an\AH\ 6MOtieS, RLoP4 DO. e.lI\e8 ciao e.) 1S4_orra4 NOTE. ALL RIGHTS OF WAY. EASEMENTS, SET BACK AND ZONING INFORMATION MUST BE CONFI.iMED BY AR CH:TECT AND //OR OWNER BASED UPON DESIGN USAGE. S V ¢.V EY Lo-rs 1 e.2, 13LocsG s� MIAMI SNO¢ES, SEC. 1 AMis V 1 LLAG6 of MIAMI OiaosaBb DADS Coue.rr Fed¢I tack According to Fiat Book _14.... Page..10....of the Public Records of Dade C:Ientz, Fla. t.%U.K ►1 19t3\ 0.1\. 34011 UPDr.TE APeIL ,19x4 337 7 50' J BOX ..•• • .. • • •• • • .. • • .. ▪ •••• • • • . •••• • • • • • • • • • • • •• • • • • • • •• •• •• • •• • • • • • • • • •. • .. • .. • •• • • .. • •• • .. .... • • • •••• • 15' 12' 0" 4 Existing Maindrain Existing Pool Replace Skimmer Use Existing Line �► 2 Existing Pump And Filter New 2" PVC Return Line Existing Concrete Deck 13' 41' Existing Residence 23' SCALE: 1/8" = 1' DESIGNED FARO JOHN DORSCHNER 390 NE 101 STREET MIAMI SHORES, FL 33138 DESIGNED BY: G IL LARSEN MOBILE: 954- 551 -6560 FAX: 866-870 -6019 gil @essigpools.com ,.,�,` .� L....r O 1800 NE 151 STREET NORTH MIAMI, FL 33432 305- 949 -0000 FAX 305 - 949 -9171 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 Project Address Parcel Number 390 101 Street 1132060135260 Miami Shores, FL 33138 -2425 Block: Lot: Expiration: 08/2512009 Applicant JOHN DORSCHNER Owner Information Address Phone CeII KATHLEEN DORSCHNER 390 101 Street MIAMI SHORES FL 33138 -2425 Valuation: $ 1,000.00 Contractor(s) ESSIG POOLS INC Phone 305 - 949 -0000 Cell Phone Total Sq Feet: 500 Type of Work: REPAIR Type of Piping: Additional Info: Bond Retum : Classification: Residential Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $0.60 $0.20 $175.00 $3.00 $50.00 ($50.00) $5.64 $184.44 Invoice # PL -2-09 -33981 Check #: 1111 PL -2 -09 -34066 Check #: 95960 Total Amt Paid Amt Due $ 50.00 $ 50.00 $ 0.00 $ 134.44 $ 134.44 $ 0.00 Available Inspections: Inspection Type: Final 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. February 26, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date February 26, 2009 1 RESTRICTIVE COVENANTS PROTECTIVE POOL ENCLOSURE PREPARED BY: ECIEJVED FEB VW C ,��,. DECLARATION OF RESTRICTIVE OVENANT KNOW ALL MEN BY THESE PRESENTS: WHEREAS, the undersigned 70 C s/are the fee simple owner (s) of the following described property situate and being in the Village Lot (s) Block 35 of e 5 ire) 1 'T Subdivision), A.K.A. (address) t) t Nl I . ��1 1 S HUSrI'� � _":3, (3'c • according to the plat thereof, as recorded in Plat Book 1 Page 7 o o(the Public Records of Dade County, Florida, and Whereas, the undersigned owner (s) desire to utilize said Lot (s) as • a single building site, and the undersigned owner (s) do (es) hereby declare and agree as follows: ` 1. That the property will not be used In violation of any ordinances of the Village . or Dade County now in effect or hereinafter enacted. 2. That the purpose of this covenant•is to induce the Village o issue a permit for a pool where the required enclosure is not on the subject property where the pool is located. • 3. That if any of our adjoining neighbors remove any portion of their fence or wall, or if our /my property shall fall.to meet code requirements for pool barriers, we, as owners will Immediately • install a protective enclosure to meet code requirements and will obtain a permit for such fence. 4. That, we, as owners, hold the Village harmless for any negligence or injury that results from not having the enclosure FURTHER, the undersigned deelare(s) that this covenant Is intended and•shall constitute a restrictive covenant concerning the use,.enJoyment and title to the above property and shall constitute a covenant running with the land and shall be binding upon the undersigned, his/her successors and assigns and may only be released by the Village I , or its successors, In accordance of said Village then in effect. IN W1TN VIREO, the undersigned has/have caused hand (s) and seal-(s) to be affixed hereto on this pp 11 day of S(ES) Signature and Print STATE OF FLORIDA ): COUNTY OF DATE ): Signature and Print Signature and Print I HEREBY CERTIFY that on this day personall y appeared before m�� Y ScJ ryC r who is personally known to me or has produced (type of identification) as identification and he/she acknowledge . that he/she executed the foregoing, freely and voluntarily, for purposes there in expressed. SWORN TO AND SUBSCRIBED before me on this d- yof°r'� _f MY commission expires: C -STAB �F FL�� 14°71 p11BL� kL ;3 1 Z ills l �� (. , !__ �� • Mr �l ! mac. F6e �� L ? Von-10<ing DATE 2 /tia* s ti at9 Deftweexeat 10050 NE 2nd Ave Miami Shores, Fl 33138 Phone 305-795-2204; Fax 305.756.8972 www.miamishoresvillage.com RECC J VE O FEB ))7 •00 SWIMMING POOL OWNER'S CERTIFICATION Lss MIAMI SHORES VILLAGE BUILDING AND ZONING DEPARTMENT ATTENTION: BUILDING OFFICIAL I certify that I am the legal owner of the property located at: e`er r C ■ic1 s z-; rvlr -tI5 5 - 33135 In accordance with Section 33 -12(0, Code of Metropolitan Dade County, I certify that I understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until a separate permit has been obtained for an approved safety barrier, and such barrier erected, inspected, and approved. I further understand that this certification, however, does not eliminate the need for obtaining a permit and erecting an approved barrier prior to final inspection and use of the pool. Legal Owner Note: This certification is to be submitted with a swimming pool permit application in duplicate. RESTRICTIVE COVENANTS PROTECTIVE POOL ENCLOSURE PREPARED BY: DECLARATION OF RESTRICTIVE COVEN KNOW ALL MEN BY THESE PRESENTS: - WHEREAS, the undersigned SCUI is/arc the fee simple owner (s) of the following described property situate and being in the Village Lot (s) 2-- Block 35 of S 1 Subdivision) A.K.A• (address) `) C� i 61 ¶ I . o+�.1 vi 1 S � ° /.3. ' according to the plat thereof, u recorded in Plat Book 1 Z Page 7 0 otf the Public Records of Dade County, Florida, and Whereas, the undersigned owner (s) desire to utilize said Lot (s) as a single building site, and the undersigned owner (s) do (es) hereby declare and agree as follows: 1. That the property will not be used in violation of any ordinances of the Village , or Dade County now in effect or hereinafter enacted. 2. That the purpose of this covenant's to induce the Village 'o issue a permit for a pool where the required enclosure is not on the subject property where the pool Is located. • 3. That if any of our adjoining neighbors remove any portion of their fence or wall, or If our /my property shall fall.to meet code requirements for pool barriers, we, as owners will immediately • Install a protective enclosure to meet code requirements and will obtain a permit for such fence. 4. That, we, as owners, hold the Village harmless for any negligence or injury that results from not having the enclosure FUR 1 Hr R, the undersigned declares) that this covenant is Intended and•shall constitute a restrictive covenant concerning the use,.enjoyment and title to the above property and shall. constitute a covenant running with • the land and shall be binding upon the undersigned, hI her successors and assigns and may only be released by the 'Village , or its successors, in accordance of said Village then in effect. EZEQ, the undersigned has/have caused hand (s) and seal {s) to be affixed hereto on ttbls11 days of 4�,(o• S(ES) SI Signature and Print Lure and Print STATE OF FLORIDA ): COUNTY OF DATE ): Signature and Print Signature and Print 1 HEREBY CERTIFY that on this day y pp YSC who s r� r Y Personall appeared before maJ�r l � who is personally known to me or has produced (type of identification) as Identification and he/she acknowledge • that he/she executed the foregoing, freely and voluntarily, for purposes there in expressed. SWORN TO AND SUBSCRIBED before me on this 1, Y PIYMIC`STATE OF FLO cotrids a � �# 1- ;7 X009 ' a ��e�� t�p Inc. MY commission expires: DATE Marne Shared T/i �'l� a ge 'edg Veforameat 10050 NE 2nd Ave Miami Shores, Fl 33138 Phone 305-795-2204; Fax 305-756-8972 www.miamishoresvillage.com SWIMMING POOL OWNER'S CERTIFICATION MIAMI SHORES VILLAGE BUILDING AND ZONING DEPARTMENT ATTENTION: BUILDING OFFICIAL I certify that I am the legal owner of the property located at: 0 5 M (ODA 33(355 In accordance with Section 33- 12(f), Code of Metropolitan Dade County, I certify that understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until a separate permit has been obtained for an approved safety barrier, and such barrier erected, inspected, and approved. I further understand that this certification, however, does not eliminate the need for obtaining a permit and erecting an approved barrier prior to final inspection and use of the pool. Legal Owner Note: This certification is to be submitted with a swimming pool permit application in duplicate. Miami Shores Village 10050 Northeast Second Avenue Miami Shores, Florida 33138 -2382 Telephone: (305) 795 -2207 Fax: (305) 756 -8972 www.miamishoresvillage.com AFFIDAVIT STATE OF FLORIDA COUNTY OF DADE a •Z 6 MEWED FEB 7 2809 o _orate a�+r The undersigned Affiant, does here by attest that the attached survey, performed by I J M . performed on , is an accurate representation of the existing conditions and locations of all Structures on the property as of this date. The purpose of the Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey Tess than six (6) months old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which may now 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 effect final inspections as applicable to this or other permits. Further, Affiant sayeth naught. Witness (sign and print) Witness (sign and print) SWORN TO AND SUBSCRIBED before me this 1'1 day of ` Affiant is personally known to me, produced as identification. PUBLIC-S ` Hernandez b riefly Hernandez C00115011 #1)D4.76455 Expires: SEP.. 27, 2009 Bonded Tutu Adentic Bonding Gn., Ins• Miami Shores Village 10050 Northeast Second Avenue Miami Shores, Florida 33138 -2382 Telephone: (305) 795 -2207 Fax: (305) 756 -8972 www.miamishoresvillage.com AFFIDAVIT STATE OF FLORIDA COUNTY OF DADE The undersigned Affiant, YC9 , does here by attest that the attached survey, performed by 14=1 M Gi e-n-e,::›S. t--, ASS oc..4 e34 r t L performed on , is an accurate representation of the existing conditions and locations of all Structures on the property as of this date. The purpose of the 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 may now 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 effect final inspections as applicable to this or other permits. Further, Affiant sayeth naught. Affiroperty er Witness (sign and print) Witness (sign and print) SWORN TO AND SUBSCRIBED before me this 1-1 day of T ‘'‘""11 1 Affiant is personally known to me, produced as identification. PUBIC -5 - YOT1Cfy CornmtSS 011 # tt 476455 Expires: SEP 27, 2009 ponded Tluu Atlantic Banding Cr,„ �i1s,