DS-07-1743Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Num
INSP -58973
Permit Number.` DS- 8-07 - I743
Inspection Date: 11/07/2007
Inspector: Rodriguez, Jorge
Owner: DEVINE, MICHAEL & CLAUDIA
Job Address: 54 102 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: CHAMPION CONCRETE
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Block:
Phone Number 305- 759 -4883
Parcel Number 1132060131470
Lot:
Phone: (305)252 -8055
Building Department Comments
Driveway old chicago brick
Passed
Inspector Comments
my
N cAziO7
//4 4
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Wednesday, November 7, 2007
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 MIT APPLICATION
FBC 2004
Permit Type (circl f : Building
G
AUG 1 62001
BY:
Permit No. iO8 C— 1143
Master Permit No.
Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple leTitlehiolder) tAittAQ.A. bt2U1 y\ Phone # '35(09A,0
Owner's Address Ai &. 2,
City 1-1441144 Si tO'a'Lf State f Zip 33 1,36i
Tenant/Lessee Name Phone # .
Job Address (where the work is being done)
City Miami Shores Village
FOLIO / PARCEL #
Is Building Historically Designated YES
County Miami -Dade
Zip 3 3 'g'
NO
Contractor's Company Name C 1 6 4i /p O4) t(61VC-
Contractor's Address 15 3 3 6 £ 1,0 `tee 7
Phone # 3 o 5 Z- 52"e'rr 4'`
"city 1,'L1 #14 State zip 3 3 y
Qualifier Name-J' /1 6f/ D Phone #
StataCerificate or Registration No. Certificate of Competency No. q5 ,e)G%f?4,5"
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $
Type of Work: ❑Addition
Square / Linear Footage Of Work:
DAlteration ❑New: ❑ Repair/Replace ❑ Demolition
Describe Work: 49il
******** * * * * * **** * ** * * * * * * * * ** * *** *** ** Fees************* *** * * ** * * ** * **** ** * * * * ** ** * ** **
Submittal Fee $ Permit Fee $ t SO — CCF $ 5•40 CO /CC
Notary $
Scanning $?-)1:
Bond $
Training/Education Fee $
Radon $
Structural Review. $
(' Technology Fee $ 3 ,
DPBR $
Code Enforcement $ Double Fee $
Total Fee Now Due $ 4-68 . q s
See Reverse side -a
Zoning $
r 2 3e �
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be deliv ed to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commenceme - must be p! - ed at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the ab -:ence of sup /; posted notice, the
inspection will not be approv ' %a e a reinspection fee will be charged.
Signature
er or Agent
The fore omg instrument was acknowledged before me this 1)
day of AuGO9c720 67 by ti 1CKA, 4 €d IS@
Signature
Contractor
The foregoing instrument was acknowledged before me thisl$
day of � 20 , by (.0NN� bS''
who is personally known to me or who has produced`„ who is onally kno..' to me or who has produced
DtS0-650-757243ACkientification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
APPLICATION APPROVED BY:
(Revised 02/08/06)
Sign:
Print:
My Commissio
LISSo NDIFiZ
slo% #DD 539 5
****************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. V S 1 Fi TAX FOLIO NO.
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 11111111111 1111111111111111111111111 1111 1111
+G Fh# 2007R0822043
OR Bk 25867 F's 4178; (1ps )
RECORDED 08/2012007 09:08:06
HARVEY RUVINr CLERK OF COURT
l'MIAMI —DADE COUI4TYr FLORIDA
LAST PAGE
BY:
1. Legal description of property and street/address:
N /02, yr''
/1 s fi— 33/✓�
2. Description of improvement: Owe L' /
3. Owner(s) name and address: M 104 se ^✓ ° 4cL)
.'Y ivy ADZ ter- /144w4 5 fit.cf fi,
Interest in property:
Name and address of fee simple titleholder:
33/11
4. Contractor's name and address: -.14/ 1J 45/44D coy 49*4/fy0 4*1
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
8 HERE E1'CEi., F
�. /of('
of
,��r ilmri�lG � _
7. Persons within the state of Florida designated by Owner upon whaif 4 lot'' : .. i� t ►� i �+rve:
provided by Section 713.13(1)(a)7., Florida Statutes, � " '
Name and address:
'c0 C9t
Ct6R.
By
IF
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
different
this Notice of Commencement:: (the expiration date is 1 year from the date of recording unless a
Signature o Owner r
Print Ow is M Name iCIA1�t U:-
Sworn to and subscribed before me this e:76,4 day of tvr
Notary Public
Print Notary's Name
My commission expires:
123.01 -52 PAGE 4 8/02
NOTARY PUBLI TATE OF FLORIDA
• •
P. pire5: NOV 17, 2009
"".*u Atlantis Bonding Co., Inc.
Prepared brill/1'7C OW ii 6
Address: X33 ®Jtu /Vd'z 4
\tb
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT N0. PS `i 1143 TAX FOLIO NO.
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 �tre� dress:
a 5' J //vim
-4 iteAvAr
2. Description of improvement:
3. Owner(s) name and address: o�
i
/'i 144 tt -J_ !�U1 33
M1 S� %
11111111111111111 111111111111111 11111 1111 lilt
C F14 2OO7RO82O4
OR Bk 25867 F's 4178; tips)
RECORDED 08/2(1/2007 09 :08 :06
HARVEY RUVINe CLERK OF COURT
nromI —DALE COUHTYe FLORIDA
LAST F'A'E
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address:-.114/41e,-.44-5/4-10 �� . ,�f+
/55 0 1Lt' .t 1.,44 l
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
INE�E1i1'C.t'T i ei +�, �) 4�tn a=.G _.-» � ...—_
‘1111iiir itf ri/e%
7. Persons within the state of Florida designated by Owner upon v✓MO
provided by Section 713.13(1)(a)7., Florida Statutes, By
Name and address:
S. 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
different
this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
Signature o' Owner �}'
Print Ow =r's Name ►r1 'AMA
Prepared b
1 '
Sworn to and subscribed
A ress:
before me this day o f 2
!�
dd
NOTARY PU Li TATS OR FLORIDA , : � <
Notary Public
Print Notary's Name
My commission expires:
12301 -52 PAGE 4 8/02
Y/1/iami SILor$ v1;
10050 N.E. SECOND AVE.
MIAMI SHORES. FLORIDA 33138 -2382
Telephone: (305). 795 -2207
Fax: 1305175,6:S972 ..
1�ava_w�• 1
pf olt cti
e
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, kl C(V P..st, .VIV\.• , hereinafter referred to as the Owner of the
(owner)
following described property:
Legal description/folio #:
Lot
Tax Folio #:
Block Subdivision
requests permission to install:
( J Asphalt, concrete, brick pavers
[ J Landscaping
[ J Other
C + 0.333
within the public road right of way of c.� �''l )� '�' 101 �� V v ���'1 5 r '�'"` y
(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
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 1/ <y of
SIGNED. SEALED AND DELIVERED in the presence
(owner)
TARY 'tJBLIc TATE
ela
ZD 7
RIDA
mmission # DD491643
Expires: NOV. 17, 2009
.. Bonded T ru Atlantic Bonding Co., Inc.
AFFIDAVIT
'STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant, I p
`� t cAtvveA NuoN2. , does hereby attest that the
(property owner)
attached survey, performed by /U O UA �%) e y Q (AJC
(name ofsurveyor's company)
performed on ) - /1 - /5. , 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) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this 13 day of
Affiant is personally known to me, i produced .9 L SID - $ 2K j as identification.
OTARY Pa,LICcgiTP '" O1A
Glilela B.
huh .t.�. 'lag •- . 3
Expires: NOV 17, 2009.
Bonded Thru Atlantic Bonding Co,, inc.
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
Folio Number:1132060131470
Owner's Name: MICHAEL & CLAUDIA DEVINE
Job Address: 54 102 Street NE
Miami Shores Village, FL
Owner's Phone: 305 - 759 -4883
Total Square Feet: 1298
Total Job Valuation: $ 8,100.00
Contractor(s)
CHAMPION CONCRETE
Phone Primary Contractor
(305)252 -8055 Yes
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 8/16/2007 : Yes
Comments: MAX 11 FT DRIVEWAY WITH MAX 2 FT FLARES AT THE ROAD PAVEMENT
N.W. 7TH STREET, SURE 20: •
•• •• •
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TELEPHONE (305)
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FAX: (305) 5544022 •
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