FW-11-1585(kJ( (1/(1Y
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):
Building
Owner's Name (Fee Simple Title
Owner'kAddrev
Ci
Tenant/Lessee Name Phone #
Permit No. C-U3 t
Master Permit No.
Roofing t �
`} � t � 8` (� b6 I� k w\-09 phone CV cro--7-$3q58
/ Cemegvirce.
Job Address (where the work is being done),�(Q� l:/l /�i�
-)/ 7
City Miami Sho s Vi
FOLIO / PARCEL #
County Miami -Dade
Is Building Historically Designated YES NO 'V
Contractor's Company Name
Contractor's
City
6ccYteo---0 o
ddress
Qualifier Name
State Certificate or Registrat
riffrtc> of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 2 p't
Type of Work: ❑Addition
•
Describe Work:
fGI to ..� :3“AICJ`�
a�eV da ^ Fb' 'r'tOtnor ,J
❑ Repair/Replace
teration
❑ Demolition
* ** ** * * * ** * * * * * * * * * * * * * * * * * * * * * * * ** *Fees* * * * * ** * **
Submittal Fee $
Notary $
Scanning $
Bond $
Permit Fee $
Training/Education Fee $
Radon $ DPBR $
Code Enforcement $ Double Fee $
a13
* * * * * ***** **** ** *** ** ** * * * ** ** **
CCF $
Technology Fee $
Zoning $
Structural Review. $
CO /CC
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 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 o atte hment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspectio w
inspection will not bekjii ve # nd a reinspection fee will be charged.
Nil
• caner or Agent
The foregoing in, nt was acknowledged before me this g 6 The' for
day of 64465
0 L j , by :To [ 1 Kr) ar•) " -e r• p , day of
who is personally known to me or who has produced who i . rsonal� to me or who has pr s ced
.. ps.. ! n uuluo
As identification and who did take an oath. as idgnti�'�t an th.
BONNIE J. HILL , m 9" 4 commit 777417
NOTARY PUBLIC - STATE OF FLORIDA P NOTARY I Y
COMMISSION # 00 791943 r _1 Expires 41912012 e
N EXPIRES JUNE 28, 2012 o Floide Natal 's" 1
Sign: (3-e--,z;,— MY COMMISSION �, r ; ,d ;`a .......x.........�..�....
VI
Sign: r.+ °`
Print: Print: �ilril J'17" r� W.
urs seven (7) days after the building permit is issued. In the absence of such posted notice, the
Contractor
ackno` 1 .
_, by /d
NOTARY PUBLIC:
f3 " e1 P•f . C... e./ L R t 1
My Commission Expires:
My Commission - pires:
. x*, x, x*** ****** ** ****** ****** **: w****: x, x****x: *** **** *, x*: x**** **: x**,x****,x **********,xa:: *************** **** * * * +:x****
APPLICATION APPROVED BY: CICS ?IA
(Revised 07/10/07)
Plans Examiner
Engineer
Zoning
s
MVliami Shores Village
APPROVED
ZONING DEPT
BLDG DEPT
BY
Alt
DATE
�JI
g•3 -
SUBJECT TO COMPLIANCE WITH ALL FEDERAL
STATE AND COUNTY RULES AND REGULATIONS
180.071
SHEET 2 OF 2
R =25.00'
D- 90.09'00.
A- 35.34'
X35.40'
36.10'
40.00'
7.50'
15.60'
ONE STORY
RES. No 465
31.30'
2.00
o°
2.55'
ai
7.70'
25.40'
.35.0'
oi
50'
4' CIF % X x x % x % 1
130.00'(R)(M) 2
Rai OT
LOT .3
100' TOTAL R/W
THOMAS J. KELLY , INC.
LB # 6486
SURVEYORS— MAPPERS —LAND PLANNERS
8125 SW 120 STREET PINECREST, FLORIDA 33156
(786) 242 -7692 DADE (954) 779 -3288 BRWD
(786) 242 -6494 DADE FAX (954)779 -3260 BRWD FAX
DATE FIELD WORK
04/18/2007
SCALE
1 ° =25'
SURVEY NO.
07 -1680
L▪ EGEND OF SURVEY ABBREVIATIONS
A ARC DISTANCE NC .... AIR CONDITIONING
C CALCULATED C.B CATCH BASIN
CL .... CLEAR C/L ....CENTER LINE
ENC ... ENCROACHMENT P.0 POINT OF CURVATURE
FIP .... FOUND IRON PIPE P.0.8POINT OF BEGINNING
O.H.... OVER HANG W.MWATER METER
P.B.... PLAT BOOK M MEASURED
P11.. ..PROPERTY LINE CONC .. CONCRETE
UP ... UTILITY POLE F.D FOUND
CBS . .. CONCRETE BLOCK STRUCTURE
O.U.L....OVERHEAD UTILITY LINE
P.C.C... POINT OF COMPOUND CURVE
P.O.C... POINT OF COMMENCEMENT
BLDG .. BUILDING
C.H CHORD DISTANCE
D.E DRAINAGE EASEMENT
F.H FIRE HYDRANT
R RADIUS
NGVD ... NATIONAL GEODETIC VERTICAL DATUM
PRC ... POINT OF REVERSE CURVATURE
RAD ... RADIAL
RAY ...RIGHT OF WAY
SEC... SECTION
SCR... SCREENED
S.I.P ..... SET IRON PIPE
SWK ...SIDEWALK
U.E UTILITY EASEMENT
CHLF CHAIN LINK FENCE
CERTIFY TO:
Julian Felip And bebrea Frank Montero
Roth, Rousso & Katsman, L.L.P.
Commonwealth Land Title Ins. Company
Wells Fargo N.A., Its Successors And /Or Assigns, A.T.I.M.A.
Sheet 1 of
FLOOD ZONE: X
THIS I5 A FLOOD
yIAZARD ZONE
THIS I5 NOT A FLOOD
HAZARD ZONE
PANEL NO.:. 93/3
COMMUNITY #: 120652
DATE OF FIRM: 07/17/1995
BASE FLOOD: N/A
FINISH FLOOR: N/A
LOWEST N/A
ADJ GRADE
LEGAL DESCRIPTION:
Lot: THE NORTHEAST 25 FEET OF LOTS 23 AND ALL OF LOTS 24 AND 25
Block:
Subdivision: Amended Plat Of Maimi Shores Section No. 4
According to the Plat thereof as recorded in
Plat Book; 15 Page: 14
Public Records of MIAMI -DADE County, Florida.
ADDRESS:
465 GRAND CONCOURSE
MIAMI SHORES, FL 33138
Encroachments Noted: I.LE.
LOCATION SKETCH
SCALE: N t" '
NOTES/
A) All Clearances and/or enc oaclunnts shown
hereon ars of apparent nature. Pans ownership
by visual means. Legal owrlsrshlp of fences not
determined.
B) This survey is Intended far mortgage or refinance purposes
only exclusively for this use by those to whom H le
certified. This sway is not to be used for construction,
p.nnitti g. design. or any other use without written con-
sent of Thaws 3. Kelly, Inc.
C) Cods restriction and title search are not reflected
on this swvey.
D) The flood information shown henwn doss not imply
that the referenced properly will or will not be free
from flooding or donaga and does not create liability
on the port of tits firm, any offkar or employes thereof,
for any damage that results from reliance on said
Information.
E) The lands depicted hereon were surveyed par the
legal description and no claims as to ownership or
matters of title an made or Unpile&
F) Underground Encroachments, If any, not located.
I hereby certify that the survey represented
Moon meats the minimum technic& stan-
dards set forth by tie Board of Land
in chapter 616 ' arida AdminIstratl Cods
pursuant 7 Fla. Statute.
+ 05E
STA
REA, '.5. dI M. #4858
F ALIO NUNLE SD MPRINTED WITH AN
EMBOSSED SURVEYORS'S SEAL
NOTES:
1. IF SHOWN. BEARING ARE 70 AN ASSUMED
MERIDIAN (BY PLAT).
2. IF SHOWN. ELEVATIONS ARE REFERRED N.6.V.0 1929.
3. THIS IS A BOUNDARY SURVEY.
Q
w
NE 5th AVE
37.5'
2
3
4
5
22
21
50'
ct
C�
Q
Cc
CD
THOMAS J. KELLY, INC.
L.B. #6486
SURVEYORS - MAPPERS -LAND PLANNERS
8125 SW 120 STREET PINECREST, FLORIDA 33156
(786) 242 -7692 DADE (954) 779 -3288 BRWD
(786) 242 -6494 DADE FAX (954) 779 -3260 BRWD FAX
DATE FIELD WORK
04/18/2007
SCALE
firm - I' :p- 'SURVEY U NO.
N 07 -1680
1
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Parcel Number
465 GRAND CONCOURSE
Miami Shores, FL
1132060170320
Block: Lot:
Owner Information
Address
Phone
Applicant
JULIAN & DEBRA MONTERO
Cell
JULIAN & DEBRA MONTERO
465 GRAND CONCOURSE
MIAMI SHORES FL 33138 -2462
305/685 -0412
1
Contractor(s)
HENRY'S FENCE INC
Phone Cell Phone
(305) 669 -0180
Valuation: $ 2,000.00
Total Sq Feet: 223
Approved: Yes
Comments:
Date Approved: 8/30/2011: Yes
Date Denied:
Type of Construction: Wood Fence
Classification: Residential
Additional Info:
Scanning: 2
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Wire & Wood
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$3.35
$3.35
$0.40
$223.00
$6.00
$1.60
$238.90
Pay Date Pay Type
Invoice # FW-8-11 -41870
09/06/2011 Credit Card
08/29/2011 Credit Card
Amt Paid Amt Due
$ 188.90 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
Foundation
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.
September 06, 2011
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
September 06, 2011 1
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 163849 Permit Number: FW -8 -11 -1585
Scheduled Inspection Date: September 26, 2011
Inspector: Bruhn, Norman
Owner: MONTERO, JULIAN & DEBRA
Job Address: 465 GRAND CONCOURSE
Miami Shores, FL
Project: <NONE>
Contractor: HENRY'S FENCE INC
Permit Type: Fence/Wall
Inspection Type: Final
Work. Classification: Wood Fence
Phone Number 305/685 -0412
Parcel Number 1132060170320
Phone: (305) 669 -0180
Building Department Comments
5' WOOD FENCE
Passed k
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
September 23, 2011
For Inspections please call: (305)762 -4949
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