941 NE 92 St (6)STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Afhant,fil &h./R.611414r, does hereby attest that the
(property owner)
Ak oa (.5 rvP ac 2c,
eyor's company)
attached survey, performed by
performed on q `7' / / 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, fitrther
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.
• Muni S/2ore
Witness(sign and print) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me this \ \ day of
Affiant is personally known to me��roduced
AFFIDAVIT
(name of
Op
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94/ iv:esi)7 „ FLiT
MEMO
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10
ts.
202
MIAMI, FLORIDA 33126
TELEPHONE: (305) 264-2660
FAX. (305) 264-0229
Property Address: 941 NE 92 ST,
For: MICHAEL ROBERT CHANDLER
A = ARC.
A/C = AIR CONDITIONER PAD
A E. = ANCHOR EASEMENT.
A/R = ALUMINUM ROOF.
A/S = ALUMINUM SHED
ASPH = ASPHALT
B C. BLOCK CORNER
BLDG = BUILDING
B.M = BENCH MARK
B 0 B. = BASIS OF BEARINGS
C. = CALCULATED.
C B = CATCH BASIN.
C B.S =CONCRETE BLOCK
STRUCTURE.
CBW = CONCRETE BLOCK WALL
CH. = CHORD DISTANCE
CH. B. = CHORD BEARING.
CL = CLEAR
C L F = CHAIN LINK FENCE.
C.M E. = CANAL MAINTENANCE
EASEMENT.
CONC = CONCRETE.
C P = CONC. PORCH
C S = CONCRETE SLAB.
D E. = DRAINAGE EASEMENT
D M E. = DRAINAGE MAINTENANCE
EASEMENT.
DRIVE = DRIVEWAY.
= DEGREES.
E = EAST.
E T.P. = ELECTRIC TRANSFORMER
PAD.
ELEV. = ELEVATION.
ENCR. ENCROACHMENT
F.H. = FIRE HYDRANT.
F I.P = FOUND IRON PIPE.
F.I R = FOUND IRON ROD.
F.F E. = FINISHED FLOOR
ELEVATION.
Noun irun ,ar • • • •
LAND SURVEYORS
LOCATION
ABBREVIATIONS AND MFANING
F N D. = FOUND NAIL & DISK
FR. = FRAME
FT =FEET
FNIP = FEDERAL NATIONAL
INSURANCE PROGRAM
F N = FOUND NAIL.
11 = HIGH (HEIGHT)
IN & EG. - INGRESS AND LGRESS
EASEMENT
L P. = LIGHT POLE
L F E = LOWEST FLOOR
ELEVATION
L M E - LAKE MAINTENANCE
EASEMENT.
' = MINUTES.
M. = MEASURED DISTANCE
MON = MONUMENT
MM = MANHOLE
M/L. = MONUMENT LINE
N AP = NOT A PART OF.
NGVD= NATIONAL GEODETIC
VERTICAL DATUM
N. - NORTH.
N T S. = NOT TO SCALE
Y • NO = NUMBER
0/S = OFFSET.
OH. = OVERHEAD.
O H L = OVERHEAD UTILITY LINES
OVH = OVERHANG
0 R B. = OFFICIAL RECORD BOOK
PVMT =PAVEMENT
PL = PLANTER.
P/L. = PROPERTY LINE
P.C.0 = POINT OF COMPOUND
CURVE.
P.C. - POINT OF CURVE.
PT. = POINT OF TANGENCY.
POC. = POINT OF COMMENCEMENT
POB = POINT OF BEGINNING.
MIAMI, FL 33f38
SKETCH Scale 1" = NTs3
39 .7
•
( GOLDEN GATE OR/
E . ,
9 .
.1 • 1 1
P.11 C = POINT OF REVERSE
CURVE.
PROP. COR = PROPERTY
CORNER
P 8 = PLAT BOOK
PG = PAGE
PWY = PARKWAY
PEW = PERMANENT HEFLRENCE
MONUMENT.
P L S = PROFESSIONAL LAND
SURVEYOR.
R = RECORDED DISTANCE
RR = RAILROAD.
RES = RESIDENCE.
R/W. = RIGHT•OF•WAY.
11AD = RADIUS OR RADIAL
R P. = RADIUS POINT.
RGE = RANGE.
SEC. = SECTION
STY = STORY.
SWK = SIDEWALK
S I P = SET IRON PIPE L B P604
S = SOUTH.
SND. = SET NAIL B DISK L8116044
SP = SCREENED PORCH.
" =SECONDS
T = TANGENT.
TWP. = TOWNSHIP.
U.E = UTILITY EASEMENT.
UTIL. = UTILITY.
U P = UTILITY POLE.
W.M = WATER METER.
W.F. = WOOD FENCE
W.S = WOOD SHED:
= CENTRAL ANGLE.
W = WEST.
= CENTER LINE
= ANGLE
LEGAL NOTES TO ACCOMPANY SKETCH OF SURVEY (SURVEY):
EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED
INSTRUMENTS, IF ANY. AFFECTING THE PROPER1 Y THIS SURVEY IS SUBJECT TO DEDICATIONS,
LIMITATIONS. RESTRICTIONS, RESERVATIONS OR EASEMENTS OF RECORD. LEGAL DESCRIPTIONS
PROVIDED BY CLIENT OR ATTESTING TITLE COMPANY
BOUNDARY SURVEY MEANS A DRAWING AND/OR A GRAPHIC REPRESENTATION OF THE SURVEY WORK
PERFORMED IN THE FIELD. COULD BE DRAWN AT A SHOWN SCALE AND/OR NOT TO SCALE
EASEMENTS AS SHOWN ARE PER PLAT BOOK. UNLESS OTHERWISE SHOWN.
THE TERM 'ENCROACHMENT' MEANS VISIBLE AND ABOVE GROUND ENCROACHMENTS
ARCHITECTS SHALL VERIFY ZONING REGULATIONS, RESTRICTIONS AND SETBACKS AND THEY WILL
BE RESPONSIBLE OF SUBMITTING PLOT PLANS WITH THE CORRECT INFORMATION FOR THEIR
APPROVAL FOR AUTHORIZATION TO AUTHORITIES IN A NEW CONSTRUCTION, UNLESS OTHERWISE
NOTED, THIS FIRM HAS NOT ATTEMPTED TO LOCATE FOOTINGS AND/OR FOUNDATIONS
FENCE OWNERSHIP NOT DETERMINED.
THIS PLAN OF SURVEY, HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF THE ENTITIES NAMED
HEREON, THE CERTIFICATE DOES NOT EXTEND TO ANY UNNAMED PARTY:
THE FNIP FL000 MAPS HAVE DESIGNATED THE HEREIN DESCRIBED LAND TO BE
Situated in Zone: X Community /Panel /Suffix:
Date of Firm: 07/17/1995 Base Flood Elevation:
Certified to: MICHAEL ROBERT CHANDLER
ROYAL TITLE & ESCROW COMPANY, INC.
LAWYERS TITLE INSURANCE CORPORATION
WORLD SAVINGS, IT'S SUCCESSORS AND /OR ASSIGN
•• • • • •• ••• ••
• • •
• • •
•• • • • • • ••• ••I5ate :
0.00 x
0.00
8M11
OF N G.V D OF 1929
BY:
REVISEDON
120652- 0093 -J
• • •.SUIllsEYNo 1- 0009528
• • •
• • •
• • • •SI-fEEt NO. OF.
SURVEY OF LOT 7 AND THE EAST 1/2 OF LOT 8 • ••• •
• • • •• • • • • • •
• • • • •
Subdivision: AMENDED PLAT OF GOLDEN GATE PARk : • • • • • • •
According to the Plat thereof as recorded in the Plat Book 7
at Page No. 54 of the public records of MIAMI -DADE County, Florida.
LESiENQ]YPICAL
2) IF SHOWN. ELEVATIONS ARE REFERRED TO
3) THIS IS A SPECIFIC PURPOSE SURVEY
REVISEDON
09/04/2001
WOOD FENCE
CHAIN LINK FENCE
CB S. WALL (CBW)
EXISTING ELEVATIONS
PROPOSED ELEVATIONS
SURVEYORS'S NOTES: 1) IF SHOWN. BEARINGS AFTE
REFERRED TO AN ASSUMED MERIDIAN. BY SAID PLA
IN THE DESCRIPTION OF THE PROPERTY IF NOT,
THEN BEARINGS ARE REFERRED TO COUNTY
TOWNSHIP MAPS
4). THE CLOSURE IN THE BOUNDARY SURVEY IS
ABOVE 1.7500 FT.
1 HEREBY CERTIFY. THAT THIS'BCUNDARY SURVEY'
OF THE PROPERTY DESCRIBED HEREON, AS
RECENTLY SURVEYED AND DRAWN UNDER MY
SUPERVISION, COMPLIES WITH THE MINIMUM
TECHNICAL STANDARDS AS SET FORTH BY
THE FLORIDA BOARD OF PROFESSIONAL LAND
SURVEYORS IN CHAPTER 61G17-6, FLORIDA
ADMINISTRATIVE CODE PURSUANT
TO 472 027, FLORIDA STATUTES .(
U°J / /C)/
p4{I l IBARRA (DATE OF FIELD WORK)
PROFESSIONAL LAND SURVEYOR NO — 0 . 40` 7 `
STATE OF FLORIDA (VALID'COPIES OF THIS SURVEY WILL
BEAR THE EMBOSSED SEAL OF THE ATTESTING LAND
SURVEYOR)
A SEAL
E
i \ \\ \ \ \ \\
\ , \ `
\ \ \ \
..
so '
e•C J
•
JO/
WON
6
J
4
3
2 1
/
c..
202
MIAMI, FLORIDA 33126
TELEPHONE: (305) 264-2660
FAX. (305) 264-0229
Property Address: 941 NE 92 ST,
For: MICHAEL ROBERT CHANDLER
A = ARC.
A/C = AIR CONDITIONER PAD
A E. = ANCHOR EASEMENT.
A/R = ALUMINUM ROOF.
A/S = ALUMINUM SHED
ASPH = ASPHALT
B C. BLOCK CORNER
BLDG = BUILDING
B.M = BENCH MARK
B 0 B. = BASIS OF BEARINGS
C. = CALCULATED.
C B = CATCH BASIN.
C B.S =CONCRETE BLOCK
STRUCTURE.
CBW = CONCRETE BLOCK WALL
CH. = CHORD DISTANCE
CH. B. = CHORD BEARING.
CL = CLEAR
C L F = CHAIN LINK FENCE.
C.M E. = CANAL MAINTENANCE
EASEMENT.
CONC = CONCRETE.
C P = CONC. PORCH
C S = CONCRETE SLAB.
D E. = DRAINAGE EASEMENT
D M E. = DRAINAGE MAINTENANCE
EASEMENT.
DRIVE = DRIVEWAY.
= DEGREES.
E = EAST.
E T.P. = ELECTRIC TRANSFORMER
PAD.
ELEV. = ELEVATION.
ENCR. ENCROACHMENT
F.H. = FIRE HYDRANT.
F I.P = FOUND IRON PIPE.
F.I R = FOUND IRON ROD.
F.F E. = FINISHED FLOOR
ELEVATION.
Noun irun ,ar • • • •
LAND SURVEYORS
LOCATION
ABBREVIATIONS AND MFANING
F N D. = FOUND NAIL & DISK
FR. = FRAME
FT =FEET
FNIP = FEDERAL NATIONAL
INSURANCE PROGRAM
F N = FOUND NAIL.
11 = HIGH (HEIGHT)
IN & EG. - INGRESS AND LGRESS
EASEMENT
L P. = LIGHT POLE
L F E = LOWEST FLOOR
ELEVATION
L M E - LAKE MAINTENANCE
EASEMENT.
' = MINUTES.
M. = MEASURED DISTANCE
MON = MONUMENT
MM = MANHOLE
M/L. = MONUMENT LINE
N AP = NOT A PART OF.
NGVD= NATIONAL GEODETIC
VERTICAL DATUM
N. - NORTH.
N T S. = NOT TO SCALE
Y • NO = NUMBER
0/S = OFFSET.
OH. = OVERHEAD.
O H L = OVERHEAD UTILITY LINES
OVH = OVERHANG
0 R B. = OFFICIAL RECORD BOOK
PVMT =PAVEMENT
PL = PLANTER.
P/L. = PROPERTY LINE
P.C.0 = POINT OF COMPOUND
CURVE.
P.C. - POINT OF CURVE.
PT. = POINT OF TANGENCY.
POC. = POINT OF COMMENCEMENT
POB = POINT OF BEGINNING.
MIAMI, FL 33f38
SKETCH Scale 1" = NTs3
39 .7
•
( GOLDEN GATE OR/
E . ,
9 .
.1 • 1 1
P.11 C = POINT OF REVERSE
CURVE.
PROP. COR = PROPERTY
CORNER
P 8 = PLAT BOOK
PG = PAGE
PWY = PARKWAY
PEW = PERMANENT HEFLRENCE
MONUMENT.
P L S = PROFESSIONAL LAND
SURVEYOR.
R = RECORDED DISTANCE
RR = RAILROAD.
RES = RESIDENCE.
R/W. = RIGHT•OF•WAY.
11AD = RADIUS OR RADIAL
R P. = RADIUS POINT.
RGE = RANGE.
SEC. = SECTION
STY = STORY.
SWK = SIDEWALK
S I P = SET IRON PIPE L B P604
S = SOUTH.
SND. = SET NAIL B DISK L8116044
SP = SCREENED PORCH.
" =SECONDS
T = TANGENT.
TWP. = TOWNSHIP.
U.E = UTILITY EASEMENT.
UTIL. = UTILITY.
U P = UTILITY POLE.
W.M = WATER METER.
W.F. = WOOD FENCE
W.S = WOOD SHED:
= CENTRAL ANGLE.
W = WEST.
= CENTER LINE
= ANGLE
LEGAL NOTES TO ACCOMPANY SKETCH OF SURVEY (SURVEY):
EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED
INSTRUMENTS, IF ANY. AFFECTING THE PROPER1 Y THIS SURVEY IS SUBJECT TO DEDICATIONS,
LIMITATIONS. RESTRICTIONS, RESERVATIONS OR EASEMENTS OF RECORD. LEGAL DESCRIPTIONS
PROVIDED BY CLIENT OR ATTESTING TITLE COMPANY
BOUNDARY SURVEY MEANS A DRAWING AND/OR A GRAPHIC REPRESENTATION OF THE SURVEY WORK
PERFORMED IN THE FIELD. COULD BE DRAWN AT A SHOWN SCALE AND/OR NOT TO SCALE
EASEMENTS AS SHOWN ARE PER PLAT BOOK. UNLESS OTHERWISE SHOWN.
THE TERM 'ENCROACHMENT' MEANS VISIBLE AND ABOVE GROUND ENCROACHMENTS
ARCHITECTS SHALL VERIFY ZONING REGULATIONS, RESTRICTIONS AND SETBACKS AND THEY WILL
BE RESPONSIBLE OF SUBMITTING PLOT PLANS WITH THE CORRECT INFORMATION FOR THEIR
APPROVAL FOR AUTHORIZATION TO AUTHORITIES IN A NEW CONSTRUCTION, UNLESS OTHERWISE
NOTED, THIS FIRM HAS NOT ATTEMPTED TO LOCATE FOOTINGS AND/OR FOUNDATIONS
FENCE OWNERSHIP NOT DETERMINED.
THIS PLAN OF SURVEY, HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF THE ENTITIES NAMED
HEREON, THE CERTIFICATE DOES NOT EXTEND TO ANY UNNAMED PARTY:
THE FNIP FL000 MAPS HAVE DESIGNATED THE HEREIN DESCRIBED LAND TO BE
Situated in Zone: X Community /Panel /Suffix:
Date of Firm: 07/17/1995 Base Flood Elevation:
Certified to: MICHAEL ROBERT CHANDLER
ROYAL TITLE & ESCROW COMPANY, INC.
LAWYERS TITLE INSURANCE CORPORATION
WORLD SAVINGS, IT'S SUCCESSORS AND /OR ASSIGN
•• • • • •• ••• ••
• • •
• • •
•• • • • • • ••• ••I5ate :
0.00 x
0.00
8M11
OF N G.V D OF 1929
BY:
REVISEDON
120652- 0093 -J
• • •.SUIllsEYNo 1- 0009528
• • •
• • •
• • • •SI-fEEt NO. OF.
SURVEY OF LOT 7 AND THE EAST 1/2 OF LOT 8 • ••• •
• • • •• • • • • • •
• • • • •
Subdivision: AMENDED PLAT OF GOLDEN GATE PARk : • • • • • • •
According to the Plat thereof as recorded in the Plat Book 7
at Page No. 54 of the public records of MIAMI -DADE County, Florida.
LESiENQ]YPICAL
2) IF SHOWN. ELEVATIONS ARE REFERRED TO
3) THIS IS A SPECIFIC PURPOSE SURVEY
REVISEDON
09/04/2001
WOOD FENCE
CHAIN LINK FENCE
CB S. WALL (CBW)
EXISTING ELEVATIONS
PROPOSED ELEVATIONS
SURVEYORS'S NOTES: 1) IF SHOWN. BEARINGS AFTE
REFERRED TO AN ASSUMED MERIDIAN. BY SAID PLA
IN THE DESCRIPTION OF THE PROPERTY IF NOT,
THEN BEARINGS ARE REFERRED TO COUNTY
TOWNSHIP MAPS
4). THE CLOSURE IN THE BOUNDARY SURVEY IS
ABOVE 1.7500 FT.
1 HEREBY CERTIFY. THAT THIS'BCUNDARY SURVEY'
OF THE PROPERTY DESCRIBED HEREON, AS
RECENTLY SURVEYED AND DRAWN UNDER MY
SUPERVISION, COMPLIES WITH THE MINIMUM
TECHNICAL STANDARDS AS SET FORTH BY
THE FLORIDA BOARD OF PROFESSIONAL LAND
SURVEYORS IN CHAPTER 61G17-6, FLORIDA
ADMINISTRATIVE CODE PURSUANT
TO 472 027, FLORIDA STATUTES .(
U°J / /C)/
p4{I l IBARRA (DATE OF FIELD WORK)
PROFESSIONAL LAND SURVEYOR NO — 0 . 40` 7 `
STATE OF FLORIDA (VALID'COPIES OF THIS SURVEY WILL
BEAR THE EMBOSSED SEAL OF THE ATTESTING LAND
SURVEYOR)
A SEAL
E
5582 N W 7th STREET, SUITE 202
MIAMI, FLORIDA 33126,
TELEPHONE; (305) 264.2660
FAX' (305) 264-0229
Z01 (S
N uu a Airi•••::ui:EY N0._
Aurunjuto
LAND SURVEYOFIS • of
••• • • • • • • • • SHEET NO. L
BOUNDARY SURVEY
L chi' c
6 75 s
(
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• •••
Sc3Ie 1" _.
• • •
• • •
• •
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• •
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• • •
- 70
07 7
•• • • • •• ••• ••
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•
• • •
• • •
• • •
••• •
• •
• • •
•
• • ••• ••
• •
••.•
• .• •
• • 0
• • •
• •••
i
PROPERTY OWNER
Q n
.i o- ,. S■-es; FL- 33 i3
Home Telephone 36c - 7e. \ 3173
Business Telephone 3 fir, 75-t-/—/30‘1
Fax Q. ✓
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'I Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Villa•e:
Step 1.
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit-
ted along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
APPLICATION
Job Address: — I ''1 I / V , C . 9,3
Address
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
1/'
Folio Number
Lot Block
Subdivision PB PG
Current Use of Property Square Feet Units
Proposed Use of Property Value of Work -) 900 • &'' Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
j *ee� i ,i Sharers FL 33138
Apt. ! City
Description of Work
Master Permit No.
Subsidiary Permit No. O& cg, ' Z c� oZQj
Zoning
ENGINEER
Name
License No.
Address
Telephone
Fax
PERMIT APPLICATION
State Zip
Linear Feet SeCU(`e._!.
Floors
CONTRACTOR
Name
License No.
Address
Telephone Fax
Qualifier Name
Page 2
IMPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all
work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits
are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
SEAL:
Personally known
STA F
Signs a of O er
? kaM- /e)
1
a - rint Name Print Name .
gnature of
Sworn to and subscribed before me this C j day of
otary Public - • to of Florida
` a
1p' P U A ANGELA M BECKER
0 1I f OFFICIAL NOTARY S'IC L
Tl � 0 CONMIS!aON NUMBER
T 117 4f: , r CC786697
9t O.O MY COMMISSION EXPIRES
OF F\.O NOV. 15,2002 . 1 ** ----- uce �n i i# niion
SEAL:
STATE OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Contractor / Qualifier
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
PERMIT APPLICATION
ELECTRICAL
TYPE (1 TYI'E
QTY . I . yPI
QTY
TN PE Q I Y
Minimum Fee
Generator
Dryer
Refrigeration, Tons
Outlet, Appliance
A/C Central, Tons
Service Repair
Cooling Tower
A/C Central 1 -3 Ton
Heating Strips, each
Fan
Vent Hood, Cost
Outlet, Wall
A/C Wall/Win. Tons
Service, Temporary
Dryer Vents, Number of
A/C Central 4 -7 Ton
Paint Booth
Fire Pump
Ventilation, Cost
Outlet, Switch
Air Handler, Tons
Signs
Ductwork, Cost of
A/C Central 8 -15 Ton
Piping, Flammable Liquid
Fixture - Fluorescent
Periodic Inspections
Oven
Barbecue
Space Heater (kw)
Fire Sprinkler System
A/C Central 16-20 Ton
Process/Pressure Piping
Fixture Light
Parking Lot Lights
Bath Fan - Vented, #
Spas/Hot Tubs
Fireplaces, Number of
A/C Central 20+ Ton
Pressure Vessel
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Laundry Tray
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Lavatory
Dishwasher
Low -volt, Television
Service, Number of Amps
Meter Set (Gas)
NIECHANICAL
TYPE QTY. TYPE QTY. TYPE ()Ty. Tvl'I.: O'fl.
Minimum Fee
TYPE
Drains, Roof
Condensate Drain
TY1'1.:
Miscellaneous Fixture
Generator
rm.:
Soakage Pit
Refrigeration, Tons
Bath Tub
A/C Central, Tons
Drinking Fountain
Cooling Tower
Miscellaneous Repairs
Heating Strips, each
Solar Water Heater
Vent Hood, Cost
Bidet
A/C Wall/Win. Tons
Filter Replace
Dryer Vents, Number of
Pool Piping
Paint Booth
Sprinkler Repair
Ventilation, Cost
Cap - Fixture
Air Handler, Tons
Fountain
Ductwork, Cost of
Pump and Abandon
Piping, Flammable Liquid
Sprinkler System
Periodic Inspections
Cap - Water
Barbecue
Gas - Appliance
Fire Sprinkler System
Pump, Domestic
Process/Pressure Piping
Supply, AC Well
Cap - Sewer
Bath Fan - Vented, #
Gas - Natural
Fireplaces, Number of
Pump, Fire Stand
Pressure Vessel
Temporary Toilet
Catch Basin
1'LUNIBING
TYPE
A/C Condensate
QTY.
TYPE
Drains, Roof
QTY.
TY1'1.:
Miscellaneous Fixture
Q"1'Y.
rm.:
Soakage Pit
YI' Y.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re-pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
D • E
Zonin
`T7�i
I d
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
1 r
Page 4
O1- FICE USE ONLY
CIIECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.)
Inspector State Educational Fund
State DCA (Radon)
Code Enforcement Fine
Zoning Review
Notary
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
$ b Q
$ - O d
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
(sq.ft. = x/1000
$ (¢.005 /sq.ft.)
$ (¢.01 /sq.ft.)
$ . }Ar
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL
PERMIT APPLICATION
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date ?' Z 48 Job Address 141 M e' 71' gfre - Tax Folio
�sii fve -S
Legal Description Loi- 7 6,64 z 164 0,( G4e t de 60c �/K P 144 Histoncally Designated: Yes No
Owner/Lessee / Tenant ( ei t Master Permit # ' f
Owner's A d d r e s s Na 92 S' 'e4-
Contracting Co. '- T C. 9 6401 f e Address /3 vz /,1 f /7eefr
Qualifier gjbYtgg - Phone 705. 65Z - a l.J
State# FI60c9 Municipal # Competency # 00000/M Ins. Co. CoVeC i9
Architect/Engineer / ii�e Address
Bonding Company /V /# f' Address
Mortgagor 4 Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTIO X // /13 Z.' f Li atm, 9�k Pe�,ea!) 1 97,✓0 th)k
4 8wc
Wit. 113
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAII.,URE TO DO SO 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.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
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. Furthermore, I authorize the above -named contractor to do the work stated.
0 14—e a0C21 EP #
Signature of owner and/or Condo President Date e of ' o a : ►O wner- Builder
nti
c :
z i �� 4 f ,
.. ' 'I
Notary as to `Ciitti4f atitlitiZdildifPf6ideit Date
My Commission Expires:
FEES: PERMIT
Estimated Cost (value) M0
c'
Signa
Phone
as t ttgC bt,de ivner-
/ t 'n* -
TOTAL DUE
Date
Ider Date
/0 • 7)
RADON C.C.F. NOTARY BOND
APPROVED:
Zoning
Building / I tt g Electrical
Mechanical Plumbing Engineering
co
NEEDS 40 SQ. FT. AT REAR
•PROPERY LINE FOR TRASH
tel-
•
•
max.
v
0D4:0
R ail End,.
a Band
Tension
Band
—
Wire
1O -O" to center
maximum
. Shop Drawing
Top Rail
Sleeve
Cap
TERMINAL POST
Wt. per ft.
LINE POST. i 4.
• . .
•
Site
1 5/8 or 2"
Wt. pts' ft.: .
4141 •
•
TOP RA1 L
•
Site
4..
1 3/8" or 1 5/8"
1
Wt. per ft.
de dimension ; : ; ; Iipepr, foot 11 . .
• 1 a
21/2"
* 3ize -is outsi
Post hole diameter is 4 :tints :the
• • • 4 .
• .. . 4
• 4 4 4 4 4
a • 4 4
a� r;_.t•b the toot:. ,
• • 1 • • it 14 • • •
•. 4 4• 4 • a 4•
• • •.. • • 4
• •4 44
• • •
. 4 ,
4 4 •
• 4 •
4 ••
• • •
4 4 4 4
4 4 4 4
• 4 4 •
4 4 4 4
• 4 • .
Chain Link
Fabric % Gouge
ii
11
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