BP-05-1503 (2)Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING �g g
��II�
PERMIT APPLICATION SEP 0 4X007
FBC 2004 BY:
0
Permit No. TtiS P 2.00S —1'503
aster Permit No. 13 zoo l soa
Permit Type (circle):(Building Electrical . Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) -SP-F ' newts //4Ss'tt 1§l ane # C3 ®�� 5 } 334-? -
Owner's Address 9 Z15 No rk■ shore_ `X>r .-
City )-41r- SINO ce_S State rt_ Zip 331 3 $
Tenant/Lessee Name Phone #
Job Address (where the work is being done) 92:15 N S Axi s ho v er
City Miami Shores Village County Miami -Dade Zip 33 1 3 8
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name \t. Phone #
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $
Square / Linear Footage Of Work:
Type of Work: ❑Addition ['Alteration ['New ❑ Repair/Replace ❑ Demolition
Describe Work:
On o n o n 1'r -a i. o( s -1' r C o....Sia .
.�-
0
Submittal Fee $ Permit Fee $
Notary $ Training/Education Fee $
Scanning $ 1 2.. ` Q Radon $ DPBR $
Bond $ Code Enforcement $
Structural Review. $ Z®® grar
CCF$
Technology
Double Fee $
Total Fee No Jeri
1
e Reversed i e —>,
�
mil 1.0
Bonding Company'
Bonding Company's Ad
City
LR •
plicable)
State Zip
Mortgage Lender's Nam- (if applicable)
Mortgage Lender's Addr ; ss
City
Application is hereby m
commenced prior to th
construction in this juris
WELLS, POOLS, FURN
OWNER'S AFFIDA
applicable laws regulatin
"WARNING TO 0
PAYING TWICE FO
CONSULT WITH
COMMENCEMENT.
Notice to Applicant: As
promise in good faith th
whose property is subjec
for the first inspection
inspection will not be ap
Signature\-
State Zip
e to obtain a permit to do the work and installations as indicated. I certify that.no work or installation has
issuance of a permit and that all work will be performed to meet the standards of all laws regulating
etion. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
CES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
construction and zoning.
R: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
OUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
t a copy of the notice of commencement and construction lien law brochure will be delivered to the person
to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
hich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
oved and a reinspection fee will be charged.
0
The foregoing instrumen
day_ of. ser, ,200
who is personally known
NOTARY PUBLIC:
Sign:
er or Agent
et
was acknowledged before me this A'
, by '1GtS= u '3)401'5
o me or who has produced fir> Viti5
identification and who did
irl- -sue
Print: lima 1
elirM
My Commission Expires:
APPLICATION APPRO
(Revised 02/08/06)
* * * * * * * * * * * * * * * * **
D BY:
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of , 20 , by
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:
****************** * * *** *** *** * * * ** * * * * * * ** * * * * * **
229 9/¢4 5/r
qfiyo7
Plans Examiner
Engineer
Zoning
FEDERAL EIVgRGENCY MANAGEIVIENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
bnpoitant Read the instructions on pages 1- 7.
BUILDING STREET ADDRESS (inclucling Apt, Unit, Stn%, andfcr Blab. No.) OR P.O. ROUTE AND BOX NO.
9275 N. BAYSHORE DRIVE
CITY
MIAMI SHORES
STATE
FL
ZIP CODE
33138
.............................
PROPERTY DESCRIPTION (Lot and Bloat Numbers, Tax Parcel Number, Legal Dom, etc.)
BUILDING USE (e.g., Residential, Nonresidential, Adalilbn, Accessory, etc. Use a Comments area, if may.)
RES.
LATITUDE/LONGITUDE (OPTIONAL)
(# °- ' -#pw or )
HORIZONTAL DATUM:
❑ NAD 1927 0 NAD 1983
SOURCE: ID GPS (Type):
USGS Quad Map . ❑ Other:
SECTION B- FLOOD INISURANCE RATE MAP (MA) IAT1N
B1. NFIP COMMUNITY NAME &COMMUNITY NUMBER
MIAMI SHORES 12052
82. COUNTY NAME
DADE
83. STATE
FL
B4. MAP AND PANEL.
B7. FIRM PANEL
89. BASE FLOOD ELEVATION(S)
NUIVEER
85. SUFFIX
86. FIRM INDEX DATE
EFFECTNFJREVISED DATE
FLOOD ZONE(S)
(ZoneAO, use depth offbocing)
12021CC093
J
7/17195
3Th94
AE
8.0
B10.It thesure oftheBase Fkaod (eFE) data stem flood &Oh erased in 139.
❑ASS 0FHA ❑Camay Determined ❑ Other ( e):
B11. Irk the elevab3n datum tract forftoBFE in 89: ►;: NO101923 ❑ NAVD 1986 ❑ alter
B12. I l s the hicks kxaradktaCoaslal Basler Sydtan(CBRS) ereaa hots (OPA)? ❑ Yes No Dertnaton Data
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY )
C1. Bulling eratations tie based a 0 Constructice Driestigt ❑ &Rag Under Corstrultn* ►_� Finished
*A riesEleration te tagged Mee ccestnictranofthe is
C2. Bulking D a m Nun 1 (Select the bilking dag=most skits bfie toickig forstudi is osificate kbeing seepages 6 and 7.Ifnotiagam
acaratelyresesents the tedcing, proud) armor Sratogreph.)
C3. Bevaliors- Zones A1 -A30, AE, AH,A(tut up, VE, V14/30,140 BFE), AR A AARM, AR/A1-A31, AR/AH, AR/A0
Carplete Items C3. -a-i beer alcarbv tithe bilking dlagam specled in tem C2. State the dakrn rtd Bthe tiatrn is crerentban the dater' used far the BFE in
Section B, corset the chitin to that ised fcr the BFE Straw frabl and dabirn cswerdon calciiike. Use tbespace xthe Comments sea of
Section D or Sedan G, as applectiate, to dor:ut ast Ora deur' emersion.
Datun NtiUD
Eitrvatiac reference hulk used DCBM Does the ire& used waist tba ARM? ❑ Yes t No
o a) Top of Worn f (i ciudiv basement a ) 6. 85itQrc)
o b) Top of mod Wier floor N./Aft n)
o c) Bottle of boast tarvatalstir n (V messily) N.!At(m)
o d) Atached grass (top of fib) N.Aft-01)
o e) L televafonofmachki y ar re ui nent
savidng the backs (Describe inaCar Cannel* sea) N.AAft(m)
o f) Lowest acct ( gads (LAG) 7.337ft(m)
o g gads (HAG) 8.93t(m)
o h) No. ofpe n entopenf odv Mt 1 ft above aimed gale
o }Ida) ate dal permassit t (QIodvent) in C3.11 NiAsq. fat (sq.an)
SECTION D- SIRVEYOR, EhIGIMEER, ORARCHITECT CERTIFICATION
This motion is to be signed and sealed by a land survey , engineer, or architect autiraized by law to cerbTy elevation information.
1 certify that the hrformeilon in Sections A B andC on this certlffr,ate represents my best efforts to Mepret the data available.
1 understand that any false *dement may be punthithte byline orimprkanment under 18 U.S. Cie, Section 1001.
CERTIFER'S NAIVE JUDO S. PITH LICENEE IUM331 5789
COMPANY NAME NIA
CITY STATE ZIP CODE
MIAMI FL 33155
DATE TEL.EPHONE
812=4 (305) 262 2404
Inspection Date: 04/25/2008
Inspector: Levrock, James
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Owner: DAVIS, JEFFREY AND YASMIN
Job Address: 9275 BAYSHORE Drive N
Miami Shores Village, FL 33138 -2304
Project: <NONE>
Contractor: HOME OWNER
r �F
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Sprinkler System
U•000009Phone Number (305)577 -3777
Parcel Number 1132050270570
Block:
Lot:
Building Department Comments
Thursday, April 24, 2008
Page 1 of 2
Passed
s'` =:c
n r Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Thursday, April 24, 2008
Page 1 of 2