FW-12-641Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
FBC 20
Permit No.
NMOMEVMiiii
la APR 1 212 U
BR V
1eommooc000es�������Bo
Master Permit No.
Permit Type: BUILDING Y.-04Y % �/�r /
OWNER: Name (Fee Simple Titleholder): —�, 4 /��L/// /'' Phone#: ,) a� 3' / / ?S
Address: 9s) ti� /DUme57
City: /41//9'M / ,517/61.65 State:
Zip:
Tenant/Lessee Name: Phone#:
Email:
dOB ADDRESS: 9Y ��
� ad' 3
City: Miami Shores
Folio/Parcel #:
Is the Building Historically Designated: Yes
County:
Miami Dade
Zip:
NO �/ Flood Zone:
Phone#: V:A PS/
Zip: ,7
Phone#: j 27
CONTRACTOR: Company' Name: Wit COWS-1
Address: i d� 5i G 1. " "" Z(€-'
City: ,W/ N/ �% CO �y
Qualifier Name: UUSG COsll
State Certification or Registration #: � C� b 6 g Certificamte�off Co tency #:
Contact Phone #: Email Address: �ll / /7ND b &lel," C� 7/
DESIGNER: Architect/Engineer: Phone#:
State:
Pt
Value of Work for this Permit:
Type of Workddition
Description of Work:
$ J i Square/Linear Footage of Work:
❑Alteration
❑New ❑Repair/Replace
c) 76
❑Demolition,
tom/
******** *** * * * *** * ** ***** *** *** ** ****** Fees * **** *$ * *** **** ***** ** *** ***** * * **** * *** ***
Submittal Fee $ Permit Fee $ ( 6 G u CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ I lA • oks
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 to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the abs of such posted notice, the
inspection wi l not i, i proved and a re jnspection fee will be charged.
Signature
Own a or Agent
The foregoing instrument as acknowledged before me this fc
day of ,20 /�byJWW%TLIX ,
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Contractor
The foregoing ins ' ent was acknowledged before me this /017e
day of 20/ by Q SE LCr/9' ,
who is personally known to me or who has produced Low"'
70" 49 cei p as identification and who did take an oath.
Bey
Tina 0
My Commission Expires:
APPROVED BY
La I
11 IRMA N OCASIO
AOMMISSION #DD787884
EXPIRES: MAY 12, 2012
Bonded through 1st State Insurance
Plans Examiner
Structural Review
NOTARY PUBLIC:
Sign: `a COQ
Print: a-n1 4
cff��u
My Commission Exp. p. ;�•r �N'ikQD787884
EXPIRES: MAY 12, 2012
;'P• Off`
Bonded through 1st State Insurance
Zoning
Clerk
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
Expires:Not Issued
Folio Number:1132060340200
Owner's Name: KENNY KOTALIK
Job Address: 950 100 Street
Miami Shores, FL 33138-
Owner's Phone:
Total Square Feet:
Total Job Valuation: $ 2,250.00
0
Contractor(s)
CAIBAI CONSTRUCTION LLC
Planning and Zoning Criteria and Comments
Approved: No Date Denied: 4/12/2012
Comments: A 40 SQ FT TRASH AREA IS REQUIRED ON THE PROPERTY ALONG THE ALLEY.
/10c de. 20.1, c c
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•
SET 1/2"
IRON ROD
& CAP
5734
FOUND 1/2"
IRON ROD
AND CAP
NO ID
0/8 0.12'(N)
0.04'(W)
N.E. 100TH STREET
0
0
0
1)
0
0
0
la
SET 1/2"
IRON ROD
& CAP
#5734
FOUND 1/2"
IRON ROD
0/8 0.20'(S)
0.11'(W)
200.00'
NOTE: SEPTIC TANK LOCATION IS P,R
AND SAID LOCATION IS NOT/
PINNELL SURVEY.
/— -
WED BY oTHTsJ
U RANTEED -BY
BLOCK/
CORNER
4' C.B.S.
WALL
0.2'(W)
23.60'
5.95'
15.02"•--
COVERED
ENTRY
0.3'(E
.1'
FINISH FLOOR ELEVATION=11.95'
GARAGE FLCOR ELEVATION=10.82'
64.6fi <0
• C:;--CONC'
19.95'
LOT 4
BLOCK 170
SET 1/2"
IRON ROD
& CAP
#5734
LOT 8
BLOCK 170
4' C.LF. 1-3'
0.6'(E
0.1'(N)
LOT 6
BLOCK 170
LOT 5
BLOCK 170
5' CHAIN
LINK FENCE
(TYPICAL)
APPROXIMATE
LOCATION OF
FLOOD ZONE
SET 1/2" CONTOUR
IRON ROD
& CAP
#5734
(ALLEY R/W)
FOUND 1/2"
IRON PIPE
o/s 0.22'(S)
1.13'(E)
9.5' ASPHALT PAVEMENT
I- 1- 1 -1 -1 -1
OVERHEAD UTIUTY LINES (TYPICAL)
-
1- 1- 1 ----.
FOUND NAIL
o/s 0.53'(S)
1FENCE
.5'(S)
0.4'(W)
5/ma/
bus&
LiJ
z
w
0
w
z
Crit
‘14
Ek *t4Y-1,
no,
1" = 30
SKETCH NO.: 10-0046
(SCALE:
DRAWN BY: Q.D.I.
SIDE 2 OF 2
PINNELL SURVEY, INC.
4855 W. HILLSBORO BLVD., SUITE B -1 COCONUT CREEK, FLORIDA 33073
PHONE(954)418 -4940 FAX(954)418 -4941 EMAIL: order@sfland.net
CERTIFICATE NO.: LB6857
SURVEY ADDRESS:
950 N.B. 100TH STREET
MIAMI SHORES, FLORIDA 33138
v
FLOOD ZONE & ELEVATIONS:
FLOOD ZONE: AE/ X- SHADED
BASE FLOOD ELEVATION: 8'
CONTROL PANEL NO.: 120652-0306-L
DATE OF FIRM INDEX: 09/11/09
LOWEST FLOOR ELEVATION: 11.95'
GARAGE FLOOR ELEVATION: 10.82'
REFERENCE BENCHMARK: MIAMI-DADE
COUNTY ENGINEERING B.M. B-400,
ELEV. =8.27
CERTIFY TO:
1. KENNY KOTALIK
2.
3.
4.
s
POTENTIAL ENCROACHMENTS:
1. CHAIN LINK FENCE CROSSES OVER THE SOUTHERLY AND WESTERLY
PROPERTY LINES.
2. WOOD FENCE CROSSES OVER THE SOUTHERLY PROPERTY LINE.
1
LEGAL DESCRIPTION:
LOTS 5, 6 AND 7, BLOCK 170 OF "MIAMI SHORES SECTION 8 ", ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT
BOOK 14, AT PAGE 33 OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY, FLORIDA.
LEGEND & ABBREVIATIONS:
A = ARC
A/C = AIR CONDITIONER
A.E. = ANCHOR EASEMENT
ASPH. = ASPHALT
B.M. = BENCHMARK
B.C.R. = BROWARD COUNTY RECORDS
C.B.S. = CONCRETE BLOCK STRUCTURE
CHATT. = CHATTAHOOCHEE
CONC. = CONCRETE
C.L.F. = CHAIN LINK FENCE
= CONCRETE LIGHT POLE
(C) = CALCULATED
C.B. = CHORD BEARING
C.R. = CABLE RISER
(D) = DEED
D.B. = DEED BOOK
M- D.C.R= DADE COUNTY RECORDS
D.E. = DRAINAGE EASEMENT
ENCH. = ENCROACHING
ESMT. = EASEMENT
ELEV. = ELEVATION
E.M. = ELECTRIC METER
FND. =FOUND
F.P. & L. = FLORIDA POWER & LIGHT
I.P. = IRON PIPE
LR. = IRON ROD
L.B. = LICENSED BUSINESS
L.P. = LIGHT POLE
M.H. = MANHOLE
(M) = MEASURED
MAINT. = MAINTENANCE
NO. =NUMBER
N.G.V.D. =NATIONAL GEODETIC VERTICAL DATUM
O.H. = OVERHANG
O.R.B. = OFFICIAL RECORDS BOOK
O/S = OFFSET
(P) = PLAT
P.B.C.R. = PALM BEACH COUNTY RECORDS
P.B.
P.C.
P.L
P.R.C.
P.T.
P.O.B.
P.O.C.
P.P.
R
RES.
R/W
T
(TYP.)
U.E.
W.F.
W.M.
A
PLAT BOOK
= POINT OF CURVATURE
= POINT OF INTERSECTION
= POINT OF REVERSE CURVE
= POINT OF TANGENCY
= POINT OF BEGINNING
= POINT OF COMMENCEMENT
= POWER POLE
= RADIUS
= RESIDENCE
= RIGHT -OF -WAY
= TANGENT
= TYPICAL
= UTILITY EASEMENT
= WOOD FENCE
= WATER METER
= DELTA OR CENTRAL ANGLE
= CENTERLINE
= ELEVATION
GENERAL NOTES:
1. TYPE OF SURVEY: BOUNDARY
2. IF THIS SURVEY HAS BEEN REVISED AS INDICATED IN THE REVISION
BOX SHOWN HEREON, THBN ANY AND ALL PREVIOUS VERSIONS OF
THIS SURVEY PREPARED BY PINNELL SURVEY, INC. ARE NULL & VOID.
3. THE PROPERTY SHOWN HEREON WAS NOT ABSTRACTED FOR
OWNERSHIP, RIGHTS -OF -WAY, EASEMENTS OR OTHER MATTERS OF
RECORD BY PINNELL SURVEY, INC. THERE MAY BE ADDITIONAL
RESTRICTIONS THAT ARE NOT DEPICTED ON THIS SURVEY THAT MAY
BE FOUND IN THE PUBLIC RECORDS OF THE COUNTY, FOR WHICH THE
SUBJECT PROPERTY IS LOCATED IN.
4. UNLESS OTHERWISE NOTED, FIELD MEASUREMENTS ARE IN
AGREEMENT W1TH RECORD MEASUREMENTS.
5. ELEVATIONS SHOWN HEREON (IF ANY) ARE BASED ON THE NATIONAL
GEODETIC VERTICAL DATUM OF 1929, UNLESS OTHERWISE NOTED.
6. UNDERGROUND IMPROVEMENTS AND UTJL1TIES ARE NOT LOCATED.
7. FENCE AND WALL OWNERSHIP IS NOT DETERMINED.
8. THIS DRAWING 15 THE PROPERTY OF PINNELL SURVEY, INC. AND SHALL
NOT BE USED OR REPRODUCED, WHOLE OR IN PART WITHOUT
WRITTEN PERMISSION & AUTHORIZATION FROM PINNELL SURVEY, INC.
9. ALL EASEMENTS SHOWN ON THE ATTACHED DRAWING ARE PER THE
RECORD PLAT S OTHERWISE NOTED
CERTIFICATION:
THIS IS TO CERTIFY TFIAT I HAVE RECENTLY SURVEYED THE
PROPERTY DESCRIBED IN THE FOREGOING TITLE CAPTION AND
HAVE SET OR FOUND MONUMENTS AS INDICATED ON THIS
SKETCH AND THAT SAID ABOVE GROUND SURVEY AND SKETCH
ARE ACCURATE AND CORRECT TO THE BEST OF MY KNOWLEDGE
AND BELIEF. I FURTHER CERTIFY THAT THIS SURVEY MEETS
MINIMUM TECHNICAL STANDARDS UNDER RULE 51-17,
FLORIDA ADMINISTRATIVE CODE, ADOPTED BY THE FLORIDA
STATE BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS.
THIS SURVEY IS NOT VALID WITHOUT THE SIGNATURE AND THE
ORIGINAL RAISED S ' . OF A.FLOlt1DA LICENSED SURVEYOR
AND MAPPER.
JASON IL 'PI
PROFESSIONAL SURVEYOR & MAPPER
LICENSE NO. 5734, STATE OF FLORIDA
UPDATE SURVEY (11 -1160) 08/11/11
S.A.
UPDATE SURVEY (10 -1406) 09/17/10
S.A.
REVISIONS
DATE
CHK'D BY
SKETCH NO.: 10 -0046
1
DATE OF SURVEY: 01/14/10
CHECKED BY: S.A.
FIELD BOOK/PAGE: 352/70
SIDE 1 OF 2