DS-12-243Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 176152 Permit Number: DS -2 -12 -243
Scheduled Inspection Date: December 05, 2012
Inspector: Rodriguez, Jorge
Owner:
Job Address: 53 NW 97 Street
Miami Shores, FL 33138-
Project: <NONE>
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: Addition /Alteration
Contractor: FORMULA DEVELOPMENT & CONSTRUCTION MANAGMEN
Phone Number
Parcel Number 1131010330280
Phone: (305)725 -6264
Building Department Comments
REMOVE 5' EXISTING CONCRETE. EXISTING POOL
COPING REPLACED. EXISTING STEPPING STONES
REMOVED, REPLACE WITH GRAVEL AND POOL DECK.
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP - 169884. not complete. nb
December 04, 2012
For Inspections please call: (305)762 -4949
Page 5 of 37
g161
I
BUILDING
PERMIT APPLICATION
FBC 20
Miami 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
Permit No. (°�
Master Permit No. Be-- 12- - 2-249
Q F
E
Permit Type: BUILDING ROOFING � h�
OWNER: Name (Fee Simple Titleholder): €/.54 ✓�'� ill 0t-1►f 4�e• Phone #: �� 21L— g?6Iw'
Address: f`(OJ A/4-
' N k — ,,per
City: ' i ►'X'ft..�y State: %r'v`
Zip: 3314)
Tenant/Lessee Na e: Phone#:
Email:
JOB ADDRESS: CA dam '994 PiAe6
City: Miami Shores County: Miami Dade Zip: 3 %Ia
Folio/Parcel #:
Is the Building Historically Designated: Yes
Flood Zone:
1 JJ nn 'T
Gt, M1" ki5i� -46 • G �t "el
CONTRACTOR: Company Name: Phone #:e I(
Address: < S r
City: 44Q / (Q. Vd Q le State: F zip: 3 3ad ?
Qualifier Name: c't' A14 Y e Phone #:3.0 70,t.5"--4.
.S"^.
o21p 5(
State Certification or Registration #: C G . 65 '?.,7 4 jf Certificate of Competency #: rr
Contact Phone #365 - ? a to a 1p'. Email Address: ,.Q. 14../12 �' 14? S @ .b e (l so z17"i'l. ne 1"
DESIGNER: Architect/Engineer: M 9 a e( k F' i t` 3 (� Phone#:
$ /1 !f C! Square/Linear Footage of Work:
New ❑Repair/Replace ❑Demolition
ac) moo' e ,14.`4, d
y. I
Value of Work for this Permit: o
Type of ,Work: -- ❑Addition alteration ��\
Description -Orr k: f e t't�1 i? like 5 iv" e x41;11.5
L
l
�x**** �x****+x�x�+** **a::a�+x�x�x**** +�x�x�x�x** ***** Fees*** * * *** * * ****+x�x�+�u�x�x** ** **** * ***�x****�x*****
Submittal Fee -, is Permit Fee $ G° CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ (Q 3 ' !o
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 absence of such posted notice, the
inspection will not be approve a r a reinspection fee will be charged..
Signature I .;` Signature
Own: ' gent Contractor
The foregoi g instrument was ac owledged t fore this The fore�gooin; instrument was acknowledged before me this �b
day o ' / 20 12 by OA.& I i • •� .�' / Z ' 1 11 AN
Y � Y � day of /� �� 20 � , by %� �1�
.&•
w : is personally know to me or ho has produced who is
as identification and who did take an oath.
NOTARY PUBLIC:
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission E
4.1.:",„, NIY =MESON $ DD 084327
EXPIRES: April 22,2014
4 of pe Bonded din Budget tlotaly Seiko
me or who has produced
Sign:
Print: 5
My Commission Expires:
******************************************** * ******** ** ** *** ** **** ** **** * ** * * ***** * ** ,** * * * * * * *** ** *** ***
APPROVED BY
Plans Examiner
772
Zoning
Structural Review Clerk
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
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
Permit NO. DS -2 -12 -243
Permit' + ' rrd ilk labs
1Alt#itiit�n
Expires:Not Issued
Folio Number:1131010330280
Owner's Name: USA RE ACQUISITIONS LLC
Job Address: 53 97 Street „
Miami Shores, FL 33138-
Owner's Phone:
Total Square Feet: 350
Total Job Valuation: $ 2,000.00
Contractor(s) Phone Primary Contractor
FORMULA DEVELOPMENT & CONSTRUCTION (305)725 -6264 Yes
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 2/15/2012 : Yes
Comments: GRAVEL NOT PERMITTED AS GROUND COVER.
REMOVAL OF CONCRETE AND PAVING STONES WILL BRING SITE CLOSER TO COMPLIANCE.
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:1131010330280
Owner's Name: USA RE ACQUISITIONS LLC
Job Address: 53 97 Street
Miami Shores, FL 33138-
Owner's Phone:
Total Square Feet: 350
Total Job Valuation: $ 2,000.00
Contractor(s) Phone Primary Contractor
FORMULA DEVELOPMENT & CONSTRUCTION (305)725 -6264 Yes
1
Planning and Zoning Criteria and Comments
Approved: No
Comments: GRAVEL NOT PERMITTED AS GROUND COVER.
Date Denied: 2/9 /2012
Permit No: 12 -243
Job Name:
February 15, 2012
Miami Shores Village
Building Department
Building Critique Sheet
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Page 1 of 1
1) Provide corrections for Zoning.
2) The plans submitted are for more than the permit indicates. Provide a plan that shows
only the work for the requested permit. Remove the garage conversion and provide a site
plan only.
Plan review is not complete, when all items above are corrected, we will do a complete plan
review.
If any sheets are voided, remove them from the plans and replace with new revised sheets and
include one set of voided sheets in the re-submittal drawings.
Norman Bruhn CBO
305 - 762 -4859
777 N.W. 72nd AVENUE SUITE 3025
MIAMI, FLORIDA 33126 JOHN
TELEPHONE: (305) 262 -0400
FAX: (305) 262 -0401
SURVEY No. 11-002645-1.
I B A R RA & ASSOC . INC.
7
LAND SURVEYORS SHEET No. 2 OF 2
DRAWN BY: A.H.V.
�� ,') 5�1 7 rp ,;
BOUNDARY SURVEY
d -
B \I' :--- - -------- - - ----
LOT -8
BLOCK -129
/11
SCALE = 1 " =20'
I LOT -7
BLOCK -129
I .Ewto'e
co rvi p I
I LOT -6
BLOCK -129
Itk ;5i:05 5
I Li)/ 5-1-1- o
r
k
10' ASPHALT „ ei.
^ • O RFI AD PUMP FILTER t:L
VE
5 CONCRETE WIRES POOL PUftAP,
FENCE
/5AL.Ley
PVMT. 20
(C. (MAR)
25.00' ° ......
+t o
° `
U.-- �l� 75.0/ ihas-a
o
- —
ism
F.I.P 1/ ��
NO CAP
—
•, ,�'c
.:' `1 0._. _'.`�
:':tea;
;nl;
s! ;�f;'.' � ∎ ∎∎
l F.I.P 112"
;149
0.15' CL `�
.PL-,
II
. .
4'
L : '
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NO CAP
ON PL.
1 2' CONCRETE
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c
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64, 4/
r FENCE
e
vi 3
5'C
L.F.
35.7
T
I
POOL v
s THE EAST 1/2
LOT -19
BLOCK 129
C S.
I
1
6' W.F.
-
14.46'
b
6
%
is.
eV STEPPING
O
STONES
10.51'
0.) Q
• P
I..
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'
0.20' CL
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0 STEPS
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a O Y
ONE ��V'P9 /
RES. # 53.
cii
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20.90'
U.
t
nj LOT - 21
BLOCK 129
0.20' ENCR. (B)
i
al �
. 10.4T
• •
12.44' ci
PL. J
._' c i 20.65'
10.55'
IRON
: : DOOR .....
.:: 5' C.B.W.
;•'1•`
F.I.P 1/2"
NO CAP
25.00'
I
STEPS
'
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NO CAP 100.00'
5'.GONC,; S.WK.
. 75.00'
�.. F P.
0.50'
CURB
in
el
(A) 0.50' CURB
ASPHALT - --
W .
22' PY -
RETURN
NO CAP
'.
f://j- - -
O1
OJ
M.
N- H
0 /
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13 "'ASPHALT N. EfY
PVMT:
y
97th STREET
w
ENCROACH '�M11 S:
_ . A SoutI si a t e ubj ct� sph ' eturn Encroaching into the R
() .• J P Encroaching
(B) East s6tte Q t e u Jec opert ighhor's Wood fence Enc
(C) North si the Sybje o y k11n rete Slab Encroaching in
`,-
SURVEYOR'S S NOTE:
There maybe Easements recorded in the Public Records not shown on this Survey.
- The purpose of this Survey is for use in obtaining Title Insurance and Financing anti should not he
NA ami Shores v I =ge
ht of Way o N.W.
f Y
c�{�l t� ®k,pRe E
7th Street.
ement StiNict Property.
DATE
o re Attey.
ZONING DEFT�T/
`•
w /���
�
% /'
BLDG DEPT
' "
SUBJECT 10 CCP,IPI.IANCE W111-1 ALL FEDERAL
STATE ANh l UN Y rI LES AND EO ULATIO dS
se foreats'strzttativi 15b•rposes. -
777 N.W. 72nd AVENUE SUITE 3025
MIAMI, FLORIDA 33126
TELEPHO'.IE: (305) 262 -0400
FAX: (305) 262 -0401
DRAWN BY: A.H.V.
JOHNI BAR RA & ASSOC. ,INC. SURVEY No 11- 002645 -1
LAND SURVEYORS
SHEET No. 1 OF
2
PROPERTY ADDRESS:
53 NW 97th STREET
MIAMI, FL 33150
LEGAL DESCRIPTION:
LOT 20, AND THE EAST 1/2 OF LOT 19 OF, BLOCK 129, MIAMI SHORES SECTION SIX, ACCORDING TO THE PLAT THEREOF
AS RECORDED IN PLAT BOOK 10, AT PAGE 39, OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY, FLORIDA.
A
A.C.=
A.E.=
A.R,=
A.S.=
ASPH.=
B.C.=
BLDG.=
B.M.=
B.C.R.=
B.O.B.=
(C) =
C.B.
C.B.S,=
C.B.W.=
CH =
CH.B.=
CL.=
C.L.F.=
C. M.E =
CONC.=
C.P.=
C . S . =
C.W.=
D.E.=
D.M.E.=
DRIVE _
EB =
E.T.P. =
LOCATION SKETCH
NOT TO SCALE
n r
9 161 161 t7 19 19 PG e1. 22.E
t
∎ B> 601 .. I,iot
I ,i , ems , y 5J�
`1,�I�,�1 .1 .98TH ITT
R0 • I •• 1 ' T SUBJECT ° `
PROPERTY 'I
X13 U? II 10 9 18 17
15 16 1't Ie(i
eU
NW 9
[ ] �'4 1.1 141 II I IL 9
;I5 lb (7 18 I:I IGLI 1,2i �'3
ARC.
AIR CONDITIONER PAD.
ANCHOR EASEMENT.
ALUMINUM ROOF.
ALUMINUM SHED.
ASPHALT.
BLOCK CORNER.
BUILDING.
BENCH MARK.
BROWARD COUNTY RECORDS.
BASIS OF BEARINGS,
CAi.CULATED.
CATCH BASIN.
CONCRETE BLOCK STRUCTURE.
CONCRETE BLOCK WALL.
CHORD.
CHORD BEARING.
CLEAR.
CHAIN LINK FENCE.
CANAL MAINTENANCE EASEMENTS.
CONCRETE.
CONC. PORCH.
CONCRETE SLAB.
CONCRETE WALK.
DRAINAGE EASEMENT.
DRAINAGE MAINTENANCE EASEMENTS.
DRIVEWAY.
DEGREES.
ELECTRIC BOX
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.
F.N.D. = FOUND NAIL & DISK.
FT.= FEET.
FNIP.= FEDERAL NATIONAL INSURANCE PROGRAM.
F.N.= FOUND NAIL.
H.= HIGH (HEIGHT)
IN. &EG.= INGRESS AND EGRESS EASEMENT.
L.B. = Certificate of Authorization L.B.#7806
L.P. = LIGHT POLE.
L.F.E.= LOWEST FLOOR ELEVATION.
L. M.E,= LAKE MAINTENANCE EASEMENT.
' = MINUTES.
(M)= MEASURED DISTANCE.
TH ST
7
50 1 3 01 O
1.
(S
•1
5 a
, f . I ^ ,L-.: Lso Lit; 41 J
SHOE ELAND w BLVD
ABBREVIATION AND MEANING
MB = MAIL BOX
M.D.C.R.= MIAMI DADE COUNTY REOCRDS
M.H. = MANHOLE.
N.A.P. = NOT A PART OF.
NGVD = NATIONAL GEODETIC VERTICAL DATOM.
N.T.S.= NOT TO SCALE.
# -NO.= WINNER.
0/S = OFFSET.
O.H.= OVERHEAD
O.H.L.= OVERHEAD UTILITY LINES.
U.R.B.= OFFICIAL RECORDS BOOK.
O.V.H.= OVERHANG.
PVMT. = PAVEMENT.
PL.= PLANTER.
P/L
P.C.C.=
P,C.=
PT.=
POC.=
P.O.B.=
P.R.C.=
PWY =
PRM =
P.L.S.=
P.P.=
P.P.S.=
P. U.E,=
(RI=
RR.=
RES.=
R/W =
RAD.=
RGE.=
R.O.E.=
SEC. _
STY.=
SEE=
S.I.P.=
S,=
S.P. _
PROPERTY LINE.
POINT OF COMPOUND CURVE.
POINT OF CURVE.
POINT OF TANGENCY.
POINT OF COMMENCEMENT.
POINT OF BEGINNING.
POINT OF REVERSE CURVE.
PARKWAY.
PERMANENT REFERENCE MONUMENT.
PROFESSIONAL LAND SURVEYOR.
POWER POLE
POOL PUMP SLAB
PUBLIC UTILITY EASEMENT
RECORD DISTANCE.
RAIL ROAD.
RESIDENCE -
RIGHT -OF -WAY.
RADIUS OR RADIAL.
RANGE.
ROOF OVERHANG EASEMENT.
SECTION.
STORY.
SIDEWALK.
SET IRON PIPE
SOUTH.
SCREENED PORCH
' = SECONDS.
T = TANGENT.
TB = TELEPHONE BOOTH
TSB = TRAFFIC SIGNAL BOX
TSP = TRAFFIC SIGNAL POLE
LEGAL NOTES TO ACCOMPANY SKETCH OF SURVEY (SURVEY):
- THERE MAY BE EASEMENTS RECORDED IN THE PUBLIC RECORDS NOT SHOWN ON THIS SURVEY
- THE PURPOSE OF THIS SURVEY IS FOR USE IN OBTAINING TITLE INSURANCE AND FINANCING AND SHOULD NOT BE USED
FOR CONSTRUCTION PURPOSES.
• EXAMINATIONS OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY,
AFFECTING THE PROPERTY.
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, SETBACKS AND WILL BE RESPONSIBLE OF SUBMITTING
PLOT PLANS WITH THE CORRECT INFORMATION FOR THEIR APPROVAL FOR AUTHORIZATION TO AUTHORITIES IN A NEW
CONSTRUCTIONS.
UNLESS OTHERWISE NOTED, THIS FIRM HAS NOT ATTEMPTED TO LOCATE FOOTING 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 FLOOD MAPS HAVE DESIGNATED THE HEREIN DESCRIBED LAND TO BE SITUATED IN ZONE: °X'
COMMUNITY 120652 / PANEL 0302 / SUFFIX. L DATE OF FIRM: 09/11/2009 BASE FLOOD ELEVATION: N/A.
THE SUBJECT PROPERTY DOES NOT LIE IN A SPECIAL FLOOD HAZARD AREA.
CERTIFICATION:
GONZALO NEGRETE
TWP =
UTIL.=
O.E.=
U.P.=
W.M.=
W.F.=
W.S.=
W.R.=
Pl. V.=
_
TOWNSHIP.
UTILITY.
UTILITY EASEMENT.
UTILITY POLE.
WATER METER.
WOOD FENCE.
WOOD SHED.
WOOD ROOF.
WATER VALVE.
MONUMENT LINE.
CENTER LAMB.
CENTRAL ANGLE.
ANGLE.
LEGEND TYPICAL
- ^� - - - -- OVERHEAD UTILITY LINES
C.B.S. = WALL (CBW).
C.L.F. = CHAIN LINK E7E0E.
I.F. = IRON FENCE.
W.F. = WOOD FENCE.
•
D. DO = EXISTING ELEVATIONS.
SURVEYOR'S NOTES:
11. IF SHOWN, BEARINGS ARE REFERRED TO AN ASSUMED MERIDIAN. BY SAID PLAT
IN THE DESCRIPTION OF THE PROPERTY. IF NOT, THEN BEARINGS ARE REFERRED
TO COUNTY, TOWNSHIP MAPS.
2). THE CLOSURE IN THE BOUNDARY SURVEY IS ABOVE 1:7500 FT.
31. CERTIFICATE OF AUTHORIZATION L8 # 7806.
SURVEYOR'S CERTIFICATION:
I HEREBY CERTIFY.' THAT THIS °BOUNDARY SURVEY° OF THE PROPERTY DESCRIBED HEREON.
HAS RECENTLY BEEN SURVEYED AND DRAWN UNDER MY SUPERVISION, AND COMPLIES WITH
THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF
PROFESSIONAL LAND SURVEYORS IN CHAPTER 5J -17, FLORIDA ADMINISTRATIVE CODE
PURSUANT TO 472.027, FLORIDA STATUTES.
BY
10-13- 011
CARLOS /BARRA (DATE OF FIELD WORK)
LAND SURVEYOR NO.. 6770 STATE OF FLORIDA
(VALID COPIES OF THIS SURVEY WILL BEAR THE EMBOSSED SEAL OF THE ATTESTING
LAND SURVEYOR).
REVISED ON
REVISED ON:
SEAL
II 2,--Rso-Lo
IN � Jg-FtDr73-J
B iiivG
PERMIT APPLIC
Miami 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
Permit Type: BUILDING
JOB ADDRESS: A 'j - 7
FBC 2010
Permit No.
a�3
ster Permit No. `D5 \—
ROOFING
City: Miami Shores County:
Folio/Parcel#: 17-3/o1-693
Is the Building Historically Designated: Yes
Miami Dade
Flood Zone:
OWNER: Name (Fee Simple Titleholder): OSA. 2*- AC-Qv( S tT(olJS Phone #: ;' • 24-11 EC
Address: LS. ao ( t (.0 Ad....1Z
City: $V )C-7 �z.,� State: L--
Tenant/Lessee Name: Phone #: --
Email:
Zip:
CONTRACTOR: Company Name: F170 A /,�� .
Address:
City: /712 I( / Matey.
Qualifier Name: /V 4 N i) ..
State Certification or Registration #: Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Phone#:3 ®S,‘.s
Value of Work for this Permit: $ 2'8
Type of Work: Addition
escription of Work:
441ter. ti ! n
Square/Linear Footage of Work:
ew DRepair/Replace
• ❑Demolition
Color thru tile:
*+ x************ *** *+ x****************m***Feer*qua:x:**** ** * * ** ***** ****+x+x *****************
Submittal Fee $ Permit Fee $ ,.J `J CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ a ' O
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 absence of such posted notice, the
inspection will not be ap,rove4 and a reinspection fee will be charged.
O
Signature
Signature
er o Agent Contractor
The foregoing instrument was acknowledged before me this CI The foregoing instrument was acknowledged before me thisC
day oCAACe.S.30 ikby ,VZ4LO t'U 4c 7?r day o C', 20 \Z., by L Dt I ht CU /f i
who is•,personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC• NOTARY PUBLp„
o1PR:PUBIi FERNANDOMONTEIRO 40..•.,% FERNANDOMONTEIRO
* MY COMMISSION 4 OD 980327 * * MY COMMISSION 4 DD 984327
EXPIRES: April 22, 2014 i!� "< EXPIRES: Apt l 22, 2014
Q. (�: ,_... fir:.... �mG` -Q'
'foFa�o"s Budget Noisy Was
Print: Pnn
My Commission Expires: My Commission Expires:
Sign:
*** * * ***xx****** **x***xx*x *** x****m x**�*1 *x) xaxxx*********** * * *xxxx**xx*x*x ***r * *** * *** *** * * * * * **
* •
APPROVED BY Plans Examiner axrG C> a /77Zonin g
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Clerk
77f.iv'cy?W.a7 Ad AVENUE SUITE 3025
MIAMI, FLORIDA 33126
TELEPHONE: (305) 262 -0400
FAX: (305) 262 -0401
DRAWN BY: A.H.V.
JOHN IBARRA & ASSOC.,INC.
LAND SURVEYORS
SURVEY No. 11- 002645 -1
SHEET No. 2 OF 2
BOUNDARY SURVE
S''nores Vi!Ipr73
t` L� '
B BY
CK -129
D(,P,IPI !ANCE WI
LOT -6
BLOCK -129
H ALL FEDERA
( rll -�L�S f1P D REGUl�4TI0 15
A
10' ASPHALT
PVMT:
25.00'_
F.I.P 1/
NO CAP
0.15' CL
2' CONCRETE
FENCE
° 75.00' I Mimi
LOT : 20
BLOCK -129
F.I.P 1/2"
NO CAP
ON PL.
THE EAST 1/2
LOT -19
BLOCK 129
STEPPING
STONES 10.51'
LOT- 1
BLOC -129
0.20' CL
10.47'
IRON
DOOR
5' C.B.W
0.20' ENCR. (B)
10.55'
F.I.P 1/2"
NO CAP 100.00'
ONC. SWK
..... .•.F;I:P.1.2"
O AP
O CC
O
Lri <
~0
1—
19' ASPHALT
PVMT.
ENCROACHMENT NOT
(A) South side of the u jest
(8) East side of the Sub I {«
(C) North side of the S
..fob
eigitbor' •
ittto the Right o4
fence Encroach
lurching into the
S LIO'EYOR S NO'T'E:
There may he Easements rect lw13 the Public Records not shown on this Survey.
The purr.). of this Survey is ifair use in obtaining Title insurance and Financing and should not be used f
y
.. _ -^-"ter
,
Miami Shores Village
Way of N.W. 97th S
wrtkAFaiihgETasralnet
eet.
Sub e , >�cYperty.
DATE
i`I%I Mi
ey.
ZONING DEPT
' rl
BLDG DEPT
rir,r� r.
.414:4 r `v_is+
SUBJECT (O CCMPL AN E W1 rrl ALL FEDERAL
STATE AND C lJN i'( &LES AND REGULATIONS
11