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DS-13-1016Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 191178 Permit Number: DS -5 -13 -1016 Scheduled Inspection Date: June 06, 2013 Permit Type: Driveways /Sidewalks/Slabs Inspector.'3AC \����� moo e_ Inspection Type: Final Work Classification: New Owner: RINEY, IRENE Job Address: 157 NE 101 Street Miami Shores, FL Project: <NONE> Contractor: CHAMPION CONCRETE Phone Number Parcel Number 1132060131951 Phone: (305)252 -8055 Building Department Comments CONCRETE DRIVEWAY ON APPROACH Infractio Passed Comments INSPECTOR COMMENTS False Passed To( Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments June 06, 2013 For Inspections please call: (305)762 -4949 Page 15 of 38 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 BUILDING PERMIT APPLICATION Permit Type: BUILDING JOB ADDRESS: 167 IN [ 0 l City: Miami Shores County: Folio/Parcel #: 1A a 3 2 06 ®CP/ 3 m qq/ Is the Building Historically Designated: Yes OWNER: Name (Fee Simple Titleholder): Address: 1 ' OO / ct A City: t iD5 Permit No. RECEIVED MAY 2013 Master Permit No. ROOFING Miami Dade Zip: 3? !3 NO Flood Zone: lit* o-t7 Phone#: d State: Zip: 3 3a 37f Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: C. 4I NAJ (°.-0 AnYir ZrZ J'o$ Address: 11.00 f!* g \/ / City: ® State: °®- Zip: Qualifier Name: ems" ' 'MAO Phone,#: State Certification or Registration #: Certificate of Competency #: O.5 eO ?S Contact Phone#: 7�b° 4 Email Address: - o Nth <4 DESIGNER: Architect/Engineer: Phone #: Value of Woik for this Permit: $ S Type of Work: DAddition DAlteration Description of Work: f � J A vs�aa., q 14 footage oia° k) .t. HMO mae& fioimlli'sS j Color thru tile: Submittal Fee $ Permit Fee $ % 0 c1'+ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF$ CO /CC$ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 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, WFT,T,S, 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 $2500, promise in good faith that a copy of the notice of commencement and construction lien law brochure will be de whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be for the first inspection which occurs seven (7) days after the building permit is issued. In the abs e of s inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this "% The fo go strument ackn wledged before day of 1`kR � , 20 a, by Sc &At *O1 'R•.n4.1 , day of , 201 , b} 0 � who is personally known to me or who has produced PAM/ who is LA C.• As identification and who did take an oath. NOTARY PUBLIC: Signature Imo' >I Iw_. 6 ,Contractor applicant must d to the person ed at the job site posted notice, the Print: % 4 me or who has produced as identification and who did take an oath. UBLIC: i Sign: _ 14A►.1A1!11.. r Print:- Notary Pub is 23.2015 Expires Sep ;v Commission # E Assn. My Commissio oa h National Notary e,F OF F�,,° Bonded Throug Mar 3, 2017 My Commission Expires: Mtrcti, 3, 20! ? NOTARY * * * * * * * * * * * * * * * * * * * * * * * * * ** *,> ******* * * * * * ** * * * * * * * * * * * * * ** ** * *** * ** * * ** * * ** * **** * * * * * * * * **> * * * * * * * * ** APPROVED BY Plans Examines (() 7( //" Zoning Structural Review Clerk (Revised 3 /1212012)(Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09) Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) -I/ %)e '24 Ai hereinafter referred to as the owner of the following described property (address): 157 /000 /01 �r - 4441- kt-im, ff- 3 3 i?-1 Legal Description _ Lot Z2, 23 Block Al Subdivision M ,5b70.5 7u-, Folio # Requests permission to install (describe work): Comm c$ tare- 41/W -e l) ° / Within the public right of way of (address) /5.7 Ad17 . ° r`$ hi-Amt t-ci� 0 I to ,E NM toga eWIIO3 401 VIS 31 • ReieatmoWl a1P"sr°- IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows: 1. To maintain and repair, when necessary, the above - mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 1 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this i day of &Abby , 2013 SIGNED, S ED ND DELIVERED in the presence of: 12450 May 7, z1 �3 ESP• 2 (Owner's SignattTle ) -; or s-r _I®t TRUST AGREEMENT ' THIS TRUST AGREEMENT made this Jr- day of May, 1987, by and between CHARLES KERTES FOX (FUCHS), hereinafter called the Settlor, and CHARLES KERTES FOX (FUCHS) and IRENE F. RINEY, hereinafter called the Trustees. If IRENE F._RINEY should predecease the Settlor, or be unable to act as Co- Trustee due to legal incapacity, then her Husband, L.B. RINEY, JR., shall serve as substitute Co- Trustee. If he also should predecease the Settlor or be unable to act due to legal incapacity, then their daughter, CATHERINE RINEY, shall serve as second substitute Co- Trustee. SECTION I:. TRUST ASSETS That the Settlor has delivered to the Trustees certain assets listed on Schedule A attached hereto, the receipt of which is hereby acknowledged. The Trustees agree to hold such assets subject to the following terms and conditions. The Settlor confirms and alleges that the assets which are being funded into this Trust are the assets of the Settlor. SECTION II: ADDITIONS TO TRUST The Settlor or any other person may, at any time and from time to time, designate the Trustees as ,.„beneficiaries of life insurance policies and deliver to ;the Trustees a other assets acceptable to them, all of which ,shall be held under the terms of this Agreement. Such additions, whet4her made by deed, assignment, bequest or deviseL maybe allotted pE....51?>- 116 COrilt\I e CONTRACTORC,hM 1C) SUBMITTAL DATE:. -0C\ ;C) ADDRESS: I S-1 13 E \C\ NAMEal , �&f\ e 1 RESUBMITAL DATES: PROJECT TYPE: •STRUCTURAL FIRE IMPACT FEES ELECTRICAL HRSIDERM PLUMBING NOC MECHANICAL BLDG '46 6 foregoing instrument as Settlor, this day personally appeared before me and acknowledged that he executed the foregoing instrument freely and voluntarily for the uses and purposes therein expressed. IN WITNESS WHEREOF, I have hereunto set my hand and seal on this S.,..444 day of May, 1987. „ My mission Expi '-- BemdGd thru .Mavrtard Bonding. AGnc My commission expires: STATE OF FLORIDA ) SS COUNTY OF DADE ) , I HEREBY CERTIFY that CHARLES KERTES FOX (FUCHS) and IRENE F. RINEY, to me known to be the samepersons whose name is subscribed to the foregoing instrument as Trustees, this day personally appeared before me and acknowledged that they executed the foregoing instrument freely and voluntarily for the uses and purposes therein expressed. IN WITNESS WHEREOF,, I have hereunto on My commision expires: PIAV, Stste c ilnrci,ci leT Commiss:at June UOded ri Mid Corking FIP 1/2" 9.84' • PERMIT #7.• • ;•:,• • • - • ES tcER Miami Shores Village SUBJECT TO COMPLIANCE WITH ALL FEDERAL -10\ STATE AND COJNef /DLES AND ULATIONS 25.16' 45.00' perky Address: 157 NE 101 S Miami Shores Community number: 120652 Village of Miami Shores Panel: 12086 C 0302 to Suffix: L Date: 09-11-2009 Date Revised: 09-11-2009 Date of field work: 05-01-2013 Completion date: 05-01-2013 z Flood zone: X Base flood elevation:N/A Diagram: 8A Finished floor elevation:13.03' Lowest acliacent grade:10.73' Highest adjacent grade:10.96' Crown of road:10.62' Garage:11.11' HP 1/2" Latitude: 25°52'05" N Longitude: 80°11'40" W C SCALE 20 NE 101 th STRE otal Right of Way = FEET 1 itih = 20 ft. SurVey.mun dW 1510h i MEV tirinf'Y NAT YOS 00410A21 SURVEY METS 1141 SI,ANDAFtbS...AS BET FORTit 'mg FLORIDA BOARD 07,PRC BiRS'YORS AND MAFPERON WAVIER 8,1147/01DAVADk PURSUANT To:stcroN 474:027.ektOtoiket,*. 'ts:Girt 010414. G11.81411Y t GAV REGISTERED SURVEY STATE ...DATE: