DS-13-65Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 185751 Permit Number: DS- 1 -13 -65
Scheduled Inspection Date: February 12, 2013
Inspector: Bruhn, Norman
Owner: BISHOP, PATRICIA
Job Address: 89 NE 107 Street
Miami Shores, FL
Project: <NONE>
Contractor: CHAMPION CONCRETE
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1121360070400
Phone: (305)252 -8055
Building Department Comments
REMOVE EXISTING CONCRETE DRIVEWAY AND
INSTALL NEW PAVERS DRIVEWAY OVER EXISTING
LAYOUT
Infractio Passed Comments
INSPECTOR COMMENTS
False
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- 184080. NEED TO REPLACE
SOD ALONG NEW WORK. JR
February 11, 2013
For Inspections please call: (305)762 -4949
Page 26 of 31
Miami Shores Village
Building Department
90050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
c s�i.�� ik or�.s, At t 1 l 3' I C 20
BUILDING Permit No. 13—((f3
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDING
JOB ADDRESS: jq fie 107 1
ROOFING
City: Miami Shores County:
Folio/Parcel #:
Is the Building Historically Designated: Yes
Miami Dade Zip:
NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): .i11/1P�'s. A- 4 % ?/ Phone #:
Address: P 09' 70mA-- 615i-icy. 21 mg (0? ,—
City: / rv'tu1i ,"1-104.144
1t'
Tenant/Lessee Name: Phone #:
State:
Zip: 33 j64
Email:
CONTRACTOR: Company Name:
Address:
, 11.
I DA) g
07
phoneots 75z79055
City: o State: Zip: 33 1 -7 0
Qualifier Name: &mss 6A-5,144Q Phone#:
State Certification or Registration #: Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ 41,00 ," ��Sgquare/Linear Footage of Work: eoe >06/00—
Type of Work: DAddition DAlteration Gli w DRepair/Replace DDemolition
Description of Work: ( JJ
Color thru tile:
*********** ****** *, x**,x***************** Fees* ******,x******* ***** * * * ** x**+x**** * *** ** ** ***
Submittal Fee $ Permit Fee $ CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ (o /,.l'50
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 FT,F,CTRICAL 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 commenceme must be ; %osted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the abt nce of sr h posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
Signature
Owner or Agent Contractor
The for Ding instrume t was • � o ledged before '. thi C The fo = ;Doing instrument w_
day o O 13 by G�� :� day of , , 20 b
who i p nally kn tll a or who has produced w, is ersogn =. ly kn wn to me or who has produced `. T
�tintification and who did take an oath. 1� �► entification and who did take an oath.
NOTARY P c LIC: ' ` OTAR ' UBLIC:
Sign:
Print:
My Commission Expires:
Sign:
Print:
My Commission
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▪ .• !• rj•; My Comm Expires Sep 23, 2015
Commission _
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*********************************+ x> k> i< ******** ************* * *** k******** ******** ****+ x*****>k*********� x+x *a��xx�+x***
APPROVED BY 7 /-,"6-----/3 Plans Examiner /i (iJ Zoning
Structural Review Clerk
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
PERMIT #
CONTRACTOR:
SUBMITTAL DATE:
ADDRESS:
RESUBMITAL DATES:
.RR
STRUCTURAL
ELECTRICAL
PLUMBING
MECHANICAL
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)l7-dl40° hereinafter referred to as the owner of
the following described property (address): gq "lig 107 If
Legal Description PJ -3 Lot ij, Block 149 Subdivision 4tuov W s
Folio# 0"2154- 007- Otolgo�
Requests permission to install (describe work): P A•40
Within the public right of way of (address) Yq Alt 107
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 ,(J day of
SI ', SEALED; AND
in the presence of:
2
CLAUDIA V Ct;11:'.0y
S5 c� V or,da
PJota'v Public - 3, 2015
My C,osr,m. Expires Sep 26810
fission # EE
Commission Assn.
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' Bonded Through National
Bp �
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2013
v a ®S
(Owner's Signature )
STATE OF (FLORIDA)
COUNTY OF (DADE)
Miami Shores Viiiage
Building Department
SURVEY AFFIDAVIT
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
The undersigned Affiant, m- I4 43)-47) , does hereby attest that
(Property owner)
The attached survey, performed by (p #Ey , C4-51eL / 1i/Weih%6 C
(Name of surveyor's company
eq eti 107 . 9 -5/6;
For address:
Performed on 14—-19/ (date of survey) is an accurate representation of the existing conditions and
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 seven (7) years old old. The Affiant, as property owner, further 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 say eth Taught.
Property Owner Signature
jPilliz A,`A )Q /d`d
Property Owner Print Name
SWORN TO AND SUBSCRIBED before me this 1 da o� ; )O
Affiant is personally known to me, produced
Revised on 5/22/2009/ Revised on 6/12/09
as identification.
CLAUDIA V. CUBILLOS
Ndtary Public - State c' Florida
My Comm Expires Sep 23, 2015
Commission # EE 128810
Bonded Through National Notary Assn.
MIamI -Dade My Home
My Home
tiliartildade. ;a.
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Summary Details:
o:::_:
♦- ryr -�a',,
89 NE 107 ST
PATRICIA A BISHOP
89 NE 107 ST MIAMI
SHORES FL
33161 -7029
Pro • Information:
000 SGL FAMILY -
101 -2300 SQ
RESIDENTIAL -
INGLE FAMILY
of $ize ::;:::;.:;: c: ,207.78 SQ FT
ear: Built: ::::.:::r.:: 947
UNNINGS MIAMI
MORES EXTNO3PB
2 -33 LOT 16 BLK 210
OT SIZE 74.860 X 123
R 12192 - 1791 06841
R 12192- 1791 0884 00
Assessment Information:
Exemption Information:
Taxable Value Information:
Aerial Photography - 2012
0 112 ft
1 Pr .9 1 Information I Property Taxes
1 East 1 Property Appraiser
deme 1 Usina Our Site 1 191MAD ethafa. 1 Diseiaimer
If you experience technical difficulties with the Property Infommation application,
or wish to send us your comments, questions or suggestions
please email us at
http://gIslms2.mlamidade.gov/myhome/propmap.asp
Web Site
® 2002 Miami -Dade County.
AU rights reserved.
MI
1/10/13 2:41 PM
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ef Highway
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Page 1 of 2
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Miami Shores Village
BY
DATE
BLDG DEPT
SUBJECTTO COMPLIANCE:NIITH ALL FEDERAL.
STATE D,co
AN;;INT( RULES'AN.D REGULATIONS
asem .?itf.' and! s
prc.
*I, FLORIDA 33.186
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. ) --(415 TAX FOUO NO.
STATE OF FLORIDA:
COUNTY OF MIAMI-DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice-of Commencement.
1111111 11111 11111 11111 11111 11111 11111 1111 1111
CFN 2013R0083162
OR Bk 28468 is 4500; (1s)
RECORDED 01/31/2013 12:57:46
HARVEY RUVIN? CLERK OF COURT
MIAMI-DADE COUNTYr FLORIDA
LAST PAGE
Space above reserved for use of recording office
1. Legal description of property amistreet/address:
a'zi A., 6r. 10-1-1)0#03 ofg-7-3— it, (
2. Description of improvement: ...9441y,utly p44,04.00)
3. Ovoner(s) narne and address: )0 i-Tivia fS)6)-tA
Interest in property: ti &he- bt,91 8V '144 444 d5114 itotfN ye, 3 /
Name and address of fee simple titleholder:
4. Contractor's name, address and phone number: €41-Aitg, („sAieN.pft-e_
Of /4„/ "5— 5. Surety Surety: (Payment bond required by owner from contractor, if any)
Name, address and phone number:
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)7., Florida Statutes,
Name, address and phone number.
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provided in Section
713.13(1)(b), Florida Statutes.
Name, address and phone number:
9. Expiration date of this Notice of Commencement:
(the expiration date is I year from the date of recording unless a different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR P
IMPROVEMENTS TO YOUR PROPERTY A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JO
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE C
OR RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF FLORIDA, COUNTY
Signature(s.) of Owner(s) Owner(s)' Authorized Officer/Director/Partner/ManagehHEREBY CERTIFY that This is a true
Title/Office i ina• filed in this office o
Prepared y
Print Name
STATE OF FLORIDA
COUNTY OF MI-DADE
The foregoj, menwas
By
CI Individually, or as
Ul Personally known, or CJ produced the following type of identification:
before me this
eniremurauttre
Prepared By
Print Name
Title/Office WITNESS my an
4 RVEY RU
for
day of
Signature of Notary Public:
Print Name:
(SEAL)
L ii_ 1. .31• • _; ....). T • E TI • •R 13. .T Li
Under penalties of perjury, I declare that I have read the foregoing and
that the facts stated in it are true, to the best of my knowledge and belie
Signatur (s) of Owner(s) or ec(sys Authorized Officer/Director/Partner
ll
By
1.
12362 PAGIMill/0 5ktio
a
Aare
E CONSIDERED
NG TWICE FOR
ITE BEFORE THE
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12/11Mag
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CLAUDIA V. CUBILLOS
,..,,"„ -,k-• '-I. Notary Public - State of Florida
i.. A..\''''‘, •1*. My Comm Expires Sep 23, 2015
Commission # EE 128810
an er ' red Through National Notary Assn.
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