DS-13-275 ,P
/\ Miami Shores Village
s\� Buildin g Department artment FEB 0 8
_ 2 13
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax: (305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 20 0
BUILDING Permit No.
PERMIT APPLICATION Master Permit No. -- �
Permit Type: BUILDING ROOFING
JOB ADDRESS: 11 0 2 I,,& 1U J 5r
City: Miami Shores County: Miami Dade Zip: ??a
Folio/Parcel#:
Is the Building Historically Designated:Yes NO >/— Flood Zone:
OWNER:Name(Fee Simple Titleholder): S\-%p U QeA-D 01 U 5 Phone#: M74
Address:_ S�t K- 103
City: ,A/\.k uy-x i ��o1 U��J State: Z?
Tenant/Lessee Name: - Phone#:
Email: ?�
CONTRACTOR: Company Name: '3RkAaC o "�P- 5 i!�vi 7DAIC Phone#: 9'J
Address: 5-E I 1-v !W .ff
City: 0"\. S 110-fe N State: V-L� Zip: 2;, 2 t?1
Qualifier Name: f!�ba-5'rt6A 1C7 CACICA. Phone#: C
State Certification or Registration#: C� QIs- ® Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: L- Phone#:
Value of Work for this Permit:$ a,PCO Square/Linear Footage of Work:
Type of Work: ❑Addition ❑Alteration ❑New ❑Repair/Replace ❑Demolition
Description of Work: C.0 Steiner aNQLjuC1 a A -to 14o uw-
�t�o
Color thru tile:
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$
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 P 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 ' wance of a building permit with an estimated value exceeding$2500, the applicant must
promise in good faith that a copy o ce of commencement and construction lien law brochure will be delivered to the person
whose property is subject to a m t. lso, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspectio a oc s even (7) days after the building permit is issued. In the absence of such posted notice, the
inspection wi a e will be charged.
Si tore Signature
Owner Agent Contractor
The foregoing instrument was acknowledged before me this ® The foregoing instrument was acknowledged before me this
day of ,2010,by day of 120_,by ,
who is personally known to me or who has produced— who is personally known to me or who has produced
As identificatio and w4,,4 take an o as identification and who did take an oath.
NOTARY PUBLIC: �ti'a�s� o 'qi�' NOTARY PUBLIC:
Sign:
r
`e
Print:
My Commission Expires: °0ii����1111e1�tik%��� My Commission Expires:
APPROVED BY �� �i�� Plans Examiner 3 zoning
Structural Review Clerk
(Revised 5/2/2012)(Revised 3/12/2012))(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007)
Sty C.
IN
RUN no Miami shores Village
Building Department
oR�pp► 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RECEIPT
PERMIT#: ®S`�°' `� DATE:
,5 Contractor
,9-Uw, er
❑Architect
Picked up 2 sets of plans and (other)
Address: k-42 NiE- (p3 -)K' -3 °
From the building department on this date in order to have corrections done to plans
And/or get County stamps. I understand that t ns need to be brought back to Miami
Shores Village Buildi epar o ue q process.
Acknowledged by:
PERMIT CLERK INITIAL:
RESUBMITTED DATE:
PERMIT CLERK INITIAL:
OR Rk 28584 Ps 1183; (I p s.t
RECORDED 04/16/2013 12:57,12
NOTICE OF COMMENCEMENT HARVEY RUVINY CLERK OF COURT
MIAMI-DADE COUNTYP FLORIDA
A RECORDED COPY MUST BE POSTED ON THE JQO' SITE AY TIMt~OF�R.ST.�ISPECTIOAI LAST
PERMIT NO TA)C FOLIO N'O. "
STATE OF FLORIDA
COUNTY OF MIAMI-DARE:
THE UNDERSIGNED hereby gives na#ice that Improverpents will be made to certain real
property,and In acoordonce wit(i Chopter''713,Florida Statutes,the following.information
Is provided in this Notice of Commencement.
Space*ove reserved for use of recording office
1.Legal description of property and street/address:
2.Description of improvement: �-wtu `pv vtL- , 29MrAw
3.Owtier(s)name and addre9 r Qro� +KoQe® Lc S
Interest In property:
Name and address of fee simple tltlelioldet
4.Contractor's name,address and phone number t,,V ��� y^ ,c q. T- ,G lzvyet` Co-'smo .
5 Surety:,(Payment bond required by owner from contractor,if any)
Name,address and phone number.__ ,
Amount of bond
S.Lender's name and address:. h s
7. Persons within the State of Florida designated by Owner upon whom notices or other documents maybe served as provided by
Section T'13,13(1)(a)7„Florida Statutes,
Name,ad)iress and phone.number -
8.In addition to himself,Owners designates.the following person(s)to receive a copy of the Lienor's Notice as provided In Section
713.1'3(1)(6),Florida Statutes.
Name,address and phone number..
9.Expiration date of this Notice of Commencement
(the expiration daC y tRe date of recording unless a different bate is spec3fto
WARNING TA OWNER.ANY PAYMENTS MADE BY THE OWNER;AFTER THE tXPIRMIOLN OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS URbER'CHAPTER 713, PART 1,SECTION 71313:FLORIDA"STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY.-A NOTICE OF commtNCEM NT 7 E JOB-WE BEF
FIRST INSPECTION,IF YOU INTEND TO OBTAIN,FINANCING,CONSULT 1 1 RE COMMEN
OR RECORDING NOTI C NCEMENT: IIEJREBY CERT FY that thsA is a tPUe copynt the ' O� cteltrNlrC%
Signature(s)of e ,r,�V tired in .s ottrce of u .
rued Offlcer/pirector/Partne onager
PreparQd"13y.. :: , AD,20
Pre
Print Names Print my an PC Ulflc+fal ea, <�
Tltle/Offlce 'r•�Q a7c era . Title/ .. r anO`�
STATE OF FLORIDA 1y` tm'
COUNTY OF M 1-DARE. t
The rag i t e t w fore rrle this day of
By
❑In d ally,or as for a
Q Personally known,or produce<I.th®following type of identificati
Signal ire of.Notary Public: Ill
Print Name:
f
R U p„•,p,, ., L CU6llLOS
�'�: Notary Pubfic State of Florida
Under penaities of perjury,l declarer that I have read the foregoing and s My Comm.Expires Sep 23,2015
that the facts stated in it are true,to the best of my knowledge and belief. %'9, P°' Commission#EE 1288M10
1. 0`f '8ondedThrUgh National Notary Assn.
Signature(s)of Owner(s)or Owner(s)'s Authorized Officer/Director/partner/Manager wh
By By
123.01-82 PAWS alto
a
BOUNDARY SURVEY
FProperty Address:
1172 NE 103RD. STREET, MIAMI SHORES, FLORIDA 33138
LEGAL DESCRIPTION:
Lot 4, LESS the West 20 feet thereof, Block 175, of "REVISED PLAT OF MIAMI SHORES,
SECTION 8" according to the plat thereof as recorded in Plat Book 43 at Page 67 of the Public
Records of Miami-Dade County, Florida.
SURVEYOR'S NOTES:
1) The above captioned Property was surveyed and described based on the above Legal
Description: Provided by Client.
2) This Certification is only for the lands as described. It is not a certification of Title, Zoning,
Easements, or Freedom of Encumbrances. ABSTRACT NOT REVIEWED.
3) There may be additional Restrictions not shown on this survey that may be found in the Public
Records of this County, Examination of ABSTRACT OF TITLE will have to be made to determine
recorded instruments, if any affecting this property.
4) Accuracy:
The expected use of the land, as classified in the Minimum Technical Standards (5J-17 FAC), is
"Residential High Risk". The minimum relative distance accuracy for this type of boundary survey
is 1 foot in 10,000 feet. The accuracy obtained by measurement and calculation of a closed
geometric figure was found to exceed this requirement.
5) Foundations and/or footings that may cross beyond the boundary lines of the parcel herein
described are not shown hereon.
6) Not valid without the signature and the original raised seal of a Florida Licensed Surveyor and
Mapper. Additions or deletions to survey maps or reports by other than the signing pa rtY or
parties are prohibited without written consent of the signing party or parties.
7) Contact the appropriate authority prior to any design work on the herein-described parcel for
Building and Zoning information.
8) Underground utilities are not depicted hereon, contact the appropriate authority prior to any
design work or construction on the property herein described. Surveyor shall be notified as to any
deviation from utilities shown hereon.
9) The surveyor does not determine fence and/or wall ownership.
10) Ownership subjects to OPINION OF TITLE.
11) Type of Survey: BOUNDARY SURVEY.
12) North arrow direction and bearings are based on Recorded Plat Book 43 at Page 67 of the Public
Records of Dade County, Florida.
13) Elevations are based on the National Geodetic Vertical Datum of 1929.
14) Bench Mark Used: Miami-Dade County Benchmark#B-26-RA. Elevation = +17.24'
15) Flood Zone: "X" Base Flood Elev.: N/A as per Dade County, Florida. FEMA Panel Number:
120652-0306-L-SEPTEMBER 11, 2009
16) 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:
A.) ROSA LOUIS
B.)
SURVEYORS CERTIFICATE.
I Hereby Certify to the best of my knowledge and belief that this drawing is a true and
correct representation of the BOUNDARY SURVEY of the real property described hereon.
I further certify that this survey was prepared in accordance with the applicable provisions
of Chapter 5J-17, Florida Administrative Code.
Field Date: January 22, 2013
#00—
Job# RP-13-046 Pablo J. Alfonso P.S.M.
Professional Surveyor & Mapper
State of Florida Reg. No.5880
Y IPA Tw
L ^ 14 D SURVEYORS , INC .
6175 NW 153`d STREET, SUITE 321 , MIAMI LAKES, FLORIDA 33014
Phone: 305-822-6062 " Fax: 305-827-9669
Page 1 of 2
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LEGEND
Overhead Wire Line =Existing Elevations F.N. =Found Nail Conc. -Concrete R=Radius
LANG auRVEYORa, INS. —n—n—Wood Fence la=Catch Basin F.LR. =Found Iron Rebar U.E. =Utility Easement A=Arc
—■—■—Chain Link Fence ®=Water Meter F.I.P. =Found Iron Pipe/Pin D.E.=Drainage Easement A=Delta
PHONE: 305-822-6062 * FAX: 305-827-9669 o Iron Fence -cl,=Power Pole F.N&D=Found Nall&Disc D.M.E.=Drainage Maintenance T=Tangent
6175 NW 153rd STREET SUITE 321 4 --—Monument Line SIP/R=Set Iron Pin/Rebar Easement
MIAMI LAKES, FL 33014 -—Centerline A/C—Air Conditioner page 2 of 2