DS-14-330Miami 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
BUILDING
PERMIT APPLICATION
FEB 11'20#
FEC 20
Permit No.
Master Permit Nov
Permit Type: BUILDING ROOFING
JOB ADDRESS: 13) N - W - i 10 S},
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): 4% L4AC,kN 3 t�orne Tr% Verfnn►i 30 t $'r'sS-371
Address:_ mil SCS W • L OJ"'' 6w e -
City:" ; a 1 f -A t% State: Zip: 37 6 14
Tenant/I.essee Name:
Email:
CONTRACTOR: Company Name:�h ' n�+� r' 1 'r1 g �✓► k . Phone#: a-OS —Zl 9 ` PZ6
Address: �(� W• L O tr^ aty -1=
city: A t at -e din State: F(- zip: 3T6 16
Qualifier Name: �ciU�•GL \tNQ lL®�, Phone#: .3o S Z1 9-fZ(,'7
State Certification or Registration #:
812-7
Certificate of Competency #:
Contact Phone#: Email Address:�4�r
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ 25CQ- r Square/Linear Footage of Work:
Type of Work: ❑Addition DAlteration M ew ORepair/Replace ODemolition
Description of Work: ��M o v Q old S t q%
12 n e.vJ PA%it r d-r-i'VC- wotv4 1 O)eS`D
w (yJal t�wa�
Color thru tile:
Submittal Fee
Scanning Fee $
Permit 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
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 approved and a reinspection fee will be charged.
Signature ...��i Signature
Owner or Agent Contract r
The foregoing instrument was acknowledged before me this _� The foregoing instrument was acknowledged,bf fore me this
day of _-, 20 jq, by [Zi C.Aard 14GN �L, day of ZD 201, by G� b- iLe
who is rsonall o me or who has produced who is sonally kno to me or who has produced
As identification and who did take an oath. as i ntification and who did take an oath.
NOTARY PUBLIC:
Sign
My ComUps; SANDY ROMERO
• �.;. , Notary Public - State of Florida
;r,+ • Q
My Comm. Expires Jul 26, 2015
pFf���:��
,
Commission # EE 116040
SANDY ROMERO
r .
APPROVED BY
° Plans Examiner
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
NOTARY PUBLIC:
Sign: C
Print:.�-
P -
My Commi .�
SANDY ROMERO
r .
Notary Public - State of Florida
My Comm. Expires Jul 26, 2015
Commission # EE 11604n
Zoning
Clerk
Miami Shores Village
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) 2, t., ti otr t� LG' -0>2 hereinafter referred to as the owner of
the following described property (address): 13 i N W it 0 r-+ -
M
k -
M ►'arn i shone. s
Legal Description M;4Wi ih#ye S Lot 2.7- Block Z Z O Subdivision
P)r+• PB +#3-qo
Folio # 1 '213 Oo3 e 6 go
Requests permission to install (describe work): OL P6LV-&r �r J`ZW GlH # b x Sb
w I wa L k You fron t dvc�-rz,
Within the public right of way of (address) I.3 1 tJ • vv , i 110!;4-
-}h.�. ero �er-�� h�S e+ciS•�r��Slc�e.wa(I'rC. ��rvl& g �..
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.
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 2 day of l , 201
(Owner's Signature)
SIMD, SEALED, A�q"ELIVERED in the presence of:
SANDY ROMERO
Notary Public - State of Florida
My Comm. Expires Jul 26, 2015
Commission # EE 116040
N
0
`-` 9' Asphalt 15' ALLEY
FND.I.P.I 7'
(NO ID) Bf OkW, 75.00' (NO ID1
90 ��o O_
0.2 0, Osn g9
L 10.CL
O
SCALE 1°-20'
Conc. �' A/CC-
0
e,� a" 17.26 14.60 ; 6. . 011c;
ONE:ST $ Lot 23
leBlLot ock 1 Chimne N RES/DEN 1 I A Block 220
,. 0.70' 10'
7 . L
17.30' c N
N C
13.40'r
5.40'
NO REVIEW REQUIRED
¢�} I Florida Heafth Miami -Dade County
O.S.T.D.S & Weli o ram
Q w�
Application No.:
cDate:
N j' Signature
90q, V
404.68'
C.
+o FND P.1 75.00' 5' Conc.Walk
IN01
I've c-*- 6.0 17.70'
-ete C 4' Parkway a
Cl)�'I N
o z
16' Asphalt
75.00' Total RiV11 z
69 N.W. 110th STREETw ' o
LEGEND: L W o W ~ .e
U,
i
A ARC OUL OVERHEAR UTILITY LINESFD FOUND ® C,n t Co R
BM BENCH MARK EL ELEVATION FH FIRE HYDRANTIVF CEJ 7
CB CATH BASIN EM ELECTRIC METER (M) MEASURED LUI
CBS CONCRETE BLOCKSTUCTURE MHE ELECTRIC MANHOLE POB POINT OF BEGINNING
CH CHORD ET ELECTRIC TRANSFORMER GM GAS METER N NAIL
CENTER LINE ENC. ENCROACHMENT FN FOUND NAIL 0/8 OFFSET
ML MONUMENT LME SIP SET IRON PIPE PC POINT OF CURVATURE T TANGENT
CONC. CONCRETE FIP FOUND IRON PIPE PT POINT OF TANGANT CH.SR, CHORD BEARING
CL CLEARANCE FIR FOUND IRON ROD PRC PONT OF REVERSE CURVATURE DME DRAINAGE MAINTENANCE EASEMENT
N&D NAIL AND DISK CLF CHAIN LINK FENCE PCC POINT OF COMPOUND CURVATURE LME LAKE MAINTENANCE EASEMENT
F.F.ELEV. FINISH FLOOR ELEVATION TYP TYPICAL POC POINT OF COMMENCEMENT CME CANAL MAINTENANCE EASEMENT
CENTER ANGLE R RADIUS SIR SET IRON ROD
DH DRILLHOLE UE UTILITY EASEMENT
MH MANHOLE RES RESIDENCE
ONLY EASEMENTS, RIGHT OF WAYS, ETC READILY KNOWN ARE SHOWN. NO RESEARCH OTHERWISE HAS BEEN MADE
SCALE: I"— ( DRAWN BY: PBi&L'o
DATED: REVISIONS: JOB NO.
?� �Z- ! l
BOUNDARY SURVEY URVEY E M__C_ :
I hereby certify that this survey meets the minimum technical Standards
as set forth by the Florida Board of Surveyors and Mappers in Chapter 61017-5
Florida Administrative Code, pars am to section 472.027, Florida Statutes. And is
True and correct to the best of my knowledge and belief The survey depicted here
X --"T13 r ]� ]� f ]� � 1C j� S U� (� Is not covered by Professional Liability Issuance.
j 1Y 1 Y L L;� [1 a NOT VALID WITHOUT THE SIGNATURE AND ORIGINAL RAISED
LAND SURVEYING, INC. SEAL OF A FLORIDA LICENED SURVEYOR AND MAPPER
LB # 7495
Office: 954)817-4440 ---� ALD T.
E-mail: Xtrememeasures 13'ci•hotmail.cam
PROFESSI AL SU�M06i NDMAPPER N0.5851
STATE OF
X-TRE1VIE MEASURES
LAND SURVEYING, INC.
LB # 7495
Office: 954)817-0440
E-mail: xtrememeasures 13(whotmail.com
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LEGAL DESCRIPTION:
Lot 22, Block 220, "MIAMI SHORES EXTENSION" Q
According to the Plat thereof as recorded in Plat Book 43, at
Page 40, of the Public Records of Miami -Dade County, Fl`' Lida. }'
PROPERTY AU�1�ESS:
131 NW 110th Street, Miami Shores, Florida 33168
CERTI_ FIED TO: g
Lucky 13 Home Investments
FLOOD ZONE INFO:
Community # 120652
Panel & Suffix: 0139 L
Flood Zone: X
Base Elevation: N/A
Date of Firm: 9-11-09
SURVEYOR'S NOTES:
1) The above captioned Property Update was surveyed and described
based on the above Legal Description: Provided by Client.
2) All bearings and distances shown hereon are recorded and
,measured unless otherwise shown.
3) The lands shown hereon were not abstracted for easements or
other recorded encumbrances not shown on the plat and the
same, if any may not be shown on this section.
4) Foundations and/or footings that may crass beyond the
boundary lines of the parcel herein described are not shown
(underground).
S) Fence ties are to be the center line of the fence.
6) Wall ties are to face of wall.
7) Ownership subject to opinion of the Ties.
8) Underground utilities are not depicted hereon.
9) Zoning and Setbacks are not by this survey.
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LEGAL DESCRIPTION:
Lot 22, Block 220, "MIAMI SHORES EXTENSION" Q
According to the Plat thereof as recorded in Plat Book 43, at
Page 40, of the Public Records of Miami -Dade County, Fl`' Lida. }'
PROPERTY AU�1�ESS:
131 NW 110th Street, Miami Shores, Florida 33168
CERTI_ FIED TO: g
Lucky 13 Home Investments
FLOOD ZONE INFO:
Community # 120652
Panel & Suffix: 0139 L
Flood Zone: X
Base Elevation: N/A
Date of Firm: 9-11-09
SURVEYOR'S NOTES:
1) The above captioned Property Update was surveyed and described
based on the above Legal Description: Provided by Client.
2) All bearings and distances shown hereon are recorded and
,measured unless otherwise shown.
3) The lands shown hereon were not abstracted for easements or
other recorded encumbrances not shown on the plat and the
same, if any may not be shown on this section.
4) Foundations and/or footings that may crass beyond the
boundary lines of the parcel herein described are not shown
(underground).
S) Fence ties are to be the center line of the fence.
6) Wall ties are to face of wall.
7) Ownership subject to opinion of the Ties.
8) Underground utilities are not depicted hereon.
9) Zoning and Setbacks are not by this survey.