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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 _ ._____.v'vd of srm sra eA rSR• B4/ A7G• �m9faaB ./.44 ' .%ar .vva'nam ra., p..I.rpv 9y. ilI Oo Ye p,�4" _ Q I ] I 'a , .IP , " , PI , PY d. a 8 ] 6 s,..a s 8 as ra rs ra r] Pa as d�iP/ pP s .Q n N.W. //aKJr • N.W %ri9•.3'T. _L. � .�._.. �._ nor faffiripaa N / a p../ el4J PN% i9Y 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. 7l b•d%B I/a � ♦ p $p/p a B1 � 7 B 0• Q l \ P / �+ ], �/IG Ia 19 gv 8/ PT � P9 P4 8S PB � 87 Pa 9a pI py �'�.. , � a e a. fi � • . s • N.W %ri9•.3'T. _L. � .�._.. �._ nor faffiripaa N / a p../ el4J PN% i9Y 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.