DS-15-3101 _ .,:
Miami Shores Village
10050 N.E.2nd Avenue NE ' ) :
��• Miami Shores,FL 33138-0000
Phone: (305)795-2204 '
y Expiration:06/19/2016
Project Address Parcel Number Applicant
440 NE 91 Street 1132060190050
DAVID TRAUPMAN
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
DAVID TRAUPMAN 440 NE 91 Street
MIAMI SHORES FL 33138-3151
Contractor(s) Phone Cell Phone Valuation: $ 2,450.00
CHAMPION CONCRETE (305)252-8055 (786)402-4802
.,. Total Sq Feet: 500
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied: Foundation
Type of Work:STAMPED CONCRETE APPROACH. Additional Info: Review Planning
Bond Retum: Classification:Residential Review Building
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.80 Invoice# DS-12-15-58056
DBPR Fee $2.00 12/22/2015 Check#:2082 $117.80 $0.00
DCA Fee $2.00
Education Surcharge $0.60
Permit Fee $100.00
Scanning Fee $9.00
Technology Fee $2.40
Total: $117.80
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either mVgelf, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOOR ,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information i ccur a and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-named tra r to do the work stated.
December 22, 2015
Authorized Signature:Owner / Applicant / Ccffitractor / Agent Date
Building Department Copy
December 22,2015 1
�F r
Miami Shores Village -- ,
D
Building Department �_ e
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 J
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
5
FBc 20 iLl(°� —
BUILDING Master Permit NorbC(G `-5` y,
PERMIT APPLICATION Sub Permit No.
Ef r6UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL
F-1 PLUMBING MECHANICAL PUBLIC WORKS CHANGE OF 0CANCELLATION EISHOP
� /�` �/ CONTRACTOR DRAWINGS
JOB ADDRESS: it D ' / 6` ��
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
t J"
OWNER:Name(Fee Simple Titlehold;�5� Y� Z Phone#:
Address: 7 ��� /_
City: d State: Zip: -73 3
Tenant/Lessee Name: Phone#:
Email: / p� y�
CONTRACTOR:Company Name: G ""' � '� Phone#:2Q5 M4,0
Address: UAW
City: Stater' Zip: 33l
i
Qualifier Name: *n-e - Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: ,, tt City: State: Zip:
Value of Work for this Permit:$ ,`T •� Square/Linear Footage of Work: SM .
Type of Work: ❑ Addition %a Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: G 1 A -. o
M C&C `�C�lT) a •
Specify color of color thru tile: p //��-�W
Submittal Fee$ Permit Fee$ 1 - CA3 CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS,HEATERS,TANKS,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 tiered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement mus be osted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. in the absence s ch posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature �.�-• �! Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
_ day of �G20 by day of G 20 .by
pbrJ ii 1 A6,ft ,wh s per�known 61r wh ' personally know o
me or who has produced.__ _ as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY P C. N NOTARY P
Sign: Sign
:77
Print: Print
•„� JE
"It*;
V P ♦ t 9'
Seal: i°�»A U•��� Notary Public-State of Florida Seal: r. Y P«`�'; Notary PubiESlic-State of Florida
•: ;Q My Comm.Expires Sep 23.2016 :•: + ,_
'Q My Comm.Expires Sep 23,2016
Commission#EE 837922 =;�,, °p?. Commission#EE 837922
rnnnunn
#ddd6 N8#6kk#♦#+k k8 i • iii#• k9kAk9eik60r89dkbb#N RBW&9MbRkf# i d !# dRilk6d#8A9R6WWk•d
r
APPROVED BY ( Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
0
(w a) oo SL
` PSE cJ r-jtr
`n
� a r C
nL11I (� CIO o�/G W F-
�- all Z' p Q
ov � LL
LL 81
� J W
Q CC
C-'�((57 1 A)6 k L) LLJ
tL a
aC)
F- C
0
ai > a Q C c
LLJ
CC Z /� C.) Q
�n gv•°71 U Try O�•
13- Z V L L
_ sr 5o tit d ,:o01! ?oG� a o
m n v
r a t7
kJO
IEdI�
co 'SL
L
7*1
• r �
\ CU
Sam
- s7�►�-eJ G�w � Ste}-���
oL -,.► el d36 13ASlilt
LIM
1-.
-a
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) .J "Se. wAhereinafter referred to as the owner of
the following described property(address)._ kLfD A 4L 5 j'
A 1 R
Legal Description Lot Block Subdivision
Folio#
Requests permission to install(deserbe work): 57,At P
A JA-Od&
Within the public right of way of(address) q t gf'F
NA$0,044 -73 i3
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
4 `
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 items)
to be removed and a lien being placed on the property and/or assessed against the Owt*r.tpr 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 ay of i P 2011
(Owner's Sig ure)
S D D ' ELI R a presence of:
oS a
C� btitc Seo �0
,, ,,,., No�aYp� ��pe#ti�12oaYPssa
soSl �o 80
2
e
Miamihores Village
even Bons" Building Department
10050 N.E.2nd Avenue
170�M P%* Miami Shores, Florida 33138
�OR> Tel: (305) 795.2204
Fax: (305) 756.8972
SURVEY AFFIDAVIT
STATE OF(FLORIDA)
COUNTY OF(DADE)
The undersigned AffiantJ'� g�- t- S. ,does hereby attest that
(Property owner)
The attached survey,performed by 4Q OYW& °off 5
(Name of surveyor's company)
For address: L4k0 UE' 'qt 5r gt-A" 5tl 1
Performed on (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 ins tions as applicable to this or other permits.
urthe , ffiant a a e -7
"/421—
Property Owner Signature Property Owner Print Name
qr
SWORN TO A3k0 CR QED me this l� day of
Affiant is ersonally known to me, produced iaa identification.
a
knotelloo
BtLLOSU
C501A V r '
Notary Publl� State of 3,2i a
Notary
='�.` fires Sep 23.2015
Revised on 5/22/2009/Revised on 6/12109 :•��.:My co" Exp
' Commission#EE 126810
Bonded Through Natrona)Notary Assn.