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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.