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DS-16-1277 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone:(305)795.2204 Fax:(305)7568972 Inspection Number: INSP-258681 Permit Number. DS-5-16-1277 Scheduled Inspection Date.July 20,2016 Permit Type: Drlveways/Sidewalks/Slabs Inspector: Mesa,Michel Inspection Type: Final Owner. GOLDSMITH,PETER Work Classification: New Job Address:141 NW 96 Street Miami Shores,FL 33150- Phone Number Parcel Number 1131010250110 Project: <NONE> Contractor. ARTISTIC CONCRETE GROUP INC Phone:(305)888-95 Building Department Comments REMOVE AND REPLACE EXISTING DRIVEWAY AND Infractio ad Comments APPROACH. INSPECTOR COMMENTS False NOT ABLE TO SCHEDULE ANY INSPECTIONS UNTIL THEY PROVIDE THE COVENANT RIGHT OF WAY. Inspector Comments Passed c Failed Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection to is paid. 6 July 19,2016 For Inspections please call:(305)762-4949 Page 9 of 41 a- v Miami Shores Village 4 10050 N.E.2nd Avenue NW Miami Shores,FL 33138-0000 `' Phone: (305)795-2204 h Expiration: 11/27/2016 Project Address Parcel Number Applicant 141 NW 96 Street 1131010250110 PETER GOLDSMITH Miami Shores, FL 33150- Block: Lot: Owner Information Address Phone Cell PETER GOLDSMITH 141 NW 96 Street MIAMI SHORES FL 33150- 141 NW 96 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone Valuation: $ 6,500.00 ARTISTIC CONCRETE GROUP INC (305)888-9095 Total Sq Feet: 880 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final Date Denied: Foundation Type of Work:REMOVE AND REPLACE EXISTING DRIVE Additional Info: Review Planning Bond Retum: Classification:Residential Review Building Scanning:3 Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Contractors Bond $500.00 Invoice# DS-5-16-59742 CCF $4.20 05/31/2016 Check#:1045 $649.20 $0.00 DBPR Fee $2.00 DCA Fee $2.00 Bond#:3099 Education Surcharge $1.40 Permit Fee $125.00 Scanning Fee $9.00 Technology Fee $5.60 Total: $649.20 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I ify tha a foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning a authorize the above-named contractor to do the work stated. May 31,2016 AuthorAftignaturoby7ner / A li / Contractor / Agent Date Building Department Copy May 31,2016 1 Miami Shores Village REcF;�_ ``~ �4P Building Department Y 12 2016 g p - 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: Tel: (305)795.2204 Fax: (305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 y S BUILDING:, Permit No. FBC 20 PERMIT APPLICA\TION Master Permit No.]�S1(o Permit Type: BUILD G ROOFING JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: ,",I' y Foho/Parcel#: //j!/VSD j-.7 //1 Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): ��'eN O�-�JW1504-- �� Phone#: Addresses O / V/ /l uj g(D ..�� City: 141 a' GU! -C�t0r" State: Zip; 331" • Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: ��� � ��� � Phone#: �.1�•- J*47-9a JJ0' Address: 10_47�1_r Aou ��'^�. 1.t'1'TW__e_' City: State: /CZ— Zip; /3�j•- a Qualifier Name: W�77>,4 Phone#: *'Of- '510 .9,4' State Certification or Registration#: Certificate of Competency M 'fro woo 4 S/ Contact Phone#: Email Address:grh-gAee&Cro�'�,;*-s ex, DESIGNER;Arch} ,t;Fngine�` ,� .. }tone#: _ RIT a I�r.t• W Value of Work for WL Permit.$ Square%}inoar Rootage 4;*".- T-1 Type of Work: DAddition DAlteration ONew LiRepair/Replace ODemolition Description of Work. 7zae_� A jow� 1Zg0k_A C C_ a' g� Lz ri i ffi& Un a A C Amgcnch Color thru dle: t Submittal Fee$ Permit Fee$ •� CCF$ CO/CC$ Scanning Fee$ V`� Radon Fee$ eRD DBPR$ Bond$ Notary$� Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ pp TOTAL FEE NOW DUE$ 1 to Li 01 .ZX) 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 ori -tion 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 TOREWND , 1OTICECOMMENCEMENT MAY RESULT IN YOUR PATWICEFIMPROVEMENTS TO YOUR PROPERTY. IF YOU 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 ays after the building permit is issued. In the absence of such posted notice, the inspection will not be aproved a t peio fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this 1 The foregoing instrumegt was acknowledged before me this 1+ day of M ,20K_,byZe4c ������� day of � .20�,by(`i�e4%r�x�t ems. who is personally known to me or who has produced L_I �L who is ersonally kno me or who has produced As ip oath as i PUSLW an oath. NOTARY PUBLIC: A NOTARY PUB STATE OF FLORIDA STATE of FL #FF948106 Comm#FF90108 es 4/17/2021, Irgs 4/17/20 ( Sign: Sign: Print: Jak",ZVeg ,5 0(ARP 4ohn Ran, Print: yoP, NOTARY Ft df &1!7 YplMy Commission Expires: STATE OFF,. t MyCommisSTATEOF FL'Oanm#FF946, C�nm�FF 9461 s/ E�3; i r • Expires 4/17/2 _ Expires 4/17/20._ �Y4nkaYrTnY4i9Fskatntnk&Srdk�tBreYdaVrahArdn1edrotdr4rokArah9rfr9e a4&4rdrpYdntje�ir4rAe4t�Yak9rdnkt&dnY�YaYeYdadr&ArArskrkaYaY4tirRr9taYdt&iraY4rdt4r9r4e9ranYstd¢sYFr�Tr9i�ir�/i4rik4E�Y+Y4nYiFat4tat&,taYsY& 3� v. APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 5/2/2012XRmised 3/12/2012)XRevised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) 7210 SW 126th Court, A762a7W d. I;arcZa, YL&M Ph(305)856-4566 c� Miami,Florida 33183 Land Surveyor &Planner Fax(305)595'1454 Record Survey Property Address: 141 NW 96th Street, Miami Shores, Florida 33150 scale 1°=20' Legal.Description: Lot 11, Block 3,of"RESUBDIVISION OF BLOCK 3, BONMAR PARK", according to the Plat thereof,as recorded in Plat Book 42,at Page 60,of the Public Records of Miami-Dade County,F MAY 12 2016 •'•••• •• • 15' Wide Alley •••••• *10' po• Asphalt • .. .. ° N89°4T30"W 7'5.00' 0000 ;r•• Qv®rrIffe ° �• s su ey is certified only to e°• • entities listed and only for this particular *09 CIT :Q transaction.Any use or reproduction of N El REQUIRED :••:•: 0.5' this survey without the express written Flo r a Health lKAiami-Dade Co inty ;•• • `" '•' permission of the surveyor is prohibited. .S.T.D.S ell Pro • Use of this survey in any subsequent • transactions is expressly prohibited and ppli on No.: ` ® ' •' ° is not authorized.The surveyor express ate: y g disclaims any certification to any parties ignatl a Lot 11, In future transactions.No entity other Bock 3 than those listed should rely upon this survey. cl C� wIN Cone m 3 c Ui 10.11• 18. r- C4nc. Lu •a Lot W of' .a o Rot 10 Block 3 W a Block 3 F- X, Z Q C °3 < c Residence z4 — o #141 ' > L Z �- > C) N `< t l0el .7' ♦ Y131. 0 cn ...1 W 10.21' d woi 3 -X Conn 10' Encr WOOm � P = _ t z C) BM 11 ' � -- � FIP 59' 7 28"E_ _01" FIP —� _ 75.Q0' W Sidewalk S89.4T28"E7 � 01 (SC)' e tl — rl tm��ctc, There may be easemerrts and/or other 6 �' i 1 Instruments effecting this property, - — ODmp4p-TIV n e i (1COMAIE� recorded in the Public Records not shown on this survey.The purpose of this survey is for use in obtaining We insurance and Is- Asphalt 0 gSAtJ� financing and should not be used for - 1? - t construction purposes or plans. - C-ora - 18' VMJ Median NW 9 _ t �ncroachments Noted: (W Total R/qt) Concrete wall encroaches 0.2 feet _ Into the east adjoining property 11dedoes rad.react r deteraeio � �Yaie- •Ofi-12-8Ef1,4 -.�; ....._.� ._. tee to b moilo to Recorded a Atantrmt of�'a " �'` Peter Goldsmith; Town & .R m �' Country Trifle Guaranty of *d 0=00 poftd� to .eee�va�e or a or ro c PLBM•5105 by 1e a h in i coat of a _ Hollywood. Inc.; First .=�/ R4''='d ft ei'ha Wt 81g=re Amman Title Insurance c ==010,r, r��errea c7`Ahe 4 giLTlo1.. I 6eod�Tc RgMf tierticd Dater►of Im OM is" � a ��r _ •sufveyor.` Order No 140207 AaAro��aMr AE-A - = Catch tliS a Cmhretet BC �oolr Cx :BeA.,= gereh ='800111 of a t0 � OSh Cr a Conarde Fmha� Cl&Mmoft= (C) Calculated tle CUE- Cann{ % boinop tThrd . CHB o Cid Beni ft al =Clear,CML- ally MovAnent une; d� - Fina*aftl*M P Frt aEwocUp= r W Feamd �m M FE DT E _ Elea►- Nom', FT a Fe* LME - Lake M �°' FPE- F1eiNhd F� Fire Hydrm* FIP "01 Measured ME- Empmront; LB - Lid Ba LCE- Lowed Floor Ekea� LP - Moranra N - North; N8Y0 1928 - National Goodeft W ttoat Dahem of ISM Nr8 a rd To S� p�.PW.�,a Per� Ofrt R"" 80* 0/8 pa Off Set Pb a Ma!So* Pc�f a unpota d 0 Lmw$aaaA MQp�: POB - PoLaat OfOrContnol ..-.W •2 a •OW PL a PImaE0 ST pmpft .�..W PLS- Protdarat Land .PLO = t0 � PTS T Of Tm r• R - (� m, �RS Of� P Pe6d C RX* p Romanoe — gm of 7r - Chia Unk FWum o a Pota a ...°�. • - — —-wood Foam ° _ Ceeabal 1Wt MY OFIDASE 1 !bobwowafffie Him Q n 10 Duet ADS 9ea1 Imp~ o/te�1�+A'Eleariroe .ao rgae ole NOR VILLU 't915flS y i illlil 11111 CCI11 11111 illll VIII VIII fIIC IIII Miami Shores Village CFH 2��1,SFi�J3827;a,S Building Department OR 8K 30135 P9 848 41P9st 10050 N.E.2nd Avenue RECORDED 06/30/2016 13:33.13 Miami Shores, Florida 33138 HARVEY RUVINi CLERK OF COURT Tel: (305)795.2204 MIAMI-DADE COUNTY► FLORIDA Fax: (305)756.8972 COVENANT OF CONS ION W HI ,R HT O1 E�AY Whereas, (owner) --eG �® hereinafter referred to as the owner of the following described property(address): /S</ IVuI 94 Legal Description: Lot Block Subdivision Folio# //-.3/O/-0p5- D//O Requests permission to install (describe work): 'd'-'leg Within the public right of way of(address) 141 N IN CONSIDERATION of the approval of this permit by the Village,the owner agrees as follows: .-.S 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 Coun lorida by the Village Manager of Miami Shores Village (or his fully aF12; ve . Signature Owner r Agent C (;OIdsv. IT+ } State of Florida County of Miami Dade The fo egoing ins iment was acknowledged before me this�day ofL(X , 20�, by DQ E< G a I d s�j��, who is personally known to me or who has produced L C_ as identification. NOTARY PUB C: Sign: Print: SEAL: ,d,►, Rowes NOTARY PUBLIC STATE OF FLORIDA caMTO FFNI106 ti Expires 41iTrAW ---. 00>$leflfl --$'UU Tiirl rrns fill,11sg1#1111 11118 11111 lilt 1141 0" Q 305275-1 x.55 . CFH 2o:L6R0:34x1:)26 U OR SK 30149 P9s 3174-3175 Mss) RECORDED 06/10/2016 13146:24 � y / { HARVEY RUVIH, CLERK OF COURT CO NAM OF CONSTRUCTION WITH N RIGHT 111FAVD D COUNTY r FLORIDA WHEREAS, 6' Hereinafter referred to as the OWNER of the following described property: RequestsperMiSSiontoinsts'll Inc i r? Within the public road right of way of IN CONSMERATION of the approval of this permit by the Dade County Public Works Department,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 the County to make repairs or maintain said item(s)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 shalt constitute a lien against the above described propertyuntil paid. r� 2. The Owner does hereby agree to indemnify sad.hold Dade County harmless from any and all liability which may arise by virtue of Dade County permitting installation of this item(s)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 Public Warks Department to do so. Failure to comply with this notice will result in the County causing the item(s)to be removed and a lien being placed on the property audlor 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 coyeneut S running with the land and shall remain m full force and effect.m- be bifi i' qn.. the undersigned,their heirs and assigns,until such time as this obligation has 'n been cancelled by an affidavit Bled ilk the Public Records of Dade County, Florida by the Director of the Public Works department (or his fully authorized representative). tt Signed,sealed,executed and acknowledged on the_ day of iJU1( 20 j at Miami,Florida. Signed,sealedkid delivered' the presence o£ . Joh,Rupm WyrARvtc 4, S'ATE Fl.c>I;,nn "`"'`9 `3 • Carnes Ffi&++310E? 4/!7/Zp20 (SEAL) Sols"" +oo valaoid.4omais 01'"AWAON antbW Avg couy�f CLERK C% �3 a _.. � �Evil" o 4 K STATE OFrift. COUNTY OF K%0,Wl1�Q�q I HEREBY CHRTIFY,that on this f h day of 3 Vy\e 20� Before me,an officer d orized to albs and take acknowledgements, Personally appeared ser G©1 c personally known to me,or pioven,by producing The following identification: pt. �.# to be the person( s) who executed the foregoing instrument freely and voluntary for the purposes therein expressed. WIIN F-SS MY HAND AND OFFICIAL SEAL IN THE County and Stats aforesaid,the day and year last aforesaid. Notary S e J6�'V-1j Printed Notary signature NOTARY SEAUSTAMP Notary Public,State of _Ejgr t O� idm Roques My commission expires: I-f —1'?-2a2 0 )NOTABW STATE OF FLORIDAt=Fq4 6 (O5 STATE of FLOli • Cammissio:o/Serial No. camti#FF8 IM - EVhm4II'Ir2= STATE OF FLORIDA,COUNTY OF DA.DE tHFRE8YCER77FYtbatane �A`�4 cot/prY COj7Y of v40 curer (� . Mons,filed in ttus pthge�p Aft,alseal. S►�9 ..�. a�.M Miami Shores Village Building Department R ► 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305)795.2204 Fax: (305) 756.8972 127 RECEIPT .mss I�- PERMIT#. DATE: br l (Nam) o Contractor 0 owner o Architect Picked up 2 sets of plans and/(other) f Address: �/ / 1�1� q b 4 From the building department on this date in order to have corrections done to plans And/or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Departme t to conti a permitting process. Signature: ( ATURE) PERMIT CLERK INITIAL: RESUBMITTED DATE: 4-- 1 2411b PERMIT CLERK INITIAL: