BP-05-1575 Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972
BUILDING OVE® �
Permit No. � � ` IS745
PERI UT APPLICATION �� aster Permit No.
FBC 2001 ---- -------
Permit Type(circle): Building Electric Plumbing Mechanical Roofing
Owner's Name(Fee Simple Titleholder) a Phone#
Owner's Addr
City 110 State �� Zip—T--
Tenant/Lessee Name Phone#
Job Address(where the work is being done)
City Miami Shores Villaize County Miami-Dade Zip
Is Building Historically Designated YES NO .
Contractor's Company Name rl14 Phone#
Contractor's Address
City State Zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name(if applicable) Phone#
$Value of Work For this Permit // Square Footage Of Work:
Type of Work: []Addition []Alteration []New R air/Re lace
ep p Eemolition
Describe Work:
Submittal Fee$ Permit Fee$ �b l . CCF$ C) . (O(D CO/CC.
Notary$5 .001 Training/Education Fee$ 0- 80 Technology Fee$ 50
Scanning$ 3- (DD Radon$ Zoning Bond$ 800 - 00
Code Enforcement$ Structural Plan Review.$
Total Fee Now Due$ � � � 14 S–7,S
(Continued on opposite side)
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 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 certtyled 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
d- Signature Signature
Owner or Agent � Contractor
C
The foregoing instrument was acknowledged before me this I The foregoing instrument was acknowledged before me this
day of- k--7)V ,20 "�by 2 G� 1 [ O day of ,20_,by
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did as identification and who did take an oath.
NOTARY PUBLIC: l c.84n $
rleNOTARY PUBLIC:
Yon
sign: 6455
Sign:
hy Print: Bonding Co. , c• Print:
My C fission Expires: My Commission Expires:
APPLICATION APPROVED BY: Plans Examiner
Engineer
chc 05/13/03 Zoning
SHoR�Es t,!
allr . ,,, MiamiS40re-4 L e
0
AFFIDAVIT.. ,
=STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant, ,does hereby attest that the
(pr erty owner)
attached survey,Performed by 0
> (name of surveyor's company)
performed on G is an accurate representation of the existing conditions and
date of survey)
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 buildingpermit for the
property without first providing a survey less than six(6)months 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 inspections as applicable to this or other permits..
Further,Affiant sayeth naught.
Affiwner
Witness(sign and print) Witness(sign and print)
SWORN TO AND SUBSCRIBED before me thisCa__day of ��V .
Affiant is personally known to me,_Produced t o • as identification.
N PUBLIC-STATE RIDA
J-A—A—� Yo eny
6455
Expires: 27, 2009
Bo ed Afland Co.,In
e
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE .STATEMENT
being the legal property owner, for the property
Located at:
Legally described as ,
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the
State of Florida,F.S.489.103(7),.end I have read and understand the following disclosure
Statement, which entitles me to 3Vork as my own contractor, I further understand that I as the owner
must appear in person to complete all applications.
DISCLOSURE STATEMENT
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor
even though you do not have a license. You must supervise the construction yourself. You may build or
improve a one-family or two-family residence or a farm out-building. I You may also build or improve a
commercial building at a cost of$25,000.00 or less.The building must be for your Own use and occupancy.It
may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the
construction is completed, the lav will presume that you built it for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed person as your contractor.It is your responsibility to make sure
that people employed by you have Iicenses required by state lav and by county or municipal licensing
ordinances. Any person working on your building who is not Iicensed must work under your supervision
and must be employed by you, which means that you must deduct F.I.C.A. and with-holding tax and
provide workers' compensation for that employee, all as prescribed by law. Your construction must comply
with all applicable laws, ordinances,building codes and zoning regulations.
Proof of ownership provided( )_initial of reviewing clerk. Tlie foregoing instrument
Was acknowledged before me this_T day of KkD\/,20 CD!S
By 1G C,,L-CD who is personally known to me or who has
Produced as identification and who did take an oath.
NO W -S" 0
ez
Owner on D 5
el
andc Bond Inc.
a, .
Owner
Legal Description: Certified To: Panel Number: 0091 - e x
ROCCO NICHOLAS RIGGO, JERICHO TITLE Suffix: J > NE TN,,,,, 5T
E HEIGHTS, SERVICES, INC., STEWART TITLE GUARANTY Data of Firm Index: 3/
Lot 4, Block 2, of COLLEG2/1994
according to the plat thereof as recorded in Plat COMPANY, ITS SUCCESSORS AND/OR ASSIGNS. Flood Zone: X I a
Date of Completion: 01/12/2005 W � l P � •' 4 j
Book 42 at Pa
ge 8, of the Public Records of
Miami-Dade County, Florida. Property Address:
•9r 3/ I 90 I Y9 PB i 27 pG c'6 PO :3 P2 Z/ PD /9 I ra /% 4
38 N.E. 110 STREET I � ;
MIAMI, FL 33161
RIEEUVE® I . N
Survey: M28108 ""
ITYw
J �
32 3/ 90 29 PB i P% f PH YB i Ps P3 I P2 Pi Pp /9 A /7
b I I
A .o
t M .-acro'D fir,
254.55• B.0 ^/ 109 Ta/a2aao I $T
15'ALLEY
�.. ...x•r
�N LOT- 3 BLOCK- 2 1!�
GENERAL NOTES: �
124.00' I (, 1) LEGAL DESCRIPTION PROVIDED BY OTHERS.
2) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE
RECORDED INSTRUMENTS,IF ANY,AFFECT THIS PROPERTY.
e_ o ;0 0 9£ ' 3) THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENT OR OTHER RECORDED
e u'. 00 (n $ 5�` I ENCUMBERANCES NOT SHOWN ON THE PLAT.
0 In 34.90' I 4) THE PURPOSE OF THIS SURVEY IS FOR USE IN OBTAINING TITLE INSURANCE AND FINANCING
s \
_ 59 60' , v` AND SHOULD NOT BE USED FOR CONSTRUCTION,PERMITTING,DESIGN,OR ANY OTHER
PURPOSE WITHOUT THE WRITTEN CONSENT OF MIGUEL ESPNOSA LAND SURVEYING.
5) UNDERGROUND PORTIONS OF FOOTINGS,FOUNDATIONS OR OTHER IMPROVEMENTS WERE
K» • No NOT LOCATED.
D �® I 6) ONLY VISIBLE AND ABOVE GROUND ENCROACHMENTS LOCATED.
13.30' 7.85' U) 7) WALL TIES ARE TO THE FACE OF THE
B0' �0• X O f o 7 8) FENCE OWNERSHIP NOT DETERMINED.
ALL.
O 20.05 M Z 00 it"!
"� 9) BEARNGS REFERENCED TO LINE NOTED AS B.R.
V)1 T1 v 10) BOUNDARY SURVEY MEANS A DRAWING AND/OR GRAPHIC REPRESENTATION OF THE SURVEY
o WO1tK PERFORMED N THE FIELD,COULD BE DRAWN AT A SHOWN SCALE AND/OR NOT TO
3 N GD 0 4 6.70' SCALE.
0 0o N z a, �,, CONC N r' 11) NO IDENTIFICATION FOUND ON PROPERTY CORNERS UNLESS NOTED.
0 12 NOT VALID ONLESS SEALED WITH THE SIGNING SURVEYORS EMBOSSED SEAL_
D v 13.95' 5.00' (�l Z7 0 o oI 1r.�*.� 13) DIMENSIONS SHOW ARE PLAT AND MEASURED UNLESS OTHERWISE SHOWN.
;0m 14.55' I r+ 14) ELEVATIONS IF SHOWN ARE BASED UPON N.G.V.D.1929 UNLESS OTHERWISE NOTED.
� X 3 ' 15) THIS ISABOUNDARYSURVEYUNLESS OTHERWISE NOTED.
D m I (n 16) THIS BOUNDARY SURVEY HAS BEEN PItEPAR FOR THE EXCLUSIVE USE OF THE ENTITIES
o U) W i H NAMED HEREON.THE CERTIFICATIONS DO EXTEND TO ANY UNNAMED PARTIES.
36.90' p SURVEYOR'S CERTIFICATION:1 HEREBY CERT HAT THIS"BOUNDARY SURVEY"IS A TRUE AND
9.20' ® 34.90' I CORRECT REPRESENT TION OF A SURV Y PR A ED UNDER MY DIRECTION.THIS COMPLIES WITH
THE MINIMUM TEC ICAL STANDA AS FORTH BY THE STATE OF FLORIDA BOARD OF
Q I PROFESSIONAL LA SURVEYORS C ER 61G17-6, FLORIDA ADMINISTRATIVE CODE
GO v 'f D I PURSUANT TO 2.0 FLORIDA STATU
6.20 �Q N o D q 0 7 IA I 1
In CA o S
t4� 7.90' �do
SIGNE FOR THE FIRM
37.50' I MIGVL ESPNOS P. NO.5101-STATE OF FLORIDA
NOT VWIT AN ICNICSIG AND AUTHEN TED ELECTRONIC SEAL ANDIOR THIS MAP IS NOT VALID
124.00' 3 .AHE SIGNA DTI¢ORI AL RAISED OF A MEN VEYOR AND MAPPER
0
o I
LOT- 5 BLOCK- 2
MIGUEL ESPINOSA
75.00'R/W LAND SURVEYING,INC.
6494 S.W. 24TH STREET
D Z MIAMI, FLORIDA 33155
� 0 —
N= PHONE: (305) 740-3319
FAX#: (305)669-3190
LB # 6463
Accepted By: _