DS-16-1128 Permit NO. DS-4-16-1128
�sHO1 s Miami Shores Village Permit Type:Driveways/SidewatksiSlabs
10050 N.E.2nd Avenue NE
Work Classification:Addition/Alteration
�"'• � Miami Shores,FL 33138-0000 Perill 'itPermit Status:APPROVED
A` Phone: (305)795-2204
1111DIssue Date:712112016 Expiration: 01/17/2017
Project Address Parcel Number Applicant
26 NE 108 Street 1121360110060
ALAN ADRIAN &RAQUEL PAST
Miami Shores, FL 33161-7036 Block: Lot:
Owner Information Address Phone Cell
ALAN ADRIAN &RAQUEL PASTORA 26 NE 108 Street
— -- MIAMI SHORES FL 33161-7036
26 NE 108 Street
MIAMI SHORES FL 33161-7036
Contractor(s) Phone Cell Phone Valuation: =9,300.00CHAMPION CONCRETE (305)252-8055 (786)402-4802
Total Sq Fee
Approved: In Review Available Inspections:
Comments:
Inspection Type:
Date Approved: :In Review Final
Date Denied:
Foundation
Type of Work:PAVER DRIVEWAY AND POOL DECK Additional Info: Review Planning
Bond Return: Classification:Residential Review Building
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Contractors Bond $500.00 Invoice# DS-4-16-59549
CCF $6.00 04/27/2016 Credit Card $50.00 $629.50
DBPR Fee $2.25
DCA Fee $2.25 07/21/2016 Check#:2248 $629.50 $0.00
Education Surcharge $2.00 Bond#:3155
Permit Fee $150.00
Scanning Fee $9.00
Technology Fee $8.00
Total: $679.50
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either m Oelf, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOOR ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information ' accu and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above name ntr t to d ork stated.
_ July 21, 2016
Authorized Signature:Owner / Applicant / C tractor / Agent Date
Building Department Copy
July 21, 2016 1
Miami Shores Village -�- ,-
Building Department APR 2 2016
10050 N.E.2nd Avenue,Miami Shores, Florida 33138
BY'
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 201`
BUILDING Master Permit No.ID t 2z
PERMIT APPLICATION Sub Permit No.
ILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP i
CONTRACTOR DRAWINGS
!
JOB ADDRESS: Ly /�� /of 51—
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Y-713 b " Oil — 001/ t) Is the Building Historically Designated:Yes NO
Occupancy Type: Load: ��ConstructionNNT11y��pe: �r� f Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titlellti
Titleholder): 1T/fly 1�ee/�rILI Phone#:
Address:
City: MA of 5MA'e')_ State: � Zip:
Tenant/Lessee Name: Phone#:
Email: `` f
CONTRACTOR:Company Name: Phone#:
Address: pd'�
City: .-0eState: ��
AL-
Zip: /2
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ �I►-3o V' Square/Linear Footage of Work:1i 100 'S�
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: JA V)ft-.SMV��'y .0a7L ma _
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ f5y ' CCF$ �U� CO/CC$
Scanning Fee$ l 00 Radon Fee$ aQ•a-s DBPR$ Notary$
Technology Fee$ �J - � Training/Education Fee$ 4& Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
I �L/
p
Bonding Company's Name(if applicable)
Bon'dink Company's Address _
ti
City ✓ ` `t State Zip
Mortgage`Cender'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 delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be po ted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of su posted notice, the
inspection will not be approved and a reinspection fee will be charged.
--�z —
-�raz�,
Signature Signature
V IF
OWNER or AGENT CO RACTOR
The foregoing instrum was ac owledged before a this The foregoing instrumen s ackno ledged before m this
�—day of 20 by Q?-1 day of 20 / , by
/ 0r/� who is personally known to who is pers nally known to
me or who has produced J-- 0 as me or who has produced l � a as
identification and who did take an oath. identification and who did take an oath.
NOTAR LI NOTARY P I
av
LUCIA ESTRELLA
MY COMMISSION#EE 880165
Sign: U, , EXPIRES:July 2,2017 Sign: o :;;'B�� LUCIA ESTRELLA
6 1 nru u petNotaryServloes MY COMMIS #EE 880165
Print: Print:
��rFOF FI�0§ Bonded Thru Budget Notary Services
Seal: Seal:
APPROVED BY / r " " Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
OS- y-��--112g
Terra Teck Consultants, Inc.
*Environmental Consultants ♦ Foundations ♦ Geotechnical Testing ♦ Inspections ♦ Construction Materials Testing ♦ Structures
FIELD DENSITY REPORTS
Client: Champion Concrete Date: 1 06/02/16
Address: 11001 NW 83rd Street, # 103, Doral, Florida 33178 Order No.: 16-2940
Project: Driveway At 26 NE 108`"Street, Miami Shores, Florida
Contractor: Champion Concrete
Description: Tan To Brown Silica Sand With Rock Fragments.
Location: SW Corner Of Driveway Lab# D-36017
Location: NW Corner Of Driveway Lab# D-36018
Test Results of
Field Densities ASTM method: D-2922-81
Description of Test Area Driveway Area Densities At 26 NE 108`"Street, Miami Shores, Florida
Lab No. D-36017 D-36018
Test No. 1 2
Depth in inches 12" 12"
Field Density lbs/Cft.) 114.6 116.6
Mositure Contents % 6.3 5.5
Maximum Density % in the field 98.1 99.8
Reg. Compaction by jobspecs 95% 95%
100 % Max. Density Proctor 116.8 116.8
Proctor No. P-2978 P-2978
Optimum Moisture% 1 8.6
Remarks I All The Above Tests Comply With Job Specifications
Checked By R.E.D.S. I Report By I A.M.
Respib \ IIIA�I � Wrt ted BY,
Ie')r CDn tt�t �rr#s, Inc.
\,\CEN J
_ * Rafael E.Dpz-Seda,P.E*
FLORIDA REGISTRATION No. 39228 -
Epte: �L ID6�l b ClI
Q STATE OF C(,
As a mutual protection to clients,the public and ourselves,all reports are submitted as the confidential properCjp nts,aup ication of 1
statements,conclusions or extracts from or regarding our reports is reserved pending otirtm
707
NDARY SURVEY
NE 108th STREE�F���
_ — .
17.5'Pavement.; Total Right of Way=75'::':
�. w
r
2ituv� oe� Di�i�reu Ab A� d 24.5'Parkway
���)�- u���L .-1}+e. ad cA
j y
FIP 1/2" 149.73'(M&R) FIP 1/2" 5' Sidewalk : '75.00' M 41„
rz ?p
0 01-
Af'R1EL2 7 2816T6,bvk_: p6o0l'4vil AT fe1t)4-e7s-A_
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K �� 10.00' Y: 10.
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...... 14.4'
(�I •• .� ' •.`'_.:�Y , 12.7 — 5.31� x�
...�. ...niam;...::...s Villa�� N A, 22.6' v,
•..::.s .. . ....
X41 PFi�4r�ld ..L'.Y� . DATE
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—9 0 ��'G fade Gp N
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- -- pt�a x O• 23.0' 10.0'0
Q ••' Block 210 0 I / _
:f `^:��N:`L��t rt r \L Q Sep6CTank
Legal Description: ''' '' NO
Lot 6,Block 210,DUNNINGS MIAMI SHORES 10” e - I xt
EXT No 7, according to the Plat thereof, as recorder 00' 1' .4' C/o I
in Plat Book 52, Page 33 of the Public Records of x I x\°c
Miami-Dade County, Florida. I I A a
<° °
Property Address: 26 NE 108 Street i A a — -�'
Miami Shores FL 33161 �lv ° . Pool
Folio No 1-2136-011-0060 snea A. ° x
7 Certify: : x - , D� x
SAN MJAN TAYLOR&RAQUEL PASTO I oo q ^5
x x
TAYL x x ii x ii x ii x ii x
GRAPHIC SCALE
FIP 1/211
R%Asbhal :::.:
( IN FEET )
1 inch = 20 ft.