DS-17-628 Permit NO. DS-3-17-628
Miami Shores Village t Permit Type: Driveways/Sidewalks/Slabs
N.E.2nd Avenue NW 010 aim I elk
' Work Classification:Addition/Alteration
Miamiiami Shores,FL 33138-0000 P 109 r
Phone: (305)795-2204 Permit Status:APPROVED
X20 RiDp'
Issue Data:3/9/2017 Expiration: 09/05/2017
Project Address Parcel Number Applicant
47 NW 94 Street 1131010340130
Miami Shores, FL 33150- Block: Lot: ANTAL PIERRE-LOUIS
Owner Information Address Phone Cell
ANTAL PIERRE-LOUIS 47 NW 94 Street
MIAMI SHORES FL 33150-2237
Contractor(s) Phone Cell Phone Valuation: $ 6,200.00
DECO CONCRETE INC (305)828-5158 (305)345-4740
Total Sq Feet: 1450
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied: Foundation
Type of Work:STAMP CONCRETE DRIVEWAY REPLACE Additional Info: Review Building
Bond Return: Classification:Residential Review Planning
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $4.20
II1vOICe# DS-3-17-63239
DBPR Fee $2.25 03/09/2017 Credit Card $50.00 $124.70
DCA Fee $2.25
Education Surcharge $1.40 03/09/2017 Credit Card $ 124.70 $0.00
Permit Fee $150.00
Scanning Fee $9.00
Technology Fee $5.60
Total: $174.70
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. rmo ,I authorize the above-named contractor to do the work stated.
March 09, 2017
7ing
' ed ignature:Owner / Applicant / Contractor / Agent Date
B44' Department Copy
March 09, 2017 1
Miami Shores Village RECEI
Building Department MAR o 9 2V
ED
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 n ,
Tel:(305)795.2204 Fax:(305)756.8972 (�
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 20 1454'�
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS:-1/7- A)uj qL
City: Miami Shores County: Miami Dade Zip: 33�SD
Folio/Parcel#: 11-310 /- 0.3!/ - 0/30
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titl/eliolder): Ak)�ryL� /�►'r� " LO; S Phone#:
Address: 141 AJ4 q7
City: M;R"T fkMrg�5S State: Zip: 33 f
Tenant/Ussee Name: Phone#:
Email: (Dm
CONTRACTOR:Company Name: DL--f_4C) Phone#:3=2-79'-'0 E9
Address: � �Z
City: I yy��, ,, State: Ziip::, /7O,1
Qualifier Name: �� ! I BUY II7� - Phone#:G�✓�"YZS 51 SIF
State Certification or/R�egistrration#: C�� 2� Certificate of Competency#:
. V
Contact Phone#: S O 2--9 51 SS Email Address:4t?rr&5@-CJC-1C0 i fic.com
DESIGNER:Architect/Engineer: Phone#: �--�
Value of Work for this Permit:$ I aoo• oD Square/Linear Footage of Work:
Type of Work: DAddition ❑Alteration ONew �!Repair/Replace ODemolition
Description of Work:
D
Color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
Bon •ng Company's Name(if applicable)
Bondi Company's Address
City State Zip
Mortga a Lender's Name(if applicable)
Mortgage nder'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 certified 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 absen h posted notice, the
inspection will not be approved nd a reinspection fee ill be charged.
Signature X. Signature
Owner or Agent on actor
The for11eg�oing instrumen
''t
��was acknowledged b=�i(j
, The foregoing instrument was acknowledged before me this
day of V 1A_,20 a,by % G /,�ay of ,20 by
who is personally known to me or who has produced_ who i personally known o me or who has produced_: .
?12t 1 �US2. As identification and who did take an oath. as identification and who did take an oath
NOTARY PUBLIC: NOTARY PUBLI
Sign: S' n•
Print: nt;•`'aµY
Jd)lA.,A /
:� o, - _:� .�- o ary u is- a o on a
M Co igtary Public State of Florida • ' ' i [t tpines:Expires ul 15,2018
My y Comm.Expires Jul 15,2018 Commission # FF 142170
OF i --cif()F f�V��`,
National Notary Assn.
l Notary
, t�,�
Commission # FF 142170 Bonded Through N
Bonded Through Nati aAssn. QP
APPROVED BY Plans Examiner ((30 3/ ` �` '� Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
B : U� ;- 0AW SURVWREVIEW REQ61RED
(p2� = 2a'
Florida Health Miami-Dade County
O.S.T.D.S. W�11 P `m \
�j Application No.: I
,_. Date:
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PHONE: 305-822-6062 + FAX: 305-827-9669 > Property Line dight Pole (R)-Record
6175 NW 153rd STREET SUITE 321 Res. -Residence
MIAMI LAKES FL. 33014 SP/R=set Won Ptu/Rabar Page 2 of 2
03/09/2017 09:40AM 3058287375 PAGE 01
♦5
OR
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,elm Miami shores Village
Building Department
10050 N,E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
CONTRACTORS' REGISTRATION Fax: (305) 756.8972
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
A. X COPY OF QUALIFIER'S STATE LICENCES
S. X COPY OF LOCAL BUSINESS TAX RECEIPT
C. X COPY OF LIABILITY INSURANCE"
D. X COPY OF WORKERS COMPENSATION INSURANCE*
(Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit)
IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY:
A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER
B. COPY OF LOCAL BUSINESS TAX RECEIPT
C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL
CONTRACTOR'S TAX RECEIPT,
D. COPY OF LIABILITY INSURACE*
E. COPY OF WORKERS COMPENSATION INSURANCE*
(Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit)
*YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW:
Certificate Holder:
MIAMI SHORES VILLAGE BLDG DEPT
10050 NE 2ND AVE
MIAMI SHORES, FL 33938
Certificate must specify the description of operations or contractor license number.
���•�Yf IF���a Y��a��i��ia�o���s■*����sa�e���r+����*e•a����rri�rYYY�������a��e���s���ar���aes
BUSINESS NAME: DECO CONCRETE, INC.
BUSINESS ADDRESS, 107 S.W. 105 PLACE CITY MIAMI STATE FL, ZIP 33174
BUSINESS PHONE: 3( 05 j 828-5158 FAX NUMBER j_ 305 828-7375
CELL PHONE 305 345-4740_ __ QUALIFIER'S NAME: JOSE MONNAR
QUALIFIER'S LIC NUMBER: CECO57725
03/09/2017 09:40AM 3058287375 PAGE 04
ACORD-, 0 11812017 CERTIFICATE OF LIABILITY INSURANCE ° 2017 raomrn
PRODUCER 'THIS CERTIFICATE I$ ISSUED AS A MATTER OF INFORMATION
COVERALL INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CER11FICATE DOES NOT AMEND, EXTEND OR
5800 W,ATLANTIC BLVD. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
MARGATE,FL 33053
PHONE 0 OR 956.0005 FAX 5(9g 956.0595 INSURERS AFFORDING COVERAGE MAIC
INSURM DECO CONCltEM INC. INsulz n • MESA UNDERM. TEING SPECIALTY
P.O.BOX IW7 INBUR a: FRANK WINSTON CRUM
MIAMI,FLOMDA 33172 INSURER 0:
INS.FAX#305480-0320 INSURER D:
INSURgA E:
COVERAGE$
THE POLICIES OF INSVR4NCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWMiOTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 8E ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED OY THE POLICIES D95CAIDEO HEREIN IS SUBJECT TO ALL THE TERMS, 6XOLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE UMTTS SHOWN MAY HAVE BEEN REDOCED BY PAID CLAIMS.
IN d IF POLIO N MHER: CT IEFIICttVE T N LAI
, ►1.LIABILITY CA CH ocCU sE 300 000
DAMA6ET REN
A X COMMERCuu GENE UABILrrY MP0009001002961 08108120160011/2017 100 000
CLAIMS MADE XL I OCCUR MED EXP JAMOnt MrMl
1 1S�0
PER NA A ADV IN"Y S 3 OW
NERAL AGGREGATE $300,000
G LAGGR6 TELLurTAPPUPSPM PRO MPIOPAGG 3000DO
X POLICY IRO. LOC
AVTOMI091I.E LMUtUTY
ANY AUTO WOOII�`A�SINGLE LIMIT :
ALL,OWNEO AV1705
L;ODILY W,IURY i
SCMZDULEO AUTOS (parpomm)
HIREDAUTOS ' ?
SOOILY INMRY j
NON-OWNEDAYPOS I (Pw soddenM1
PRO(Par QLi 3
GARAGR I M IUYY Y-EA ACCIDENT
ANY AUTO EA ACC 3
OTTER THAN
ALTO ONLY: AG i
yymall L iLRY URREN!E 3
OCCUR CLAIMS MADE AbGR T 3
s
DEDUCTIBLE
RETFtvnQN 8
woRKERB COMPONSA"AND TA pTN
S ERS'LIA I
ANY FMC10120200 1=712016 i014TJ201J HAC IDENT x 100000
NYP9 FROPRIETONmARA3AR:TNfwEXECLJrLVE
OFFICMMENBER EXCLUDED4 E-6A EMPLOYS s 100 000
E.IT ;describe undef
L.DISEASE-POLICY LIMIT 3 100,000
OINGR
OWCMPTION OF OPERATHma/LCCAMON*I WAMLES I EILCLUMOM3♦00311)BY 2UWR5EYENT/9VEOfAL PROVISIONS
CONCRETE CONSTRUCTION
LICENSE#000057726 AND E1500304
CERTIFICATE HOLDER CANC LLA11ON
8H0VLD AN'f OF THE A9OW DESC=W POUCIEi BL CAMCELRiO>tEIORE TIIEEIrPIRATgN
MIAMI SHORES VUAQE DATE T>,IeIe�P 133 Stsul�En writ Yore To MAn. 10 GAYS wATTTEN
10050 NE 2ND AVENUE NOTICE TO TkE LDff o Ta no so a>Lau
MIAMI SHOOES FL 33138 IrPOBE No 0 oP D UPON a INfURER,ITti Aa>:Nra OA
A PRES�NTATIVEa.
FAX 305.79"072 AUTHORIZED REPR$OE#TATWF
ACORO 25(2001103) 0 ACORD CORPORATION 9998
i
03/09/2017 09: 40AM 3058287375 PAGE 03
t)01aD5
Local Business Tax Receipt
Miami—Dade County, State of Florida
-TN1S IS NOT A 81t1-PO NOT PAY L=BT
;398935
BUSIN8S5 NAMIE&OCATrON RimOIPT NO. EXPIRES
DECO CONCRETE INC RF.MEWAL SEPTEMBER 30, 2077
1 o7 5VV 105 PLACE 7487409 Must M disptaYed as place of business
MIAMI FI.33172 Pursuant to County code
Chapter 8A-Art.9&10
OWNER SOC.TYVE OF BUSINESS PAYMENT RECRIVEC,
DECO CONCRM INC 196 SUB:-GENERAL BLDG CONTRACTOR ]BY TAX coLL9C OR
C/O JOSE MONNAI2 CBC057726 $45,00 07/27/2016
Worker(s) 1 , ECHECK-16-171891
This Laeai Brlsiaess Tax Remfpt oaN c mfi,,.PaYmeat of the Local Business Tax The Receipt jr,not
lacer",
permit.or a cartiScetiom of the bolder's ali icatioa 4 to do busimU&Holder rma WnPly n gov
Or mangoraswraabt repalatory laws mad rmtuhmrmtM which aypltr to the boniness.
The RECEIPT NUJ.Move mist be displayed as all eommereiai vatuCles-fUia>si-Dada Code Sec 6a-V&
Fortaareipfatw>dam,visttyvvrw�ie •Q =SEllt
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RICK SCOTT, GOVERNOR KEN LAWSON,SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATIONa:'ib ,Yk;t
CONSTRUCTION INDUSTRY LICENSING BOARD11 ,':-
CSGa57725 r7
The BUILDING CONTRACTOR �ti,�-s<..
Named below IS CERTIFIED '''W` . ``��`
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31,2018
MONNAR, .LOSE `
DECO CONCRETE INC.
107 SW 105 PLACE
MIAMI FL 33174
ISSUER 011100016 DISPLAY AS REQUIRED BY LAW SEa# L160716000117
D
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5"�I
�C Miami shores Village
sell 11112" Building Department
�^-� y♦ 10050 N.E.2nd Avenue
��ORtIDp' Miami S TS15)'7
Tel: (30 95.2204
Fax: (305) 756.8972
SURVEY AFFIDAVIT
STATE OF(FLORIDA)
COUNTY OF(DADE)
The undersigned Affiant, Ab, kL Pf&yr&,UDL,does hereby attest that
(Property owner)
The attached survey,performed by Ct.IA L 1Plk
j t , /�► L (Name,of surveyor's company)
For address: "[ q N�
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 inspections as applicable to this or other permits.
Furth I t s y eth n t.
Property Owner ignature Property Owner Print Name
SWORN TO AND SUBSCRIBED before me this day ofbJ .
Affiant is personally known to me,_produced •k0kQ- CWeas ide 'Icati
.0 11 V/'fi71�i M.AGUILAR
. IVIiC-State of Florida
My Comm.Expires Jul 15.2018
Revised on 5/22120091 Revised on 6112109 V_�F Commission # FF 142170
""`` Bonded Through National Notary Assn. '
15t�oREs Miami Shores Village
tlogoo Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
�ORiDA Tel: (305) 795.2204
Fax: (305) 756.8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
Whereas, (owner, &I)qL- �( � "I's hereinafter referred to as the owner of
the following described property(address): /L)L�j
Legal Description P13 12.--(;L+ Lot 2,14 VVY Block Subdivision
Folio#
Requests permission to install(describe work): C+6 r
Within the public right of way of(address) 47
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
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 County,
Florida by the Village Manager of Miami Shores Village (or his fully authorized representative).
SIGNED,SEALED, EXECUTED AND ACKNOWLEDGE on this 4d day of ra ,201��5' ,
oe
e",
(Owner' ignatu
SIGNED, SEALED D IVERED in the presence of:
N . MARIA M.AGUILAR
Notary Public State of Florida
•_ My Comm.Expires Jul 15.2018
Commission # FF 142170
Bonded Through National Notary Assn.
2