DS-17-1379 Miami Shores Village 7, Driveways/Sidi vlralkXI*' ;
10050 N.E.2nd Avenue NW
Addition/Alteration
Miami Shores,FL 33138-0000
Perin i>a S ttx APPROVED '
hyc Phone: (305)795-2204
io
6j't� 17s: Expiration: 12116/2017
Project Address Parcel Number Applicant
17 NW 107 Street 1121360070470
Miami Shores, FL 33168-4306 Block: Lot: ARACELY BORGES
Owner Information Address Phone Cell
ARACELY BORGES 17 NW 107 Street (305)970-3289
MIAMI SHORES FL 33168-
17 NW 107 Street
MIAMI SHORES FL 33168-
Contractor(s) Phone Cell Phone
Valuation: $ 13,000.00
STAR ISLAND CONCRETE DESIGN C( (305)776-7916
__ _. ...._.. Total Sq Feet: 1500
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied: Foundation
Type of Work:INSTALL CONCRETE DRIVEWAY Additional Info:INSTALL CONCRETE DRIVEWAY Review Planning
Bond Return: Classification:Residential Review Planning
Scanning:3 Review Building
Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Contractors Bond $500.00 Invoice# DS-5-17-64078
CCF $7.80
DBPR Fee $2.63 06/19/2017 Credit Card $660.06 $50.00
DCA Fee $2.63 05/23/2017 Credit Card $50.00 $0.00
Education Surcharge $2.60 Bond#:3434
Permit Fee $175.00
Scanning Fee $9.00
Technology Fee $10.40
Total: $710.06
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,WI FS DORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I ce a P ation is accurate and that all work will be done in compliance with all applicable laws regulating
construction and tonin /uthe above-named contractor to do the work stated.
June 19,2017
re:Owner / Applicant / Contractor / Agent Date
B ' .i g Department Copy
June 19,2017 1
tzE(vr- Lll,`712�4A ( 77/ ,�?'
\tib rA- Miami Shores Village RECEIVED
Building Department MAY 23 20th'
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 Iq
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No.
'BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 17 /vim /Q 9J,-A
City: Miami Shores
County: Miami Dade Zip: 337`
Folio/Parcel#: //-2/ 361- Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type:
+ Flood Zone: BFE: FFE:
/�
OWNER:Name(Fee Simple Titleholder): zae' & o gr2!�j Phone#:
Address: /7 /V A1 107 J'-,PA-
City: /YID arti State: �7oiiOP40 Zip: :I s/6 0,
Tenant/Lessee Name: Phone#: 3®-r-'
Email: Ae gg e-e k. �icr�.r Ag
CONTRACTOR:Company Name:�m/ ZS `•t-vr er24! /9�Phone#:-3�;)!�;7 :27���/
Address: /090
City: Ht� State: F-,--'O' Zip:
Qualifier Name: Phone#: 2a-.3(--2
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 3 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ®-New ❑ Repair/Replace ❑ Demolition
Description of Work: :Z77rV 5 7-4 Z/
Specify color of color thru tile:
Submittal fee$ �0 Permit Fee$ ° CCF$ TDO CO/CC$
Scanning Fee$ `00 Radon Fee$ DBPR$ Notary$
Technology Fee$ 0. 40 Training/Education Fee$ 60 Double Fee$
Structural Reviews$ Bond$ S
TOTAL FEE NOW DUE$ 16no (-)C�>
(Revised02/24/2014) 66 0
OA tfbnding 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 on 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. the absence of such posted notice, the
inspection wi=4V
einspection fee will be charged.
I
Signature Signature
ER or AGENT CONT CTOR
The foregoing instrument was acknowledged before me this The foreg ing instru nt w acknowledged before me this
day of 120 I by � 7 day of 20��,by
Rra� ®r-5-p� who is ersonally know t0 �.•�C �`T who is personally known to
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 PUBLIC: NOTARY PUBLI
i
o �
Sig Sign: -
Print: LtKc, kvq Print:
MY COMMISSICIN#GG 017733
Seal: � �Po,, Seal: -�, EXPIRES:August 16,2020
LINA FIGUEROA BETHEL Bonded Thru Notary Public Underwriters
* . Notary Public-State of Florida
's;qr Po�c My Comm.Expires Jul 15,2018
****Gem # P ffgl%li
APPROVED BY Plans Examiner "�-� Zoning
Structural Review Clerk
(Revised02/24/2014)
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