PW-17-1302Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
7-1X02.
Public Works
Public Works
APPRO"
Parcel Number
Per
Expiration: 08/14/2017
Applicant
8901 NE 4 Avenue Road
Miami Shores, FL 33138 -
1132060460001
Block: Lot:
SHORES VILLAS CONDOMINIUM
Owner Information
Address
Phone
Cell
SHORES VILLAS CONDOMINIUM
8901 NE 4 Avenue Road
MIAMI SHORES FL 33138-
(305)785-7760
8901 NE 4 Avenue Road
MIAMI SHORES FL 33138-
Contractor(s)
CHAMPION CONCRETE
Phone Cell Phone
(305)252-8055 (786)402-4802
Valuation:
Total Sq Feet:
$ 8,500.00
1750
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$5.40
$0.00
$0.00
$1.80
$100.00
$9.00
$7.20
$123.40
Pay Date Pay Type Amt Paid Amt Due
Invoice # PW -5-17-63993
05/16/2017 Check #: 2538 $ 73.40 $ 50.00
05/11/2017 Credit Card $ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Excavation
Review Public Works
Final Public Works
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, `y agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, R•-• r ING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing informati• is accurate - : that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above-na d co ' ctorj do the work stated.
A+J May 16, 2017
Authorized Signature: Owner / Applic
Building Department Copy
ontractor /
Agent Date
May 16, 2017 1
BUILDING
PER A IT APPLICATION
Ink.0 LDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION El RENEWAL
Miami Shores Village RECEIVED
Building Department MAY 1,. to»
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
W3t120
Master Permit No. P ` I-;
Sub Permit No.
❑PLUMBING ❑ MECHANICAL EUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: ego/ NG. LiIv QQ
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: dj "*3206— 0 Kb— 0(20)
Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): 51-101-1.> V a 11 A5 Cpp,O 0 Phone#:
Address: S;"901 E9tAsie
City: MIGNI1 5k0c- .S
-r
State: Zip: 331 38
Tenant/Lessee Name:/� ( Phone#:
Email: \1(JB /M MOM, �` CA\AI .,. C-C3(Y)
CONTRACTOR: Company Name: e!"//f' iA/1idi Ow Phone#:3� watrorS
Address: /O 2499 #1/R) %3 j :e ///Lf . 10-11,5
City: Jli/114 State: Y 4*-' Zip: `3/7f
Qualifier Name: ..// 7 4 - 4 • 443/4 0 Phone#:# of q?" -14333
State Certification or Registration #: Certificate of Competency #: CGO$54)46)"/.S7
DESIGNER: Architect/Engineer: Phone#:
Address: - City: State: �1 Zip:
Value of Work for this Permit: $'/r' 19®, Square/Linear Footage of Work: 1l �.sv 5F
Type of Work: ❑ Addition 11 Alteration ❑ New 11 Repair/Replace [1 Demolition
Description of Work: Q 'el/4e) IS 20169/4) .s 74 err 511 rUJA L, ..
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ T
(Revised02/24/2014)
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 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 . ;delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement m be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absencf such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of 71®/t%%G ,20 /�' ,by
mine fifore 50/2t,ho is personally known
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
********
•
411
!uu
FELIX GIRALY
MY COMMISSION #FF115925
'"•„o,,„,e,'' EXPIRES April 24, 2018
) t'I`ft** •&WA* * icecom ***
OprOM I
APPROVED BY
(Revised02/24/2014)
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of N-'. ALL , 20 , by
-P-IN'N1"6 1ho ss personally known to
me or who has produced TA-- 752 ic N1
identification and who did take an oath.
NOTARY PUB if :
Sign:
Print:
Seal:
r************************
Plans Examiner
,s,PaY , votary Public State of Florida
Sindia Alvarez
n' r/ Commission FF 156750
3A; o=xpires 09/03/2018
Zoning
Structural Review Clerk
Monde Department of State
Department of State / Division of Corporations / Search Records / Detail By Document Number /
DIVISION OF CORPORATIONS
Detail by Entity Name
Florida Not For Profit Corporation
SHORES VILLAS CONDOMINIUM ASSOCIATION, INC.
Filing Information
Document Number 726513
FEI/EIN Number 59-1548009
Date Filed 05/25/1973
State FL
Status ACTIVE
Last Event REINSTATEMENT
Event Date Filed 10/12/2016
Principal Address
8901 NE 4 AVE ROAD
MIAMI SHORES, FL 33138
Changed: 05/11/2005
Mailing Address
C/O Florida Advanced Properties
12895 SW 132 STREET
#103
MIAMI, FL 33177
Changed: 09/08/2014
Registered Agent Name & Address
FLORIDA ADVANCED PROPERTIES, INC
12895 SW 132 STREET
#103
MIAMI, FL 33186
Name Changed: 09/08/2014
Address Changed: 09/08/2014
Officer/Director Detail
Name & Address
Title P
ROMAN, GUSTAVO
r
PO BOX 771566
MIAMI, FL 33177
Title S
STOBS, BETH A
PO BOX 771566
MIAMI, FL 33177
Title VP
SELLES, ELISA
PO BOX 771566
MIAMI, FL 33177
Title Director
SERDA, WILLIAM
463 NE 100TH STREET
MIAMI SHORES, FL 33138
Title Treasurer
PATTERSON, WADE
PO BOX 771566
MIAMI, FL 33177
Title Director
COLON, IVETTE
PO BOX 771566
MIAMI, FL 33177
Title Director
MIGUEL, NORMA
PO BOX 771566
MIAMI, FL 33177
Annual Resorts
Report Year Filed Date
2014 02/20/2014
2015 09/29/2015
2016 10/12/2016
Document Images
10/12/2016 — REINSTATEMENT
09/29/2015 -- REINSTATEMENT
09/08/2014 -- AMENDED ANNUAL REPORT
02/20/2014 -- ANNUAL REPORT
03/29/2013 — ANNUAL REPORT
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02/Q7/2012 — ANNUAL REPORT
04/20/2011 — ANNUAL REPORT
04/23/2010 — ANNUAL REPORT
04/27/2009 — ANNUAL REPORT
07/18/2008 — ANNUAL REPORT
05/05/2008 — ANNUAL REPORT
04/12/2007 — ANNUAL REPORT
01/26/2006 — ANNUAL REPORT
05/11/2005 — REINSTATEMENT
05/01/2003 — ANNUAL REPORT
03/28/2002 — ANNUAL REPORT
01/24/2001 —ANNUAL REPORT
01/21/2000 — ANNUAL REPORT
09/15/1999 — Reg. Agent Change
02/23/1999 — ANNUAL REPORT
08/05/1998 -- ANNUAL REPORT
07/28/1997 — ANNUAL REPORT
03/29/1996 — ANNUAL REPORT
03/23/1995 — ANNUAL REPORT
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Honda Department of State, Division of Corporations
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