DS-17-1177Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO. DS -4-17-1177
PPerm0 it Type: DrivewayslSidewaikslSiahs
erryal Worts Classification: Addition/Alteration
Permit Status: APPROVED
Issue Date: 6/6/2017
Expiration: 12/03/2017
Parcel Number
Applicant
Owner Information
Address
9200 NE 12 AVE
MIAMI SHORES FL 33138-2997
Phone
Cell
Contractor(s) Phone
STAR ISLAND CONCRETE DESIGN C( (305)776-7916
Cell Phone
Approved: In Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Work: BRICK PAVER ON SAND WALKWAY AND
Bond Return :
Scanning: 3
Additional Info: BRICK PAVER ON SAND WALKWAY
Classification: Residential
Fees Due
Bond Type - Contractors Bond
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$500.00
$1.80
$2.00
$2.00
$0.60
$100.00
$9.00
$2.40
$617.80
Pay Date Pay Type
Invoice # DS -4-17-63852
06/06/2017 Check #: 239
Bond #: 3418
Amt Paid Amt Due
$ 617.80 $ 0.00
Available Inspections:
Inspection Type:
Final
Foundation
Review Planning
Review Building
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
constructiand zoning. Futhermore, I . thorize` above-named contractor to do the work stated.
1+
Aut orized Signature: Owner / Applicant /
Building Department Copy
r
actor / Agent
June 06, 2017
Date
lune 06, 2017 1
o. e),(0 -z --os - 306 - (3-(0 65
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: BUILDING
JOB ADDRESS: IZoo (,L. t�
RECEIVED
APR 28 2017
SIN�
FBC 201M
Permit No. 1"
Master Permit No.
ROOFING
City: Miami Shores County: Miami Dade
Folio/Parcel#: 11 2 OS -. O O Zoo
Zip: '33118
Is the Building Historically Designated: Yes NO
OWNER: Name (Fee Simple Title older): "1 Ari es ULA arm"
Address: a 2n0 A'1Z144
City: 14 t - t l )1i -o12 -es State: FL. Zip:
Tenant/Lessee Name: Phone#:
Email:
Flood Zone:
Phone#: op - 088tit
CONTRACTOR: Company Name: ST162..T IS C..d OD 6V CaY
Address: fon. ittiv Y 7 S -
Phone#:
Z1;47-'? 7'a
City: IV1) ^ nState: Zip: 3 S 1, 2r7
Qualifier Name: i"t (COt 1 Q)ZPP 1-- Phone#:
State Certification or Registration #: Certificate of Competency #: g zO ( q a 3
Contact Phone#: -7 $L 304,2-4 / Email Address:
DESIGNER: Architect/Engineer:/4--
It2.Ldo0
Value of Work for this Permit: $
Type of Work: Addition ❑Alteration
on of Wrk .. 4312.{.C_4. p'
Descripti6o
1 «A, .:zco,..G.rv::0'tr,!
:mi•. sc Ya'?_4 Ilii
6,0
New
s6KJ
Color thru tile:
Phone#:
near Footage of Work:
rittr
ace.... �......w..❑Demolition
.........�.a....-w.w�wdrw.wr...'. „w. ; a.�« "Tvw....•,+:i� ::+M
***************************************Fees********************************************
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 $
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 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 absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
igna
AldiP "(1
Owner or Agen
The for oing instrument was acknowledgedbefore me this
day of (� , 20 (1, by o}0..' 0-1442-7-13-- ,
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign.`
Print:
My Commission Ex
0:,
N
JOSE -N. A .FONSO
MY COMMISSION • X000904
EXPIRES: July 12, 2020
Bonded Thu Notary Public Undawdtere
11 in *Der or-
********************************
The fore
day of
Contractor
was acknowAle�ged before me this 74'
0 � !"dZ U
1-- , 2 0 by B2 C/G'4-5.
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
*** ********************************************************************
4/1l
Sign:
Print:
My Co
Plans Examiner
APPROVED BY '
Structural Review
(Revised 5/2/2012XRevised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007)
Zoning
Clerk
ORDER NO. 6297
Revised this 13th day of August, 1979 to show Foundation Location and
elevations of building under construction. F.B. 244, p. 1.
1
RECEIVED
APR 28 2011
cirl!
IVEST.
0011111-0
N. E .
MEIN=
N E.
S r.
--a Tom' apo
wi1OG woLt v
Sm.
P1 P&
(22 .70'
Lci
.2S'
IT #:
Miami S
'R 1LL
Ho LE
-res Village
L0C4T1OMU A/1 P
Sca.t.e
SKETCH, OF SURVEY
APPROVED
ZONING DEPT
-.BLDG DEPT
LIT
••
•
...
•
•
•
.
•
SUBJECT TO CCMPLiANCE WIT ALL FEDERAL
STATE AND CCUN'i Y RULES AND REGULATIONS
SURVEY Qf Lots 23, 24, 25 and 26 (inclusive), less the North
Oe feet -they of , Block 3 of "BELVIDERE ' 'ARR" , according to the
Plat'thereo€ recorded in Plat Book 16 at Page. 71 of the Public
Records of Dade County, Florida, being situated in the Village
of Miathi Shores, and containing 7,490 sq. feet of land.
ORDER NO, 6133 DATE: February 21, 1979
F.B. 224, P. 39., 40 & 41 SCALE: As shown
WE HEREBY CERTIFY that the attached SKETCH OF SURVEY of the
above described property is true and correct to the best of
our knowledge and belief as recently surveyed and platted
under our direction.
A, R. TOUSSAINT & ASSOCIATES INC.
LAND SIIRi YOR,S
620 N.E. 126 Street, North Miami •U
Florida
Howard C. Gamble
Registered Land Surveyor No. 1683
State of Florida
V. Pres.
•
0
1.6
•
..•.
/0.6 e.
1 •
• •
••
.
••
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PIPE
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HOLE,
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�LcV.
Pd R4KVVdY
?'v.''--Srea�,...4--!..�.r.--„'.-r-�:... ,.,,, •.,ter *y:.y+et
Surveyor'.e Nate:
Elevations .shown refer to National Vertical Datum of 1929, formerly known
as U.S.-C. .&- Ga. S . Datuin, Mean Sea Level.
"'F' E_.t::5 71 --FMS 17-1-7-4 cF 1✓ C. t cJ To SHasry 1=1 .
;ORD R NO.: 6679,. F.B. .2'62, P. 17
S.K&TC H of
.sc A C. E 1 =
lris�icc� s �I�vc 4IcDn-
NO 0
Florida Health
O.S.T.D.
Application No.:
Date:
ON
Miami -Dade County
S. & Well Program
-,9/&/a
.VR VEY Elevation data as of August 10, 19'
-2 0 ELEVATION:
Crown of Road:
(E. Dixie Highway) 9.08'
Edge of Pavement: 8.93
Back of Sidewalk: 9;45
ops taken oppgs:ite. front
door:
Floor E evat .e fo er) :11.86
L'Tririr r eayat; rATN ina � 4 '11.01
feet
feet
feet
feet
feet.
E'levati
2
EPERI\
Sm.
P1 P&
(22 .70'
Lci
.2S'
IT #:
Miami S
'R 1LL
Ho LE
-res Village
L0C4T1OMU A/1 P
Sca.t.e
SKETCH, OF SURVEY
APPROVED
ZONING DEPT
-.BLDG DEPT
LIT
••
•
...
•
•
•
.
•
SUBJECT TO CCMPLiANCE WIT ALL FEDERAL
STATE AND CCUN'i Y RULES AND REGULATIONS
SURVEY Qf Lots 23, 24, 25 and 26 (inclusive), less the North
Oe feet -they of , Block 3 of "BELVIDERE ' 'ARR" , according to the
Plat'thereo€ recorded in Plat Book 16 at Page. 71 of the Public
Records of Dade County, Florida, being situated in the Village
of Miathi Shores, and containing 7,490 sq. feet of land.
ORDER NO, 6133 DATE: February 21, 1979
F.B. 224, P. 39., 40 & 41 SCALE: As shown
WE HEREBY CERTIFY that the attached SKETCH OF SURVEY of the
above described property is true and correct to the best of
our knowledge and belief as recently surveyed and platted
under our direction.
A, R. TOUSSAINT & ASSOCIATES INC.
LAND SIIRi YOR,S
620 N.E. 126 Street, North Miami •U
Florida
Howard C. Gamble
Registered Land Surveyor No. 1683
State of Florida
V. Pres.
•
0
1.6
•
..•.
/0.6 e.
1 •
• •
••
.
••
•
•a..
. .
.•. •
•
••
•
•
PIPE
C7R1LL
HOLE,
r3. N.A.
�LcV.
Pd R4KVVdY
?'v.''--Srea�,...4--!..�.r.--„'.-r-�:... ,.,,, •.,ter *y:.y+et
Surveyor'.e Nate:
Elevations .shown refer to National Vertical Datum of 1929, formerly known
as U.S.-C. .&- Ga. S . Datuin, Mean Sea Level.
"'F' E_.t::5 71 --FMS 17-1-7-4 cF 1✓ C. t cJ To SHasry 1=1 .
;ORD R NO.: 6679,. F.B. .2'62, P. 17
S.K&TC H of
.sc A C. E 1 =
lris�icc� s �I�vc 4IcDn-
NO 0
Florida Health
O.S.T.D.
Application No.:
Date:
ON
Miami -Dade County
S. & Well Program
-,9/&/a
.VR VEY Elevation data as of August 10, 19'
-2 0 ELEVATION:
Crown of Road:
(E. Dixie Highway) 9.08'
Edge of Pavement: 8.93
Back of Sidewalk: 9;45
ops taken oppgs:ite. front
door:
Floor E evat .e fo er) :11.86
L'Tririr r eayat; rATN ina � 4 '11.01
feet
feet
feet
feet
feet.
E'levati
•
••
•
•
•
•
•
•
••
•
•. • •
• •
••••
••••
•
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•
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fl+iIAMi_D,417 - Cituivry H,.. % / 3
PERMIT # 1147,/ rZ/1L
"✓fEIYT
DA Tc. /s7
STATE OF (FLORIDA)
COUNTY OF (DADE)
Miami Shores Village
Building Department
SURVEY AFFIDAVIT
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
The undersigned Affiant, t V ' T -S , does hereby attest that
(Propertyowner)
The attached survey, performed by Q.. Q • 16uS S krT 4
(Name 91f surveyor's company)
For address: CI, 2-0C) Ale- 1 2 A.
Performed on n (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 Tess 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.
Further, Affiant eth naught
Ceet4-- /MARY p f►?FLAhAu5E O1ART
Prop wner Signature Property Owner Print Name
SWORN TO AND SUBSCRIBED before me this K.* day of A-Pn.4L.... 2017.
Affiant is personally known to me, (— produced
Revised on 5/22/2009/ Revised on 6/12/09
as identification.
*z
1.11
JOSE N.ALFONSO
MY COMMISSION 01 GG 000984
EXPIRES: July 12.2020
'%;,or : g, 6 Bonded Thru Notary Public Underwriters
44/41
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: BUILDING
1200 1J (21J v�
JOB ADDRESS:
City:
RECEIVED
JUL 13 2017
5411
FBC 2014
Permit No. bS Il - E�-
Master Permit No. RSV 11 1 S o o
ROOFING
Miami Shores
County: Miami Dade
Zip: 3 3 13
Folio/Parcel#:
NO 1./ Flood Zone:
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple Titleholdgt): t— l &ie 0 L- 1e- . Phone#: C3, lS1 - Oggq
Address: l Zoo 1 -)e -
City:
City: S(,o()
LAF
State: Zip:e;51-2,27
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: X77
Address: i° r " t-✓ 17 5`1
City: 11( bk,t( State:
Qualifier Name: / ve--/ Phone#:
State Certification or Registration #: r 2.0 / �f 05 Certificate of Competency #:
Contact Phone#: Ci SY 30 CP 2-1, (' j Email Address:
DESIGNER: Architect/Engineer: Phone#:
SC -4/0 GigLeigi ISdPhone#: b 304 Zb •
• Zip: 3 3 /27 .
Value of Work for this Permit: $ 2 cam"
Type of \'ork_,,OAddition.,. ...-,:kGlAlteration;
Description of Work:
ar inear Footage of Work: 4004 .
New ❑Relair%Replace `"'°`Cll,�o`fif"On
e•
Color thru tile:
***************************************Fees********************************************
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO/CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
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 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 issue•. In the absence of such posted e, the
inspection will not be approved and a reinspection fee will be charged.
Signature ✓ U/ , , , 4...r VIAdc
40 wner or Agent
The foregoing instrument was acknowledged before me this k 1114
day ofTU U L' , 2011 , by pi ha.%) a 4P-1
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
** *** * ***** * ** * ** ****** ****** *
APPROVED BY
Signature
Contractor
The foregoing instrument was acknowledgedwlbefore me this 1,114
day of cv � , 20 (1, by JLa r S\0 j (0,4(
who is personally known to me or who has produced
i) l t a u e Ccs pats identification and who did take an oath.
NOTARY PUBLIC:
Sign.
Print:
My Co
******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
212,i 0
Plans Examiner Zoning
Structural Review Clerk
(Revised 5/2/2012XRevised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007)
pRpER NO. 6297
Awised:this 13tli day of August, 1979 tg_show--punda
ilevationS of building under constructiorpallI,
P>.ni 17- le•00
(i100 INJE II_ 4v/.. Aliam;S wesvED
1(___
7rVr'G DEPT
ion Location
Shorc.c, VAIRge
-1' Dr3 DrPT 03z .
-• q -s ,r -CT TO CC',11-R,/iCE WI
I: • • '''
...._
--"=D"T'
WING 1414.L1.2., :0
. •
. 301
_ FEDERAL
•.....
• • •
51;
• •
.....
......
• •
.....
•
ANTED
2017.
•
eljay.
PZIRKWAY
NO OBJECTION
Florida Health Miami -Dade County
& Well Program •
Application No.:
Date:
Signa
(611-
1118(cprI, <EA
Elevation data. as (7f Nagnst 10, 19
Crown of Road:
(E. Dixie Highway) V418' feet
Edge of Pavement: 849$ feet
Back of Sidewa 9A'5 feet
ETtiarxn-
Iratifang ta- n oPPoik#:0 front door: r+.= Ni2M+Ziailf) ;HAI_
STATE OF (FLORIDA)
COUNTY OF (DADE)
Miami Shores Village
Building Department
SURVEY AFFIDAVIT
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
The undersigned Affiant, M 4N? 004-I s , does hereby attest that
(Property owner)
The attached survey, performed by 4 $5•41 h r 4- SO Gl b1 ( me of surveyor's company)
For address: Q r2.0O ue- Z
Performed on Z/ Zi 7 (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.
Further, Affiant sa - naught.
Property
)1;
I -16,2`f' 0E4107T
r Signature Property Owner Print Name
117 day ofJUV"4 7-0r7
SWORN TO AND SUBSCRIBED before me this
Affiant is Lrsonally known to me, produced
Revised on 5/22/2009/ Revised on 6/12/09
as identification.
RgE N. ALFONSO
*• ,�, ' ': MY COMMISSION # GG 000984
EXPIRES: July 12, 2020
• .,?MOF ,. Bonded Thru Notary Public Underwriters