DS-18-242 Permit'NO. DS-1-18-242
Miami Shores Village Permit Type.DriveWaYS[SideW11kslSlabs
�Pe
10050 N.E.2nd Avenue NE Work Classification. New
.. V `" Miami Shores,FL 33138-0000 l l l
Phone: (305)795-2204 Permmt Status:APPROVED
FLORIDA
issue ate.2120i2018 Fxpi ration: 08/19/2018
Project Address Parcel Number Applicant
9341 NE 9 Avenue 1132060010050
Miami Shores, FL 33138- Block: Lot: ANOUK THIEBAUT
Owner Information Address Phone Cell
ANOUK THIEBAUT 9341 NE 9 Avenue (786)768-0854
MIAMI SHORES FL 33138-
9341 NE 9 Avenue
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
Valuation: $ 2,400.00
AQUARAMA POOL INC (305)934-4226
Total Sq Feet: 600
Approved: In Review Available Inspections:
Comments: Inspection Type:
Date Approved:: In Review LJ
Final
Date Denied:
Foundation ,
Type of Work:NEW PAVERS ON SAND Additional Info:NEW PAVERS ON SAND Review Building
Bond Return: Classification:Residential Review Planning
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.80
Invoice# DS-1-18-66283
DBPR Fee $2.00 02/20/2018 Credit Card $ 142.80 $0.00
DCA Fee $2.00
Education Surcharge $0.60
Permit Fee $125.00
Scanning Fee $9.00
Technology Fee $2.40
Total: $142.80
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 AFFI : I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction ing. Futhermore,I authorize the above-named contractor to do the work stated.
February 20, 2018
ed Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
February 20, 2018 1
,y
i
Miami Shores Village RECEIVED
�1a�
I Building Department JAN 3 0 2018
bs 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 , J
Tel:(305)795-2204 Fax:(305)756-8972 �(
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 201
- _► 3�
BUILDING Master Permit No. �Y I
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ROOFING REVISION EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL [::]PUBLIC WORKS ❑ CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: jf5;�3`T, c� V-
ICity: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): C �rT�hS�1� � �SS�Jy� Phone#: '
Address:
6p o vc,
City: State: �1-L__ Zip:
Tenant/Lessee Name: / Phone#:
Email: C �� ) C�1 �('( W_-L
c
CONTRACTOR:Company Name: ja(L/�M� �C�U�—S C_ Phone#:
Address: 3t� 't7 X1+2 �u�
City: _rzy/ State: Zip: 3�3Z�i
Qualifier Name: Phone#: ��`��
r
State Certification or Registration#: C��� 1���og . Certificate of.Competency#: +
DESIGNER:Architect/Engineer: Phone#:
t
Address: City: State: Zip:
Value of Work for this Permit:$ --`��� , Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration 0,New ❑ Rep Replace ❑ Demolition
Description of Work'.!`.^Yz. , ��, � `/L6 �v` '� „'�.r, ,er,�•>, �� �a,.. , ,. ,T
�u
. ,.^�SSy:.�L41"':ln� � Yr��'� r- f"'..R'•str'aSE;Q tSi'4 � :.+Yby P ti ::
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ (4-S W CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$ 1
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ C '
TOTAL FEE NOW DUE$
(Revised02/24/2014)
t
r
Bonding Company's Name(if applicable)
Bonding Company's Address
City ' State Zip
Mortgage Lender's Name(if applicable)
_Mortgage Lender's Address
City r State Zip
( r
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 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. '
} ` 4
Signature Signature
OWNER or AGENT t DRACOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day fIIf Imo/ 20 ��J by _ \d�y of , 20J by
h 'L personally known to, i11� 41'Z�l�:�lZ �t7J ,wh personally known t
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 PUBLIC.
Sign: Notam Pubk State of Florida i . Sign: • NAY Pubic State of Rxida
Regino Betancourt 4. KegInO Betencourt
Print: My Commission GG 023377 Print: MY Commfsslon GG 023377
pir E.xores 08122/2020
Seal: Seal:
g
APPROVED BY L Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
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Miami Shcres Qillage
APPROVED Y DA
ZONING DEPT LIMIT OF PLAT
r (N.A.P.)
BLDG DEPT
I
SUBJECT TO CCNIPIJANCE WITH ALL FEDERAL i
STATE ANL)Cc UMY ill-A- S AND REGULATIONS
SURVEYOR'S NOTE.