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DS-18-858 Permit No. DS-4-18-858 Miami Shores Village IL Permit Type.,Driveways/Sidewalks/Slabs 10000w.s.2nd Avenue mvv Work Classificafion.Addition/AlterationPer 11 Miami Shores,FLao1o8-0000 ^ Phone: (305)7e5-2204 to 11Dissue Date:4/10/2018 Expiration: 10/07/2018, Project Address Parcel Number Applicant/ 225 NW 91 Street 1131010331350 MARIE THERMITUS Miami Shores, FL 33150- Bloc k Lot:Owner Information Address Phone Cell GRACIA THERMITUS 225 NW 91 Street MIAMI SHORES FL 33150-2258 Contractor(s) Phone Cell Phone Valuati CHAMPION CONCRETE (305)252-8055 (786)402-4802 Total Sq Feet: 1100 Approved:In Review Available Inspections: Comments: Inspection'Type: Da I te Approved: : In Review Final Da'te Denied: Foundation Type of Work:CONCRETE DRIVEWAY,APPROACH AND Additional Info: Review Building Bond Return Classification: Residential Review Planning / ~ Fees Due Amount Pay Date Pay Type Arnt Paid Arn't Due— CCF $4.20 Invoice# DS-4-18-67020 DCA Fee $2.00 Education Surcharge $1.40 04/03/2018 Check#:2828 $50.00 $0.00 PermitFee $150.00 Scanning Fee $9.00 T4chnology.Fee $5.60 Total: $174.45 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBI G,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify t t all the foregoing information is accurate and that all work will be done in compliance,with all applicable laws regulating April 10, 2018 Authorized QAAnature:Owner / Appli-det 7 Contractor / Agent Date ` � . / ) / Building Department ^ ~ April 10, 2018 1 1 Miami Shores Village REC Building DepartmentJAPr3 2018 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 B INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 hid-Zt BUILDING Master Permit No. 1 � PERMIT APPLICATION Sub Permit No. ILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION [—]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP r� CONTRACTOR DRAWINGS JOB ADDRESS: Z2 5 /wj 61 1 51- City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11- 310 ( y l z --I jTV Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): &Y-A-a g- Phone#: Address: OU City:!1 l 1 W� State: Zip: 7 7 3 )5() Tenant/Lessee Name: Phone#: i Email: 1 CONTRACTOR:Company Name: Phone#: Address: �ZU /Jlks City: () State: Zip: 7 Qualifier Name: _j NN-e- Phone#: State Certification or Registration#: Certificate of Competency#: CCC _65®d 4�� I DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ G;LYD Square/Linear Footage of Work: /L/ UU S ;1 Type of Work: F-1Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: co-A)91�= '04jN5ftW 3'1i1�`B'l— 519 &FfL" Specify color of color thru tile: Submittal Fee$ �� Permit Fee$ r�w " CCF$ CO/CC$ Scanning Fee$ Radon Fee$ a DBPR Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ ``fi TOTAL FEE NOW DUE$ 1 `( • 4S (Revised02/24/2014) 1 Bonding Company's Name(if applicable) W. t; , T Bonding Company's Address .City _- 4 „ 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 be del•vered to the person whose property is subject to attachment. Also,a certified copy of the recorded'notice of commencement must be osted at the job site - for the first inspection which occurs-seven (7) days after the building permit is issued. In the absence of,s h posted notice, the,,.,, inspection will not be approved and a reinspection fee will be charged. Signature ( ( �J7 Signature - U OWNER or AGENT C NTRACTOR The foregoing instrument �was �acknowledged before me this The foregoing instrument was acknowledged before me this \ day of 1 IJ�t I�Cy� 120 by 23 day of f�b f& 120 IR by —76nCi'�TbtfM nn who is personally known to i m'e .A GtS 11 © who is personally known to me or who has produced,,0L T6S3-L�'O Z`?�'6 MW or who has produced �f�V�r i CrehS P as identificatio n ho did take an oath. identification and who did to NOTARY UBLIC: NOTARY PU LIC: Sign: b Sign: I Print: P ' o Print: ' Seal: Seal: t� `' -- 'Py''- ANAOYPRI ! �."•••�,;,; YA ADYPRIETO ?' = MY COi ISSION#FF 214031 +; +: Mti COMMISSION#FF 214031 * .+ a EXPIRES:March 25,2019 =_;;;, :o; EXPIRES:March 25,2019 •'��F••••ON� ''�:q�„4;•` Bonded Thru Nota Public Underwriters BondedTh;uNotaryPublicUnderwriters ry *********. 7k?kR?K71UR'�[Atllt". (CakZ�*fir .k+k�.+lc '******************�k********** k'9r**'*'+Ir�R'*S-s�K'Y'#slnts•k**le�l'•k ******** APPROVED BY t Q) Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ti t PACE 2 OF 2 Nor VALID WOHOUf PACE 1 OF 2 • • ••• • -• • • ••a ? + EFRAIN C. LOPEZ J PROFESSIONAL LAND SURVEYOR No.2300 1 � • • • 06: •• • • 1800 W. 49th SUITE 324E O 9 18 • • • • HIALEAH, FL 33012 pR �t�•. PHONE:(305) 512-3710 •��� �� .•• • • . • •• • P. Q R. ' O + ;� 15ALLEY ' F 10PAVEMENT 2 0 75:00'(R&M) (I1 J L n 1 � w I ' < I `6' C.L.F. 8.75' ,��, c'l 1 < _a cn 1,Q 413 LO 21 f B K 13 /� I �L` E� Li 11J J 00 10 > p o W 24.60' ZD < ( n w 17 0 Lu El CD5� a (� • �� vJ CL z D :. F.F.E=13.40' S l Q O m < Q 2.1' ^ v 0 1 ,* a r)V w 8.50':' L 0.0 -4/l o c') 01)' I fi,,E�s X33 W OJ I I U7 17.20' a ONE STORY RESIDENCE � GJw Lprtipo9D h - U' CC 5' sW #225 r'` ri ro I ¢V F.FEL.= 6/�A_9�Y0�.¢GJPA�-�. "� �fy JAI . 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