DS-18-516 (2) Permit NO. DSi-2-18-516
a3+O1S y,� Miami Shores Village Permit Type:Driveways/Sidewalks/Slabs
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10050 N.E.2nd Avenue NE
Per � ' WorfcClassiircation:Addition/Alteration
Miami Shores, FL 33138-0000
yyery ` Permit Status:APPROVED(305)7952204
FCORiDA
Issue Date:3/12/2018 Expiration: 09/08/2018
Project Address Parcel Number Applicant
1420 NE 103 Street 1132050310030
MARC AND ANNE LITZENBERG
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
MARC AND ANNE LITZENBERG 1420 NE 103 Street
MIAMI SHORES FL 33138- r
1420 NE 103 Street i
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
EJD CONSTRUCTION CONSTRACTOF 305 433-4843 Valuation: $ 2,000.00
( ) (305)318-4978
Total Sq Feet: 800
Approved: In Review Available Inspections:
Comments: Inspection Type:
Date Approved:: In Review Final
Date Denied: Foundation
Type of Work:DRIVEWAY AS PER PLANS Additional Info:DRIVEWAY AS PER PLANS Review Planning
Bond Return: Classification:Residential Review Building
Scanning: 1
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Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
DBPR Fee Invoice# DS-2-18-66609
$2.00 03/12/2018 Credit Card $90.20 $50.00
DCA Fee $2.00
Education Surcharge $0.40 02/28/2018 Credit Card $50.00 $0.00
Notary Fee $5.00 r
Permit Fee $125.00
Scanning Fee $3.00
i
Technology Fee $1.60
Total: $140.20
.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.
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OWNERS AFFIDAVIT: I certify that all the fore oing informati is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I author' e t e abo e e ontractor to do the work stated.
March 12, 2018
Authorized Signature:Owner / Applic I
nt / tractor / Agent Date
Building Department Copy
March 12, 2018 1
G ,
3�2 Miami Shores Village RECEIVED
�-A Building Department FEB 28 2018
10050 N.E.2nd Avenue, Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 i
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No. DS e- 51 (o
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
�f �/�/ ; CONTRACTOR DRAWINGS
JOB ADDRESS: i t � /V /�, rr6)3 T ' I
City: Miami Shores County: Miami Dade Zip: X3313 p
Folio/Parcel#: Is the Building Historically Designated:Yes iNO
Occupancy Type: Load: /JConstruction Type: / Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): "' Y%/1L r"rz e n J e r j Phone#:
Address: 1 /..Zr� /U 10 ST
y: � , 3313
Cit ' 1 pf111 �YlO�PS State: F� Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: E ',b copi6t(uc-f byi Phone#: 305 y33 48 43
Address: 1 760 Off Ns c,
City: 4z.i'//<<cf-V 1 State: — Zip: 8 '
Qualifier Name: E L C . Sea X6v Phone#: 3M 344003
State Certification or Registration.#:, . G Certificate of Competency M
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Dt�
Value of Work for this Permit:$_�°000 t Square/Linear Footage of Work: g0�
Type of Work4,'I10"'Addition ❑ Alteration [ New ❑ Repair/Replace ❑ Demolition
Description of Work '.' lr;✓e v✓Q'V Cr S fie( ���N�
Specify color of color thru tile: '
Submittal Fee$ Permit Fee$ iz9' W CCF$ CO/CC$ t
y .
Scanning Fee$ Radon Fee$ DBPR$ Notary$ Gp
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ C
TOTAL FEE NOW DUE$ Gr0 0
(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 be delivered to theyerson
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 occur even (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and r inspection fee will be charged.
Signatur Signature
OWNER or AG T CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoin strument was acknowledged before me this
I +day ofQ.�) 2�-_� by y of �R—� 20 1� by
Anne 1 whis personally knownI L S413o a�who isrsonaTl�no n to
me or who has produce 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: \\\`\\\"� III4�`////,//
Sig v L Sign: •.`f'
Ny m=
'I�:� P ,hd¢aF'- =�• �cGa4, 94Print: Print: 19MY COMMISSION 122181
019Seal: Seal: 0•d "oc�EXPIRES:October 18,2rs3onded Thfu Notary Pubk UndeKe
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silt 6 v0:
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)