DS-18-169Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit NO. DS-1-18-169
Permit Type: Driveways/Sidewalks/Slabs
e m ' Work Classrftcation: Repair
Permit Status: APPROVED
Issue Date:1t23/2018
Expiration: 07/22/2018
Parcel Number
Applicant
1242 NE 104 Street
Miami Shores, FL 33138-2660
1122320300070
Block: Lot:
HAROLD PHILIP & ROBIN CAHIL
Owner Information
Address
Phone
Cell
HAROLD PHILIP & ROBIN CAHILL III
1242 NE 104 Street
MIAMI SHORES FL 33138-
(305)753-6218
1242 NE 104 Street
MIAMI SHORES FL 33138-
Contractor(s)
HOME OWNER
Phone Cell Phone
Valuation:
Total Sq Feet:
$ 2,500.00
990
Approved: In Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Work: MAINTENANCE OF ASPHALT DRIVEWAY
Bond Return :
Scanning: 3
Additional Info:
Classification: Residential
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Work without Permit Fee
Total:
Amount
$1.80
$2.00
$2.00
$0.60
$125.00
$9.00
$2.40
$125.00
$267.80
Pay Date Pay Type
Invoice # DS-1-18-66197
01/23/2018 Credit Card
01/23/2018 Credit Card
Amt Paid Amt Due
$ 217.80 $ 50.00
$ 50.00 $ 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
construction . d .,�,� uthermore, I authorize the above -named contractor to do the work stated.
January 23, 2018
A t orized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
January 23, 2018 1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
16.BUILDING ❑ ELECTRIC ❑ ROOFING
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: I Z. H., S t-
RECEIVED
2321117
FBC j2017,
Master Permit NoDS' 1 'r .((--16,
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑ CHANGE OF ❑ CANCELLATION E SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: / I — 1 D 3v C.0 %Q Is the Building Historically Designated: Yes
Occupancy Type: Load: Construction Type: Flood Zone:
OWNER: Name (Fee Simple Titleholder): 14 A ani_to Pm L i r G.41111L_.
Address: / f D t/ !i, -
City: lii//Lift/ 56'0PE f State: �`L. Zip: 33 t 3
Tenant/Lessee Name: Phone#:
Email:
3313S'
NOFX
BFE: FFE}
Phone#: 306- 7c3 G.Z/6"
CONTRACTOR: Company Name: '-i0intUwnID r'' .. Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: 4 q Zip:
Value of Work for this Permit: $.1. SZIC7 Square/Linear Footage of Work:. V I 16 ,‘',2¢ Pr -
Type of Work: ❑ Addition ❑ Alteration ❑ New ;Reair Re l p / � pace ❑Demolition
M A. t A%TE,U/i )C5 OF 45 OLT-, D Rlierit. y `. r2�SGe Rt=,4
Description of Work:
LL))17t Yeg12, cf) FSPNALr'. *�
Y
S .
Specify color of color thru tile:
Submittal Fee $ �� Permit Fee $pA
Scanning Fee $ . Radon Fee $
Technology Fee $ Training/Education Fee $
-Structural Reviews $
CCF $ CO/CC $
DBPR $ Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $) • p "
(Revised02/24/2014)
f 74 i,, i .. ,1 `. ?
Bonding Company s'Name (if applicable)
Bonding Compan\'s Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City `. * State I 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 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
Signature •
OWNER or AGENT ' CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
a3 • day of 'i?s.--) , 20 (43— , by day of , 20 , by
4.1-D GAM ((,L , who is personally known to , who is personally known to
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: 0011IIIII1II///j/ NOTARY PUBLIC:
Sign:
. Mary _ O
,` N. oZ:m-
Print: f� p% s3j e ` :a
a�i2 ' - '
Seal: d3. S',:
�' '1/. . Pe, .• '\
J�� flORIO11*w1.'
i
********************************,,****#*s** **************************
APPROVED BY
Plans Examiner
Structural Review
Sign:
Print:
Seal:
Zoning
Clerk
(Revised02/24/2014)
6S£SI 'ON 1031'08d
LEGAL DESCRIPTION: CERTIFIED TO: `
LOT 2, BLOCK 2, RIVER BAY PARK, ACCORDING TO THE PLAT H. PHILLIP CAHILL; ROBIN J. CAHILL; HOLLY COHEN, P.A.; OLD REPUBLIC NATIONAL TITLE INSURANCE
THEREOF, AS RECORDED IN PLAT BOOK 41, PAGE 55 OF THE COMPANY; KINECTA FEDERAL CREDIT UNION , ITS SUCCESSORS AND/OR ASSIGNS, AS THEIR INTERESTS
PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA. MAY APPEAR. ,
. FOR: 1242 N.E. 104th Street, MIAMI SHORES, FLORIDA 33138
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I. LEGAL DESCRIPTION PROVIDED BY OTHERS, UNLESS OTHERWISE NOTED.'
2. THIS SURVEY DOES NOT DETERMINE OR IMPLY REAL PROPERTY OWNERSHIP.
3. THE LANDS SHOWN HEREIN ARE SUBJECT TO RESTRICTIONS OF PLAT (S) OF
RECORD, THERE MAY BE ADDITIONAL RESTRICTIONS THAT MAY BE FOUND IN THE
PUBLIC RECORDS OF THIS COUNTY, AFFECTING THESE LANDS.
4. MEASURED VALUES OF BOUNDARY DISTANCES, DIRECTIONS AND INTERIOR ANGLES,
HAVE BEEN FOUND CONSISTENT WITH VALUES OF RECORD, UNLESS OTHERWISE
SHOWN.
5. ELEVATIONS, IF SHOWN, ARE REFERRED TO N.G.V.D. 1929.
6. UNDERGROUND IMPROVEMENTS, FOOTINGS AND UTILITIES ARE NOT LOCATED ON
THIS SURVEY MAP.
7. FENCE OWNERSHIP NOT DETERMINED, APPARENT CLEARANCES AND/OR
ENCROACHMENTS ARE NOTED BY VISUAL MEANS ONLY.
8. NO IDENTIFICATION CAPS FOUND ON SURVEY MONUMENTS, UNLESS OTHERWISE
NOTED.
9. THE SCALE, AS SHOWN IS THE INTENDED PLOTTING SCALE OF THIS MAP.
10. THIS SURVEY IS EXCLUSIVELY FOR THE USE OF THE PARTIES TO WHOM IT IS
CERTIFIED.
II. THIS SURVEY MAP AND THE COPIES THEREOF, ARE NOT VALID WITHOUT THE
SIGNATURE AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER.
12. ADDITIONS OR DELETIONS TO SURVEY MAPS OR REPORTS BY OTHER THAN THE
SIGNING PARTY OR PARTIES IS PROHIBITED WITHOUT WRITTEN CONSENT OF THE
SIGNING PARTY OR PARTIES.
GENERAL NOTES
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BENCH MARK USED: N/A
FLOOD INSURANCE RATE MAP (FIRM) INFORMATION:
COMMUNITY NUMBER: 120652 PANEL NUMBER: 0306
SUFFIX: L PANEL REVISED DATE: 09/11/2009
FLOOD 'ZONE: X •
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