DS-17-75Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit "'
Issue Da
Permit NO. DS-1-17-75
it Type: Driveways/Sidewalks/Slabs
oi*Classi cation: Addition/Alteration
Permit Status: APPROVED
f: 2/2/2017
Expiration: 08/01/2017
Parcel Number
Applicant
841 NE 95 Street
Miami Shores, FL
1132060142940
Block: Lot:
ARTURO CADILLA
Owner Information
Address
Phone
Cell
ARTURO CADILLA
841 NE 95 Street
MIAMI SHORES FL 33318-
841 NE 95 Street
MIAMI SHORES FL 33318-
Valuation:
Total Sq Feet:
$ 5,500.00
800
Approved: In Review
Comments:
Date Approved: : In Review
Date D
Type of
Bond Return :
Scanning: 3
EL
4 Co
DRIVEWAY FOR PAN/ Additional Info:
Classification: Residential
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Notary Fee
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$3.60
$2.00
$2.00
$1.20
$5.00
$125.00
$9.00
$4.80
$152.60
Pay Date
Invoice #
01/12/2017
02/02/2017
Pay Type
DS-1-17-62586
Credit Card
Credit Card
Amt Paid Amt Due
$ 50.00 $ 102.60
$ 102.60 $ 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 and zo + g. F�thermo e, I aut rite th above -named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent
February 02, 2017
Date
Building Department Copy
February 02, 2017 1
BUILDING
PERMIT APPLICATION
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
FBC20 t
Master Permit No..) 5 v1-5
Sub Permit No.
BUILDING , ❑ ELECTRIC 0 ROOFING ❑ REVISION 0 EXTENSION 0RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shore
•Folio/Parcel#: t I —
,Occupancy Type: Load:
9 S Si -
County: Miami Dade Zip:
Is the Building Historically Designated: Yes NO
n Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple
Titleholder): A 1 ) aO C(kct (l J ck Phone
((I #: Address: $ ` I SO 9 is
V& S� p�
City: (Q (, lit Q State: Zip: `3 3 13
,Tenant/Lessee Name: Phone#:
Email: /� ,� / �� /
CONTRACTOR: Company Name: e_Q uo V1 \ Phone#: l 7C�-) ' S -2550 > 2
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #: ' . ,
DESIGNER: Architect/Engineer: Phone#:
Address: City:
00
Value of Work for this Permit: $ 6 I 5C9 0Square/Linear Footage of Work:
State: Zip:
g-vo
Type of Work: ❑ Addition E. Alteration ❑ New ❑ Repair/Replace
RP? L [�Ge Ex ,V ��
r ,CIF
Description of Work:
❑ Demolition
f; (,
"f'1'ff•Ja..• •
�� ems. � �•C
40
Specify color of color thru tile: - - , t,�.
Submittal Fee $ Permit Fee $ I 2 O CCF $ J • CO/CC $
Scanning Fee $ Radon Fee $ L- DBPR $ 2-- Notary $ .
Technology Fee $ 80 Training/Education Fee $ I Z..Double Fee $
Structural Reviews $
Bond $
TOTAL FEE NOW DUE $ I O •
Co 0
(Revised02/24/2014)
Bonding Company's Name (if applicable)
,7
Bonding Company's'Address
City State Zip
Mortgage Lender's Name'(if applicable)
Mortgage Lender's Address
City. I 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. A
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF/,COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTATO YYOUR !PRO1? TY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDEliNtlikaTTORNEY 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
1'2 day of , 20 1 , by day of , 20 , by
��jj
At11)10 C (�nrho is personally known to , who is personally known to
me or who has produce�—V(0 Sd IO d �
ass 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
Print:
Seal:
MAHARA►K.GONZALEZ
•'•is�.. , y • .02
*ciEXPIRES: November 2, 2020
%)<".`- Thru Notary Public Undervirtters
so� oa;. goaded
Sign:
Print:
Seal:
***********************************************************************************************************
APPROVED BY ' t Y \ Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)