DS-18-1445Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit NO. DS-5-18-1445
Permit Type: Driveways/Sidewalks/Stabs
e' Wank Classification: New
Permit Status: APPROVED
Issue Gate 7/10/2018
Expiration: 01/06/2019
Parcel Number
Applicant
9505 NE 5 Avenue
Miami Shores, FL
1132060140710
Block: Lot:
DONALD STOBS
Owner Information
Address
Phone
Cell
DONALD STOBS
9505 NE 5 Avenue
MIAMI SHORES FL 33138-3161
(305)757-0950
9505 NE 5 Avenue
MIAMI SHORES FL 33138-3161
Contractor(s) Phone
ALL QUALITY ELECTRICAL SERVICE: (305)968-7832
CeII Phone
Valuation:
Total Sq Feet:
$ 1,200.00
20
Approved: In Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Work: CONCRETE SLAB FOR 22 KW GENERATC
Bond Return :
Scanning: 1
Additional Info: CONCRETE SLAB FOR 22 KW GENE
Classification: Residential
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
P&Z Review Fee
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$2.00
$2.00
$0.40
$35.00
$100.00
$3.00
$1.60
$145.20
Pay Date Pay Type
Invoice # DS-5-18-67708
05/25/2018 Check #: 1734
07/10/2018 Credit Card
Amt Paid Amt Due
$ 50.00 $ 95.20
$ 95.20 $ 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 WIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing infor atio is accura an that work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above ame contractoto dohe k stated.
Authorized Signature: Owner / Applicant / Contractor
/ Agent
July 10, 2018
Date
Building Department Copy
July 10, 2018
1
BUILDING
PERMIT APPLICATION
Vf BUILDING ❑ ELECTRIC
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
❑ ROOFING
❑ REVISION
RECEIVED
MAY 2 5 '. f3
0_/t
CQ 1 m
FBC n1.9.
Master Permit No. e 1 l ` . qg
Sub Permit No. `[)S .S tU`� S
❑ EXTENSION ❑RENEWAL
❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9o's Ait rx� I ,or
City: Miami Shores County: Miami Dade Zip: 33/ �
Folio/Parcel#: / f f 3 U- �' Q . ` d / fo Is the Building Historically Designated: Yes NO V
Occupancy Type: S ? Load: Construction Type: C#4.S Flood Zone: Ai BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
Address:
City:
v)ake J 74 g So,)7. 75/ 7995/
F5-0 A/6 C. 71LL. 40e-
/ (ti%y/ l �l'7% 0 _7 State: , Zip:
Tenant/Lessee Name:
Email:
Phone#:
CONTRACTORJJ: Company Name: 1( w e1
Address: /�7 O (TZ , I ,�/'�.
City: C,a it4 f State:
•
Y
Phone#: 3tr 9-‘ i /?3)-
Zip: 3 / % 7
'Qualifier Name: s Sarn Jvr�i.0 —
(j ?/ (�j ✓
n q �
State Certification or Registration #: /30/ 3s . 6
3
DESIGNER: Architect/Engineer:
/04
Phone#:
f
Certificate of Competency #: -0O11 r 7c?
Phone#:
Address: ,�,/ City: State:
Value of Work for this Permit: $ /o''t/ �/
•
Type of Work: ❑ Addition ❑ Alteration IYew
(')2 C1-10 slams
Description of Work:
Square/Linear Footage of Work:
❑ Repair/Replace
❑ Demolition
Specify colorof cglir;r;#Fir`ualex'
Submittal Fee $ $ k� ' (� c c Permit Fee
Scanning Fee $ Radon Fee $ a . Ql
CCF $ CO/CC $
DBPR $�, - c
Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ Q5
(Revised02/24/2014)
— J
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if'applicable)
r;
Mortgage Lenders 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."`.
Applicant: As a condition to the issuance
of a building permi
Notice to t 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.
C:
Signature 1I(-4 (
- • OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of- t �>_ , 20 {1 % , by
er a-1 a S-�?26 S I , who is personally known to
me or who has produced' pr5C)r'& _1 i -J Pl ns
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
•
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
D jdayofa Jv\n(X� ;20 , by
,1 m►uoJ LLG�n'�bUU✓nn_, who is personally known to
pc or who has produced c isc (Nn —as
n�r1ref w(
identification and who did take an oath.
NOTARY PUBLIC:
Seal:
et► ••'•`;"1rr' • - ALEJANORA GRIGORE8CU
• MY COMMISSION t FF 143529
:'eso r r ' . dA EXPIRES:July 21, 2018
************************************************************************s*`***�* **� �o************
Seal: �`:�•�: ALEJANDRAORIGORESCU
a MY COMMISSION t FF 143529
EXPIRES: July 21, 2018_
lank/ Tbru Bulger Notary Servkes
APPROVED BY Plans Examiner
Zoning
Structural Review
(Revised02/24/2014)
Clerk