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DS-18-3046Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Permit NO.: DS-10=18-3046 Permit IVR Number: 100289 Permit Type: Driveways/Sidewalks/Slabs Work Classification: New Permit Status: Approved issue Date: 10/OS/2018 Parcel Number Expiration: 04/01/2019 1499 NE 104TH ST, Miami Shores, FL 33138 1122320320110 Contacts PATRICK LONGMAN 1499 NE 104 ST, MIAMI, FL 331382663 Other: 3056773046 Owner CHAMPION CONCRETE JAIME BASILIO 10280 NW 63 TER 105, DORAL, FL 33178 Business: 3052528055 Other: 7864024802 Contractor Description: PAVERS DRIVEWAY TO REPLACE DS 18-462 Fees Amount Concrete/asphalt/pavers, slabs, dways, swalks Total: $75.00 $75.00 Valuation: $ 8,600.00 Total Sq Feet: 1,200.00 Payments Total Fees Credit Card Amount Due: Amt Paid $75.00 $75.00 $0.00 Inspection Requests: 305-762-4949 Building Department Copy In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required or ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS regulating 41111111111. FFID . nstru IT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws on and zoning. Futhermore, I authorize the above named contractor to do the work stated. Authoriz d Sigt•1$• t-/r e.. 5i44 : Owner / Applicant / Contractor / Agent Date October 05, 2018 Page 2 of 4