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DS-18-2302 (2)PERMIT # CONTRACTOR: SUBMITTAL DATE: ADDRESS: NAME: PROJECT TYPE: PUBLIC WORKS 'Z ;' ZONING PLUMBING STRUCTURAL MECHANICAL ELECTRICAL BUtEQING ''"'� Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: Permit No.: OS-8-18-2 02 Permit Type: Driveways/Sidewalks/Slabs Work Ciassihcation: New Permit status: Approved Expiration: 04/23/2019 Location Address Parcel Number Project 1201 NE 96 ST, Miami Shores, FL 33138-2553 1132060143830 <NONE> Contacts POL ZAZADZE Owner POL ZAZADZE Applicant 1201 NE 96 ST, MIAMI SHORES, FL 33138 1201 NE 96 ST, MIAMI SHORES, FL 33138 Other:3057902785 Other:3057902785 HOME INTERIOR SERVICES AND Contractor INVESTMENT INC JUAN PABLO BETANCOURT 1690 W 38 PL 131, HIALEAH, FL 33012 Business: 3053288590 Other:7865978093 Inspection Requests: Description: INSTALL DRIVEWAY AND WALKWAY (CONCRETE Valuation: $ 6,000.00 Ins 7ction Re SLABS) TotalSq Feet: 245.00 Fees Amount CCF $3.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $1.20 P&Z Review Fee $35.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $4.80 Total: $157.60 Building Department,Copy Payments Date Paid Amt Paid Total Fees $157.60 Credit Card 10/25/2018 $107.60 Credit Card 08/28/2018 $50.00 Amount Due: $0.00 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 regulati truction and zoning. Futhermore, I authorize the above named contractor to do the work stated. e Authorized Signature: Owner / Applicant / Contractor / Agent Date October 25, 2018 Page 2 of 2 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 _ FBC 210 I *t BUILDING Master Permit No. �C I 1b _ ( / PERMIT APPLICATION Sub Permit /BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 4 City: Miami Shorties County: Miami Dade Zip: I p Folio/Parcel#: I — d'(J b4 — 3 W Is the Building Historically Designated: Yes NO ✓ Occupancy Type: Load: Construction Type: Flood Zone:: BFE: OWNER: Name (Fee Simple Titleholder): f� � Q Phone#: nFFE: / r' Address: 1 City: IM t L_ >t Tenant/Lessee Name: Email: --4c, vctt 1 1 CONTRACTOR: Company Name: 1 "`�C• Address: � 6�O W - Z, 6 7v' State: Zip: 3 2,13 q) ne#: p`ne#4 bo 3 36 b S `� 0 City 'd.���.� n Stater T l Zip:— qualifier Name: '� a -. - `lhC_ J'A . c.4 rPhorie#:i fSt74fe Certification or Registration #: C Z `�� `�'� Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ r6ice Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Specify color of color thru tile: vo Submittal Fee $ G Permit Fee $ �� • CCF $ 3 • 6 d CO/CC $ Scanning Fee $ 1 Radon Fee $ Z DBPR $ Notary $ Technology Fee $ 4 . 6O Training/Education Fee $ 1.2o Double Fee $ Structural Reviews $ & Bond $ ? % �, S d• TOTAL FEE NOW DUE $ (Revised02/24/2014) �- Bonding Company's Name (if applicable) _ Bonding Company's Address City ' State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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. 3 Signature OWNER or AGENT The foregoing instru nt was acknowledged before me this T day of 20 b by Tl 7 &ae--1 who is personally known to me or who has produced : WL-- as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: o�pnr °� Notary Public State of Florida Seal: ? Dennis Lefton @o` MY Commission GG 073636 or no Expires 02/15/2021 APPROVED BY / (Revised02/24/2014) Signature _ P=� - NTRACTOR The foregoing instru nt was acknowledged before me this day of C+ 20 1 it by Ra fit•- t , who is personally known to me or who has produced 9/!_._ as identification and who did to NOTARY PUBLIC: votary Public State D211nls Leiton ' v+y�,, MY Commission GG is' Tort Expires02/15/2021 Sign: `"',• r,"' Print: Cv%.�t Seal: OSp0 P1,. Notsry : •:: ' . "nte Oi Florida o' w �9 t,�yl; n«. ^fG073f35 Plans Examiner Zoning Structural Review Clerk N•E. h :•.. A E ;: U •� o 0 r� � . V W ASPy -.iP£RP W1:::;::;: •... z O _ y 22 PAR K WA 3 Y 0 il: i i i i:i i + F 25.45' Ar, CL: '. O '.^ :.r k W O 23.40' H 23.82' p - ' [ Qi t' � : . : W .;• 30.47' n s m N mc) N o o J • •• '� `.. c u i< 25.10, om o_ u- O:o:: ::1;: ;:;:; -• .} 9 JT N !r a •,:;.. ' �,�'� �:. o - 24.05'w r7:: M zzi OOA •- 1 .7 J o .. _ o POOL �R•- •.Y••• Cr.,� ;Z; _Y• fib N 69.60' ply 690 ..,. ., 2.30'.CL 40.00' 9 52.80' ram'; 0- o i32.12' R& M a z I: N \ n, ?Z: cm NOT VALID UNLESS EMBOSSED WITH K. '�-SEAL #TL REVISED: 0 ABBREVIATIONS S1M(=SIDEW4LIt CBS=CONCRETE BLOCK STRUCTURE. CLF=CHAIN LINK FEN CE,PL=PROPERTY LINE: DUE=DRAINAGE UTILITI'EpSEMEN7 IP=IRCNPIPE.- F=FOUND, A/C=AIR CONDITIONER PAD, P/C --PROPERTY CORNER. D/H=DRILLED HOLE, WF=V:OODEN FENCE, RES=RESIDENCE CL-CLEAR RB=REBARI' UE=UTILITY EASEMENT. CONC=CONCRETE SLAB. RAN -RIGHT OF VAY, DE=DRAINAGE EASEMENT, CIL=CENTER LINE, O=nIAMTER, TYP=TYPICAL, M=MEASURED. R=RECORDED. ENCR=ENCROACHMENT, COMP=COMPUTER. ASH=ASPHALT• N/D=NAIL & DISC. S=SET, FEE=FINISH FLOOR ELRATION. OIS=OFFSET, P/P=POVYER POLE. OHP=OVERHEAD PQ"ERLINE, 1hM=VW.TER METER t •:-V100DFENCE= p MA$oNRYl114L6= ELEVATION BASED ON LOC. # 325() S CONCRETE=,.':•:•.:••s••:•:•:-:::••s::••s:.••s.•:.•s.•:. CBM# .. . MAINTENANCE&DRAINAGEEASEMENT=M&D.E B-62 ELV. 8.661 TYPE OF SURVEY: BOU14DARY SURVEY SURVEYOR'S NOTES- 1)- OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATURE AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT' COVERED (BY PROFESSIONAL LIABILITY INSURANCE.. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT . 5). UNDERGROUND ENCROACHMENTS NOT LOCATED- 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC VERTICALDATUM OF 1929_ 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL RESTRICTIONS NOT SHOWN ON THIS S URVEYTHAT MAYBE FOUND 1N THEPUBLIC RECORDS OF THIS COUNTY. 9) ' CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING INFORMATION, 10) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADETO DETERMINE RECORDED INSTRUMENTS, IFANY,AFFECTINGTHIS PROPERTY. Additions or deletions to survey maps or reports by other than the signing party or parties is prohibited 'Nithout written consent of the signing party or parties. BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE_OF-& ,D P8 -PAGE LOCATION SKETCH SCALE: NTS N,E• 12 fh a l,__ a IL .r N m PROPERTY ADDRESS: 1201 NE 96 ST., MIAMI SHORES, FL. 33138 LEGAL DESCRIPTION: LOT 17 AND THE WEST Y2 OF LOT 16, BLOCK 83, OF MIAMI SHORES SECTION NO. 3, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 10, PAGE 37, OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA. I HEREBY CERTIFY That the survey.represented theteon meets the minimum technical requirements adopted ty the STK E OF FLORIDA Board of Land Surveyors pursua it to Section 472,027 Florida Statutes. There are no encroachments, overlaps, easements appearing on the plat or visible easements otherthan as shown hereon. ADIS N. NUNEZ. REGISTERED LAND SURVEYOR STATE OF FLORIDA #5924 SINCE 1987 - BLANGO SURVEYORS INC. Engineers • Land Surveyors • Planners • LB # 0007059 555 NORTH SHORE DRIVE MIAMI BEACH, FL 33141 (305) 865-1200 Email: blancosurveyorsinc@yahoo.com Fax: (305) 865-7810 FLOOD ZONE: X SUFFIX: L DATE. 9/11/09 BASE: N/A PANEL: 0306 JCOMMUNITY* 120652 DATE: SCALE: DWN. BY: JOB No 1 1"=:30F.[3lanco 18-147 Miami Shores Village Building Department SURVEY AFFIDAVIT STATE OF (FLORIDA) COUNTY OF (DADE) 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 The undersigned Affiant,��1 i�rA a -e, does hereby attest that (Property owner) The attached survey, performed by la-vi Svs —Lnc . (Name of surveyor's ompany) For address: i a-0 1 �� � S-t-r "' I�l' Icvu,L,j - 3 t � , Performed on W ,- aD (date of survey) is an accurate representation of the existing conditions and locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits. Further A nt say eth naught. � Prop rty Owner Signature Property Owner Print Name SWORN TO AND SUBSCRIBED before me this 0 day of Affiant is _personally known to me, _produced -Y L as identification. Notary Florida wY P Public State of ;otP, p�rinis Leiton GG 073635 < iAy Commission 4y oe Expires 0211512021 �o,� Notary Revised on 512212009/ Revised on 6112/09