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DS-05-19-1074Location Address Permit NO.. CSS -05-19-1074 Miami Shores Village Permit Type: Driveways/Sidewalks/Slabs 10050 NE 2 Ave Miami Shores FL 33138 Work Classification: Addition/AkeraUon 305-795-2204 1Permit Status: Approved Issue Date: 06/03/2019 1 Expiration: 12/02/2019 Parcel Number 1060 NE 104TH ST, Miami Shores, FL 33138 1122320290220 Contacts ERIC )NOODLING Owner CHAMPION CONCRETE Contractor 1060 NE 104 ST, MIAMI SHORES, FL 33138 JAIME BASILIO Other: 7275600539 10280 NW 63 TER 105, DORAL, FL 33178 Business: 3052528055 jaimechampion@yahoo.com Other: 7864024802 Description: DRIVEWAY PAVERS REPLACE EXISTING Valuation: Ins vection Requests: p $ 13,100.00 3Q5=7f2 4�t' Total Sq Feet: 2,200.00 Fees Amount Application Fee - Other $50.00 CCF $8.40 Concrete/asphalt/pavers, slabs, dways, $150.00 swalks DBPR Fee $3.00 DCA Fee $2.00 Education Surcharge $2.80 Planning and Zoning Review Fee $35.00 Scanning Fee $9.00 Technology Fee $5.00 Total: $265.20 Payments Date Paid Amt Paid Total Fees $265.20 Check # 613 06/03/2019 $265.20 Amount Due: $0.00 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 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 zoning. Futhermore, I authorizi the above named contractor to do the work stated. Authorized Signature: Owner / Applicagt/ 1Lontractor / Agent Date June 03, 2019 Page 2 of 2 BUILDING 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 PERMIT APPLICATION UILDING ❑ ELECTRIC ❑ ROOFING MAY 14 39 FBC 20 Master Permit Nolls— OS_ i ((�� -1 ( W Sub Permit No. - ❑ REVISION ❑ EXTENSION RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLICANORKS ❑ CHANGE OF CANCELLATION SHOP ��1 CONTRACTOR DRAWINGS y6 JOB ADDRESS: IO ti� It City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): C-0-dL' "�i�(9Q 44 N Phone#: Address: 0b Ca / c- 110 3;3)7t- Tenant/Lessee City: �`',t w SI-Ge1iV`q State: Zip: /3I7t Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Address: 101?0 NW ` City: Qualifier Name: State Certification or Registration #: hone#: -3 0. .757-4W Certificate of Competency #: C—CO5 DESIGNER: Architect/Engineer: Phone#: Address: V ' ff. City: State: Zip: �Value,of.Work for thi'; Pe&it: $ `� � � V Square/Linear Footage of Work: �.>i� ��>'IF Type�f Worka ❑ ,Qddion ❑ Alteration ❑New ❑Repair/Replace ❑Demolition Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $_ Structural Reviews $ (Revised02/24/2014) Permit Fee $ Radon Fee $ Training/Education Fee $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond$ 1aT-��' TOTAL FEE NOW DUE $ 2�6 . 20 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. I "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, a applicant must promise in good faith that a copy of the notice of commencement and construction lien low brochure will be dery red to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must b p sted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of s posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature' OW or AGENT //The foregoing instrum t was acknowledged before me this The foregoing instru c2� day of 20 by day of ?O�L-2(c (,t�` 4Q /'� 157 who is_personally known to M t M -e /} . me or who has produced as Ade or identification and who did take an oath. NOTARY PUBLIC: NOTE Sign: Print: Print: Seal: CATHERINE;A,.DUFFIN Notary Public - lorida • Commi`;�lon 296 �aeHfiiry'hx1 APPROVED BY (Revised02/24/2014) Seal: NTRACTOR was acknowledged before me this u Gj 20 1 1 by 1 O U who is personally known to I& It\KQ SAW d ho did ake an oat * • �y� g••p ****************************************************************** Plans Examiner �? Zoning Structural Review Clerk r BOUNDARY SURVEY ABBREVMnONS : 'C -M CDNDMDNER SLAB LEGEND 9- - CF_KTERUNE Ce - colwW-M BLOCK n 'V o y ~+ - FouND 5/8 -,Roar ROD R& aECTMC METER I O - FOUND PK AWL FIP - FOUND IRON ROD. FOUND ia-a N P,PE CONC. -FWND M ROD !V !� � LV (1iC Ci�� D = w WATER METPR P -PLAT �� Vl ® - CABLE TELEVISION M - MEASURED NO ID -NO IDEAMR ATION OHW-,_OV@RIEAD WIRES RAN RIGHT-OF-WAY 17�111 UE -UTILITY �� I a�`' �� Poi -POINT - � 1 POB - POINT X140 +0 1^r ,14,(9 )f �i'p�`�. ��;►� Gip a�� _ os- M N U ! N.E.104TH STREET ° m (50'R0.W.. 22' ASPHALT PAVEMENT) C-. yP b r o CO m� - - N 9( AMm G) -n L La i' O cm i 0 . WEST ea' of LOT 9 C i V\ 4 1'lw O 33AP 1 V_ Was • ... Acam Garaw T. �.. - ao Nt LLI � Q 1 ` 20r o ...... u.i • ... ..... � 0` ......� LOT lf.0 • Covered Parch 28' 1 -STORY FRAME RESIDENCE #loco 2Z Lawn f 9r Covered Parch 4 Cam \ 18' \ � crehc. Pavers BLOCK 2 LOT 8 Wood Fa m O.)_,,.,_ 33AP _ •..• ..•.•• Was • ... ...... �.. ...... u.i • ... ..... ......� LOT lf.0 to Q . ,Z X3.W i