DS-19-256X
BUILDING
PERMIT APPLICATION
11
Miami Shores Village
Building Department .
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
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INSPECTION LINE PHONE NUMBER: (305) 762-4949
FF BSC 20
Master Permit No. Nc - - g
Sub Permit No. 502-19 _ 2 Sro
BUILDING ELECTRIC ROOFING REVISION EXTENSION RENEWAL
PLUMBING MECHANICAL [:]PUBLIC WORKS CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: Iyulr Iy V `4113 A V E
City: Miami Shores .
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County: Miami Dade Zip: --33 k 3 $
Folio/Parcel#: I I J I/OIJ I 1 —1 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Q` (5 i' ret 6u'tQ' Phone#:
Address: i C0 -:f N b u4h A(E
City-
Tenant/Lessee Name: _
Email: Ci?DRA-V
CONTRACTOR: Company Name:
S State: Ori zip: V5 t 33
APhone#:
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Address: IOk555 VI N Wd #99& p
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City: o'(/1 C(M J t state: 1' (G f (' Q. zip: 53I t
Qualifier Name: GO 1.1 i 5 -Mm 6LA, M I A Phone#:
State Certification or Registration #: C G C 01 ( (0d Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit: $
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1 Square/Linear Footage of Work:
gZip: (
1
I, I 59 iT•
Type of Work: Addition Alteration] New Repair/Replace Demolition
Description of Work: corex e, &—ri
Specify color of color thru tile:,
Submittal Fee
Scanning Fee $
Technology Fee $
Structural Reviews $
Revised02/24/2014)
Permit Fee $ CCF $_
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Radon Fee $ DBPR $
Training/Education Fee $
CO/CC $
Notary
Double Fee $
Bond $
TOTAL FEE NOW DUE $ C'[ rD .
Bonding Company's Ndme (if applicable)
Bonding C 's Address
City State _
Mortga Lender's Name (i licable)
Lender's Addr s
P —.
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 wilt be approved and a reinspection fee will be charged.
A
OWNER or AGENT
The foregoing instrument was acknowledged before me this
4u --d a of -Fe-br UtIL6 20 by
CIS)U Ue4 who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign G
Print' e,-tlam'
Seal:
Nil
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of h –C 20 by
who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: `
Print:
Seal:
IAY r: i•.b ,CATHERINE A, DUFFIN
f Notary Public - State of Florida
M My Comm. Expires May 14, 2021
I1ur41cd lhr0ugh Nmlonai Notaryassn.
APPRO _ _ * Plans Examiner
Structural Review
Revised02/24/2014)
Zoning
Clerk
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:
Location Address Parcel Number
10007 NE 4 AVE, Miami Shores, FL 1132060170490
Contacts
Permit NO.: DS -0249-256
Permit Type: Driveways/Sidewalks/Stabs
Work Classification: Addition/Aiteradon
Permit Status: Approved
Expiration: 08/05/2019
JOHN & CRISTINA BUTLER Owner JOHN & CRISTINA BUTLER Applicant
500 NE 102 5T, MIAMI SHORES, FL 33138 500 NE 102 ST, MIAMI SHORES, FL 33138
IMBURGIA CONSTRUCTION SERVICES, Contractor
INC.
LOUIS IMBURGIA
Business: 3055255707
Description: CONCRETE DRIVEWAY Valuation: $ 900.00
Ins ection Requests:
Total Sq Feet: 1,192.00
Fees Amount
Application Fee - Other 50.00
CCF 0.60
Concrete/asphalt/pavers, slabs, dways, 100.00
swalks
DBPR Fee 2.25
DCA Fee 2.00
Education Surcharge 0.20
Planning and Zoning Review Fee 35.00
Scanning Fee 3.00
Technology Fee 3.75
Total: 196.80
Building Department Copy
Payments Date Paid Amt Paid
Total Fees 196.80
Credit Card 02/22/2019 $196.80
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
regulatina conskuction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
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Authoriz ure:Owner / pplicant Contractor / Agent Date
February 22, 2019 Page 2 of 2
PERMIT ADDRESS: 10007 NE 4 AVE PARCEL: 1132060170490
Miami Shores, FL
APPLICATION DATE: 02/05/2019 SQUARE FEET: 1,192.00 DESCRIPTION: CONCRETE DRIVEWAY
EXPIRATION DATE: 08/04/2019 VALUATION: $900.00
CONTACTS NAME COMPANY ADDRESS
Applicant JOHN & CRISTINA BUTLER 500 NE 102 ST
MIAMI SHORES, FL 33138
JOHN & CRISTINA BUTLER 10007 NE 4 AVE
MIAMI SHORES, FL 33138
Contractor LOUIS IMBURGIA IMBURGIA CONSTRUCTION SERVICE
INC. MIAMI SHORES 33138
LOUIS IMBURGIA IMBURGIA CONSTRUCTION SERVICE 1875 NE 149 ST
INC. NORTH MIAMI, FL 33181
Owner JOHN & CRISTINA BUTLER 500 NE 102 ST
MIAMI SHORES, FL 33138
JOHN & CRISTINA BUTLER 10007 NE 4 AVE
MIAMI SHORES, FL 33138
REVIEW ITEM STATUS REVIEWER
Building v.1 Requires Re -submit Ismael Naranjo email: naranjoi@msvfl.gov
Review item used to allow building to comment during a plan review
Comments: 1. Zoning approval required.
Planning v.1 Requires Re -submit Travis Kendall email: kendallt@msvfl.gov
Review conducted by the planning and zoning department
Comments: Proposed driveway fails to meet the reuired 10 foot setback from the property line. Please revise and resubmit.
302.5
February 14, 2019 10050 NE 2 Ave Miami Shores FL 33138 Page 1 of 1