DS-19-2739Miami Shores Village
10050 NE 2 Ave
Miami Shores Fl. 33138
305-795-2204
Permit NO.: DS-1 1 -19-2739
Permit Type: Driveways/Sidewalks/Slabs
Work Classification: Addition/Alteration
Permit Status: Approved
Issue Date: 01/14/2020 1 Expiration: 07/13/2020
Location Address Parcel Number
1201 NE 103RD ST, Miami Shores, FL 33138 1132050200060
Contacts
Lorine McGee Owner CHAMPION CONCRETE Contractor
1201 103 JAIME BASILIO
10280 NW 63 TER 105, DORAL, FL 33178
Business: 3052528055 jaimechampion@yahoo.com
Other:7864024802
inspection Description: REPLACEMENT OF ASPHALT DRIVEWAY WITH Valuation: $ 9,200.00 inspection Requests:
2-4949
CONCRETE.
Total Sq Feet: 1,840.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$6.00
Concrete/asphalt/pavers, slabs, dways,
$125.00
swalks
DBPR Fee
$2.63
DCA Fee
$2.00
Education Surcharge
$2.00
Notary Fee
$5.00
Planning and Zoning Review Fee
$35.00
Scanning Fee
$9.00
Technology Fee
$4.38
Total
$241.01
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$241.01
Credit Card
01/14/2020 $191.01
Credit Card
11/15/2019 $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
regulating construction and zoning. Futhermore, I authorize a above named contractor to do the work stated.
Authorized Signature: Owner / Applicant /
/ Agent
Date
January 14, 2020 Page 2 of 2
Miami Shores Village
madqJ Iliz,9111
BUILDING
PERMIT APPLICATION
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
❑BUILDING ❑ ELECTRIC ❑ ROOFING
1 5) 2019
IM
FBC 20
Master Permit No. -11-19 -2731
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS I'O-\ O 1 N F_
City: Miami Shores County: Miami Dade Zip: 3 3 �(
Folio/Parcel#: � 1 — 3a 05 ~ C)a 0 '- () () ( IZIs the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): L-- e r \n e M C Phone#:
Address: k al W N 1 10 3 Y d S-k-
City: fi 1 wn I S�X (! S State: EL Zip: 33 I
Tenant/Lessee Name: i Phone#:
Email
CONTRACTOR: Company Name: (Olyan-e— Phone#:3bS ZSZ
Address: (tiZ C� IKAU) Of i
City: 15 004l State: Y►— ,Zip:
Qualifier Name: ..%i'�%% L d/!s/c.� ii Phone
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#: _
Address:: --- / City: State: — Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ 'Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
.Description of Work: co no e 1nS1nh Y \ V e IA OGLE./ W 1 �jn
Lon c r e �c
Specify color of color thru tile: `
Submittal Fee $ Jy � I Permit Fee $ \- ' CCF
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Radon Fee $
Training/Education Fee $
DBPR $
_ ,,J:.,':fs t}''ALL°�t .;tt�� a" .;,. ( •' ��
Notary $ S ' GkN
Double Fee $
Bond $ G 0 ) ' 00
TOTAL FEE NOW DUE $ 191 , n I
CG1 .61
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be doivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must b posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of ch posted notice, the
inspection will not be approved and a reinspection fee will be charged.
�
Signatu em Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
Q day of AUm,� 20, by
Nm #K4584 who is personally known to
me or who has produced as
identification and who did take n oath.
NOTARY PUBLIC:
Sign:
Print: %/fZ C ` ✓NUJ
The foregoing instrument Nov---,
w\a�s acknowledged before me this
5 day of 1 Vo V 20 1 by
it 171�S� �► O who is personally known to
e or who has produced 11 L as
identificeion nrwhoid take an oath. ����p.DY PR/FT iOTARYC ��• ao�;�\SSi25O •ii��i
Sign: b ? OGG287268
••�dy;!�ded kVN �`0 • Q� �
Print: G�11►1 A rl� a �� • jubG� unbe.•_,O _��
Seal: � W Seal: ////Z��PUC S1111�
•: ,.:sAS
My COMMIISSION II GG 227924
EXPIRES: June 1$ 2=
••.�o::;a.••
APPROVED BY I Plans Examiner �J\�j'D\ �� Zoning
Structural Review Clerk
(Revised02/24/2014)
D LE POWER OF ATTORNEY
O
1. I, LORINE MCGEE, of Palm Beach County, Florida, hereby
appoint MARTHA I. MCGEE, my true and lawful attorney in fact for me
and in my name place and stead, and for my use and benefit:
a. To exercise, do, or perform any act, right, power,
duty or obligation whatsoever, that I now have or may acquire the
legal right, power, or capacity to exercise, do, or perform in
connection with, arising out of, or relating to any person, item,
things, transaction, real or personal property, tangible or
intangible, or matter whatsoever;-
b. To ask, demand, sue for, recover, collect, receive,
and hold and possess all such sums of money, debts, dues, bonds,,
notes, checks, drafts, accounts, deposits, legacies, bequests,
devises, interests, dividends, stock certificates, certificates of
deposit, annuities, 'pension and retirement benefits, insurance
benefits and proceeds, documents of title, choices in action,
personal and real property, intangible and tangible property and
property rights, and demands whatsoever, liquidated or
unliquidated, as, are now, or shall hereafter become due, owing,
payable, owned or belonging to n which I have or may acquire
an interest, and to have u t`ke all lawful ways and means
and legal and equitable e i procedures, and writs in my name
for the collection and re o thereof, .and to compromise, settle,
and agree for the same, and to make, execute, and deliver for me
and in my name all endorsements, acquittances, releases, receipts,
or other sufficient discharges for the same;
C. To lease, purchase, exchange, and acquire, and to
bargain, contract, and agree for the lease, purchase, exchange, and
acquisition of, and to take, receive and possess any real or
personal property whatsoever, intangible or tangible, or interest
therein, on such terms and conditions, and under such covenants, as
such attorney in fact shall deem proper;
d. To improve, repair, maintain, manage, insure, rent,
lease, sell, release, convey, subject to liens, mortgages, and
hypothecate, and in any way or manner deal with all or any part of
any real or personal property, intangible or tangible, whatsoever,
or any interest therein, which I now own or may hereafter acquire,
for me and in my name, and under such terms, conditions, and under
such covenants as such attorney shall deem proper;
e. To sign, endorse, execute, acknowledge, deliver,
receive, and possess such applica s, contracts, agreements,
options, covenants, deeds, e , security agreements, bills
of sale, leases, mortgages a ig ent , insurance policies, bills,
bonds, debentures, check fts, notes, stock certificates,
proxies, warrants, commercial paper, receipts, withdrawal receipts
and deposits instruments relating to accounts or deposits in, or
certificates of deposit of, banks, savings and loan or other
institutions or associations, proofs of loss, evidence of debts,
1
I
I .
releases, and satisfaction of mort s, judgments, liens, security
agreements, and other debts bligations, and such other
nts in writing of zFe kind and nature as may be
necessary or proper in th��i e of the rights and powers herein
granted. v
f. I To transfer securities and other property, real or
personal, to any trust established by me, whether before or after
exdcution of this power, and to make such gifts (to my attorney and
others) and such contributions for charitable, religious,
educational and public purposes as my attorney may deem advisable
in light of my past practice, my estate plan and my desire to
minimize current and -prospective state and federal income, estate
and inheritance taxes.
2. I grant to my attorney in fact full power and authority
to do and perform all and every act and thing whatsoever requisite, '
necessary, and proper to be o e in the exercise of any of the
rights and powers herei n ed as fully to all .intents and
purposes as I night c d o if personally present, hereby
ratifying and con f' i 1 that my attorney in fact shall
lawfully do or cause o e done by virtue of this power of attorney
and the rights and powers herein granted.
3. This instrument is to be construed and interpreted as a
durable power of attorney which shall not be affected by my
disability except as provided by statute. The power conferred on
said attorney; _n fact by this instrumf:rt shall be exercisable from
the date of this incapacity on my part, unless otherwise provided
by Statutes of the state of Florida. All acts done by said
attorney in fact pursuant to the power conferred during any period
have the same effect and
of my disability or incompetence shall
inure to the benefit of and bind me and my heirs, devisees, and
personal representatives, as if I were competent and not disabled.
This durable power of attorney shall be non -delegable and shall be
valid until such b acourt of competentjurisdiction. e as I shall die, voke this power, or be
judged incompetenty
1993.
Dated
OU
Signed, sealed and delivered
I _
LORI 4GEE
H
STATE OFF O
COUNTY OF BEACH
The foregoing instrumen
t was acknowledged before me this
;;)
dal" of /�11
1993, by, LORINE MCGEE, who is personally known
.ate--identi:f-ic-at±&P, and
to me sr—
who did- ( did not) take an oath.
NOTARY P C STATE OF FLORIDA
SEAL:
.+�"'•_= C)FFICIAL SEAL
►"••`; Barbara Mitts Chancey
Irv,Nly Commission expires
i,r a )an. 19, 1997
r"yN''G;•' Comm. No. CC 253814
Accepted:
MART I MCGEE
3 ,
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IP=IRON PIPE, FND•FOUND, STY=STORY, AIo=AIR.COND J.ION.I:NG_P_AD.,_P/C-PROPERTY CORNER, O/H=DRILLED HOLE
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SCALE: 1r - FNCROACHMENT, COMP=COMPUTED,
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FOR:
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PROP. ADD. /2o/ .g /03Ro re>✓ /!'tam.l rjL>oYe 1 %Otrt�rs. F. BOOK�1��
LOCATION SKETCH 33 i 3
LEGAL DESCRIPTION: SCALE: 1 n = SOO I DATE FIELD SURVEY:
7Q..6C,T 151 A -of "MI MMI-1c7eE� 5rcttio�.► ¢,��1�E�„
�tZPIt.�C� -Ca T4-l� F -&T Tva1 zf-Qf, Q pQGtTr� ti�l ;�T YG 31, &T
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G EIR T I F- I E D TO: 21 G 1-+��ZD M. r tJa-r.� G .z , �..��+? • j D �Ti� �z t.� �Y
TtT t"eSZI +GS- -wwP, t IY�,
SURVEYOR'S NOTES:
1)THE SURVEY OF THE PROPERTY SHOWN HEREON 15 IN ACCORDANCE WITH THE DESCRIPTION FURNISHED BYl�L.1 '�
2)ACCORDING TO THE NATIONAL FLOOD INSURANCE PROGRAM, THE SUBJECT PROPERTY LIES WITHIN FLOOD ZONE:
3)UNLESS A COMPARISON IS SHOWN, ALL BEARINGS AND DISTANCES SHOWN ARE THE•SAME AS PLAT VALUES:
4 THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENTS OR OTHER RECORDED ENCUMBRANCES NOT SHOWN
ON THE PLAT AND THE SAME, IF ANY MAY NOT BE SHOWN ON THIS SKETCH: 5)UNDERGROUND PORTIONS OF FOOTINGS_
FOUNDATIONSOR OTHER IMPROVEMENTS WERE NOT LOCATED: 6)FENCE TIES ARE TO THE CENTERLINE OFrITHE SAME:
7)WALL TIES TO THE FACE OF THE SAME: 8)ELEVATION WHEN SHOWN ARE BASED ON NATIONAL GEOD & IC VERTICAL
DATUM (NGVD): 9)THERE ARE NO ABOVE GROUND ENCROACHMENTS OTHER THAN THOSE SHOWN: 1O)THIS SURVEY IS
FOR MORTGAGE PURPOSES ONLY, NOT TO BE USE FOR CONSTRUCTION PURPOSES.
I HEREBY CERTIFY THAT THE ATTACHED SKETCH OF BOUNDARY SURVEY OF -THE ABOVE DESCRIBED PROPERTY IS A
TRUE AND CORRECT REPRESENTATION OF A FIELD SURVEY MADE UNDER MY DIRECTION AND MEETS THE MINIMUM
TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL LAND SURVEYORS IN CHAPTER
21HH-6 FLORIDA ADMINISTRATIVE CODE. PURSUANT TO SECTION 472.027. FLORIDA STATUTES.
P.O. Box 65-3706 TELEPHONES (305) 266-4451262-7840 KA L F. KUHN
MIAMI, FLORIDA 33265. FAX (305) 262-5007 -REGISTERED LAND SURVEYOR N! 4916
710 SW 99TH CT. CIRCLE STATE OF FLORIDA
SO. MIAMI, FLA. 33174-
NOT VALID UNLESS SEALED WITH AN EMBOSSED SURVEYOR'S SEAL
MORES
CRITERIA
D
p p
f�ORIDp'
PERMIT ADDRESS:
1201 NE 103RD ST
PARCEL: 1132050200060
Miami Shores, FL 33138
APPLICATION DATE:
11/15/2019 SQUARE FEET:
1,840.00 DESCRIPTION: REPLACEMENT OF ASPHALT DRIVEWAY WITH
EXPIRATION DATE:
05/13/2020 VALUATION:
$9,200.00
CONCRETE.
CONTACTS
NAME
COMPANY
ADDRESS
Contractor
JAIME BASILIO
CHAMPION CONCRETE
10280 NW 63 TER, 105
DORAL, FL 33178
JAIME BASILIO
CHAMPION CONCRETE
10280 NW 63 TER, 105
DORAL, FL 33178
Owner
Lorine McGee
1201 103
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 require.
Planning v.1 Requires Re -submit Travis Kendall email: kendallt@msvfl.gov
Review conducted by the planning and zoning department
Comments: The largest permitted area for a circular driveway through the swale is 12 feet. Please make revisions and resubmit.
Public Works v.1 Approved Chris Miranda email: pw
November 22, 2019 10050 NE 2 Ave Miami Shores FL 33138 Page 1 of 1