DS-19-1738Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
1421 NE 104TH ST, Miami Shores, FL 33138
Contacts
Permit NO.: DS-07-19-1738
Permit Type: Driveways/Walkways/Slabs
Work Classification: Addition/Alteration
Permit Status: Approved
Issue Date: 04/13/20201 Expiration: 10/12/2020
Parcel Number
1122320320060
1421 MIAMI SHORES LLC Owner
1421 NE 104 ST, MIAMI SHORES, FL 33138
Home: 9544152648
THE WATER RESTORATION GROUP Contractor
HENRY DOW
Business:3056612505 hdow@thewaterrestorationgroup.co
m
Description: REPLACE EXSITING DRIVEWAY WITH CINCRETE Valuation: $ 7,500.00 Inspection Requests:
BLOCK PAVERS 05-762-4949
Total 5q Feet: 1,800.00
i �
Fees
Amount
CCF
$4.80
Concrete/asphalt/pavers, slabs, dways,
$175.00
swalks
DBPR Fee
$2.63
DCA Fee
$2.00
Education Surcharge
$1.60
Planning and Zoning Review Fee
$35.00
Scanning Fee
$9.00
Technology Fee
$4.38
Total:
$234.41
Applicant Copy
Payments
Date Paid Amt Paid
Total Fees
$234.41
Credit Card
04/13/2020 $234.41
Amount Due:
$0.00
COV I D 19
For Inspections, Call (305) 762-4949 or Log on at https://bidg.miamishoresvillage.com/cap/.
Requests must be received by 3pm for following day inspections.
NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
additional restrictions applicable to this property that may be found in the GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS,
public records of this county. STATE AGENCIES, OR FEDERAL AGENCIES.
April 13, 2020 Page 1 of 2
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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
BUILDING
PERMIT APPLICATION
�UILDING ❑ ELECTRIC ❑ ROOFING
RECEIVEI?
J L 2 9 2019
BY: ftcn��
FBC 20 R
Master Permit No. os- tcl -
❑ REVISION
Sub Permit No.
PLUMBING ❑ MECHANICAL PUBLIC WORKS [:]CHANGE OF
CONTRACTOR
JOB ADDRESS: i f - ' 1 V1.) 1� ) ��a S
❑ EXTENSION RENEWAL
CANCELLATION ❑ SHOP
DRAWINGS
City' Miami Shores County: Miami Dade Zip: /
Folio/Parcel#: 11ZZ3-163 ? Q�Ot:� Is the Building Historically Designated: Yes NO
Occupancy Type: � Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): R Choy 6—J Phone#:
Address: N E L 01-Ai` S4
City: ft Ck""`" State:
Tenant/Lessee Name:
Zip
331.?
Email:
CONTRACTOR: Company Name: G �' Phone#: �yS b�ZJ
Address:
City: I ``f o-l•^^\\�w�, nn State: r Zip: J )S o
Qualifier Name: _ �'1-hn-/ `Jy `^' Phone#: 5S �y1S 2-Q-0
State Certification or Registration #: GCC 1-5 Z Z Certificate of Competency #:
DESIGNER: Architect/Engineer:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work: woo 5-�
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work:Rzales kX41Iw.0 �lf�yQt�rUy V'1l� l�s�C�e�Q b�dC% P QrS
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
Radon Fee $
Training/Education Fee $
CCF $
DBPR $
CO/CC $ -
Notary $,
Double Fee $ _
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $ ,34 , 4.)
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
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.
Signature Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of Jo 20 J by
4�9�0 6 W C3 who is personally known to
me or who has produced j�—JQAQ Q� (,QEQ2--as
identification and who did take an oath.
NOTARY
Sign
Print:
I t-,-;7 4"-�
CONTRACTOR
The foregoing instr ment was acknowledged before me this
2 or day of U 1 20 (' by
1-, C)� , who is personally known to
me or who has produced 31 `�l!/ll�C2 (A O;QV,T- as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
!rW: Sl pin► G -P UJ'pr -�
Seal: SINDIA ALVAREZ SSe
MY COMMISSION # GG 238273
EXPIRES: September 3, 2022
Bonded Thru Notary Public Underwriters
**************************
APPROVED BY
********************************
Plans Examiner
SINDIA ALVAREZ
MY COMMISSION # GG 238273
EXPIRES: September 3, 2022
q Thru Notary Public Underwriters
J- Zoning
(Revised02/24/2014)
Structural Review
Clerk
Detail by Entity Name
Page 2 of 2
Detail by Entity Name
Florida Limited Liability Company
1421 MIAMI SHORES LLC
Filina Information
Document Number
L18000111752
FEI/EIN Number
83-2888730
Date Filed
05/03/2018
Effective Date
05/03/2018
State
FL
Status
ACTIVE
Principal Address
555 NW 95 ST
MIAMI, FL 33150
Mailing Address
555 NW 95 ST
MIAMI, FL 33150
Registered Agent Name &Address
ALITOM, LLC
555 NW 95 ST
MIAMI, FL 33150
Authorized Person(s) Detail
Name & Address
Title MGR
ALITOM , LLC
555 NW 95 ST
MIAMI, FL 33150
Annual Reports
Report Year Filed Date
2019 02/08/2019
Document Images
02/08/2019 -- ANNUAL REPORT I View image in PDF for,
05IO3/2018 -- Florida Limited l..iabilily View image in PDF for
a 7,er.a .: Ent Cf Stare, .. ns:- nl: Cerf+^•:
http://search. sunbiz. org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 7/29/2019
Detail by Entity Name
Page 2 of 2
Detail by Entity Name
Florida Limited Liability Company
ALITOM LLC
Filing Information
Document Number
L18000081359
FEI/EIN Number
82-4502468
Date Filed
03/30/2018
Effective Date
03/24/2018
State
FL
Status
ACTIVE
Principal Address
555 NW 95 ST
MIAMI, FL 33150
Mailing Address
555 NW 95 ST
MIAMI, FL 33150
Registered Agent Name & Address
MARIN, MARTA
555 NW 95 ST
MIAMI, FL 33150
Authorized Person(s) Detail
Name & Address
Title MGR
DOW, HENRY
555 NW 95 ST
MIAMI, FL 33150
Annual Reports
Report Year Filed Date
2019 02/08/2019
Document Images
02r08/2019 -- ANNUAL REPORT I View image in PDF format
OMO/2018 -- Florida Limited i..ialgLy View image in PDF formal
n—t of "It 3::P, Dt.I-, ;It ;;,, —atl—
hnp:Hsearch. sunbiz. org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 7/29/2019
mission:
To protect, promote & improve the health
of all people in Florida through integrated
state, county & community efforts.
Deysi Sanchez
12611 SW 143 Lane
Miami, FL 33138
i
HEALTH
Vision: To be the Healthiest State in the Nation
RE: Contingency Letter
Application Document No: AP1430768
Centrax Permit Number: 13-SC-1985892
OSTDS Number:
1421 NE 104 St
Miami, FL 33138
Lot:6
Block:3
August 28, 2019
Subdivision: River Bay Park
Ron DeSantis
Governor
Scott A. Rivkees, MD
State Surgeon General
Dear Applicant:
This will acknowledge receipt of an application dated 08/27/2019 for a permit to use an existing
onsite sewage treatment and disposal system located on the above referenced property.
Review on 8/28/2019.
NO OBJECTION FOR NEW PAVERS ADDING IN THE REAR PROPERTY PER SITE PLAN
PROVIDED. NO IMPACT OVER THE EXISTING SEPTIC SYSTEM.
From a review of your completed application, it has been determined that your existing system
appears to meet the minimum standards of F.A.C. 64E-6 for the proposed use. It is approved for
use with the plans submitted to this office. If this system should fail, causing an unsanitary
condition to exist, steps must be taken to bring the system into compliance immediately.
Department approval of the system does not guarantee satisfactory performance for any specific
period of time. Any change in material facts which served as a basis for issuance of this approval
requires the applicant to modify the permit application. Such modification may result in this
approval being made null and void. Issuance of this approval does not exempt the applicant from
compliance with other Federal, State, or Local Permitting required for development of this
property.
If you have any questions on this matter, please call our office at (305) 623-3500.
Sincerely,
Gerard Philizaire, Environmental Manager
Florida Department of Health www.FloridaHealth.gov
in DADE COUNTY TWITTER:HealthyFLA
1725 NW 167 St, Opa Locka, FL 33056 FACEBOOK:FLDepartmentofHealth
PHONE: (305) 623-3500 FAX: (305) 623-3645 1 YOUTUBE: fldoh