DS-19-858Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Contacts
Permit NO.: DS-0419-858
Permit Type: Driveways/Sidewalks/Slabs
j Work classification: Addidon/A1teration
Permit Status: Approved
Issue Date: 08/02/2191 Expiration:01/29/2020
Parcel Number
1132060132770
Leocava LLC Owner J&R STRIPING CORP Contractor
PO BOX 381703, Miami, FL 33238 RAQUEL GROVE LLANOS
Business: 7865566406
Re
Description: RE -STRIPE PARKING LOT Valuation: $ 1,000.00 nests:
Inspection 305-Re
BEHIND THE FIRE STATION
95 ST AND NE 2 AVE Total Sq Feet: 5,000.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$0.60
Concrete/asphalt/pavers, slabs, dways,
$275.00
swalks
DBPR Fee
$4.88
DCA Fee
$3.25
Education Surcharge
$0.20
Planning and Zoning Review Fee
$50.00
Scanning Fee
$6.00
Technology Fee
$8.13
Total
$398.06
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$398.06
Credit Card
04/18/2019 $50.00
Credit Card
08/02/2019 $348.06
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, PL �BIING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify th a or
Ong information is accurate and that all work will be done in complian with all applicable laws
regulating construction and zoning. hermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent
August 02, 2019 Page 2 of 2
Miami Shores Village
Building Department
� g p
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
BUILDING ❑ ELECTRIC ❑ ROOFING
f'1 1
'jFBC 2011
Master Permit No. 1),s-v4- 19 —xS 0
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF. ❑ CANCELLATION ❑ SHOP
//•� /�//, CONTRACTOR DRAWINGS
JOB ADDRESS: cy� 'V 95Jr.
City: Miami Shores County: Miami Dade Zip: 93131
Folio/Parcel#: Cl `32a6 2�6Q Is the Building Historically Designated: Yes NO _
Occupancy Type: Load: __ Construction Type: Flood Zone: _ BFE: _ FFE:
IrC.0
OWNER: Name (fee Simple Titleholder): (� 0Ca uc' Phone#:
Address: be>x 3 % 1763 ' _
City: � i (�'. (Y\t State: t! G� Zip:
3 3�-3
Tenant/Lessee Name:
Email:
one#:
� 4 _
CONTRACTOR: Company Name:Y� Phone#
\
Address: `� 1 5 � S�T {
City: C?.�, � State: ( � Z;p331 co�.
Qualifier Name: k.,C) Qd1y
State Certification or Registration #:
DESIGNER: Architect/Engineer:
W
Phone#%��p—���
Certificate of Competency #: �� �3 c> c>
Phone#:
Address: City: State: . Zip:
Value of Work for this Permit: $ &&W&V li &0 0 Square/Linear Footage of Work: S: 7
Type of Work: ❑ Addition ❑ Alteration ❑(New t❑ Repair/Replace ❑ Demo!it:ion
f1 Description of Work: e- %(-tom— P0'r\r— e t b k (S.')`^1
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Technology Fee
Training/Education Fee $
CCF $ CO/CC $
DBPR $
Notary $
Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond $
TOTAL FEE NOW DUE $ 3 C4G • V G
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 $250C, 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 wh'ch occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be appr ed and a einspection fee will be charged.
Signature Signatur
OWNER or AGENT CONTRACTOR
�TTh f egoing instrum ,ltwas acknowledged before me this
ay of by
12D 0 /,IZPjl o is personally known to
me or who has produced
identification and who did take an oath.
as
The foregoing instrum nt was acknowledged before me this
day of I ',C[C k 20 Zc
C)1 1 , by
P: txWC41(s-4 VVUXt4V , who is personally known to
me or who has produced as
I LA
identification and who did to e an Xtkh. aA V
NOTARY PUBL C: NOTARY PUBLIC:
Sign: V Sign: g g
Print: Print: ' r
Seal: ANDREW VOGEL Seal: MY COMMISSION # GG 106978
my comNass1oN # FF919683 i n to`.' EXPIRES:trt' Pu lk Ur4 1
EXPIRES: November 25, 2019 Bonded Thry Notafy PubGC Underwriters
APPROVED BY Plans Examiner �'`' Zoning
Structural Review Clerk
(Revised02/24/2014)
J + R Striping Corp
103 NE 154" St
N. Miami Beach, Florida 33162
786-282-0256
3/14/19
State of Florida
County of Miami -Dade
/ `Zxne
Before me this day personally appeared tle-/ twit who, being duly sworn,
deposes and says:
That he or she will be the only person working on the project located at:
105 NE 95" St. Miami Florida 33138. Folio: 11-3206-013-2760
Contractor Signature
Sworn to (or affirmed and subscribed before me this 2D day of LACycj1 , 2019,
by
Personally Known
OR Produced Identification
Type of Identification Produced
ERICA C.HAYNE
MY COMMISSION # GG 106978
'o EXPIRES: July 27, 2021
F .. off•' ers
Print, Type or Stamp Name of Notary
Lok A-s 6o?< \0 v ��
,rs k��q - IC-1
1&R STRIPING CORPORATION
103 N.E.154T" STREET
NORTH MIAMI BEACH, FL 33162
July 23, 2019
Miami Shares Village, Bldg. Dept,
10050 N.E. 2" Avenue
Miami Shares, FL 33138
Re. permit No: 19-859
lobsites: 105 N.E. 95"' Street Miami Shares, FL 33138
Dear Sir or Madam:
In reference to the above -mentioned permits, please be assured that all striping will be done in
accordance with all codes and zoning requirements.
Specifically, all drive lanes will be at least 24' wide, and all parking spaces will be 81/2' x 18'.
All ADA spaces will be 12' x 1.8', as well as the 5' space adjacent to ADA parking.
Respectfully SubmittedT
Raquel Grove Llanos,
President