DS-19-1328Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.: DS-06-19-1328
ftifnPermit Type: Driveways/Sidewalks/Slabs
i
Work Classification: Addition/Alteration
Permit Status: Approved
Issue Date: 06/13/2019 I Expiration: 12/10/2019
Location Address Parcel Number
1421 NE 103RD ST, Miami Shores, FL 33138 1132050310150
Contacts
VILMA QUINTANA Owner CHAMPION CONCRETE Contractor
1421 NE 103 ST, MIAMI SHORES, FL 33138 JAIME BASILIO
Other: 3055273904 10280 NW 63 TER 105, DORAL, FL 33178
Business: 3052528055 jaimechampion@yahoo.com
Other:7864024802
Description: DRIVEWAY PAVERS Valuation: $ 6,200.00 Inspection Requests:
TotalSq Feet: 890.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$4.20
Concrete/asphalt/pavers, slabs, dways,
$75.00
swalks
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$1.40
Planning and Zoning Review Fee
$35.00
Scanning Fee
$9.00
Technology Fee
$3.13
Total:
$181.73
Building Department Copy
Payments Date Paid Amt Paid
Total Fees $181.73
Cash 06/13/2019 $24.63
Check # 188 06/13/2019 $157.10
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 tole above named contractor to do the work stated.
Authorized Signature: Owner / Applicant / \Contractor / Agent
Date
June 13, 2019 Page 2 of 2
BUILDING
Miami Shores Village 1,ECE1o4FED
Building Department JUN 1 2019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBc Zo n 4
Master Permit No.11) 5—do —iq--I 3Z�
PERMIT APPLICATION
U`IL DING ❑ ELECTRIC ❑ ROOFING
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:1142 I 476 103 2r
City: Miami Shores County: Miami Dade Zip: 331314
Folio/Parcel#: /I - -3 Z06 - 03/ 0A D Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):a w-rAWA Phone#:
Address: t '1 Z bt /0
7
Ij—
City: h U S' State:
Tenant/Lessee Name: �Phone#:
Email:
CONTRACTOR: Company Name: k
Address: I �D 2r/pD W W Tee x /0
p: 3-�/
one#:305 zsZ-ws-T
City: 60 t , State: � Zip: 33/7/
Qualifier Name: JA-/ 'e Phone#:-3�q'�d' y�3�
State Certification or Registration #: Certificate of Competency #: CCVS �5 00�/5
DESIGNER: Architect/Engineer: e Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ GjloSquare/Linear Footage of Work: altos r
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: -AL)y UL4 y A V �eg S _.___..._..�_.._...e �.�..
Specify color of c for thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $ _
T..'G7['7p.�.•^T:.YHKMMIM"'�AC��+N J.+6* ♦'��' V'../NnW Y'�"ti"�
CCF $
DBPR $
CO/CC $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ (8 I ' 93
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lenders 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be del' vffed to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be p ted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of suc posted notice, the
inspection will not be apprpved and a reinspect n fee will be charged.
Signature _,��Gc-� l G� Signature
OWNER or AGENT
NTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 120 �� by day of :yt ry 20 by
1Y1�►17AK/� '' nn, who is personally known to I M [�jSl r_Iy ,who is rsonally k ow to
me or who has produced DL 4 535—$d0-- 63— Z 0me or who has produced �� 4 as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:Fea"�*0;1
BASIW
Print: Seal:EXPIRES: June 12, 2o22
ded Tlku Notary Fu UndemdWs
identification and who did take an oath.
NOT
Sign
Print
Seal
rs*******s******
APPROVED BY ` � Plans Examiner � , j � � Zoning
Structural Review Clerk
(Revised02/24/2014)
• •
• ev
7210sy 126h cyart • n i.V4 i GatejC j PLSM Fax (305) 5951454
Miami, Florida 33183 LarSd Surveyor•& PkAropr agarcia297@aol.com
Property Address:
1424 Ni! I03rd.;treei Miami Shorgp, Florida 33138
L'gel ��,clSptio�i: • •:
Lot'13'$?ock fybf RE;PLAT CIP TWT "C" MIAMI
SHORES BAY PAMESTA"i Iccording to the
Plat thereof, as recorded in Plat Book 64, Page 97,
-of th6e*P*4t Fie card' of Miami-pjide-County-Ffiorida
• • ..w % •
o • • • 6 • •
. . • • •
'���VAPI
v� 5
► f / L`
River Bay Park Addition
�'1►i0 13cw Not a Part of this Plat
5:Zr .0e- • Improved)
FIR
A,b-#901Acq
� ?���i�;���i�;: •����ag i�i >�agrg>�i. is 40_0
h
1
J Ih1�y '�^1tih% f,
0
Lot 12, CD
oopaeve.
.
a► ii
4, �� y •� ,
:...
Lot J,ner of
SW Car I'll
Residence
# 1421
�o
N89a50'54"E 90.00'
15' Parkway
C u�, 20' Asphalt Povemmt
_ NE 103rd Street
(50' Tao R/W)
Boundary Survey
Scale 1 "= 20'
SCHEDULE B- SECTION II of the Title Commitment:
1. Defects, liens, encumbrances, adverse claims or other matters, if any created, first
appearing in the public records or attaching subsequent to the effective date hereof but prior to
the date the proposed Insured acquires for value of record the estate or interest or mortgage
thereon covered by this Commitment.
Not a survey or a plottable matter
2. Facts which would be disclosed by an accurate and comprehensive survey of the premises
herein described.
Refers to this survey
PIP— - 3. Rights or claims of parties in possession.
= Not a survey or a plottable matter
On
PL 4. Construction, Mechanic's, Contractors' or Materialmen's lien claims, if any, where no notice
thereof appears of record.
Not a survey or a plottable matter W
r
10.95'
5. Easements or claims of easements not shown by the public records. tl
No information was provided on this matter
c66. General or special taxes and assessments required to be paid in the year 2018 and
subsequent years. 1
� Lot ,4, Not a survey or a plottable matter
O Block 6
7. All matters contained on the Plat of the Re -plat of Tract "C" Miami Shores Bay Park Estates
z recorded in Plat Book 64, Page 97.
0.4• If there is any plottable matter affecting our property, it is shown on the surveycl
1 Y D A'F
FIRM
as per ! —
Plot
1in%,
N r
7 _ / Q 1• I .I_
j ra P`1= N;(
.j. ro
l- F
Title Commitment by First American Title
Insurance Compnay v Chain ach
1 — link fence along the west side encroaches
7.5 feet into the north adjoining alley right of way
File Number: 17129272 yt� _��(�,-(q _1 '�'�Effective Date: December 07, 2017 @ 8:00 A.M.
A = Arc Length; AC = Air Conditioner; AE = Anchor Easement; BC = Block Comer; SM = Bench Mark; BOB = Basis Of Bearings; (C) = Calculated Dimension; CB LEGAL NOTES
= Catch Basin; CBS = Concrete Block Structure; CFW = Concrete Fence Wall; CH = Chord Length; CHB = Chord Bearing; Cl = Clear; CML = City Monument Line;
Cn CME — Conal Maintenance Easement; Conc = Concrete; DE = Drainage Easement; DME = Drainage At Maintenance Easement; Or = Drive; E = East; Elev = This Survey does not reflect or determine ownership; Examination of the Abstract of Title will
Z Elevation; EN = Encroached; ETP = Electric Transformer; FDH = Found Drill Hole; FIR = Found Iron Rod; FFE = Finished Floor Elevation; FH = Fire Hydrant; FIP have to be made to determine Recorded Instruments, if any, affecting the property, This
Z O = Found Iron Pipe; FN = Found Nail; FT = Feet; LME = Lake Maintenance Easement; LB = Licensed Business; LFE = Lowest Floor Elevation; LP = Light Pole; (M) Survey is subject to dedications, limitations, restrictions, reservations or easements of records;
Q F =Me
asured Dimension; ME = Maintenance Easement; MON = Monument; N = North; NGVD 1929 = National Geodetic Vertical Datum of 1929; NITS = Not To Scale; Legal Description provided by client; The liability of this Survey is limited to the cost of the
Z; OE = Overhead Cables; OH = Over Hang; ORB = Official Record Book; O/S = Off Set; Pb = Plat Book; PC = Point of Curvature; PCC = Point Of Compound Survey; Underground Encroachments, if any, are not shown; This firth has not attempted to
W Curvature; PCOR = Property Corner, PCP = Permanent Control Point; Pg = Page; PL = Planter or Property Line; PLS = Professional Land Surveyor, PLSM =
W
U. OfProfessional Land Surveyor and Mapper; POB = Point Of Beginning; POC = Point Of Commencement; PRC = Point Of Reverse Curve; PRM = Permanent Reference locate fooling and/or foundations and/or underground improvements of any nature; If shown,
W Co Monument; PT = Point Of Tangency; R = Radius; (R) = Recorded Dimension; RLS = Registered Land Surveyor and Mapper; R/R = Roil Road; R/W = Right Of Bearings ore referred to an Assumed Meridian; If shown, Devotions are referred to National
� CO Way ; Sec = Section; T = Tangent; S = South; SIP = Set Iron Pipe With Cap Stamped PLS 5105; UE = Utility Easement; UP = Utility Pole; UTY = Utility; Geodetic Vertical Datum of 1929 (NGVD 1929)
Q W = West; WF — Wood gFence; WM = Water Meter; WV = Water Valve; � = Centerline; —x— = Chain Link Fence; ® = Concrete Wall; ' = Degrees; A = Central
Angle; 0 = Diameter; 7 = Existing Elevation; ' = Minutes; " = Seconds;—xx—= Wood Fence; Unless otherwise noted, found markers had no identification
For:
Vilma Quintana; Holland & Knight
LLP; Old Republic National Title Insurance
Date of Field Work 12-19-2017 Company; Caliber; ome Loans, Inc., its
successors and/or astslgns
Aniano J. Garcia PLSM 5105
Not valid without the signature
and the original raised seal
of a Florida licensed surveyor and mapper Order No 17-0378