DS-11-22-2985Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit NO.: DS-11-22-2985
Permit Type: Driveways/Walkways/Slabs
Work Classification: Addition/Alteration
Permit Status: Approved
Issue Date: 11/30/2022 Expiration: 06/01/2023
Location Address Parcel Number
602 NW 112TH ST, Miami Shores FL 33168 1121360210320
Contacts
Nataki Cooper Owner HOMEOWNER Contractor
601112 HOME OWNER
Mobile:7867680870 AMPSUBSFORLESS@GMAIL.COM
Description: CONCRETE DRIVEWAY Valuation: $ 3,000.00 Inspection Requests:
Total Sq Feet: 870.00 ,.
Fees Amount Payments Date Paid Amt Paid
50% Renewal Fee $62.5 TotalFees $62.50
"otal: $62.So Credit Card 11/30/2022 $62.50
Amount Due: $0.00
Building Department Copy
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
/ Applicant / Contractor ! Agent
Date
November 30, 2022 Page 2 of 2
Miami Shores Village ENTERED
Building Department NOV 2a ozz
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY. ._
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20,90—"—n
BUILDING Master Permit Nols I�����u,J
PERMIT APPLICATION Sub Permit No.
0 UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION 5/ENEWAL
❑PLUMBING ❑ MECHANICAL CHANGE OF CANCELLATION ❑ SHOP
J CONTRACTOR DRAWINGS
JOB ADDRESS: lD ci I IJ `A% \ k j S T
City Miami Shores County: Miami Dade zip: 331 b SC
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): (V fi FFkt C,00IP&7rZ Phone#: -It& 0$-1D
A,Mr.cr (o(-)I NvO 112. 4T
City: "I VI Mk S "DYGG-4 State: PL Zip: -3 3 l b?
Tenant/LesseeyyName: Phone#:
Email: IJ51 IGtb --76 q&A_00+ (1'IYrn
n
CONTRACTOR: Company Name: 0 • 1 R/ri �V IVI l/1"' I I Phone#:
Address:
Email:
Qualifier Name:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ 3 b 10 O - Q CO Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
Description of Work:
Specify color of color thru tile:
Submittal Fee $
Permit Fee $
Scanning Fee $
DCA Fee $
Technology Fee $
Training/Education Fee $
Structural Reviews $
CCF
DBPR $
P&Z Review $
Zip:
Td
❑ Demolition
CO/CC $
Notary $
Double Fee $ _
Bond $ _
TOTAL FEE NOW DUE $
(Revised04/05/2022)
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 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 t_/ �� Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day of 1 20 �-a . by
tu P who is personally known
to
me or who has produced (LPY0(h 1 XC_as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:M
Print:
Seal: ?
APPROVED BY
The foregoing instrument was acknowledged before me this
day of
me or who has produced
20 1 by
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
Plans Examiner
as
Zoning
(Revised04/05/2022)
Structural Review
Clerk
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PROPERTY ADDRESS: 601 NW 212 ST., MIAMI SHORES, FL 33168
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Mission:
To protect.. promote & improve the health
of all people in Florida through integrated
state. county & community efforts.
HEALTH
Vtaton : To be the Healthiest State in the Nation
August 24. 2021
(Statewide)
P.o. Box 3865
Hollywood, FL 33083
RE: Contingency Letter
Application Document No: AP1638584
Centrax Permit Number: 13-SC-2252095
OSTDS Number:
601 NW 112 St
Miami, FL 33168
Lot:12 Block:2 Subdivision:
Ron DeSantis
Governor
Scott A. Rtvkees, MD
State Surgeon General
Dear Applicant:
This will acknowledge receipt of an application dated 03/17/2021 for a permit to use an existing
onsite sewage treatment and disposal system located on the above referenced property.
No objection for New Driveway installation as per your site plan. NO BEDROOM ADDITION. NO
FLOW INCREASE.
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 (786) 654-6620.
Sincerely,
Jesus HernandezAcosta. Engineering Specialist II
Flor(da Department of Health w .FlorldaHealth.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