DS-09-19-2281Miami Shores Village
Building Department
10050 N.E.Znd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
BUILDING
PERMIT APPLICATION
Master Permit No.DS-09-19-2281
Sub Permit No.DS-09-19-2282
□REVISION □EXTENSION Q RENEWAL□BUILDING □ELECTRIC □ROOFING
□plumbing □mechanical □CHANGE OF □CANCELLATION Q SHOP
CONTRACTOR DRAWINGS
142 NW 100 StreetJOBADDRESS:
Zip;33150MiamiShoresMiamiDadeCity:County:
Folio/Parcel#:^0220340 NO XIstheBuildingHistoricallyDesignated:Yes
Flood Zone:FFE:BFE:Occupancy Type:Load:Construction Type:
Kevan T.Cramer 305-606-3777Phone#:OWNER:Name (Fee Simple Titleholder):.
Address:142 NW100 Street
Q^l^iami Shores
Tenant/Lessee Name:
Email:ktcramer@bellsouth.net
statlilorida .33150Zip:
Phone#:
Champion Concrete .305-978-4333Phone#:CONTRACTOR:Company Name:
10280 NW 63 Ter.105 Doral,FI.33178Address:
Email:Unknown
Phone#:Qualifier Name:
State Certification or Registration #:
DESIGNER:Architect/Engineer:
Address:
Value of Work for this Permi
Type of Work:P Addition D Alteration
Description of Work:Contractor Jaime Basilio took $2100 deposit,but never did the job.Reached out several times over years.
No response until last year.Said he couldn't remember job,then when sent copy of deposit check,said he was
Certificate of Competency #:_
Phone#:
Zip:City:
Square/Linear Footage of Work:
O New O Repair/Replace
State:
□Demolition
'embarassed"and would return deposit.Never did.
Specify color of color thru t//e;
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $.
Permit Fee $
DCA Fee $
Training/Education Fee $
CO/CC$.
Notary $.
Double Fee $_
Bond$_
TOTAL FEE NOW DUE $
CCF$_
DBPR$
P&Z Review $
(Revised04/05/2022)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City Zip.State
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 low 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 nohpe approved and a reinspection fee will be charged.
^Signature.Signatun
CONTRACTOROWNERorAGENT
The foregoing instrument was acknowledged before me this
day of
The foregoing instrument was acknowledged before me this
Au^u^.20 2^,byC-f who is personally known to
day of .20 .by
me or who has produced .PL.
j who is personally known to
me or who has produced
identification and who did take an oath.
asas
identification and who did take an oath.
NOTARY PUBLIC:NOTARY PUBLIC:
Sign
Print:UO/jy
Sign:.
Print:
Seal:Seal:WENDY RODRIGUEZ
n Notary Public-State of FloriCa
*/Commission #HH 528689
My Comm.Expires May 19.2028OFp-r,--'
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
{Revised04/05/2022)
From:Kevan T.Cramer
To:Miami Shores Building Dept
Re:Open permits DS-09-19-2281,DS-09-19-2282
Date:July 25,2024
To Whom It May Concern,
This is a request to close the permits listed above that were opened in 2019 by
Jaime Basilic of Champion Concrete to put in a driveway at my home at 142 NW
100 Street in Miami Shores.Mr.Basilio received a $2100 deposit,but after his
original design was denied,communication ceased and no further work was done.
Reached out to him numerous times over the years and finally got a response this
past February.Fie said he couldn't remember the job,then when sent a copy of
the check he had deposited,said he was "embarrassed"and would return the
money,but never did.
If you require any further information,please let me know.
Thank you.
Wend^Rodriguez
Site Inspection-Permit Cancellation
142 NW 100 ST
Subject:
Location:
Thu 8/8/2024 11:00 AM
Thu 8/8/2024 11:30 AM
Start:
End:
(none)Recurrence:
Meeting organizerMeetingStatus:
Wendy Rodriguez
Ismael Naranjo;Arlenis Silvera;Vivienne Yao;Kristine Yao
Organizer:
Required Attendees:
DS-09-19-2281
142 NW 100 ST
1
EDMiamiShoresVillage
Building Department
019
'V
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
V,'
FBC 20
t\>J O'i’!-k
BUILDING
PERMIT APPLICATION
Master Permit No.
Sub Permit No.
BUILDING □ELEaRIC ]ROOFING EXTENSION □RENEWALREVISION
]PLUMBING □MECHANICAL CHANGE OF
CONTRAaOR
CANCELLATION SHOP
DRAWINGS
PUBLIC WORKS
lC>C>JOB ADDRESS:
City:Miami Shores County:Miami Bide Zip:
Folio/Parcel#:j_}0 )—O XT-—Cf^^0 Is the Buildmg irijAlly Designated:Yes NO
Load:Occupancy Type:FWod Zone:Construction Type:BFE;FFE:
Phone#:3 3^1^OWNER:Name (Fee Simple Titleholder):_Kl^VAlU CJly.7 T/OV WOOAddress:
15 0/
City:
Tenant/Lessee Name:
Zip;State:V
Phone#:
Email:
.T
LOlr^O iMJly
Phone#:CONTRACTOR:Company Name:
Address:
City:
Qualifier Name:
State Certification or Registration #:
DESIGNER:Architect/Engineer:
Address:
Value of Work for this Permit:$^^
Addition CH Alteration
-l^r]iVj --I
Statk Zip:■J ^7^Phone#:
Certificate of Competency #:CTd
Phone#;
City:
Square/Linear Footage of Work;
I I Repair/Replace
State:Zip:
I I NewTypeofWork:Demolition
<7-'\Description of Work:
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $.
Permit Fee $
Radon Fee $
Training/Education Fee $
CCF$_
DBPR$
CO/CC$_
Notary $.
Double Fee $_
Bond S
TOTAL FEE NOW DUE $
(Revised02/24/2014)
Bonding Company's Name {if applicable)
Bonding Company's Address
City State Zip
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:1 certify that all the foregoing information is accurate and that ail work will be done in compliance with all
applicable laws regulating construction and zoning.
//WARNING TO OWNER:YOUR FAI
RESULT IN YOUR PAYING TWICE FQR IMPROVEMENTS TO YOUR PROPERTY.IF YOU INTENDTOOBTAINFINANCING,CONSULT WlA YOUR LENDER OR AN ATTORNEY BEFORE RECORDINGYOURNOTICEOFCOMMENCEMENT.'*^M
RE TO RECORD A NOTICE OF COMMENCEMENT MAY
notice to Applicant:As a condition to the issuance of a bujlding permit with an estimated value exceeding $250p,the applicant mustpromiseingoodfaiththatacopyofthenoticeofcommencemenft^d construction lien law brochure will be aelivered to the personwhosepropertyissubjecttoattachment.Also,a certified copy of ti(^ecorded notice of commencement must pje posted at the job siteforthefirstinspectionwhichoccursseven(7)days after the-bulM
inspection will not be approved and a reinspection fee will be cborjfo.g permit is issued.In the absence oniuch posted notice,
I
Signature.Signature_
OWNER or AGENT lONTRACTOR
The foregoing instrument was acknowledged before me thisdayof^1 foregoigg irtstrument was acknowledged before me this_d^of 1*^
js personally known to
The
.bv
ti ,who is personally known
who has producedl^l—
identification and who did take an/oath.
_,20 .by
to
has produced"^me or whomeoras
identification and who did take an oath.
NOTARY PUBLIC:NOTARY PUBLIC:
Sign;.Sign
JAIME ARMANDO BASUO
MY COMMISSION #00227924
EXPIRES:June 12,2022
Bonded Tivu Notary Pubic UndenrtMi
iPrint:Print:
SlNDlA ALVAREZMVCOMMISSIONifGG23S27F)(PlRES;Septemb6r3,2Uzz.
rSfiiS^fWtipr^***********
Seal;Seal:
Plans Examiner ZoningAPPROVEDBY
Structural Review Clerk
(Revised02/24/2014)
Miami Shores Viliage
Public Works Department
(305)795-2210
Public works forms are available from the building department,10050 N£2"“^Ave.,Miami Shores,FL 33138
PUBLIC WORKS PERMIT APPLICATION
Permit Type:Work in the Right-of-Way on Miami Shores Village or Miami-Dade Property
Permit#:
iC \AJNameofApplicant(if utility see below):
Owner off the following described property:
Legal Description:Lot
Folio #;
Address:
Block Subdi\Mon
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City:
Telephone:
State Certification or Registration #:
Sti ZIP:
Email:
y i Certificate of Competency #
CONTRACTOR NAME;I
Qualifier/Authorized Agent:.IAddress:VVUi/WCity:J)oU/yL ^State:-U1 _._Telephone:E^^^>V'VhMOOStateCertificationorRegistration#:Certificate of Competency #:'T
i^^rioWvork,attach separate page if necessary)in the adjoining right of0b
\^
.1
ZIP:
Requests permission to install (d
way:
/W 1>-r
C IJ Utility □Sidewalk □Electric
□Landscap^^y Antenna □Other:
DESIGNER:Architect/Engineer:
Address:
City:
Telephone:
Registration #:
Type of Work:□Paving □Irrigation
State:ZIP:
Email:
Value of Work for this Permit:$j L ^0 -Square/Lineal Footage of Work:Jr/
**********Fees
Permit Fee $100.00
Notary $
Bond $
Training/Education $0.20 Technology Fee $0.80 Scanning $
Total Fee Now Due $ (if required)
Bonding Company's Name (if applicable):
Bonding Company's Address:
City:State:ZIP:
Application is hereby made to obtain a public works permit to do the work in the right of way andinstallationsasindicated.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,regulation construction inthisjurisdiction.I understand that separate permits must be secured for
APPLICANT'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be
done in compliance with applicable laws regulating construction and specifically construction in theright-of-way.
"WARNING TO APPLICANT:YOUR FAILURE Ti^pCORD A NOTICE OF COMMENCEMENT MAY RESULT INYOURPAYINGTWICEFORIMPROVEMENTSTOTHE.^IGHT-OF-WAY.IF YOU INTEND TO OBTAINFINANCING,CONSULT WITH YOUR LENDER OR ^feN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."\●
Notice to Applicant:As a condition to the issuance oT a public works permit with an estimated value
exceeding $2,500,the applicant must promise in good faith'ihat a copy of the notice of commencement
and construction lien law brochure will be delivered tc^h^oferson whose property is subject to theattachment.Also,a certified copy of the recorded noticej^^mmencement must be posted j^t the Jobsiteforthefirstinspectionwhichoccursseven(7)days after the public works permit is issuabsenceofsuchpostednotice,the inspection will not be apg^roved and
f.In the
charged.a reinspection will
%
:●c:
V.
Signature Signature
Applicant or Authorized Agent
The foregoing instrumei^was acknowledged beforedayofAV2'tUy r~.20 .by
ComM«y/Utility Agent
The foregoing instrenWnt was acknowledged beforemethis2^day o^"LP7^Vl^^^0 ^.by
^personally knowi^o*me ^who has produced
me this
U/U.who who
is personally known to me or who hasjDroduced
identification.V
as
identification.
/
NOTARY PUBLIC:NOTARY PUBUjCr
Sign:Sign:
//15/6^7Print:
SEAL:
Print:
SEAL:SINDIA ALVAREZ
.my COMMIS.SiON#GG 238273
EXPIRES;September 3,2022
Bonded Thru Noiaiy Public Underwriters
JAIME ARMANDO BASlUO
i MY COMMISSION #00 227924 1,EXPIRES:June 12,2022
Notary Public
nc.
It ***
.Public Works Director,or DesigneeAPPROVEDBY:
2017-04-15
Illlllllllllllllllllllllllllllllllllllllll
CFW
OR BK 31616 Ps 1865 (IPgs)
RECORDED i;i9/20/2019 15:2i;i352
HARVEY RUVINt CLERK OF COURT
rilAfll-DADE COIJNTYr FLORIDA
>.\Vi Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores,Florida 33138
Tel:(305)795.2204
Fax:(305)756.8972
wml?mn ‘mUi■III
h.7 A.CQUN.TY OF M!Af»'n*DADS^j:opy &●tKo.OR)'STATE 01 a ti
If
COVENANT OF CONSTRUCTION WITHIN RIGHT 0|^WATWhereas,(owner)_jCWren.—
hereinafter referred to as the owner of the^ilowing describedproperty(address):.IHZ.MU loo
Legal Description:Lot Block
Folio-#^_
Requests permission to install (describe worl^^^^
Subdivision
Within the public right of way of (address) /<f2./U/10f9 9T Af.UnW
IN CONSIDERATION of the approval of this permit by the Village,the owner agrees as follows:
1.To maintain and repair,when necessary,the above-mentioned item(s)installed within the
dedicated right of way.If it becomes necessary for Miami Shores Village or Dade County to
make repairs or maintain said items within public right of way including restoration of street by
reason of the Owner’s failure to do so,such expense shall be paid by the Owner or shall
constitute a lien against the above described property until paid.
2.The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County
harmless from any and all liability,which may rise by virtue of permitting the installation of
these items within the public right of way.
3.The Owner does hereby agree to remove or relocate their facilities at their own expense,
within 60 days notice by the Village to do so.Failure to comply with this notice will result in the
Village causing the item(s)to be removed and a Hen being placed on the property and/or
assessed against the Owner for ail costs incurred in the removal and disposal of the item(s).
4.The undersigned further agrees that these conditions shall be deemed a covenant running
with the land and shall remain in full force and effect and be binding on the undersigned,their
heirs and assigns,until such time as this obligations has been canceled by an affidavit filed in
the Public Records of Dade County,Florida by the Village Manager of Miami Shores Village
(or his fully authorized representative).
(LacSignature
Owner or Agent
State of Florida
Sounty of Miami Dade .^^The foregoing instrument was acknowledged before me this .day of ^20_who is personally known to me or who has produced *
.by
JAIME ARMANDO BASH.K)
MY COMMISSION #00227924
EXPIRES:June 12.2022
In*
/OTARY PUBLJ^
''ign:^^Tint:SEAL: