DS-10-22-2626 & PW-12-22-3016Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
948 NE 92ND ST, Miami Shores, FL 33138
Contacts
Permit NO.: DS-10-22-2626
Permit Type: Driveways/Walkways/Slabs
Work Classification: Addition/Alteration
Permit status: Approved
Issue Date: 11/28/2022 Expiration: 05/29/2023
Parcel Number
1132060060100
DANIEL GOLDBERG Owner HOMEOWNER Contractor
948 92 ST, Miami Shores, FL 33138 HOME OWNER
Mobile: 7816366761 dsgoldbe@gmail.com
Description: NEW DRIVEWAY +REMOVAL OF OLD DRIVEWAY / 4: Valuation: $ 8,480.00 Inspection Requests:
rnPf OF WORK ON SURVERY
305-762-4949
Total Sq Feet: 744.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$5.40
Concrete/asphalt/pavers, slabs, dways,
$75.00
swalks
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$2.70
Planning and Zoning Review Fee
$70.00
Scanning Fee (Manual)
$9.00
Technology Fee
$12.50
Total:
$228.60
Payments Date Paid Amt Paid
Total Fees $228.60
Credit Card 10/17/2022 $50.00
Credit Card 11/28/2022 $178.60
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.
/ O(I/U',l G. ijL7 11l nzt
Owner / Applicant / Contractor / Agent Date
November 28, 2022 Page 2 of 2
Miami Shores Village u]EcEivED
Building Department OCT 17 202Z
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 BY:
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 2q;Ml
BUILDING Master Permit No. It AgIVE Z�
PERMIT APPLICATION sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
a /A{CONTRACTOR DRAWINGS
JOB ADDRESS: 4 P CI Z 5 t
Folio/Parcel#: II 3z0(.)0 Is the Building Historically Designated: Yes NO_*>_
Occupancy Type: Load: Construction Type: Flood Zone: BFE: I (FFE:
OWNER: Name (Fee Simple Titleholder): Q C' C( v `�"'� 1 Phone#: ? � ` _3 ° g _170
Address: `� 0 Af/ Q_ )fie '
City: M-,4.i S6r&( State: �tl Zip: 3%;;
Tenant/Lessee Name: Phone#:
Email: O SC oL *t, ��d41 RILCO^
CONTRACTOR: Company Name: II Vt Y I w lam Phone#:
Address:
Email:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:: r
Value of Work for this Permit: $ A - °' Square/Linear Footage of Work: %a'-ipif� LLY / w.r
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demo it on
Specify color of color thru tile:
Submittal Fee $ 50in) Permit Fee $
Scanning Fee $ I, DCA Fee $
Technology Fee $ I9 • z V Training/Education Fee $
CCF $ 4y CO/cc $
DBP^R7$D OD Notary
• 1 Double Fee $
Structural Reviews $_��
(Revised04/05/2022)
P&ZReview$ IU'jjj/ Bond$ j
TOTAL FEE NOW DUE $ lY
Bonding Company's Name (if applicable)
A
Bonding Company's Address
City
State
Mortgage Land er'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�✓�J
OWNER or AGENT
The for��egoing instrument was acknowledged before me this
I'll
flay of , 20 Z2 , by
twho is personally known to
me or who has produced LU as
identification and who did take an oath.
NOTARY PUBLIC:
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of
me or who has produced
20 , by
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal:
as
44�APPROVED BY Plans Examiner oning
Structural Review Clerk
(Revised04/05/2022)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
r/
y0 OWNER BUILDER DISCLOSURE STATEMENT
NAME: C/lll t( �o ��d( �Q/; C l DATE: tO % f 7/ZZ
ADDRESS: 1 `1
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have
read and understood the following disclosure statement, which entitles me to work as my own contractor; I further understand that I as the owner
must appear in person to complete all applications.
State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption
allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the
construction yourself. You may build or improve a one -family or two-family residence. You may also build or improve a commercial building at a
cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and occupancy. It may not be built for sale or
lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built
for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. it is your responsibility to make
sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on
your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and
with -holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all
applicable laws, ordinances, buildings codes and zoning regulations.
Please read and initial each paragraph.
1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner -builder permit under an
exemption from the law. The exemption specifies that 1, as the owner of the property listed, may act as my own contractor with certain
restrictions even though I do not have a license. 0 G
Initial
2. 1 understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and
is not hiring a licensed contractor to assume responsibility.
Initial "
3. 1 understand that, as an owner builder, I am the responsible party of record on a permit. I understand that I may protect myself from potential
financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the
contractor is required by law to be licensed in Florida and to list his or license numbers on permits an1dre'ontracts.
Initial 9 V
4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding. I may also build or improve a commercial
building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially
improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the
construction is complete, the law will presume that I built or substantially improved it for sale or lease, 1rwhich violates the exemption.
Initial 0
S. I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
Initial 06
6. 1 understand that I may not hire an unlicensed person to act as contractor or to supervise persons working on my building or residence. It
is my responsibility to ensure that the persons whom I employ have the license required by law and by (:unty or municipal ordinance.
.. , . _.., Initial
7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner -builder permit that erroneously
implies that the property owner is providing his or her own labor and materials. I, as an owner -builder, may be held liable and subjected to
serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's
insurance may not provide coverage for those injuries. I am willfully acting as an owner -builder and am aware of the limits of my insurance
coverage for injuries to workers on my property.
Initial
I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the
work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by
me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the
Federal Insurance Contributions Act (FICA) and must provide workers compensation for the employee. I understand that my failure to follow
these may subject to serious financial risk. 0
Initial
I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and
requirement that govern owner -builders as well as employers. I also understand that the
Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations.
Initial P
10. 1 understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States
Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the Florida Construction Industry
Licensing Board at 850.487.139E or http://www.mvfloridalicense.com/dbpr/pro/ciIb/index.htmI
Initial
11. 1 am aware of, and consent to; an owner -builder building permit applied for in my name and understands that I am the party
legally and financially responsible for the proposed construction activity at the following address:
q 4 V ffli � Z `
Initial
12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that I have provided on
this disclosure.
Initial 0 �
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the
Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial
loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or
employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner -builder
permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is propefly licensed and the status of
the contractor's workers compensation coverage.
Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and returned to the local
permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the notarized signature of the property
owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued.
Was acknowledged before me this Ill day of0(%)l2ty20 P�9�
ByDnnix/l who was personally known to me or who has
Produced there license or as identification.
MERUNE CHERy
o W COMUNION # HN 252206
OWNER
Miami Shores Village
10050 NE 2 Ave
Miami Shoes FL 33138
305-795-2204
Permit NO.: PW-12-22-3016
Permit Type: Public Works
Work Classification: Public Works
Permit5tatus: Approved
issue Date: 12/20/2022 Expiration: 06/20/2023
Location Address Parcel Number
948 NE 92ND ST, Miami Shores, FL 33138 1132060060100
Contacts
DANIEL GOLDBERG Owner BARON BRICK PAVERS CORP Contractor
948 92 ST, Miami Shores, FL 33138 Jonathan Aldana Mayorga
Mobile: 7816366761 dsgoldbe@gmail.com 3281 NW 18 ST, Miami, FL 33125
Business:7863897893 i.aldana420@yahoo.com
HOMEOWNER
Description: NEW DRIVEWAY +REMOVAL OF OLD DRIVEWAY / Valuation: $ 250.00
SCOPE OF WORK ON SURVERY
Total Sq Feet: 375.00
Fees
Amount
Education Surcharge
$0.30
Public Works Permit Fee
$100.00
Scanning Fee
$9.00
Technology Fee
$10.00
Total:
$119.30
Building Department Copy
Ins ection Requests:
rl t35-762-4949..
Payments Date Paid Amt Paid
Total Fees $119.30
Credit Card 12/20/2022 $119.30
Amount Due: $0.00
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhennore, I authorize the above named contractor to do the work stated.
ul
/ L0 c.r..l �a l ��av} 10 2 a I Lj
Signature: Owner
/ Applicant / Contractor / Agent
Date
December 20, 2022 Page 2 of 2
ENIrERED
L 2022
Miami Shores Village
W, Public Works Department BY.
(305)795-2210
Public works forms are available from the building department, 10050 NE 2"d Ave., Miami Shores, FL 33138
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property
Permit#: O�`Ib-Z2-b
- iL-2Z-3ott�
Name of Applicant (if utility see below):
Owner off the following described property: �.(1 pAx rj { /
Legal Description: Lot lb-%Oyx' " Block Subdivision
Folio#, 11310bOOCcla�
Address: 94 8 nt5 57 % i SLv A;L 33V
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City:
Telephone:
State Certification or Registration #:
CONTRACTOR NAME:
Email:
State:
ZIP:
Certificate of Competency #
Address: SOSI (VW t$ s}na
City: M•ui b State: Pc ZIP:
Telephone: I-744I Email: J, At,M" Jvjc" �
State Certification or Registration #: Certificate of Competency
as
Requests permission to install (clescrible work, attach separate page if necessary) in the adjoining right of
way: PL, }ra ,,,,,I L +- tt rt /c-.J.
Type of Work: W Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
City:
Telephone:
Registration #:
_ State:
Email:
FM
Value of+Work for this Permit: $ ,. Square/Lineal Footage of Work'"�T
A.
{ fees
Permit Fee4_1 00 3o Ip,�p
Notary $ Training/Education $ 0,29- Technology Fee $-0-80 Scanning $ ICc'
Bond $ (if required) Total Fee Now Due $ (I S . z a
Bonding Company's Name (if applicable):
Bonding Company's Address:
City:
State:
Application is hereby made to obtain a public works permit to do the work in the right of way 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, regulation construction in
this jurisdiction. 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 the
right-of-way.
"WARNING TO APPLICANT: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN
YOUR PAYING TWICE FOR IMPROVEMENTS TO THE RIGHT-OF-WAY. 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 public works permit with an estimated value
exceeding $2,500, 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 the
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 afterthe public works permit is issued. In the
absence of such posted notice, the inspection will not be approved and a reinspection will be charged.
Signature
Applicant or Authorized Agent
The foregoing, instrument was acknowledged before
me jZ day of Vin v . 20�2,1 by
Signature -4 W,
Com ny/Utility Agent
The foregoing instrument was acknowledged before
methis 3-61i"dayof Nwew,it.r .201., .by
ly known to m r wM has produced is personally known to me o� who has produced
as EL �t f�bI7a10otJ as
on. identification.
Sign: i Sign: :!K }}
Print: Print: A412e�( dl�eJ IQ
SE ' pAOLAR0DRIG1JE2 SEAL:
'+R';;_ MY COMMISSION # GG 917431
•
EXPIRES: September 29, 2023
i•,,Ow' "'�.. AMELL IGLESIAS
-•.�.#,•aiit°,+
•
R..WThm Nary
i .M .: Notary Public - State of Florida
Q't Commission a HM 3a1M1
''^P•,M1'My Comm. EllPiflS Aqf 31, 3026
* *****
**********####*####*
APPROVED BY:
Li Public Works Director, or Designee
2017-04-15
Mission:
To protect, promote & inprtnethe health
Ball people in Raridathrogh integrated I HEALTH
�''
state'munly&omTnx yeforts. Pionaa
Vision: To be the Healthiest State in the Nation
November 14, 2022
Natalie Lopez
948 NE 92 Street
Miami Shores, FL 33138
RE: Modification to a Single Family Residence - No Bedroom Addition
Application Document Number: AP1910279
Centrax Permit Number: 13-SM-2603112
948 NE 92 Street
Miami Shores, FL 33138
Lot: 1213 Block: Subdivision:
Dear Applicant,
Ron DeSantis
Governor
depyb A. trp4 MD, PhD
Stale Surgeon General
ENTERED
NOV 16 2022
,BY:-.
This will acknowledge receipt of a floor plan and site plan on 11/07/2022 for the use of the existing
onsite sewage treatment and disposal system located on the above referenced property. Reviewed by
Vida Talab on November 14, 2022. No objection to installation of new driveway ONLY as per your site
plan. The septic system exists outside the scope of work, in the backyard on the opposite side of the
house where the new driveway will be, approximately 65ft. NO BEDROOM ADDITION. NO FLOW
INCREASE.
This office has reviewed and verified the floor plan and site plan you submitted, for the proposed
remodeling addition or modification to your single-family home. Based on the information you provided,
the Health Department concludes that the proposed remodeling addition or modification is not adding a
bedroom and that it does not appear to cover any part of the existing system or encroach on the
required setback or unobstructed area. No existing system inspection or evaluation and assessment,
or modification, replacement, or upgrade authorization is required.
Because an inspection or evaluation of the existing septic system was not conducted, the Department
cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use.
You may request a voluntary inspection and assessment of your system from a licensed septic tank
contractor or plumber, or a person certified under section 381.0101, Florida Statutes.
If you have any questions, please call our office at (305) 623-3500.
y
/G(i1G(JlJ
Vida Talab, Engineering Specialist II
Department of Health in Dade County
FlarmaDprtbeaaterttaatth ww,r "-W-F-ALQw
in Dade County • • , Florida TWITTER:HealthyFLA
PHONE: (305)623-3500 FACEBOOK:FLDepartmentofHealth
YOUTUSE: fldoh
Miami Shores Village
Public Works Department
(305)795-2210
Public works forms are available
from the building department,
10050 NE 2"d Ave., Miami Shores, FL 33139
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
Whereas, (hereby referred to as the owner)
Of the following described property:
Legal Description: Lot Block_
Address: "
.[
Subdivision
N11111 i 1.Ili I. 11 111li11 i;311i 1" e i
CFN 21i22RI i89363
OR BK 33481 F'9 1563 (1P3s)
RECORDED 11+_%:.%.G il7 J.i1B4`!;;
HARVEY RUVINP C,.ERK DF COURT
`IiAllf-DADS COUNTY: Fi_0171Di';
Folio#; II
Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of way:
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 necessaryfor Miami Shores Village or Miami -Dade County to make repairs or maintain said items within the public
right of way including restoration of the street by reason of the Owners 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 herby agree to indemnify and hold Miami Shores Village or Miami -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 14 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 lien
being placed on the property and/or assessed against the Owner for all 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 obligation has been
cancelled by an affidavit filed in the Public Records of Miami -Dade County, Florida by the Village Manager of Miami Shores
Village (or his fully authorized representative).
Signature
Owner or Authorized Agent
State of
County of /�i c.<.' ✓✓
The foregoing instrument was acknowledged before me this :% `/ day of �. , �3!; �a 20__L,) by
C __who is personally known tq'me or who has produced
as identification.
NOTARY P11BiiC.
Sign:
Print: SEAL:
PAOLARODRIGUEZ 4
My COMMISSION # GG 917431
EXPIRES: September 29, 2023
`STATE OF FLORIDA, COUNTY OF MIAMI-DADE
1 HEREBY CERTIFY that this is a true copy of the
orig jilpdgt 's 410 day of
AD 20
WITNESSmv-h n and Pcia eat//
°FF;'•` BondedThmNotaryPublic underwriters Documents 2ire-Me6rdi
MIAMI-DADE COUNTY
County Courts
the Clerk of the Courts,
)RDER, COURTHOURSE EAST,
2017-04-11
22 N.W. First Street, 1st Floor, Miami, FL 33128.
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
. �,toJZ -Iut 1 c�C_I o
PERMIT NO. _ TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF MIAMI-DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following Information
is provided in this Notice of Commencement.
description of prop rty and street/
1??74. SDI T"MM. 4L
2. Description of improvement:
:ss:
'16fiF EIF iQil:&IQ i(iiF.E[s6E "yi:iE III jE sf
Ch t`% 6
Lis' Bf:. ^1+2:1.
chit L _
Space above reserved for use of recording office
3. Owner(s) name and addresO i NG 5` S>• j-lfc..•SI'^1 rL �>., >, B/ A W F L &oWi,3 a 2 U / � 1 10- I L_ �±> EMI AC
Interest in property: 'Z!) Iub
Name and address of fee simple titleholder NIEL, tool$ 6rg� 9 4 d' F S t Y L h1Epr 56i rtti
4. Contractor's name, address and phone number ,
5� a4n,aN R22/k, %PuViRS /eke. /!. ( A-Icl". M<2 r,
5. Surety: (Payment bond required by owner from contractor, if any)
Name, address and phone number:
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)7., Florida Statutes,
Name, address and phone number:
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes.
Name, address and phone number:
9. Expiration date of this Notice of Commencement:
(the expiration date Is 1 year from the date of recording unless a different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713,13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED !ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH Yl f _®�iQ1� "ti:110rv"t"T U�Fi IR t DOMMENCII K
OR RECORDING YOUR NOTICE OF COMMENCEMENT.
I HEREBY CERTIFY that this is a true copy of the ll,� e couv
./-
Signature(s) of Owner(s) or Owner(s)' Authorized Officer/Director/PartnerA
Prepared By �y �' �— Prepared
Print Name n _ , / F' < a Print Nan
Title/Office
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
The
my
7r
before me this day o !�'L
i,-,�1
- or
j6lznally known or Q produced the following type of identlea ion:
Signature of Notary Public: f
Print Name:
(SEAL)
Under penalties of perjury, I declare that I have read the foregoing and
that the facts stated in It are true, to the best of my knowledge and belief.
of
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Signature(s) of Owner(s) or Owner(s)'s Authorized Officer/Director/Partner/Manager who signed above:
By 1Xa4Z By
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Scope of work:
1. Removal of old driveway permitted by permit #BP 2003-485 (750 square feet including what's in the ROW).
2. Construct new driveway as substantially depicted on attached sheet LH-1 (744 square feet including what's
in the ROW). Materials are:
a. 6 inch limerock base, 1.5 inches of sand, and 1 inch thick marble pavers.
3. Removal of two small palms on either side of new driveway (large palm in front yard and numerous trees in
rear yard to remain to comply with Sec. 536(1)(b) of the Code.
4. Removal of any concrete tiles in the path of the driveway.
S. Re -sod forfner driveway footprint in ROW. o
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NO OBJECTION ; `
Florida Health Miami -Dade County I
OSTDS &Well Pro ram
COLr1EN
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,R (,HB 7. M. 54)
Send STREET
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Application No.:
Date: 11 /14/20,22 ENTERED
Signature zffl
NIIV 16 2022
z
Approximate
location of
septic tank,
drainfield, and
reserve area here
Note: All septic
system is in back
yard. Driveway
I
work only to
I
occur in front
yard. Setback is
over 65 feet
from SW edge of
driveway work
to NW edge of
�s
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Fill —Lill
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Scope of work:
1. Removal of old driveway permitted by permit #BP 2003-485 (750 square feet including what's in the ROW).
2. Construct new driveway as substantially depicted on attached sheet L.H-1 (744 square feet including what's
in the �OW). Materials are:
anch limerock base, 1.5 inches of sand, and 1 inch thick marble pavers.
3. Removal of two small palms on either side of new driveway (large palm in front yard and numerous trees in
rear yard to remain to comply with Sec. 536(I)(b) of the Code.
4. Removal of any concrete tiles in the path of the driveway.
5. Re -sod forger driveway footprint in ROW.
0
00I EN GAM
ORR2
N.E.
92nd
y_m
ev>E
>, PG. 54)
CITY
COPY
M'AIIpS 9pMI, XE%WI RQAR N MIKW.I, GFCIA'']C l£NINX MIUY Of 19Z9 .GY.0.i9) 4® MX I ,ores
R-F CEIV,
OCT 1 7
UW
U2ZBY:,
Building Dept. cDate/ l,
Subject to compliance with al NWal,
State and County rules and regulations.
Pernni bl-*--n�
r I W y W y
W W
W W
I ••SAD EAOK W
FRONTYARDAREAS: W W W W V
FRONTYARD: 1,666 SF
'D.
W V W W\W y W W W ROW: 1,500 SF
FRONT YARD LOT IMPERVIOUS AREAS:
DRIVEWAY: 7" SF (365 SF WITHIN FRONT YARD PP)
WALKWAY: 250 SF
v a W W W
W *� W •u W W w W
W W W 1 W W
OCT 1 lt-
BY:
,Ml
SHORES VILLAGI
IBLIC WORKS REVIEW
OVED DATE
DRNMAY/HARDS APE
walk ore, wa eaRnee
Lantlscape ArtM1itec[ure ♦Urban Design w .e u6+¢siwai
Planning I Reseamh I Consulting sc.w, im r Mivxsnxet noise LH-1
..t a1 •'1 , R]��ki'�, F. v''p)j..i
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