DS-08-22-2025 & PW-08-22-2026Je 114 -ill. i2e ANIF6. JCe JUT
Miami Shores Village
Building Department
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
JILDING ❑ ELECTRIC ROOFING
❑PLUMBING ❑MECHANICAL ❑PUBLICWORKS
AUG 10 2022
BY:
-74-r)
1(F��BC 20.2_0
Master Permit No. -D- ,'—0(2� -Z2 -202�
Sub Permit No.
❑ REVISION ❑ EXTENSION [:]RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: L4`77 N6 12- 511
City• Miami Shores ` County: Miami Dade Zip: 3 3/3?
Folio/Parcel#: I /' 32116 - O / �'% Z� V Is the Building Historically Designated: Yes NO
Occupancy Type: Load
OWNER: Name (Fee Simple Titlehold
Address: � 7/7N E7 E II jj
City: �ii�r� SI'�OAV�S State: YI Zip: )-31 3�/
Tenant/Lessee Name: Phone#:
Construction Type: Flood Zone: BFE: FFE:
Email:
r): Phone#:
ram! A'
CONTRACTOR: Company Name: G If
`
Address: / 692`� 0 A/0 017117
City: %. �fL
Qualifier Name:
State Certification or Registration #:
DESIGNER: Architect/Engineer:
ne#:
Zip: J31/Cl
Phone#: %� �/-7j` y���
Certificate of Competency #:
Phone#:
Address: City: State: Zip:
Value of Work for this Permit: Square/Linear Footage of Work: % ood
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: C"�� & I 'A&6" 7
Specify color of color thru tile:
Submittal Fee $ ' OC Permit Fee $ %5 • CD CCF $ �' CO/CC $
Scanning Fee $ (a C7y Radon Fee $ UG DBPR $ Notary $
Technology Fee $ Training/Education Fee $ 3- &1D Double Fee $
Structural Reviews $
1 4 Z_ -1() • CA:-,
Bond $
TOTAL FEE NOW DUE $ `
0
(Revised02/24/2014)
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 livo
such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
17-7 day of Z-V 20 -ZZ- , by
1624i, l). L ® is personally known to
me or who has produced �. l� as
identification and who did take an oath.
NOTARY PUBLIC:
Sign
CONTRACTOR
The foregoing instrument was acknowledged before me this
0 day of I o o)y !�-A 120 ` l by
k' &�' who is personally known to
me or who has produced (-L k: ` � ` , `' L- ' c' as
identification and who did take an oath.
NOTARY PUBLIC:
Sign
Print: J e/ ld r , k) Print:
Seal: Seal:
`•
JAIME ARMANDO BASILIO =_
MY COMMISSION II HH 268243
'• +o,*oP:°' EXPIRES: June 12, 2026
APPROVED BY 1e�2'L-A , Plans Examiner
Structural Review
Vivienne Yao
Corn m,:HH 222410
�.• a< Expires: Jan, 31, 2026
OF \` Notary Public • State of Florida
J�l eII�1z7. Zoning
Clerk
(Revised02/24/2014)
rim..."L%.Y414 +
0
BOUNDARY SURVEY
BY•�C,A _
1tV\ 01--4> EL O K 50? LOT 3, BLOCK 511'
.,
ScT ur ASPHALTROADWAY
LOT '20
BL CC 50
O
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LU
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to
W
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z
US
0
It
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LOT 2, BLOCK 5
L01`
BLOCK 50
).-11 (15.001) SET 1/2^ - (35.00')x 4
90°00'0wALDWOW
IRON ROD
y—x
Miami Shd&WVRl g Building
Dept.Y"�•Dtmeht
ZoniDate n Dept. Date
Building C
Subject to compliance with all Federal; y
State and County rules and regulations.
Permitk - �a 92nd STREET
TT�
_ 75' RIW (IMPROVED)
t .t,
F I 0 e\
AT
? �P R \
%� Na. e415 m 2
SURVEYORS CERTIFICATE
c
!
I HEREBY CERTIFY THAT THIS BOUNDARY SURVEY
A'
IS A TRUE AND CORRECT REPRESENTATION OF A
r
a
SURVEY PREPARED UNDER MY DIRECTION.
NOT VALID WITHOUT AN AUTHENTICATED ELECTRONIC
NN STATE
OF
SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL,
a
OR A RAISED EMBOSSED SEAL AND SIGNATURE.
(SIGNED)
KENNETH J OSBORNE
PROFESSIONAL SURVEYOR AND MAPPER #6415
Kenneth Digitally signed by
Kenneth Osborne
Osborne Date: 2020.1120
porn (� 14:17AA9-055''000'
(OT COMP& WU1'9fA 1)
.00K 50
CLUDED)
�Lu
U c�
THE E LINE OF
LOT23
BLOCK 50
TILC)11?3 T
BLOCK 50
NTOT INCLT T
bo
I
POINT OF
CURVATURE
FOUND 112'
IRON PIPE
65.39' (P)
65.40' (M)
SURVEYING, LLC
LB #7893
SERVING FLORIDA
6250 N. MILITARY TRAIL, SUITE 102
WEST PALM BEACH, FL 33407
PHONE (561) 640-4800
STATEWIDE PHONE (800) 226.4807
STATEWIDE FACSIMILE (800) 741.0576
WEBSITE: Mp:11targetsurveying.net
AUG 10 2022 PLOPOSED Df21\/EWAY PLAN
)BY:
NE2RINGBONEN ATG RNRI 4Ik`°w . 8 1 OR� F 'SI4-1-AGE
€.
PUBLIC RK� 7\'
PROVED �"ICE
:)NTINUOUS
OLD CN I CAGO Bf 21 CK DETAIL_
NTS
SCOPE OF WO(?<
I. REMOVE EXISTING ASPHALT DRIVEWAY AND CONCRETE WALKWAY
AS SHOWN IN PLAN AND INSTALL OLD CHICAGO BRICK AS PER PLAN
AND DETAIL.
2 COMPACT SUBGRADE AND INSTALL 6 WELL COMPACTED LIMEROCK
BASE
3. INSTALL 7 LEVELING SAND, GRADE SURFACE AND OLD CHICAGO
BRICK AT DRIVEWAY AND WALKWAY AS INDICATED ON SITE PLAN
USING HERRINGBONE PATTERN AT 45 DEGREE.
4. TRIANGLE OF VISIBILITY SHALL BE KEPT CLEAR OF VISUAL
OBSTRUCTION BETWEEN A HEIGHT OF TWO AND HALF (2.5) FEET
AND EIGHT (8.0) FEET ABOVE THE ESTABLISHED GRADE
5, 40% OR GREATER OF GREEN AREA WILL BE MAINTAINED ON THIS
PROPERTY.
& ALL WATER WILL BE RETAINED WITHIN PRIVATE PROPERTY,
7. NO TREES BEEN REMOVED FOR PROPOSED DRIVEWAY.
8. ALL IMPROVEMENTS ON THE RIGHT OF WAY AREA DAMAGED DURING
CONSTRUCTION TO BE RESTORED TO ORIGINAL OR BETTER
CONDITIONS.
9. ANY DEBRIS WILL BE REMOVED AND RE -SODDING OF DISTURBED
SWALE AREAS IF REC RARED.
Champion
CONCRETE - 'tRAVERTM - PAVERS
10280 NW 63rd Terrace # 105
Doral, Florida 33178
Office: 305.252.8055
Mobile: 305.978.4333
www.championconcreteandpavers.com
477 NE 92 ST
MIAMI SHORES, FL 33138
OWNERS: ROSARIO A COLOMBO
FOLIO:11-3206-014-0270
SCALE: 1"=20' 1 DATE: 07/27/22 1 SHEET 1 OF 1
EXIST, CBS -
WALL (TYR)
•
MIAMI 54MS SEC 2
LOT 20 BLK 50
PB 10-37
NOT A PART)
EXIST. CBS -
WALL (TYP.)
EXIST, UTILITY POLE (TYP.) SCALE 1" = 20'
� 115,0'
,x_x—x_x-
x-x-_x--.__x=x_-
iT,TREETO------------- -
�-
AIN (TYR)
L x_x_x_x_x_x
Ml' .V' SNORES S -2
LCT 21 BLK 50
EXIST.
MIAMI SNORES SEC 2
LOT 22 SILK 50
I
" o
PB 10-37
CONIC.
PB 10-37
n
pUwQ'�
cv0
POOL -
SOUP, PLANTER
`)
a-
`r
EXIST,
CONIC,
EXIST, PALM TO
REMAIN (TYP.)
EXIST, POOL
I
I
CONC.
EXIST.
N
CONC.
I
�
LANTER
AIC
EXIST
477 NE 92 ST
i CONIC, XOE�
MIAMI SNORES SEC 2
EXIST.20'X20' CONCRETE SWK MIAMI SHORES, FIL 33138 LOT 23 RK 50
SLABPB 10-37
AREA Tu0 PAVED LL7OT21
3206-014-0270 WOT A PART)
WITH OLD CHICAGO SNORES SEC 2
i p E W 15FT OF LOT 23
BRICK ON TOP OFEEXIISTING CONCRETE iPB io-
EXIST, ASPHALT DWY.' .1
TO BE REMOVED AND `x
REPLACED WITH PROP.
IOLD CHICAGO BRICK
DRIVEWAY AS PER DETAIL
i
EXIST. 5' CONC, SWK, TO REMAIN
EXIST. ASPIA AP120AC14
TO BE REMOVED AND
REPLACED WITH PROP.
OLD CNICAGO BRICK
C '' D
= '
EXIST. TREE TO
REMAIN (TYP)
TILE.
EXIST. 4' CONC. WALKWAY
TO BE REMOVED AND,
ERIICK ASP
CH�ICAAGGOO RE
4.0'
DETAIL II
`
10'XIO' VISIBILITY TRIANGLE AT
.\\\
BOTH SIDES (TYP) SEE NOTES
115.0' R/W
R/W
EXIST, 5' CONC, SWK, TO REMAIN
EXIST, TREE TO
(57
f REMAIN (TYPJ l EXIST, SWALE
`"' 157MIM I�p H �x
io
DRIVEWAY PER DETAIL
EXIST, SWALE (TYP.)
— EDP------------- - -
5,0' 15,0'
28.08,0'
/-PROPOSED APPROACH TO
BE FLUSH WITH EXISTING
PROP. TREE ROOT C0
PROTECTION
ASPHALT PAVEMENT
FENCING (TYPJ
--------------------EOP--
NE 92 ST
__
EXIST. 75' R/W (IMPROVED).
40% TOTAL LANDSCAPE MIR
14,663 X 40% - 5,865
In; IN -I-�''.e.Q`+ &;L3
AUG 10 2022
P?__��_Nffl
Miami Shores Village
Public Works Department
BY:
(305)795-2210
Public works forms are available from the building department, 10050 NE 2nd 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#: R� 02� --22 2.)�b
Name of Applicant (if utility see below):
Owner off the following described property:
Legal Description: Lot 1-2—Block _ 9 Subdivision —e JPt
Folio #; f - 32 DG / _07,7 0
Address:
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City:
Telephone:
State Certification or Registration #:
CONTRACTOR NAME: G "►r
Qualifier/Authorized Agent: ../
Address: [020 AW
City:
Telephone: Z
State Certification or Registration #:
State:
Email:
/o 0
State:T
Email: Jf} Wt4 iVFA
ZIP:
Certificate of Competency #
y1 ZIP: 7�t/ 'r0
. min
cate of Competency
Requests permission to install (describe work, attach separate pa a if necessary) in the adjoining right of
way: /, 2 P�CS A i ,�—�G K� Arm' �z
Type of Work: ❑ Paving ❑ Utility ❑Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
City:
Telephone:
Registration #:
State:
Email:
ZIP:
Value of Work for this Permit: $� 00 Square/Lineal Footage of Work: 0v
***** Fees *****
Permit Fee $100.00
Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
Bond $ (if required) Total Fee Now Due $ 11 !A—. —7 —
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 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 after the public works permit is issued. In the
absence of such posted notice, the inspection will not be approved and a reinspectigh will be charged.
Signature
Applicant or Authorized Agent
The fore 'ng instrument was /acknowledg before
met is day of 6 20 by
D 0 who
is personally known to moor who has produced
as
identificati n.
NOTARY PUBLIC:
Sign:
Print:
SEAL:
APPROVED BY:
2017-04-15
t4c)
Signature
Company/Utility Agent
The foregoing instrument was acknowledged before
me this da of UC A 20 r. 1 , by
c. s. who
is personally known to me or w_ho has..p.coduced.
L �V es s a s
identification.
NOTARY PUBLIC:
Sign: l.J` '-A-Z
Print:
V \ Vt C;nr�.L 1 (-)L-C)
SEAL:
\01111i�
JAIMEARMANppBASILIO \'X''� VivienneYao
ate= MY COMMISSION#HH269243 f2: `� CommAH222410
ExPIRES:,lune 12, 2M a
•. • a; Expires: Jan. 31, 2026
�;� Notary Public, State of Florida
*******************************************
Public Works Director, or Designee
EN r a R D
AUG 10 2022
BY:
DOCUMENT COVER PAGE
For those documents not providing the required 3 x 3 inch
space on the first page, this cover page must be attached -
An additional recording fee for this page must be remitted
Document Title:.
(Mortgage, Deed, Etc.)
Return Document To / Prepared By:
eh
OR BY, 33331 PJs 4658-401,5 ` (2F'sl_)
Ii
(,,�'�tE`, = ;UT14f :L.Er.'% O r. I!_,h.
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4QFeouate� ��
------------------------------------
1
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I
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I
(Space above this Trot reserved for mcordmg office use)
Rule 2.520 (d) On all ... documents prepared ...which are to be recorded in the public records of any county ... a 3 -inch by
3 - kdLspace at fhe top right-hand comer onthe firstpage and a 1- inch by 3 - inch space atfhe top right-hand corner
oneaeh snbsequentpageshallbeleftblankandreservedfor use by the clerk of courL
CLK/CT 155 Rev. 08/16 Clerk's web address: www.miaml-dadecierk.com
STATE OF 1=i.ORII t, COU-N s i "s :':if T�'.CE '--` L_...
HEREDY CERTIFY z° r�
Y that this i s ,rum ^opy the h tPK o
original filed in this off on _day of '''
Gil 20
fR
WITNESS my hand and t I Seal.
1! IN GOD Y.'E TFIVST Q=
I.!A:,r I n L. u I ounty Courts
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
Whereas, (owner}_ �0_:5A Lj ro Lv%-ily hereinafter referred to as the
owner of the following described property (address):
Legal Description Lot Block Subdivision
Folio # I1- 3L - 0/ — D7zt)
Requests permission to install (describe work): Ow r*' To M4<
Within the public right of vyay of (address) u
IN CONSIDERATION of the approval of this pe
2- -5r
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 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 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).
Signature
Owner or Agent
T� eforegoing iRr}strujjn�ent was acknowledged before me this day of A, 20 2Zby
"a0 (olfl,0%01D who is personally known tome or who has produced
as identification and who did Joke an oath.
NOTARY PUBLIC:
Sign: L...""
... JaMEA"D00ASIL10
Print: G ''r�o o�A�r IRME dla�i June#269
My Commission Expires: