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DS-08-22-2023 & PW-08-22-2024Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 241 NW SIM ST, Miami Shores, FL 33150 Contacts Permit NO.: DS-08-22-2023 _ Permit Type: Driveways/Walkways/Slabs Work Classification: Addition/Alteration Permit Status: Approved Issue Date: 11/10/2022 Expiration: 05/10/2023 Lori Brandt Owner 241 NW 91 ST Mobile: 7865531962 lori.brandt@compass.com Description: CONCRETE DRIVEWAY Fees Amount Application Fee - Other $50.00 CCF $2.40 Concrete/asphalt/pavers, slabs, dways, $50.00 swalks Contractor Registration Fee - First Time $50.00 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $1.20 Notary Fee $5.00 Planning and Zoning Review Fee $70.00 Scanning Fee $9.00 Technology Fee $10.00 Total: $251.60 Parcel Number 1131010331340 Contractor JAIME BASILIO 10280 NW 63 TER 105, CORAL, FL 33178 Business: 3052525055 jaimechampion@yahoo.com Mobile: 7864024802 Home: 3059784333 Other: 7864024802 Inspection Requests: Valuation: $ 4,000.00 305-762_4949 Total Sal Feet: 300.00 Payments Date Paid Amt Paid Total Fees $251.60 Credit Card 11/10/2022 $196.60 Credit Card 08/10/2022 $55.00 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 stri conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this p9iffnit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELVJtTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AF DAVIT: certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating uthermore, I author the above na contractor to do the work stated. Authorize Signature: Owner / Applicant / Crontractor / Agent Date November 10, 2022 Page 2 of 2 Miami Shores Village gED B dAi D t t UI Ing epar men A�G102022 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 j4h INSPECTION LINE PHONE NUMBER: (305) 762-4949 gYt BUILDING PERMIT APPLICATION UILDING ❑ ELECTRIC ❑ ROOFING FBC 20'2D Master Permit No.DS- u-ZZ-2o23 Sub Permit No. ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 310►u33134o Occupancy Type: Load: Construction Type: 3 the Building Historically Designated: Yes NO Zone: BFE: FFE: OWNER: Name (Fee (Simple Title�h/older): I oAli 6�//Tr�l/I Phone#: Address: 7-1 NW/ City: ft/%^.1� State: Zip: 7 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: _ Address: 4OXY10 AA j . City: �01�1f Qualifier Name: State Certification or Registration #: DESIGNER: Architect/Engineer: _ e#: 3e� znowr Zip:: ?r 517 / Phone#: 3L6! Q! 2 S{ of Competency #:�.5,//O��J Phone#: Address: City: State: Zip: Value of Work for this Permit: $ N.00a Square/Linear Footage of Work: j00;_'� Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition 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 $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 4 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 WE 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 on 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 syh posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature AA OWNE or AGENT CONTRACTOR The aVrGgoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this i da( of 20 ZZ , by da20 ZZ by ntii /J%ii A/�',U0 . who is personally known to �� L, V - g 0.g' (`o who is personally known to me or who has produced ,- At � 67 J'/J t GZ-affsy- Ome or who has produced rL ±>✓ i lrIffy'= i as identification and who did take an oath. NOTARY PUBLIC: Print: J !MYT,- /1�kJli7 V Seal: ya" ti; JAIMEARMANDOBASILIO •` MYCOMMISSIONMHH2MA ^r, noa EXPIRES. -Am 12, 2026 *****sorts********* identification and who did take an oath. NOTARY PUBLIC: Sign: Print: -= Seal: ;``Pa.+►u°��, �qa i� ` �: wenneYao Comm.:HH222410 y.:� Expires: Jan.31,2026 Florlda .`` Notary Public • State of •s**s**ss*ss*�LY4�i":s**s**s***********s**********er** APPROV DPBY K—112- 1`2Z— Plans Examiner Zoning Structural Review (Revised02/24/2014) Clerk A _ ' LAND_ F N —x—x— s�r,hact(, F I. R.I/2 IS.J9' AL b 0 N t en . '"Cu.rvo rPe I O'ASPHAL c5 ONE STORY 6.95' C.B.S- g RESIDENCE b #241 to,", 19.40' 0'00"W 75.00's:3" ;fir u CO Alfae 25' PARKWAY 18' ASPHALT PAVEMENT 70' RIGHT-OF-WAY N.W. 91st STREET N.W. 91 Street ni Shares. FLORIDA 33150 SIGNED EFRAIN D STATE OF FOR THE FIRM P.S.M. No. 6792 N � N N jto — ly cr) SOY 0WU 09 Zm 5 SW 19Dth Sreel ,3110 11, FL 33157 ie: (305) 740-3319 (305)669-3190 7969 Proudly Serving r the Florida Real ME1, xn Estate Community for Over 20 Years K'W W.MELANDSERNCCS.COM ENTITaIDD AUG 10 202 C�-cl� 2i✓�cvxy Pj2ftW'e aid �cwrcr�y A&M -fW f1&aY J tram ..I-natsn. pp�� JN3 {�� Wib ,�/� Writ colk l4-ti7�e . �P �AIJYLI�A.fI oM`1 _t 11 6w (Rill h 4,74)t G % �,"c 3�soo 6tivelpr F.I.P. I /2" Miami Shores Vil Building Zoning Dept.. Building Dept. `.Subject to compliance with all Wd County rules and regulati ORES VILLAGE Aw ]A. _ ME LAND_ r surveyf:6-n!lx Client File 4: 201"36 Peg. lof2Notvdidwitltmell pg., Miami Shores Village 100SO NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 241 NW 91ST ST, Miami Shores, FL 33150 Contacts Lori Brandt Owner 241 NW 91 ST Mobile: 7865531962 lori.brandt@compass.com Permit NO.: PW-08-22-2024 Permit Type: Public Works Work Classification: Public Works Permit5tatus: Approved Issue Date: 11/10/2022 Expiration: 05/10/2023 Parcel Number 1131010331340 CHAMPION CONCRETE JAIME BASILIO 10280 NW 63 TER 105, DORAL, FL 33178 Business: 3052528055 Mobile: 7864024802 Home: 3059784333 Other: 7864024802 .ate Inspection Requests: Description: CONCRETE DRIVEWAY Valuation: $ 0.00 40 305-762-4949 Total Sq Feet: 50.00 Fees Amount Education Surcharge $0.30 Public Works Permit Fee $100.00 Scanning Fee $3.00 Technology Fee 510.00 Total: $113.30 Payments Date Paid Amt Paid Total Fees $113.30 Credit Card 11/10/2022 $113.30 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 pe I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFI AVIT:Ertifyt all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating cons ionuthermore, I authorize the abov named contractor to do the work stated. Authorized gnature: ner / Applicant / Contractor / Agent D to November 10, 2022 Page 2 of 2 ENX EKED Miami Shores Village Public Works Department AUG 10 2022 (305)795-2210 Public works forms are available from the building department, 10050 NE 2nd Ave., Miami Shores' PUBLIC WORKS PERMIT APPLICATION Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property Permit#:TCO -DS'22-2C24- Name of Applicant (if utility see below): Loa 6o*Ao—r Owner off the following described property: (, Legal Description: Lot—jl Block 13•6 Subdivision �tA44!91' H4 l4�? SCE Folio#; AL 3)0/— 033— 13L07 Address: ZN/ i✓W 49/ S)r UTILITY NAME Qualifier/Authorized Agent: Address: City: Telephone: State Certification or Registration #: ;Ti7��1:TS9Yylv_1bI? Qualifier/Authorized Agent: Address: ��kt City: __&A 0 AI Telephone:T 247dDS State Certification or Regisf State: Email: ZIP: Certificate of Competency # ZIP: _ Email: 150-VIY/N Ce �Y"1jt/ mm*y.cpljf' #: Certificate of Competency #: Requests permission to install (describe work, attach separate page if J / way: S'Tp GSsj' 9'dl.U'� "L in the adjoining right of Type of Work: ❑ Paving ❑ Utility idewaIk ❑ Electric ❑ Irrigation ❑ Landscape ❑ Antenna ❑ Other: DESIGNER: Architect/Engineer: Address: Citv: Telephone: Registration #: _ State: Email: ZIP: Value of Work for this Permit: $ y00. Square/Lineal Footage of Work: Permit Fee $ 100.00 Notary $ Bond $ ***** Fees ***** Training/Education $ 0.20 „Technology Fee $ 0.80 Scanning $ (if required) Total Fee Now Due $ 1 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 iss d. In the absence of such posted notice, the inspection will not be approved and a reinspection wie charged. Signature � 1490� A plicant or Authorized Agent The foregoing instrumen was acknowledged before me this day of 37 20�17— by "bLALt who is personally known to me or who has produced ou ✓, as identificatio . NOTARY PUBLIC: Sign: Print: SEAL: JAIMEARMANOO BASILIO MYCOMMISSION t HH 289243 EXPIRES: June 12, 2020 APPROVED BY: Signature The foregoing instrument was acknowledged before methis_D—dayof AN4U5 4- 20_�by J3 iO a, .f3as; I,T is personally known to me or who has produced F::r— ZJ(iV-exX CE, as identification NOTARY PUBLIC: Sign: S ) `,� ` l "" Print: SEAL: V l V b -Z V1rL,0'IC-0 a�",',��,, *AenneYao a+` rJ',.. 4n' P-61" ;`�= Comm.:HH222410 Expires: Jan. 31, 2026 Notory PWb c • State of Florida **************************** Public Works Director, or Designee 2017-04-15