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DS-10-20-2358Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 766 NE 95TH ST, Miami Shores, FL 33138 1132060141880 Contacts TIA BOWMAN Owner 766 NE 95 ST, MIAMI SHORES, FL 33138 Home: 3053454247 CHAMPION CONCRETE Contractor JAIME BASILIO 10280 NW NW 63 terr 105, DORAL, FL 33178 Business: 3052528055 jaimechampion@yahoo.com Mobile: 7864024802 Home: 3059784333 Other:7864024802 -•••_•••• ____Ma � `�� _ �� (€ Description: DRIVEWAY PAVERS Valuation: $ 5,400.00 Inspection Requests: 7 49 13 TotalSq Feet: 900.00 Fees Amount Application Fee - Other $50.00 CCF $3.60 Concrete/asphalt/pavers, slabs, dways, $75.00 swalks DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $1.20 Planning and Zoning Review Fee $35.00 Scanning Fee $9.00 Technology Fee $3.13 Total $180.93 Payments Date Paid Amt Paid Total Fees $180.93 Credit Card 11/02/2020 $130.93 Credit Card 10/16/2020 $50.00 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 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. Authorized Signature: Owner / Applicants( Contractor / Agent Date November 02, 2020 Page 2 of 2 Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 766 NE 95TH ST, Miami Shores, FL 33138 1132060141880 Contacts TIA BOWMAN Owner 766 NE 95 ST, MIAMI SHORES, FL 33138 Home: 3053454247 CHAMPION CONCRETE Contractor JAIME BASILIO 10280 NW NW 63 terr 105, DORAL, FL 33178 Business: 3052528055 jaimechampion@yahoo.com Mobile: 7864024802 Home: 3059784333 Other:7864024802 --._---- _----------------------- Descri lion: DRIVEWAY PAVERS Valuation: Inspection Requests: p $ 5,400.00 305-762-4943 r: Total Feet: 900.00 Fees Amount Application Fee - Other $50.00 CCF $3.60 Concrete/asphalt/pavers, slabs, dways, $75.00 swalks DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $1.20 Planning and Zoning Review Fee $35.00 Scanning Fee $9.00 Technology Fee $3.13 Total: Applicant Copy $180.93 Payments Date Paid Amt Paid Total Fees $180.93 Credit Card 11/02/2020 $130.93 Credit Card 10/16/2020 $50.00 Amount Due: $0.00 For Inspections, Call (305) 762-4949 or Log on at https://bidg.miamishoresvillage.com/cap/. Requests must be received by 3pm for following day inspections. NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that maybe found in the GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, public records of this county. STATE AGENCIES, OR FEDERAL AGENCIES. November 02, 2020 Page 1 of 2 BUILDING 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 max: l44 FBC 20 ��k f Master Permit No.- - ( d' 20-2.33 PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 2 G -5 r City: Miami Shores County: Miami Dade Zip:�� Folio/Parcel#: ac>6 — Q %'I — I M0 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple� Titleholder): T!.4 b Q N � Phone#: Address: �,�� & (0 rA`�CL5 � City: r tj L@h,j � I �°,top-V> State: Jam-- Zip: 3 Tenant/Lessee Name: Phone#: Email CONTRACTOR: Company Name: ' � p/t' `->N �n-e— Phone#:a Address: 1 02, ow, 03 Z City: C) State: ice' Zip: -3 3 / Qualifier Name: 64-sl"L) Phone#;��.5 47 State Certification or Registration #: Certificate of Competency #:�� DESIGNER: Architect/Engineer: ne#: Address: C City: State: Zip: Value of Work for this Permit: $ .5�+-f Square/Linear Footage of Work: q 0d 6 Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 11V - T -AV Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ r- CO/CC $ a, Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Structural Reviews $ Training/Education Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 30 3 (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) i^vi�r"tga^ge 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 IN T END 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 b delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement m t be posted at the job site for the first inspection which occurs seven (7) days after the building prewit is issued. In th absent of such posted notice, the inspection wil , of be approved and a reinspection fee will be charged. / L 71 a �jd Signature i SignaturE O.A./NER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this y .,.,_ day of O4. 20 M by j /�- S ?AQ &` , who is personally known to me or who has produced as identification and wiiu did take arl Oath. NOTARY PUBLIC: i Sign: Print: Seal: ...... , +A SOF p1 APPROVED BY (Revisedo2%24j2014) JAIME ARMANDO BASILIO My COMMISSION # GG 227924 EXPIRES: June 12, 20?2 The foregoing instrument was acknowledged before me this I day of _ (�'�— 20_ by 1 "_�-2, ( LkO , who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Print: Seal: Plans Examiner Structural Review as ALVARLZ I fviYCC�,AWS,oI0iJ#c.G'L38273 �. Ii C-RP+RLS: September 3 2022 9r�,,;yQ Bonded ThruNotaryPublic Underwritero Zoning Clerk BOUNDARY SURVEY RECF,-WED NE_95_TH_STREET - - ; 80' R/W (IMPROVED) :-- lot ETE' IE L, Q " 0000'00"E 75.00' 5' WALK v, FOUND 1/2" I FOUND 1/2" IRON PIPE IRON PIPE NO I.D. '. - NO I.D. 6cP m N (a 7 14.6 9.8' 7-LV a 12W MgIA9'd SX80M 0I o � Jbr11I n S3�OHS 1W � �27.a� � � o BUILDING ui `0`� �� J (r/rP Sr>�'(, LOT 5 #766 REMAINDER Or BLOCK 67 ti LOT 3 0 BLOCK ) `cm 10.11 N tNOTryIzyCLU L2il IO.T 132001-PM AZT v SURVEY NOTES LOT 4 ti CONCRETEDAN CROSSING INTO RMV ON NORT D SOUTHERLY SIDE OF LOT. I BLOCK 67 cc ? N PORTION OF LOT 3 ��l�Q'0f�/Gn J1a 5P� THERE ARE FENCES NEAR THE BOUNDARY BLOCK 67 "-� 4q OFT PERTY. (INCLF _Q0. UDED SET 1/2" I I IRON ROD IRON R06— I LB #7893 -0.4'0 ! s"o LB #7893 I 75.00' J _ 8' WALK ALLEY ---- - -- — �..._ . w No. 6415 F�m� SURVEYORS CERTIFICATE I HEREBY CERTIFY THAT THIS BOUNDARY SURVEY IS A TRUE AND CORRECT REPRESENTATION OFA SURVEY PREPARED UNDER MY DIRECTION. NOT VALID WITHOUT AN AUTHENTICATED ELECTRONIC STATE OF SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL, O a l n o °' OR A RAISED EMBOSSED SEAL AND SIGNATURE. (SIGNED) KENNETH J OSBORNE NOfLL1\iAL TE ?iiOf T1;h(E II PROFESSIONAL SURVEYOR AND MAPPER;Y6415 ,•A R"G E i �-RVING FLORIDA 6250 N. MILITARY TRAIL, SUITE 102 • ` ` E LR?BlICM FL 334�7 i . IE (5�1)6q�.48()D�• •STRTE"DE PHONE (800)IU6•1807 • • • •• STXtVVft -AGSb4LE18b0)lt-0576