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DS-03-22-663Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: DS-03-22-663 Permit Type: Driveways/Walkways/Slabs Work Classification: Addition/Alteration Permit Status: Approved Issue Date:07/19/2022 Expiration:01/19/2023 Location Address Parcel Number 121 NE 110TH ST, Miami Shores, FL 33161 1121360040220 um-- .--"', _,e. P- Contacts Elizabeth Amaran Owner HOGAN CONSTRUCTION COMPANY INC Contractor 121 NE 110 ST, Miami Shores, FL 33138 FRANCIS HOGAN vgiuseppe@outlook.com 1331 BRISTOL AVE, DAVIE, FL 33325 Business: 9544447081 frank@hccsfl.com Description: REMOVE EXISTING DRIVEWAY AND REPLACE WITH Valuation: $ 7,260.00 Ins ection Requests: BRICK PAVERS Total Sq Feet: 660.00 Fees Amount Application Fee - Other $50.00 CCF $4.80 Concrete/asphalt/pavers, slabs, dways, $75.00 swalks DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $1.60 Planning and Zoning Review Fee $70.00 Scanning Fee $9.00 Technology Fee $3.13 Total: $217.53 Payments Date Paid Amt Paid Total Fees $217.53 Cash 07/19/2022 $167.53 Cash 03/15/2022 $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. AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws :onstruction and zoning. Futhermore, I authorize the above named contractor to do the work state. \ ) 1AA4 G it 4PQ2 VA2cp 'e2- - I lit 2;)— Applicant It I Contractor I Agent Date July 19, 2022 Page 2 of 2 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 QBUILDING ❑ ELECTRIC ❑ ROOFING FBC 20 Master Permit No. DS-03-22-663 Sub Permit No ❑ REVISION ❑-EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS V CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 121 NE 110 St. City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Elizabeth Amaran Phone#: ,,,,,,,e 121 NE 110 St. City: Miami Shores Tenant/Lessee Name: Email: State: FI Zip: 33161 CONTRACTOR: Company Name: Hogan Construction Company, Inc. Phone#:954-444-7081 Address: 1331 Bristol Ave. City: Davie State: FI Zip: 33325 Qualifier Name: Francis X. Hogan Phone#: 954-444-7081 State Certification or Registration #: CGC1507037 Certificate of Competency #: DESIGNER: Architect/Engineer: N/A Phone#: Value of Work for this Permit: _City: State: _Zip: � p Square/Linear Footage of Wor : SG/ft te�d S(J - r 7— Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of work: Remove existing driveway and replace with place brick pavers Specify color of color thru tile: Submittal Fee $ eD'Co Permit Fee $ 25 101) CCF $ 4 •� co/ccs Scanning Fee $ _t •to Radon Fee $ L 66 DBPR $1$ 2' Ci) Notary $ Technology Fee Training/Education Fee $ I ' bV Double Fee $ Structural Reviews $ (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $ Bondine Company's Name lif applicable) nja Bonding Company's Address City State 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: 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 r s inspectlan-whIch occurs -seven (7) days after tire -building permi"s-issued._In the absence_¢/ such posted_ notice, the insnection will not be onnroved and a reinsnection fee will be charged. Signature J0kXffAWNT The foregoing instrument was acknowledged before me this day of ✓ 20 —0—L, by 1u�& who is personally known to me or who has produceas identification and who did take an NOTARY PUBLIC: Seal: APPROVED BY Expires 0dober 29, 2025 Ballad Tiro Budget NaYry SWIM Signat e CONTRACTOR The foregoing instrument was acknowledged before me this lr day of 1 .20 y by who/ is p sonally known to me or who has produced rG d L as identification and who did take an oath. NOTARY PUBLIC: (/ ) Print: Seal: }#iiiiiiiYiYkYii}}}}Y#F#i###iiiiiiiii###########}#####iYtiiYi 2025 Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk 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 ILDING ❑ ELECTRIC ❑ ROOFING Master Permit Sub Permit REC,Ex�TED BY:... FBC 20Z0 -DS -03._zZ-�E3 ❑ REVISION ❑ EXTENSION [—]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 121 NE 110th Street, Miami Shores 33161 Folio/Parcel#: 1 17-1 3 � M I-Q ZZy Is the Building Historically Designated: Yes Occupancy Type: Load OWNER: Name (Fee Simple Titleholder):_ nririP �.121 NE 110th Street, Miami Construction Type: Flood Zone: BFE Amaran 33161 City: M i I t-6- State: J a. Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Designer Pavers, Inc, Address:2751 SW 130th Terrace City, Davie Qualifier Name: State Certification or Registration NO x FIFE: i�)51 b I one#:954-921-5555 one#: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ n 7 to . —e9 Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace Description of work: Remove existing driveway and replace with brick pavers Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ 33330 Zip: ❑ Demolition CCF $ CO/CC $ DBPR $ Notary Double Fee $ Structural Reviews $ (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $ ' 31 .13 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 t e absence such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature NERorAGENT ONTRACTOR The foregoing instrumentt was acknowledged before me this —A dayof zL—�� 20 tiL- by 1 i p"'^" J who is personally known to me or who has produced FL JL, as identification and who did take an oath. NOTARY PUBLIC: The foregoing instrument was acknowledged before me this 10 day of VVL \ 20 2Z . by ersonally know to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print Seal: vRr•w GRISELCALDERO Seal: Coma"sion # IN1191125 xM E re• October 29, 2025 a ��F O•" agbM rlru Bul,sIN.W,MvleM APPROVED BY S-/3 /l/ Plans Examiner ODIESHA GRANT ° Notary Public. State of Florida Commission# HH 145698 My Comm. expires June 27 2025 ########### Zoning (Revised02/24/2014) Structural Review Clerk T�21✓ Pro paoly-S Puc& Pc•e— hEASEBDTE- 30ATPP.UF£PTY65 SEWUD SYRIA C0XIpES. Aala"ie Condilnas . lias>ro/t Ih 4iwtm: _..-._.... __.. .YA'% S2Y2 f"'S d!M} f CYfSS dLTtY�GE 9R � GI kY1Y. P'g2$2 iC^.t lil G{r 1l£GSrS 81 wmr`zx^�uxymmluap c6akvla'm7Yor o-�ntl wic�r;�a�^spa*3. i b;; s:nxy h5 teen RuM E71r k1U/nv la a� $r+�r5 r."w. 600 Fairway Drive -Ste, 101 Deerfield Beach, FL. 33441 Office: (561) 367.3587 Fax: (561 ) 465-3145 iwrw.LandtnSurvey.com CITY COPY RECEIVED BY a.. —_ - — .44 Drwtu-& 'A b rlr� ec vw: xr:scE;Fw>nc �aYv�OV� �i aC�'Ci.S'CffSCCFsE TY. BJX p- w OI(f7ESLii6FD Cr5TRYfE -w p e- xcFxcrtsna,,ucEta�Fe:h'r _ J2!>S%, t FNOCM3IESfAA!L" � U urFs,��s+;an • • • f I • • ��resovE,r�„auaueE • ..•_ J)GAiESNAI •.. ____.__.� �.. r.`:^. _'•::, •• iQFYv"±ESYAzfl7Af•� �1G • iC€PC7FSPA.at� ( ` • '!; CfiriiES iE:Ew UiE R'SEfl /��j �,�f�77O-C/l.w �EAi!Tf's t!f@tiYF.4$�7rt:Y1 J Ix,�, M�rr� x�-rh�Ea • 7,sY-7s _ t�sa�5b a'ex 3of Fok�o,h r . ..:. ..x.Atv..ixn 775', v: N/ LANDT`E� / U R V E Y i N G k Miami Shores Vi a uil g uepa 4 Date Zoning Dept. Date Building De Fed Subject compliance and Counnand regulations. ty r Permit# — _ 7 1 � - r - 7 Ron DoSantle Mission: Governor To protect, pra note & in -prove the health of all people in Florida through integrated state, DOUfty & OOrTTrlAlity efforts. Joseph A. Ladapo, MD, PhD HEALTHState Surgeon General Vision: To be the Healthiest State in the Nation March 29, 2022 Giuseppe Vasquez 8816 Collins Avenue Miami Beach, FL 33154 RE: Modification to a Single Family Residence - No Bedroom Addition Application Document Number: AP1812667 Centrax Permit Number: 13-SC-2480609 121 N E 110 Street Miami, FL 33138 Lot:23 Block: 1 Subdivision: Dear Applicant, This will acknowledge receipt of a floor plan and site plan on 03/23/2022 for the use of the existing onsite sewage treatment and disposal system located on the above referenced property. No objection for New Driveway installation ONLY as per your site plan. 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. 1 Sincerely JOSE R. VALDIVIESO ENGINEER SPECIALIST II Department of Health in Dade County Florida Department of Hearth www.florldahealth.gov in Dade County • - , Florida TWITTER:HealthyFLA PHONE: (305) 623-3500 FACEBOOK:FLDepartmentofHealth YOUTUBE: fldoh ACCORV CERTIFICATE OF LIABILITY INSURANCE `� TE (MMIDDIYYYY) °A 7/14/2022 07/14/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WANED, subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Nathan Sanchez Farmers Insurance 51 W 84th Ave Ste 215 Thornton, CO 80260 CONTACT NAME: Nathan Sanchez PHONE 720-50"272 a No): 720-458-5065 E-MAILD; nsanchez@farmersagent.com INSURERS AFFORDING COVERAGE NAIC S INSURER A: Berkshire Hathaway INSURED Hogan Construction Company 1331 Bristol Avenue Davie, FL 33325 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF (MMM-PIYYYY) POLICY EXP (MMMnrfYYYILIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ PREMISES a occurrence) $ MED EXP Any oneperson) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY I JECT PRO- LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED _..._._... AUTOS COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) . _.... _............................ _............ ................. BODILY INJURY (Per accident) $ ........ ........... ............................................................ $ PROPERTY DAMAGE (Per accldentL -. ww.._.__.._.__.,..... $ _._............................... _.......... ..... .-...... UMBRELLA UAB EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITYER ANY PROPRIETOR/PARTNERIEXECUTNE YIN OFFICERIMEMBEREXCLUDED? (Mandatory In NH) If yes describe under DESCRIPTION OF OPERATIONS below N /A NXT6WOA4RY-01 WC 05/01/2022 05/01/2023 WC STATLIMU- OTH- E.L. ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,Q00 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, li more space Is required) GCG1507037 - Francis X Hogan CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2nd Ave ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FI 33138 AUTHORIZED REPRESENTATNE I ACORD 25 (2010105) 01988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD