DS-07-617CONCRETE DRIVEWAY
ON 1 1 2001
Passed
Inspector Comments
Fibermesh tickect not a permit package for final inspection. 5/10/07 CG.
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
�p
1
tiara Nu .
7
Inspection Date: 05/10/2007
Inspector: Grande, Claudio
Owner: LOPEZ, EDWIN
Job Address: 133 91 Street NE
Project: <NONE>
Contractor: SUPER STAMP CONCRETE
Building Deuartment Comments
Thursday, May 10, 2007
Miami Shores Village, FL
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Block:
Phone Number
Parcel Number 1132060133320
Lot:
Phone: 305 - 220 -1163
Page 1 of 2
CONCRETE DRIVEWAY
APR 0 6 2007
Passed (9-6
f i r
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Date: 04/06/2007
Inspector: Grande, Claudio
Owner: LOPEZ, EDWIN
Job Address: 133 91 Street NE
Project: <NONE>
Miami Shores Village, FL
Contractor: SUPER STAMP CONCRETE
Building Department Comments
Wednesday, April 4, 2007
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit Type: Driveways /Sidewalks/Slabs
Inspection Type: Foundation
Work Classification: New
Block:
Phone Number
Parcel Number 1132060133320
Lot:
Phone: 305 - 220 -1163
Page 2 of 2
Mar 30 07 01:17p
STATE OF FLORIDA
COUNTY OF DADE
5. Surety: (Payment bond required by owner from contractor, if any)
Name sad address:
Amount of bond: $
6. Lender's e and address:
Narne and address:
Name and address:
7. Persons within the State of Florida designated by Owner upon whoi,
served as provided by Section 713.13 (1) ( a ) 7., Florida Statutes:
Print Owner's Name u.l i
Notary ?obit
Print Notary's Name
lvly Commission Expires:
p.2
1111111 11111 11111 1111111111 111111i 11111111111
CF t 2007R0328583 DR I;K 25495 Fs 3857; WO
?
RECORDED 03/30f2007 14 :20:47
HARVEY MIEN, CLERK OF COURT) MIAMI-DADE CDUNTYP FLORIDA
LAST PAGE
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON TAE JOB SITE AT TIME OF H ST INSPECTION
PERMIT NO. TAX FOLIO NO. if- 300 - O i 3- 33 a r�
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
1. Legal description of property and str address: 1 33 vg q I S t . !"� • Sky reS , (3 3 i 3 e
E J/? of lot 1-2 c1- (-a't 1�1 M S ores Sec. J ) P 1V P6 - .an
2. Description of improvement: . Carri Cam# t✓
3. . Owner (s) name-and address: Ca p-
1 :Y i } 0* 9 i S • rn. ,. e. ?3 3
Interest in property:
Name and address of e simple titleholder: �±
4. Contractor's name and address: � `� �- 6' ( .lt.. •D
90 131d- nv amp
tires or other documents may be
8. In addition to himself, Owner designates the following person (s) to receive a copy of the Lienor's Notice as
provided in Section 713. 13 (1) ( b) 7., Florida Statutes.
4.
9. Expiration date of this Notice of Commencement (the expiration date is 1 year from the date of recording
unless a different date in specified) �� t, � ti t1Y A s ,, OFFlC}a L inT ,844
s p • s Marola Franco /Sans
Commission # DD282247 .
QF.... My Commission Expires
'`�•,���• +`` APRIL 06, 2008
o�1- day : + 20
Prepared by:f. a t: L i
Address: 5 g U `, i 311 d-
I1+L:air+ -4; i re ° . 1 ,
BUILDINGn ;'° ` : m Permit No. C®k
PERMIT APPLICATION MAR 2 j of ter Permit No.
FBC 2004
Permit Type (circle):
Owner's Name (Fee Simple Titleholder)
Owner's Address i 3 3 NE 6 11 , "f
Cit f1 • 5 h a r{ S State t'L
Tenant/Lessee Name
Value of Work For this Permit $
Scanning $ Y Radon $
Structural Review. $
Miami Shores Village eshs\ 31 wl
Building Department 'mot ‘v■ twos'"' 'fi
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
3 X)
Electrical Plumbing
E;Ghv i ✓1 L o p e -a,
Job Address (where the work is being done) 133 N G GI i S-i
City Miami Shores Village County Miami -Dade Zip 3 ) 3 g
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name S 11 1 P Co fLPhone #
Contractor's Address 6 ,SW 1 N' c±
City N ( State pl., Zip 83 1
Qualifier Name 1/.3 111 ` Qj m 1 5g V) S Phone # .3 6 2 2-0 1 1 W3
3
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name if apps caber le) Phone #
Type of Work: DAddition ElAlteration ['New
Describe Work: LS f vin , C ,, a
Square / Linear Footage Of Work:
******** * * * * * * * * * * * * * * * * * *** *** * * ****** F * * * * *** * * * * * * ** * * * * * * *** * * * * ** *
Submittal Fee $ Permit Fee $ 1 Z' . CCF $ 2, "1 0 CO /CC .e)0 r�
Notary $ Training/Education Fee $ •V Technology Fee $ J• (2—
DPBR $
Mechanical Roofmg
Phone # 3 5'1 1 'S 8 y"
Zip 3 3 g
Phone #
305 12.0 Lc. 3
Repair/Replace ❑ Demolition
Zoning $
Bond $ Code Enforcement $ Double Fee $
Total Fee Now Due $ 'Vby • 5 L-
See Reverse side —> em o ()L Iv
j S
1)t J
Bonding Company's Name (if applicable)) _�—
Bonding Company's Address
City State Zip
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ,20 ,by , day of ,20 ,by
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLIC:
Sign: Sign:
Print: Print:
My Commission Expires:
APPLICATION APPROVED BY:
(Revised 02/08/06)
My Commission Expires:
Plans Examiner
Engineer
Zoning
BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department
FBC 2001
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) E d W e Phone # 3 o S - 5 q a- 58
Owner's Address ?a$ q 1 5f
City M . sr-wires State -Ft-
Tenant/Lessee Name Phone #
Job Address (where the work is being done) 1 '3'3 N - 9 1 5+
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO
Contractor's Company Name 3)t'EP-- Sfarry aNc12Q 0
Contractor's Address O (A) 1 3y
City K re S State n or ca tct Zip S 1` 3&.
Qualifier 1,k) A(fl cAN 5
Architect/Engineer's N ' e (if applicable) - Phone #
Architect/Engineer's Addr
City '-
$ Value of Work For this Permit
State
Zip 331 3 $
Permit No.
Master Permit No.
Zip `3 3
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Phone # 30 S 20 -11 (p3
r * ** ** * * * * * * * * * ** ** * ** * * * * ** F ees * * * * * *** * * * * * * * * *** * ** ** * * ** **
Zip
Square Footage Of Work: 6 40
Number of: Bays Stories 1 Families Bedrooms ` Baths
Type of Work: ['Addition []Alteration ['New ►:i Repair/Replace ❑ Demolition
Describe Work: 5 0 - — d - V °
County Escrow Fee $ Permit Fee $ Notary $
Education/Training Fee $ Tech $ Scanning $ Radon $
Code Enforcement $ Bond $ Struct. $
Minus Plans. Check Fee $ Total Fee Now Due $ (Continued on opposite side)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 Ls issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
" I OFFICIAL NOTARY SEAL
Signature
��,,..t. 49 %Marola Franco /Sans
�;,q� Commission # DD282?8lgnature
Owner or Agent ' 0 — `¢ My Commission Expires
06, 2008
The foregoing instrument was acknowledged before me this
g al- The foregoing instrument was acknowledged before me this
day of aid 20 a-I •O11. cop , day of n et/01'R 4', 20 0-7,-by 11) ■ 11 /Am : AAn ,
who is personally known to me or who has produced T who is pei o y k no to me or who has produced
tification and w did take an oath. as identification and who did take an oath.
NOT 4. / .X IC: �
r NOTARY PUBLIC:
Sign. /Jae
Sign:
Print: •L...l 04 ' �r 1GIl
1 oe My Commission
Print
ices: ?� II y � I S So; S C' h 5
My Commission Expires: •
* r****************** *** ** * * * * * * *,r *** * ** * * **** *** * ter******* * **** * ** ** ** ****** **** * ** *t*** I * ** *** * *** * * ** ***
(Certificate of Competency Holder)
Certificate of Competency No.
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
chc7/7/o3
State Certificate or Registration No.
P OURY PUBLIC- STATE OF FLORIDA
Yelissa Sans
Commission # DD401796
Expires: MAC{. 01, 2009
Contracboflded Thru Atlantic Bonding Co., Inc.
Plans Examiner
Engineer
Zoning
ba. .cam Rnc.?r 4,14. .1atl216&°4KD
Olt ... s* .+e IA%
CERTIFY TO:
Edwin Lopez
Brian b. Smith. Empire
Attorneys' Title insurance Fond. loc.
Washington Mutual Home Loans Tits Its Successors
-' g icrefo ebisiiFi r
3� 44; : 94 0.Af
LEGAL DESCRIPTION;
1 . 0 " E h of lot 18 & all of lot 19 .• f1
Nock: 24
r. vidan: An Amended Plat Of Miami Shores
According to the Plat thereof as reemded in
Plat kook: .10 Page
Pub t ecards ACE
A bbi S:
183 NE 91 STREET
/AWAY $f4ORES. FL 33135
Encroachments Woredt ikioa
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STATE OF FLORIDA)
COUNTY OF DADE)
The undersigned Affiant, , does hereby attest that the
(property owner)
attached survey, performed by 7.
(name of surveyor's company)
performed on
000
(date of survey)
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the
property without first providing a survey less than six (6) months old. The Affiant, as property owner, firther
agrees to remove or obtain permits for any structures which now may exist on the property which are not
permitted or which may violate zoning or building code regulations. The Affiant further understands that the
existence of any such structures may affect final inspections as applicable to this or other permits..
Further, Affiant sayeth naught.
Affiant is personally known to me,
• • • •••
•• ••• • •
S :? Il •••.
• • • •
iam _
•
, is an accurate representation of the existing conditions and
AFFIDAVIT
• • . • • • • .••
•
•• • • •.•• • • • •
• ••• ••••••
• • • • • • • • •
• • • • • • • • • •
• • ••• • • •
•• • : • .•• ••• ••
• • • • • • • • - •
• • • •
• • • .! • •• • •
.• •
•• • • • • • ••• ••
SWORN TO AND SUBSCRIBED before me this day of t 0
IpL
FFICIAL NOTARY SEA
v PG Marola Franco /San:
. Cu„ fiss ion # D D28224'
;oz. My Commission Expires
;FOF,,,�,�• APRIL 06, 2008
as identification.
STATE OF FLORIDA
) SS.
COUNTY OF MIAMI DADE )
STATE OF FLORIDA )
) SS.
COUNTY OF MIAMI DADE )
Title or Rank:
Title or Rank:
• • ••• • • • •••
•• •• • • • •• •• •
• • • • • • • • • •
• • • ••• • • •
• • • • • • • •
• • ••• • • • • •••
(ACKNOWLEDGEMENT - INDIVIDUAL) • • • • •
•• • •••• •• •
• • • • • • • • • • • • •
• • • • • • • • • • •
• • • • • • •• •••
• • ••• • • • •
•
•• • • • •• ••• ••
• ••• • • • • •• • •
The foregoing instrument was acknowledged before .me on,,„ • ... • •. • by
..
, who is personally known to me or who has produced
as identification and who did (did not) take an oath.
Signature of Acknoweedger:
Name of Acknowledger.
(Typed, Printed, or Stamped)
Serial No.(if any):
(ACKNOWLEDGEMENT - CORPORATION)
The foregoing instrument was acknowledged before me on by
of
a corporation, on behalf of the corporation. He/She is
is personally known to me or bas produced as
identification and did (did not) take an oath.
Signature of Acknowledger:
Name of Acknowledger.
(Typed, Printed, or Stamped)
Serial No.(if any):
Planning and Zoning Criteria
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)758 -8972
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 3/28/2007 : Yes
Comments:
Issue Date: Not Issued
Folio Number:1132060133320
Owner's Name: EDWIN LOPEZ
Job Address: 133 91
Miami Shores Village, FL
Owner's Phone:
Total Square Feet: 670
Total Job Valuation: $ 3,800.00
Contractor(s)
SUPER STAMP CONCRETE
Phone
305 -220 -1163
Primary Contractor
Yes
1
Project Address
133 NE 91 Street
Miami Shores Village, FL
Owner Information
EDWIN LOPEZ
Friday, March 30, 2007
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Contractor(s)
SUPER STAMP CONCRETE
Phone
305 -220 -1163
CeII Phone
Building Department Copy
Address „_
Fees Due
Bond Type - Contractors Bond
CCF
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$300.00
$2.40
$0.80
$125.00
$3.00
$3.12
$434.32
Permit NO. DS -3.07 -617
is Permit Type: DrivewayslSidewalkslSlabs
e rill! Work Classification: New
Permit Status: APPROVED
Issue Date: 3/30/2007 Expiration: 09/26/2007
133NE91ST
MAIMI SHORES VILLAGE FL 33145
Approved: Yes
Comments:
Date Approved: 3/28/2007: Yes
Date Denied:
Type of Work: DRIVEWAY
Bond Retum :
Additional Info:
Classification: Residential
Parcel Number
1132060133320
Block: Lot
Authorized Signature: Owner / Applicant / Contractor / Agent
Phone
Total I Amt Paid I Amt Due
$ 0.00 $ 0.00 $ 0.00
Payment TlifriP c Z�Z ',)
l�
I 04-
Applicant
Valuation:
Total Sq Feet:
EDWIN LOPEZ
Available Inspections:
CeII
Inspection Type:
Final
Landscaping
Foundation
Sidewalk
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
March 30, 2007
Date
1
Date
Friday, March 30, 2007
03/30/2007 Check
03/30/2007 Check
Receipt
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit Number: DS -3 -07 -617
Invoice Number: DS -3 -07 -27987
Applicant: EDWIN LOPEZ
Company Name:
Owner Address:
133 NE 91 ST
MAIMI SHORES VILLAGE,
Job Address:
133 91 Street NE
Miami Shores Village, FL
Payment Type Check Number
2202
13338
Amount
Change
$300.00 $0.00
$134.32 $0.00
Total Payment: $434.32
Page 1 of 1
May 31 07 07)2a'
SUPER STAMP CONCRETE INC
MAY 3 1
. 200
BY: (ite-
To: INSPECTOR
COMPANY: MIAMI SHORES VILLAGE
FAX NUMBER: 3o 5 - q-5(. - gQ 2
BUSINESS PHONE: 305- 795 -2207
WILLIAM J. SANS, OR MAROLA SANS
FROM: SUPER STAMP CONCRETE INC
FAX NUMBER:305 -480 -3794
BUSINESS PHONE: 305_220 -1163
DATE & TIME:MAY 31, 2007
PAGES:1
RE:
5204 sw 134 CT
MIAMI, FL 33175
FAX FORM
TO INSPECTOR WHO INSPECTED ADDRESS
133 NE 91 ST. PERMIT #DSO7 -617. YOU
REQUESTED THE FIBER MESH RECEIPT. HERE
IS THE COPY OF THE INVOICE FOR THAT JOB.
PLEASE FINALIZE THIS PERMIT. I WILL SEND A
COPY TO THE OWNER ALSO FOR HIS RECORDS.
ANY QUESTIONS CALL THE OFFICE.
THANK YOU.
OFFICE 305 -220 -1163 FAX 305 -480 -3794
p.1
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DATE
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May 31 07 07:f)2a
FROM ; BM G BROTHER'S CONCRETE & PUMP FAX NO. : 305 229 9553 May. 29 2007 04: 29PiM Pi
THE BIG BROTHERS CONCRETE PUMPING
< r��
�� 4520 S.W. 98TH AVENUE • MIAMI, FL 33165
- 74;i4 TEL: (305) 223 -3101 (305) 229 -9653
OU4'NTITY _- _ DE :CRIPT!O;J PRICE °?=,J' -= EXTEN SiOLI
isu
1 1.111 ' A+��RMIN
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HOURS ON.JOB
TIMMS PERM Yo. ILLOWEP Tito) PEn Want-
SUAEP MIS OELTYEAY TOTAL _ GI7. YOS AMOUNT
.oF Yo0A ORO9i FOR cIL YOS TAX
cumin ONaana mTenals RILL REVOISEUTYPZIOSTINCHA f1
PEraORaNCE CIF ANY ca+aiL,E PACO Abaltat 3bNSLIMOatnaar
satin ama eFSL; LJ Ye a to As
TERMS
The ag SrMdrors conn+eze .Pumping shad not be heid.rsapol'rslbre
diem fees b be responsible far at !Mali g but rot
fnvmlca 00 tames past due after.(15) days Dam Me tOde. and Shat
anus. Mill agrees le adios* end held nannies. The Sig U
knees, and eapenses. Making toasorrabio attorney's fees In easel
big out of performance of the ands Bated shoiaa. '
N_° 10:644
2Y
AIL CIAINISNASTIE WIVE ff
ens a en ease
Me ar eresr adjacent UrereIO.
and ra of ton � percents
aa nd
defend
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