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DRIVEWAYCONTRACTOR Name PA A ft-Liu) ``- 6—t C License No. / Address ` ( /, y e-s L ] / re ( /,0 K ia 2 29 3 333 / Tekpl 3 . 7 4 f,_ i co 0 Fax Qualifier Name � ci h e -,4 - 3 itpmdi A-A PROPERTY New Construction / �� OWNER Name , / / A . �C'"I�JT ii... v ; / /6/ la b Enclosure Address l y -1.a 7 �r ' S 4J--4 Home Telephone ! j— ® 7 A- - C 6 3 / Business Telephone Demolish Fax Shell Only TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION Job Address: I l l 97 �T Folio Number Lot 3 Block t8' / Subdivision C g PB__3 PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Address Apt. Description of Work �t • laspkr � l P�5 4 1 t"--.6 �, Jb g C.-Z /t- crt, SA /M (eA4 i e 5r a e Zoning Linear Feet Square Feet 6 S ) 0 Units Floors Value of Work * 6 ei 7 Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No. TIN City riA State PERMIT APPLICATION Zip ENGINEER Name License No. Address Telephone Fax Page 2 IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Choosing a Contra /or. STATE OF J� Si Signature of Notary Pub i SEAL: IDA, COUNTY OF MIAMI -DADE ( , e17 4W - 4( //b d s bscribed before e this '� day of ` er_ M. C. PADRON * MY COMMISSION # DD 055049 EXPIRES: September 30, 2005 qr FOF oa` OP Bonded Thru Budget Notary Ser ices FI ... Personally known OR, Produced Identification Type of Identification Produced: PERMIT APPLICATION Review the brochure at Village Hall on Construction Lien Law and STATE OF FLORIDA, COUNTY OF MIAMI -DADE o � Signature of Contractor / Qualifier ,Fv toit 9 - epA 7LO Print Name Sworn to ands ; bscribed before me j 2- day of 4 1) e Signature of tary SEAL: Personally known ° M. C. PADRON MY COMMISSION # DD 055049 s blic - State of Florida EXPIRES: September 30, 2005 r EOF Fv, Bonded Thru Budget Notary Service_ OR, Produced Identification Type of Identification Produced: ELECTRICAL TYPE Q"fl'. '1'1'1'1 QT1'. "1'V1'h: Q"I'1". Tl"1'1•: ()iv. Minimum Fee TyI :, Refrigeration, Tons Dryer A/C Central, Tons Outlet, Appliance Cooling Tower Service Repair Heating Strips, each A/C Central 1 -3 Ton Vent Hood, Cost Fan A/C Wall/Win. Tons Outlet, Wall Dryer Vents, Number of Service, Temporary Paint Booth A/C Central 4-7 Ton Ventilation, Cost Fire Pump Air Handler, Tons Outlet, Switch Ductwork, Cost of Signs Piping, Flammable Liquid A/C Central 8 -15 Ton Periodic Inspections Fixture - Fluorescent Barbecue Oven Fire Sprinkler System Space Heater (kw) Process/Pressure Piping A/C Central 16-20 Ton Supply, AC Well Fixture Light Bath Fan - Vented, # Parking Lot Lights Fireplaces, Number of Spas/Hot Tubs Pressure Vessel A/C Central 20+ Ton Temporary Toilet Flood Lights Catch Basin Plugmold/Strip Gas - Propane Subfeeds, No. of Amps Pump, Re- circulate A/C Window Temporary Water Closet FPL - Load Central Clothes Washer Posts Gas Piping Swim Pool, Commercial Pump, Replace - Pool Air Conditioners Urinal Garbage Disposal Dental Chair Range/Range Top Grease Trap Swim Pool, Residential Pump, Sprinkler Chiller Utility - Sewer Generators, etc. Discharge Well Receptacles Ice Maker Switchboards Pump, Sump Clear Violations Utility - Water Heat Recovery Dishwasher Refrigerator, Comm. (p/PH) Indirect Wastes Temp Serv., Construction Relay Repair Compactor Vacuum Pump Low -volt, Burglar Disposal Refrigerator, Domestic Interceptor Temp for Test - 30 days Roof Inlet Deep Freezer Water Closet Low -volt, Fire Domestic Well Renew - Temp Service Laundry Tray Septic Connection Demolition Water Heater Low -volt, Intercom/Teleph. Drainfield, 4" Tile/Res. Repair Circuits Lavatory Septic Tank Dishwasher Water Heater New Low -volt, Television Drains, Area Service, Number of Amps Meter Set (Gas) Sewer Connection n'IECHANICAL • l ' ypE Minimum Fee Q . Condensate Drain QT} .. .LyI,I,: Generator QTY. TyI :, Refrigeration, Tons QTR A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING .1.yI,1,: A/C Condensate ()Ty. ' Drains, Roof (inc. TYPE Miscellaneous Fixture ()Ty. . r\ . I , I.: Soakage Pit QTY Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning / (°)/ a Electrical Mechanical Plumbing Fire Public Works Structural 7 f/7 �L Building Official Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review Notary ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ (s .ft.. 0) x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ cf ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12 /6/2002 Applicant: J PATRICK Owner: VILLOLDO JOB ADDRESS: 1146 NE 97 Contractor PADRON BRICK SALES INC Local Phone: 305 - 378 - 1000 PAY RDER OF �v✓ FOR Parcel # 1132050170160 Legal Description: 5 53 42 Fees: FEE2002 -6975 FEE2002 -6976 FEE2002 -6977 Description Building Fee Buildier's Bond CCF Total Fees: Permit Status: APPROVED Permit Expiration: 6/1/ Work: REMOVE ACDU A , - - PADRON BRICK SALES INC. 4474 W ESTON RD., 95 28 DAVIE, FL 3333 -3195 America® ACH R/T 063100277 / 0/f/41) L 5 u x:06 300004 7 00 38 L592' _ Building Permit Permit Number: BP2002 -2107 VILLOLDO J PATRICK ST Contractor's Address: 16155 SW 117 AVE 16 qua DATE Amount $115.00 $300.00 $4.20 $419.20 o e3 $y /9.2 -t OLLARS 8 . 1592 63-4/630 FL 893 Page 1 of 1 PB 43 -51 REV PL MIAMI SHORES SEC 8 LOT 3 BLK 181 Total Fees: $419.20 Total Receipts: $0.00 ns. Re- inspection application herefor in strict compliance with all specifications that may have been submitted to ances or if the plans are changed without responsibility for a thorough knowledge of the and that he assumes responsibility for work done 3tions pertaining thereto and in strict conformity 1e responisibility for all work done by either NOTICE OF COMMENCEMENT PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF DADE: 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 61 Commencement. 1. Legal description of property and street address: / / Y,6 2. Description of improvement: 3. Owner(s) name and address: • // � 9 7 s k'r4t ,K. U i tII ii1 -0 Interest in property: Name and address of fee simpletitleholder: 4. Contractor's name and address: 11 D a \4 1 q Wese-t-n_ 14 41/).-Y `� ��l c �1� 3 :3 � 5. Surety:(Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other doc by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Uenor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this 'Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) Signature of Owner Print Owners Name )J - \ - (1 , Sworn to and subs • before me this 1 4 day of II •� , Print Notary's Name M - ( • Notary Public My Commission Expires: . ° ;00 M. 0. PADOON * MY COMMISSION # DD 055049 EXPIRES: September;w, /Mb 8 ' of �oP B0nded PIN Budget Notary Services 02880 e7' 4 e70 2002 DEC 26 14102 � Y v nts may be served as provided (--� Prepared by: g • Address: `'v 7 Y vq! yt SKETCH OF SURVEY 15.00 .a O,A,1TG12. SCALE: 1" _ aC)' 1 FoLwo 0,4 %RpN1 o;PS 0 • tL1"L%t.L. • . C/L 7e a./ SKETCH OF SURVEY t1. E. .q1Y` S'TAEET 22: ;=i- IALT• •F' /W /ENT oae sios�y. Gee ass. moo. t' I- ..1.6 Cr't' S - T2�'T Mt to-A% ; FLOCZ%04. aouNC • )1 9 0 SCALE: 1" = e IIRT( ADDRESS: //46 Na 7 77, tt .s 7:ea .$AioePS� FL • I F1000 TONE .X : CE • OF LEGAL DESCRIPTION: ,4Z oR.„ , 0z- S s�GQG�J • LEGAL DESCRIPTION LOT 3 SUBDIVISION M/•4fT/ s'ro' Es se-c."iok1 �g ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK AT PAGE s/ OF THE PUBLIC RECORDS OF .0 OE COUNTY, FLORIDA. • 1; • -N0 WIN! •0 . 001011.00 ••0 ••a -••w LOS -Sabo* • Yee - 04••0 00' -•d 544• 1 - 0.10 C a .410 MN CIS -0141 NOM 1014401/0 Ce -4/1. 110 01. 1 4 O.- 00.0 0,t. w - 01101 Cab -ow ••••• ow u- 4.000u•C or. um MCI 1•C - CYOfR CI CO•C•CM - S ICI L. on .4. Tn i • / 211.02 . -fie F t? �~ I 7 . Wig• 4 ; I ' I 5 z d 4 e I c �C z1 \ �% 4..,•07.1 _ 44 / E.; 5400.. A9c Z o e o z s e c ,e o g -mood Ti 7t. E Azi rv2-4. c ,tom 1 . c.,.ty r2 co TRA-c t/cco oo, .SU 41G C4.rf sAtiihJ 'B.CIO..t04,rl.:A;S.SOCia 770 ��FSA, 4 , 'Ere.acc Gam.? a re a Z shirr /A/44. /r. OC i.4 100 A-) LOCATION 9CE - C1 • coon 4 00.• 0►4 .■.1 0 -0461 WI • 001.•14 •. LAP \� . 414410. DC • 4•0•0•0••• 1p•1 - 4010.01. a 1 • • •41014•: •■••••■•• ••• r .0040 0 00 1O40001L.a4 / • 4 -1110.0 1000/ Y.• -1•4 r • - ••00.•• •• . .•w •r. MK 10 - 0 040Mi. .4 .1•04• ...VA. 1 154• .e. NOT VALID UNLESS SEALED WITH AN EMBOSSED SURVEYOR'S SEAL !HEREBY CEIITIFY: Thal the aliened boundary 040ry of ant 140•e 00W0 pooany 1 Ina 1.0 Como lo v.0 0401 01 my 04004.dpe Ind 00601 as fbantty aune7I0 HlOer 1100 dra441, also NI Ne.e 00 na na0aar . , ., . 0.0.10 AnCroido nll unions Shown. ou...l.aoo• 04 d.e a OW' or Ile .4 have a a no 0.0 onermils PROF I,A1N0 SUDEYOR - F IO ° "..� laeerdad ImIndo0041. d ant.. 1601440 NI property. 1/ea1se and denti4aron el vabiia on aed'0• alaau• 40 Ire oroparly owe not i *sand as such inlalrreon was ma 11AAes1ed. O•nersaip is s.dis• 10 semen e1 use. S OF FLORIDA �Olg : 4 r% /� L This S1n10y mobs die ..:nolrrn IOCMC•1 standards as tau . . by fine Halos 8004 04 0.0143s0.a1 Land Svvayas in cna.,. 6I G17.6 Fblids Adml000$ova Cods l'JT11ot to ooc4.o .172.027 Flo Small. ABBRENAT1ONS ANO LEGEND OAT E: DATE: OATE: 41.4 04 Yas I••• • M • • El WV 04 •la 045 0+• S • NATIONAL 7801 CORAL WAY SURVEY SUITE 123 , FL 33155 SERVICES, I nc_ H 16 •ee II ••• 40 II.1 001 ••e PAN •40 ei aC 00000 .0.•0401010 0 •01 RAM WWI 0000014 •••01//1010• 400 •••••• /00400.00e1 ••••••■ 10•0•001 404 ball IMMO 000014 •0•ns•••• 5440040 11 • SCALE: 1 = 400 • DATE. .� B /`Je BLOCK /G / r FOR 1" ZZO 0 ORDER NO 7 6. . / 7 4.• - 11.0. we W • 0•C a• - te.m•p•0 a • • .aa••. A - nnuar 0.14 - 10444no ca- 111x 100004 en •4 - IMII.401 0R•WV.I %C - M000 to . • ••• •.410 . - •0•1 .04• ..e.. • w* 14 40-CV. .� � y14 c �� u Lurie 4 .• 14 - .�Z1D1. vw•OC• •10• •.011.14 Date Time -• Type Insp' Permit No. �P 6 ! 0 - Name / , Address A / / ` 7 �� �a' �A - p Company ���d ` ' �� /� Q .�- C. Phone # 5 D (000 - Re-Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Name & Da Issue Date: 6/20/2006 Owner's Name: YOLANDA TECSON Permit Type: Driveways /Sidewalks /Slabs Work Classification: Addition /Alteration Job Address: 10 98 Street NE Comments: STAMP CONCRETE DRIVEWAY Additional Information Miami Shores Village, FL 33138 Fees Due Bond Type - Owners Bond CCF Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $300.00 $1.80 $0.60 $150.00 $3.00 $3.75 $459.15 Building Department File Copy Applicant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 12/11/2006 Contractor(s) Phone SUPERIOR STAMP CONCRETE, INI 786 - 443 -5472 Primary Contractor Yes Type of Work: DRIVEWAY Bond Return : Additional Info: STAMP CONCRETE Classification: Residential 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. Parcel #: Block: Section: Permit Status: APPROVED Permit Number: DS -6 -06 -1612 Phone: (305)754 -3708 1132060130950 Lot: PB: Total Square Feet: 0 Total Valuation: $ 2,500.00 Required Inspections Foundation Sidewalk Landscaping Final Invoice Number DS - 6 - 06 - 25272 Total: Amt Due $459.15 ,t 6 9,Y7 Amt Paid NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES .