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
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SCALE: 1" _ aC)'
1
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SKETCH OF SURVEY
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IIRT( ADDRESS: //46 Na 7 77, tt .s 7:ea .$AioePS� FL •
I F1000 TONE .X
: CE • OF LEGAL DESCRIPTION: ,4Z oR.„ , 0z- S s�GQG�J •
LEGAL DESCRIPTION
LOT 3
SUBDIVISION M/•4fT/ s'ro' Es se-c."iok1 �g
ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK AT PAGE s/
OF THE PUBLIC RECORDS OF .0 OE COUNTY, FLORIDA.
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LOCATION 9CE -
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NOT VALID UNLESS SEALED WITH AN EMBOSSED SURVEYOR'S SEAL
!HEREBY CEIITIFY: Thal the aliened boundary 040ry of ant 140•e 00W0 pooany 1 Ina 1.0 Como lo
v.0 0401 01 my 04004.dpe Ind 00601 as fbantty aune7I0 HlOer 1100 dra441, also NI Ne.e 00 na na0aar . , ., .
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laeerdad ImIndo0041. d ant.. 1601440 NI property. 1/ea1se and denti4aron el vabiia on aed'0• alaau• 40
Ire oroparly owe not i *sand as such inlalrreon was ma 11AAes1ed. O•nersaip is s.dis• 10 semen e1 use. S OF FLORIDA �Olg : 4 r% /� L
This S1n10y mobs die ..:nolrrn IOCMC•1 standards as tau . . by fine Halos 8004 04 0.0143s0.a1 Land
Svvayas in cna.,. 6I G17.6 Fblids Adml000$ova Cods l'JT11ot to ooc4.o .172.027 Flo Small.
ABBRENAT1ONS ANO LEGEND
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DATE:
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SURVEY SUITE 123
, FL 33155
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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 .