DS-15-283s �+ Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address Parcel Number Applicant
38 NW 108 Street 1121360110120
MIAMI PROPERTY SOLUTIONS I
Miami Shores, FL 33168- Block: Lot:
Owner Information Address Phone Cell
MIAMI PROPERTY SOLUTIONS LLC 38 NW 108 Street (305)807-4045
MIAMI SHORES FL 33168-
38 NW 108 Street
MIAMI SHORES FL 33168-
Contractor(s) Phone Cell Phone
CITY ROOFING AND CONSTRUCTION (305)248-2994 (305)218-7901
In Review
Approved:: In Review
Denied:
of Work: EXPAND WIDTH OF EXISTING REAR DRIB Additional Info:
Retum : Classification: Residential
nina: 3
Fees Due
Amount
Bond Type - Owners Bond
$500.00
CCF
$1.20
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.40
Permit Fee
$125.00
Scanning Fee
$9.00
Technology Fee
$1.80
Total:
$641.20
Valuation: $ 1,200.00
Total Sq Feet: 576
Pay Date Pay Type Amt Paid Amt Due
Invoice # DS -2-15-54443
02/09/2015 Check* 7649 $ 50.00 $ 591.20
03/13/2015 Check* 7687 $ 591.20 $ 0.00
Bond #: 2639
Avanaoie
Inspection Type:
Final
Review
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 aut4grize tie abop=aamed contractor to do the work stated.
March 13, 2015
Authorized Signature: Owner / Appl' nt / Contractor / Agent
Building Department Copy
March 13, 2016 1
I
1_0
BUILDING
Miami Shores VillagePg `l
Building Department FEB 0 a L
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972'
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC MO
Master Permit No.
PERMIT APPLICATION Sub Permit No.
BUILDING
❑ ELECTRIC
❑ ROOFING
❑ REVISION ❑ EXTENSION
❑RENEWAL
❑PLUMBING
❑ MECHANICAL
❑PUBLIC WORKS
CHANGE OF ❑ CANCELLATION
❑ SHOP
-PAr0An /Al
-Af peo
CONTRACTOR
DRAWINGS
AIA)
3 i7 ' °' A)
V
JOB ADDRESS:
City:
Miami Shores
County:
Miami Dade Zia:
33161
Folio/Parcel#:
Is the Building Historically Designated: Yes
NO
Occupancy Type:
Load:
Construction Type:
Flood Zone: BFE:
FFE:
OWNER: Name (Fee Simple Titleholder): //l "*M r P1?o9Ae4, �G U I i oil f Phone#: 105 `&0 7 —_y`
Address: '?e110 4 :e- Avw
City: `�8r Ay'PPf State: Zip:./ ?13
Tenant/Lessee Name: Phone#:
Email: /� .,( 7 Q
CONTRACTOR: Company Name: / ®® i l (%?dC4e'��Phone#: 9� o� l
Address: 0? 9 % ®d 50 222 cgi ^�
City: ` Stag Zip: 11 / 6)
Qualifier Name: ��rt C,/� n �7A Phone#: _
State Certification or Registration #: Certificate of Competency #: C G 1. 16-0939
DESIGNER: Architect/Engineer: Phone#:
Address: t, City: State: Zip:
Value of Work for this Permit: $ ! -'niD Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration /f ❑ New 0Repair/Replace Demolition
Description of Work: cx /� W , Ct' A q" exi S 41.n X)?1 / U P G%
-Ae6m // r `ti1YP -�D /6J o k,JiA n e ` : n ff feA
io -4ef, wo dt'3qgeq
ffy c91o'roYcWr Niru tile:_
Submittal Fee $ Permit Fee $ .J ' w CCF $_
Scanning Fee $ Radon Fee $ DBPR $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
(�Ri?vPwfa
CO/CC $
Notary $ ikp x � 4e
Double Fee $/� '
Bond
TOTAL FEE NOW DUE $
59 1 '2,0
.ei✓ew,41
rA i?*A
YAW
Oy ft'mll
-PAr0An /Al
-Af peo
Submittal Fee $ Permit Fee $ .J ' w CCF $_
Scanning Fee $ Radon Fee $ DBPR $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
(�Ri?vPwfa
CO/CC $
Notary $ ikp x � 4e
Double Fee $/� '
Bond
TOTAL FEE NOW DUE $
59 1 '2,0
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 the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
NER or AGENT CONTRACTOR
The foregoing instrument as acknowledged before me this The foregoing instrument as a now edged before me this
_ day of 20 A/ by da��yy^ of � 20 � by
who is personally known to �'i a /zur , who is personally known to
me or who has produced
identification and who di
NOT4PUBLIC:Sign:
Print
as me or who has produced
an oath. identification and who di
NOTARY PUBLIC:
Seal �q &H No&FY Public State of Florida
Maxine Y Gomez
c My Commission EE 839239
oFa�� Expifes09130/2016
Sign:_
Print:
an oath.
00 Notary Public 46 of Florida
Seal: 4P Maxine Y Gomez
n �� My Commission EE 839239
CW
Expiies 09/3012016
as
APPROVED BY Plans Examiner G Zoning
Structural Review Clerk
(Revised02/24/2014)