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DS-15-2333 �< y Miami Shores Villages 2� a 10050 N.E.2nd Avenue N z ,a Cl y Miami Shores,FL 33138-0000 Nom` Phone: (305)795-2204 w X 'ctortls 1 Expiration: 03/19/201 Project Address Parcel Number Applicant 10130 N MIAMI Avenue 1131010210060 Miami Shores, FL 33150- Block: Lot: MILDRED&MIROSLAV DJORDJ Owner Information Address Phone Cell I MILDRED&MIROSLAV DJORDJEVIC 10130 N Miami Avenue I MIAMI SHORES FL 33150 10130 N Miami Avenue MIAMI SHORES FL 33150 Contractor(s) Phone Cell Phone Valuation: $ 5,850.00 CHAMPION CONCRETE (305)252-8055 (786)402-4802 Total Sq Feet: 980 Approved: In Review Available Inspections: Comments: Inspection Type: Date Approved: : In Review Final Date Denied: Foundation Type of Work:driveway pavers. Additional Info: Review Planning Bond Return : Classification:Residential Review Building Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Owners Bond $500.00 CCF Invoice# DS-9-15-57079 $3.60 09/21/2015 Credit Card $ 147.60 $500.00 DBPR Fee $2.00 DCA Fee $2.00 09/21/2015 Cash $500.00 $0.00 Education Surcharge $1.20 Bond#:2845 Permit Fee $125.00 Scanning Fee $9.00 Technology Fee $4.80 Total: $647.60 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. September 21, 2015 Auth Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy September 21, 2015 1 Miami Shores Village EP 5 'Z015 Building Department S 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 "-T INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201' I _ BUILDING Master Permit No. 0- PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 10 13 o A)o off tf#4 RV City: Miami Shores County: Miami Dade Zip: 3 315 Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFEFFE: 2,`�l� 1K OWNER: Name(Fee Simple Titleholder): I`l�(r'G�1.A-V J'To0__6jeV� Phone#: ly� � Address: t o(3© N�ONI(,m H 4Ag A 1/ /� City: jA>w► S�I.V�te'J State: EL zip: 331 D Tenant/Lessee Name: Phone#: Email: �CZ3') . c5:1, C"(� CONTRACTOR:Company Name: 4�WAW WJ✓ 6-)A) e7% Phone#:,3t 2xzyoSs _ Address: U0191 AW 6035J' 3y)1'L Ic> / City: .�01AL State: - zip: ✓?3�7�_ Qualifier Name:_ _Pb h-L A401C 0 Phone#: jC5 q7?k�3 State Certification or Registration#: Certificate of Competency#: GLO$.SSOAB'�s DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$S�sv. Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee$ ,(3�5 Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ MO TOTAL FEE NOW DUE$ 1. ± --) . G'3 (Revised02/24/2014) r Bonding Company's Name(if applicable) Bonding Company's Address 4 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 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 mustb posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of uch posted notice, the inspection will not be approved and a reinspection fee will be charged. , Si ure- — —' Signature ` OWNER or AGENT CONTRACTOR The foregoing instrument was ore acknowledged before me this The foregoing instrument was acknowledged before me this g _g _ day of t '7`t=l`�� C<- ,20 !S by day of (�A(1�t ,220�0 �` , by t—)Q)�PdS who is personally known to / t -G7'7 u''Y J PI ,who is personal y k own to me or who has producedas me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: Seal- Seal:Notary Public Outs d#Fldflda /'.�"'✓�J" Sindia Alvarez t0sr°vs Notary Public State of Florida t my CCt»trllAsigll 155750 Sindia Alvarez OF Expires 09/03/3016 ny P¢ My Commission FF 156750 csfsvop Expires08103/2818 APPROVED BY I r Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 15�OREs lI cl Miami shores Village Boom Building Department Lys 10050 N.E.2nd Avenue Tes tMiami Shores, Florida 33138 A�OR Tel: (305) 795.2204 Fax: (305) 756.8972 SURVEY AFFIDAVIT STATE OF(FLORIDA) COUNTY OF(DADE) The undersigned Affiant, lj)LCf U 9J0"-1,eQfC ,does hereby attest that (Property owner) The attached survey, performed by eX&'7/, - L/9iAt0 S�ti��° OrlS (Name of surveyor's company) For address: In 13 0 0 t-04" -AV. , Performed on 0-2?-?al 0 (date of survey) is an accurate representation of the existing conditions and 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 seven (7) years old old. The Affiant, as property owner, further 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 say eth naught. Property Owner Signature Property Owner Print Name SWORN TO AND SUBSCRIBED before me this t `f day of 1013 . Zoite Affiant is personally known to me, _produced -T1--t>ZA\Xe. L(GE( entification. Notary RaD ic State of Florida arez sion FF 15675003/2018 Revised(6/25/12)Revised on 5/22/2009/Revised on 6/12/09 1 PROPERTY ADDRESS: 10130 N.MIAMI AVENUE,MIAMI SHORES,Florida 33150 SURVEY NUMBER-FL1011.1045 FIELDWORK DA'T'E:iimnmo REVISIONDATE(S):("mo fm2mm TABLE: =` FL f0f1.f09�5 N°r�' LI,_.50UTH IOG 55_0 PENCE owrat><5rur Nor tits�n.mD t fl�D F BOUNDARYSURVBY r or aPet� ,ro s;�vx�ar CITY WATER AND sr MMM,'DADE000NT}' L 50t�Tti`Ips t� _ LOT 7l-' 015`(M) 5LK I RF51D€NCE FIP r w 144a•o 1. ` $9°2820' I/2 E 143. 6 (M) z a NO ID `� rs - NO S 5'CHPJN NK t'_p �.. •' f _ 7.2' a { l Baa ; 64.1' 10.5' �fM -rte s ' !6 -f Y- ��• W m I STY. v - RES 110130 N Qt.is . -. ._ 00 � O _g fu 7.a 10 w Z fri aC 24.5' 00 ' — cu Z Z LOT5 8 9 13.1• BLK l - zo . 1/2'PR f NO IDaetWe 144 00 IIOR -:56400 le, J 45e- I N. T 10 40 .¥ <4 NO mr,cor- IIdD/ iQ1��A� .3 11 E I k 4512 l i! (` r yoffhe%rea�ded pionom COR. { and a _ ► ���_ E. 101ST AVENUE iE iE bw mem>arr�lNenh ' Of �� desedrrll7�Nxe 30 o is PAUL k VALET "" i J t y G MC SCALE (In Feet) N sfrr 4soar. _-; 1 inch = 30' ft. UcenseN44612 5rt _ M m TC? L1AN,_E W;T1-I ALL FEDERAL _ CL y��. .t thv OfThit$16112y 'POI �ISAvi4�rt-f-r..•� �b.�,wWdttw f %wm b2 at dw e1Qf[INI1ww �fttmvwStKYC�O� i+ Nadd {I¢fp011511�ItM�bllShue•+Aol O POINTS OF INTEREST ' ` •• • • • • ••• • m Norte Visible �� v _ `� � � � • � • • • • • • � m .n FLOOD INFORMATION: • .•! E4 0 By performing a search at www.fisma gov,it appears to be the prope�y to be located in 0;f�newrtlt a Bye Flcpbilflevatlofff Cf N10..This Property was found in a VILLAGE OF MIAMI SHORES,and oonum number 120652,dated 09/11/09. 0 • ••• 0 • • • E CLIENT NUMBER.985687 DATE: 11/22/2010 lorida Land AFFILIATE Title v Association BUYER:MIROSLAV DJOREVIC AND MILDRED J.DJORDJEVK; .. DJMEMBERS a SELLER:THE BANK OF NEW YORK MELLON ••• • • CERTIFIED TO:MI ear�JORDi"C�U NED1 DJOiRD,RELS T tE:FlRST 1 a Miami!'Nfit a