DS-16-1620 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-260760 Permit Number: DS-6-16-1620
Scheduled Inspection Date: November 04,2016 Permit Type: Driveways/Sidewalks/Siabs
Inspector: Mesa, Michel
Inspection Type: Final
Owner: MEDINA, PAOLA VERONICA Work Classification: New
Job Address:10531 NE 3 Avenue
Miami Shores, FL 33138- Phone Number (305)788-9779
Parcel Number 1122310130360
Project: <NONE>
Contractor: CHAMPION CONCRETE Phone: (305)252-8055
Building Department Comments
CONCRETE DRIVEWAY, CONCRETE PATIO Infractio Passed comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
November 03,2016 For Inspections please call: (305)762-4949 Page 4 of 28
P i IC
Miami Shores Village yjifeW,1t 'i�Ws�(it81 �� u
10050 N.E.2nd Avenue NE Olt
c+ W
Miami Shores,FL 33138-0000 a
Phone: (305)795-2204t;1 , t€i =A i '
\�
Expiration: 02/19/20
w17
Project Address Parcel Number Applicant
10531 NE 3 Avenue 1122310130360
PAOLA VERONICA MEDINA
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
PAOLA VERONICA MEDINA 10531 NE 3 Avenue (305)788-9779
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 18,420.00
CHAMPION CONCRETE (305)252-8055 (786)402-4802 Total Sq Feet: 2420
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied: Foundation
Type of Work:CONCRETE DRIVEWAY,CONCRETE PAT 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-Contractors Bond $500.00 Invoice# DS-6-16-60149
CCF $11.40 06/10/2016 Credit Card $50.00 $695.40
DBPR Fee $3.00
DCA Fee $3.00 08/23/2016 Check#:3457 $695.40 $0.00
Education Surcharge $3.80 Bond#:3200
Permit Fee $200.00
Scanning Fee $9.00
Technology Fee $15.20
Total: $745.40
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-name contractor to do the work stated.
August 23,2016
Authorized Signature:Owner / Applicant r57Contractor / Agent Date
Building Department Copy
August 23,2016 1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores,Florida 33138 JUN 092016
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 _ __—
FBC 201 ¢
BUILDING Master Permit No. �s 1(bZ0
PERMIT APPLICATION Sub Permit No.
ILDING ❑ ELECTRIC ROOFING REVISION EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP
I �y CONTRACTOR DRAWINGS
2
JOB ADDRESS: 5 3/� 0G (4 " `"L
City: Miami Shores County: Miami Dade zip: 33)38
Folio/Parcel#: jk— ?1;�0A—O(3' 0 3Gs0 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type::, Flood Zone: BFE: FFE:
IAOOWNER:Name(Fee Simple Titleholder): IA U � ' 1idk Phone#: '� �
Address:eJos'u ?�jc 3(y AV2
City: State: 4'L Zip: �3�
Tenant/Lessee Name: Phone#:
Email: yK0IPA @ ^1ASUU&j;T-e. Con
CONTRACTOR:Company Name: 4--yeVA-) f Phone#: �
Address: i 0g30 MW 7q 'L— 7-0
City: Ffe-0 02f:4 State: 4A— Zip: d
Qualifier Name: -R-AodLA& Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Z Square/Linear Footage of Work: 4 vw � �
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: ="JAVA1, cupZCAS#)� A" 0,.
Specify color of color thru tile:
Submittal Fee$ 50 o C4� Permit Fee$ 2—CZ CCF$ "40 CO/CC$
Scanning Fee$ ''9 • CO Radon Fee$ '3 r--k) DBPR$ ' (A) Notary$
Technology Fee$ 1 o Training/Education Fee$ Double Fee$
Structural Reviews$ 70Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014) 4 0
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 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 mus a posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence f such posted notice, the
inspection will not be appro ed and a reinspection fee will be charged.
(]-
Signature Signature
OWNER or AGENT ONTRACTOR
T e f going instrumen was acknPwledged beforr mne this The f going instrument was acknowledged bef r me this
da f o� 20 1 U' .by da f 20— ,by
�{ 1,/►n(4, ,who is personally known to / i o is personally own to
me or who has produced ;t7� D-2 as me or who has produced as
identification and who did take an oath. identification and Who did take an oath.
NOTAR ^B IC: NOTARY PUBLIC:
?�ei.� LUCIA ESTRELLA
Sign: MY COMMISSION#EE 860165-_ _._
Stgn:
Print: ter' �«o��OP BondedThruMgt NotaryServicea Print: t YPu
ttICIAESIRELLA
Seal: Seal: # c* MY COMMISSION#EE U0165
NEXPIRES:July 2,2017
�9tEpp MOR�OP Bonded Thru Budget Notary Service,
######################### # ### i;;�nlng
APPROVED BY Plans Examiner
Structural Review Clerk
(Revised02/24/2014)
5/2/2916 4 Property Search Application-Mann Dade County
111111a
IMPORTANT MESSAGE The Property Appraiser does not send tax bills and does not set or collect taxes.Please visit the Tax Collector'ss
website directly for additional information.
Address Owner Name Folio
SEARCH:
10531 NE 3 AV Suite Q
Back to Search Results
PROPERTY INFORMATION
Folio: 11-2231-013-0360
Sub-Division:
PASADENA PARK 1STADDN
Property Address
10531 NE 3 AVE
Miami Shores,FL 33138-2007
Owner
JUAN P DONOFRIO
PAOLA V MEDINA
Mailing Address
10531 NE 3 AVE
MIAMI SHORES,FL 33138
Primary Zone
1000 SGL FAMILY-2101-2300 SQ
Primary Land Use
http://www.miamidade.gov/propertysearch/`#/ 1/8
Rick Scott
Manion: Governor
To protect,promote&improve the health
of all people in Florida through integrateda Celeste Philip,MD,MPH
1 state,county&community efforts. HEALTH Surgeon General and Secretary
Vision:To be the Healthiest t'7State in the Nation
July 15, 2016
(Glasshammer Engineering)
19341 Sterling Drive
Miami, FL 33157
RE: Contingency Letter
Application Document No:AP1247817
Centrax Permit Number: 13-SC-1694589
OSTDS Number:
10531 NE 3 Ave
Miami, FL 33138
Lot:13, 14 Block:12 Subdivision:Pasadena Park
Dear Applicant:
This will acknowledge receipt of an application dated 07/12/2016 for a permit to use an
existing onsite sewage treatment and disposal system located on the above referenced
property.
From a review of your completed application, it has been determined that your existing system
appears to meet the minimum standards of F.A.C. 64E-6 for the proposed use. It is approved
for use with the plans submitted to this office. If this system should fail, causing an unsanitary
condition to exist, steps must be taken to bring the system into compliance immediately.
Department approval of the system does not guarantee satisfactory performance for any
specific period of time.Any change in material facts which served as a basis for issuance of
this approval requires the applicant to modify the permit application. Such modification may
result in this approval being made null and void. Issuance of this approval does not exempt the
applicant from compliance with other Federal, State, or Local Permitting required for
development of this property.
NO OBJECTION FOR DRIVEWAY RENOVATION AND REAR DECK AND WALKWAY ON
NORTH SIDE.
If you have any questions on this matter, please call our office at(305)623-3500.
Sincerely,
Florida;Health"'NMI,iami-c)ade County Gerard Philizaire, Engineering Specialist II
Og,, ogram
Florida Department of Health www.FloridasHealth.com
in DADE COUNTY TWITTER:HealthyFLA
1725 NW 167 St,Opa Locka,F 33056 FACEBOOK:FLDepartmentofHealth
PHONE:(305)623-3500.F (305)623-3 YOUTUBE:fidoh
JUN 0 g 2016PI ON! PM sm bPI ON
o WOOL
ut � �� Eby ., to•�
SIT
zgK
qsm
-
eee••• • • %':
e• a •� ••• 1-�d
ee•ee• •••• • •• I = Pod .•
d/M �J
SZ—� SC8 S '�
*.••• ••e• •• ••• I
a
Tl
•. . • . . ••
.::•••• Q q ( if 60 p0d
a • • C7 •e• �.;� :� 1811Bd
�.
•a•••• • •• ••• vi;-3f
*see 00
seO
ASIS c F
rc
rum- -juO3
El
Opp Nfl. �'._.. U lU
W
i 0 U ¢
i I
c9_ -Lu
co
DoW
M.00A WM AM .w : r N 5x" Om-
IPI
W I
CIT-Y
qq i .-• _ .a� -: ;:: ..:asap =•-�:� .-- Qp��
a� a ...;_;. . .;:
WNPON
Abm�2so& pawIle vllljel�
®� Y