DS-17-302 Permit NO. DS-2-17-302
s�'O1iES y,� Miami Shores Village t Permit Type:Driveways/Sidewalks/Slabs
S+� 10050 N.E.2nd Avenue NE Work Classification:Repair
Miami Shores,FL 33138-0000
Phone: (305)795-2204
Permit Status:APPROVED
FGORiDP
Issue Date:2/7/2017Expiration: 0$106/2017
Project Address Parcel Number Applicant
9915 NE 4 Avenue Road 1132060171300
Miami Shores, FL Block: Lot: ESTEBAN GIUGOVAZ TRS FRAP
Owner Information Address Phone Cell
ESTEBAN GIUGOVAZ TRS FRANCESCA 9915 NE 4 Avenue Road
- - -- --- MIAMI SHORES FL 33138-
9915 NE 4 Avenue Road
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 1,000.00
GMB CONSTRUCTION INC (305)967-3640 (305)613-5572
Total Scl Feet: 125
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved: : In Review Final
Date Denied: Foundation
Type of Work:REPAIR CONCRETE SIDEWALKS Additional Info:REPAIR CONCRETE SIDEWALKS Review Planning
Bond Return: Classification:Residential Review Building
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
Invoice# DS-2-17-62853
DBPR Fee $2.00 02/07/2017 Credit Card $64.60 $50.00
DCA Fee $2.00
Education Surcharge $0.20 02/07/2017 Credit Card $50.00 $0.00
Permit Fee $100.00
Scanning Fee $9.00
Technology Fee $0.80
Total: $114.60
In consideratio4su ance to a of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereict c r ity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this ume re p nsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELL M I ,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFe h t all the f oing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction ant r re,I orize the above-named contractor to do the work stated.
February 07, 2017
Authorized Sign e:Owner / Applicant / Contractor / Agent Date
Building Dep rtment Copy
February 07,2017 IJ 1
Miami Shores Village FIR Q7 zo»
'W
Building Department LB
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 2014 Yt�
BUILDING Master Permit No. IDS Z"- 11 —302-
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION F-1 RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS • ❑ CHANGE OF ❑ CANCELLATION 0 SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9915 N E 4th ave rd
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder):Esteban Giugovaz& Francesca Rinonapoli fund phone#:
Address: 9915 NE 4th ave rd
City. Miami Shores state: FL —Zip:
33138
Tenant/Lessee Name: Phone#: 305-613-5572
Email:
GMB Construction Inc 305-613-5575
CONTRACTOR:Company Name: � Phone#:
Address: 7929 West dr#703
City. North Bay Village state: FL Zip:
33141
Qualifier Name: Gustavo Biaggi Phone#: 305-613-5572
State Certification or Registration#: CGC 1514518 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: G Zip:
Value of Work for this Permit:$ 1000 Square/Linear Footage of Work: J
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of work: Repair,concrete sidewalks
Specify'color,df tdi&thru tile:• >'
Submittal Fee$ ✓� Permit Fee$ CCF$ 0A30 CO/CC$
200
Scanning Fee$ Radon Fee$ • o� DBPR$ Notary$
Technology Fee$ O Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised 02/24/2014)
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 commen me must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In th obse ce of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature - Signature_
OWNER or AGENT CON RACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument wa acknowledged before me this
S� day ofp f �p(l!y —20 ,by day of � A3..•� 20 0— by
{,*113UA901,'who is personally known to �Ct�Si Dpi ���6(0� who is personally known to
me or who has produced as 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: Notary Public to "a
Willi My mi FF 856808
Seal: �F `f; tkieFr�41 �� Seal: awj Expireso3J 020
My comriilii FF Obd>!�
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APPROVED BY 7 r? Plans Examiner Zoning
Structural Review Clerk
(Revised 02/24/2014)
15 ORE �I
s �► Miami shores Village
_ n
"� � ""'� Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Notice to Owner - Workers' Compensation Insurance Exemption
2 Mm
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05
allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to
obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure:
An employer in the construction industry who employs one or more part-time or full-time
employees, including the owner,must obtain workers' compensation coverage. Corporate officers
or members of a limited liability company (LLC) in the construction industry may elect to be
exempt if:
1. The officer owns at least 10 percent of the stock of the corporation, or in the case of
an LLC,a statement attesting to the minimum 10 percent ownership;
2. The officer is listed as an officer of the corporation in the records of the Florida
Department of State,Division of Corporations;and
3. The corporation is registered and listed as active with the Florida Department of
State,Division of Corporations.
No more than three corporate officers per corporation or limited liability company members are
allowed to be exempt. Construction exemptions are valid for a period of two years or until a
voluntary revocation is filed or the exemption is revoked by the Division.
Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use
day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will
be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of
workers' compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Signature: ._
Owner
State of Florida
County of Miami-Dade
The foregoing was acknowledge before me this day of �j ,20�.
Bywho is personally known to me or has produced
as identification.
Notary:
fary Pu Ifc f da
SEAL: P a
'� � My mission FF 9
a n Expiros 15=20
GMB Construction, Inc
7929 West dr,#703
305-613-5572
Miami, February the 6th, 2017
State of: FLORIDA
County of: MIAMI- DADE
Before me this day appeared Mr. Gustavo Biaggi who, duly sworn, deposes and says:
That he will be the only person working on the project located at 9915 NE 4th Ave Rd.
Sworn to uscribed me this 6th day of February, 2017,
by
Personally known
00 Pu c tate of a
tri a aggionat
My ommfaalon FF 9 808
or n ExPlres0311 020
L ism
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LOCATION SKETCH : .:.
N" SCALE: NTS
F ^� LOT 14 ^ • •
• .•.
Pi N '• • -
z BLOCK 96 -"
•.•H .. 130.00 R & M •
37.50 � 41&1` ;1L w���:••: 00 00
... .
::W)...,•.••..•:.0. .�'. `AJO oo c 5'C.B.S WALL
• N N : C .
25.30' - LOT 15 " E,.••.• Q • • ' "
• • •.• :•
" , " •
BLOCK 96 4.65' .= r • • • • ••
Q'�• • '
• .'�,.�•.•.'•'•••.• 45.85' -}- :.a::••: 0 . • • • . ,
v1 r• • • e
3 ^ $
Z
w CONC. WALK 10.18' 1�`+ 11.1 r
'�. 6.0' ONE STORY 5.60' \\\ Q
�•, � .,�.:`..i' � C.B.S.RESIDENCE �,,+\\\\`` '' .:•.� Q �
N \ y :•'.
W :•• •" ••. ; 9915 `\\\`\\,`\ ` o � '�:�•:•.: P � r
gyp. F.F.ELEV.=12.50' �,``\,``+\ ; -' : '`a::•' h ��.j �-•;•.
8.80' , L '. .•': �W [�
, - - - - - - - Z OD V/ FEB 2017
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t'9 9 i
IN C N LOT 76
30.07' BLOCK 96 N.E. 5th AVENUE — - �-
CARPOR
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����y���������� •� �� ��������������� ., ,pb � GARAGE � 9.OSo�", fY 1- 4 _•.•_ •S:lrrz?5 VII^(7p
■ -`' -�' 42.60' a ^r?-LED BY DATE
.. '. ' 12s' -
28.75' �4 �o ' ac o �� �T
7'.. 5'C.B.S WALL X _
z LOT i7 10 Gti P +
37.50', i\.. z-
-� 130.00 ( R 8 M ) BLOCK 96 �! .:::::_: LV%P,CE WI rH ALL FE rE
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i'�s1�J��•-� Property Address:9915 N.E.4`h Avenue Rd., Miami Shores, FL.33138.
ABBREVIATIONS:
S M=51DEw4LK,CBS=CONCRETE BLOCK STRUCTURE,CLF=CHAIN LINK FENCE,PL=PROPERTY LINE,DUE=DRAINAGE UTILITY EASEMENT,IP=IRON PIPE. Legal Description: Lots 15 and 16, Block 96,AMENDED PLAT OF MIAMI SHORES SECTION NO.4,
F=FOUND,A/C=AIR CONDITIONER PAD,P/C=PROPERTY CORNER.D/H=DRILLED HOLE,VWF=VIOODEN FENCE,RES--RESIDENCE,CL CLEAR,RB=KEBAB according to the Plat thereof as recorded in Plat Book 15, Page 14 of the Public Records of Miami-Dade
UE=UTILITY EASEMENT, CONC=CONCRETE SLAB. RAN-RIGHT OF WAY, DE=DRAINAGE EASEMENT C/L=CENTER LWE, O=DIAMTER, TYRB=RECAL
M=MEASURED.R=RECORDED.ENCR=ENCROACHMENT,COMP=COMPUTER•ASH=ASPHALT,N/D=NAIL&DISC,S=SET,FEE=FINISH FLOOR ELEVATION, County, Florida.
O/S=OFFSET,P/P=POWER POLE.OHP=OVERHEAD POWERLINE,VM4=W4 TER METER
- VSo FENCE
WELL= ,..
MASONRYVA :.�•. ELEVATION BASED ON LOC. # 3100
NOT VALID UNLESS EMBOSSED WITH '"' " ''= 7 '•'•_• ••..=•
SURVEYOR'S SEAL MAINTENANCESDRAINAGEEASEMENT=M&D.E CBM#N_397 ELV. 9.80
TYPE OF SURVEY:BOUNDARY SURVEY _
SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2)NOT VALID WITHOUT THE SIGNATURE I HEREBY the eon meets he minimum t chnical requirements FY That the survey represented SINCE 1987
�� , AND RAISED SEAL OF S FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT adopted by the STATE OF FLORIDA Board of Land BL.ANCO SURVEYORS INC.
�'- — COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5) Surveyors
UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC Statutes. pursuant to Section 472.027 Florida Engineers•Land Surveyors•Planners•LB#0007059
VERTICAL DATUM OF 7929.- 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL There are no encroachments, overlaps, easements
RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAYBE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9) appearing on the plat orvisible easements other than 555 NORTH SHORE DRIVE
CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING as shown hereon. MIAMI BEACH,FL 33141
REVISED:
INFORMATION. 10)EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVETO BE MADE TO DETERMINE RECORDED 305 865-1200 Email:blancosurve orsinc
INSTRUMENTS,IFANY,AFFECTINGTHISPROPERTY Y @yahoo.com Fax: (305) 865-7810
Additions or deletions to survey maps or reports by other than the signing ~� FLOOD ZONE: % SUFFIX: L BASE:
party or parties is prohibited DATE: 9/11/09 N/A
without written consent of the signing party or parties. ADIS N.NU NEZ PANEL: 0302 COMMUNITY# 120652
BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE-OF SAID PEI`15_PAGE 14 REGISTERED LAND SURVEYOR DAT SCALE: OWN.BY: JOB No
STATE OF FLORIDA#5924 12723/14 1"=20, F.Blanco 14-1062