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DS-17-799 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-279302 Permit Number: DS-3-17-799 Scheduled Inspection Date: May 26, 2017 Permit Type: Driveways/Sidewalks/Slabs Inspector: Porta Jr,Jose Inspection Type: Final Owner: DORN, MICHAEL Work Classification: Addition/Alteration Job Address:502 NE 106 Street Miami Shores, FL 33138- Phone Number (305)754-1311 Parcel Number 1122310140220 Project: <NONE> Contractor: DECO CONCRETE INC Phone: (305)828-5158 Building Department Comments REPLACING EXISTING WALKWAY WITH PAVERS 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. May 26,2017 For Inspections please call: (305)762-4949 Page 11 of 32 _ CFN:20170169927 BOOK 30471'PAGE 3748 DATE:03/28/2017 08:23:20 AM HARVEY RUVIN,CLERK OF COURT,MIA-DADE CTY (/ �7 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. DS "3' I/!— 7 f?TAX FOLIO NO. 7--7-3/ q-'04M STATE OF FLORIDA: COUNTY OF MIAMI-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 of Commencement. 1. Leal descri on of property and street/address: �� D �� fVl:gtvt; SNartS •5 . & 5L0+ Id i W u _ '� //Q. ,�t3 ID-��, AJb _ -Sfr6e jf, f.Ar aj' nr*s WL 159., 2. Description of improvement Orl& faWe 3. Owner(s)name and addresa�rn?I,_�L darn SOZ A.� IIr.Yo rv�YP �Yl�flh►i Grl s/E's Interest in property: /L �+Z Name and address of fee simple titleholder. name aild • 4. tractoeC"fin a 5. VLe (Paymentndrequired by owner from contractor,if any) nd dress:tof bond 36. r's name and address: 7. Tersons within the state of Florida designated by Owner upon whom notices or other documents may be served as ided by Section 713.13(1)(a)7.,Florida Statutes. NaMe and Address: 8. addition to himself,Owners designates the following person(s)to receive a copy of the Lienor's Notice as provided 1 ection 713.13(1)(b),Florida Statutes. N e 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 �r , Print Owner's Name I (rn�1 l4�L C• ✓yn Prepared by Sworn to and subscribed fore me this D day of 1��? .20 : Address: Notary Pu ^ Print N s My commi 80 Ill. xpiles OtI Commission#FF 1421 Bondod Through NatianA Ck city Assn Permit No. DS-3-17-799 ,SNORes 0 Miami Shores Village Permit Type:Driveways/Sidewalks/Slabs 10050 N.E.2nd Avenue NE Perlill work Classification:Addi�t on/Alteration Miami Shores,FL 3313&0000 Permit Status:APPROVED ties Phone: (305)795-2204 ORtDP' Issue Date:3/23/2017 [7Expiration: 09/19/2017 Project Address Parcel Number Applicant 502 NE 106 Street 1122310140220 Miami Shores, FL 33138- Block: Lot: MICHAEL DORN Owner Information Address Phone Cell MICHAEL DORN 502 NE 106 Street (305)754-1311 MIAMI SHORES FL 33138-2046 Contractor(s) Phone Cell Phone Valuation: $ 5,000.00 DECO CONCRETE INC (305)828-5158 (305)345-4740 Total Sq Feet: 327.5 Approved: In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final Date Denied: Foundation Type of Work: REPLACING EXISTING WALKWAY WITH F Additional Info:REPLACING EXISTING WALKWAY V Review Planning Bond Return:REPLACING EXISTING WALKWAY WITH F 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-3-17-63428 CCF $3.00 DBPR Fee $2.00 03/23/2017 Credit Card $50.00 $571.00 DCA Fee $2.00 03/23/2017 Credit Card $571.00 $0.00 Education Surcharge $1.00 Bond#:3351 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $4.00 Total: $621.00 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 c ify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zonin uth I authorize the above-named contractor to do the work stated. March 23, 2017 ri gnature:Owner / Applicant / Contractor / Agent ate B ' ding Department Copy March 23,2017 1 Miami Shores Village L� Building Department n 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 ^�V Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201` BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑'SHOP ��yy ,�, C�,, ^,, o CONTRACTOR DRAWINGS. JOB ADDRESS: as up �1"IWj . City: , Miami Shores + County: Miami Dade Zip: Folio/Parcel#:_ i D9-3 I. 0 Ll • D0ag-C) Js the Building Historically Designated:Yes NO Occupancy•Type: Load: Construction Type: Flood Zone: BFE: FFE: F OWNER:Name(Fee Simple Titleholder): ( 6Y n Phone#: c�,�7CGp Addre``ss:11 V 1` City:_M 1 oy- I State: Zip:33 133 Tenant/Lessee Name: - Phone#: Email: C)e AC. • — Gam- 9-06 3 Ji CONTRACTOR:Company Name- C) Inc. Phone#: Address: "T=OLD 1 City: State: Zip: Qualifier Name, o � �: Phone#: State Certification or Registration#:. C .i'' ZS Certificate of Competency#: . DESIGNER:Architect/Engineer: •Phone#: . Address: City: State:• Zip: .V616e"&'Work for this Permit:$_ l Square/Linear Footage df Worker _ 9 7- SID Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition 1wDescription'of:Work: / / Specify color of color thru tile: Submittal Fee$ '% R!j�d .Permit Fee$ CCF$ CO/CC$ r Scanning Fee$ r�1 Radon Fee$ DBfPR$ Notary$ Technology Fee$ Training/Education Fee$ 1 Double Fee$ Structural Reviews$ Bond$ ©� TOTAL FEE NOW DUE$ �5 =Z) I (Revised02/24/2014) ' r 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..... i 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. Signaturex r- Signature OWNER or AGENT CONT COR The foregoing instru6nttwas acknowledged before me this The foregoing instrument was acknowledged before me this day of k&4 20 ,by .day,of ,. �C-"1 20 1 by who is personally known to ! ��/�� who is personally known to me or who has produced %L 1?1-14W U:74�as or who has produced i as identification and who did take an oath. identification and who did take ah oath. NOTARY PUBLIC: -` NOTARY PUBLIC: • A Sign: Sign: Print: Print: v! ,,111,1,,, Notary Public-State of Florida "`Hca,, MA IA M.AGUILAR Seal: =?: '.°• Seal: , .•� My Comm. Expires Jul 15,2018 . Not Public-State of Florida Commission # FF 142170 : •? My Comm.Expires Jul 15,2018 ,,OF ` Commission # FF 142170 Bonded Through National otary Assn. <<' ********************************** *** *** ******************* Bo a Florida]************ APPROVED BY 3 7 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Mission: Mak Scott To protect,promote&inpme the health i Go�ert>or al people in ooridafhax�h integrated stoourty NQ�rias CGlesb Phlllp,MD,MPH ' � HEALTH State&rgeon Gerad and Seaetary Vision:To be the Healthiest State in the Nation March 15, 2017 DECO CONCRETE INC PO BOX 720067 Miami, FL 33172 RE: Modification to a Single Family Residence-No Bedroom Addition Application Document Number: AP1280119 Centrax Permit Number: 13SM-1746152 502 NE 106 Street Miami, FL 33138 Lot: 11 Block: 110 Subdivision: Miami Shores Dear Applicant, . . . .. . . .. • This wil:acknovwledge receipt of a floor plan and site plan on 03/10/2017 for the use of the existing • •••• onsite sewagestreatnvent and disposal system located on the above referenced property. Proposed •• Walkway. •••••• "" ff 44tion letit4r.tas issued by C. Icaza on 03/15/17. ..... . . ...... • Tris effrice ha9reviewed and verified the floor plan and site plan you submitted, for the proposed ..deling ... •••••• rempadp.itL,onjr modification to your single-family home. Based on the information you provided, ...... the HApIth DeparZl;iVjtt concludes that the proposed remodeling addition or modification is not adding a b&&6Qrfi and that it does not appear to cover any part of the existing system or encroach on the • •••• re .gwi#ed setback or!obstructed area. No existing system inspection or evaluation and assessment, or"@dification, replacement, or upgrade authorization is required. Because an inspection or evaluation of the existing septic system was not conducted,the Department cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use. You may request a voluntary inspection and assessment of your system from a licensed septic tank contractor or plumber, or a person certified under section 381.0101, Florida Statutes. If you have any questions, please call our office at(305)623-3500. Sincerely Carl s Ic a Engineer Department of Health in Dade County rtndft n"Wboo e K x..Nr ......flnw.r..nr�.. in Dade County• •,Florida TWITTER:HealthyFLA PHONE: (305)623-3500 FACEBOOK:FLDepartmentofHealth YOUTUBE:fldoh Miami Shores Village Building Department - �• 10050 N.E.2nd Avenue toil Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) hereinafter referred to as the owner of the following described property(address): Legal Description 1 am,Lot Block lQ Subdivision Folio # Requests permission to install (describe work): mutt/( N')A IVwot Within the public right of way of(address) t ► � IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows: 1. To maintain and repair, when necessary, the above-mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). Signature ��--- Owner or Agent .The foregoing instrument was acknowledged before me this day of , 20�, by H1 6 L DOW who is personally known to me or who has produced �_ 1�,1�✓ r fC��r►�c_ as identification and who did take an oath. NOTARY PUBLI Sign: Print: InAPi,9 j LAR `4PHP(pi Notary Public-State of Florida My Comm.Expires Jul 15,2018 vP Commission # FF 142170 Bonded Through National Notary Assn. AMISCAPL DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES BNZM1142 03/10/2017 ADD MISCELLANEOUS APPLICATION PAGE 1 08 : 38 : 03 MARGALV APPLICATION DATE 03/10/2017 PROCESS NO. X2017077928 OTHER DEPT. APPLICATION # OR BLDG DEPT. PERMIT #/ADDRESS: AP1280119 CONTACT NAME DECO CONCRETE SUB TOTAL $70 . 00 ADDRESS 502 NE 106 ST. CITY TATE _ ZIP PHONE 3058285158 LINTY AGENCY SALES FEE UNIT USER PAID TYPE CODE UNITS DESC FEE DESCRIPTION ID FEE IND DOH H006 1 EACH EXISTING SYSTEM MARGALV 70 . 00 PF1 = UPDATE PF9 = MOD MISC APL NEXT SCREEN NEXT KEY MISC APPLICATTOWENTER NEXT KEY TO CONTINUE N.E. 106t1a STREET ST E-E-T-- :•Tr .ra -• r., .. �i..-.•-r tee':r`-.•c �:�,•:4.•.. .a, 0' SKETCH , OF SURVEY 912 11 10 9 8 7 6 5 4 3 • :5' GONG. SIOEYIALK n 110 FD. 3/4 I.P. •7 ` 4 ` s 50'05' ru. REeAR A. R. TOU�SAINT do ASSOCIATES. INC. LAND FLORIDA CECATE OFS RTIFIURVEYORS AUTHORIZATION NO. LB-273 13 14 15 16 17 18 19 20 21 22 -" 620 N.E. 126 ST. NORTH MIAMI, FLORIDA 33161 FH: 11 PG: 66 DATE JANUARY 2. 2006 14 ORDER No. 13873 SCALE. 1" — 20' ' 30 r SET I.P. �>.� '"' �, ' • • 19.00' INL 4.0' ST 6.24' ''► .�' I-' 4 ANC h_ • 40 0 '—STY _ u I v )CO-1 _LOCATION AAAP • •••.� •• _ -f- `r� 0 SCALE. 1•— ' FMM t€ �� y � In �M�� LELEGENS—STY p ?/ AC. NR COICfTIONER i••i•• C.B.S. SC2 C.B.S CONCRETE BLOCKSTUCCO c(m� C.S. = CtEIW OUT ., :. .. .... _ ENC • •�i •••••• :' 10.00' . 4 3• o � � MENT FO • s • „ IP WON PIPE • • ti• • •••••• RLS PROPEMY UNE SUWANCR 1—STY a.... ••• !• .•.� • • wm 330'; ' ,.. ' ' p!AR 2 3 2017 EGA DE C tPT! N: �•.•a._ -. LOT 12 AND THE WEST 172 OF LOT 11, BLOCK 110, AMENDED PLAT �� '• O.00 .':: = OF SECTION No. 5 MIAMI SHORES: ACCORDING TO THE PLAT THEREOF, BY: AS RECORDED IN PLAT HOOK 10 AT PAGE 4.7 OF THE PUBUC RECORDS ` OF MIAMI—DADE COUNTY, FLORIDA. 'NQ 0�� ,g)a0e C°untY SURVEY CERTIFICATION: IL i'R OR S L,c alth&1 W ell P rogram WE HEREBY CERTIFY THAT THIS SURVEY IS TRUE AND CORRECT 0.9 Florida He TO THE BEST OF OUR KNOWLEDGE AND BELIEF As RECENTLY SURVEYED AND PLATTED UNDER OUR DRECIIION AND THAT THIS jv �± �p1lcation N°.: SURVEY COMPLIES WITH THE MINIMUM TECHNICAL STANDARDS Miami Shores Village FOR LAND SURVEYING IN THE STATE OF FLORIDA. UNDER CHAPTER 61G17-6uIN1STRATIVE CODE. CHAPTER pate: 472.07 FLORIDA ST T .. t nature APPROVED BY DATE �p NOT VALID WrrH0U1 I ,AND RIIISEp SEAL OF THE ,. . I.P. S 9 DEPT REGISTERED LAND S�{JRVIYbRWIIN. wI).PO FD. I.P. ZONINGf c f A.R. TOUP SAINT do ASS O&LATES, INC. BLDG DEPT . .. r3 ASPHALT•PAVEMENT�•. g r� /1 SUBJECT TO COMPLIANCE WITH ALL FEDERAL .r .. } ' PRE:S. STATE AND COUNTY RUL FS AND REGULATIONS f AIt Pir ` IJ k.� ja0. am ATE'OF 1MR NO. 907 ' i �