RC-16-375 S �
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
nspection Number: INSP-283124 Permit Number: RC-2-16-375
Inspection Date: May 24, 2017 Permit Type: Residential Construction
Inspector: Dacquisto, David
Inspection Type: Survey Final
Owner: FRANCESCA RINONAPOLI TRS, Work Classification: Garage Enclosure
CCTCCAAI !`_11 U2`^\/A7 TCC
Job Address:9915 NE 4 Avenue Road
Miami Shores, FL Phone Number
Project: <NONE> Parcel Number 1132060171300
1.
Contractor: GMB CONSTRUCTION INC Phone: (305)967-3640
Building Department Comments
CONVERSION OF EXISTING OPEN AIR BREEZE WAY Infractio Passed Comments
INTO HABITABLE SPACES BEDROOM, BATHROOM, INSPECTOR COMMENTS False
PLAYROOM PARTIAL GARAGE CONVERSION INTO
LAUNDRY ROOM
Passed
Inspector Comments
��\�
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
For Inspections please call: (305)762-4949
May 24,2017 Page 1 of 1
LOCATION SKETCH
►• a o LOT 14 SCALE: NTS
u;z 130.00' ( R & M) BLOCK96 z!ESE ,'% :.:. Vi
37.50' N A
p�•• c aZ
Oj: •� to ooAd
c u;
25.30' 45.85' a~ 4.65'
0 El
C41 \\ pS 2.0'CL
N • • •
::.::�..;w ` n' 10.18' ONE STORY 5.60' \\` \ LOT 15 " RECEIVED Z .• . .• :•• •�•
0 •••.•.
Q..:::: .•.•, C.B.S. RESIDENCE \ `\ 3 W !� • •' • •. •
Q'•'.'..'.'.� } #9915 \\\\\\\\\\ \ c BLOCK 46 MAY 2 �f X11 Q •••••• •• •• •i
..O'•'•••.'.' QI r iw T *666 •• ••
' Lj
�/ '.'. :.:.aV. ;::::. N O '• 65 F.F.ELEV.=12.50' \ \\ \\\\ rn -C - •.•••• •.
\ \ \ .........d.
•
/` • •,• .
. N O 11 a •� •• •••
�. N r C N to \ `\ �� ',W 1. •• • .� ••
!0 N �r: - - - - M- - - - - - \ 8.80 - - - - - - �O �]1'•' ■ �••••• • •
11 W • .
•
Oj et \ \\ b •• • ••• • so ••
• ` \ N so:
•.
:::::::::: L.F.F.ELEV.=10.95' .
Q':':': ::'::':•:•:.: 6.0\ N.E. 5th AVENUE
:: .55' \`\ ..in
:: :':: `.r• `\\\ LOT 16 3 0► '
:::::::::: '•', `\\\\ BLOCK 96 J : N C o PERMIT r11Y1 1 .
■:.:' '. .... ::::! PAVERS o GARAGE ^
t..••' i, ;. DRIVEWAY N ELEV.=10.65' 6.00' 62' :•::� II 1- G Miami Shores Village
u�: J
.;
APPROVED BY DATE
28.75' 42.60' �p5� o ,�0 2.0'CL
� 12.5' �,'•: A/C `� `'� off, ZONING DEPT
..,,•o'. `° "eft q �� 4 ° of BLDG DEPT
T 5'C.B.S. WALL
SUBJECT TO COMPLIANCE Wf FH ALL FEDERAL
37.50' •'' z ..
130.00 ( R & M ) c :p •....... STATE AND COUNTY RULES.AND REGULATIONS
LOT 17 C14
.Y. z c BLOCK 96 csZ _
...... .... ;'..i
Property Address:9915 N.E.4"'Avenue Rd., Miami Shores, FL. 33138.
r
ABBREVIATIONS: Legal Description: Lots 15 and 16, Block 96,AMENDED PLAT OF MIAMI SHORES SECTION NO.4,
SV�t(=51DEW4LK,CBS=CONCRETE BLOCKSTRUCTURE,CLF=CHAIN LINK FENCE,PL=PROPERTY LINE.DUE=DRAINAGE UTILITY EAS EM'cNT,IP=IRON PIPE
F--FOUND.A/C=AIR CONDITIONER PAD,P/G=PROPERTY CORNER.DM=DRILLED HOLE,YJ/F=WOODEN FENCE,RES=RESIDENCE,CL-CLEAR,RH=REHA4. g
accordin 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 MY, DE=DRAINAGE EASEMENT, C/L=CENTER LINE, O=DIAMTER, TYP=TYPICAL
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,WM=VATERMETER
I'MASONRYVALL= ELEVATION BASED ON LOC. # 3100
NOT VALID UNLESS EMBOSSED WITH CONCRETE=_ •':.:•.:.:••:.:::;:•.:;:••: :,•.:,•:,.,,•:, -
SURVEYOR'S SEAL MAINTENANCE BDRAINAGE EASEMENT=M&D.E. CBM#N-397 - ELV- 9.80 1 TYPE OF SURVEY:BOUNDARY SURVEY
1 HEREBY SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2)NOT VALID WITHOUT THE SIGNATURE the eon meets CERTIFY
minimum t chnicalhat the r requirements
ANDements SINCE 1987
L @ AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT adopted by the STATE OF FLORIDA Board of Land BLANGO SURVEYORS ING.
W COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5). Surveyors pursuant to Section 472.027 Florida Engineers•Land Surveyors•Planners•LB#0007059
UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC Statutes,
VERTICAL DATUM_OF 1929.- 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL There are no encroachments, overlaps, easements 555 NORTH SHORE DRIVE
RESTRfCTIONS NOT SHOWN ON THIS SURVEY THAT MAYBE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY 9) appearing on the plat or visible easements other than MIAMI BEACH,FL 33141
CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING as shown hereon.
INFORMATION. 10)EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED (305) 865-1200 Email:blancosurveyorsinc@yahoo.com Fax: (305) 865-7810
REVISED: INSTRUMENTS,IF ANY,AFFECTING THIS PROPERTY
Additions or deletions to survey maps or reports by other than the si FLOOD ZONE: X SUFFIX: L DATE: 9/11/09 BASE:N A
gning party or parties is prohibited ���ttt ����1fff l
without whiten consent of the signing party or parties. ADIS N.NUNEZ PANEL: 0302 COMMUNITY# 120652
BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE-OF SAID P$' 15 14 REGISTERED LAND SURVEYOR DATE. SCALE: DWN-BY: JOB No
PAGE STATE OF FLORIDA#5924 3/ O/17 l-_3�0
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,-- SPECT10N RECORD POST ON SITE
y�oRFs
Permit NO. RC-2-16-375
Miami Shores Village Permit Type:Residential Construction
10050 N.E.2nd Avenue
Miami Shores,FL 33138-0000 work Classification:Garage Enclosure
tn,kkPhone: (305)795-2204 Fax: (305)756-8972 11/13/2016
�t0R1(tp' Issue Date: 5/17/2016
Expires:
INSPECTION REQUESTS: (305)762-4949 or Log on at https://bidg.miamishoresvillage.com/cap
REQUESTS ARE ACCEPTED DURING 8:30AM-3:30PM FOR THE FOLLOWING BUSINESS DAY.
Requests must be received by 3 pm for following day inspections.
Residential Construction Parcel #:1132060171300
Owner's Name:ESTEBAN GIUGOVAZ TRS FRANCESCA RINONAPOLI ' Owner's Phone:
Job Address: 9915 NE 4 Avenue Road Total Square Feet: 860
Miami Shores FL
Bond Number: 3091 Total Job Valuation: $ 50,000.00
nr�—��`..w�aem wsawoaw. vr,=--�._=��.. ara�s+neirac---esre�orrsac•
WORK IS ALLOWED:
Contractor(s1 Phone Prima Contractor MONDAY THROUC H FRIDAY,8:OOAM-7:00PM.
Primary SATURDAY 8:OOAM-6:OOPM.
GMB CONSTRUCTION INC (305)967-3640 Yes NO WORK IS ALLOWED EiD ON SUA',CA d 0HOLIDAYS.
BUILDING AND ROOFING INSPECTIONS ARE DONE
MONDAY THROUGH FRIDAY.
71
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410 [6 VAV5T G.e � tired v< <l e
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elf 57 444941Ad`) &,fie e, w i, 01
-7 7- a Le+v—
e
NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED. PLANS ARE READLY AVAIL.-ABLE IT IS
THE PERMIT APPLICANT'S RESPONSIBILITY TO ENSURE THAT WORK IS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER
THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF AN),MATERIAL
REQUIRED TO ALLOW INSPECTION.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED
AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER C'R AN
ATTORNEY BEFORE COMMENCING WORD OR RECORDING YOUR NOTICE OF
COMMENCEMENT.
A;i
-� C4 v/1M
J�
INSPECTIONFR."ECO" T'
STRUCTURAL ZONING PLUMBING
INSPECTION D T 1 INSPECTION DATE INSP INSPECTION DATE INSP
Foundation Zonin Final
Stemwall ZONING COMMENTS Rough
Slab Water Service
Columns 1 st Lift t$ 2"d Rou h
Columns 2nd LiftTo Out
Tie Beam Fire Sprinklers
Truss/Rafters Septic Tank �
Roof SheathingSewer Hook-up
Bucks Roof Drains
indows/Doors ELECTRICAL Gas
Interior FramingINSPECTION DATE INSP LP Tank
Insulation Temporary.Pole Well
Ceiling Grid, AA 30 Da Temporary Lawn Sprinklers
Drywall Pool Bonding Main Drain
Firewall Pool Deck Bonding Pool Piping
Wire Lath Pool Wet Niche Backflow Preventor
Pool Steel Underground Interceptor
Pool Deck Footer Ground Catch Basins
Final Pool Slab Condensate Drains
Wall Rough
HRS Final
Screen Enclosure Ceiling Rougtj, `
Driveway Rough PLUMBING OMMENTS
Driveway Base Telephone Rough -�; t-a+
Tin Cap- Telephone Final
Roof in Progress TV Rough ��+, � ►
Mop in Progress TV Final
Final Roof Cable Rough t.S'
Shutters Attachment Cable Final / Av �+
Final Shutters Intercom Rough
Rails and Guardrails Intercom Final '
ADA corn liance Alarm Rough INSPECTION DATE INSP
farm Final Underground Pipe
DOCUME ire Alarm Rough .001
Soil Bearina Cert Fire Alarm Final Rough
Soil Treatment Cert Service Work Witlf
Floor Elevation Survey Ventilation Rough
Reinf Unit Mas Cert ELECTRICAL COM ENTS Hood Rough
Insulation Certificate Pressure Test
Spot Survey Final Hood
Final Survey Final Ventilation
Truss Certification _ Final Pool Heater
STRUCTURAL COMMENTS Final Vacuum
MECHANICAL COMMENTS
LS!ECTION DATE IN7
SP
nal S rinkler
Final Alarm
INSPECTION RECORD POST ON SITE
Permit NO. RC-2-16-375
1 y^►t
OR
uS
1 Miami Shores Village Permit Type: Residential ons ruction
�� UC� 10050 N.E.2nd Avenue
un MUM.. WorkCJassific Miami Shores,FL 33138-0000 rte, tion:.Garage Enclosure
OP,* Phone: (305)795-2204 Fax: (305)756-8972
L� `+ Issue Date: 5/17/2016 Expires: 11/13/2016
klii-r
INSPECTION REQUESTS: (305)762-4949 or Log on at https://bldg.miamishoresvillage.colTVcap
REQUESTS ARE ACCEPTED DURING 8:30AM-3:30PM FOR THE FOLLOWING BUSINESS DAY. I
Requests must be received by 3 pm for following day inspections.
Residential Construction Parcel #A 132060171300
Owner's Name:ESTEBAN GIUGOVAZ TRS FRANCESCA RINONAPOLI ' Owner's Phone:
Job Address: 9915 NE 4 Avenue Road Total Square Feet: 860
Miami Shores„FL
Bond Number: 3091 Total Job Valuation: $ 50,000.00
WORK IS ALLOWED:
MONDAY THROUGH FRIDAY,8:00AM-7:00PM.
Contractor(s) Phone Primary Contractor SATURDAY 8:OOAM-6:OOPM.
GMB CONSTRUCTION INC (305)967-3640 Yes NO WORK IS ALLOWED ON SUMCAY 0<HOLIDAYS.
BUILDING AND ROOFING INSPECTIONS ARE DONE
MONDAY THROUGH FRIDAY.
u Te
i
�� e Co VkW+�9 • A' 4eAISiags
�� t6 ,mus
��,- (vewtisAec'�1vt�1 �-ee v�
c�I w57 A ce e `u,4dw
c Q Q 12 �� 1e4 OWA
L -Nb INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED. PLANS ARE READLY A�vNttABLE IT IS
THE PERMIT APPLICANTS RESPONSIBILITY TO ENSURE THAT WORK tS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER
THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL
REQUIRED TO ALLOW INSPECTION.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED
AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU
INTEND TO' OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ANL
ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF
COMMENCEMENT.
3 tiT
!j A,, G.a`7F' r'
V
INSPECTION RECORD
INSPECTION T I INSPECTION DATE INSP INSPECTIONZONING PLUMBING
STRUCTURAL I DATE IN
Foundation Zoning Final
Stemwall ZONING COMMENTS Rough .�
Slab Water Service
Columns 1 st Lift A 1416& 2nd Rough
Columns 2nd Lift Top Out
Tie Beam Fire Sprinklers
Truss/Rafters ,' Septic Tank
Roof Sheathing Sewer Hook-up
Bucks Roof Drains
r indows/Doors Gas
Interior Framin INSPECTION DATE IN LP Tank
Insulation Tem ora Pole Well
'
CeilingGrid, 30 Da TemporaryLawn Sprinklers
DrywallPool Bonding Main Drain
Firewall Pool Deck Bonding
Pool Piping
Wire Lath Pool Wet Niche Backflow Preventor
Pooh Steel Underground Interceptor
Pool Deck Footer Ground Catch Basins
Final Pool Slab Condensate Drains
Final Fence Wall Rough HRS Final
Screen Enclosure Ceiling Rou '
XT
Driveway Rough PLUMBINGOMMENTS
DrivewayBase Tele hone Rou
Tin Cap. Telephone Final N'► W y"
Roof in Pro ress TV Rough �'1°h. �" � _•
Mo in Progress TV Final
Final Roof Cable Rough lS
I Shutters Attachment Cable Final /
Final Shutters Intercom Rough
Rails and Guardrails Intercom Final MECHANICAL
ADA compliance Alarm Rough INSPECT I D rF-1 INSP
farm Final Underground Pipe
DOCUME Pire Alarm Rough
1 Soil Bearing Cert Fire Alarm Final Rough
Soil Treatment Cert Service Work Wit
Floor Elevation Survey Ventilation Rough -
Reinf Unit Mas Cert ELECTRICAL COM ENTS Hood Rough
Insulation Certificate Pressure Test _
Spot Survey Final Hood
Final Survey Final Ventilation
G Truss Certification Final Pool Heater
STRUCTURAL COMMENTS Final Vacuum
'..®- 7MECHANICAL COMMENTS
INSPECTION DATE INSP
Final Sprinkler
final Alarm
I
i
RECEIVED
MAY 18 201/
L b.
a '1
AA26001388
April 29, 2017
Miami Shores Village
Building Department
10050 NE 2nd Avenue
Miami Shores, Florida 33138
Final Inspection Letter
Permit Number: RC 16-375
Address: 9915 NE 4th Ave Rd
Building Department,
I, Victor J. Bruce and Architect of Record, having performed visual observations of the
project, hereby attest to the best of my knowledge, belief, and professional judgment,
the structural and envelope components of the above referenced renovation are in
compliance with the approved plan.
I also attest that to the best of my knowledge, belief, and professional judgment, the
approved permit plans represent the as built condition of the structural envelope
component of the said structure.
Please contact me at 305.310.5030 if you have any questions and/or comments.
S' cerely,
VI J. Bruce A.I. EED R
Architect
AR-0017103
P.O.Box 530019
Miami Shores,Florida 33153
telephone 305-310-5030
email vb@b2-ai.com
,U.S.-DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30, 2018
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for(1)community official,(2)insurance agent/company, and (3)building owner.
SECTION A—PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name Policy Number:
FRANCESCA RINONAPOLI
A2. Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and
Box No. Company NAIC Number:
9915 NE 4 AVE RD
City State ZIP Code
MIAMI SHORES Florida 33138
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description, etc.)
LOTS 15 AND 16, BLOCK 96, P.B. 15, PAGE 14
A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat.N25°51'59.18" Long.W80°11'15.61" Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 8
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 2703.00 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade 15
c) Total net area of flood openings in A8.b 1920.00 sq in
d) Engineered flood openings? ❑Yes Z No
A9. For a building with an attached garage:
a) Square footage of attached garage 200.00 sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A9.b N/A sq in
d) Engineered flood openings? ❑Yes ❑x No
SECTION B—FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1. NFIP Community Name&Community Number B2. County Name B3. State
TOWN OF MIAMI SHORES 120652 MIAMI-DADE Florida
B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s)
Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth)
Revised Date
12086CO302 L 09-11-2009 09-11-2009 X N/A
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 69:
FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item 139: 0 NGVD 1929 ❑ NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes ❑x No
Designation Date: ❑ CBRS ❑ OPA
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 1 of 6
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: November 30,2018
IMPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Policy Number:
9915 NE 4 AVE RD
City State ZIP Code Company NAIC Number
MIAMI SHORES Florida 33138
SECTION C—BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ❑x Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete. .
C2. Elevations—Zones Al A30,AE,AH,A(with BFE),VE,V1—V30,V(with BFE),AR,AR/A,ARIAE,AR/A1—A30,AR/AH,AR/AO.
Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only,enter meters.
Benchmark Utilized: N-397 Vertical Datum:NGVD 1929
Indicate elevation datum used for the elevations in items a)through h)below.
0 NGVD 1929 ❑ NAVD 1988 ❑ Other/Source:
'Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a) Top of bottom floor(including basement, crawlspace,or enclosure floor) 10.70 x❑ feet ❑ meters
b) Top of the next higher floor 10.95 21 feet ❑ meters
c) Bottom of the lowest horizontal structural member(V Zones only) N/A ❑x feet ❑ meters
d) Attached garage(top of slab) 10.65 0 feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building feet meters x
(Describe type of equipment and location in Comments) 11,10 ❑ ❑
f) Lowest adjacent(finished)grade next to building(LAG) 10.40 x❑ feet ❑ meters
g) Highest adjacent(finished)grade next to building(HAG) 10.60 ❑x feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including ❑
feet❑N/A x meters
structural support
SECTION D—SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer,or architect authorized by law to certify elevation information.
I certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false
statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? Yes ❑No ❑Check here if attachments.
Certifier's Name License Number
ADIS N. NUNEZ 5924
Title #5924
REGISTERED LAND SURVEYOR 3/20/17, � Place
Name
BLANCO SURVEYORS INC Sial
Address Here 555 N. SHORE DR.
City State ZIP Code
MIAMI BEACH Florida 33141
Signature Date Telephone Ext.
03-20-2017 (305)865-1200
Copy all pages of this Elevation Certificate and all attachments for(1)community official, (2)insurance agent/company, and(3)building owner.
Comments(including type of equipment and location, per C2(e), if applicable)
LONGITUDE AND LONGITUDE OBTAINED BY GOGGLE. C2.e)A/C ELEVATION.
CROWN OF THE ROAD ELEVATION: 10.10'ON CENTERLINE ON CENTER OF ROAD.
BM#N-397 LOCATOR: 3100 ELEV:9.80'
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 2 of 6
BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30,2018
IMPORTANT: In these spaces,copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and Box No. Policy Number:
9915 NE 4 AVE RD
City State ZIP Code Company NAIC Number
MIAMI SHORES Florida 33138
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the
instructions for Item A6. Identify all photographs with date taken;"Front View"and'Rear View';and, if required, "Right Side View"and
"Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or
vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
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Photo One
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Photo Two
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FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 5 of 6
U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008
Federal Emergency Management Agency Expiration Date: November 30,2018
NatiAnal Flood Insurance Program
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for(1)community official,(2)insurance agent/company,and(3)building owner.
SECTION A—PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name Policy Number:
FRANCESCA RINONAPOLI
A2. Building Street Address(including Apt., Unit, Suite, and/or Bldg. No.)or P.O. Route and
Box No. Company NAIC Number:
9915 NE 4 AVE RD
City State ZIP Code
MIAMI SHORES Florida 33138
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description, etc.)
LOTS 15 AND 16, BLOCK 96, P.B. 15, PAGE 14
A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat.N25°51'59.18" Long.W80°11'15.61" Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 8
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 2703.00 sq ft
b) Number of permanent flood openings in the crawlspace or enclosures)within 1.0 foot above adjacent grade 15
c) Total net area of flood openings in A8.b 1920.00 sq in
d) Engineered flood openings? ❑Yes 0 No
A9. For a building with an attached garage:
a) Square footage of attached garage 200.00 sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A9.b N/A sq in
d) Engineered flood openings? ❑Yes x❑ No
SECTION B—FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1. NFIP Community Name&Community Number B2. County Name B3. State
TOWN OF MIAMI SHORES 120652 MIAMI-DADE Florida
B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s)
Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth)
Revised Date
12086CO302 L 09-11-2009 09-11-2009 X N/A
B10. Indicate the source of the Base Flood Elevation (BFE)data or base flood depth entered in Item 139:
❑ FIS Profile ❑x FIRM ® Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item 69: ❑x NGVD 1929 ❑ NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes ❑x No
Designation Date: ❑ CBRS ❑ OPA
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 1 of 6
ELEVATION CERTIFICATE OMB No. 1660-0008
Expiration Date: November 30,2018
IMP*IORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number:
9915 NE 4 AVE RD
City State ZIP Code Company NAIC Number
MIAMI SHORES Florida 33138
SECTION C—BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ❑x Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations—Zones Al—A30,AE,AH,A(with BFE),VE,V1—V30,V(with BFE),AR,AR/A,AR/AE,AR/A1—A30,AR/AH,AR/AO.
Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only,enter meters.
Benchmark Utilized: N-397 Vertical Datum:NGVD 1929
Indicate elevation datum used for the elevations in items a)through h)below.
❑x NGVD 1929 ❑ NAVD 1988 ❑ Other/Source:
'Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a) Top of bottom floor(including basement, crawlspace,or enclosure floor) 10.70 ❑x feet ❑ meters
b) Top of the next higher floor 10.95 x❑ feet ❑ meters
c) Bottom of the lowest horizontal structural member(V Zones only) N/A ❑x feet ❑meters
d) Attached garage(top of slab) 10.65 ❑x feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building feet x
(Describe type of equipment and location in Comments) 11,10 ❑ ❑ meters
fj Lowest adjacent(finished)grade next to building (LAG) 10.40 ❑x feet ❑ meters
g) Highest adjacent(finished)grade next to building(HAG) 10.60 x❑ feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including ❑ feet x
structural support N/A ❑ meters
SECTION D—SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer, or architect authorized by law to certify elevation information.
1 certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false
statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? ❑x Yes ❑No ❑Check here if attachments.
Certifier's Name License Number
ADIS N. NUNEZ 5924 .
Title #5924
REGISTERED LAND SURVEYOR 3/20/17
Company Name
Place
BLANCO SURVEYORS INC Seal
Address
555 N. SHORE DR. � ere
City State ZIP Code
MIAMI BEACH Florida 33141
Signature Date Telephone Ext.
03-20-2017 (305)865-1200
Copy all pages of this Elevation Certificate and all attachments for(1)community official, (2)insurance agent/company, and(3)building owner.
Comments(including type of equipment and location,per C2(e), if applicable)
LONGITUDE AND LONGITUDE OBTAINED BY GOGGLE. C2.e)A/C ELEVATION.
CROWN OF THE ROAD ELEVATION: 10.10'ON CENTERLINE ON CENTER OF ROAD.
BM#N-397 LOCATOR:3100 ELEV:9.80'
FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 2 of 6