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RC-16-634
{ } RC�b-63`I c��ee I �� �' _ ���• :a9M11[We1(:-mo]mine] 111U1:411* DOLL0vr►—•a a v . Miami Shores Village Building Department 10050 NE 2 Ave Miami Shores FL 33138 9i. FAO RIOP' � Permrt NO�C-3-1-6-�3� ' ryps .Bullding.(Roald'ntlfitl)• workcrass:.,Additlen/AlteratIon -i b Permit Sta�js..A13nfbved" Issue Date: 5/19/2017 INSPECTION REQUESTS: (305)762-4949 or log on at hftps:Hbidg.msvfl.gov/energov—Prod/selfservice Requests must be received by 3:30pm WORK IS ALLOWED: MONDAY THROUGH FRIDAY, 8:OOAM - 7:OOPM SATURDAY 8:OOAM - 6:OOPM. NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS BUILDING AND ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY . NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED . PLANS ARE READILY AVAILABLE. 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 ANY MATERIAL REQUIRED TO ALLOW INSPECTION . Owner's Name: Job Address: 10125 BISCAYNE BLVD Miami Shores, FL 33138-2647 Expires: 03/11 /2019 POST ON SITE 1132050190190 Owner's Phone: (786)390-3177 Total Square Feet: 627 rotal Job Valuation: $ 100,000.00 Contractor(s) Phone Address TOSCANA CONSTRUCTION GROUP INC (786)953-2130 6365 COLLINS AVE 804, MIAMI BEACH, FL 33141 Description: NEW ADDITION TO INCLUDE A MASTER BEDROOM, BATHROOM AND CLOSET . 03-16-2017 Permit process extended due to the fact that the applicant was working on obtaining outside agencies approval. 01-08-2017 Stop work order issue for failure to pass required inspections. FBC 2014, Section 110.1 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 AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Page 1 of 1 INSPECTION RECORD STRUCTURAL INSPECTION DATE INSP Foundation Stemwall Slab Columns (1st Lift) Columns (2nd Lift) Tie Beam Truss/Rafters Roof Sheathing Bucks Interior Framing Insulation Ceiling Grid Drywall Firewall Wire Lath Pool Steel Pool Deck Final Pool Final Fence Screen Enclosure Driveway Driveway Base Tin Cap Roof in Progress Mop in Progress Final Roof Shutters Attachment Final Shutters Rails and Guardrails ADA compliance EJW Soil Bearing Cert Soil Treatment Cert Floor Elevation Survey Reinf Unit Mas Cert Insulation Certificate Spot Survey Final Survey Truss Certification STRUCTURAL COMMENTS WINDOWS:.... INSPECTION DATE I INSP Attachment WORKSPUBLIC INSPECTION DATE INSP Excavation ELECTRICAL INSPECTION DATE INSP Temporary Pole 30 Day Temporary Pool Bonding Pool Deck Bonding Pool Wet Niche Underground Footer Ground Slab Wall Rough Ceiling Rough Rough Telephone Rough Telephone Final TV Rough TV Final Cable Rough Cable Final Intercom Rough Intercom Final Alarm Rough Alarm Final Fire Alarm Rough Fire Alarm Final Service Work With ZIN I ELECTRICAL COMMENTS INSPECTION DATE INSP Final Sprinkler Final Alarm DATE I INSP Water Service 2nd Rough Top Out Fire Sprinklers Septic Tank Sewer Hook-up Roof Drains Gas LP Tank Well Lawn Sprinklers Main Drain Pool Piping Backflow Preventor Catch Basins _ Condensate Drains HRS Final PLUMBING COMMENTS INSPECTION I DATE I INSP Underground Pipe Ventilation Rough Hood Rough Pressure Test Final Hood Final Ventilation Final Pool Heater Final Vacuum Miami Shores Village Building Department 10050 NE 2 Ave Miami Shores FL 33138 �ORIDp' Issue Date: 10/17/2018 Expires: 04/15/2019' INSPECTION REQUESTS: (305)762-4949 or log on at https://bidg.msvf.gov/energov_prod/selfservice Requests must be received by 3:30pm WORK IS ALLOWED: MONDAY THROUGH FRIDAY, 8:OOAM - TOOPM SATURDAY 8:00AM - 6:OOPM. NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS BUILDING AND ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY . NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED . PLANS ARE READILY AVAILABLE. 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 ANY MATERIAL REQUIRED TO ALLOW INSPECTION . POST ON SITE 1132050190190 Owner's Name: Owner's Phone: (786)390-3177 Job Address: 10125 BISCAYNE BLVD Total Square Feet: 897 Miami Shores, FL 33138-2647 dotal Job Valuation: $ 3,500.00 Contractor(s) Phone Address TOSCANA CONSTRUCTION GROUP INC (786)953-2130 6365 COLLINS AVE 804, MIAMI BEACH, FL 33141 Description: INSTALLATION OF NEW BRICK PAVERS FOR DRIVEWAY . Stop work order issue for failure to pass required inspections. FBC 2014, Section 110.1 Ma f I IN'S p. JOB AT IMF OF am U,n r C-1, P -z a 4N 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 AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Page 1 of 1 ,<'* INSPECTION RECORD INSPECTION E INS Foundation I Stemwall Slab Columns (1st Lift) Columns (2nd Lift) Tie Beam Truss/Rafters Roof Sheathing Bucks Interior Framing Insulation Ceiling Grid Drywall Firewall Wire Lath Pool Steel Pool Deck Final Pool Final Fence Screen Enclosure Driveway Driveway Base Tin Cap Roof in Progress Mop in Progress Final Roof Shutters Attachment Final Shutters Rails and Guardrails ADA compliance I - FINAL DOCUMENTS Soil Bearing Cert Soil Treatment Cert Floor Elevation Survey Reinf Unit Mas Cert Insulation Certificate Spot Survey Final Survey Truss Certification STRUCTURAL COMMENTS I - WINDOWS :DOORS INSPECTION DATE I INSP Attachment WORKSPUBLIC INSPECTION DATE INSP Excavation ELECTRICAL INSPECTION DATE INSP Temporary Pole 30 Day Temporary Pool Bonding Pool Deck Bonding Pool Wet Niche Underground Footer Ground Slab Wall Rough Ceiling Rough Rough Telephone Rough Telephone Final TV Rough TV Final Cable Rough Cable Final Intercom Rough Intercom Final Alarm Rough Alarm Final Fire Alarm Rough Fire Alarm Final Service Work With ELECTRICAL COMMENTS INSPECTION DATE INSP Final Sprinkler Final Alarm PLUMBING INSPECTION DATE INSP Rough Water Service 2nd Rough Top Out Fire Sprinklers Septic Tank Sewer Hook-up Roof Drains Gas LP Tank Well Lawn Sprinklers Main Drain Pool Piping Backflow Preventor Interceptor Catch Basins Condensate Drains HRS Final • PLUMBING COMMENTS MECHANICAL INSPECTION DATE INSP Underground Pipe Rough Ventilation Rough Hood Rough Pressure Test Final Hood Final Ventilation Final Pool Heater Final Vacuum MECHANICAL COMMENTS MIAMM EMDADE Miami -Dade County Building Department 11805 S.W. 26 Street, Miami, FL 33175-2474 www.miamidade. o«v/buildin(, ENERGY, SOUND AND IMPACT CERTIFICATE Building Permit No: RC - 3 - 16 - 634 Project Name: 10125 6 (5 CA YNC- 61_V 0 Job Address: 10126 615C44yrA &%-VA - E" IA nA % '$VtO ee� STATEMENT OF COMPLIANCE We, the undersigned, hereby certify that the ENERGY. SOUND AND IMPACT INSULATION has been installed in the above referenced project, in compliance with the latest edition of the FLORIDA BUILDING CODE. the. APPROVED ENERGY CALCULATIONS and Plans and in accordance with good construction practice. The insulation furnished and installed has the characteristics shown below: (check only applicable boxes). ❑ 1) Exterior CBS Walls Insulation: R- 5.1 (Min.): Material: -TNEKMo Poll. Thickness: 0.0625 inch (es): Density: lb/ft: Mfgr: 0 2) Exterior Frame/Metal Stud Walls: R- (Min.): Material: Thickness inch (es): Density: Ib/ft: Mfgr: ❑ 3) Exterior solid concrete walls: R- (Min.): Material: Thickness: inch (es): Density: Iblft: Mfgr. ❑ 4) interior walls separating A/C from non A/C spaces insulation: R- It (Min.) Material: TIME ,40($ ;Thickness: 3'1 inch (es); Density: Ib/ft ❑ 5) XIUL;TI-FAMILY RESIDENTIAL. CONSTRUCTION ONLY: The COMMON (Party) walls to two separate conditioned tenancies shall be insulated to a minimum of R-I 1 for frame walls, and to R-3 on both sides of common masonry walls See ENERGY CODE, 2007. paragraph 13-602. ABC. 1.1, on page 13.74, latest edition. These "minimum levels of insulation**,are not included in the Energy Calculations, but shall be installed in the field. ❑ 6) Ceiling insulation R- 30 (Min.); Material: f %6E 2 ArL^sl Thickness t 2 inch (es): Density: Ib/ft: Mfgr. ❑ 7) Walls, partitions and floor/ceiling assemblies between dwelling units or between dwelling units and adjacent public or service areas such as halls, corridors, stairs, etc. must have a sound transmission class (STC) of not less than 50 (penetrations must maintain the required rating). ❑ 8) Floor/ceiling assemblies between dwelling units or between dwelling units and public or service areas such as halls, corridors, stairs, etc. must have an impact insulation class (IIC) rating of not less than 50. Make photocopies of this sheet in your office, as required for future jobs. Installed by: Insulation Company Name Insulation Contractor CC# O.CdBuildcr: TOSCANA C0NSfA0C.Tt0J CjAWP Company Name Building Contractor CC#: C Cc C 1 5 2 5 1 M Insulation Contractor Signature Date. Certified: �� _l oil G.C.iI uilder's Signature Date. Certified: 0 41 2y / 2 a ll Note: For lightweight Insulating concrete, use appropriate forms, separate from this one. Revised 02-26-2009 Notice of Preventative Treatments for Termites ( as required by Florida Building Code ( FBC ) 104.2.6 ) Certificate of Compliance for Termite Protection (as required by Florida Building Code ( FBC )1816.7 ) ou N PEST CQNTRQL 840 SE 1 ST Hialeah FL 33010 Ph:305-725-4737 Fax:305-863-8675 10125 Biscayne Blvd Miami FL 33138 Address of Treatment or Lot / Block of Treatment June 20-2017 10:45am Arquimedes Duran Date Time Applicator Adonis 75 WSP Product Use 0.05% Percent Concentration Imidacloprid Chemical Used (active ingredient) 578 sf Area Treated (square feet) Stage of treatment (Horizontal, Vertical, Adjoining Slab, retreat of disturbed area) Soil barrier Method of termite treatment - soil barrier, wood treatment, bait system, other 58gl Number of Gallons Applied Linear Feet Treated CORPORATE SEAL As per 104.2.6 - If soil chemical barrier method for termite prevention is used, final exterior treatment shall be completed prior to final building approval. The building has received a complete treatment for the protection of subterranean termites. Treatment is in accordance with rules and laws established by the Florida Department of Agriculture and Consumer Services If this noWo iclf'or final exterior treatment, initial and date this line------------- Notice ot Preventative Treatments for Ilerm-ftes ( as required by Florida Building Code ( FBC ) 104.2.6 ) Certificate of Compliance for Termite Protection _(as required by Florida Building Code ( FBC )1816.7 ) K30 V RAN PEST CONTROL 840 SE 1 ST Hialeah FL 33010 Ph:305-725-4737 Fax:305-863-8675 10125 Biscayne Blvd Miami FL 33138 Address of Treatment or Lot / Block of Treatment August 24-2017 1:23pm Arquimedes Duran Date Time Applicator Bifen XTS Bifenthin 11 al Product Use Chemical Used (active ingredient) Number of'Gallons Applied 0.06% ------------- 100 If Percent Concentration Area Treated (square feet) Linear Feet Treated Horizontal Adioinina Slab Stage of treatment (Horizontal, Vertical, Adjoining Slab, retreat of disturbed area) CORPORATE SEAL Soil barrier Method of termite treatment - soil barrier, wood treatment, bait system, other As per 104.2.6 - If soil chemical barrier method for termite prevention is used, final exterior treatment shall be completed prior to final building approval. The building has received a complete treatment for the protection of subterranean termites. Treatment is in accordance with rules and laws established by the Florida Department of Agriculture and Consumer Services If this notice is fi exterior treatment, initial and date this line j, August 24-2017 Authorized ature ' spy DIVISION OF `� Environmental Health Florida Health An% kMiami-Dade County r� OSTDS/Well Division11805 SW 26thStreet • Miami, FL 33175 I`Onspector��� �� Date 3.2 •/7 Address �O/,2f � OSTDS # A/ o ?73� Comments: Signature c .... SOUTH FLORIDA S.G. & ENGINEERING STRUCTURAL, GEOTECHNICAL & ENVIRONMENTAL ENGINEERING Testing Laboratory Certificate Number 04-0329.02 8060 West 231" Avenue Suite 97 Hialeah Florida 33016 Telephone: (305) 826-3855. Fax: (305) 826-8545 Field Density Test of Compacted Soils Client I Date: 06/20/2017 Address 10125 Biscayne Blvd, Miami Shores, FL 33138 1 Order# 017-0003 Project Slab Contractor Description I Fine sand with some fragment rock, time sand Location Test #1 south side Lab# D-10702 R Location Test #2 south center Lab# D-10703 R Location Test #3 north west side Lab# D-10704 R Location Test #4 north east side Lab# D-10705 R Location Lab# Location Lab# Test Results of Field Densities ASTM method: D-2922-81 Description of Test Area I Density Test Slab; 10125 Biscayne Blvd, Miami Shores, FL 33138 Lab No. D-10702 D-10703 D-10704 D-10705 Test No. 02 03 04 05 Depth in inches 12" 12" 12" 12" Field Density (lbs/Cft.) 109.7 109.7 110.1 109.8 Moisture Contents % 8.9 8.5 9.6 9.2 Maximum Density % (in the field) 96.0 96.0 96.3 96.1 Reg. Compaction by jobspecs 95% 95% 95% 95% 100% Max. Density Proctor 114.3 114.3 114.3 114.3 Proctor No. P-216 P-216 P-216 P-216 Optimum Moisture % 18.9 Remarks: 1) All the above tests comply with the jobspecifications. Checked By I J.Ch. Report B J T Respect y Submitted By, South Florida ring Ar, &igar, P: E ; Florida Registration Nu.-iber:38863 Seal: 4 DATE: CLIENT: SOUTH FLORIDA S.G. & ENGINEERING STRUCTURAL, GEOTECHNICAL & ENVIRONMENTAL ENGINEERING Testing Laboratory Certificate Number 04-0329.02 8060 West 231d Avenue Suite #7 Hialeah Florida 33016 Telephone: (305) 826-3855. Fax: (305) 826-8545 06/20/2017 PROCTOR COMPACTION TEST PROJECT: Slab - ADDRESS: 10125 Biscayne Blvd, Miami Shores, FL 33138 SAMLPED BY: J.T. TESTED BY: J.Ch. TEST RESULTS Sample Number-1 The following compaction test was conducted in accordance with the Standard Methods for Moisture Density Relations of soil using a 10 lb. Hammer and 18" drop AASHTO designation T-180-C. % MOISTURE DRY DENSITY lb/scft 5.6 108.5 8.9 114.3 11.3 109.7 116 114 Optimum Moisture 8.9 Percent 100% Maximum Dry Density 114.3 lbs./cu.ft. 112 110 108 106 % MOISTURE 4 6 8 10 12 14 16 18 Respectful# Submitted By, South Flori veering Ars d V qar, 1P .E- , Florida Registration Number:38863- SEAL: D R Y D E N S I T Y 3401 NW 82nd Ave. Suite 370 Doral, FL. 33122Eastern (305) 599-8133 Engineering Group ime www..easterneg.com Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores, FL 33138 Re: Permit # RC-3-16-634 Folio #: 11-3205-019-0190 Attn: Building Department, I Raissa Lopez, PE, having performed and approved through my authorized representative the required inspections for Masonry Walls at the renovation and addition. I hereby attest to the best of my knowledge, belief and professional judgement, the structural and envelope components of the above referenced renovation are in compliance with the approved plans and other approved permit documents. I also attest that to the best of my knowledge, belief and professional judgement, the approved permit plans represent the as -built condition of the structural and envelope component of the said structure. This document is being prepared in accordance with Chapter 1 of the Florida Building Code and must be submitted to the Village of Miami Shores Building Department in conjunction with the application for a Certificate of completion for the above referenced structure. Should you have any questions or need any additional information please do not hesitate to contact me. Sincerely, Engineer in record Date: Q�::�\cENsE Signature and se No 59399 STATE OF ;''� ................. 3401 NW 82nd Ave. Eastern Suite 1370 22 Doral, FL. 33122 (305) 599-8133 Engineering Group me info@easterneg.com Shores Village Building Department 10050 NE 2nd Ave Miami Shores, FL 33138 Re: Permit # RC-3-16-634 Folio #: 11-3205-019-0190 Attn: Building Department, I Raissa Lopez, PE, having performed and approved through my authorized representative the required inspections for Pre -manufactured Wood Trusses at the renovation and addition. I hereby attest to the best of my knowledge, belief and professional judgement, the structural and envelope components of the above referenced renovation are in compliance with the approved plans and other approved permit documents. I also attest that to the best of my knowledge, belief and professional judgement, the approved permit plans represent the as -built condition of the structural and envelope component of the said structure. This document is being prepared in accordance with Chapter 1 of the Florida Building Code and must be submitted to the Village of Miami Shores Building Department in conjunction with the application for a Certificate of completion for the above referenced structure. Should you have any questions or need any additional information please do not hesitate to contact me. Sincerely, Engineer in record �F�/'f cSS A Lo �� Sp. IRf I tl/y�/// Date: 3 C \� g ................ to Signature and seal _ N 59399 cc Z STATE OF QJ 111i;S/ONA' 1E�\��\ 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: BISCAYNE 10125, LLC A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 10125 BISCAYNE BOULEVARD City State ZIP Code MIAMI SHORES Florida 33138 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lots 8 & 9, Block 176, "Revised Plat of Miami Shores Sec. 8" PB. 43-67 FOLIO: 11-3205-019-0190 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat. 25' 52' 08.24" N Long. 80° 10' 28.90" W Horizontal Datum: ❑ NAD 1927 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) 1,895 sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 9 c) Total net area of flood openings in A8.b 1,927 sq in d) Engineered flood openings? ❑ Yes Z No A9. For a building with an attached garage: a) Square footage of attached garage 540 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0 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 Village of Miami Shores - 120652 Miami -Dade Florida B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood Zone(s) B9. Base Flood Elevation(s) (Zone AO, use Base Number Date Effective/ Revised Date Flood Depth) 12086CO306 L 09/11/2009 09/11/2009 AE (EL. 8) B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9: ❑ FIS Profile 0 FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ❑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 Z 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: Novemher.30 201R 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: 10125 BISCAYNE BOULEVARD 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* 0 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 AT In Puerto Rico only, enter meters. Benchmark Utilized: MDC BM B 400 EL.= 8.28' Vertical Datum: NGVD29 Indicate elevation datum used for the elevations in items a) through h) below. 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) 9.61 © feet ❑ meters b) Top of the next higher floor 10 54 ❑x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) NSA. ❑x feet ❑ meters d) Attached garage (top of slab) 9.47 ❑x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 10 34 feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 8.0 ❑X feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 9 2 0 feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including NSA ❑x feet ❑ 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. l certify that the information on this Certificate represents my best efforts to interpret the data available. 1 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 Alfredo Diaz LS # 6903 ,T>`� _ ". • "� . Title Professional Surveyor �;•:` 0` r{ Y ys3 ' Company Name Pegasus Land Surveyors INC. •• 'u-) ; a ._ O , . CID = ere ' v° Address 801 Madrid ST # 209 ', • '. ;� "" _ ��' City State ZIP Code Coral Gables Florida 33134 Signature Date Telephone 06/06/2019 (305) 310-3942 Copy all pages of this Elev ion Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including pe of equipment and location, per C2(e), if applicable) 1- C2 e) Refers to the A/C Unit concrete Slab located on the South Side of the Building. 2- Highest Crown of Road: 8.72' 3- Latitude and Longitude obtained from Google Earth. 4- A One Story Building, with attached Garage. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 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: 10125 BISCAYNE BOULEVARD City State ZIP Code Company NAIC Number MIAMI SHORES Florida 33138 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B; and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2011,13 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: 10125 BISCAYNE BOULEVARD City State ZIP Code Company NAIC Number MIAMI SHORES Florida 33138 SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) or Zone AO. G3. ❑ The following information (Items G4—G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE Continuation Page 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: 10125 BISCAYNE BOULEVARD City State ZIP Code Company NAIC Number MIAMI SHORES Florida 33138 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. 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. r r s Photo One Photo One Caption North Side View (06/06/2019) 1, Photo Two Photo Two Caption South Side View (06/06/2019) FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEIVI/NITIPJ ,1 vEPTICI%CA`T&E_ See Insstructions for Item A6 Expiration Date: vovember 30, 2vir 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: 10125 BISCAYNE BOULEVARD City State ZIP Code I 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. Photo One I Photo One Caption Front View (06/06/2019) 1 Photo Two I Photo Two Caption Rear View (06/06/2019) FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6