PL-19-7482C, -1 53 2
ELPIDIO MOREJON INC.
933 nw 134 place Miami FI 33182
Date: �.b:p I `1
State of... (tt2it AC
.......................
County of... t>-P6.........................
Before me this day personally
appeared,Ve.1.13t..... who being Duly sworn.
That he or she Will be the only person working on
the project aal/lii�cate at: ®A�' cc
35
N la"i SHORe5
contract s0patwre.
Sworn to (or affirmed) and subscribed
before me this.. Z ...Day
of....... ........... 20. ......
By........................................... 1
Personally know .... V ......................
OR Produces identification .................
MY C10AIISSION# GG 007879
PPO- JY& 4, 2020 -
................................
t, Type or stamp name OF Notary
Notice to Owner — Workers' Corn
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
nsation Insurance Exemation
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. i
Signature:
State of F14
County of Miami -Dade
The foregoing was acknowledge before me this day of 20�.
BytGQs6C, &C.C) C�)Ck tl _ C3, who is personally known to me or has produced
as identification.
Not
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Miami Shores Villa e
�� gBuilding Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 11
BUILDING Master Permit No. — k — 1(9- 3s; 32-
PERMIT APPLICATION Sub Permit No. L- O4--l-6 -74S
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
16PLUMBING ❑ MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: �® % ILO'r-1
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO _
AOt Occupancy Type: 4 oad: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titlehold
Address: 1,061 --3-1'3 AT,
City: / AAA. �GID (2�� State:� � Zip: /
T
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company
P Y Name:
G- —
Address:
City: State:�� Zip: leD
Qualifier Name: /j,IMD r e- C O''Z Phone#:
State Certification or Regi�tration #: d Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: �Y�L��1�c1� City: t State/ Zips
Value of Work for this Permit: $ 7,7 TO Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New [Repair/Replace ❑ Demolition
Description of Work:�j'lli��,/��n�PvlfP
•I1, ]H� U,! a `qs ri £ e. •ia!,i:�{?lY��`.',�. }'..3. ,'y( .•9Y �?,
Specify color of color thru tile:
1 i 1.. ••
Submittal Fee $ C Q Cl Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
DBPR $
Notary
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
Zip
4
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 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 aleinspection fee will be charged.
Sign
AGENT
The foregoing instrumen was Icknowledged before me this
day of /'� 20� by
� Y01,In �,)(CWlyj o y , who is personally known to
me or who has produced
as
Signature ff
CONTRACTOR
The foregoing instrurqVt was acknowledged before me this
to day of 20 , by
ELPs h /tiiAw('owho is personally known to
me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
I I I
Sign: Sign:
Print: 1 I l Print:
�ytv rv, KRIS Notary Milk State of Florida
Seal: �.•••'a COMMI SioO#CiG#l�4f74 Seal: Jett*Rorsseaa'
t * octbv 30,20 '^� My Comotission GG 191 I
'?� ��alt3` ThroEM,�ttlouryS+r�� :` Expires05/04/2022
APPROVED BY y / 111i9 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
r
FRONTIER
ENGINEERING I DEVELOPMENT
CITY OF MIAMI SHORES BUILDING DEPARTMENT
10050 NE 2nd Avenue
Miami Shores, FL 33138
Phone: 305-795-2204
:0*0:0
RE: GAVIRIA SFR Remodeling/Alterations •
10635 NE 10 Court •••••• •'•'•'
Miami Shores, FL 33138 "•"' •
*Goo ..
Our Project No: 18-1103 ' ' .... ...
.
. .
Violation Case No: NOV- 10-16-3245 •••••• "'.. ..
00Movember 200*018 ••••
•
. . . . 00000:
AS -BUILT CERTIFICATE :••••9
.. . ..
. .
This letter is prepared to provide the as -built conditions at the bathrooms scope area of the above
referenced project. A representative from our office performed visual inspections on November 03 and
November 12, 2018. The area of the inspection was at the interior of two bathrooms that is currently
under construction, a part of which are concealed and not easily visible. The areas that were opened
for the purposes of this inspection are left open for city inspectors to also view. The items inspected
are the interior partition walls, the ceiling and wall board materials including drywall repairs. The items
inspected are classified under the current FBC 2017, 6th Edition since the construction shall be
completed and be inspected in the most part by city inspectors.
Items Constructed Identified
a) Interior non -load bearing partitions framing and GWB:
i) The interior partition walls are existing and built using S.Y. pine No 2 wood framing 2x4
spaced at 16" o/c. An opening in the partition walls was made revealing the stud width,
spacing and the north wall exterior side of bath #2 and at the west wall at the exterior side
of the wall located inside the closet of the master bath. No new partitions are built. At the
master bath, an existing closet door set was removed where the toilet is now located
increasing the overall area of the bathroom.
ii) The new wall board material inside the bathrooms in both locations found to be %" Durock
The wall board was cut and revealed the thickness. The #8 drywall screw pattern was spot
checked with metal stud finder and revealed to be spaced at 8" o/c along perimeter and 12"
in field.
h) Interior wall finish at shower and wet walls and bathroom floor:
i) The shower stalls irate: for is finished in wa;l the E3 the ceiling. The ceiling is also finished in
tile.
ii) The wall board behind the wall tile is found to be %" Durock. The Durock material is now
visible as the ceiling tile is in -progress. The Durock board is attached to existing ceiling
furring at 16" o/c along the roof trusses. The exterior wall wood furring is existing. The
FRONTIER ENGINEERING DEVELOPMENT, LLC.
FL C.A. No: 30629 • LBB042
P.O. Box 222023, HOLLYWOOD, FL 33022 f
OFFICE (954) 678-2030 • FAx (954) 678-2032 �62
FRONTIER
ENGINEERING I DEVELOPMENT
interior wall finish at the bathroom wet walls (toilet and sink) also %" Durock. The wall base
is the same as the floor tile.
......
c) The interior doors slabs at both bathrooms, bedroom and closets are.-pplpced including the
trim with door jambs appearing to be existing and existing opening size9.• • • • • ......
d) Bathroom Shower Enclosure: """ ' •
i) The shower is now open and is to have a frame -less glass enclosfij;:pllth 3f8"$IlAss and...
metal hardware connectors to walls and bottom curb. The shower-cigoris foLmd;(.be 256'•••
wide. The top of the enclosure is found to be 72" in height. This fem'shall be built after*::*
permit issuance. ••••••
e) The bathroom vanity and sink unit are installed at loc. Indicated on plan:. ••� 9*000 :....:
f) The toilet unit is installed at loc. Indicated on plans. •
g) Electrical Items:
i) The interior electric wiring is found to be Romex. All electrical wiring is found to be
matching gauge and type of existing wiring that is extended. All boxes shall be open and
visible at all receptacles, switches and light fixture locations for normal rough inspection.
ii) The electrical boxes at the partition walls are found to be plastic full depth.
iii) The electrical panel is existing and not part of this permit scope
iv) The Plumbing Water lines are inspected via the openings at the ceilings, the wall openings
at the shower faucet locations and vanity interior lines exposed.
v) The Cold Water and Hot Water lines CPVC having sizes indicated on the plumbing water
plan with shut-off valve found all fixtures.
vi) The sanitary plumbing lines all concealed at this time. A camera inspection at the time of
rough inspection will be required. No certification is made of the sanitary lines under the
slab.
To the best of our knowledge the above details are found to meet the requirements of the FBC 2017,
6th Edition for interior residential living area. I hereby attest that to the best of my knowledge and
professional judgment the playroom area at the above referenced project shall satisfy the stated code
requirements following the completion of the items indicated. If you should have any additional
concerns, please contact our office at your earliest convenience.
Respe tfully S bmitted,
A I
41 Ww
Fran isco A. Aguirre, P.E.
FL. Reg. No: 35457
FRONTIER ENGINEERING DEVELOPMENT, LLC.
FL C.A. No: 30629 - LB8042
P.O. BOX 222023, HOLLYWOOD, FL 33022
OFFICE (954) 678-2030 • FAX (954) 678-2032
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