RCRT-10-941Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING Permit No. R. T 10'141
PERMIT APPLICATION Master Permit No.
FBC20
Permit Type: BUILDING 1!..91 OF G
Owner's Name (Fee Simple Titleholder) ACIVDAT ",VVW)C,
Owner's Address
City State Zip
Tenant/Lessee Name
Email
Phone #
Joh Address (where the work is being done) ION 0 1.1E, 2_ AV
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL # 11/1 .x o O /� i 13 O S 1
Is Building Historically Designated YES NO
Zip
Flood Zone
Contractor's Company Name Phone #
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Contact Phone E -mail
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ Square / Linear Footage Of Work: [ I1 ?01
Type of Work: DAddition ❑Alteration ❑New 0 Repair/Replace ❑ Demolition
Describe Work:
)1() f" cq, )0r)
* * * * * * * * * * * * * * * ** * * * * * * * * ** * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ CCF $ CO /CC $
Notary $
Scanning $ Radon $
Double Fee $
Training/Education Fee $
Technology Fee $
DPBR $ Bond $
Violation date:
Structural Review. $ Total Fee Now Due $
See Reverse side -*
I _
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIJ IAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws re ating 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certed copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 120 _, by day of , 20 _, by
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLIC:
Sign: Sign:
Print: Print:
My Commission Expires: My Commission Expires:
************** * * * * * * * * * * * * * * * * * * *'� * * * * * * * **
APPROVED BY / ** J } d
* * * *
Plans Examiner
Zoning
Engineer Clerk checked
(Revised 07 /10 /07XRevi$ed 06/10/2009)
7009 1410 0000 7000 9767
U.S. Postal'Seree_
CERTIFIED IV1AIL. RECEIPT
(Domestic Mail Only; No Insurance Coverage Provided)
For delivery information visit our website at www.usps.come
F
A
us
Postage
Certified Fee
Return Receipt Fee
(Endorsement Required)
Restricted Delivery Fee
(Endorsement Required)
Total Postage & Fees
Postmark
Here
PSFOrm 3800, August 2006 See Reverse for Instructions.
ENDER: - COMPLETE THI SE TI ®N'
• Complete Items 1, 2, and 3. Also complete
Item 4 if Restricted Delivery is desired.
• Print your name and address on the reverse
so that we can retum the card to you.
• Attach this card to the back of the maiipiece,
or on the front if space permits.
1. Article Addressed to:
cJlnuYC,ln
»310 fe-- 2lV
A\ gAeKB, TI 3313
COMPLETE THIS SECTION ON DELIVERY
B. Received by (PZ Name)
Agent
0 Addressee
Cb/3of peli,e►y
/r��
Yes
0 No
D. Is delivery address different from item 1?
If YES, enter delivery address below:
3. Service 1j'pe
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0 Registered
0 Insured Mail
0 Express Mall
0 Return Receipt for Merchandise
0 C.O.D.
4. Restricted Delivery? (Extra Fee)
2. Article Number
(Transfer from service labee
7009 1410 0000 7000 9767
0 Yes
PS Form 3811, February 2004
Domestic Return Receipt 102595-02-M -1540
UNITED STATES POSTAL SERVICE
0 11 I
First -Class Mail
Postage & Fees Paid
LISPS
Permit No. G -10
• Sender. Please print your name, address, and ZIP +4 in this box •
,0111AfAI SHORES VILLAGE'
10050 N. E. 2nd AVE.
MIAMI SNORES. R.A. 33138
111J1111111111111:
t11111t11111111111 1$411111It1Ji11111 111
MIAMI SHORES VILLAGE
Building Department
10050 NE 2 Ave, Miami Shores Fl, 33138
Tel: 305- 795 -2204- Fax: 305- 756 -8972
5/28/2010
Certified Mail # 7009 1410 0000 7000 9767
Property located at: Address: 10390 NE 2 Avenue
Miami Shores, Florida, 33138-
Permit Number: RCRT -5 -10 -941
Folio #
Notice of Required Inspection/Certification
Dear Owner:
The Village has been notified by Metro -Dade Building & Zoning Department that the above
referenced property has a building or structure that is forty (40) years old or older. In
accordance with Miami -Dade County Chapter 8 Section 8 -11, the subject property must be
inspected by a Florida Registered Architect or Engineer and a report furnished to this office.
A report and a fee of two- hundred fifty dollars must be submitted to this office within ninety (90)
days of receiving this Notice of Required Inspection/Certification.
If you would like a copy of Minimum Inspection Procedural Guidelines for Structural and
Electrical Recertification, or if you have any questions, please call my office at 305- 795 -2204.
Sincerely,
Norman Bruhn, Building Official
305- 795 -2204
'ow
May 10, 2011.
VITP 771 7-77)■
LOI
'01(7. .. ... .... . .....
tryarEactric, Inc
1958 NE 151 St
North Miami Fl. 33162
Tel: 305-949-6166 Fax: 305-949-6266
Email: femando@royalelectriconline.com
State Licensed 0001719
BUILDING & NEIGHBORHOOD COMPLIANCE DEPARTMENT
MINIMUM INSPECTION PROCEDURAL GUIDELINES
FOR BUILDING ELECTRICAL RECERTIFICATION
INSPECTION COMMENCED
INSPECTION COMPLETED
Date: CH( TITLE:
INSPECTION MADE BY ri
SIGNATURE:
PRINT NAME: e , . • Ortiz
13-exicleetr
ando Ortiz Date:
ADDRESS: ifgz Ade 1S-7 St L'/fl/if
1. DESCRIPTION OF STRUCTURE
a. Name on Title: ADVENT LUTHERANT CHURCH OF MIAMI SHORES
b. Street Address: 10390 NE 2nd AVE, MIAMI SHORES 33138-2055
c. Legal Description: MIAMI SHORES SEC 5 PB 10-47 LOTS 1 THRU 6 & LOT 23 BLK 122 LOT SIZE
IRREGULAR
d. Owner's Name: ADVENT LUTHERAN CH OF MIA SHORES
-. Owner's Mailing Address:
Additional Comments:
TYPES OF WIRING METHODS:
Conduit Raceways: Good (X )Repairs Required
FEEDER CONDUCTORS:
Comments:
Good (X) Repairs Required
N/A
EMERGENCY LIGHTING:
Comments:
Good (X) Repairs Required
The existing fixtures are in working condition.
BUILDING EGRESS ILLUMINATION:
Good (X) Repairs Required
Comments:
Existing ones in working condition
Additional Comments:
FIRE ALARM SYSTEM:
Good (X) Repairs Required
Comments:
Existing ones in working conditions.
EXIT LIGHTS:
Good (X) Repairs Required
Comments:
Existing ones in working condition.
EMERGENCY GENERATOR:
Good
Comments:
N/A
Additional Comments:
( )
Repairs Required
GROUNDING SERVICE:
Good (X) Repairs Required
Comments:
N/A
GROUNDING OF EQUIPMENT:
Good (X) Repairs Required
Comments:
N/A
SERVICE CONDUITS/RACEWAYS:
Good (X) Repairs Required
Comments:
N/A
SERVICE CONDUCTOR AND CABLES:
Good (X) Repairs Required
Comments:
N/A
Additional Comments:
GUIDELINES AND INFORMATION FOR RECERTIFICATION OF ELECTRICAL
SYSTEMS OF FORTY (40) YEAR STRUCTURES
2. ELECTRIC SERVICE
1. Size: Amperage (600 Amps) Fuses
2. Phase: Three Phase ( YES )Single Phase
3. Condition: Good (X) Fair (
Comments:
N/A
L
(
) Breakers
) Needs Repair
METER AND ELECTRIC ROOM
1. Clearances: Good (X) Fair ( ) Requires Correction (
Comments:
N/A
GUTTERS
Location:
Comments:
N/A
Additional Comments:
Good (X) Requires Repair (
ELECTRICAL PANELS
Location: Good (X) Needs Repair
1. Panel
Good (X) Needs Repair
2. Panel
Good (X) Needs Repair
Comments:
N/A
BRANCH CIRCUITS:
1. Identified: Yes (X) Must be identified (
2. Conductors: Good (X) Deteriorated ( ) Must be replaced (
Comments:
N/A
Additional Comments:
WIRING IN OPEN OR UNDER COVER PARKING GARAGE AREAS:
Require Additional
Good ( )
Comments:
N/A
L
Illumination
OPEN OR UNDERCOVER PARKING GARAGE AREAS AND EGRESS ILLUMINATION:
Require Additional
Good ( ) Illumination
Comments:
N/A
SWIMMING POOL WIRING:
Good
Comments:
N/A
Repairs Required
WIRING TO MECHANICAL EQUIPMENT:
Good (X) Repairs Required
Comments:
N/A
Additional Comments:
f. Folio Number of Property on which Building is Located: 11 21360130751
.. Building Code Occupancy Classification: 0044 RELIGIOUS
Present Use: RELIGIOUS
General Description, Type of Construction, Size, Number of Stories, and Special Features
Church Building, Masonry, 11,807 square foots, two stories, no special features.
Additional Comments:
ADDITIONAL COMMENTS:
No Additional Comments
Sincerely,
ROYAL ELECAA, , INC.
_■0110111400.
Ferran. iz, President
Additional Comments:
INSPECTI
Date:
BUILDING & NEIGHBORHOOD
COMPLIANCE DEPARTMENT
MINIMUM INSPECTION PROCEDURAL GUIDELINES
FOR BUILDING STRUCTURAL RECERTIFICATION
OMMENCED
07/
OMPLETED
1/
INSPE
Date:
1. DESCRIPTION OF STRUCTURE
idUrn pLailigkon C-24' 42 Ala 540
a. Name on Title:
,74
SIGNATURE: 7 ) fric,,
INSPECTION MADE
TITLE: /4.-44imuArai.
PRINT N
ADDRESS: 4/6j) 51 /111E,
5
b. Street Address: 1050 0 1116 z- Ave. /*DM koke5i 5 3 5
c. Legal Description: /4/tork.,<>/40A5 SE-c vy.,3 10-47 /171444., IL;
Jo.t ,c)fzi ai_A Ire LOT ulc4ri ,
d. Owner's Name: Adv6p1i 4L Aekaii C'Al 0 AOL 4vit-Q5.
e. Owner's Mailing Address: /C:36-0 4) C. Z" Ale AtlIoYfl4 .
f. Folio Number of Property on which Building is Located:
g. Building Code Occupancy Classification: e7ais4 ROI
h. Present Use: Ps elic,iou5
i. General Description, Type of Construction, Size, Number of Stories, and Special Features Additional
Comments:
MoSeiel 00m)-buithbv) oihivoyirnoc(eij lev006esq.? 00E_ S
Additions to original structure:
iUo
2. PRESENT CONDITION OF STRUCTURE
a General ali nmeif/2(34S
tt (not good, fair' poor, explain if significant)
( g 1 I, p p tf ignificant)
1. Bulging Kit)* rj � lE
2. Settlement ,101:1L
3. Defections �`�■e,65 Cr)
4. Expansion
5. Contraction 0-ik,
b. Portion showing distress (Note, beams, columns, structural walls, floors, roofs, other)
cir1i/LE.s a
c. Surface conditions _describe general conditions of finishes, noting cracking, spalling, peeling,
signs of moisture penetration & stains.
// �� �/ ,r
Sic � Pol-
/5. es erg J , 006 20 qC.` (1 1 o+/j
d. Cracks _note location in significant members. Identify crack size as HAIRLINE if barely discernible;
FINE if Tess than I mm in width: MEDIUM if between 1 and 2 mm in width; WIDE if over 2 mm.
!SIbi
e. General extent of deterioration _cracking or spalling of concrete or masonry; oxidation of metals; rot or
borer attack in wood.
uut kit. t' a OA-S. 01, 50 0 0 i1C iTc0 ' hp vt Sr Ibi , C't tC%tvi „
J) ?a iI h ,
Ok- ok►`dq -kf n o-' m --Lois.
1. Previous patching or repairs rok,7+O \
g. Nature of present loading indicate residential, commercial, other estimate magnitude.
Ae 11 otk5
3. INSPECTIONS
a. Date of notice of required inspection
b. Date(s) of actual inspection +O5/ dab
c. Name and qualifications of individual submitting inspection report:
, "
e
1,:-5105f?
d. Description of any laboratory or other formal testing, if required, rather than manual or visual
procedures
• Structural repair -note appropriate line:
None require
2. Required (describe and indicate acceptance)
4. SUPPORTING DATA
a. sheet written data
ti
5. MASONRY BEARING WALL = Indicate good, fair, poor on appropriate lines:
a. Concrete masonry units ejOVL�
b. Clay tile or terra cota units
c. Reinforced concrete tie columns VOA-
-1. Reinforced concrete tie beams
e. Lintel 4)OCC
f. Other type bond beams �0 G
g. Masonry finishes .exterior
1. Stucco CIOC?
2. Veneer ckii; r✓
,,
3. Paint only '7ova.
4. Other(descri be)
h. Masonry finishes .interior
1. Vapor barrier
2. Purring and plaster
3. Paneling
4. Paint only e),.01 a
5. Other (describe)
Cracks: I n
1. Location _note beams, columns, other
2. Description
Spalling: 1) 0 I`t 5 4
1. Location .note beams, columns, other
2. Description
k. Rebar corrosion -check appropriate line:
Iced
None visible,
2. Minor - patching will suffice
3. Significant -but patching will suffice
I. Samples chipped out for examination in spall areas:
2. Yes .describe color, texture, aggregate, general quality
6. FLOOR AND ROOF SYSTEM
a. Roof:
1. Describe (flat, slope, type roofing, type roof deck, condition.
.3) ioof2 o/ ea/ coec' andi cuvj .
2. Note water tanks, cooling towers, air conditioning equipment, signs, other heavy equipment and
condition of support:
ME..-7ke S nO .9 /1-.)5-41 fig d . j? /WD,
3. Note types of drains and scuppers and condition:
11)/A.
b. Floor system(s)
1. Describe (type of system framing, material, spans, condition)
Carke '(e Poo& #04_,5 /11 oo (.-' idirt 01A
-. Inspection _note exposed areas available for inspection, and where it was found necessary to open
ceilings, etc. for inspection of typical framing members.
/1111th Woi-Q- ava(r (o1 145 h cf °'li
7. STEEL FRAMING SYSTEM
/UPI-
-. Description
b. Exposed Steel .describe condition of paint & degree of corrosion:
Non
c. Concrete or other fireproofing _note any cracking or spalling, and note where any covering was
removed for inspection
d.Elevator sheave beams & connections, and machine floor beams _note condition:
8. CONCRETE FRAMING SYSTEM
Full description of structural system
(l so /1 fJ 2 4E4'01(4 5kq'
b. Cracking
- 1. Not significant
2. Location and description of members affected and type cracking
General condition
uA5 jl? ()0d 03n di llo1/1
Rebar corrosion .check appropriate line:
1. None visible
2. Location and description of members affected and type cracking
3. Significant but patching will suffice
9. WINDOWS
a. Type (Wood, steel, aluminum, jalousie, single hung, double hung, casement, awning, pivoted, fixed,
other), 1Lt. tni IN • OJ3€ vvW Ytt Q' t Q d
b. Anchorage _type & condition of fasteners and latches:
ash nFft
0110„ jQ +cl s 0#0,0k, ivy 50Dd Lvvd t(•0 !A
c. Sealant _type of condition of perimeter sealant & at mullions:
i/i t 1;`) .
d. Interiors seals _type & condition at operable vents:
CLllu. (�C� Cit 14-5v4
e. General condition: "---44---a
10. WOOD FRAMING
a. Type _fully describe if mill construction, Tight construction, major span
b. Note metal fitting i.e., angles, plates, bolts, split pintles, pintles, other, a
OY lc l q'(C'S YtCi 1< .l axe. l vx ' - (\AL -i 1(6A -
c. Joints _noter if ellitt d and still cFosea:
Qk_ (Veil : (4@t Wad 4lc .
d. Drainage _note accumula'f ons of moisture:-
Uo (We. co Ng U la Lditi /L{ OtSW 1,045 )0 uvt. cl
e. Ventilation —note any concealed spaces not ventilated:
f. Note any concealed spaces opened for inspe tion:
0,11 5racE5 1)0*( 4 Q avoa !col: , )OL i spec 4/ of
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ondition: