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DS-10-900Inspection Number: INSP- 144019 Permit Number: DS -5 -10 -900 Scheduled Inspection Date: November 22, 2010 Inspector: Bruhn, Norman Owner: HELDSTAB, LINDA GAIL Job Address: 952 NE 91 Terrace Miami Shores, FL Project: <NONE> Contractor: RONAN CONSTRUCTION INC Building Department Comments November 19, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060030130 3' SIDEWALK ON THE SIDE OF THE HOUSE Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments OWNER PHONE# 541 - 993 -0326 LINDA HELDSTAB IF YOU HAVE ANY QUESTIONS. For Inspections please call: (305)762 -4949 Page 4 of 23 BUILDING PERMIT APPLICATION FBC 2004 Permit Type (circle): Value of Work For this Permit $ Owner's Name (Fee Simple Titleholder) Owner's Address ej 52, d J City � IQa-ti Shores b State Tenant/Lessee Name Job Address (where the work is being done) Architect/Engineer's Name (if applicable) Miami Shores Village Fp` O M E l Etil g ' MAY202010 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Roofing "441c 7a- gad 4/46. -6 9 / -- err. Zip 33 /38 Type of Work: ❑Addition ['Alteration Describe Work: Submittal Fee $ - cin Permit Fee $ Phone # q z G°' qt "firy 04- Structural Review. $ Permit No. 1) 0 `9 Master Permit No Phone # 6'41- 993- 021 City Miami Shores Vi 1 e County Miami-Dade Zip FOLIO / PARCEL # /1 °- 32,o.5 - o ® 3 - 01 ® P. 0/ 13ISCa y 1)e fide ,o6 3f-4/ E 49:s9 /at 6 Is Building Historically Designated YES NO ` G 0 dr Go t 5 6/ Contractor's Company Name /0/6?/7 • l p , e G . Phone # 3` 2 3S- 3/51 3/9641 Contractor's Address 7 0 2- Co Ste) 13s- S 7 City State ,/� Zip 6/7 Qualifier Name Or / Phone # gas !Ar 4"i:Q/ /Z -f7J9 State Certificate or Registration No. e 79 /8 e / Certificate of Competency No. E 99/$a7 Phone # Square / Linear Footage Of Work: BY: ['New 12 Repair/Replace ❑ Demolition CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Total Fee Now Due $ See Reverse side - 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 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 Signature Signature eat aLLibiZTA Owner or Agent fir" C3 The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me day of , 20 , by (o.(_L day of \- ' , 20 t by 1111111 1 ' who is personally known to me or who has who is personally known to me or who has produced As identification hd kto F `�"�' as identification and who did take an oath. 03 /i �I lllnnllfrrrr� NOTARY PUBLIC: 'p , % 12 _ NOTARY PUBLIC: ��` d Q I ?i p 2`y % v , : Com miss ion c ` • ' `�/ `� ' , Sign: i : J. ' . DD785 Sign: , j O : r Print _� �'�, ' � .e` Print: s m 4 /y b / /IN 111111 ▪ 7 •.,' 4 0 �, My Commission Expir My Commission Expires :• o •� li 4i4 ** *gym * * * * * * * ** ��'I /lflllllllll" APPLICATION APPROVED BY: (Revised 07/10/07) Plans Examiner Engineer Zoning PERMIT #: IS/cJ' DATE: J — A 3 I, ;14.1. `'7 d ❑ Contractor Owner ❑ Architect Picked up 2 sets of plans and (other) Tc Address:f. /, From the building department on this date in order to have corrections done to plans And /or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged by: G /4 PERMIT CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAL: RECEIPT R1 10 M iami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 FROM Accurate . 4C PRODUCER Accurate 8300 West Flagler Suite 114 Miami, FL 33144 Phone (305)22E-8727 INSURED Ronan Construction Corp 10260 SW 135th Street Miami, FL 33176- 305 COVERAGES A 0 GARAGE LIABILITY U ❑ ANY AUTO ❑ GENERAL LIABILITY ® COMMERCIAL GENERAL LIABILITY 00 CLAIMS MADE ❑ OCCUR 0 ❑ _ GENL AGGREGATE LIMIT APPLIES PER ❑ POLICY (l PROJECT ❑ LOC AUTOMOBILE LIABILITY o ANY AUTO U ALL OWNED AUTOS ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON OWNED AUTOS 0 0 EXCESS / UMRRELLA LIABILITY U OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE YM OFFICER / MEMBER EXCLUDED? (Mendatory de9G u nn G er S 'ECIAL PROVISIONS below • OTHER CERTIFICATE HOLDER Miami Shore Village 10050 NE 2 Ave Miami Shore, Fl 33138 305 -750 -8972 ACORD 25 (2009/01) QF (THU)MAY 20 2010 9:29/ST. 9: 28/No.7500000078 P 1 L.tK1 DIVA 1t Ur LUAUILIIT INSURANCE I YAIt t MMAA!!T T ) 05/20/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR _ . ALTER THE COVERAGE AFFORDED By POLICIES BELOW. Fax (305)220 -8787 INSURERS AFFORDING COVERAGE NAIL # INSURER A: LLOYD'S LONDON INSURER B: INSURER C: INSURER DI INSURER E THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT W ffH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED OVINE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WAIT ADDT POLICY EFFECTIVE PPUGY EXPIRATION TR INSROI TYPE OF INSURANCE POLICY NUMBER DALE , , n DATE D UMITS EACH OCCURRENCE 500,000 ARTE021503 05/01/2010 05/01/2011 REMI E aa oca Hence) 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEH CLE$ / EXCLUSIONS ADDED BY ENDORSEMENT) SPECIAL PROVISIONS CANCELLATION AUTHORIZED REPRESENTATIVE LUCIA ESTRELLA MED EXP (Any one Person) 5,000 PERSONAL S ADV INJURY 500,000 GENERAL AGGREGATE 1,000,000 PRODUCTS - COMP /OP AGG 500,000 COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accldeng PROPERTY DAMAGE (Peracckient} AUTO ONLY - EA ACCIDENT I OTHER THAN AUTO ONLY: EA ACC AGG EACH OCCURRENCE AGGREGATE ❑ t STATU• ❑ OTH- ER E.L, EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE • POLICY IJMIT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 80 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, 1988 •2009 ACORD CORPORATION, All rights reserved, The ACORD name and logo are registered marks of ACORD • .e ,l'Z ' S 0 LIB...1E0T 10 C( :A/IPLIANCE ANL'. EGTOS Company name: RONAN CONSTRUCTION INC. Owner: Reba Contact name: Roger Ricardo 952 NE 91 Terr. Address: 10260 SW 135 ST Miami Sho 14 3 38 Miami, FL 33176 4 +r • ,Contact Number:305-235-3154 ,t :. 11■13"12AVd 11VHdSV ,OZ AM 2 1 2016 01