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DS-10-2148t Scheduled Inspection Date: December 29, 2010 Inspector: Bruhn, Norman Owner: KUTCHER, GARY Job Address: 386 NE 92 Street Miami Shores, FL Project: <NONE> Contractor: US WRECKING & LAND CLEARING INC Building Department Comments December 28, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 153967 Permit Number: DS -12 -10 -2148 For Inspections please call: (305)762 -4949 Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060136420 Phone: (305)757 -5557 REPLACE REAR DRIVEWAY AND PATIO WITH STAMP CONCRETE Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 4 of 10 BUILDING PERMIT APPLICATION FBC 20 City: v0-44 "r-F .r' Value of Work for this Permit: $ V7V Type of Work: Address ❑Alteration /� Description of Work: U — £ O�L n /� c Miami 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 COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by: 7 Master Permit No. Permit No.D5 l0'2-1 v Permit Type: BUILDING OWNER: Name (Fee Simple Titleholder): 6 ;1 ,4 Y �� �° { �' r� K Phone #: 3°Y " 6 g� er Address: 349,6 eti F ® s 7 State: Zip: 3 3 ( eF Tenant/Lessee Name: "`" Phone #: 7 0 5 - 7: - g Email: &' k v C € ( 19- G+ 0 -p = (Y f- JOB ADDRESS: • ,R6 e ?2 74-1 S City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: /7. 3 2 ©6 - 013 6 Y z Gl Is the Building Historically Designated: Yes NO k Flood Zone: CONTRACTOR: Company Name: 62S Est. £ C 6 e (cam r f /hone #: 3 0 F6 Address: / 9 e / 57 P ° /L" E 9 3 City: / 464-(4 ( 5 emu": €S State: r Zip: 3 3 ( Qualifier Name: (7" ( / r--1 F -? Phone #: �,r S�6 Fs r ° State Certification or Registration #: C 7 C ° 3 2 7 2 a Certificate of Competency #: Contact Phone #:3 S ?C - )77° Email Address: DESIGNER: Architect/Engineer: v `"" ° ✓`� Phone #: 2C (F (3) Square/Linear Footage of Work: -fir X ( , -11 l 's X ❑New epair/Replace ❑Demolition /LE q it • Da( vF!uwo1 / l� d'{ S"f'A.•..i? C CA-E +10- tA. 0 ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * *** * * * * * * * * * * * * * * * * ** Submittal Fee $ 5 � ,� Permit Fee $ /5e7 O CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address �� City State Zip Mortgage Lender's Name (if applicable) / 1 Mortgage Lender's Address City State Zip Signature NOTARY PUBLIC: Sign: Print: My Commission Expires: (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10) 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. ner or Agent The foregoing instrument was acknowledged before me this day of , 20 10 by 131 1C*1 i who is personally known to me or who has produced ( (� As identification and who did take an oath. utuion ill .ova. sk very s 1 �,��°% Sign: Print: Signature Contra r The foregoing instrument was acknowledged before me this 30 day of /U ✓ ,20 ,by M/ '2( CO 41 f who is personally known to me or who has produced Cc 0.7 as identification and who did take an oath. NOTARY PUBLIC: My Commission Expires: ',// S TA T E CAF o ```'` „� 'r/ rrrrrrrrr$�ti��` � ° � \` •'' C ��1 APPROVED BY `,�: -Y� V '« Plans Examiner �7: / /0 " Toning ��� Structural Review Clerk ACC laQ, CERTIFICATE OF LIABILITY INSURANCE PRODUCER DIXIE SPECIALTY RISK 4290 10th Ave N *102 Lake Worth, FL 33461 -2304 (561) 968 --6026 INSURED COVERAGES cERTIF1CAYE HOLDER ACORD25(2a0v08) U.S. Wrecking & Land Clearing, Inc. 9999 NE 2nd Ave., Suite 313 Miami Shores, FL 33138 Village of Miami Shores Building Department 10050 N.E. 2nd Avenue Miami Shores, F1. 33138 Fax: 305- 756 -8972 L00 /LOOII DATE(MMIDD,r YY) 11/30/2010 THIS CERTIFICATE 1S 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 ST THE POLICIES BELOW, INSURERS AFFORDING COVERAGE INSURERA: Colony INSURER e: GMAC /Integon INSURER C: INSURER D: INSURER e CANCELLATION ISId AllVI33dS 3IXI0 RIZED REPREBENTA NAIL# THE POLICIES OF INSURANCE LISTED BELOW RAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PoUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDInON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE 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. LTR ° • • , :f is _ . - POLICY NUMBER A B POLI 6 02/09/10 07/13/10 IVE GENERAL LABILITY X COMMERCIAL GENERAL LIABILITY 1 CLAIMS MADE © OCCUR GENT. AGGREGATE LIMIT APPLIES PERI G 7 POLICY I I 78i: P LOC AUTOMOBILE LIABILITY ANYAUTD ALL OWNED AUTOS —X— SCHEDULED AUTOS X HIRED AUTOS X NON -OWNED AUTOS GARAGE LIABILITY ANYAUTO EXCESS/UMBRELLA LIABILITY OCCUR El CLAIMS MADE DEQV TIBLE RETENTION $ WORIKR3COMPENSATIONAND EMPLOYERS' LIABILITY ANY FROPRISTOWPARTmaExEcurivE oPPICIPMSI 5$R eXCLUnlo, BPE? IA PROVISIONS below OTHER GL3783841 FLC1566139 -17 • • v' L aiu i•4u� PO Y EXPIRA 02/09/11 01/13/11 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES! EXCLU SIONS ADDED EYENDORSEMENT / SPECIAL PROVISIONS Demolition & Land Clearing EACH OCCURRENCE DAMAGt - fJ IAN l rU PREMISES (Ea oaurenr e) MED MCP (Any Ono person) LIMITS PERSONAL ADV INJURY GENERAL AGGREGATE PRODUCTS • COMP/OP AOG COMBINED SINGLE LIMIT BODILY parso INJURY BODILY INJURY (P."ecld ne) PROPERTY DAMAGE (PeramISMl) AUTO ONLY. EAACCIDENT OTHER THAN AUTOONLY: EAACC AGO EACH OCCURRENCE AGGREGATE E.L DISEASE - EA EMPLOYEE a 1,000,000 1 50,000 5,000 s 1,000,000 S 2,000,000 s 1,000,000 s$1,000,000 $ $ 5 a 5 5 $ 5 $ TORY Pit EL EACH ACCIDENT 5 $ S EL DISEASE - POLICY LIMIT 5 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR RE ESENTATNES. ®AZORD 7958 8tL8898499 XV3 MOO OLOZ /LO /ZL ...w yr imotartmra.c LFi I cU Uts„WYV HAVE BEEN ISSUED TO THE INSUREDNAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE 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. LT LTR DL IR Rr! TYPE CF BIHtJ M&rn .. POLICY NUMBER POLICY EFFECTIVE DATE geMIDD/WYYI POLICY TWN DATR tatM W/YI MGM GENERAL IJABLUTY COMMERoAL GENERAL. UAB&UTV EACH OCCURRENCE S PR (E rroel $ 1 CLAMS MACE 0 OCCUR WED Ea (Arty ono person) 5 PERSONAL a ADV INJURY GENERAL AGGREGATE $ $ OEML AGGREGATE UNIT AP S PER — I POLICY n .I I I LOC PRODUCTS - COMP/OP AGO $ AUTOMOBLE _ _ LIABIJTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON.OWNED AUTOS SINGLE LIMIT $ BODILY eippemaS INJURY s BODILY I dypj $ (Pmt $ GARAGE ANY AUTO AUTO CSMLY- EAACCIDENT $ EA ACO $ AUTO ONLY: AGO $ ECCE8$ I UMBRELLA LIABILITY OCCUR ❑ CLAIMS MADE PACH OCCURRENCE $ AGGREGATE $ DEDUCIBLE RETENTION 5 $ . 5 5 A MID EMPLOYERS' L COMPENSATION R WCPE0000003201 AND 6YP LI UAeH.ILIT Y R Y / N FROPFDETORIPARTNERrOtECUTsi D , RCERSIEMBER EXCLUDED? E d d no In If EPEGW- PROVISIONS balm 1/1/2010 1/1/2011 1 w i s 1 M EL. EACH ACCIDENT 5 1.000.000 EL. DLSFASE EA EMPLOYEE $ 1.000050 5 1,000.000 E.L. Dom. POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VENOMS / EXCLUSIONS ADDED BY ENDORSEMENT/ BPBIDAL PROVISIONS Coverage provided for all leased employees but not subcontractors of US WRECKING & LANDCLEARING, Inc. CERTIFICATE HOLDER CANCELLATION 3502013 Villa • = of Miami Shores Buff• ,! Department 10050 E 2nd Avenue Miami Shores FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLMCIESSECANCELLED> THEEXPI RATION DATE THEREOF., THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30' DAYS WRITTEN NOTICE TO THE CE RTFICATE HOLDER NAMED TO TILE LEFT. BUT FARJRMET000SOSHALL IMPOSU NO OBUoATION OR UABILRY OF ANY KIND UPON THE Iwo ITS AGENTS OR RPRESENTM. • 10 Days for Non-Payment of Premium. AUTHORIZED REPRESENTATIVE L Douglas Ulak �y�� Nov 30 2010 12:34PM B.O.S.S. .ARE, I oats tersoarrrno 11/30/2010 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 THE POLICIES BELOW. CERTIFICATE OF LIABILITY INSURANCE PRODUCER www.ins4blz.com Alliance Insurance Solutions LLC PO Box 1777 St Petersburg, FL 33731 727 -497 -1247 727-497 -1280 INSURED Thrive HR FL1, LLC 8902 N. Dale Mabry Hwy Suite102 Tampa FL 33618 INSURERS AFFORDING COVERAGE INSURER* SUNZ Insurance Company INSURER IC INSURER INSURER D: INSURER E: NAIC 34762 COVERAGES CEBT DD.. ee73674 ROe. HOU, L1/3O/2010 et41,5Q AM Pago 1 of 1 8136372187 p.1 ® 1888 -2009 ACORD CORPORATION. All rights reserved, A / LLL LL LL j )lll ill ill I-4 ( / ac 111 TREI.Ui{9 ICC 1 1I f:t ANC. tj�oy ���L . LLL'r. di a , SLAB LLL LLLLLLLLLLLLLLLLLLL a _ LLLLLL q�y�.,�},�LLL LI. e LLLLLL 31ULr• • LLL LI. ' I'T �,. LLLLLL LLL L4 ..LLLLLL LLL Ll LLLLLLLLL LLL L (/ r?- 1.LLLLLLLLLI. C 1 j � 1 R = 25.00',u, ss.11 CT TO C - A = 89`521011 ANI) CO INTY A=3921' -- -- T = 24.94' Wf:0A EM :. ,3 = aF (4 b7f o9of Dalua s rf1..+ p Ce..L.CisCrk y // /o i2 E vf r„ Pi► t r � c,�: CC y/ 4.: SURVEYOR'S SEAL *asset bears Om signastre and * original reLieti seal of a 'tride licensed greyer and lamer. this map/report iF. 1nr 11ornaOa 1341Daes only and pat vaid. Location Sketc, NTS LEGAL DESCRIPTION: Lots 1 & 2, Block 48, SECTION ONE OF MIAMI SHORES AS AMENOED according to the Plat thereof, as recorded in Plat Book 10, Page 70, of the Public Records of MIAMI-DADE County, Fiorida. BOUNDARY SURVEY liF.7-0.E-ay =7:rt. Mat OR, idiaKt sur.ay undo? It resottosib5o dans and subdatidadly ostoti the a:trifoliate tostadosi standwds as sat forth by the FLCIVaa. CARD OF LAN SURVEYORS i aptar VS774, FUtitta Adritiobstrative Coda, pursuant to Secton 472.027. Ps:trivia Statutes. Meru we ra3 encrosokrects, overlaps, c appaarleg tha ois4 tasornants ttur: as shown NELSO OjA.R.ENA lief:Petered Suiveyor & Mappar Pa 5,.504 State of FiLrklb OJARENA & ASSOCIATES, INC. Land Surveyors & Mappers Certificate of Authorization No. 698 12925 S.W. 132nd Avenue Miami, Florida 33186(305)278-2494 w4. a FL OOD ZONE: X DATE: SCALE; 07-23-03 1 20' E: N/A DWN. BY JOB NO. 03-0669 CERTIFIED TO: 'Gary S. Kist:her & by Nen:Asa lc Banif.ers rte Services Cop.: Attorneys,' T'Je !nsurance Fund, inc.; Fidelity National Me lnsorance Company, Chase Manhattan Mortgage Corporation. PREPARED OR Gary fi Kutrzer & Fiaby Narcisa Kutcner, ti86 T4. 92 Sveat, Miami S•:ores, FL 33133 Encroachrrrents: Porlion of the asphalt dnve is encroaching over the South boundary tine 2 Nate. • A/ cite:vendee andlor, arricaohments =Vet !Itrfittr. am cif appaisit nature. Farca awaera:nip by visual Ineana. Leg e; cs.vnership c.4 fences not datered, ▪ Encroaahments Noted: 1 • Underigretutd struotures, if any,. not .rousted. • Bearings if snow, .are based on assumed meridian or Plat -a Record. • Leads s:*leven hymen were not atggracted tof easements arelor rtght-ot-ways of more, 1 LEGEND A CardraS An& AJG Air Oendttener ASPI1 Ascher 4,110 Radoccas CB Cedt S* CBS = Commas eol*simue..m - Chord C4ai CAbalattoociwe = Center iias Chain Ceti( Pence = Cw.oc. CaTcrea = Dead 0 = Diameter Dri LAI ?gas = Drainage 14 Mal- Pasmt Easier = Easement EriCreaCrenent Rya Hydrsat Fl P =F1T 44o4IPS FR = Found VT iT011 Rabe FP-1. rierkle Preete & Light 40 = tdentificatfon I.P. = iron Pes LC = licensed Beretese UAF Lake MetAmeme Easement LS. = tand Surveyor M Measured kriaintenance Easement = itketurneat MJA Mom Morurontri NIA/ago:Vs N/C teak & Disc N• NTS lez4 St4;4 OiS = Off be GALL = Overhead Lid4ty Lines = Re PS n P'ost Beck PC = Rid at CuiVattEM PCP •, Pennissaft Cooed Poirit PIS n Nes po44 iriefsedion PKWY Pallswy Property LOW Pante PIS Protessionat Land Sunreyer P.O.S. Pckd of Beginning Poitil of Cartiff *COUP Fett't P,P, =Povear Polo PC = Point a( Reverse Curvature ▪ r 'Ott St of Relerenca Mammon PT point t f Tangency R = Ream Ras. = Reldrience Registesec LOW 6.610f6y0i RHO =n Reamed RSari Registerer Surveyor Mapper RAPt itritt-@f-Way Weir = Sidewalk Sec. = SeotkE T TeL TWP Townsite Litety Samson UTtL = Utility W.F. Wood Fence = Water Meere WME = Wa4 Maketanance 1:,,asemeat