DS-11-573Inspection Number: INSP - 157861
Scheduled Inspection Date: May 11, 2011
Inspector: Bruhn, Norman
Owner: MARINO, STEPHEN
Job Address: 1249 NE 97 Street
Project: <NONE>
Miami Shores, FL 33138-
Contractor: CHAMPION CONCRETE
Building Department Comments
May 10, 2011
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
Permit Number: DS -4 -11 -573
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Phone Number 305 - 812 -0629
Parcel Number 1132050090410
Phone: (305)252 -8055
INSTALLATION OF NEW PAVER DRIVEWAY
Passe
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Page 11 of 25
1 11 1111 1 1111 111 11 11111 1111 1 11111 11111 1111 11 11
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB Siff AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOUO NO.
S IAI t OF FLORIDA:
COUNTY OF MIAMI -DADS
THE UNDERSIGNED hereby gives notice that Improvements will be made to certain real
property. and in accordance with Chapter 713, Florida Statutes, the following Information
is provided in this Notice of Commencement.
1. Legal description of property and street/address:
2'/ AM" 0 17
2. Description of Improvement: _D4 I/44 y ,,Awn
3. Owner(s) name and address: 57r/ r/ h'v/) All y
2 Sl /L q) /t•I4 114$ 5 h3
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address:
/D , er-) 57
5. Surety (Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond
6. Lender's name and address:
7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(7., Florida Statutes,
Name and address:
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provided
in Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
diffe = is =•:_,-
Signature • er
Print Owner's Name . Sit r -t( W AM'-1/%4
Swom to and subscribed before me this — 9( day of thituell
Notary Public
Print Notary's Name
My commission expires:
12301482 PAGE 8M2
Cif- 4 ,�,0� .) &u a ) -e
RU' n 1 FDESMP OLIVERO
NOTARY PUBUC
STATE OF FLORIDA
Comm# EE028807
Expira81 /18/20
CFN 2011R0185332
OR B1: 27626 F's 2454; (1Ps )
RECORDED 03/23/2011 12:59:45
HARVEY4:RUVINa CLERK OF COURT
MIAMI -DADE COUNTY, FLORIDA
LAST FATE
0/ 3 I
3 ?/
Prepared by -- C.- 04-3 / r)
,20
Address: / /.LSO/ MU 4T
Jr i')r[ . , 3 3i;'e
PRODUCER Accurate —r
8300 West Flagler Suite 114
Miami, FL 33144
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.
Phone (305)226 -8727 Fax (305)226 -8767
INSURERS AFFORDING COVERAGE
NAIC #
INSURED Jamie Basilio Corp D /B /A Champion Concrete
INSURER A: American Builders Insurance Co.
INSURER B:
15330 SW 148 Terrace
Miami, FL 33196-
INSURER C:
INSURER D:
INSURER E:
COVERAGES
INSURER F:
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 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. _
*MR
R
ADD'L
INSRD
T YPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDDIYY)
POLICY EXPIRATION
DATE (MMIDDIYY)
LIMITS
rr
El
GENERAL
I/
❑❑
❑
•
GEN'L
•
LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE V OCCUR
070610000003366
08/22/10
08/22/11
J
EACH OCCURRENCE
1,000,000
DAMAGE TO RENTED
PREMISES (Ea occurence)
100,000
MED EXP (Any one person)
5,000
PERSONAL & ADV INJURY
1,000,000
1,000,0001
1,000,000
GENERAL AGGREGATE
PRODUCTS - COMP /OP AGG
AGGREGATE LIMIT APPLIES PER:
POLICY ❑ PROJECT • LOC
AUTOMOBILE
❑
•
❑
•
❑
❑
•
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
(Per accident)
❑
GARAGE LIABILITY
❑ ANY AUTO
❑
AUTO ONLY - EA ACCIDENT
OTHER THAN EA ACC
AUTO ONLY: AGG
EXCESS /UMBRELLA LIABILITY
• OCCUR ❑ CLAIMS MADE
❑ DEDUCTIBLE
❑ RETENTION $
EACH OCCURRENCE
AGGREGATE
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR / PARTNER / EXECUTIVE
OFFICER / MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
• WC STATU- ❑ OTH-
TORY LIMITS ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
—
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION _
Village of Miami Shors
10050 NE 2 Ave
Miami Shors, Fl 33138
1305- 756 -8972
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL E AVOR TO MAIL
30 DAYS WR NOTICE TO THE CERTIFI % • a -" NAMED TO
q , • .
THE LEFT, BUT FAILURE TO DO SO SHALL IMPO - - o = . • N OR LIABILITY
- _ TIVES.
OF ANY KIND UPON THE INSURER, ITS AGENTS + +'� '� t_
AUTHORIZED REPRESENTATIVE
Lucia Estrella - ^ ATIA \I 41100
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYY)
07/06/10
ACORD 25 (2001/08) QF
BUILDING
PERMIT APPLICATION
FBC 20
City j• State
Tenant/Lessee Name
Email
Is Building Historically Designated YES
Miami Shores Village
Building Department
Permit Type: BUILDING ROOFING
Owner's Name (Fee Simple Titleholder) -.5 7 ( 7"io J7 j°t)1)
Owner's Address l ZL/9' /t/ q
Job Address (where the work is being done) 1 2 Ng 'V q7 51
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL # /1-3105 ° OO9 -0 (1J 0
Contractor's Company Name eh J lY .f cm) rp"7ret
Contractor's Address ] ( 01 m u (03
City ,.,9 State -ft--
Name ,J 4-it j_. b 4- j ...' (}
State Certificate or Registration No.
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Permit No. CS 11 ✓ 3
NO Flood Zone
Master Permit No.
Phone #
Zip 33 /3
Phone #
Phone #
Zip 3 3/ 3 (!
Zip 33/70
Phone #
0x2311
Certificate of Competency No. Cc 05 weir
Contact Phone 305 252 er05 E -mail J4/ e/f) t / YAHOO, Ceito
Architect/Engineer's Name (if applicable) Phone #
Submittal Fee $ Permit Fee $
Structural Review. $ Total Fee Now Due $
Value of Work For this Permit $ 7,.� .' `. Square / Linear Footage Of Work: O(7 S II ° ellt
Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition
Describe Work: Qty 'AV
* * * * * * * * * * * * * * * * * * * * * * * * *** F ** * * * * * * * * * * * * * * * * *** * *r * * *** **
CCF $ CO /CC $
Notary $ Training /Education Fee $ Technology Fee $
Scanning $ Radon $ DPBR $ Bond $
Double Fee $ Violation date:
See Reverse side -
Bonding Company's Name (if applicabl
Bonding Company's Address
City S
Mortgage Lender's Name (if applicable
Mortgage Lender's Address
City
Signature
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED BY
(Revised 07 /10 /07)(Revised 06/10/2009)
n
RUTH 0. LEDESMA OLIVERO
NOTARY PUBLIC
AT' OF FLORIDA
u'C ie Expires 1/18/2015
Plans Examiner
Engineer
President II
admin @championmiami.com
Office: 305.252.8055
Mobile: 305.978.4333
Mobile: 786.402.4802 III
Lic & Ins. CC 058S0081 5
RESIDENTIAL / COMMERCIAL
INTERLOCKING PAVERS TRAVERTINE MARBLE STAMPED CONCRETE
OLD CHICAGO BRICK CONCRETE SQUARES SPRAY DECK - ∎TILE INSTALLATION
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 delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement m be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the bsenc of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this g_ 1 The foregoing instrument was acknowledged before me this r3
day of N� � , 20 11 , by .57E—PAL � D , day of /4 20 f l , by j I ar, .e / ( l t1 ,
who is personally known to me or who has produced who is personally own 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:
Print:
My Commission Ex
•
TH O. LEDESMA OLIVERO
NOTARY PUBLIC
STATE OF FLORIDA
Comm# EE028807
'CE 19 Expires 1/18/2015
********************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Zoning
Clerk checked
+
1 111,
L
co
ro
I 108.5
75.00'
in
•
9 o
r
- -7- 5..00'- -
v
co cn
0
o
108.57'
75.00'
7 0
r
— 7540= —
,LS'801. c �
Lei co
I
g 0
J
i
o
108.57'
75.00'
in
4 0
-- 75.0.0- ° --
11 to
0
136.60'
12 'r?
0
75.00'
13 Ln
0
75.00'
14 :
0
75.00'
. 4
:
,LS '80l
,Lg'80l
17 `n
0
75.00'
ONE STORY C.B.S
RES.41249 NE 97th ST
MIAMI, FL 33138
F.I.P.X 0
(no cap)
0.20'
0.20'
LOT 14
(#
1
TYPE OF SURVEY'BOUNDARY
OF BOUND
N.v
LOT 6
5' U.E.
THIS SURVEY HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF THE ENTITLES NAMED
HEREON AND THE CERTIFICATE DOES NOT EXTEND TO ANY UNNAMED PARTY.
BASIS OF BEARING SYSTEM WHEN SHOWN REFER TO
. 1770- 1 7.
APR n
4 all
1 12.50' 4 4 , 6a
VEY
LOT 5 '?
F.I.P.3t
no cap)
.10'
-" - -0.10'
Lit
/ Y / A //7///// //
/ 747
! // if s
SCALE 1' =20'
I ct
2 z
C
0 0
u <
Q
0
ZONING, ZONED STREET ONES, SETBACK, UNDERGROUND EASEMENT AND RIGHT OF
WAY, ETC. FROM ABSTRACT TO BE VERIFIED AND /OR OBTAINED BY OWNER, ARCHITECT
OR BUILDER BEFORE DESIGN OR CONSTRUCTION.
COMMUNITY NUMBER
120652
D
PASTS DFARD&i
aKH
DLVIMELLEVAR
PEMI NARK
O. CURVE
C TWI BASSI
MS. =CRETE BLOCK STRUCTURE
01.010 AND GUTTER
CN.CIEIRD DISTANCE
CIRO.CIRCLE
CHI-ION DEMDNU
CL.CLEAR
CLF.04401 LDNK FENCE
&MCAT£
CITE SLAD
aNN=CUT DRILL. HOLE
•DIMETER
NOT VALID VITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF FLORIDA LICENCED
Examination of the abstract of title will have te •beeutH$dt: is dit%rri a :ft -44%d instruments
any affecting the property. Location and ident$flcation of utilities an an o5e adjacent to
property were not secured as such Information •was rIER rligLlbs d! Ott hb? Is subject to
Lt
opinion of title. Underground foundation and liiiftes rowiteL.fhe here Is
not covered by professional liability insurance.
m
PROPERTY ADDRESS' 1249 NE 97th ST MIAMI, FL 33138
SOURCE OF LEGAL DESCRIPTION' CLIENT
,LEGAL DESCRIPTION±
LOT 15 & WEST 14 LOT 16
SUBDIVISION EARLETON SHORES
ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK
OF THE PUBLIC RECORDS OF MIAMI —DADF COUNTY, FLORIDA.
FLOOD ZONE INFORMATION 1
PAD
PANEL NUMBER SUFFIX DATE OF FIRM
306 L 09/11/09
ABBREVIATIONS & LEGEND
INADED
A MADnEPURCE
ELWELEVATION
ESKNEASDERT
£TP.EI.ECTRIC TRNGFORIER PAD
F4TAAND
FTDO.FaAm DRILL HOLE
FFE.FROS I FLIER ELEVATION
FH FIRE it1LRl•NT
FDa4OOa MN PIPE
FN.FOUND NAIL
FIND.FIRRID I NAIL &DISC
FR.FDUI0 RE-BAR
DISANUSTANCE
F T4EET E
lk}EIG OWN
LFE Y.DNE STS FLffiQ ELEVATES/
LA•N.AE
MOM= DRD.L H5E
FFEWIXISI R. ELEVATION
FTH.FIE liTIRANT
FOALFSlID IRON PD'E
FINWOUND NAIL
FIED.FCAJND NAIL &DISC
FR -FOLIO RE -DAN
DIET- DISTANCE
FRA=FRAE
144EDIFIT (MO
HWYMENVAY
M.N./REST FLOOR ELEVATION
LWOW
JOSE A DIAZ
PROFESSIONAL SURVEYOR •••
AND MAPPER
CERTIFICATE NUMBER LS 278
NE 97th ST
LOCATION SKETCH
'EL
M
IaaSAEVHT LAW
WHETAL SHED
11455Th
KEVDNARTIONAL
VERTICAL rf
tIDNADIDER
WHEN RADIAL
NTS TOT TO SCALE
LIRRAFFICIAL RECORD DOCK
040 VER EAD
DV- OVESEAD WIRES
P-PffiNr
PAVar-PAVEWIff
PD.P AT 155C
PC•4ODR OF CIRVATUFE
1V Iu 98th ST
1
ST.
E 14
3175
7432
FIRM ZONE
AE
PCC4DINr OF CONFOUND CURVE
~AGE
PKVY4YRRVAY
PLACE
PIL.PROPERTY LINE
PI.Ad LAIITER
INID.POINT W DEED5IDA3
PUDNNTINT OF COIQVCOENT
Nam
NONU ENT
SURVEYOR
& RAPPER
IMEADOS
RDARAOAL
RIMICIAD
NERNECORD
ROONIANSE
WAY
if
BLOCK 3
43 AT PAGE E0
SCALE 1'= 100'
BASE FLOOD ELEVATION
8
VEYOR AND MAPPER
PSM N0, 2798 JOSE A. DIAZ
STATE OF FLORIDA
DATE OF FIELD •
SURVEYI 06/ 8/2010
FOR' STEPHAN A. MARINO
ORDER NO, 30 -17055
DRAWING L.R.M.
SSOh
SNrtET K4D.
PORCH
STY-STONY
SWC.SIDEVM.K
T TANGENT
TVP.TDYNSIP
EASEIENT
UPS POLE
W--VOOD FENCE
VIMVATER NETER
WIRE FENCE
�
A ANGLE
GMPN LINK MICE -CLF
V I D F -WP
VORCAFIRKE
FLORIDA DEPARTMENT OF
HEALT
(Rolando Arrieta)
19341 Sterling Dr
Miami, FL 33157
RE: Contingency Letter
Application Document No: AP997454
Centrax Permit Number: 13 -SC- 1306654
OSTDS Number.
1249 NE 97
Miami, FL 33138
Lot:15 -16 Block:3 Subdivision:
Dear Applicant:
This will acknowledge receipt of an application dated 03/11/2011 for a permit to use an existing
onsite sewage treatment and disposal system located on the above referenced property.
Proposed a New artistic paver circular driveway.
There is not increase in sewage flow, change sewage characteristic, or any alteration that change
the conditions under which the system was approved.
From a review of your completed application, it has been determined your existing system is
adequate for the proposed use.
If you have any questions on this matter, please call our office at (305) 623 -3500.
Enclosures
cc:
March 15, 2011
Miami -Dade County Health Department
1725 NW 167 St, Opa Locka, FL 33056
Phone: (305) 623 -3500
Rick Scott
Governor
100 41-
STATE OF (FLORIDA)
COUNTY OF (DADE)
The undersigned Affiant, , 57 - 091it 044,401 , does hereby attest that
(Property owner)
The attached survey, performed by - /O3C if ®1 /12
(Name of surveyor's company)
For address: 1244 119E q'7 51 /114 M4 5-m4 e'5 ?3/31 ,
Performed on Q 111 1 0d' (date of survey) is an accurate representation of the
existing conditions and locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property
without first providing a survey Tess than seven (7) years old old. The Affiant, as property owner, further agrees to
remove or obtain permits for any structures which now may exist on the property which are not permitted or which
may violate zoning or building code regulations. The Affiant further understands that the existence of any such
structures may affect final inspections as applicable to this or other permits.
Fu ffiant sa h naught.
Propertytwner Signature Property Owner Print Name
SWORN TO AND SUB CRIRFD fore me this e I day of Pi - it . 2 -0 / /
Affiant is personally known tom , _produced
Revised on 5/22/2009/ Revised on 6/12/09
SURVEY AFFIDAVIT
RUTH O. LEDESMA OLIVER()
NOTARY PUBLIC
STATE OF FLORIDA
Comm# EE028807
Exptres 11181201
M iami Shores Vivage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
J7ypfiat/ Nil #d
as identification.
1
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
Whereas, (owner) .S"m FF4) hereinafter referred to as the owner of
the following described property (address): / Z 1 q /Ur �f
� 1y ittoiw v 33/31r
Legal Description Lot If , / 6 Block 3 Subdivision e,gL /rrviv
Folio # /9- 3Z o5- 004-o K/ 0
Requests permission to install (describe work): 2, # -94f7 o/1e$> 1- '°e/��
Within the public right of way of (address) /2 /t/E q7 5
rl I 4 - M 5 1 - a im s /'- 33/7$
M iami Shores VHIage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows:
1. To maintain and repair, when necessary, the above - mentioned item(s) installed within the dedicated right of
way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said
items within public right of way including restoration of street by reason of the Owner's failure to do so,
such expense shall be paid by the Owner or shall constitute a lien against the above described property
until paid.
2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any
and all liability, which may rise by virtue of permitting the installation of these items within the public right of way.
SIGNED, SEALED, EXECUTED AND 4CKNOWLEDGE on this g r day of a
D, SEALED, AN DELIVERED in the presence of:
3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days
notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s)
to be removed and a lien being placed on the property and /or assessed against the Owner for all costs
incurred in the removal and disposal of the item(s).
4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land
and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until
such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County,
Florida by the Village Manager of Miami Shores Village (or his fully authorized representative).
2
am 0. LEDESMA OL%VE O
NO1'AR`f PUBLIC
STATE OF FLORIDA
Cumm# EE028807
Expires 1/18/2015
(Owners Signature )
, 201 l