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DS-11-99Scheduled Inspection Date: March 07, 2011 Inspector: Bruhn, Norman Owner: KLEINMAN, DENNIS Job Address: 655 NE 97 Street Miami Shores, FL 33138 -2470 Project: <NONE> Contractor: PAVERS AND BRICKS SERVICES CORP Building Department Comments March 04, 2011 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 155092 Permit Number: DS- 1 -11 -99 For Inspections please call: (305)762 -4949 Permit Type: Driveways /Sidewalks/Slabs Inspection Type: Final Work Classification: New Phone Number 305/759 -7750 Parcel Number 1132060171890 Phone: (305)986 -2544 NEW DRIVEWAY WITH OLD CHICAGO BRICK WITH SAND BASE. Passed L�F./ Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments C'c- -- Page 13 of 30 Qualifier Name BUILDING PERMIT APPLICATION FBC 2004 Permit Type (circle): Building Roofing Owner's Name (Fee Simple Titleholder) ._ '.` . i =L/ ✓'';! / one # Owner's Address r«%' -- City 11.4' ///' 4' tate ! . Zip — , .. ,,,,,./ Tenant/Lessee Name - __. Phone # Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES Contractor's Company Name Contractor's Address ° 4 y' G / City 13A- 7/4'!/ State - �/ Zip / Phone # State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Type of Work: ['Addition Describe Work: /t.../ 44 °a 5Ef tc $ `tom- Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ❑Alteration Square / Linear Footage Of Work: ❑ Repair/Replace Permit No. 1)S 1 -"'9e) Master Permit No. Phone # 7`.S Phone # v Ae ❑ Demolition ********* * * * * * * *:* * ** * * * * * * * * * * * * * ** * * ** F * ** ** * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ 50 Permit Fee $ CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ See Reverse side --* Bonding Company's Name (if applicable) Bonding Company's Address City ,�' State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City 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. Owner or Agent Co! The fore 'ng instrument was acknowledged before me this C o! day of 'Y7 , 20..1 , by til lv 1 ~ L C i nd vAii, who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC•STATE OF FLORIDA "N Shanteti Ruthiely lopes tordeiro Commission # EE019117 .,,,p, Expires: NOV. . 15, 2011 nonlin TBRU ATLANTIC BONDING CO., INC. h ( - ‘24.elLS, krt. My Commission Expires: l.. ..i 5 _ . ) c NOTARY PUBLIC• Sign: Print: APPLICATION APPROVED BY: (Revised 07/10/07) State Zip Signature Contractor The foregoing instrument was acknowledged before me this 0 / day of i� �i' , 20 , by J '1 (:J 13444 C..?5 who is personally known to me or who has produced �J I MY COMMISSION # DD 968086 • � • : vi EXPIRES: October 1, 2014 • ;, Bonded Thru Notary Public Underwriters as identific NOTARY Sign: Vrint: My ommission Expires: Zip i ciii -rod ac-f- a/ ?c Plans Examiner Engineer Zoning Lot Tax Folio A!: requests permission to install: [Asphalt, concret , brick pavers [ ] Landscaping [)Other within the public road right of way of SIGNED. SEALED AND DELIVERED in the presence of Lama SA,ore 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138 -2382 Telephone: (305) 795 -2207 Fax: (305)7E- 8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY WHEREAS, e.'N /& $ Lc' A444-/ , hereinafter referred to as the Owner of the (owner) following described property: Legal description/foio #: //2 P: Block a al Subdivision /tie .4,4/ Y alb � 9 ,�✓�/ IN CONSIDERATION of the approval of this permit by the Village, the Owner agrees as follows: • 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. 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•tIie land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligation 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 represe r tive). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this Oi day of PP.or4cf F RIDA •"'"ti,�Sha ell Ruth* Lopes tordeno = Co # EE019117 c• xpires: NOV. 15, 2011 a...w BQ2O) °TEOATLAS=BOI DINOCO.,II1C. 31 01 11 09:55 I Ni DATE (MWIDDIY'1') A, d' CERTIFICATE OF LIA 1LITY INSURANCE o THIS CERTIFICATE LS I SSUED *5 AMA IEt OF INFORMATION PRODUCP.R Accurate AND CONFERS NO RN3HTS UPON THE CERTIFICATE 1 83fl0 West FIa81e► Stdta T td HOLDER. 'Tin CERTOFCA1E DOES NOT AMEND. EXTEND OR i Miami. FL 33144 lIt- '_"f1O�/ERI�iE,iEo BV THE PO s BtAF. Phone (305)2206727 Fax �3a5)2Z6 B7s7 INSURERS AFFORDING COVE atAGE NA1c / INBURER/,A: Lloyds a London mono Pavers And Bricks Services Corp. > g $ St3A — 99 NW 158 Street INSURER c Miami, Fl 33169 URBR1 ..� INSURER - COVERAGES INSURER F: rTHE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE NSUREO NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REGUIROWENir. TERM OR CONDITION OF ANY CONTRACT OR OTHER OCCUPANT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE DIED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN E SUBJECT TO ALL THE TERNS. EXCLUSIONS AND CONDITIONS OF SUCH 1 P2UC1ES. AGGREGATEtD.1S SHOWN MAY HAVE BEEN REDUCED ITV PAID CI ABA3. PoucY �- = YOIJCY ' __ .. IN LIMITS TYPE OF INSURANCE POLICY RUMEN ATS ' �/ CIA NSA ADD'L EACK OCWRRENCE A Li CI a GENERAL LABILITY COMMERCUIL GENERAL LIABILITY 00 cLA,AASMADE Ffj OCCUR ❑ — 0 GENT. AGGREGATE LIMIT APPLES ❑ POLICY a PROJECT CI LOC AuTOIAOaR6 LIABILITY ❑ ANY AUTO ❑ ALL OWNED Aunts ❑ soma:Q mAuras ❑ HIRED winos O NON OWN W AUTOS r GARAGE LII911.RY Miro ONLY - EA ACCIDENT O ANY AUTO OTHER THAN E 9; ❑ AUTO ONLY AGa EXCESSADEBRE.LA LIABILITY EACH OCCURRENCE Q OCCUR ❑ CLAIMS WOE AGGREGATE O DEDUCTIBLE ❑ RETEIrum s VionseRSCONAr N iris N Arab E MPLOYERS' UABIUTY 5 A NY PRBPRIETOR J PARTNER I EXECUTIVE O FFICER / MEMBER EXCLUDED? If rem describe under SPECIAL PROVISIONS belwv OTHER bESCII PTION OF OPERATIONS 1 LOCATIONS r VEHICLES / EXCLUSIONS ADDEO BY ENDORSEMENT t SPECIAL. PROVISIONS CERTIFICATE HOLDER ACORN 26 (2001108} CF PAVERS AND BRICKS SERVICE City of Miami Shores 10050NE2Ave Miami Shores, Florida ARTE009373.2 WSAUIEC11590902 trn i i.inn Le LV t e P 307-31 5- 59 65 „Jti. r p.1 r 011121/1 01112712 05106110 05100111 J D RENTED AEA saturencs) EXP (Am 4Penman) PERSONAL a ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LMT a aeddert) - BODILY INJURY Per persgn_ - BODILY INJURY (Per sodden) PROPERTY DAMAGE Per accident) 1 1.000.000 50,000 5 ,000 1,000.000 2,000,000 1,000,000 EL EACH ACCIDENT 100,000E E.L. DISEASE -EA ENPLOYEE 500,000 EL. DISEASE POLICY LEST 100,000 CAINCEUJITWN SHOULD ANYOF TIIE ABOVE DEED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO NAIL 30 DAYS WRITTEN NO - CERTIFICATE MOLDER NAMED TO THE LLFT, BUT FAILURE TO • 5 fi 4 SIP08L' NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE IN zi p 4 , AGENTS OR REPAESENTATtVEB. '' Lucia Estrous I1% AUTH4OWJEDREPRESENT : 1 ACORN CO UTOIiATIOIFI s -7 Z12- ZYZ111 JAN 2 0 2011 Miami Shores Village APPROVED ZONING DEPT BLDG DEPT 81.113,11 "CT TO COMPLIANCE WITH ALL FED STA AND COUNTY RULES AND REGU d mm st-de O fat..f e c - a s ` ► , � � Do u. I/101 elf (5 k-.) (70 ?e` ) 5A/ 0 i l l 3ASIS OF BEARING SYSTEM WHEN SHOWN REFER TO: 6 TYPE OF SURVEY; BOUNDARY l+ ' • _ /' v o rl p r o I • / !� .. / '. ' ... !b .. )7 .. it ., .- •• - a ' - _ /1 - t o 6 -- 4 , /7) i . 4 .0e / !� .. / '. ' ... !b .. )7 .. .�4� ✓ i i, A iN Zo . 4 _ PROPERTIADDRES& 97v-"-Sr: /1/dr / ;o2�S XXIIICE041ESAL G/ i /S .="E'Y?. dindAn. .c»C: L E G A L D E S C R I P T I O N - LOT 1 i 9 1 ,Q A i T.�E' - ef/E - 7 ©r GOT' - mock #0•0,1- SUBDMSION . ive.ar s/ , ' se'cP70,4" ,t/s ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 4 5 - AT PAGE Ai OF THE PUBLIC RECORDS OF p; COUNTY, FLORIDA: Ala fie' 57 a sp • r VALO UNLESS SEALED WITH AN EIRIOSEED SUiVEYORSSEAL 7S . AZ 7P-" CE.G7Y.� /� T4. ' G /Tj 2�eit s .�B.f�Es' GG. $.oa�✓�1G .d '1_d dr" '.'°.s. spvi vas t3, f'j , ,2-cr4 o.�i +..v Trp ' Aces. co.- 414.A0 ,d9.e / /7. c. ,K40/.c•Wdx, LocAT tSKETcH HEREBY GERM: That the attached bamdaly survey of the above descrilmd party 10 true area coned to the best of ots Imoviledge and hebt as recently 'eyed under ow sin, also that them we no above mod encroadmsnits Iss down, extmdmdlon of the atcdract of Me two to be made to rrded ' If any. - ate the joperty. Lit and klentlficallon of ties on anitor guard to the plenty were not secured as sch Manton - 15 subject to of MMe.T c stuvey meets the mtnhnom dank as agitated by the Rotkla Boani. of Pgdfanksal LIM Surveyors rsnto chapter 21 -HH-6 Rodcb Muhl Cada BRICKELL LAND SURVEYORS, INC. 1414 N.W. 107th AVENUE, SUITE 315 MIAMI, FLORIDA 33172 TELEPHONE (305) 4772300 scaler. loa fi 1142WZONE > Et .L*M SIAIVEYOR KO. Z STATEOFFLOMA a 4- • ORDER No. G '- 74t 2S-Z-