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DS-10-1947Inspection Number: INSP- 154393 Scheduled Inspection Date: December 30, 2010 Inspector: Bruhn, Norman Owner: OLASO, M CLAUDIA Job Address: 55 NE 99 Street Miami Shores, FL Project: <NONE> Contractor: AG STAR CONSTRUCTION INC Building Department Comments CIRCULAR PAVE DRIVEWAY Passe Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 152948. Replace sod at disturbed areas. NB December 29, 2010 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 -11 -10 -1947 Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060131290 Phone: (786)431 -5292 Page 14 of 23 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. 11 . " 24120 6 - 013-/g9 0 STATE OF FLORIDA: COUNTY OF MIAMI -DADE: 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. Y Space above reserved for use of recording office 1. l �sCri 17 p7r 4 s d 7 S a i �c � � �� �` �. . /0-7D L a r Z . 2. Description of improvement: 2 �' f_ 3. Owner(s) name and address: ti C. Interest in property: Name and address of fee simple titleholder. 4. Contractor's name address and phone number '7f l Sj "2'7 !J - k 5 - t kA I es. IA 1) F L 5. Surety: (Payment bond required by owner from ontractor, if any) Name, address and phone number. /N /� Amount of bond $ ffi 6. Lender's name and address: /�1 / Ivr 7. Persons within the State of Florida des! nated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, /ti /0 Name, address and phone number. 11111111111111111111 111111111111111111111 1111 CFN 21 1080797676 OR Bk 27501 P9 4S2B; ups) ) RECORDED 11/2912010 10:46:24 HARVEY R:UVIWr CLERK. OF COURT MIAMI— CDACDE COUNTYr FLORIDA LAST PAGE G-Y-tO 3L. 2, 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name, address and phone number. N j 9. Expiration date of this Notice of Commencement (the expiration date Is 1 year from the date of recording unless a different date Is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERE 2 IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FO IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE TH FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WOR OR RECORDING YOUR NOTICE OF COMMENCEMENT Signature(s) of Oyun e ) r Own orized Officer/Director/Partner/Manager Prepared By ` Prepared By Print Name M '104 (J '4 U Print Name C W.J 'ii Title /Office D& P Title /Office STATE OF FLORIDA Ft-. 33 l s COUNTY OF MIAMI -DADE �t h"' �.l V' �Q \ Thhe,fgreg +g jpstrej ANI Cr i ttfE e me this day of l 751 Individually, or ( 6] as . (- G f (/I (� for ❑ Personally known, or Ptproduced the following type of ident Signature of Notary Public: Print Name: (SEAL) VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true, to the best of my knowledge and belief. Signature(s) of Owner(s) or Owner(s)'s Authorized Officer/Director/Partner/Manager who signed a By By 123.01 -32 PAGE 3 3/10 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE/DDIYYYY) 11/29/2010 PRODUCER 305- 303 -7080 Insure Safe Inc 45 Curtiss Parkway Y Suite B Miami Springs, FL 33166 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. INSURERS AFFORDING COVERAGE NAIC # INSURED AG Star Construction Inc 1827 NW 1ST Street Miami, FL 33126 INSURER A: Accident Insurance Company LIMITS EACH OCCURRENCE INSURER B: Progressive Insurance Company ✓ INSURER C: $ 100 INSURER D: CLAIMS MADE I OCCUR INSURER E: $ 5,000 THE POLICIES OF INSURANCE LISTED BELOW 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. INSR LTRINSRD A ADDI. GENERAL TYPE OF INSI RANGE LIABILITY COMMERCIAL GENERAL LIABILITY POLICY NUMBER AGL9000056 POLICY EFFECTIVE DATE (MWDD /W1 06/17/10 POLICY EXPIRATION DATE (MM/DD/YYl 06/17/11 LIMITS EACH OCCURRENCE $ 1,000,000 ✓ DAMAGE P ISE TORE xurence) $ 100 CLAIMS MADE I OCCUR MED EXP (Any one person) $ 5,000 PERSONAL &ADVINJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 GEM_ AGGREGATE LIMIT APPLIES PER: POLICY n j� n LOC PRODUCTS - COMP/OP AGG $ 2,000,000 n B AUTOMOBILE LIABILITY ANY AUTO ALL ALL OWNED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS 07675978-0 10/18/10 10/18/11 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ 50,000 BODILY INJURY (Peracddent) $ 25,000 PROPERTY DAMAGE (Peracddent) $ 50,000 GARAGE LIABILITY ANYAUTO AUTO ONLY - EA ACCIDENT $ OTHERTHAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ I OCCUR I CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes describe under SPECIAL PROVISIONS below WCSTA - OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS! LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS 11/29/2010 10:02 CERTIFICATE HOLDER ACORD 25 (2001/08) CANCELLATION Page 1/1 Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, FL 33138 Fax 305 - 756 -8972 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 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. A UTHORIZED REPRESENTATIVE ©ACORD CORPORATION 1988 BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING OWNER: Name (Fee Simple Titleholder): /l • 12 I4 l 0/45 o Phone #: ? ifb 4941 Address: SS' A1i7 1/ a S12 tt/ S1. / S/hi/Les PL 33/3 } J City: 04/41 / .5/ AC State: �L Zip: 3 3 / 3 a Tenant/Lessee Name: ---- Phone #: --- Email: Ch+VDi x4 .0145 5 G0114 JOB ADDRESS: /vG t a stu4/- City: Miami Shores County: Folio/Parcel #: it 3.206 E HJ/12 9 Is the Building Historically Designated: Yes 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 NO Miami Dade Master Permit No. CONTRACTOR: Company Name: -q 4' 5 t 1J e2— UC T /®0 Phone #: 7 er 6 43 /. a 9 Address: ) � N 1 S 54- -e,2„ 36 City: / l I State: r Zip: 3 3/ 2 Qualifier Name: /49( - rte' � �-- Phone #: 3 ca 4 q Z k 91 State Certification or Registration #: G 4T/be) Z /Certificate of Competency #: Contact Phone #: � a L' Email Address: V �j a Y CO es A. CAHre'ski '` 4 140/3 •�� DESIGNER: Architect/Engineer: � Phone #: VafW�rl� for t1�iC PPMIYt $ 1 ` T �? Square/Lin �►��o Type of Work: Address UAlteration UNew DRepair/Replace Permit No. D6 la ^ 11 Zip: )3 Flood Zone: !� tdi o ¢2010 � �1 G t if ❑Demolition COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by: Submittal Fee $ Permit Fee $ / 643 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ '& ( o 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 CONDMONERS, 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 7a. (2 k Owner or Agent Contractor The foregoing instrument was acknowledged before me this 2-5 The foregoing instrument was acknowledged before me this (:).47 day of ft,ie) r,20IO,by` (l'l(11 (0A011(4 Warth of ®eTti3er ,20 ,b r:1 �nog ww S t( ho is personally*nown to me or who has produced4eeaDer y iko)) N, as identification and who did take an oath. NOTARY PUBLIC: who is personally known to me or who has produced As identification and who d • t. e Sign: -- Sign. f .. ---0 Print: V ( � A J ! / Print: e- My Commission Expires: My (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10) Plans Examiner Structural Review pires: ;,�I�. ;. /3 MYCOMMI ION D845393. EXPIRES: February 12, 2013 *** ** Banded Thru Notary Public Underwriters �e >r******* (i7ed Zoning Clerk - --- - - Miami Shores Village APPROVED : DATE ZONING DEPT BLDG DEPT AI) im 1st 113,11CT TO COMPLIANCE WITH ALL FEDERAL. ONE STORY RES. # 55 F.F.E.=12.43* GARAGE ELEV.=10.88' OF LOT- 17 BLOCK - 9 82 SP 5 1.156 5F Nov 1 ly 13 Y: .... ........... ATV AND CO I IN TY RULES AND REGULATIONS Miami Shores Village Building Department M COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY M Whereas, (owner) • CIOD/ 0/Me 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 hereinafter referred to as the owner of the following described property (address): 63 N6' 99 d. S'f At /JiM / -S/r0 -S FL 3313' /I �,'�4�w /`�ND `o ? D 1-07-1 S 4 E 1 /2. of I ei- s z L o 7 �. 00o x 11 Legal Description Sj�C. I /M A Q Lo Block Subdivision Folio# I1-32e6— Cil --/a70 // Requests permission to install (describe work): C/I e (/4 . fikt/ 1,5 bailie Within the public right of way of (address) �s A1C 9 / /i St/ Ld — * t/ t/Sh /CS �L 33/3y 1 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, SEA ED, AND DELIVERED i the presence of: ► u►u n u►i mien, ". " 88 co o��` ,0„ . %,� ,��.`\. nJ/nnmos 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). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this 2 day of l O , 2010 (Owner's Signature ) STATE OF (FLORIDA) COUNTY OF (DADE) Further, Affiant say eth naugh t SURVEY AFFIDAVIT Property Owner Signature SWORN TO AND SUBSCRIBED before me this L:.) da of l7 Affiant is personally known to me, X produced - L Revised on 5/22/2009/ Revised on 6/12/09 Miami Shores Village Building Department The undersigned Affiant, M L / ./)i`A `V fA 0 , does hereby attest that ( 'roperty trwne The attached survey, performed by (Nameof- sut-veyees -c pany)_ For address: SS X6'3 d`ST,�,t c ' film s/ PL 3313e M C/4 - u4 OI4s o Performed on (date- o€-strry ey)isan 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 less 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. 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Property Owner Print Name Y 4 - LiS - reui - D id yaw cation. Notary � Notary Public State of Florida ' Kristine O'Connor - 4 My Commission 00984821 ' Expires 0510612012