RCRT-10-981BUILDING
PERMIT APPLICATION
FBC 20
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
Permit NQ. IZCt 1 •5 - IO
Master Permit No.
Permit Type: BUILDING _ OOFIN G
Owner's Name (Fee Simple Titleholde O 41l l ` YJ Q Phone #
Owner's Address
City State Zip
Tenant/Lessee Name Phone #
Email
Job Address (where the work is being done) M 1 el V d
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL # 1.132,0(0011 0 1 50
Is Building Historically Designated YES NO Flood Zone
Contractor's Company Name Phone #
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Contact Phone
E -mail
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $
Type of Work: ❑Addition
Describe Work:
❑Alteration
Square / Linear Footage Of Work: c, 405
❑New ❑ Repair/Replace ❑ Demolition
Submittal Fee $
.=,210
Notary $
Scanning $ Radon $
Double Fee $
Structural Review. $
Permit Fee $
Training/Education Fee $
DPBR $
Violation date:
CCF $ CO /CC $
Total Fee Now Due $
Technology Fee $
Bond $
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
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of , 20 _, by , day of , 20 , by
who is personally known to me or who has produced who is personally known 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: Sign:
Print: Print:
My Commission Expires:
My Commission Expires:
APPROVED BY
(Revised 07 /10 /07)(Revised 06/10/2009)
Engineer
Plans Examiner Zoning
Clerk checked
UNITED STATES POSTAL SERVICE
• Complete items 1, 2, and 3. Also complete
item 4 If Restricted Delivery Is desired.
• Print your name and address on the reverse
so that we can retum the card to you.
• Attach this card to the back of the maliplece,
or on the front if space permits.
1. Article Addressed to:
JOHN MILITAtsfA
ggp� 815C4YNE BLVD
M1lIMi St/ORES.F 33/38
2. Article Number
(Transfer from service label)
• Sender. Please print your name, address, and ZIP +4 in this box •
hiMbA SHORES VILLAGE
NAN aceso M. E. 2nd AVEi
SHORES. FLA. 33139
1 tr llftiIIu 'filial tlt
SENDER: COMPLETE THIS SECTION
COMPLETE MS SECTION ON DELIVERY
. 12 " 410
AS
X
❑ Agent
Addressee
0 Mer
PS Form 3811, February 2004 Domestic Return Receipt
First -Class Mail
Postage & Fees Paid
LISPS
Permit No. G -10
D. Is delivery different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mall
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mall ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
7009 1410 0000 7000 9897
102595-02-M-1540
For - delivery _..' o u,sit { website at www€ ap.,p x =,:
Sent To
J o
IAN MIL.11AWi
Ala $$o l BIS CAYNE $ LVD
City, State, ZIP+4
Mi t S,!R
FL 3 3f-3381
Certified Mail Provides:
• A mailing receipt ,
• A unique identifier for your mailpiece
■ A record of delivery kept by the Postal Servioe for two years
Important Reminders:
• Certified Mail may ONLY be combined with First -Class Mail® or Priority Math®.
• Certified Mall is not available for any class of international mail.
• NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables, please consider Insured or Registered Mail.
• For an additional fee, a Retum Receipt may be requested to provide proof of
delivery. To obtain Return Receipt service, please complete and attach a Retum
Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse mallpiece Return Receipt Requested °. To receive a fee waiver for
a duplicate return receipt, a USPS® postmark on your Certified Mail receipt is
required.
• For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent. Advise the clerk or mark the maiipiece with the
endorsement 'Restricted Delivery°.
If a postmark on the Certified Mail receipt is desired, please present the arti-
cle at the post office for postmarking. If a postmark on the Certlfied Mail
receipt is not needed, detach and affix label with postage and mail.
IMPORTANT: Save this receipt and present' it when making an inquiry.
PS Form 3800. August 2008 (Reverse) PSN 7530-02-000-9041
5/28/2010
MIAMI SHORES VILLAGE
Building Department
Certified Mail # 7009 1410 0000 7000 9897
Property located at: Address: 8801 BISCAYNE Boulevard
Miami Shores, Florida, 33138 -3381
Permit Number: RCRT -5 -10 -981
Folio #
Dear Owner:
10050 NE 2 Ave, Miami Shores Fl, 33138
Tel: 305-795-2204. Fax: 305- 756 -8972
Notice of Required Inspection/Certification
The Village has been notified by Metro -Dade Building & Zoning Department that the above
referenced property has a building or structure that is forty (40) years old or older. In
accordance with Miami -Dade County Chapter 8 Section 8 -11, the subject property must be
inspected by a Florida Registered Architect or Engineer and a report furnished to this office.
A report and a fee of two- hundred fifty dollars must be submitted to this office within ninety (90)
days of receiving this Notice of Required Inspection/Certification.
If you would like a copy of Minimum Inspection Procedural Guidelines for Structural and
Electrical Recertification, or if you have any questions, please call my office at 305- 795 -2204.
Sincerely,
Norman Bruhn, Building Official
305- 795 -2204
MINIMUM INSPECTION PROCEDURAL GUIDELINES FOR
BUILDING'S STRUCTURAL RECERTIFICATION
INSPECTION Cr E
DATE:
INSPECTION COMPUTED
DATE
MIAMI -DADE COUNTY, FLORIDA
Folio Number of Building:
.1V.040\ kl.r10-96
tus
•'15� •CoCo�l, ��B�I
0
BUILDING DEPAR TJ d �i 201 1
INSPECTION MAD
SIGNATURE t A�P
PRINT NAM
� I /+ 1'
Building Code Oc� upan Classification:
Present Use:
General Descri ption, Type of Construction, Size, Number of Stories, and Special Features
Additional Comment
sitikr
3ESCRIPTIO
. Name of Title: v- n�!% 111 iMISIZI. _
Street Address: ,wT rPIIIVir-lre T�NF", s/i ITIS '
Legal Description: „ / ."!'�r
Owners Name: ;311 :'
Owner's Mailing Address: .�.`� %— ' %
R P 115 "1 :,"., r 3!_►1E" y
3 132
N
MINIMUM INSPECTION PROCEDURAL GUIDELINES FOR
BUILDING'S STRUCTURAL RECERTIFICATION
Name of Title:
Street Address
Legal Description:
Owner's Name l c�.'►q
Owner's Mailing Address:
General
Description, Type
Additions to original structure:
Contra
DESCRIPTION F`STRUCTURE
Building Official Folio Number:
. Building Code Occupan Classification: 7 7���
N rai rm i ni l-- - ire o js4 .1 r i to__ �
of on ize Number of Stones, and Spe al Fea res
nn�cc��srrtaatiiai :.C::hc?r c r=
Surface conditions — describe general conditions of finishes, noting cracking, spelling, peeling,
signs. of moisture penetration & stains. i
. Cracks — note location in significant members. Identify crack size as HAIRLINE if barely
issembie; FINE ifiess than 1 mm in width: MEDIUM if between 1 and 2 mm in width; WIDE if
ver 2 mm.
General extent of deterioration — cracking or spoiling of concrete or masonry; oxidation of
metals; rot or borer attack in wood.
MAW --
14 0 N
g. Nature of present loading indicate re s en a "commercial, ether estimate magnitude.
. Previous patching or repairs
3:. INSPECTIONS
General alignment not good, fair, poor, explain if significant
1. Bulging V.:, c2N
2. Settlement 0
3. Defections PsIent4
4. Expansion
5. Contraction
b.
Portion showing distress (Note, beams, columns, s
ctural walls, floors, roofs, other)
N
MINIMUM INSPECTION PROCEDURAL GUIDELINES FOR
BUILDING'S STRUCTURAL RECERTIFICATION
Name of Title:
Street Address
Legal Description:
Owner's Name l c�.'►q
Owner's Mailing Address:
General
Description, Type
Additions to original structure:
Contra
DESCRIPTION F`STRUCTURE
Building Official Folio Number:
. Building Code Occupan Classification: 7 7���
N rai rm i ni l-- - ire o js4 .1 r i to__ �
of on ize Number of Stones, and Spe al Fea res
nn�cc��srrtaatiiai :.C::hc?r c r=
Surface conditions — describe general conditions of finishes, noting cracking, spelling, peeling,
signs. of moisture penetration & stains. i
. Cracks — note location in significant members. Identify crack size as HAIRLINE if barely
issembie; FINE ifiess than 1 mm in width: MEDIUM if between 1 and 2 mm in width; WIDE if
ver 2 mm.
General extent of deterioration — cracking or spoiling of concrete or masonry; oxidation of
metals; rot or borer attack in wood.
MAW --
14 0 N
g. Nature of present loading indicate re s en a "commercial, ether estimate magnitude.
. Previous patching or repairs
3:. INSPECTIONS
a. Date of notice of required inspection
`b. Date(s) of actual inspection ) j J ". L. L. 1010
c. Name and qualification of individual submitting inspection report:
•. Description of any laborato or othe formal testin • , if required rather than
,• rocedures
manual or visual
Stru tural repair note appropriate line:
one required
0.
Required (describe and indicate acceptance
la. Concrete masonry units .!►T;
t. Clay tile or terra cots units /fie
. Reinforced concrete tile columns ./!
.. Reinforced concrete tile beams
i
ie. Lintel
Other type bond beams
ig. Masonry finishes - exterior
1. Stucco
2. Veneer
3. Paint only
° 4. Other(describe)
Masonry finishes - interior
.
1. Vapor barrier
2. Purring and plaster
3. Paneling
4. Paint only
PrIIA,AZ _
K.4
5. Other ( describe) r�1aLli
. Cracks:
N Cif,,
1. Location - note beams, columns, other
2. Description
'
Spelling:
.
1. Location - note beams, columns, other (� I
,
Li C _.
2. Description
c. Rebar corrosion -check appropriate line:
1. None visible
2. Minor - patching will suffice z\rf�l�E'!.7..�J
3. Significant -but patching will suffice
/e4
4.. 'SUPPORTING ;.DATA.
a. NIA* N
b. ,�A�
c. i
:IIAA'SGNR 'M
sheet written data
photographs
drawings or sketches:
" lnak14e51oad lair,; anrvni;ippriipriaterlinest
b. Exposed Steel - describe condition of paint & degree ot corrosion: N Li ur
1. Sampies chipped out for examination in spell areas: N epme,
1. No.
2. Yes - describe color texture, aggregate, general quality
E FLOOR AND .ROOF SYSTEM
Root
.
AA
p 1. Describe (flat, slope, type roofing, pe roof deck, condition. A
'
2. Note water tanks, cooling tow -rs air cons itio ing equ ■ment, s • ns, other eavy
equipment and condition of support il. , 4 01e ' hi
•
I 3. Note types of • ems and scupper a ' • Inditionooling towers, air condition:
ot gnificant
fb. Floor systems(s)
1. Describe (type of system framing, material, spans, condition)
- ' , ^-
410
General condition
S
.:40i0r44:;11111avitIg-iatUa-'-‘
c. Inspection - note exposed areas available for inspection, and where it was found
open ceilings, etc. for - nspection of typical framin• mem' -rs.
necessary to
MIUMMIRMALgallIllr
la. Description
b. Exposed Steel - describe condition of paint & degree ot corrosion: N Li ur
. Concrete or other fireproofing - note any cracking or spelling, and note where any covering
was removed for inspection
II. 46,
i jd.Elevator sheave beams & connections, and machine floor beams - note condition: 1\1 k
. Full description of structural system -4E
Pro31 ita;
.. Cracki,,
ot gnificant
ocation and description of members affected and type cracking
General condition
.
4. Significant-structural repairs required
• e a - .
la. Type — fully describe if mill dOnstruciton, light construction, major spans, trusses;
Note metal fitting i.e., angles, plates, bolts, split pintles, pintles, other, and note condition:
. Joints — note if well fitted and still dosed:
•. Drainage — note accumulations of moisture:
ie. Ventilation —note any concealed spaes not ventilated:
If. Note any concealed spaces opened for inspection:
i
1. Non le
. ocation and description of members affected and type cracking
3. Significant but patching will suffice
4. Significant - structural repairs required (describe)
e. Sam. = ipped out in spall areas:
No.
.
s, describe color, texture, aggregate. general quality:
9.: 'WINDOWS
(Wood, steel, aluminum, jalousie, single hung, double hung, casement, awning, pivoted,
r xed they) 11
nchorage — type & condition of fasteners and latches:
Sealant — type of condition of perimeter sealant & at mull' s: �� L L - •
Id. Interiors seals — type & condition at operable vents: N
je. General condition 1
MIAMI -DADE COUNTY, FLORIDA
MINIMUM INSPECTION PROCEDURAL GUIDELINES FOR
BUILDING'S •ELECTRICAL RECERTIFICATION
INSPECTION C M
DATE: /�/"
INSPECTION COMPLt 1 tD
DATE
cZho—
INSPECTION MADE B
SIGNATURE:
PRINT NAME
TITLE
ADDRESS:
BUILDING DEPARTMENT
t1
AM
. Name of Title:
1 .,K4,4, 1111■111111
. Folio Number of Building:
1
MIKEDIMILMERWIfir
Street Address:
Legal Description: LO
Owners Name:
Owners Mailing Address:
Budding Code Occupancy Classification:
Present Use:
General Descrip on, T
Additional Comment
of Construction, Size, Number of Stones, and Special Features
GUIDELINES AND INFORMATION FOR RECERTIFICATION OF ELECTRICAL
SYSTEMS OF FORTY (40) YEAR STRUCTURES
1. :ELECTRI:CSERKiCE
1. Size: Amperage
2. Phase: T. - ' ase
3. Condition:
4. Comments
2. METER :AND'ELECTi1C RO
1. Clearances: Good (
. Comments:
• :� Ilry
Fit
. Location:
2. Taps and Fill:
Z. Comments:
13. Panel # (
Location:
4. Panel # ( ) Location:
r
FuseO ( ) Breakers (
Single Phase
Fair ( ) Needs Repair
Fair
E
Good
Good
Requires Correction
Requires Repair
Requires Repair
Needs Re . air
Needs Repair
77
Needs Repair ( )
(
1 5. Panel # ( ) Location:
16. Comments:
BRA461111*
1. Identified:
2. Conductors:
3. Comments:
ood
{
Good (
Good (
)
Needs Repair (
Needs Repair (
).
.N..�.::: .:,'..�. �•. •:...::':ilia: Rmti:aw tivb� �i .. ............... ».
Yes ( ) Must be identified
Deteriorated ( ) Must be replaced ( )
1
6. GROUNDING 2 1 .
Condition:
!Comments:
7. GROUNDING OFEQUPME
Condition:
!Comments:
8. •SERV10EiCP OPILIPIRAAPV.A.
Condition:
Comments:
9. SERVIdE
Condition:
Comments:
t :EMER,
Condition:
Comments:
Condition:
omments:
Orillato ,
14. FiRgAlAwp.
Condition:
omments:
15. SMOKE` DETIBC:43RS
■••
APAIMMO.Ai
10.. TYMBP: TRICIG5
Condition:
Conduit Raceways:
Conduit PVC:
NM Cable:
BX Cable:
PP "Ate=s etif
Condition:
Comments:
Good
Good
M. •••,.
• •
••••••,. ?:
Good
Good
Good
Good
Good
Good
Good
Good
Repairs Required (
Repairs Required (
- 711-7;D:
•
■••-• , F . , " :"••" '?"7 , 7i7•7" , . •;•"!
Repairs Required ( )
Re airs Re uired
(><
( )
( )
( )
Repairs Required
Repairs Required
Repairs Required
Repairs Required
- go4 , 14. %.*71.ydr.
Repairs Required
Repairs Required ( )
t200d • • '
Re Reguired
Repairs Required
Condition:
Comments:
1
16. EXITALI
Condition:
Comments:
1
16. WJFWJ
Condition:
Comments:
Condition:
omments:
17. EMERWW
Condition:
•
lComments:
*EC _
Condition:
Comments:
SD:rtc:rv:09/01/2000:40yrintranetsystem
Tatfthligft70#4 7:47.A70.0017eW.
Good ( )
4 '•
Condition:
omments:
410041g ,
Attif . gratrrpi
urrt4i; •NE • hIlgq....t■T •
Good ( ) Repairs Required (
- - • • .
Good Repairs Required
RKING. SURFACE t, zpt • r .1.! UGHTNG
Good Illumination Required
Repairs Required ( )
Repairs Required
Repairs Required
Lt5= 1, .•
- • Good
(
Re airs Required
r r,r4A161. 4 ..