RC-11-787Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 159240 Permit Number: RC -5 -11 -787
Scheduled Inspection Date: June 08, 2011
Inspector: Grande, Claudio
Owner: ROGERS, SHAUN D & NADINE M DAVE
Job Address: 121 NE 100 Street
Miami Shores, FL
Project: <NONE>
Contractor: CRUZ R RODRIGUEZ
Permit Type: Residential Construction
Inspection Type: Final Building
Work Classification: Alteration
Phone Number (305)756 -7345
Parcel Number 1132060132040
Building Department Comments
CONNECT EXISTING GRADE BEAM IN WIDNWO AREA
TO INSTALL WINDOW PROPERLY. (REPAIR WINDOW
OPENING) LOCATION IS ON FRONT RIGHT SIDE.
PassedW d;(-1
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
June 07, 2011
For Inspections please call: (305)762 -4949
Page 9 of 24
6tql1.-/34.‘)(
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
BUILDING Permit NoRI ()
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: BUILDING ROOFING
P,87,--.-.5..
OWNER: Name (Fee Simple Titleholder): 51"kii ' Phone#:
Address: /42 %t 24- f ®® -fA
City: ,�''1 i , fle e-ft:1- State: /4::-C Zip:
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS:
/G / /toz� /919 L
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #: // 3,?& A 013 07Oc / a ttS) ilb
Is the Building Historically Designated: �� VC
g y grated: Yes NO 4� Flood Zone:
CONTRACTOR: Company Name: CA/ �a' / , y /e �P- Phone#: 302269 7 / v
Address: 360 r• ' gibes '
City: 4 7 ®% State: Zip c ??/60
Qualifier Name: Zi ie A���14,- .
State Certification or Registration #: C'(` C- �/ Certif ate of Competency #:
Email Address: 4C ,fir �e� exr �'
Contact Phone #: �� 7/0 ��6 � � ��
DESIGNER: Architect/Engineer: Phone#:
Phone #:
°a
Value of Work for this Permit: $ ���D Square/Linear Footage of Work: 5)
Type of Work: ❑Addition ❑Alteratiion i ❑New ff ' ' epair/Replace ❑Demolition
Description of Work: 9f,7e0C/ i I /`, 6,P4 � #' i CA), 94.,
e Mf• i IF
********* axe+ ********** *+x** **** **** ** *** Fees * *** **• ********** **+ x**+x*+x******* * * * **** *****
Submittal Fee $ Permit Fee $ /jO °a CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 1 Q 4 r (
Bonding Company's Name (if applicable) /Y/J7
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) /1<2,
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
Owner or Agent
Contractor
The foregoing instrument was acknowledged before me this 344' The foregoing instrument was acknowledged before me this Bid
day of r/' 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_ i T
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: — ; • TARY PUBLIC:
Si
Print:
My Commission Expires:
APPROVED BY
My Commission Expires:
Plans Examiner Zoning
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Clerk
Poky Number: 04GL000739344
. CERTIFICATE OF LABILITY INSURANCE
The World Of Insurance, Inc.
13155 S.A. 134 ST SUITE #209
MIA G , FL 33186
Phone: (786)573 -2221
Fax (786) 573 -2229
ROUND
Date Entered: elzrzoio
THIS CERTIFICATE IS ISSUED AS A
ONLY AND CONFERS NO RIGHTS
HOLDER. THIS CERTIFICATE DOES
ALTER THE COVERAGE AFFORDED
I OATS possoIYYY1r)
12/3/2010
MATTER OF INFORMATION
UPON THE CERTIFICATE
NOT AMEND EXTEND OR
BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
CRUZ R. RODRIGUEZ
GENERAL CONTRACTORS
80 S. W. BTR STREET SUITE 2230
MIANI, FL 33130
COVERAGES
WsuRER AMID— CO21711931EP CASUALTY COWART
POURERS APIN:RICAN HONE ASSURANCE
POURER C
INSURER
INSURER E
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 AU. THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
PO.ICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BYpAIDCLAIMS.
INSR ARM
LTR 'MRS POLO/ NUMBER �W
POLICY EFFECTIVE POLICY E PIRATION
QATEantrai YYI DATE nOIYYYYI
TYPE OF
GENERAL LIABILITY
XCOMMERCIAL GENERAL UABUTY
CLAIMS MADE OCCUR
GENT. AGGREGATE LIMIT APPLIES PER
(
POLICY N I EECt I jj 1 LOC
04GLOOO739344
12/3/2010
12/3/2011
LIMITS
EACH OCCURRENCE
DAMAGE TO RENTED
PRF ESFISTESa:aeMIEG._
MtEDEXP (MGarteersora
PERSONAL AM/ INJURY
s 1, 000 , 000
_ 1DOJ CIP
$ EXCLUDED
$1,000,000
SERERP4. AGGREGATE s 2,000,000
PRODUCTS • COMIPJOPAGO $ 2,000,000
AUTOMOBR.E LIABILITY
ANY AUTO
ALL OWNED AUTOS
_ SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AI. OS
N/A
COMBINED (Ea I PALE LINT
BODILY INARY
(PerparsanJ
I
r
BODILY HAIRY
Imo acddad)
$
PROPERTY DAMAGE
(Pmseckiard)
S
GARAGE LIABILITY
ANYAUTO
EtA
AUTO ONLY , EAACC_OENT
OTHER THAN EA ACC $
AUTO ONLY AGO $
S
EXCESS IUNBI.LA LIABH./IY
OCCUR { CLAWS MAEIE
DEDUCTIBLE •
RETENTION • S
WORKERS COMPENSATION
*No EMPLOYERS LIABILITY •
B ANY PROPRIETOWPARTNERESECUTIVE
18m*Aery In ERIE
Vasentm °SPECIAL NS
OTHER
YIN
6873.888
12/3/2010
12/3/2011
EACH OCC RRE:NCE
AGGREGATE
$
$
- o
TORY I RAIL N3
E L. EACH ACCIDENT $ 500 , 000
EL Disease -EA EMWPI.oYER $ 500,000
$
E L. Dr> -POLICY LIST $ 500, 000
N OF OPERATIONS f LOCATIONS susweLes a EKCLUSIONA ADDED BY EmoRSISSENT a SPECIAL PROVIS
GENERAL CONTRACTOR.
OLDER
CANCELLATION
Miami Shores Village
Building Department
10050 N.E. 2nd Avenue
Miami Shores, FL 33138
ANY OF DES DPOLICIES
DATE THEREOF. THE issu a INSURER WILL ENDEAVOR
NOTICE TO THE CERTIFICATE HOLDER NAMED TOTUE
IMPOSE NO OBLIGATION OR UASILITY OF ANY IONS
REPRESENTATIVES.
BE C' LLED BE E THE EXPIRATION
TO MAR.30 DAYS WRITTEN
LEFT. But FAILURE TODOSOSHALL
UPON THE INSURER. ITS ADMITS OR
AUTHORIZED REPRESENTATIVE
9.40sefer
.46 4,64.16.V.
egeowa<er
ACORD 25 (2009101)
Permit No: 11 -787
Job Name:
May 9,2011
Miami Shores Viiiage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Page 1 of 1
Building Critique Sheet
1) The plans submitted are unreadable. Submit plans that are readable.
2) Provide a floor plan showing the location of work in the house.
Plan review is not complete, when all items above are corrected, we will do a complete plan
review.
If any sheets are voided, remove themfrom the plans and replace with new revised sheets and
include one set of voided sheets in the re- submittal drawings.
Norman Bruhn CBO
305 - 795 -2204
• SHAUN ROGERS
121 NE 100 ST.
MIAMI. SHORES, FL.33238
To Remain
BATHROOM
STUDY ROOM
KITCHEN
To Remain
To Remain
To Remain
To Remain
New
•
U
a
I
•
DINING ROOM
DEN
AVA\ I'IYH
To Remain
IA1001IHIVS
IN0011HIVB
I
•
I
IAIOO11 ONIAII
I
I
•
I
I
A— 1>aor
B- Trtx.n:Arn
•
•
To Remain
To Remain
To Remain
To Remain
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT N Z TAX FOUO NO.1lY,e,
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.
1. L . d= . ription o
2. Description o
1 1111111111 11111 1111111111111111111 11111111
CFh! 201 1R0 325302
OR Bk 27692 P9 08624 (1Rg) j
RECORDED 05 /1E /2011 09 :59421
HARVEY RUVIH's CLERK OF COURT
' IiIAMI —DADE COUNTYv FLORIDA
LAST PAGE
Space above reserved for use of recording office
nd treet/a
dress:
improvement:
3. Owner(s) name and address: 4i : ' 2f ✓ tom= . ✓ _ i . rt r ��
Interest in property: "4.401
Name and address of fee simple titleholder.
4. Contrac or's name, adds= and pho e number:
5. urety: (Payment bond required by owner from contractor, if any)
Name, address and phone number
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)(a)7., Florida Statutes,
Name, address and phone number.
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. / i // /�
Name- ddress and phone number. / >. �. / ��•- �°i� ' l�
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 CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK
OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Signature(s) of Owner(s) or Own .4(s)' uthorized Officer /Director/Partner /Manager
Prepared By _ / :0- P .- Prepared By
Print Name VAirrao■.r .rfit' Print Name
Title/Office PA1'LPi?al.� Al'�1�1.`1 >TTitle/Office
STATE OF FLORIDA / -1/
COUNTY OF MIAMI -DADE
The foregoing instrument was acknowledged before me this / y of '/"te.., 2 ore
By
,� I dividually, or la
l7 Personally known, or a produced the following type of i
Signature of Notary Public:
Print Name:
(SEAL)
for ,
de �►
` . armah,
VERIFICATION URSUANT TQ 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 ) of Owne ) or Owner(s)'s Authorized Officer /Director/Partner / /Manager who signed above:
By By . ®`C fP'°
123.0142 PAGE 3 31O
STATE Of FLORIDA, Cots i` F CAE
I HEREBY CERTrr�'tft t::,s AR iron Ct�pgefhe
or i i Y (3'f;,- 7Appr' 3 an-
- —day al
1 8 aU 11:
0 JOISTS TO REMAIN
AMAGED JOISTS
SCOPE OF WORK
PROJECT CONSISTS OF REPAIR OF
DAMAGED JOISTS ON LIVING ROOM
SPECIFICATIONS:
VE DAMAGED JOISTS
1. TO THE THE BEST OF THE ENGINEER'S KNOWLEDGE AND
PROFESSIONAL ABILITY, THESE DRAWINGS COMPLY WITH THE
EXISTING REQUIREMENTS OF THE FLORIDA BLDG. CODE 2007
EDITION.
EXISTING CONDITION
SCALE:1 /4 " =1' -0"
DEMOLITION PLAN
SCALE: 3/1611=1.'
2. GENERAL CONTRACTOR TO OBTAIN ANY AND ALL NECESSARY
BUILDING PERMITS WITH LOCAL AUTHORITIES HAVING
JURISDICTION ON THE SUBJECT PROPERTY.
3. G.C. TO TAKE EXTREME CARE DURING THE DEMOLITION
PROCESS TO SAVE AND REUSE THE EXISTING WOOD FLOORING.
4. USE #2 GRADE SOUTHERN PINE PT LEDGERS
5. CONCRETE TO BE 4000 PSI AT 28 DAYS. W/C RATIO NOT TO
EXCEED 0.47
6. USE REINFORCING STEEL PER ASTM A-615 GRADE 60
7. USE HILT! KWIK BOLTS ON SIZES AND SPACING AS SHOWN.
EXIST. IY WIDE FTG.
15 =2 3/4•
PROPOSED RETROFIT PLAN
(4) E5 CONTINUOUS BARS
EMBEDED ONTO EXISTING FOOTING AT LEAST 8'
WITH HILTI HY 150 OR APPROVED EQUAL
NEW IT WIDE X EXIST.FTG. DEPTH
CONCRETE GRADE BEAM
WITH 455 CONT. BARS AND #3 TIES lb 12
CA 09550
140 BUTTONWOOD DRIVE
KEY BISCAYNE. FL. 33149
PHONE: 305-772-7599
Miami Shores Village
APPROVED
ZONING DEPT
BLDG DEPT
STRUCTURAL TABIO EN,NEERIPIG CORPORATION
REPAIRS
RESIDENCE AT 121 NE 100 ST
MIAMI, FLORIDA
PROJECT LOCATION
(N.T.S.)
MAURICIO SALAZAR, P.E.
FLA. LICENSE #55757