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DS-11-104
1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 155128 Permit Number: DS -1 -11 -104 Scheduled Inspection Date: July 14, 2011 Inspector: Bruhn, Norman Owner: FLEITES, DANNELLE Job Address: 131 NE 110 Street Miami Shores, FL Project: <NONE> Contractor: FLEITES CONSTRUCTION GROUP INC Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: New Phone Number Parcel Number 1121360040200 Phone: (305)216 -4027 Building Department Comments INSTALL CON PAVER IN THE DRIVEWAY. Inspector Comments Passe 4' 2/w Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. July 13, 2011 For Inspections please call: (305)762 -4949 Page 4 of 19 CFN: 20100847056 BOOK 27526 PAGE 3415 DATE:12120/2010 08:14:48 AM DEED DOC 1,380.00 HARVEY RUVIN, CLERK OF COURT, MIA -DADE CTY prepared by and return to Alfred F. Andrea, Esq. Mary Lou Roden, P.A. 2222 Police de Lean Blvd. Penthouse Suite Coral Gables, FL 33134 305 - 445 -$i1 File Number: 10- 11469 Will Cali No. Parcel Identification No. 11-2136-004.0200 Mince Above This Line For Retarding.Datal Warranty Deed. (STATUTORY FORM SBCT[ON 689.02, F.S.) This Indenture taad0 this 15th: day of Derernber, 2010 between Pedro L. Acosta, a single ran whose post office address is elo Duffy Realty, 9710 NE 2 Avenue, Miami Shores, FL 33130 of the County of Mland Dade, State ofFlorida, grantor*, and Danraelle Mites, a shale woman whose post office address is:ISSl 79 Street Causeway, North Day Village, FL 33141 of the County of Mtanni Dade,, State of grantee *, Wltnepseth'that said smelter, for and in .consideration of the man of TEN AND NO/100 DOLLARS ($10.00) and other good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby acknowledged, has granted, bargained, and sold to the said grantee, and grantee's, heirs and assigns forever; the following described land, situate, lying and being in M anglade County, Florida, to-wit Lot 21,;inIllock 1;: of COLLEGE EIIIGHTS,:aeeordiag to the Plat thereof; as recorded in Plat Book 42, at page 8, of the Public Records of Miasoi. -Dade County, Florida. Subfect to too for 2011 and subsequent years; covenants, .conditions, restrictions, . easements, reservations and limitations of record, if any, but this reference shall not serve to reimpose same. and said grantor does :hey fully ant the title to said land, and will defmd the same against lawful: claim of all persons whomsoever. o "Omar' sad "Gustaf aroused for singular or Woad, as context mums* Witness. Whereof, ,grantor has lhereuoto set grantor's hand and seal the day and year first above written. Signed, sealed and delivered in our presence: oyfy,� ' ��1�. /"'°'. R 1, Witness Name: v V • i5 "- 4 Miami Shores Village TOMV3 IN JAN 2 0 2011 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 APPLICATION FBC 20 Permit Type: BUILDING OWNER: Name (Fee Simple Titleholder): Dcam el la Title S Address:1; 1 ti .E , ( to Sif2t -e t Permit No. DS ( Master Permit No. Phone #: (ADS) 4e141- IS' ID- City:M16lW't ShfOZES State: 4L Zip: 331 Lai Tenant/Lessee Name: WI V Phone/4. Email: c(C(hn- eIt2•f1el+e3 a Irnai 1. ( JOB ADDRESS: 1 1 NJ • L • 11j City: Folio /Parcel #: Miami Shores County: Miami Dade Zip: 3 ((o f Is the Building Historically Designated: Yes NO V Flood Zone: h 0 CONTRACTOR: C mpany Name: _ I?.t ZS .i S`` LV t w GrbJ , 'Cr, Phone #: 30C- 2-1-C 4°2') Address: 8413 ` kit yt.1G�G l.Q (i�t,}�, ` p `1 %L City: M��� �l'I�I�S State: 1'�. Zip: '3�j) Qualifier Name: 001199 f 1 - 0 lit. e. teres Phone #: 307 - - 2. L( C-11-02.) State Certification or Registration #: C,C.. p -5 ) Si 3 Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: /� Phone #: Value of Work for this Permit: $ 'Z./ 0 U0 - - Square /Linear Footage of Work: q(>0 S 4Z I DAlteration New DRepair/Replace ❑Demolition Description of Work: y G. l 1 Co . Q( 1. - l VQ. W Type of Work: DAddress COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by: ******** it* ****** ******tt*** *l.*********** Feesx***. It% tr******** * ******* * ******* ****it* ****tt.t Submittal Fee $50 Permit Fee $ YcX CCF $ CO /CC $ 'vx� a /.....) "' Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ ?g • IP Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) 0/6t 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 Owner or Agent The foregoing instrument was acknowledged before me this I 1i4 I l i , The fo day of- lCrn(tcer , 2011 , by Daft Q Fk - s , day o who is s ers ally known to e or who has produced who is p Contractor oing instrument was ackn ledg4 bef ,2011 ,by Yri sonally kno, tome or who has produced gt:fication and who did take an oath. TARP PUBLIC: As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: 0(61' C7 8--IZ e.t_k, cep d° My Commission Expires: Y PaIfiekil&EF4LORIDA %Gloria Jean Breward Commission #DD638896 `'••• �•`' Expires: FEB. 18, 2011 BONDED TORO A:IM IIC BONDING CO, INC. ** ****** **** * ** ***** ***************** **** *** * ****K' * %*W**** * **************** N Sign: Print: My Commission Expires: APPROVED BY e :t// Plans Examiner * # ** * * * ** 1SA'' 1, CA' * * * * * ** * * * * * * * ** Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10) m (Y-) m L ) m m ) 1-7-1 r-r-1 Cr) C=") m m L ) Cr) c m NC- 100 Si SKETCY OF SURVEY SCALE: "=20' 10' ASPHALT 15'ALLEY 75.00' 10.1' 0.7 ft 0.7'X2.5' WALL 4.20' AWNING 20.90' tO 0' N.) RES# 131 1-STY 19.10' 53CMEW3n JAN 2 L2011 , I 1311% ....................... Miami Shores Viliaile - APPROVED x BY DATE ZONING DEPT * //1/// /,-,:// BLDG DEPT SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY R JLES AND REGIJI ATIONS 13.40' 14.75' 1 0 Pkatelt-- DT2Nivivib 0 0 143NN/ PktitS C- OX NYbt-IL tUROW )a)e1C1-1.34, C6b4,011 75.00' 5' SDWK 4+ NE 110th STREET 18' ASPHALT PAVEMENT 329.5' 2nd AVENUE 07 -21 -2010 ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE PERSON: FEIN: 07/21/2010 EXPIRATION DATE 07/2012012 FLEITES HUMBERTO M 264386912 BUSINESS NAME AND ADDRESS: FLEITES CONSTRUCTION GROUP INC 640 NIGHTINGALE AVE MIAMI SPRINGS FL 3316E -3810 SCOPES OF BUSINESS OR TRADE 1— GENERAL CONTRACTOR * IMPOHTART: Pursuant to Chapter 440. 05(14) F.S., as officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation ender this chapter. Pursuant to Chapter 440.05(12, F.S., Certificates of election to be exempt.. apply only within the scope of the business or trade listed on the notice of election 10 be exempt. Pursuant to Chapter 440.05If3, F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice ar certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for faire of the person named on the certificate to meet the regairementa of this section. QUESTIONS? (850) 413-1609 DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISEO 09-06 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE 07/21/2010 EXPIRATION DATE: 07/20/2012 PERSON: F4JMBERTO N FLEITES FEIIIE 264388912 BUSINESS NAME AND ADDRESS: FLEITES CONSTRUCTION GROUP INC 840 NIGHTINGALE AVE MIAMI SPRINGS. FL 33166 -3810 SCOPE OF BUSINESS OR TRADE 1- GENERAL CONTRACTOR F Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election I- under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be H exempt_ apply only within the scope of the business or trade listed on E the notice of election to be exempt E Pursuant to Chapter 440.05(13). F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named an the notice or certificate no longer meets the requirements of this section far issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meat the requirements of this section. IMPORTANT QUESTIONS? (850) 413 -1609 CUT HERE * Carry bottom portion on the job, keep upper portion for your records. DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06 Jan 20 11 10:36a 0 30544296330 p. 1 ACC-MIX THIS CERTIFICATE LS WIRD AS A MAT/ER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERINRCATE HOLDER. T1115 CERTIFICATE DOES NOT AFRRNIATIVELY OR NEGNM/MY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED NY THE POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSITTUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORTZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. CERTIFICATE OF LIABILITY INSURANCE DATE (IMICIDNYYY) Cri ram 1 IMPORTANT: Eflte cedllicabt hr1du ADDMONAL DIM, the pall mitts* Must Ire endorsed. if ELIBROGATION IS WAIVED„ subject be the banns and conditions of the policy, =Mtn pada% may require= endarSersent. A etateMent ao this certilleste does not canter rigids Who ccathadarin Wu at such andamentenitst. PRODUCER Royal Tax MEW-Mite Agency 36E3 SW El St R203 Miami, FL 33135 Phone (30)442-2701 R4SURED FLEITES CONSTRUCTION GROUP INC SO Nightingale Ave MIAMI SPRINGS, FL 33166- Fax (305)442.9839 isitcLum -Ii JX151P14C46 442-2791 % 1 UNC,. Ka FAX _mama isyslWilimmscaWW=Aeem salMERisl AFFORDOUS cfNERAME egsuRER A: CATLEN SPECIALW MS CO 222 (305)4424839 INSURER B: INSURER C: INSURER CI: MMIRER E INsUREN F: COVERAGES CERTIFICATE NUMBER: REVISIONNUMBER: r-tHISLSTO CERTIFY THO.T THE POLICES OF mums= LIMO 13B.OIN HAVE-BEEN ISSUED-MIME INSURED NAMED ABOVE FOR THE POLICY/3E1WD INDICATED. NOTWITHSTANINNG ANY REQUIREMENT. TERM DE coNUMON oF ANY CONTRACT OR OMER =ANENT WNW REsprcr TO WHICH "MIS GERTFICATE MAY BE ISSUED OR MAY PERTAIN, ME *SOMME/MEWED. Fff 'ME POLICIES DESCRIBED HEREIN IS MEW= MALL ME TEM% PAlO CLAIMS. MISRLTR T'YPE OF DMUSIANCE 1 , 0 AIL= NUMEIER 0900101016 Ad tirsrra 1 A DENERAL LIMMIFY 1Z anfilraVAL GENERAL LIMALITY L3 Q MAINS-MACE D aCcUR oanizario EACH OCCURRENCE s 1,00O,000.00 09/17/2011 ' DAMAREtn RNTED' SalaigmFeesEEL s =maw _aligri. loottots.okajmus posor, s %PERM PFRoosse.sadAt =MY s 1.001:000.150 GENERAL AGGREGATE $ 2.000.S00.00 PRODUCTS.COMMOPAGG S 2,000.000.00 REM_ AGGRECIATE Latir APPIJESPErt E] PoLICY El MI D Las comaalaSivaesLE. UMIT Ma acdthein s s AtifteMBRE UR/331TV ANY AUTO o zpowNED c SCHEDULED 0 HMEDAUMS 0 raremED • D 0 - ONLY INJURY per pesos) S —I 1 (=HY erAMY(Per tp., s 0 LISMAIELIA WM 0 mem 111 815cEss 11.103 0 CLABASVIADE EACH =LIO= AGGREGATE S eRNIKERS CtINFIRMATION AND Elert.OYEIRS: LAMM Y. N ANY PROPMETORPARTNEREDIEWME I [NM; ' ,33 ,■.)* ■• ',4' EL MCI* =Mar EL. DISEASE- EA EISPLOYE ' S °FRMUMMER EXCLUDED7 pdandmy ar in NH) 1 I EL DISEASE - POLICY MST It ms demons tester DESCRERION OF OPERATIONS b� oF_scRIPTPON GENERAL OF OPERATIONS tuDcATIONSIVENCLES Mach =ORD M. ;Walesa) Ragas Sarah% It seam la letalmist CONTRACTOR CERTIFICATE HOLDER MIAMI SHORES VILLAGE 10050 NE 2 AVE MANS SHORES FL 33135 SHOULDANY OF THE ABOVELIEECRIEW FOLicESI3ECAILcELIBUINTI:IRE • THE EXPIRATIoN DATE THEREOF, NOME WEL RE DELIVERED IN AcoORDAtioR MTH THE POLICY PROVEREINS. ACORD 25 (2010515) QF ACORD CORPORATION. All rights reserved. ACORD name and Ingo aiv tegistesed marks °memo T -E S RVEY DEP CT -) -ERE S i\OT COVERE) BY PROFESS O \AL L AB LP' SKETCH OF SURVEY SCALE: 1 " =20' 10' ASPHALT 15'ALLEY 75.00' 1' ---- o1 0 N A/C 0.7' 10.1' F. 1C) f 0.7'X2.5' WALL 0 4.20' N (0 U7 AWNING Crt 20.90' CO RES# 131 1 —STY 19.10' 2©k' 14 Li fet.qt5S N cPc,,,Lttocl 0 (n 13.40' 14.75' dx 0.1' 4536.3 LOCATION MAP (NTS) NE 111th STREET FOR DANNELLE FLEITES, a single woman JOB No.: 1213102 ADDRESS: 131 NE 110th STREET, MIAMI SHORES, FLORIDA 33161 SURVEY DAZE 12 -13 -2010 LEGAL DESCRIPTION: LOT 21, IN BLOCK 1 OF 'COLLEGE HEIGHTS;" ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 42 AT PAGE 8 OF THE PUBLIC RECORDS OF MIAMI —DADE COUNTY, FLORIDA. x 0.1' 0 g N 4 75.00' 5' SDVX 0 L0 M NE 110th STREET 18' ASPHALT PAVEMENT NE 2nd AVENUE 12 13 ALL 20 •Y 14 19 15 18 16 17 NE 110th STREET CERTIFIED TO: DANNELLE FLEITES, a single woman GIBRALTAR PRIVATE BANK & TRUST COMPANY, ISAOA /ATIMA MARY LOU RODON, P.A. OLD REPUBUC NATIONAL TITLE INSURANCE COMPANY LEGENDS = CATCH BASIN 0- = GAY POLE pro = HYDRANT iil = IRON PIPE © = IRON ROD x z = LIGHT POLE O = SEWER MANHOLE ® = DRAINAGE MANHOLE 0 = NAIL & DISC CO = POWER POLE D = WATER METER = WELL —0— = SIGN — = CENTERUNE — MONUMENT UNE —x —x x— = CHAIN LINK FENCE — OVERHEAD POWERLINE —0-- CONCRETE FENCE —0-- METAL FENCE —i/-4-4—= WOOD FENCE NE 2nd AVENUE ABBREVIATIONS ENC= ENCROACHMENT (BASED ON APPARENT PHYSICAL USE), SDWK= SIDEWALK, PL= PROPERTY UNE, F= FOUND, STY = STORY, A/C =AIR CONDITIONING UNIT, PC =POINT OF CURVATURE, PT =POINT OF TANGENCY, D/H =DRILL HOLE, RES= RESIDENCE, CONC= CONCRETE, R /W= RIGHT —OF —WAY, (TYP)= TYPICAL, (FM) =FIELD MEASURED, (C)= CALCULATED, (R)= RECORD, C /N= CUTNAIL, R/N =ROUND NAIL, N/TT =NAIL & TIN TAB, S =SET, FFE= FINISH FLOOR ELEVATION, 0/S =OFF SET, PB =PLAT BOOK, PG. =PAGE, NTS =NOT TO SCALE, PRC =POINT OF REVERSE CURVE, PCC =POINT OF COMPOUND CURVE, POC =POINT OF COMMENCE, POB =POINT OF BEGINNING, CB =CHORD BEARING, BLDG = BUILDING, EASM'T = EASEMENT, UT EASM'T= UTILITY EASEMENT, DME= DRAINAGE MAINTENANCE EASEMENT, C.N.A.= CORNER NOT ACCESSIBLE, M.SH. =METAL SHED, P /F= PLASTIC FENCE, MH= MANHOLE. SURVEYOR'S NOTES: 1) PROPERTY SURVEYED ACCORDING TO LEGAL DESCRIPTION PROVIDED BY CLIENT; 2) UNLESS NOTED PROPERTY CORNER MONUMENTS HAVE NO ID; 3) EXAMINATION OF ABSTRACT OF TITLE AND A SEARCH OF THE PUBUC RECORDS WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS AFFECTING THE PROPERTY; 4) BELOW SURFACE LOCATION NOT DONE; 5) THIS SURVEY IS FOR THE EXCLUSIVE USE OF THE ENTITIES NAMED HEREON; 6) THIS SURVEY IS FOR MORTGAGE PURPOSE ONLY, NOT TO BE USE FOR CONSTRUCTION; 7) NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER I HEREBY CERTIFY THAT THIS "BOUNDARY SURVEY" MEETS THE "MINIMUM TECHNICAL STANDARDS" AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS IN CHAPTER 5J- 17.05, FLORIDA ADMINISTRATIVE CODE, PURSUANT TO SECTION 472 -027, FLORIDA STATUTES. FREEDOM OF LAND CORP Surveying Services 7575 W. FLAGLER STREET, SUITE 207 MIAMI, FLORIDA 33144 305.266.4451 FAX 305.262.5007 / LB4515 Q H. -FO SADA da'd Surveyor No.5133 STATE OF FLORIDA 1