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DS-11-541Ir Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 164240 Scheduled Inspection Date: September 12, 2011 Inspector: Bruhn, Norman Owner: FADELY, CHARLES Job Address: 280 NE 91 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ARROW ASPHALT & ENGINERING INC Permit Number: DS -3 -11 -541 Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060190410 Phone: (305)556 -5702 Building Department Comments REMOVE AND REPLACE EXISTING CEMENT RIBBONS AND CEMENT WALKWAY. INSTALL ASPHALT SWALE WITH 6" LIMEROCK AND 1 1/2" HOT ASPHALT. 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- 157702. Sidewalk must be repaired /replaced Replace sod in disturbed areas. NB September 09, 2011 For Inspections please call: (305)762 -4949 Page 24 of 35 (etm Shores Village Building-Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 B Y: Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No. D51 ( -54 if PERMIT APPLICATION FBC 20 M MAR 2 (:-) 2011 Master Permit No. Permit Type: BUILDING OWNER: Name (Fee Simple Titleholder): h A 5 F17 1/ Phone#: 30.57- 796- g37: Address: ,-,230 N E 97 - City: M /9 iv State: AVORM04 Zip: 33/3 Tenant/Lessee Name: Phone#: JOB ADDRESS: 0 Al ,E W City: Miami Shores County: Miami Dade Zip: 33 12g Folio/Parcel#: //- 3,,,?‘96) -0/9 -011/0 Is the Building Historically Designated: Yes NO X Flood Zone: CONTRACTOR: Company Name: A ROW /4,6,41/ Phone#: 305-681 -g65.26 Address: 36,---2:L_____ J.,0 a ? s 7i. city: (7,0/4 /0cA,i9 State: F io k; f D efl Zip: 2,Z aCtill Qualifier Name: SA419,17/f/ 0 ?Oa / Phone#: 95'/.6 */ State Certification or Registration #: Certificate of Competency #: 9,7 - 4:2,06 Email Address: 4./ZRO tz-,i9SPh 47 gad4 Contact Phone#: 30.5-6 9 'Y'- g‘ 2. 6, DESIGNER Architect/Engineer: Phone#: Value of Work for this Permit: $ 17/ 92.67 °° Square/Linear Footage of Work: ic2,(::0 As pAA hii Type of Work: ClAddress DRepair/Replace CIDemolition Description of Work: E iR 1 A, s 4-fi41 b de-ptie,u-f DAlteration CINew ptP 64-1 / • COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by: ***************************************F ******************************************** Submittal Fee $ Permit Fee $ C� $ CO/CC $ CFP- efi' Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review .$ TOTAL FEE NOW DUE $ (15i 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 co . cement and construction lien law brochure will be delivered to the person t. Also, a certi whose property is subject to a for the Lion Bich spec copy of the recorded notice of commencement must be posted at the job site fter the building permit is issued In the absence of such posted notice, the ill be charged Owner or Agent The foregoing instrument was a • i owledged before me 2I day of rnarCh . MIL by . aile5 who is personally known to me or who has produced C. Di— As identification and who did take an oath. NOTARY PUBLIC: APPROVED BY Contractor The forego', i g instrument was acknowledged before me this 224 day of fho is personally known to m)or who has produced . as identification and who did take an oath. NOTARY PUBLIC: by 511A0k 0ITok Plans Examiner Structural Review (Revised 07/10/07 )(Revised 06/10/2009)(Revised 3/15/09 »rev6 /4/10) 4,/ JAW GARCIA r MY COMMISSION # DD 842418 I EXPIRES: December 14, 2012 Bonded Thru Notary Public Underwriters Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) h / ��� hereinafter referred to as the owner of , 8O A 6 E 9/ s1.ez-/ the following described property (address): Legal Description Folio # Requests permission to install (describe work): (c // /i t- EROCA g v Lot Block Subdivision R ie_ B� Within the public right of way of (address) AO . I s /0h/9 /7 5ek) /9 A— �/ /h Asph4 /'/ 28O V E 9/ . `AEA -' 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. 1 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 SIGN Z, SEALED, AND DELIVERED in the presence of: 2 'STATE OF FLORIDA DEPARTMENT OF HEALTH /APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PEtRMIT JJO Permit Application Number _"71- - - PART II. - SITEPLAN Scale:- Each -bR ck represents 10 feet and 1 inch = 40 feet. SO le l v ► Notes: Site Plan submitted by: Plan Approved gnature Not Approved c Title Date 5 By County Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015, 10/96 (Replaces HRS -H Form. 4016 which may be used) (Stock Number: 5744-002-4015-6) a , cal; WALL • •( .A.MF c"" ( . I. Ci.e4474. Li, E. 7 LCCA1101',) GAL This property dettrf. Lot 5, Block 3, EL PORTAL, • according to the PI thereof, as recoede Plat Book 9, Page' • of the Publ ic Recor: Dade, County, Florida Arnt0161) p to plot5.y*, Date.. e\i-o 1%, . Nuoti-Dadeco■Illti iieattb:Dte • Po • Mb R4-7)/9CW oxiCRE're • Arbbo/us /9.N6 COAVRE-72r • koAt-//4WJ4y • vs›At •reit677 itroile ,„ Mitnj j,yo4 6's4' PPM " ;V-h 7397e 5-3 AVM / ••,-*j4- I hereby certify that the- attached .sketch represents a recent survey made under t • my • direct Ion, and s• true- and correct tp the best Of my knooledie and belief, -1 and that there are • no en-- croachatents on said land •- othext.h:n shzin here- on, •. •• .„,4,•-•to Fia. Re9. Surveyor No. ,001 pm. Reg, Engineer No.; LANNES and GARCIA, ENGINEERS- LAND SURVEYORS - LAN P 0. Box 661131 It Miami. Florida. 33156 •hiE RS DATE 14-a--77 SCALE lw= ' DRAWN BY .•,i. • — ,, •(""-"•U''':.. oftWG,-.N0,: j 1-.77-452' Miami Shores Villa e APPROVED ZONING DEPT BLDG DEPT StIOAVTIOCOMINCIIVICAMMOVII• STATE MOCCOMIVIVAISANDRESUUM01. opts•. • • • • ...4 . • • • • • ••• • • •• • • • • .•$ts•' opts•••. • •• • • • •op••o• • • •••. Re•• • • • •' 1•1'S • • 41,••••• ••••• s •r ••••• • • • •.... -0 i. opts 410, 111 • • • r • • • • • • • • • • • • • • 0 • • • • •• • ARROW ASPHALT & ENGINEERING, INC. 3051 NW 129 ST OPALOCKA, FL 33054 990004611 . ..UNTIL SEPTEMBER 30, 2011 FORCE NOTE THIS MEN • •OCCUPATION SPECIFIED H CITY OF OPA-LOCKA IS HE PLEASE DETACH AT PERFORATION City of Opa-locka Department of Business and Licensing Occupational License ARROW ASPHALT & ENGINEERING, INC. 3051 NW 129 ST OPALOCKA, FL 33054 UCENSE FEE $150.00 SED TO ENGAGE IN THE BUSINESS, PROFESSION OR OCCUPATION OF RENT OFFICE OR SPACE FOR BUSINESS NOT F OPA-LOCKA, WITH THE AOWING REST TIONS: 11( 1' 0 BY: CITY MANAGER DISPLAY AS REQUIRED BY LAW 2011 NV( REGULATIONS NOW IN THE BUSINESS OR ai,A49.4411c) LICENSECLERK . . . . • RD CERTIFICATE OF LIABILITY INSURANCE OP 1D Q6 DATE (MM!DDIYYYY) 03/02/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED -R EPRESENTATIVE OR PRGIAIGER, -AND -- THE CERTIFICATE HOLDER.. `ORTANT: If the certificate- holder is an ADDITIONAL INSURED, the policy(ies) must be endotsLd. If SUBROGATION IS WAIVED, subject to terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER BROWN & BROWN OF FLORIDA INC 14900 NW 79th Court Suite #200 Miami Lakes FL 33016 -5869 Phone: 305 - 364 - 780 0' Fax:305- 822 -5687 (.UN I AL1 NAME: PHONE A/C, No, Ext): E-MAIL ADDRESS: FAX (A/C, No): PRODUCER CUSTOMER ID #: ARROW -4 INSURER(S) AFFORDING COVERAGE NAIC # INSURED Arrow Asphalt & Engineering Inc. Shawn O'Toole 3051 NW 129th Street Opa Locka FL 33054 INSURER A: National Trust Insurance Co. 20141 INSURER B: FCCI Commercial Insurance Co 33472 INSURER C : FCCI Insurance Company 10178 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE AUUL INSR SUBI WVD POLICY NUMBER �E�pFFp (MM/D� DDY/YYYY) FOLIC (MM/DDIYYYY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR GL00099592 02/28/11 02/28/12 EACH OCCURRENCE $ 1,000,000 X PREMISES (Eatoccurrence) $ 100,000 CLAIMS -MADE X MED EXP (Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,0 0 0 , 000 GENERAL AGGREGATE $ 2,000,000 GEM_ AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY PRC LOC JECT $ [' JTO X ANY AUTO MOBILE LIABILITY ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CA00154332 02/28/11 02/28/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ B x UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE UMB00103021 02/28/11 02/28/12 EACH OCCURRENCE $2,000,000 AGGREGATE $ 2,000,000 DEDUCTIBLE RETENTION $ 10,000 $ X $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIV OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS Y / N N / A 001 -WC11A -63765 02/28/11 02/28/12 WCSTATU- X OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 below E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER. CIT3138 CANCELLATION - SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ' THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ITY-: =OF MIAMI SHORES -100507=14E- -2ND AVENUE -141.411 "SHORES FL 33138 AUTHOR.IaD REPRESENTATIVE ACORD 25,(2009109) The ACORD name and logo ar 01988 -2009 ACORD marks ofACORD 41Hit _ text...4_0( Pia eig and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Folio Number:1132060190410 Owner's Name: CHARLES FADELY Job Address: 280 91 Street Miami Shores, FL 33138- Total Square Feet: 220 Total Job Valuation: $ 2,495.00 Contractor(s) ARROW ASPHALT & ENGINERING INC Phone (305)556 -5702 Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: No Date Denied: 3/29/2011 Comments: PLEASE REDRAW THE DRIVEWAY SO THAT IT IS LOCATED NO CLOSER THAN 4 FEET TO THE EXTENSION OF THE SIDE YARD LOT LINE THROUGH THE SWALE (NORMALLY A 5 FOOT SETBACK IS REQUIRED). FLARE CAN NOT BE GREATER THAN 2 FT x 2 FT. 04/06/2011 10:10 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES eon TRANSMISSION OK TX /RX NO RECIPIENT ADDRESS DESTINATION ID ST. TIME TIME USE PAGES SENT RESULT * * * * * * * * ** * * * * * * * * * ** * ** TX REPORT * ** * * * * * * * * * * * * * * * * * * * ** 1248 93056888484 04/06 10:10 00'21 1 OK 41ilti Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone. (305)795 -2204 Fax. (305)756 -8972 PJ< 2 —(erY try Permit NO. DS -3 -11 -541 Issue Date: Not Issued Expires:Not Issued Folio Nurnber:1132060190410 Owner's Name: CHARLES FADELY Job Address: 280 91 Street Miami Shores, FL 33138- Owner's Phone: Total Square Feet: 220 Total Job Valuation: $ 2,495.00 Contractor(s) Phone Primary Contractor ARROW ASPHALT & ENGINERING INC (305)556 -5702 Yes Planning and Zoning Criteria and Comments Approved: No Date Denied: 3/29/2011 Comments: PLEASE REDRAW THE DRIVEWAY SO THAT IT IS LOCATED NO CLOSER THAN 4 FEET TO THE EXTENSION OF THE SIDE YARD LOT LINE THROUGH THE SWALE (NORMALLY A 5 FOOT SETBACK IS REQUIRED). FLARE CAN NOT BE GREATER THAN 2 FT x 2 FT. Permit No: 11 -5`'/ Job Name G( , 2011 Miami Shores Village Building Department Building Critique Sheet 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 3 -66i- Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from 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 Cnr:Aouc1ion Trades Qualifying tioa,d cif r�5 CERTIFICATE.. OF COMPETENCY E 7200 ARROW ASPHALT & ENGIN ERiri3G IP'C D.B.A.. O'TOvl SHAWL ! ss c rtificd - s:nder the previ;:ion$ ca! C