RC-11-1621Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 164045 Permit Number: RC -9 -11 -1621
Scheduled Inspection Date: September 12, 2011
Inspector: Bruhn, Norman
Owner: KHAN, BEATRIZ
Job Address: 520 NE 92 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: SNAPP INDUSTRIES INC
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Repair
Phone Number
Parcel Number 1132060141190
Phone: (305)635 -0687
Building Department Comments
REPAIR RIB JOIST UNDER HOUSE FOR SPALLING
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
September 09, 2011
For Inspections please call: (305)762 -4949
Page 21 of 35
AMERICAN SOCIETY
OF CIVIL ENGINEERS
NATIONAL ACADEMY
OF BUILDING INSPECTION
ENGINEERS
NATIONAL SOCIETY OF
fiR. 1! S���� ®�� AE. PROFESSIONAL ENGINEER:
CONSULTING ENGINEER FLORIDA ENGINEERING
SOCIETY
PROFESSIONAL BUILDING INSPECTION
12420 S.W. 75th AVE., / MIAMI, FLORIDA 33156
TELEPHONE: (305) 37 8-1244
Established 1976
Village of Miami Shore
Building Department
10050 N.E. 2nd Avenue
Miami Shores, Florida 33138
Dear Building Official
9 September, 2011
520 N.E. 92nd Street
Snapp Industries
I, J.N. Sheingold, P.E., having performed and approved the required inspections, hereby attest
that to the best of my knowledge and belief, the repairs to the reinforced concrete rib joist
complies with the permitted documents. I also attest to the best of my knowledge and belief, the
approved permit plans represent the as -built condition of the structural and envelope components
of said structure ". This document is being prepared in accordance with Section 105 of the 2007
Florida Building Code and is being submitted to the Village of Miami Shores building
department at the time of final inspection for the above referenced structure.
Should you have any further questions or need any additional information, please do not hesitate
to contact me.
heingold, P.E. 21181
520 N.E. 92ND STREET
Permit RC -9 -11 -1621
Date of Inspection
9 September, 2011
Time of Inspection
1:30 P.M.
Location CRAWL SPACE
By Unit #
e of work ins . ected 115111 ✓ Demolition �' ebar Prep 0 Rebar Splice 1 1 Dowel/core drilling
✓ Rebar /Concrete Epoxy Coating ✓ Concrete Pour L jFinish Plaster
Other (Specify)
final
Comments
Approved ❑Rejected
Repair of reinforced concrete rib joists in crawl space
Enginee
Engine
Sigma
J.N. SHEINGOLD
J.N. SHEINGOLD, P.E.
RECEIVED
S P 01 2911
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel (305) 7952204 Fax (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 200f7
Permit Type (circle):
Building
Permit No. U '14-6
Master Permit No.
Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) I IIi /cf a"/ Phone 3o -3 3c
Owner's Address 57:20 O A/C- 9 ' �/
City / i SheaS State pi. Zip ,33f3P
Tenant/Lessee Name Phone #
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip 33/32
FOLIO / PARCEL # i 0 (C, tf2f Vi 90
Is Building Historically Designated YES NO 1-------.
Contractor's Company Name �s i Phone # (�� �� ` 010.? '7
Contractor's Address x-9o2 ,'Vk) ad "cif
City 'o)47 1 State / Zip
33140,1- /y
Qualifier Name 7 -Se, � S✓si Phone # r jC S 6/SS--- 0 6, ,
State Certificate or Registration No. C6-C /s 07 6' 7 / Certificate of Competency No.
Architect/Engineer's Name (if applicable) % Phone #' c=�
Sdo
0
Value of Work For this Permit $ c2 45-6
Type of Work: ❑Addition
Describe Work:
['Alteration
Square / Linear Footage Of Work:
QNew
Repair/Replace
D Demolition
* * * * * * * * ** t * **** *** *** **** ***** * * ** Fees * * * * * * * ** * *** * * ***** ** * * * * * * ***,r*** * * **
Submittal Fee $�._.� Permit Fee $
CCF $
CO /CC
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $
Total Fee Now Due $
See Reverse side -3
Bonding Company's Name (if applicable) a
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.
The foregoing instrument was acknowledged before me this
d a y of ,20 (,by a4 i 1 Kha /4 , day 0
Contractor
Th ' foregoing instrument was acknowledged before me this 09
20 lt by 731'(
who is personally known to me or who has produced who is person
As identification and who did take an oath.
NOTARY PUBL
Sign:
Print:
es'Y Piik DOPNAJ. EGAN
* * MY COMMISSION # DD 755165
Ti : EXPIRES February 22, 2012
4 0FF400Oc Bonded iiuuBu Notary Services
My Commission Expires:
ly known to me or who has produced
�`i➢ r 1' -
tification and who did take an oath.
NOTARY P IC:
Sign:
Print:
M y Commission Ex B d e d R a u et Nor Senn
IRES: February 22, 2012
******** * * * * * * * * * * * * * * * * * * * * * * * * *** ** ** *art *** * ** Year******** ******** ** * * * * * ** * ** *** ** * ** *> tier* **** *t************
APPLICATION APPROVED BY:
(Revised 02/08/06)
Plans Examiner
Engineer
Zoning
P ID: SI_
. a
'��.._. ---- CERTIFICATE OF LIABILITY INSURANCE
DATE O 04/11
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 POUCIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. .
IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the
cell ificate holder in lieu of such endorsementjs).
PRODUCER 386- 252 -9601
Brown & Brown of Florida, inc. 386- 238 -15728
Daytona Beach Office
P.O. Box 2412
Daytona Beach, FL 32115 -2412
.
CONTACT
PnONE IAX
udC. ti. Eck i INC. Nok
A ua
tilt
CUSTOMER ID# SNAPP -2
INSURERR AFFORDING COVERI GE
NAM 4
INSURED SNAPP INDUSTRIES, INC.
2902 NW 22ND STREET
MIAMI, FL 33142
INSURER A: Starr Indemnity & Liability Co
38318
INSURER B :Harleysville Mutual ins Co Inc
14168
INSURER C: Bridgefield Employers
10701
INSURER D:
INSURER E :
INSURER F:
.
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO -THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR COMMON OF ANY CONTRACT OR OTHER DOCUMENT WffH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALI. THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMIT$ SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
R
TR
A
el'Ic . iii
GENERAL UA81WY
COMMERCIAL GENERAL UAB&LrrY
CIAO -MADE ! X 1 OCCUR
X XCU/CONTRACT LIAR
GEN'L AGGRE�GA R
ATTE LIMIT APPLIES PE
POLICY ► A ( fl LOC
SIPG- GL00055 -00
12/301/0
12130/11
EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES Ms occurrence)
MED EXP (Any one Pte)
$ 1,000,000
60,E
$ 5,000
PERSONAL & ADV INJURY
GENERAL AGGREGATE
$ 1,000,000
$
2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCI ED AUTOS
HIRED AUTOS
ION -OWNED AUTOS
8A00000032568E
12130/10
12/3011
COMBINED SINGLE LIMIT
(Es oxidant)
$
$ 1,000,004X
BODILY INJURY (Per person)
BODILY INJURY (Per ecddenn)
PROPERTY DAMAGE
(Per accident)
$
$
$
UMBRELLA UAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
WORKERS COMPENSATION
AND EMPLOYERS UABIUTY
C ANY PROPRIETOR/PARTNERI CUTIVE
OFFICERNEMBER EXCLUDED?
(Mandatory in NH)
It yes, desca'bewader
DESCRIPTION OF OPERATIONS below
Y
N
83041481
04/01/11
04/01112
X WC STATU- 1 l0TH-
TORY LIMITS ER
E.L. EACH ACCIDENT
E(.. DISEASE - EA EMPLOYEE $
B.L. DISEASE - POUCY war $
50?,o0e
500,0001
600 000,
DESCRIPTION OP OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Rem Schedule. #'more s Is required)
CERTIFICATE HOLDER
CANCELLATION
VILLMIII
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED ARE.
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WffH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATWE
sir ITY--
ACORD 26 (2009108)
(� 1988 -2008 ACORD CORPORATION. Alt rights rese
The ACORD name and logo are registered marks of ACORD
Miami -Dade My Home
My Home
"ir itii or" . - Z.7�
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LiProperty Appraiser Tax Estimato
LJProperty Appraiser Tax
Comparison
J Portability S.O.H. Calculator
Summa
Details:
FolioNo.:
. 3206 -n14 -11.90
Pro.ert •
.20 NE 92 ST
Mailing
ddress:
: EATRIZ KHAN
loots:
20 NE 92 ST MIAMI FL
•
3138-3157
Prope
Information:
rimary Zone:
1000 SINGLE FAMILY
ESIDENCE
2010
+001 RESIDENTIAL -
INGLE FAMILY
Beds/Baths:
• /3
loots:
$324,546
•
Market Value:
d' S• Foote e:
4,190
� '•yM11.1.
12 700 SO FT
$50,000/
1948
$433,304
MIAMI SHORES SEC 2
chooi Board:
PB 10-37 LOT 4 & 5 BLK
egal
.8 LOT SIZE 100.000 X
■escription:
127 COC 23940 -3146 10
005 4 OR 23940 -3146
1005 01
Assessment Information:
METNIIIIIIIIII
2011
2010
Land Value:
EIPLEZIMEIM
$25,000
:uildin. Value:
$324,546
$326,196
Market Value:
$483,304
'.524,142
ssessed Value:
$483,304
$50,000/
Exemption Information:
Taxable Value Information:
2011
2010
axing Authority:
$25,000
$25,000
MORIMMIll
YES
MEM
Taxable Value Information:
Sale Information:
(Sale Date: 110/2005
ale Amount: 0
ACTIVE TOOL: SELECT
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MIAMI -DADE
Legend
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Boundary
Selected
Property
Street
Highway
Miami -Dade
County
Water
N
E
http://gisims2.miamidade.gov/myhome/propmap.asp 8/26/2011
2011
2010
axing Authority:
Applied
Exemption/
Taxable
Value:
Applied
Exemption/
Taxable
Value:
egionai:
$50,000/
$433,304
$50,000/
$474,142
ouMy:
$50,000/
$433,304
$50,000/
$474,142
550,000/
$50,000/
$433,304
5474,142
chooi Board:
525,000/
$458,304
$25,000/
$499,142
Sale Information:
(Sale Date: 110/2005
ale Amount: 0
ACTIVE TOOL: SELECT
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http://gisims2.miamidade.gov/myhome/propmap.asp 8/26/2011
Miami Shores Village
Building Department
19050 N.13. 26e Avenue, Miami Shores, Fl 33132
Tel.
303.7q5-1204 " Fax: 305.7364972
1.10410 MIAMI SHOD. IS 13UIl.,U(NC �Ltt'A121t'Ntt N't;
OF iO4.111 . ., _ .NT ° SP , CIAL.. ? p'O NO
2,fiz FLo IDS, WLDIN COU)r.
(We) have Oren retained by (name of owner /argent) Beatriz Khan
to perform Special Inspector cervices under the Florida Building Code at the project (address)
520 N.E. 92nd Street , ivlialtti Shores, as of 8/29/2011 (dote).
f am a registered Architect or Professional Engineer licensed in the Statc orM Merida.
P1>RMIT NUMBb".R:
L Special 1 :ispector for Reinforced Unit Masonry, FBC 2122,4
0 Special inspector for Trusses over 35 Ft. Long or 6 Ft. High, FBG 231. 9.17.2.4,2
0 Special Inspector for Steel Connections, i7BC 2218.2
Special Inspector for Soil Compaction, FBC 1X20,3,1
C Special Inspector for ?recast Units & Attach,tnents, FBC 1927,12.2
0 Special Inspector for Pilings, F RC 1822.1 .41
Special Inspector for Structural repair of rib joist under residence
0
NOTE: P ease marts loxes that annlv
ng inch vidueis(s) employed by this firm or me are authorized to perform Inspections.
gold P.E.
2.
stand that a Special impactor inapaction log Cyr each building must bo displayed Ina convenient locattan an the aite for
er y the Miami Shores Building Department Iaspcatar, All mandatory Inspeotians, as required by the Florida BualdinsCnde,
st be performed by Miami Shores. The building inspections must be called for all mandatory Inspections. Inspections par need by
the Special Inspector hired by Oro Owner am In addduen ra the mandalety Inrpeef ens petlarn+ad by the bulld(ng Depnrtnennt
Further, upon completion orthe work under each Building Permit, I will submit to the Miami Shares Building Department at the lima
before the Anal inspection the completed inspection log form and a sealed usWttant indicating that, to the best of my ieiowiedge,
belief and ptofeesionr+l Judgment those potions of the proJeei outlined above meet the intent of the Merida Building Code and are in
substantiat accordance with the approved plans.
Date:
Sealed
8/29/2011
Engineer /Architect
Name J.N. Sheingold
(Print)
Address 12420 S.W. 75th Avenue, Miami
Phone No, 305 -986 -7002
Florida License No: P.E. 21181
Miami Shores' "ill
APPROVED
BY
DATE
ZONING DEPT
BLDG DEPT
SUBJECT TO COMPLIANCE 41- FED
STATE AND COUNTY R A REGULATiO
AMERICAN SOCIETY
OF CIVIL ENGINEERS
NATIONAL ACADEMY
OF BUILDING INSPECTION
ENGINEERS
52. Ti Stieeefeid, '5•
CONSULTING ENGINEER
PROFESSIONAL BUILDING INSPECTION
12420 S.W. 75th AVE., / MIAMI, FLORIDA 33156
TELEPHONE: (305) 378 -1244
Established 1976
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, Florida 33138
NATIONAL SOCIETY OF
PROFESSIONAL ENGINEER
FLORIDA ENGINEERING
SOCIETY
29 August, 2011
Att: Building Official Ref: 520 N.E. 92nd Street
Miami Shores, Florida
I, J.N. Sheingold, P.E. have prepared the concrete restoration plans and specifications to
correct the structural deficiency at the above referenced single family residence. Please
be advised that the work as described will not reduce the structural strength or the
stability of the building structure, or any individual member, thereof as per FBC2007
edition.
If you have any questions or require additional information, please do not hesitate to call
this office.
414//
#1f>
eingold, P.E. 21181
AMERICAN SOCIETY
OF CIVIL ENGINEERS
NATIONAL ACADEMY
OF BUILDING INSPECTION
ENGINEERS
1. T . S44 190144 RE.
NATIONAL SOCIETY OF
PROFESSIONAL ENGINEER
FLORIDA ENGINEERING
CONSULTING ENGINEER SOCIETY
PROFESSIONAL BUILDING INSPECTION
12420 S.W. 75th AVE., / MIAMI, FLORIDA 33156
TELEPHONE: (305) 378 -1244
Established 1976
29 August, 2011
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, Florida 33138
Att: Building Official
Dear Sir:
We have been retained by the owners of 520 N.E. 92nd Street, Miami Shores, to provide
special inspector services as defined in section 105 of the F.B.C. The repairs are to be
performed by Snapp Industries under contract to the owner. The repairs will consist of
the following:
1. Structural repair to approximately 14 lineal feet of reinforced concrete
rib joists under the existing living area.
1. Remove all loose and spalling concrete using a light chipping hammer.
2. Inspect exposed interior reinforcing steel and replace any steel damaged in excess of
10 %. Should laps be required, at least 48 bar diameters or 30 inch minimum is
required as per ACI 318 -05. Steel is to be 60 KSI. Concrete cover for steel rebar is
to be a minimum of 1.5 inches.
3. Embedment of rebar into existing concrete structures is to be a minimum of 9 inches
and Sika 31 Gel epoxy is to be used.
4. Sandblast existing exposed rebar and coat with EPO -Chem, 110 or equivalent.
5. Restore to original dimension using pneumatically applied concrete. (5000 psi)
6. Contractor to remove all debris and clean up site.
Note: no work to be concealed without inspection by the Engineer -of- record. The
engineer's inspections are in addition to those required by the Village Building
Department.
In progress inspections will be performed and a fmal inspection report will be forwarded
upon completion.
N. E 92nd STREET
?Si kW (PER PLAT)
20' ASPHALT
22,50' PARKWAY
F,LP 1/2'
1
100.OP►(P &Mj 5' CONC. WALK
F.I.P 1 /2'
CONC.
ROCK
WALK
30.08'
14.70'
0.20'
0.40'
, .,
LOT8
BLK 58 4
F.F.4211.82'
20,70'
,51
LOT 3
(LK58
4
12.90'4*
21,40'
CONC.
.H.L LOT 4 BLK 58
0,ea'
oe.; z.e Platil Soo NE-
NO I.D.
100 00'{F&
1' ASPHALT ALLEY
01.0.
AMERICAN SOCIETY
OF CIVIL ENGINEERS
NATIONAL ACADEMY
OF BUILDING INSPECTION
. ENGINEERS
p. ie. , :,�.
CONSULTING ENGINEER
PROFESSIONAL BUILDING INSPECTION
12420 S.W. 75th AVE., / MIAMI, FLORIDA 33156
TELEPHONE: (305) 378 -1244
Established 1976
520 N ,ci2n9v*.
NATIONAL SOCIETY OF
PROFESSIONAL ENGINEERS
FLORIDA ENGINEERING
SOCIETY
f 2c>t..t