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DEMO-11-434
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 157135 Permit Number: DEMO -3 -11 -434 Scheduled Inspection Date: October 04, 2011 Inspector: Bruhn, Norman Owner: CARROLL, BARBARA Job Address: 1461 NE 103 Street Miami Shores, FL Project: <NONE> Contractor: ESR FLORIDA CONSTRUCTION INC Permit Type: Demolition Inspection Type: Final Work Classification: Building etoososio Phone Number Parcel Number 1132050310190 Phone: (305)812 -2716 Building Department Comments REMOVE EXISTING CONCRETE SLAB AT NW CORNER Inspector Comments Passed ,i4j(/ ogio Failed l( Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. October 04, 2011 For Inspections please call: (305)762 -4949 Page 1 of 26 04- 7500 O4- 333 15-03 -m 15 00 04 - 714 00 Date: 3/30/2011 03:07 PM Sender's Fax ID: 239 -931 -5604 Page 2 of 2 OP ID: YG '4�_°RO� CERTIFICATE OF LIABILITY INSURANCE DATE /30 11YYY) 03/30/11 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 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 certificate holder in lieu of such endorsement(s). PRODUCER 239 -931 -5600 Lykes Insurance, Inc. - FTM 239 - 931 -5604 P.O. Box 60043 Fort Myers, FL 33906 -6043 Agency Account CONTACT E: PHONE FAX °' Ems)` (A/c. No): E-MAIL PRODUCER CUSTOMER IDS: ESRFL -1 INSURER(S) AFFORDING COVERAGE NAIC • INSURED E.S.R. FL Const Inc. P.O. Box 150472 Cape Coral, FL 33915 INSURER A:Old Dominion Insurance Co. 40231 INSURER B : MPG0030C INSURER C: 08/30/11 INSURER D : $ 1,000,000 INSURER E : PRMAI Ra ENTED PREMISES ES ( (E occurrence] 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 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL LWBIUTY COMMERCIAL GENERAL LIABILITY OCCUR MPG0030C 08/30/10 08/30/11 EACH OCCURRENCE $ 1,000,000 X PRMAI Ra ENTED PREMISES ES ( (E occurrence] 300,000 $ , CLAIMS -MADE X MED EXP (My one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMP/OP AGG $ 2,000,000 —1 POLICY 7 ,JECT LOC $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accdent) $ — BODILY INJURY (Per person) $ BODILY INJURY (Per scddent) $ PROPERTY DAMAGE (Per accident) $ _ $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS Y / N N / A WC STATU- IOTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ below E.L. DISEASE- POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOL IO Miami Shores Village Hall 10050 NE 2nd Avenue Miami Shore, FL 33138 1 MIAM 100 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ,r /'� � Vim' `-! ACORD 25 (2009/09) O 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD II t --- 4,31-1 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. I ! —3OS 031 -0170 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. Le ai des ription of pproper a K Es - eS kio 2. Description of imp oyerllerrt: ` • and treet/addres of P e ews04 i . N ade • 32 RE t-s -aa s 3. Owner(s) name and address: r r Interest in property: ©cJ& .tS C � a•lo� Jte� Name and address of fee simple titleholder: 0 %ON l:a°S 4. Contractor's .ame, address and hone number: 3 o se /: J2. ,� 5. Surety: (Payment bond required by owne from contract r, if any) Name, address and phone number: Amount of bond $ • • Recg ea'i cret'es owe, 1111111111111111111111111111111111111111111 CFN 201.11R0160588 OR Bk 27614 Ps 3874; (1pg) RECORDED 03/11/2011 12 :46 :36 HARVEY RUVI4fr CLERK OF COURT NIAI'1I -DARE, COUNTY? FLORIDA LAST PAGE 4 A Space above reserved for use of recording office tf U L. br' avi *OM V-6iNE •ve) ;am gloms f 03 10411 s • 4214-Pal �t1 it site=' • ,-.'. 1 et s t 33 eta) step 3313 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon who D GeS, D h�L u lz[1,t f��y g, env d as provid Section 713.13(1)(a)7., Florida Statutes, ��At Vr�OK'�:WIV' Y yr �A�E Name, address and phone number. OW UIMCS 5� 4, 64AEREBY�nF Ythatt�Isatnte copy ofthe 8. In addition to himself, Owners designates the following person(s) to 713.13(1)(b), Florida Statutes. A s . WITNESS my hand and Official' Seal. ,.Name, address and phone number: 1\b0 - f `° ��I MAR `3, It ?:.. of Cirr�lal and Ciw Pe 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. Signatures Prepared Print Name Title /Office STATE OF FLORIDA COUNTY OF MIAMI -DADE '/ The fozigoing instrument A acknowledged f before me this day of By IC:J/9� fa Individually, or CM as for CI Personally known, or 'produced the following type of identi Signature of Notary Public: of ne .) or Own ized Officer /Director /Partner / Mana•er/ / By • �> L YYO Prepared By Print Name • • Y M Y11'D� Title /Office Print Name: (SEAL) VERIFICATION PURSUANT TO 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. Sign:tu - - , of 0 • -r(s) or 0 ner(s)'s thorized O0 i /Director /Partner /Manager who signed above: By OD r VVeet 123.01 -52 PAGE 3 3/10 By q0 \ 1 t` 1101 t I i t t I/ f P! \C�P ART w N. ./(68/49„,_ � CP' bet 1, <-101:.• i ,0� li tP • 'k s .s >° Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Expiration: 09/11/2011 Applicant 1461 NE 103 Street Miami Shores, FL 1132050310190 Block: Lot: BARBARA CARROLL 1 Owner Information Address Phone Cell BARBARA CARROLL 1461 NE 103 ST MIAMI SHORES FL 33138 -2625 masicsis Contractor(s) Phone Cell Phone ESR FLORIDA CONSTRUCTION INC (305)812 -2716 (302)279 -4726 Type of Demo: Building Additional Info: REMOVE SLAB AT NW CORNER Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $3.00 $2.00 $2.00 $1.00 $100.00 $3.00 $4.00 $115.00 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO -3 -11 -40336 03/30/2011 Check #: 1308 $ 65.00 $ 50.00 03/10/2011 Check #: 1296 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final 1 Applicant Copy For Inspections, Call (305) 762 -4949 or Log on at https: // bldg .miamishoresvillage.com /Cap /. Requests must be received by 3 pm for following day inspections. NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that may be found in GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT the public records of this county. DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. March 30, 2011 2 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 1461 NE 103 Street Miami Shores, FL 1132050310190 Block: Lot: BARBARA CARROLL 1 Owner Information Address Phone Cell BARBARA CARROLL 1461 NE 103 ST MIAMI SHORES FL 33138 -2625 Contractor(s) Phone CeII Phone ESR FLORIDA CONSTRUCTION INC (305)812 -2716 (302)279 -4726 Valuation: Total Sq Feet: $ 4,325.00 0 1 Type of Demo: Building Additional Info: REMOVE SLAB AT NW CORNER Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $3.00 $2.00 $2.00 $1.00 $100.00 $3.00 $4.00 $115.00 Pay Date Pay Ty e Amt Paid Amt Due Invoice # DEMO -3 -11 -40336 03/30/2011 Check #: 1308 $ 65.00 $ 50.00 03/10/2011 Check #: 1296 $ 50.00 $ 0.00 L Available Inspections: Inspection Type: Final 1 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. March 30, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date March 30, 2011 1 64 F LOG DEPT c PI LANCE WITH ALL FEDERAL RAL n "I?) c c Y 1311 FS AND REGULATION S otherwise noted, SIP -set - i- & "x3 /4 BY:_ P f n /4" iron pipe n :rii n�1 l e s e, P /L Property Line, Wood Pence, io rr< cture, Y Vent: A =s Are, ' CH i curvature .1) =tidenti ica ` . ." = Found Nail, 13/L =- "1 Bearings are assured on 'T H. CT 1 CONConcrete, CL=Clear, 0/S Offset, IMF x— = Chain Link /L=- ' On Li rz S d N & D = Sep Nail 8. `' Disk 42852, CBS _ . Concrete lk` 'Av - 'arrant, 3 =Parll a, . i =Radius. t+► Central Angle, sU Monument Lime, `;PC =Point of (P) =Record, (M) a e M/L =' Residence, pt, = Point ; . ' " 3*ound t/2" Iron Bar, ': 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 d Permit No. 1iI)(tflYLt ( �u 6 BUILDING PERMIT APPLICATION FBC 20 7, T Ts W T. 0 t MAR 1 0 2011 0 Master Permit No. Permit Type: BUILDING ROOFING Owner's Name (Fee Simple Titleholder) May k r r& ant ( Phone # 3 f1 S '7�% -% /o s Owner's Address 1 ( E 10 3rd ST Zip 3 3 ?- o o Z S City v i Rv1 t stio eS State E. Tenant/Lessee Name ) of ' A- (p t i C& b k Phone # Email 'Barr 1 l 9 0. ct o * Co r✓% Job Address (where the work is being done) 141 N E 103rd ST City Miami Shores Village County Miami -Dade FOLIO / PARCEL # 1 —3 .o 03 —© 1 ?) zip 33I3?.-a(7 S Is Building Historically Designated YES NO X Flood Zone Contractor's Company Name t C R. flOY IXQ l onStrueliPoti, l Phone # 30C-- &( ' .27( t� Contractor's Address P. ca ox. 15 C) 47 .CMcd ,' ic) j 31/0 SE// '°' / -Ve (Physic," City ea p2 & ra.� State F L Zip 3 3 l S Qualifier Name Phone # State Certificate or Registration No. F R 0 39 7 L Certificate of Competency No. C. ( b b �-- Contact Phon( 6) -5 ) ( t Z - a 9-1 a. E -mail Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Phone # Square / Linear Footage Of Work: Type of Work: DAddition DAlteration ❑New ( P ❑ Repair/Replace ❑ Demolition Describe Work: `Re.wtovf� e9Cis -f v ��Cret� SL0.6 - N� �rvier bT NO ******** * * * * * * * * * * * * * * * * * * * * *,* * * * * * *** Fees * * * * * * * * * * * * *: * * * * * * * * ** * * * * * * * * * * * * * * * * * ** Submittal Fee $ L) Notary $ Scanning $ Radon $ DPBR $ Double Fee $ Permit Fee $ /00 bj Training/Education Fee $ CCF $ Violation date: Structural Review. $ Total Fee Now Due $ COS CO /CC $ Technology Fee $ Bond $ See Reverse side -4 Bonding Company's Name (if applicable) /0 of 4e c)1 c0. 1-e- Bonding Company's Address City State Zip n Mortgage Lender's Name (if applicable) No+ APP 1: cal ( - 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 All 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. Owner or Agent The foregoing instrument was acknowledged before me this The foregoing instrume day 0(1,6w, 20 te), by , dayo who is personally known to me or wh has prod d �C 1.t . who As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Co 1 NOTARY PUBLIC-STATE OF FLORIDA ,,.,.,, Natasha Marksman s bI: 1 � 11 .d i • 1' Sy4y,,, or Expires: OCT. 12, 2012 was acknowledged before me 20 tO by e or who has produced as identification and who did take an oath. NOTARY PUBLIC: My o z's ;a;,f a,h ,1 +on #DD830223 ,/' Expires: OCT. 12, 2012 ONO ID ******************************* ******************************************** * * * * * * ** * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY Plans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009)