Loading...
DS-11-1566Permit Number: DS -8 -11 -1566 I Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: INSP - 163732 Inspection Date: April 16, 2012 Inspector: Bruhn, Norman Owner: SMITHERMAN, DAVID Job Address: 570 NW 112 Street Miami Shores, FL 33138 -0000 Project: <NONE> Contractor: LIVING EARTH REMODELERS INC Permit Type: Driveways /Sidewalks/Slabs Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 3021360210620 Phone: (954)925 -5003 Building Department Comments CONCRETE DRIVEWAY i Passed oi/ C Inspector Comments '/74 Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 April 18, 2012 Page 1 of 1 A CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 04/05/2012 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 cerficate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and condftions 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 Highpoint Risk Services LLC 5510 LBJ Freeway, Suite 1200 Dallas, TX 75240 CONTACT NAME: PHONE (NC. NO. 5* (800) 728 -0823 I "A" WC. NOI` (972) 404 -0380 EMAIL ADORE= INSURERS AFFORDING COVERAGE NAIL 4 INSURER A: 1—e po'.iw, Pcopre ly ai.J Gown: W •., >•r enc< lar■pnay 12157 INSURED: AMS 1 /c /f: LIVING EARTH REMODELER'5, INC. 1121 -A SOUTH 21ST AVE HOLLYWOOD, FL 33020 Phone: (954) 523 -5003 Fax: (959) 925 -5325 INSURER B: INSURER C: INSURER D: $ INSURER E: DAMAGE 70 RENTED PREMISES (Ea aacwreaea) INSURER F: I..1 VCRNl7 THIS NOTWITHSTANDING PERTAIN, ut INSR CO ■GIN IS TO CERTIFY THAT THE POUCIES OF INSURANCE ANY REOUIREMENT, TERM THE INSURANCE AFFORDED BY THE ■ : 1 t : •: a .: „ TYPE OF INSURANCE r HAW, l a. 1,1,011..A.11-1s. c7,-...1.4. .a.+...«.. ...... ...__ -- -_ LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED. OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN INSR SUBR POLICY NUMBER DATE (MMIDD/YY) DATE (MM /DDfYY) LIMITS GENERAL -- LIABILITY COMMERCIAL GENERAL LIABILITY f ICLAIMS MADE ' 1 OCCUR 1 ❑ ❑ EACH OCCURRENCE $ DAMAGE 70 RENTED PREMISES (Ea aacwreaea) $ MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GENL AGGREGATE LINT APPLIES PER: "-1POLICV n JJECT (ILOC PRODUCTS - COMP /OP AGG $ $ AUTOMOBILE — ..._ —•— — — LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS . COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAR EXCESS LIAB CLAIMS -MADE OCCUR ❑ ❑ EACH OCCURRENCE $ AGGREGATE $ — DEDUCTIBLE RETENTION $ $ $ . WORKERS EMPLOYERS' ANY OFFICER.MEMBEREXCLUDED? (Mandatory If yes, SPECIAL COMPENSATION LIABILITY PROPERIETORIEXECUTtVE In NH) describe under PROVISION below AND MI © N/A ❑ DPE2627274 04/01/2012 04/01/2013 WW X I TORYTUMTTS 1 1 OET R E.L. EACH ACCIDENT 1000000 EL.DISEASE - EAEMPLOYEE $ 1000000 E.L. DISEASE • POLICY LMIT $ 10 00 00 0 1 DESCRIPTION 1. Cov Utlgl] PA Compensatt.lon Co OF OPERATIONSILOCATIONSNEHICLES This certificate remains za a 1S t ov deO qqgg O lnp t mg 20 L !U !�AB,V; pe D ion ISS Ao l� & Employers in t r 'T 46 U liability Attached effect, an eg O GDEA ACORD101, Additional Remarks rovided the erplo Vtor which Of Si. ego tTo LiV�( BY�6 LING as a co em o ex p y Schedule, If more space is required c ten 's account is in aood standingq with AMS. tt e c err��t s npopttLgr fogrtj wagq CO ANTS• NGgM 1 '1'H E RIETE O� THE ATTZ H 1 8iSTERe AN t 0) 7 SEO 2 3 nsur�d is of or edd workerg. d po11c ('or em o ees ease from AM under t e y p Y l.l_K I Irl oPA I C n%JLUCR CITY OF MIAMI SHORES BUILDING DEPARTMENT 10050 NE 2ND AVENUE MIAMI SHORES FL 33138 -- -.. - - -- - - 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 .t" oa a •nee •nnn AF f1DR f`f1DDADATI1 MI All rinh4 racarVarl ACORD 25 (2010105) 04/06/2012 10:53 9549560555 COVER ALL INSURANCE PAGE 01/01 ACORD CERTIFICATE OF LIABILITY INSURANCE PRODUCER COVER ALL INSURANCE 5800 W. ATLANTIC BLVD. MARGATE FL. 33063 PH (954)956-0009 FX (954) 950.0555 INSURED [ ATE (UNUDOl1 YYY) 04S 62012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POL CIES BELOW. INSURERS AFFORDING COVERAGE NAIL # LIVING EARTH REMODELER'S INC 1121A SOUTH 21ST AVENUE HOLLYWOOD FL 33020 INSURER A; AMERICAN VEHICLE INSURANCE COMPANY INSURER 8• INSURER C: INSURER D: INSURER E; THE POLICIES OF INSURANCE LISTED BBLOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. Nt3TWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MA' BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND COMMONS OP SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. N$,R 4i g POLQ1NUMBER POLI C Y EF, PECTiu IV E POL ICr Y E V )TT ION LIMITS • A - GENERAL .�� •� rv_ , �,� COMMERCIAL GCNERAL LIABILITY 0_4504008495M 1211612011 12116122012 EACH OCCURRENCE 8 1,000,000 DAMIKGE TO RENTED 9 1� 00 -1 MED EXP (Arty ata parsons S 5,000 CLAIMS MADE X OCCUR PERSONAL 8, ADV INJURY $1,000,000 ■ GEN GENERA AGGREGATE s 2,0130,000 L AGGREL�AATE LIMN APPLIES PER P0L1CY.r I 1 LOC LIABILITY ANY AUTO Al,L OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS PROOVCTS - COMPIOP AGG. $ 2,000,000 COMSINEO SINGLE LIMIT (Ee W OIdern) X AUTOMOBILE g • BODILY NJURY (p9* Pi • SDDILY INJURY (fir �� g ■ • PROPERTY DAMAGE (Per Accldordj 9 • (GARAGE LVU3WY ANYAUTO AUTO ONLY. EAACCIDSNT OTHERTMAN EAACP AUTO ONLY: EACH OCCURRENCE 1 WORKERS EMPLOYERS' ANY OFFICER?MEMBER 1( ' " ". tO(CE558IAABRELLA up,5 J..Pn AGGREGATE 1 OCCt1R CLAIMS MADE DEDUCTIBLE RETENTION 5 COMPENSAT(DN AND LIABILITY EXECUTIVE EXCL DE07 ' W • PROPRIETOR(PAR7 d • .. - FjTATU- OTH ,. a i:.)u c ' EL EACH ACCIDENT EL. DISEASE -EA EMPLOYEE :1 E.lo D SEASE -POLICY LIMIT i OTHER DESCRIPTION REMODELING OF OPERATIDNS 1 LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS I1ON _`••'•• •_ ^•_ ••T_!_•• CITY OF MIAMI SHORES BUILDING DEPT 10050 NE 2ND AVENUE MIAMI SHORES FL 33135 FAX 305.7554972 ^_ 514011 _._..;� OF THE ABM Duo ., - DATE ' -4 F, TM ISSUING INS NOTICE HS CERTIFICATE HOL. IM •� E NO ,:- r. ,• to , I FRFSENTA' -• Limes BECANCELLEDBE FORE THREXPIRATION 1•ENDEAVOR TO NAIL _ 10 DAYS INR17TEN • THE -.-` . BUT FAI.URE TO GO SO SMALL � Kum ' ' • N THE INS MK ITS AGENTS OR .....::ISIS wr+seneAT,nu 4U M A - ,, r • - PRESENTATNE ACORD 25 (2001108) 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 BU DING Permit NoP 51 I 6°S" PERMIT APPLICATION FBC 20 Master Permit No. LOA- Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): ), ti 11'/ Phone # 74 .-. �Sy } Cal Address: ..."74) N W 112 s1 // .(� City: � ' � �. State: Zip: 331 (� . Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: %� t) V) 1 12 J %� City: Miami Shores County: Miami Dade Zip: 1 C� Folio/Parcel #: I) -213G-002C—(0 c`2O Ls the Building Historically Designated: Yes NO Y Flood Zone: CONTRACTOR: Company Name: \) 1\(‘" (:-'` 0-ee1 Phone #: 4-530� Address: 1 1 21 _), c.rk. ` -4.)-e.- City: 1 "x' 1 h103 c State: Zip:3 30 Qualifier Name: 1 `c State Certification or Registration #: Certificate of Competency #:C�n�Q f 2-(01/4--/ Contact Phone #: 33 ...33 1 0172 Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $11 Square/Linear Footage of Work: �p� Type of Work: ❑Addition DAlteration UNew ❑Repair/Replace ❑Demolition Description of Work: �`,� `�e-. U Phone #: ■ .x***** ** * **** * *** ******* **** ** *** **** *Fees **** ** ***** *** * *******.x***** * * * * ** x****** al Submittal Fee $ Permit Fee $ /�D CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $_� p,. 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 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 t( Owner or Agent The foregoing instrument was acknowledged before me this Z day of f�, 20!( , who is personally known to mp'who has produced As identification and who did take an oath. NOTARY P IC: My Commission Expire APPROVED BY V Signature Contractor The foregoing instrument was acknowledged before me this day of t + , 24A_, by 1 s 4 arftN.,21.",/, who is personally known to mr who has produced as identification and who did take an oath. NOTARY P :. IC: Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Sign: Print: My Commission Zoning Clerk C6 1 Permit No: 11 -1566 Job Name: August 29, 2011 Miami Shores Vivage Building Department Building Critique Sheet 1) Provide approval from HRS /DOH. 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 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 r UZ I 1 Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)758 -8972 Folio Number:3021360210620 Owner's Name: DAVID SMITHERMAN Job Address: 570 112 Street Miami Shores, FL 33138 -0000 Owner's Phone: Total Square Feet: 600 Total Job Valuation: $ 4,300.00 Contractor(s) LIVING EARTH REMODELERS INC Phone (954)925 -5003 Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 8/25/2011: Yes Comments: FALLS UNDER MIAMI -DADE REGULATIONS, RU2 BY: CEIVED k4.4 3 0 2011k Rick Scott Governor H. Frank Farmer, Jr., M.D., Ph.D. State Surgeon General October 05, 2011 (A Super Septic) 7701 W 18 Ln Hialeah, FL 33016 RE: Contingency Letter Application Document No: API048605 Centrax Permit Number: 13 -SC- 1371543 OSTDS Number. 570 NW 112 St Miami, FL 33168 Lot:3 Block:4 Subdivision: West Shores Dear Applicant: This will acknowledge receipt of an application dated 09/30/2011 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced Proposed two concrete driveway at front of the house, septic system is at the back yard. There is not increase in sewage flow, change sewage characteristic, or any alteration that change the conditions under which the system was approved From a review of your completed application, it has been determined your existing system is adequate for the proposed use. If you have any questions on this matter, please call our office at (305) 623 -3500. Enclosures cc: Miami -Dade County Health Department 1725 NW 167 St, Opa Locka, FL 33056 Phone: (305) 623 -3500. Fax: (305) 623 -3645 . http: / /www.MyFloridaEH.com BOUNDARY SURVEY SCALE: 1" = 20' 0__. -- 111133.00'. BLOCK k CORNER FIP. 1/2" No I.O. rn • o cr w g0 w w o < CC I 1- Z § a Z Q Ir J a. z _ ▪ t— U G 1-...1 L! ta. Q r L LL.i I-- C I 0 0 R • 1 f: \DRAVANG \570 NW 112 STRE€T.dwg 03/22/2011 IRON FENCE 89'55'52" 5' CBS WALL 0.3 c k4 is' LOT 2, BLOCK 4 A/C j 2.6'X3.6' 17.4 A/C 3'X4' 1.1 a °oa_— 'I �� 9'20" 5 90'0'40" LAND 1U RV MVO RB„ INC. PHONE: 305-822-6062 * FAX: 305- 827 -9669 6175 NW 153rd STREET SUITE 321 MIAMI LAKES FL 33014 LEGEND 4' CHAIN LINK FENCE 58.00' CL 10' UTILITY EASEMENT LOT 18, BLOCK 4 OH Overhead Wire Line t1 Wood Fence — X Chan Link Fence Iron Fence { — — — Monument Line — — Centerline ..�...�,. Property Line c.B.s. . += Existing Elevations =Catch Basks ID =Water Meter =E7ectric Box Q =Sanitary Manhole =Sprinkler Pump CD., =Woad Pole ® =Cone Pate 71 =tight Pole =Fire Hydrant =Water Valve •Inlet E =Florida Power Light Transformer =Cable Tv Box 'electric Meter Box I![JI 002 he 1/2 "41 I A /C=AU Conditioner Conc. =Concrete G.B.S. =Concrete Block & Stucco O.E. =Drainage Easement D.M.E. =Drainage Maintenance Easement F.F.E. = Finish Floor Elevation F.I.P. mound Iron Pipe/Pin F.I.R. =Found Iron Reber F.N. =Found Not F.N&D =Found Nall & Doc LM.E. =Lake Maintenance Easement • `(M) =Measured (P) =Plotted (R)-=Record Res. =Residence SIP /R =Set Iron Pin/Reber U.E. =Utllit Easement Y A =Arc BRG =Bearing CH =Chord Delta L =Length R=Radfuo T =Tangent Page 2 of 2 1 BOUNDARY SURVEY Property Address: 570 NW 112th STREET, MIAMI, FLORIDA, 33168 LEGAL DESCRIPTION: Lot 3 Block 4 of "WEST SHORES" according to the plat thereof as recorded in Plat Book 42 at Page 18 of the Public Records of Dade County, Florida. SURVEYOR'S NOTES: 1) The above captioned Property was surveyed and described based on the above Legal Description: Provided by Client. 2) This Certification is only for the lands as described. It is not a certification of Title, Zoning, Easements, or Freedom of Encumbrances. ABSTRACT NOT REVIEWED. 3) There may be additional Restrictions not shown on this survey that may be found in the Public Records of this County, Examination of ABSTRACT OF TITLE will have to be made to determine recorded instruments, if any affecting this property. 4) Accuracy: The expected use of the land, as classified in the Minimum Technical Standards (61G17- 6FAC), is "Residential High Risk ". The minimum relative distance accuracy for this type of boundary survey is 1 foot in 10,000 feet. The accuracy obtained by measurement and calculation of a closed geometric figure was found to exceed this requirement. 5) Foundations and /or footings that may cross beyond the boundary lines of the parcel herein described are not shown hereon. 6) Not Valid without the signature and the original raised seal of a Florida Licensed Surveyor and Mapper. Additions or deletions to survey maps or reports by other than the signing party or parties are prohibited without written consent of the signing party or parties. 7) Contact the appropriate authority prior to any design work on the herein - described parcel for Building and Zoning information. 8) Underground utilities are not depicted hereon, contact the appropriate authority prior to any design work or construction on the property herein described. Surveyor shall be notified as to any deviation from utilities shown hereon. 9) The surveyor does not determine fence and/or wall ownership. 10) Ownership subjects to OPINION OF TITLE. 11) Type of Survey: BOUNDARY SURVEY. 12) North arrow direction and bearings are based on Recorded Plat Book 42 at Page 18 of the Public Records of Dade County, Florida. 13) Elevations are based on the National Geodetic Vertical Datum of 1929. 14) Bench Mark Used: Miami -Dade County Benchmark 15) Flood Zone: "X" Base Flood Elev.: N/A as per Dade County, Florida. FEMA Panel Number: 120835- 0139 -L- SEPTEMBER 11, 2009 16) This PLAN OF SURVEY has been prepared for the exclusive use of the entities named hereon. The Certificate does not extend to any unnamed party: A.) LISA BAILEY & DAVID SMiTHERMAN SURVEYOR'S CERTIFICATE: 1 Hereby Certify to the best of my knowledge and belief that this drawing is a true and correct representation of the BOUNDARY SURVEY of the real property described hereon. I further certify that this survey was prepared in accordance with the applicable provisions of Chapter 61G17 -6, Florida Administrative Code. Field Date: March 22, 2011 Job# RP -11 -170 Pablo J. Alfonso P.S.M. Professional Surveyor & Mapper State of Florida Reg. No.5880 Moir. . C]11N1'm L A N D S U R V E Y O R S, I NC, 6175 NW 153`d STREET, SUITE 321, MIAMI LAKES, FLORIDA 33014 Phone: 305- 822 -6062 ** 305 - 698 -9468 ** Fax: 305- 827 -9669 P:\BOt1NDARY- SURVEY- NOTESt570 NW 112 STREET -2011- DADE- NTS,doc Page 1 of 2.