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RC-11-2000Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 165969 Permit Number: RC -10 -11 -2000 Scheduled Inspection Date: March 12, 2012 Inspector: Bruhn, Norman Owner: Rengstl, Jack Job Address: 1496 NE 104 Street Miami Shores, FL Project: <NONE> Contractor: DETAIL CONSTRUCTION 4 YOU CORP Permit Type: Residential Construction Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1122320320340 Phone: (786)286 -7295 Building Department Comments RENOVATION OF BATHROOM AND ADD HALF BATH. Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 09, 2012 For Inspections please call: (305)762 -4949 Page 6 of 31 PERMIT # 11 i AAAJLO CONTRACTOR: f_ 121-, L (f° S N\J SUBMITTAL DATE: ADDRESS: l 4 ci k.0 (4 31 NAME: \1ELEZ. RESUBMITAL DATES: PROJECT TYPE: ING FIRE UCTURAL IMPACT FEES ELECTRICAL HRS/DERM k\ i PLUMB G NOC MECHANICAL ‘ M (- BL Permit No: 11 -2000 Job Name: November 9, 2011 Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Building Critique Sheet The permit applications do not match the scope of work. Please correctapplication. Provide all permit applications prior to any further reviews(mechanical) r orrections must be made for Mechanical. Ventilation is required. The demo plan must be drawn at a convenient scale.' /a" per foot minimum. The plans are designed under the wrong code sections. The FRC for the High Velocity urricane Zones reference Ch 44 for more than structural only. See the first paragraph xceptions in each chapter for applicable section. his structure is located in a special flood hazard area (AE -9). Provide an elevation certificate that is signed and sealed and no more than 1 year old. rovide a completed substantial improvement verification worksheet. Available at the front counter or at www.MiamiShoresVillage.com rovide an appraisal of the structure or the appraised value from the Miami Dade County Pyoperty Tax Appraiser for the structure alone. his structure is built with a hand framed joist roof and ceiling. Identify all interior bearing walls in the area of construction including the wall behg removed in the living room. Provide a detail of interior non - bearing walls and one for bearing walls if needed. 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 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID 19 DETAI -2 DATE (DD 10/27/11 TYPE OF INSURANCE PRODUCER Emmanuel Insurance Agency Sarai Medina 2370 E 8 Ave Hialeah FL 33013 Phone: 305- 693 -0003 Fax :305- 691 -4381 THIS CERTIHCATE 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 POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED DETAIL CONSTRUCTION 4 YOU CORP 780 NE 119TH STREET VILLAGE OF BISCAYNE PA FL 33161 INSURER A: American Vehicle Ins. Co. 10790 INSURER B: BRIDGEFIELD EMPLOYERS INS 10701 INSURER C: 06/18/12 INSURER D: $ 1,000,000 INSURER E: PREMISES(EatoccUence) COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWRHSTANDING 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INbH LTR ADO NSRB TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MWDD - POUCY EXPIRATION DATE MM/DD LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY GL- 0506003889 -00 06/18/11 06/18/12 EACH OCCURRENCE $ 1,000,000 X PREMISES(EatoccUence) $100,000 I CLAIMS MADE I X I OCCUR MED EXP (Any one person) $ 5,000 PERSONAL BADV INJURY $ 1, 000, 000 GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY n JET n LOC PRODUCTS - COMP/OP AGO $2,000,000 X i AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE OMIT (Ea acddent) _ BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY- EA ACCIDENT $ —I OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ nOCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY IETOREXE? ECUTIVE O FICERR/MEMBER C EXCLUDED? II yes, describe under SPECIAL PROVISIONS below 830 -48059 05/12/11 05/12/12 X ITORYSLIMITS I IOE E.L EACH ACCIDENT s1,000,000 EL DISEASE - EA EMPLOYEE $ 1, 000, 000 E.L. DISEASE • POLICY OMIT $ 1, 000 , 000 OTHER DESCRIPTION OF OPERATIONS! LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Remodeling Contractor CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES B DATE THEREOF, THE ISSUIN NOTICE TO THE CERTIFICAT IMPOSE NO OBLIGATION OR REPRESENTATIVES. INSURER WILL ENDEA HOLDER NAMED TO T BITTY OF ANY KIND AUTHORIZED REPRESENTATIVE Sarai Medina ACORD 25 (2001/08) ANCELLED BEFORE THE EXPIRATION R TO MAIL 30 DAYS WRITTEN LEFT, BUT FAILURE TO DO SO SHALL PON THE INSURER, ITS AGENTS OR 0 ACORD CORPORATION 1988 s.P0sTAcIE 1 PAID N0.231 THis is war A 13tt1 63b493-9 • 61021+6-4. 4 YOU x14268 . �C�Nu���j�C ;It1N CORP STATiFI 7'88 :NE 119 ST 33 61, ' BISCAYNE PARK DETAIL CONSTRUCTION 4 YOU ,CORP 7.-VgataMt BUILDING CONTRACTOR n. -..- HQLDER TO VOLAME - -: memo REGULATORY OR _. COMM OR area. - NOR DOES A EXOE'T . VIE ..HOLDER MOO ANT OtO FEFOOT EDgY LAW-IS CEEMOCATOM OF OOT TOE �"wL a . DO NOT FORWARD DETAIL CONSTRUCTION 4 YOU CORP LILIANA ROJAS PRES 780 NE 119 ST BISCAYNE PARK FL 33161 09/02/2011 y `y 000045.08 1 {illtlfii1111t� milli Inman all s�i����1in d SEE OTHER SIDE BATCH NUMBER 134 sa,. Return to: (enclose self addressed stamped envelope) This Instrument Prepared by: JEROME HURTAK, ESQ 10800 BISCAYNE BLVD., STE 520 MIAMI, FL 33161 Property Appraisers Parcel Identification (Folio) Number(s): 11- 2232 - 032 -0340 Grantee(s) S.S. #(s) Space Above This Line for Processing Data Space Above This Line for Recording WARRANTY DEED (Statutory Form - Section 689.02, F.S.) THIS INDENTURE, made this _ day of ,20 , Between JACK J. RENGSTL and CANDICE B. RENGSTL, his wife, and WILLIAM B RENGSTL and PATRICK J. RENGSTL, their sons, of 1496 N.E. 104 Street, Miami Shores FL 33138, of the County of Miami -Dade, State of Florida, Grantors, and LUIS DAVID BARJUM and CAM LA VELEZ, husband and wife, whose Social Security No. is and whose post office address is 7 of the County of , State of Florida, Grantee, WITNESSETH: That said Grantors, for and in consideration of the sum of TEN DOLLARS ($10.00), and • other good and valuable considerations to said Grantors 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 for ever, the following described land, situate, lying and being in Miami -Dade County, Florida; to -wit: Lot 13, Block 4, RIVER BAY PARK ADDITION, according to the Plat thereof, as recorded in Plat Book 40 at page 72 of the Public Records of Miami -Dade County, Florida. This property is not the Grantor's residence or homestead. Jack J. Rengstl, Candice B. Rengstl and William B. REngstl reside in Lake Worth, Florida and Patrick J. Rengstl resides at 1155 Brickell Bay Drive, Miami, Florida SUBJECT ALSO TO restrictive covenants of record, if any, which are not specifically reimposed or extended hereby. and said Grantors do hereby fully warrant the title to said land, and will defend the same against the lawful claims of all persons whomsoever. IN _WITNESS WHEREOF, Grantors have hereunto set their hands and seals the day and year lirst .above written. 0 Candice B. Rengstl, Grantor (k?JijbLkJfOP I kfa ACtU. 111 6PhiJ ° Print Name W. s Name telc-47 R-F-.;re... e Print Name: Vitness Name: Witness Name William B. Reng , Grantor Patrick J. Rengstl, Grantor Print Name: Witness Name: Print Name STATE OF FLORID COUNTY OF The foregoing instrument was acknowledged before me this , day ofSJA64. 20 // , by Jack J. Rengstl and Candice B. Rengstl, who arepersonally knowb.o me or have produced their Florida Drivers' Licenses, Nos. and respectively, and who did (did not) take an oath. t p; WITNESS my hand and official seal in the County and State last aforesaid this rs day of -411364) ;Uzi. , 201 . Printed Name LL 1-11. Notary Public, State of Florida at Large My commission expires: 5//9//1 STATE OF FLO COUNTY OF ; •:cArrtnta o<, +� %%n4 ;4, LAURA DEMILLO M Notary Public - State of Florida p • . fii' q My Comm. Expires May 19, 2013 4 s, „ ir:,, Commission # DD 890916 i The foregoing instrument was acknowled ed before me this3l'day of 4:72A1201, by William B Rengstl, who is personall known to me r has produced his Florida Drivers' Licenses, Nos. , and who did (did not) take an oath. WITNESS my hand and official seal in the County and State last aforesaid this 30-day of 201( . Printed Name rt. 4 &4 oNry � Notary Public, State of Florida at Large -° My commission expires: .es+ Notary Punic State of Florida a4 Afye A George • My Commission 00992359 q wo Expires 0712112014 STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this day of 20_, by Patrick J. Rengstl, who is personally known to me or has produced his Florida Drivers' Licenses, Nos. , and who did (did not) take an oath. WITNESS my hand and official seal in the County and State last aforesaid this day of , 20 . Ptinted Name Notary Public, State of Florida at Large My commission expires: SUBJECT ALSO TO restrictive covenants of record, if any, which are not specifically reimposed or extended hereby. and said Grantors do hereby fully warrant the title to said land, and will defend the same against the lawful claims of all persons whomsoever. IN WITNESS WHEREOF, Grantors have hereunto set their hands and seals the day and year first above written. Signed, sealed and delivered in our presence: Witness Name Jack J. Rengstl, Grantor Print Name: Candice B Rengstl, Grantor Witness Name: Print Name Witness Name William B. Rengstl, Grantor Print Name: Witness Name: Print Name Patrick J. Rengstl, G for if Print N. itness Name: Ana til. S1azar Print Name STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this day of 20___, by Tack J. Rengstl and Candice B. Rengstl, who are p ersonally known to me or have produced their Florida Drivers' Licenses, Nos. - and respectively, and who did (did not) take an oath. WITNESS my hand and official seal in the County and State last aforesaid this day of , 20 Printed Name Notary Public, State of Florida at Large My commission expires: STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this _ day of 20_, by William B. Rengstl, who is personally known to me or has produced his Florida Drivers' Licenses, Nos. , and who did (did not) take an oath. WITNESS my hand and official seal in the County and State last aforesaid this day of . 20 _ r'. , t Printed Name Notary Public, State of Florida at Large My commission expires: STATE OF FL9 RIDA COUNTY OF P UtflY The foregoing instrument was acknowledged before me this L day oft 2011, by Patrick J. Rengstl, whoIs personally known to me or has produced his ' Florida ers' Licenses, Nos. ,, an3- o did (did not) take an oath. WITNESS my hand and official seal in the County and State last aforesaid this %- day of Whit ' 201[. VaU Printed Name , 1.�uve VpvgUJ Notary Public, State of Florida 0 at Large My commission expires: 71 13) ZDi s" .01110 MO* i13� 49494s ' WI 099721 MARTINEZ & MARTINEZ ENTERPRISES, INC. Business License x 7702 5600 W. s Lane, Hialeah � Florida 33012 Phone: 305-362-1127 Fax: 305'817'8696 Property Address: 1496 NE. 104 STREET, MIAMI SHORES, FL 33138 LEGAL DESCRIPTION: Lot 13, im Block 4, uf" RIVER BAY PARK ADDITION° according to the plat thereof as recorded in Ptat Book 40, at Page 72 of the Public Rocords af Miami- 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 deterrnine recorded instruments, If ariy affecting this property. 4) Accuracy: The expected use of th land. classified in the Minimum Technical St d nd 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) Underground utilities are not depicted hemmn, contact the appropriate authority prior to any desigri work ar constt-uction on the property herein described. 8) The surveyor does not detormine fence and/or wall ownership. 9) Ownership subject to OPINION OF TITLE. 10) Type of Survey: BOUNDARY SURVEY. 11) If shown, elevations are based on the National Geodetic Vertical Datum of 1929 12) This survey is not to be used for any design or cortstwction purpose. 13) Flood Zone: AE Base Flood EIev.: 9'00'ao per map 1206G2.Suffix L.Panel 0306 Date of Panel 9-11-09 14) This Survey has been prepared for the exclusive purpose for use as an old in obtaining title insurance on the hereon descrtbed property. property. No additicnal warranties extended. 15) A complete list of abbreviations used in this survey are shown on the back of this sheet. 16) Survey #11'86 17) This PLAN OF SURVEY has been prepared for the exclusive use of the entities named hereon. The Certificate does riot extend to any unnamed party: A.) LUIS DAVID awauw B.) MARIA CAMILA VELEZ C.) IJRBAN TITLE Field Date: O9-08-2011 For the firm: 0 of Florida Reg No.5443 Luis Martinez P.S.M. �� �� \ | �_~�~_^/ Page 1 of 2 1 11P. 1/2' 1.0. ULM< CORNER SKETCH OF SURVEY SCALE: 1" = 20' (50 TOTAL VW.) 15.3' PAVEMENT NE. 104 104 STREET ASPH. 11' PARKWAY .1 CONC. SIDEWALK L01-12 BLOCK- 4 1/2- No .D. WALL AGRI DRIVE 75.00'1 BRICK I PLANTER 19.3 9.0 BUiLDING #1496 20.0 16 8 EIP. 1/2" No ID. WALL 100' 75.00 FI* LOT-14 BLOCK-4 cd nr 1/2" No I.D. RVEY MAP OR THE COPIES THEREOF ARE 0 WITHOUT THE SIGNATURE THE ORIGINAL RAISED SEAL OF FLMIDA LICENSED SURVEYOR & MAPPER. LIMITS 01 IS T'LA FIR 1/2" No I.D. LEQEND_ %ire j • WOO —CninIrtIc Fence tIno Elevall V, or e Ireler ..Colch in oo., -favor PeN 4 (1. .LIaht Pole EON. ..fternei a'1 e F.N'O. .rFrnotel .fond Iron Roller Sheet 2 of 2 IVliami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT #: 1`'C/(1 DATE: 1 \10V gkei I 1, Arn \, Contractor ❑ Owner ❑ Architec c. (9. d� c i �►.� PrL^ke u�2 sets of plans and (other) Address: Cowed/ 14--(20 tO4-S From the building department on this date in order to have corrections done to plans And /or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAL: .1, 25 tel NI' CUMULATIVE SUBSTANTIAL I ROVEMENT VE ICATION WORK SHEET in accordance with FEMA regulation and Miami Shores Village Flood .Damage Prevention Ordinance the costs of all improvements must be monitored. The costs of any improvements in the past 12 months and the costs of any proposed itnprovements must he shown on the worksheet. The cost of improvements must include demolition, raw and finished materials (include those donated). tabor (including volunteer and self-performed), construction supervision and management, and overhead and profit. A list of items the costs of which are to he included as well as those excluded is attached for your reference. (A Copy of the Contract must be attached) PROPERTY OWNER: 1..V p- ear3vh PERMIT # 11.- 2°°C) ADDRESS: .14q. Ile 104 "ifrek FOLIO NUMBER: -2232-032 -0340F LOOD ZONE: BASE FLOOD ELEVATION: FREEBOARD: EAST OF FL.CCCL: COST OF PAST IMPROVEMENTS (12 MONTHS): COST OF PROPOSED IMPROVEMENTS: tbcoo (ATTACH COPY OF CONTRACT) TOTAL CUMULATIVE COST OF IMPROVEMENTS (past and proposed): ti (:)°° VALUE OF PRINCIPAL STRV OWNERS SIGNATURE: PLANREVIEWER: PLAN REVIEWER SIGNATURE: URE (attach appraisal): Created on June 2009 4135,suo DATE: DATE: ___ _ Property Information Map My Home Miami-Dade County, Florida Page 1 of 1 ‘-3(• °" Property Information Map Aerial Photography - 2009 0 112 ft This map was created on 11/10/2011 9:09:52 AM for reference purposes only. Web Site © 2002 Miami-Dade County. All rights reserved. Folio No.: Property: Mailing Address: Summary Details: • 1-2,24a-2N-Q349 1496 NE 104 ST JACK J RENGSTL &W CANDICE 8 LE REM WILLIAM B RENGSTL ETALSJTRS 1496 NE 104 ST MIAMI SHORES FL 33138-2664 Property Information: Primary Zone: 1100 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds/Baths: floors: 3/2 1 Living Units: Adj Sq Footage: 2,087 Lot Size: 8,850 SQ FT Year Built: 1955 Legal Description: RIVER BAY PARK ADDN P8 40-72 LOT 13 BLK 4 LOT SIZE 75.000 X 118 OR 15025-1951 0591 1 COC 26156-3145 26219-1351 0108 1 OR ,26156.3145 0108 00 Assessment Information: and Value: uildin Value: .r1e1M.V.51111/Mill 2011 5127,493 5135 516 5263.009 $263 009 2010 lanai Taxable Value Information: Year: 2011 2010 Taxing Authority: Regional: County: City: Applied Exemption/ Taxable Value: $0/$263,009 $0/$263,009 Applied Exempticm/ Taxable Value: $03243,020 $0/$243,020 $0/$263,00910/$243,020 ‘School Board: $0/$263,00910/$243,020 Sale Information: Sale Date: 1/2008 Sale Amount 5455,000 Sale 0/R: Sales Qualification Description: 1145 Sales which are qualified YiewAcklitigrAtaak* littp://gisims2.miamidade.goviMyHome/printmap.asp?mapurl=http://gisims2.miamidade.... 11/10/2011 11/15/2011 Estimate and Contract. Attention: Luis David Barjum 1496 Ne 104 Street Miami Shores, Fl 33138 Description: DETAIL CONSTRUCTION 4 YOU CERTIFIED GENERAL CONTRACTOR LIC # CGC1514268 & INSURED 1. Remove Living room walls as per plans. 2. Remove interior closets doors as per plans. 3. Add half bathroom. 4. Renovation of master bathroom. 5. Renovation of 2nd bathroom. 6. Electric job required by plans. 7. Plumbing job required by plans. Total $9,000.00 Appro ` by Luis :avid Barjum Owner. Approved by Liliana Roj Contractor. o. 17570 ATLANTIC BLVD # 409 SUNNY ISLES FLORIDA 33160 U.S.A e- mail :detailconstruction @gmail.com Juan Carlos Rodriguez 786 - 286 -7295 - Liliana Rojas 786 - 399 -9505 FAX: 305 - 974 -0164 t' S. DEPARTMENT OF HOMELAND SECURITY • Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1 -9. OMB No. 1660 -0008 Expires March 31, 2012 SECTION A - PROPERTY INFORMATION Al. Building Owner's Name LUIS DAVID BARJUN AND MARIA CAMILA VELEZ A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. 1496 NE. 104 ST. City MIAMI SHORES State FL ZIP Code 33138 For Insurance Company Use: A3 Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 13. BLOCK 4 , OF " RIVER BAY PARK ADDITION " PB. 40, PG. 72 MIAMI -DADE COUNTY RECORDS Company NAIC Number A4. Building Use (e.g., Residential, Non- Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude /Longitude: Lat. 25.870907 Long. - 80.167579 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood in A7. Building Diagram Number 8 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 1846 sq ft b) No. of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 10 c) Total net area of flood openings in A8.b 1280 sq in d) Engineered flood openings? ►� Yes ❑ No A9. For a) b) c) d) Horizontal Datum: ❑ NAD 1927 ® NAD 1983 surance. a building with an attached garage: Square footage of attached garage 405 sq ft No. of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 32 Total net area of flood openings in A9.b 256 sq in Engineered flood openings? ❑ Yes a No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION - ---./ .._...,, w ".,,,,,,u1„Ly ivunwUer VILLAGE OF MIAMI SHORES 120652 B4. Map b . County Name MIAMI -DADE B3. State FL /Panel Number 12086C0306 65, Suffix L B6. FIRM Index Date 9 -11 -09 B7. FIRM Panel Effective /Revised Date 9 -11 -09 B8. Flood Zone(s) AE B9. Base Flood Elevation(s) (Zone AO, use base flood depth) 9.00' 10. indicate the source of the Base Flood E■ evation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile r FIRM ❑ Community Determined ❑ Other (Describe) 311 Indicate elevation datum used for BFE in Item B9: ill NGVD 1929 812. is the building located in a Coastal Barrier Resources System (CBRS) area ❑or O NAVD 1988 therwise Protected Area r(OPA) ?be) Designation Date NA ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) 01 Building elevations are based on: ❑ Construction Drawings* `A new Elevation Certificate will be required when construction of he building is complete. complete. Under Construction* C2. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 -A30. AR/AH, AR/AO. Complete Items C2.a -h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized COUNTY Vertical Datum NGVD 1929 Conversion /Comments NA ❑ Yes // No Finished Construction a) b) c) d) e) f) 9) h) Top of bottom floor (including basement, crawlspace, or enclosure floor) 5.0 Top of the next higher floor Bottom of the lowest horizontal structural member (V Zones only) Attached garage (top of slab) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) Lowest adjacent (finished) grade next to building (LAG) Highest adjacent (finished) grade next to building (HAG) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support 7.5 N.A 5.1 7.3 5.0 5.1 N.A Check the measurement used. feet ❑ meters (Puerto Rico only) ® feet ❑ meters (Puerto Rico only) ❑ feet ❑ meters (Puerto Rico only) ❑ feet ❑ meters (Puerto Rico only) ® feet ❑ meters (Puerto Rico only) feet ® feet ❑ feet ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a and surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? ►Z4 Yes ❑ No Certifier's Name PEDRO LUIS MARTINEZ Title SURVEYOR AND MAPPER License Number LS5443 Company Name MARTINEZ AND MARTINEZ ENTERPRISES, INC. Address 5600 WEST 9 LANE City HIALEAH Signature FEMA Form 81, M. 09 State FL ZIP Code 33012 Date 09 -08 -11 Telephone 305 - 362 -1127 'P 1 �^ 1 r #A-443 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. 1495 NE. 104 ST. City MIAMI SHORES State FL ZIP Code 33138 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments A/C UNIT ON TOP OF METAL STAND ON WEST SIDE OF HOUSE. TO OBTAIN LAT. AND LONG. USED GOOGLE EARTH MAPS. BOTTOM OF A/C UNIT ELEVATION 7.3'. Signature SECTION B Date 09 -08 -11 ❑ Check here if attachments ILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO .'nd A without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR -F request, complete Sections A, B, and C. For Ite s -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑feet ❑meters ❑above or ❑below the HAG. feet E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and❑/or 9 (see pages 8-9 0 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and /or equipment servicing the building is ❑ feet ❑ meters 0 above or 0 below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA - issued or community- issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address Signature City State ZIP Code Comments Date Telephone SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E). and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8 and G9. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO. G3. L_j The following information (Items G4 -G9) is provided for community floodplain management purposes. G4 Permit Number ❑ Check here if attachments G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: 0 feet 0 meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: . ❑ feet ❑ meters (PR) Datum G10. Community's design flood elevation ❑ feet ❑ meters (PR) Datum Local Official's Name Community Name Signature Comments Title Telephone Date FEMA Form 81 -31. Mar 09 ❑ Check here if attachments Replaces all previous editions liotcu (AktiAc2, Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores. Florida 33133 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (30S) 762.4949 0CT, BY BUILDING Permit No. ' I PERMIT APPLICATION Master Pert No. F'BC 20 Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): Luis D Barjun & Maria Velez phonet 305- 450 -4316 Address:1496 NE 104th Street City: Miami Shores State: FL Zip: 33138 Tenant/Lessee Name: Phone: Email: barjum@gmail.com JOB ADDRESS: 1496 NE 104th Street City: Miami Shores �y County: Miami Dade Zip: 33138 Fo1io/Parcel #: 0 02132632.03 �p e 0 Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Detail Construction 4 You phi: 786 - 286 -7295 Address: 1 26 N e 11clth St - City: 0 PQ e 4 Sl,te: P L Zip: '33 1(o 1 Fip Qualifier Name: lL G °Cling Zoo a • Phoned: 11 ( 7�ctcts .- State Certification or Registration #: �,7t C d S 0 41 2 CO/ • Certificate of Competency #: Comact Phone#: la ( 21&124:1 (i124:1 S. Email Address: de i-Cit 4 C N A 3-ti K ' " (1.03n 0 rflA G , C O M DESIGNER: Architect/Engineer. Phone#: Value of Work for this Permit:' _47t) '0 13 Square/Linear Footage of Work: 2. S 0 e ° Type of Work: °Addition Alteration ❑New [IRepair/Replace °Demolition /q Description of Word: fe f ii,� %- t°�. $ Ion 2, b Q $ h r O 0 Vim , >� 1—' �6� ' L.N ., !" ,c2A' , a , ., ai.... , *.aaaaae'we, eras ** ******** vc,******.+4•¢waa apep,..4** _ w .t.no* sa.vua+*a$ve****a*waa�+e m Submittal Fee $ Permit l . 230 ' .;CF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ _,,J Bonding Company's Nanie (if applicable) Bending Company's Address City State Zip Mort., : ge 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. 1 understand that a separate permit must be secured for ELECPRICAL 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 promisee in good ,faith that a copy of the notice of commencement and construction lien law brochure will be delivered tv 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 jor the first inspection which occurs seven 7) days after the building peainit is issued. In the absence of such posted notice. the inspection will not be approved and a reins ection fee will be charged. Signature Owner or Agent ry The toregoing instrument was acknowledged before tae thi , l day of'4 Ant, 20 L[ . by who itrirsonally known to meelr who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: /'QA € Cie Print: 01114 U,ct G a le 305 My Commission Expires: APPROVED BY Marcella Gallegos by ' COMMISSION # DD966767 EXPiRES: MAR. O�1,�olr 2s�014 e,t ® gh., Rtli t Alit *yam, « * **** Signature `.AGM '* 8 Contractor r�7� The foregoing instrument was acknowledged before nee t is?! day of bartwess , 20 1 1_, by who i mrsonall known to me r who has produced as identification and who did take an oath. NOTARY PUBLIC: (Revised 07110 /O7)(Reviseil (kdl(N2iXJ9 )(Revised 3/15/09) Plans Examiner Structural Review Sign:40A a9� Print. _f j ot,L(e-9 5 My Commission Expires: �.••tia� ?p•, Marcella Gallegos •� O' u3,i = c0MMISSION DD966767 '''''' WWW.AARONNorAA.RY.eoitt Zoning 4gc:g� Clerk Miami Shores Village Building Department /0050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ,91i 0 t9___, % _ u INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING FEB 0 1 2:;2 G-` Permit No. PE ' ► PLICATION Master Permit No. C II 2. ®63 FBC Perini ype: BUILDING pROOFING OWNER: eTitehder): OCAV 1 /\ Phone #: -1$62q U12-�� Address: % �4 5 _ i City: \ckvA 1 3Veo V J' o State: L Zip: 3..J 1 - Tenant/L.essee Name: Phone #: Email: JOB ADDRESS: ( 4 \ („Q t V / 5-1- U a City: Folio/Parcel #: Miami Shores County: Miami Dade 11 12 32 c 2- c '1 C Zip: X31 5-6 Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: P (V\ 1/UCA �C� 1\ eV �®0 Phone #: Address: l U 0 1 `ci't c�sl` • City: 173) ('5 1 -° testate: Qualifier Name: `-1 ` \A V\ ON„ (Y State Certification or Registration #: C C.- l 5'1 4-1-ZG ,� Certificate of Competency #: f Contact Phone #: � l �- Email Address: C � ... (011\51 1 C ®Yi Q3�\ —`c"�' • DESIGNER: Architect/Engineer: Phone #: zip: l 1 Phone #: 7 Cigz 3C4 o1 Q Value of Work Type Alteration Square/Linear Footage of Work: ❑New ORepair/Replace *****************:***********************Fees************* ** ** * * * * * * * ******* * * ** * ****** ** Submittal Fee $ Permit Fee $ Y] . ee CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ v 6 ° 0 t 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 subje to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspectio; which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not b Rpj, ed and a reinspection fee will be charged. Signature Signature Lfrwo opo - Owner or Agent Contractor The foregoing instrument was acknowledged before me this 1 The foregoing instrument was acknowledged before a this 1 day o -1s, 20 (E-, by LIU 15 901r j i,'n , day of- TebrVCtf ` / , 20 IQ; by ( i Cl o )c6 , who 1 s personally known to m. or who has produced who is ersonally known to me ±r who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: GL1 Sign: C.a, A` . Print: QPC )?Q GOO cC5 Print: f'- rcet/k GM,egvs 44Pp•,, Marcella. Gallegos My CommissionExpi;r ' � i;••, Marcella Gallegot;r� I_° ~' ICOOMMISSION #DD966767 I,k :. i,%CGMM'SSiON#DD966767 I . .' EXP, ZES: MAR. 01 2014 E IT %� -•1.. Ey, = 4ES: MAR. 01, 2014 1 •.%.oF °.• WWW.AARONNOT' � ` •44,0F v∎..4 *, ,,h r..AARONNOTARY.com APPROVED BY aOle 'v/t1—%L Plans Examiner Zoning My Commission Expires: Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)