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DS-12-723Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 172682 Scheduled Inspection Date: June 18, 2012 Inspector: Bruhn, Norman Permit Number: DS -4 -12 -723 Owner: BENJAMIN, MATHEW & LUCILLE Job Address: 595 NW 111 Street Miami Shores, FL 33138 -0000 Project <NONE> Contractor: NOVA BUILDING CONTRACTOR INC Permit Type: Driveways /Sidewalks/Slabs Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 3021360210790 Phone: (786)9854810 Building Department Comments CONCRETE DRIVEWAY INSTALLATION ON FRONT YARE Failed Inspector Comments Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. June 15, 2012 For Inspections please call: (305)762 -4949 Page 10 of 27 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 BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING ROOFING APR 2._2, 2012 J a Y: Permit No. CT !2--- Master Permit No. OWNER: Name (Fee Simple Titleholder): k/14716 04, ts-Va ;Phone#: Address: 4 TO ap City: ail a State: Tenant/Lessee Name: Phone#: ROS as 5 Z Email: Zip: el� JOB ADDRESS: "e fl b fl ci City: Miami Shores County: Miami Dade Zip: r& A to % FoliolParcel#: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: A•ki l) 041, fit0 t 04 k On e—i rt Phone#: 7e $&o Address: 1.4 18. p 1e k, 'ST City: H a ,a State: Fe— Qualifier Name: ' I:MP —V j State Certification or Registration #: II Lo Certificate of Competency #: Contact Phone#: i1 n6 an ® Email Address: K1 ©01 G1141 t ;fir4 n . Cc DESIGNER: Architect/Engineer: Phone#: Zip: ? 4® l$ Phone#: Value of Work for this Permit $ 1 S"00 • 0 0 _Square/Linear Footage of Work C, /l Type of Work: []Addition °Alteration °New ©Repair/Replace °Demolition Description of Work C 3 vs. c-A- 16-v- ,--' a P'-,— P *********************444 *g ********* Submittal Fee $ Permit 0 Fee $ Sd CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ raining/Education F� $ Tedmologyy Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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. 1 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 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 COMMEENCEMENT. ". Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to r nt. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection w occurs seven (7) days after the building permit is issued" In the absence of such posted notice, the inspection will not be , , ed and a reinspection face will be charged Si The fore day of who is Owner or Agent trument was ac Signature '79' 7 Contractor The foregoing instrument was acknowledged before me this 1.5 NOT Sign: Print My Commission Exp me or who has produced dentification and who did take an oath. • * **** ******* * * ***** v 4 � *o* *********a+ *******1'* * *******p** � my Comm. Expires Sep 23, 2015 1y0tgr 44 Commission # EE 128810 "v,$;;,`.•A` Bonded 'hrough National Notary Assn. y of � 'L..- 1 2014, byFt 24y &I. .St Mco J is personally known to me or who has produced 'T C_ b itaev. tiCeas D _as identification and who did take an NOTARY PUBLIC: Si Print My commission Expires: 411s APPROVED BY -‘)‘-/rJ_ (Revised 07 /10/07)(Revlsed 06/10/2M9)(Revised 3/15109) Plans Examiner Structural Review Clerk DBPR - SIMON, FITZROY MONTGOMERY; Doing Business As: NOVA BUILDING ... Page 1 of 1 12:57:41 PM 4/23/2012 Licensee Details Licensee Information Name: Main Address: County: License Mailing: LicenseLocation: License Information License Type: Rank: License Number: Status: Licensure Date: Expires: Special Qualifications Construction Business SIMON, FITZROY MONTGOMERY (Primary Name) NOVA BUILDING CONTRACTOR INC (DBA Name) 5248 NW 186TH ST MIAMI Florida 33055 DADE Certified General Contractor Cert General CGC1511916 Current,Active 09/11/2006 08/31/2012 Qualification Effective 09/11/2006 View Related License Information View License Complaint 1940 North Monroe Street. Tallahassee FL 32399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA /EEO employer. Coovriaht 2007 -2010 State of Florida, privacy Statement Under Florida law, e-mail addresses are public records. If you do not want your a -mall address released in response to a public-records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. https:// www. myfloridalicense .com/LicenseDetail. asp ?SID= &id= BA0DOA9D02BF277C81... 4/23/2012 10 -06 -2010 ALEX SINK STATE OF FLORIDA CHIEF Ftf4M4CtAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law, EFFECTIVE DATE: 10106/2010 EXPIRATION DATE: 10/05/2012 PERSON: SIMON FITZROY M FEIN: 223937042 BUSINESS NAME AND ADDRESS: NOVA BUILDING CONTRACTOR INC 8248 NW 188TH ST MIAMI FL 33088 SCOPES OF BUSINESS OR TRADE: 1- CARPENTRY IMPORTANT: Pursuant to Chapter 440 . 05114), F.S., en offIcer of a corporation who elects exemption from this ebeptar by filing a cortiflcsto of election ender this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05111), F.S., Certificates of election to be exempt... apply only within the scope of the business ar trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05113), F.S., Notices of election to be exempt and calif lentos of election to be exempt shell be subject to maculae 1f, n Noy time after the tltiog of the notice ar the imam of the can't loofa, the parten named on the Notice or motif Note no longer meets the requirements of this section for issuance of a certlllcete. The department shell revoke a cerUNcate at any time for failure of the person named on the cortiticato to meat the requirements of this section. DWCm262 CERTIFICATE OF ELECTION TO OE EXEMPT REVISED 09-08 QUESTIONS? (8601 413-1609 T E 13ATGH DISPLAY AS REQUIRED FIRST -CLASS U 5. POSTAGI WHAMl, FL PEAMIT'NO. 23 TRACTi 5248 NW _ 186 ST r 33055 UNIN LADE COUNTY i'A BUILDING C ITRt CI1 It,II � C ,ESs TAx MA ow Daft NOT PERMIT i tIE HtOER TO XIOL HY N LAYS Ql THE. OR MIRO. -NPR R%EMYf TOE OR L RBY CA . THIS'Is RA TAX 9//2011 9010460001 00075.00 SEE OTHER SIDE DO NOT FORWARD NOVA BUILDING CONTRACTOR INC FIZROY M SIMON PRES 5248 NW 186 ST MIAMI FL 33055 133 APR -23 -2012 12:51 From: ACCORD To:3057568972 CERTIFICATE OF LIABILITY INSURANCE Pase:1/1 DATE(MM/DDNYYY) 4/23/2012 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; It the certificate holder Is an ADDITIONAL INSURED, the polloy(les) must as endorsed if SUBROGATION 1S WAIVED. Sabiect 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 el suety andorsement(s)_ PRODUCER Building Trades Association 6353 W. Rogers Circle, Unit 3 Boca Raton, FL 33487 INSURED NA°n"IFACTGina Barragato A V."No F,* (800) 326 7800 l (NC,No):(561) 241 -0621 ADDASS.gina@blaidAE9tradeS.COM INaLIRER{S) APPDRDING COVERAGE NAICY INSURERA. United Specialty Ins Nova Building Contractor, Inc. INSURER B • 5248 NW 186th Street Miami, FL 33055 _ 786 -985 -3810 COVERAGES • Co. 12537 INSURER C: INSURER 0 SURER E : INSURER F : CERTIFICATE NUMBER REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSIJRANOE UST CO 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 01- SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LI MGR TYPE OF INSURANCE ' eu ii POUgy� }FC 1.000Y EXP . . POLICY NUMBER (MM/DO/YYYY) (MMIDOTYYYY) LIMITS GENERAL UABIUTY X COMMERCIAL C3ENERAL UADIUTY CLAIMS -MADE U CCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POUCY PIERr : 1 LOo AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS HIRED AUTOS UMDRCLLA LIAD EXCESS (JAB SCHEDULED AUrua NON -OWNED AUTOS NS1210985 10/24/2011 10/24/201a EACH OCCURRENCE s 1.000.000 PREMISES (NA nomurrnneo) 2 100 000 MED EXP (Any o e par-.ten) $ 5,000 PERSONAL ADV INJURY $ 1, 000,000 GENERAL AGGREGATE $ 1, 000 ,000 PRODUCTS - comma A09 $ 1, 000 , 000 COMBBIIN EE m SINGLE LIMIT (Ea BODILY INJURY (Per person) BODILY INJURY (Pet eoaderu) PROPERTY DAMAGE (Per accident, DED 1 I RETENT ON WORKERS COMF'tNSATION AND EMPLOYERS LIARII ITY ANY enoesiFrnr rAnT rivoc corns OFFGGTVMCMIrn psmaefory In NH) ifyari.cescriee under DESCRIPTION OF OPERATIONS bete OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE N/A DESCRIPTION OF OPERATIDNS f l CATIONS / VEHICLES (Anarh ACORD 101, Additional Remarks Schedule if menp epees Ia required) CERTIFICATE HOLDER TRY Li °E r S I R EL. EACH ACCIDENT $ _E.L. DISEARF . FA FMPI OYE6. FL DISEASE • POUCY LIMIT $ Village of Miami Shores Building Department 10050 NE 2nd Avenue Miami Shores, FL 33138 Fax 305 -756 -8972 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR' REPRGSENTA 019M-2010 ACORD CORPORA HON. All rights reserved. AGORD25 (2010105) The ACORD name and logo are registered marks of ACORD SCOPE OF WORK NEW CONCRETE DRIVEWAY SITE DATA ZONING CLASSIFICATION RU -1 LOT AREA PROVIDED 10125SQFT. SETBACKS ALLOWED PROVIDED FRONT 25' 25' REAR 25' 66' SIDES 5' 10' BUILDING AREA BUILDING HEIGHT 35' 13' -6° EXISITING BLDG. 1441SQFT. RENOVATIONS 841SQFT. (DRIV LOT COVERAGE 4050SQFT 1441SQFT. RAINWATER SHALL BE RETAINED WITHIN PROPERTY LINES (OR ON SITE) LEGAL DESCRIPTION WEST SHORES MANOR PB 42 -18 LOT 20 BLOCK 4 FOLIO# 11 -2136- 021 -0790 OCCUPANT CLASSIFICATION R -3 TYPE OF CONSTRUCTION TYPE V B 2'-6" WWM RETURN _Trr17u fu7n II —°III 145 CONT. 8" THICKEND EDGE SLAB DETAIL N.T.S. III SITE PLAN 114 ° =1' -0° 4 a 4 4 4 4 4 A a 4 4 4 4 4 4 a 4 44 4 4 4 a 4 4 Q 44 4 co Z 4 4 a 4 4 4 4 4 4 4 4 4a 4 4 T 4 4 4 4 4 APR 2 3 2012 CHARLES MITCHELL, P.E. 924 NORTH FEDERAL HWY. HOLLYWOOD,FL. 33020 305.336.5069 ROJECT: ESIDENTIAL PROPOSED DRIVEWAY DRAINFIELD DDRESS: 5 N.W. 111 ST. MI, FL. 33168 VS l -1 �3 OWNER: 4 10'-0° 4 4 4 4 4 4 a 4 la 4 I4 4 4 4 4 I4 4 a■ 4 § 44 4 4 4 4 4 4 4 a4 4 44 EX. 1 STORY RESIDENCE 4 CONTRACTOR: DATE: 4-5-12 DRAWN BY: JB APPROVED BY: cm REVISIONS: 24'•5° 4 SEAL: 20'4° ° MB 1° CWL NE4W DRIVEWAY a4 4 4 ° 4 a a 4 4 a 4 4 a 4 4 4 4 L SIDEWALK 4 n P OCC a° J 4 44 4 44 4 4 4 44 4 4 4 4 4 4 4 4 4 a 4 a ° 4 4 4 4 ° 0 4 4 4 4 4 4 4° 4 -4- 4 a N.W.111TH ST. 4 44 ° a 4 4 ° a, 4 4 a 444 4° v. 4 SHEET NO. A -1 JM3 4 NMI ZatattUtP.400 OT TC: P.VVretitirrin MA 23 KM VTM " •. Of • In # GENERAL STRUCTURAL NOTES 1. GENERAL A. THE CONTRACTOR SHALL FIELD CHECK ALL DIMENSIONS ON THE STRUCTURAL DRAWINGS AND VERIFY SAME ON THE ARCHITECTURAL SET. ARCHITECTURALDETAILS SUCH AS; SLAB DEPRESSIONS, WATER PROOFING, CURBS, MECHANICAL OPENINGS, FASCIA FRAMING AND BRACING SHALL BE INSTALLED AS SHOWM ON THE ARCHITECTURAL SETS. B. THE CONTRACTOR SHALL BE RESPONSIBLE FOR SHORING AND BRACING TO ENSURE SAFE WORKING CONDITIONS AT ALL TIMES. ALL CONSTRUCTION SHALL CONFORM TO THE FLORIDA BUILDING CODE. 2. CONCRETE A. ALL CASTI -IN -PLACE CONCRETE IN THIS JOB SHALL ATTAIN A MINIMUM COMPRESSIVE STRENGTH (fc) AT 28 DAYS OF 3000 PSI. B. CONCRETE WORK SHALL CONFORM TO ALL REQUIREMENTS OF ACI 301 -72 SPECIFICATIONS FOR STRUCTURAL CONCRETE FOR BUILDINGS. STRENGTH (fc) AT 28 DAYS OF 3000 PSI. 3, REINFORCING STEED A. REINFORCING STEEL SHALL BE DETAILED AND PLACED IN ACCORDANCE WITH ACI 318 -83. B. REINFORCING STEEL SHALL BE DEFORMED BARS CONFORMING TO ASTM A 615 GRADE 60, UNLESS OTHERWISE NOTED. C. ALL WELDED WIRE FABRIC SHALL CONFORM TO ASTM A 185 D. REINFORCING TO BE SECURELY IN POSITION WITH STANDARD ACCESSORIES DURING PLACING OF CONCRETE, E. ALL BOTTOM BARS SHALL BEARS" MINIMUM OVER SUPPORTS. 4, MIN, CONC, OVER REINF,1 MIN. CLEAR COVER A. CONCRETE AGAINST AND PERMANENTLY EXPOSED 3" TO EARTH (UNFORMED FACES) B. CONCRETE EXPOSED TO EARTH / WEATHER (FORMED FACES) (FORMED FACES) a. #6 BARS AND LARGER 2" b. #5 BARS AND SMALLER 1 112" C. NOT EXPOSED TO WEATHER OR IN CONTACT W /GROUND a. STRUCTURAL SLABS AND WALLS b. BEAMS AND COLUMNS PRIMARY REINFORCEMENT, TIES, STIRRUPS & SPIRALS c. SLABS ON GRADE 3/4" 1 1/2" 1 1/2" TERMITE PROTECT'N. NOTES 84409,13,5 ALL BUILDINGS SHALL HAVE PRE - CONSTRUCTION TREATMENT PROTECTION AGAINST SUBTERRANEAN TERMITES. THE RULES AND LAWS AS ESTABLISHED BY THE FLORIDA DEPARTMENT OF AGRIC. AND CONSUMER SERVICES SHALL BE DEEMED AS APPROVED WITH RESPECT TO PRE - CONTRUCTION SOIL TREATMENT FOR PROTECTION AGAINST SUBTERRANEAN TERMITES. A CERTIFICATE OF COMPLIANCE SHALL BE ISSUED TO THE BUILDING DEPARTMENT BY THE LICENSED PEST CONTROL COMPANY THAT CONTAINS THE FOLLOWING STATEMENT: "THE BUILDING HAS RECIEVED A COMPLETE TREATMENT FOR PREVENTION OF SUBTERRANEAN TERMITES TREATMENT IS IN ACCORDANCE WITH RULES AND LAWS BY THE FLORIDA DEPT. OF AGRIC. AND CONSUMER SERVICES "THE BUILDING HAS RECIEVED A COMPLETE TREATMENT" SOIL STATEMENT THE SOIL HAS BEEN OBSERVED TO BE SAND AND ROCK WITH A BEARING CAPACITY OF 2000PSF. A SIGNED AND SEALED STATEMENT WILL BE SUBMITTED TO THE CHIEF BUILDING OFFICER AFTER THE GROUND HAS BEEN BROKEN ATTESTING THAT THE SITE HAS BEEN OBSERVED AND THE FOUNDATION CONDITIONS ARE SIMILAR TO THOSE UPON WHICH THE DESIGN BASED CHARLES MITCHELL, P.E. 924 NORTH FEDERAL HWY. HOLLYWOOD,FL. 33020 305.336.5069 PROJECT: RESIDENTIAL PROPOSED DRIVEWAY ADDRESS: 595 N.W. 111 ST. MIAMI, FL. 33188 OWNER: CONTRACTOR: DATE: 4 -5 -12 DRAWN BY: JB APPROVED BY: cm REVISIONS: SEAL: SHEET NO. A -2 4 • o 6 44 6 11 t. , FLORIDA DEPARTMENT OF HEALT Rick Scott Govemor Steven L. Harris, M.D., M.Sc. State Surgeon General April 11, 2012 Matthew Benjamin 1260 NW 207 St Miami, FL 33169 RE: Contingency Letter Application Document No: API068340 Centrax Permit Number: 13 -SC- 1403479 OSTDS Number: 595 NW 111 St Miami, FL 33168 Lot:20 Block:4 Subdivision: Dear Applicant: This will acknowledge receipt of an application dated 04/09/2012 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. From a review of your completed application, it has been determined your existing system is adequate for the proposed use.This permit is granyed to install a driveway only. Mo cange in sewage flow, **** ******* **** **** * * *** ***'' ** ** *APPROVED******** ******* **.h.,*********** 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