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DS-12-862Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 173577 Permit Number: DS -5 -12 -862 Scheduled Inspection Date: June 19, 2012 Inspector: Bruhn, Norman Owner: ARNOLD, WILLIAM Job Address: 746 NE 94 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ESPINOSA CONCRETE Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: New Phone Number Parcel Number 1132060141660 Phone: (786)346 -5579 Building Department Comments STAMPED CONCRETE DRIVEWAY Inspector Comments PassedG Wb-l&AZ. Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. June 18, 2012 For Inspections please call: (305)762 -4949 Page 5 of 16 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 AP - ON MAY 1 5 2011 G FBC 20 Permit No. 93519° Master Permit No. Permit Type: BUILDING ROOFING City: Miami Shores y6ti� gLI sT County: Miami Dade Zip: 33 /3 6 Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): U i \Jjjj-,(e 6v1T&C Phone #: 3 ©S eq' /53 Address: 6 /(% q / sT City: /l/j-Z4 ( Sj ht...5 State: Zip: 33e3e Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name: F-5 P/V o54 6ov c,t eke //we Phone #: '96-3c16—.5,5-1 Address: / SC/ CI! .c W 6 D 0 5). �r,, 3 City: ml J - K/�, i / State: /" l_ Zip: 3 3 / 0 Qualifier Name: ! L 1. � �5 P//l% ( SA Phone #: e6 - 3(46- S-5- State Certification or Registration #: Certificate of Competency #: 0 S Bs 0 0 `I (j g Contact Phone #: 966- -3 Lid SS 1 Email Address: E$ JJ/,t/®Sel • C c2 /ciee Te 6 '/ A ROD, aw DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 310 0 -a- Square/Linear Footage of Work: a /1 6 Type of Work: ❑Addition DAlteration )4New ORepair/Replace ❑Demolition Description of Work: S T 6' AA FRO C o x/ C/l. Te, ni 0 Ii w A/ Color thru tile: &sr, * * * * * * * * * * * * * *** r**** * *** x** * *** * * * ** * Fees * * * ** * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ YO `Pc) CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ \A 1 ' 9.1) 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Owner or Agent The fore oing instrument was ackno ledged befor me tlpj day of ,20 a, by Vv-7i Z who is personally known to me or who has produced As identification and who did take an oath. NOTARY P C: Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY -soto e, Notary Public State of Florida . Usney Abin Q My Commission EE 188977 %o. w9 Expires 0412/2018 Signature ontractor c� The fore! g instrument was acknowle91 d befo me this day of ,20 41, by_ li) 1ft9)'1 who is person. �y known to me or who as produce as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission 4, Notary Public State or Floida Usney Abin Ex Commission 188977 Expires 04/12/2016 * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Structural Review (Revised 5 /2 /2012XRevised 3 /12 /2012)(Revised 07 /10 /07)(Revised 06 /10 /2009XRevised 3/15/09) * Zoning Clerk P11 iami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) V / �},%/ �U 77 2 hereinafter referred to as the owner of the following described property (address): -9(41,t/,e Iv sr 4mz4 sl7 n €$ PC3313e Legal Description ?A4//) Tl►e f. �`. OPLot " I Block / 5 Subdivision Folio # Requests permission to install (describe work): $ 74 pi/ ? Pft % ,V C/t eTe %)1l 1 v e U/A-y Within the public right of way of (address) 3 6 6 PE 9 5 T M /fL4) Slro/LeS fL 33) 5d IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows: 1. To maintain and repair, when necessary, the above- mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 1 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and /or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). Signature CL Owner or Agent The foregoing instrument was acknowledged before me this 7 day of who is personally known to me or who has produced an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: 2 Notary Public State of Fbrida . Lisney aem %Ay My Commission EE 188977 op Expires 04/12/2018 20 ( by 17("/ 1)Q As identification and who did take 1 Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Folio Number:1132060141660 Owner's Name: WILLIAM ARNOLD Job Address: 746 94 Street Miami Shores, FL 33138- Owner's Phone: Total Square Feet: 826 Total Job Valuation: $ 3,900.00 Contractor(s) ESPINOSA CONCRETE Phone Primary Contractor (786)346 -5579 Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 5/18/2012 : Yes Comments: May. 30. 2012 3: 51 PM P 1/1 • - Ak°R"r CERTIFICATE OF LIABILITY INSURANCE L "' Y) 05/30/12 PRODUCER Florida Bankers Insurance 7278 SW 8 Street Miami, FL 33144 Phone (305)266-6493 Fax (305)262 -0679 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 POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED ESPINOSA CONCRETE INC 15441 SW 160 St MIAMI, FL 33187- INSURER A: LANDMARK AMERICAN INSURANCE INSURER B: ASCENDANT INSURANCE CO. INSURER C: INSURER D: INSURER E: COVERAGES INSURER F: THE POLICIES OF INSURANCE LISTED 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 MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MIMI/DDIYY) POLICY EXPIRATION DATE (MIMIDDIYY) LIMITS A GENERAL LIABILITY APP123544107 04/18/12 04/18/13 EACH OCCURRENCE 1,000.000.00 0 COMMERCIAL GENERAL LIABILITY PREMISES TO RENTED 100.000.00 ❑ • CLAIMS MADE V OCCUR IVIED EXP (Any one person) 5.000.00 PERSONAL & ADV INJURY 1,000.000.00 • GEN'L n GENERAL AGGREGATE 2,000.000.00 AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG 1,000.000.00 POLICY • PROJECT • LOC B ❑ AUTOMOBILE LIABILITY • ANYAUTO ❑ ALL OWNED AUTOS SCHEDULED AUTOS ❑(Per HIRED AUTOS • NON OWNED AUTOS ri CA- 30196 -00 08/17/11 08/17/12 COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY person) 10,000.00 BODILY INJURY (Per accident) 20,000.00 PROPERTY DAMAGE (Per accident) AUTO ONLY- EA ACCIDENT 10,000.00 • GARAGE LIABILITY ❑ ANYAUTO ❑ OTHER THAN EA ACC AUTO ONLY: AGG EXCESS/UMBRELLA • • • LIABILITY EACH OCCURRENCE • OCCUR • CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below ❑TORYLIN11TS ❑ ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CONCRETE FINISH CFRTIFICATC tin/ nee ELLATION MIAMI SHORES 10050 NE SECOND AVE MIAMI SHORES, FL. 33138 1 305) 756 -8972 ACORD 25 (2001/08) QF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE © ACORD CORPORATION 1988 PAlu R, I) ∎N het -Ur 4 2t Power ti BOUNDARY SURVEY 12&75m0. 11 n '�d� inlJ oP- t o'i °I 9,46' a l*,yS(tti -t3 :go 24 3S' • 'fr 'figs ors s'r... cp 6e>5 fb5,tJo.746 3124 ' 45 4.25' • fPrzlt Cffr- MAY 1 5 712 I NOT VAL.O UNLESS EMSOSSCo wiTN SURVEYOR'S SEAL • REVISED: ti I .Miami abtb Vid e U APPROVED . . +mil 7 DATE ZONING DEPT (;1' BLDG DEPT 0-7 O AI.- SUBJECT' TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS .S.P.C.- SET1/2- PIN&CAPU34789 P1peF t::D =Focn: Nail CENTERUNEPERMANENT �RTY UNNE. POINT ON UNE MAR MANHOLE, WM- WATER METER, PPa POWER POLE FC.- FENCE CORNER, R- RECORD, M- MEASURED CHAIN UNK OR WIRE FENCE- • W000 FENCE- w MASONRY WALL - CONCRETE- . , ; • • • . ' •: . NOT E E LESS OTHERWISE SHOWN, THE FOLLOWING NOTES APPLY. : 1) Record and measured calls ere In substantial agreement. 2) Bearings. if shown are based on Plat data. 3) The lands shown hereon were not abstracted for Easements or other recorded emcumbrances not shown on the plat and the same, it any may not be shown on this sketch. 4) Underground portions of Footings, Foundations or other improvements were not located 5) Elevations are based on National Geodetic Datum. 8) Fence Ties are to the Centerfne of the•ferre. 7) Wall Ties to the face of the Wall. 8 BFARINII,'' t HEN SHc%ARE REFERED '10 AN ASSUMED VALLT SAID P8 PAGE_ O. • a Disc Ele•,a'iars tased cn CEM Elev • • NGV D_turn. Locator Index x • ‘N 44),‘ • • UN '37,56' TByL�T 75 CERTIFIED a 4 41 L O C A T I O N S K E T C SCALE: N T S 1$ 20 at 42 23 C 1 24 �5 21 14 o 15 ►4' 13 12 11 10 0 TO: WILLIAM A. ARNOLD AND VIVIANE GUTTER, 746 N.E. 94TH ST., MIAMI SHORES, FLORIDA 33138., CHRISTOPHER P. KELLEY, P.A., ATTORNEYS' TITLE INSURANCE FUND, INC., NORTHSTAR MORTGAGE COMPANY, ITS SUCCESSORS AND /OR ASSIGNS, ATIMA. LEGAL DESCRIPTION: LOT 8 AND THE E. 1/2 OF LOT 9 BLOCK 65 OF MIAMI SHORES SECTION NO. 3 SUBDIVISION ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 10 AT PAGE OF THE PUBLIC RECORDS OF MIAMI -DADE (COUNTY, FLORIDA.' I HEREBY CERTIFY That the survey represented hereon meets the nurumum technical requirements adopted by the STATE OF FLORIDA Board of Land Surveyors pursuant to Section 472.027 Florida Statutes. There are no encroachments. overlaps. easements appearing on the plat or visible easements other than as shown hereon ADIS N. NUNEZ Regis :erect Land Surveyor No. 5924 State of Florida 37 SINCE 1987 BLANCO, DANIAL & ASSOC. INC. Engineers • Land•Surveyors • Planners LB i/ 4789 555 NORTH.SHORE DRIVE MIAMI BEACH FL. 33141 (305) 865 -1200 FLOOD ZONE: • PANEL : 47o," DATE: SCALE: • /0 -lo -/0 1't =20r Fax (305 ?865 -7810 SUFFIX ::J DATE: 7-17 -95 BASE: NA • • Si •S&u.`y :41 Y .1 haL' : DWN. BY: F181104 co JOB No. 00- /foC Z NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOUO NO. 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. 111111111111 111111111111111111111111111111111 CFI-4 2012R035. 297,3 OR Bk 28115 Ps 24211 (lps) RECORDED 05/17/2012 13:10:05 HARVEY RUVIHr CLERK OF COURT HIANI—DALE COUNTYr FLORIDA LAST PAGE 1. Legal description of property and strerWaddrese: VIA k varel . AlW 2. Description of Improvement 37 tt4 CO", cA,t7o Ph/ lle.L1/.41 Space above reserved for Use Of recording office 3. Owner(s) name and address: VIV/h/f/? 6-e es-6 Interest In properly: Name and address of fee simple titleholder: 4. Contractor's name, address and phone number: 5 5. Surety: (Payment bond required' by owner from contractor, if any) Name, address and phoile numW: Amount of bOnd $ 3q 00 ''‘` 6. Lender's name and address: • 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 71113(1)(a)7., Florida StatUtes, . . Nainksddress and phone number: 8,11i addition to hknself, Owners designates the following person(s) to receive a .copy.of the Uenor's Notice as providedinSecUon • 713:13(1)(2), Florida Statutes. *Name, address and phone number: .9. Expiration date of this Notice of Commencement (the expiration date Is 1 year from Me date of reconing unless a diftefent date Is spedfled) WARNING TO OWNER. ANY PAYMENTS MADE BY THE OWNER AMER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA skrums; 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 BEFO9E THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTO BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Prepared By Print Name • The/Office • • ors) or Qmort #41004. riz ed Officer/Director/Partner/Manager \BA Prepared By Print Name •I UN Title/Office STATE OF FLORIDA COUNTY OF MIAMI-DADE The forpg2Ing Inctrumeitmas i.. !edged before me this day of By (it Cl-f4,,G Or CI Individually, or CI as for personally knovm, or 131Produced the following type of Identifi Signabire of Notary Public: Print Name: (SAL) .e Pi 0.5A- Eigh,t(wItiLmlwAmrvstaLtE 112,5, amu&srmtims. Under penalties of perjury, I declare that 1 have read the foregoing and that the facts statedin it are trim, to the best of my knowledge and belief. Signature(s) of Ovvrter(s) or Owner(s)'s Authorized Officer/Director/Partneanager By By 123.01-52 PAGE 8/10 STATE OF FLORIDA, COUNTY OF DADE I HEREBY tomxirtii- is a ?we .1N4 carru=t cf tve igirim t4?., ice, jaaAD ELIARVEY RINK Clerk of Circuit arid Con) Coucit Deputy Clerk ,