Loading...
DS-12-841Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 t317P- 12- SOS" Inspection Number: INSP - 173426 Permit Number: DS -5 -12 -841 Scheduled Inspection Date: July 02, 2012 Inspector: Bruhn, Norman Owner: FREDRICKS, THOMAS Job Address: 433 NE 91 Street Miami Shores, FL Project: <NONE> Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: New Contractor: PHOENIX CONSTRUCTION SERVICE & PAVERS INC Phone Number Parcel Number 1132060140120 Phone: (954)818 -9625 Building Department Comments INSTALL CONCRETE POOL DECK Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. June 29, 2012 For Inspections please call: (305)762 -4949 Page 13 of 38 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 sfaa Qma -s-rh� BUILDING PERMIT APPLICATION Permit Type: BUILDING /22 iv E, 9 /f, Sizes-37— JOB ADDRESS: MAY 1 1 2012 B Y: e FBC 20 Permit No. Master Permit No. gjq'- /p1 -•S"0S ROOFING City: Miami Shores County: D r Miami Dade Zip: .73/28 Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): 7-#044 resm/Z Phone #: 9 25/ '76 ff Address: 1/33 .' /Jr- s- City: al //-m/ fs0o k State: r L Zip: Tenant/Lessee Name: Phone #: „Zit ? Email: CONTRACTOR: Company Name: r/i®LriU /K st JCCP A rkreL r //t/C Phone #: 9SY f /o° .9'. -ZS Address: /Os/ s/ /), Cv. J /i7 City: /40014‘46 B3 -tt State: Zip: 330 Qualifier Name: / Ee°rni iu a--/U0 kA !,</d Phone: ;2(2.f State Certification or Registration #: C6 C./51 rcate of Competency #: Contact Phone #: `M' e'/ f 96' 2f Email Address: fix Oa/v et-uj Wcr; /6 ad, 7yy, ®G DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit $ 60 0' �' 'Square/Linear Footage of Work: ': /6.ro Pr Type of Work: DAddition DAlteration MOW ORepair/Replace Demolition Description of Work: / ISTA. L C X... 4-7-4s— arCse ******** ** * **** * **** *** * * * * ** * * * ** ***** Fees ** ** ** * ** * **** * ** ** * ** * ** *** Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ /7P"' * * * * * * * * * * * * ** CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ n b2( o 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 no approved and a reinspection fee will be charged. Signa Owner or Agent Signature Contractor The foreg • ' g instrument was ackn wledged efore e this 1 The foregoing instrument was acknowledged before me this day o` t.v 2012; by I04 vdio is own to me or who has produced entification and who did take an oath. NOT " Y PUBLIC: Sign: Print: 1 My Commission Expires: C1 'public - State 0 23.2p15 MY Commission # EE S26 ZonnenlInongOationa1 Alotaty Assn. * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY ,2Of ,by- greed/ /&4-74 , o is 12ersor laic n.to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: ---)271.“14) Print: Lc v9 4- l yzl My Commission E i oe®eeeeaa 1157.nunBBBBB■Beeae¢BBBBB® LINDA D. WURO pRHtli , Z" . Comte# DD 76 E Ires 1 019 #1* * * * * * * ** * *� ** **,fix ** .�ifj `flp��� ' a N IG BOOM* .1• ■% a. e 7:rMP UR0eeAAnPa NP Zoning ********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** - Plans Examiner Structural Review (Revised 3 /12/2012)0tevised 07 /10 /07)(Revised 06 /10/2009XRevised 3/15/09) Clerk 04 -29 -2010 ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL 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: PERSON: FEIN: 06/27/2010 EXPIRATION DATE: 06/28/2012 NOVATNE STEPHEN J 651087780 BUSINESS NAME AND ADDRESS: PHOENIX CONSTRUCTION SERVICES AND PAVERS INC 230 NE 42 STREET FT LAUDERDALE FL 33334 SCOPES OF BUSINESS OR TRADE: 1- CERTIFIED GENERAL CONTRACTOR e IMPORTANT: Pursuant to Chapter 440 . 06(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.06(12), F.S., Certificates of election to he exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.06(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, et any (fine after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The deportment shell revoke a certificate et any time for failure of the person named on the certificate to meet the requirements of this section. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 'QUESTIONS? (850) 413 -1609 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 06/27/2010 EXPIRATION DATE: 06/26/2012 PERSON: STEPHEN d NOVATNE FEIN: 651087750 BUSINESS NAME AND ADDRESS: PHOENIX CONSTRUCTION SERVICES AND PAVERS INC 230 NE 42 STREET FT LAUDERDALE, FL 33334 SCOPE OF BUSINESS OR TRADE 1- CERTIFIED GENERAL CONTRACTOR IMPORTANT DPursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election I- under this section may not recover benefits or compensation under this D chapter. H Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt.. apply only within the scope of the business or trade listed on Ethe notice of election to be exempt E Pursuant to Chapter 440.05 {13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? ill 50) 413 -1609 CUT HERE Carry bottom portion on the job, keep upper portion for your records. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06 PHOEN -2 OP ID: SS A'G�°. -R ©� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDlYYYY, a5to9t12 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(ies) 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 thls certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 772 -2$7 -3366 R.V. Johnson Insurance (JCK) 772_2$7 -4439 2041 S.E. Ocean Blvd. Stuart, FL 34996 JCK Insurance CONTACT NAME: PHONE FAX INC. No, Ext): (A/C, No): EMAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC 0 INSURER A:Owners Insurance Company 32700 INSURED Phoenix Construction Services and Pavers Inc. 1051 NW 31st Avenue Pompano Beach, FL 33069 INSURER B: 72614053 INSURER c 04/17/13 INSURERD: $ 1,000,000 INSURER E : 100,000 $ r INSURER F : $ 10,000 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 WM-I 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 TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 72614053 04717/12 04/17/13 EACH OCCURRENCE $ 1,000,000 DAMAGETO RENTED PREMIS al :Eccurrence) 100,000 $ r MED EXP (Any one person) $ 10,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS- COMP/OP AG G $ Z000,000 GEN'L AGGREGATE LIMIT APPLIESPER: 7 POLICY n Ecc : LOC $ AUTOMOBILE LIABIUTY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENT ON $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A WC STATU- TORY LIMITS OTH- FR E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) ICATE MIASH01 City of Miami Shores 10050 Ne 2nd Ave Miami Shores, FL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ALITHORRIZEE_D�RE_PRREESENTATIVVEE ACORD 26 (2010106) O 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954- 831 -4000 VALID OCTOBER 1, 2011 THROUGH SEPTEMBER 30, 2012 DBA: Receipt #:180 -6939 Business Name: PHOENIX CONSTRUCTION SERVICES Business Type. GENERAL CONTRACTOR) iCERTI PAVERS INC Owner Name: STEPHEN J NOVATNE Business Location: 1051 NW 31 AVE POMPANO BEACH Business Phone: Rooms Seats Employees 1 Business Opened:04 /15/2coo StatelC o u my /Ce rtlReg : C G C 1517 3 6 7 Exemption Code:NONEXEMPT Machines Professionals For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non - regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business Is sold, business name has changed or you have moved the business location, Thls receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: STEPHEN J NOVATNE 1051 NW 31 AVE POMPANO BEACH, FL 33069 Receipt #03A- 10- 00012308 Paid 09/01/2011 27.00 2011 - 2012 WATER METER 1 RE -ROUTE ELECTRIC 23ft9 n. 75 ft PROPERTY LINE 3Sft 11 9 ft. 5,n. x FPLc KID SAFE POOL NET SAFETY BARRIER POOL SAFETY COVER TO COMPLY WITH ASTM F.1346 -91 AS OUTLINED IN PBC SECTION R4101 TOP OF POOL EL. 9.5' 200A METER RESIDENCE 20 ft. 51n. POOL EQUIPMENT I I `T! EXISTING 200 S.F. DRAIN FIELD EXISTING 750 GAL. -r- SEPTIC TANK, INSTALL NE W ' I 1,050 GAL TANK, ft . 75ft PROPERTY LINE Miami Shores Village' APPROVED ZONING DEPT BLDG DEPT BY DATE SUBJECT TO COMPUANCE NTH ALL FEDERAL STATE AND COUNTY RULES ANND REGULATIONS x PROPOSED 300 S.F. D POOL REQUIREMENTS; SELF - CLOSING/ SELF - LOCKING GATES REQUIRED FENCE: 4' HIGH (MIN.) AND NON - CLIMBABLE IF NEIGHBORS REMOVE FENCE/ WALL, OWNER MUST REPLACE WITH A 4' FENCE ON OWNER'S PROPERTY ':4ECHAN1CAL BLDG. f 1 SUBJECT TO STATE AND C F PERMIT #:_. DA,TE:- 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:1132060140120 Owner's Name: THOMAS FREDRICKS Job Address: 433 91 Street Miami Shores, FL Owner's Phone: Total Square Feet: Total Job Valuation: 1650 $ 5,000.00 Contractor(s) PHOENIX CONSTRUCTION ASSOC. Phone 305/769 -1101 Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 5/11/2012 : Yes Comments: SEE NOTE ON PLANS FOR REQUIRED FENCING.