RC-12-1455Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 176689 Permit Number: RC -8 -12 -1455
Scheduled Inspection Date: September 27, 2012
Inspector: Bruhn, Norman
Owner: DOBRIKOW, HEIKO & ELENICE
Job Address: 270 NE 100 Street
Miami Shores, FL 33138-
Project <NONE>
Contractor: MAST GENERAL CONSTRUCTION
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060134450
Phone: (305)420 -6123
Building Department Comments
REMODEL MASTER BATHROOM (RESET SINK, TOILET
AND SHOWER ENCLOSURE, INCORPORATE WALK IN
CLOSET INTO MASTER BATH, BUILD A NEW WALK IN
CLOSET.
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
September 26, 2012
For Inspections please call: (305)762 -4949
Page 9 of 43
111111111111111111111111111111111111111111111
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED oil THE JOB $ITE-AT T[$E oEpotsT INSPECTION
PERMIT NO. C 2 1 1155 TAX FOLIO NO.
STATE OF FLORIDA
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED ftereby gives;at 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.
CFN 2012R0579260
RR Bk 28231 Ps 3658; (1p9)
RECORDED 08/16/2012 15 :41 :43
HARVEY RUVIH, CLERK OF COURT
MIAMI -GAGE COUNTY? FLORIDA
LAST PAGE
above r�eser ati ffor tic a ofseeondng oifice
1. Legal description of property and street/address: 5/ M 4 L FAM L.Y 61,ESi:I ENCE G
240 ieiap TAIT'> M1 AMi iloPJ FLT 33 (3$ . .
2. Description of improvement: 641 I tco,'�i REJ�to oV 6 * QUsZ /AIG WALK.- Lv er oc'r
3.Owmer{e) name and address: ABOVE. 14E) K O & ELEttgicE ko [.Qa t J >
Interest In property:. 9W AEEfZ
Name and address of fee simple titleholder:
4. Contractor's actor's name, address and phon number: 57- E 0-41- Coeu ST7wcr °/ v
600 arileEritr2 M *k -FAi - )4Ev giSefilStAAE,, L7
5. Surety: (Payment bond required by owner from contractor, if any)
Nance, address and phone number. AM- STATE OF FLORIDA, COUNTY OF DADE
Amount of bond $ 1 HEREBY CERTIFY rr6Z1M ra>
6. Lender's name and address Af . A- " 0 , i.filed i- ate 917 ,
.?'il,ih
AiJA
7. Persons within the State of Florkia designated by Owner
Sects
Nam , p umber.
y upon a u•• :�. r :�� be s
on71 Florida
3.13(1)(a)7., Statutes, `�� x•Sm i�� �d a `'�•
e address and hone number
r o
41;0'-)=--
8. In addition "to himself, Owners designates the followin Ups Notice as
g persons)
713.13(1)(6); Florida Statutes. _ /
Name, address and phone number. /"t 14--
•
9. Expiration date of this Notice of Commencement:
WARNING TO OWNER ANY PAYMENTS MADE BY THE OWN
IMPROPER PAYMENTS UNDER. CHAPTER 713, PART I,
IMPROVEMENTS TO. YOUR PROPERTY A NOTICE
FOIST INSPECTION. IF YOU INTEND TO O
OR RECORDING YOUR NOTICE OF
Signature(s). of- Owner(
Prepared By
Pri „fc = MQ(T4o u9 TF�L LFS
Titie/Oif`ice • OtAPA11575 fr<GFi'v.r. A aizE�
STATE OOP FLORIDA
COUNTY OF' MIAMI-DADE
The foregoin ' instrument was acknowledge acknowksOged tLefore me this
�! Personally known, or produt the`following type of identificatio
Sigrtaturi3 of Notary Public•
(the !ration date Is 1 Year from the date-of recrordligj a � e Ii specNted)
THE EXPIRATION OF THE NOTICE OF COMMENC EMENT ARE CONSIDERED
3.13.'FLORIDA STATUTES, AND CAN RESULT IN YOl)R PAYING TWICE FOR
EMENT MUST BE RECORDED' AND POSTED ON- THE'JOIPSJTEBEFORE THE
WI,Til YOUR LENDER OR AN ATTORNEY BEFORE.COMMENCING WORK
ndlyldually, or Pis ,
r/Partner/Manager
Prepared By •. - • :.> .
Print Narne •
Titl(3/Qffice .; ..
for
day of
i 7-�:
Print Name:
(sue
117 Ch
VERiFICATIO URSU IT• TO SECTION 982,526. FLORIDA STATUTES - y i �°�i '7
Under penalties' of perjury, f declare that I have read the-foregoing and �' F1 'rs ��/
that the facts stated in it are true, to the best of my knowledge and belief. co '•• 0/0,47 6': • •
SignatUre(s) of Owner(s) or Owners) s Authorised Officer/Director/Partner/Manager w'ESagF Ptiiti eP
O
/ rrinnntt'��
By By
12944 42 PAGE 9 9/10
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
C JVED
AUG 022012
FBC 2010
Permit No. I ° '12 t `�
Master Permit No.
Permit Type: !BUILDING ROOFING
JoB ADDRESS: NE E 1 ° 6'1 ST
City: Miami Shores County:
Folio/Parcel #: 11 ° 3206 - 0 (3 41150
Is the Building Historically Designated: Yes
Miami Dade
Zip: 331 3R
Flood Zone:
�Ei Ko I OG�l� 01) µJ6 ELEN �CF ° � Ko1rJ
OWNER: Name (Fee Simple Titleholder): k p Phone #: 30.3 g�s�
Address: 2 :0 NE .boo IA- ST
City: M f f M 1 s of$ State: FL- Zip: &3 1 38
Tenant/Lessee Name: � Phone#: {�
Email:
CONTRACTOR: Comp/a�ny�Name: i "f i4 sT a�5 L L`v�'T��` Phone#: 3' 5556
Address: ‘0O (."!7 4eET (?f 4 7 Fk/
city: KE AA ,,e i 5 cogAia state: FL- Zip: ��
Qualifier Name: !vl A R.o A TEL ES Phone#: 335 35 R -5'
State Certification or Registration #: ti 6C IS/ 17 2 Certificate of Competency #:
Contact Phone#: y jay 3(5 56 Email Address: MA (.Woe 84 s he - COM
DESIGNER: Architect/Engineer: All Phone#: iLJ/4
6V
Value of Work for this Permit: $ (3/ 000 Square/Linear Footage of Work:
Type of Work: OAddition itillteration ONew ORepair/Replace ODemolition
Description of Work: 12F-1401a ISM e.47-4(ZM (w� `r 5iNK, `gyp i f.B1' s?.. (bINErz air:guP ),
iNeoteeirre 011.1. iN CL..O I AITO ilt4A it «Tti) {3vil& A NE& WALk iN
GGOSE-°r.
Color thru tile:
******** * *** * * * * * * ****** * * *** * * * *** * * ** Fees * *** ** * * * ***** *** * * * *** * * *** * * ** **** * * * ** *
9d
Submittal Fee $ CO • (= Permit Fee $ 6 ----CCF $ CO /CC $
Phi 0
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $ `
Double Fee $ Structural Review $
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 $2500, the applicant _,st
promise in good faith that a copy of the notice of commence construction lien law brochure will be delivered to
whose property is subject to attachment. Also a certified . <' Hof recorded notice of commencement must be pos
for the first inspection which occurs seven ilding permit is issued. In the absenc
inspection will not be approved and charged
Signature
Owner o Agent
The foregoing instrument was acknowledged before me thisa6
day of 3)L) , _t Z, by �tc.>r TIC(
�S o1Nrni
/Oka—
Signature
w
Contractor
The foregoing instrument was acknowledged before me this?$
day of , 20 by b1-'(C--q C,0
e or who has produced who is personally known to or who has produced
entification and who did take an oath. as iden cation and who did take an oath.
OTARY PUBLIC:
NOTAR
Sign:
Print: ' LJC . ∎
My Commission Expires:
,.���� P DOUGLAS F. HALLIDAY JR.
( _� — � Notary Public - State of Florida
>t ., l� l4i 7' 24041] * *** * * * * * * * * * ** ** **
"•,1. �c,; miss E 1i(
APPROVE r. a. , Plans Examiner
r
Sign:
Print: w4
My Commission Expires-
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(evised 3/15/09)
DOUGLAS F. HALLIDAY JR.
Notary Public - State of Florida
My SQ,tnm Vo ryes un 17•', 2014
el Commission ...
''F,°FPg`' Bonded Through National Notary Assn
Zoning
Clerk
4444444444
copy
SPECIAL POWER OF ATTORNEY
HEIKO DOBRIKOW and ELENICE ALVES DOBRIKOW legal owner(s) of the property
located at 270 NE 100th STREET, MIAMI SHORES, FL, 33138, such property hereafter
simply named "Unit", hereby appoints MARCO A TELLES, located at 600 Grapetree Dr suite
7FN, Key Biscayne, Florida 33149, as my attorney -in -fact ( "Agent ") to exercise the powers and
discretions described below.
My agent shall have full power and authority to act on my behalf but only to the extent permitted
by this Special Power of Attorney. My Agent's powers shall include the power to:
1. Authorize entry and access of any third-party person, subcontractors and/or service
providers to the above referenced unit;
2. Prepare, sign, and file permit applications with the City of Miami and/or Miami -Dade
County, as well as file Notice of Commencement and any other documents with any
governmental body or agency related to the maintenance /remodeling of the above
referenced unit;
3. Request inspections and close permits related to the remodeling of the above
referenced unit;
4. Manage the property day -by -day, such as, collecting mail, packages, using the unit's
assigned parking space, allowing maid services, dealing with emergencies;
I hereby grant to my Agent the full right, power, and authority to do every act, and thing
necessary or advisable to be done regarding the above powers, as fully as I could do if personally
present and acting.
I hereby authorize my Agent to utilize and park at the unit's assigned parking space, or to have
the same parking privileges while acting as my Agent.
Any power or authority granted to my Agent under this document shall be limited to the extent
necessary to prevent this Power of Attorney from causing, (i) my income to be taxable to my
Agent, (ii) my assets to be subject to a general power of appointment by my Agent, or (iii) my
Agent to have any incidents of ownership with respect to any life insurance policies that I may
own on the life of my Agent.
My Agent shall not be liable for any loss that results from a judgment error that was made in
good faith. However, my Agent shall be liable for willful misconduct or the failure to act in
good faith while acting under the authority of this Power of Attorney. A successor Agent shall
not be liable for acts of a prior Agent.
My Agent shall not be entitled to any compensation, during my lifetime or upon my death, for
any services provided as my Agent. My Agent shall be entitled to reimbursement of all
reasonable expenses incurred as a result of carrying out any provision of this Power of Attorney.
THIS IS T RTIVY trwu THIS IS
My Agent shall provide an accounting for all funds handled and all acts perforiA- ,17 • COPY OF
but only if I so request or if such a request is made by any authorized personal „ -i -r�,
fiduciary ac ng on y behalf.
—AO .00: ,
Ownerfsl
Initials
Marco A Telles
SPECIAL POWER OF ATTORNEY
Notary Public - State of Florida
•= My Comm. Expires Jun 17, 2014
yY+a g e coEir scion # EE 2181
" "° ' '' Bonded Through National Notary As<<
THIS 1s
A
This Power of Attorney shall become effective immediately. This Power of Attorney shall
continue effective until revoked. This Power of Attorney may be revoked by me at any time by
providing written notice to my Agent.
Dated on 5 J 2-0X‘ z O Z. , at b 1 A Nl i
, Florida.
Print name:
STATE OF FLORIDA, COUNTY OF MIAMI-DADE, ss:
The foregoing instrument was acknowledged before me this ;0 day of N B y 200 -
by // /,cd and Pe s ce ho wbo a personally known to me or presented the
following document/identification: F� 8 • L. °
RT1FJ T THIS IS
-COPY OF
,•i''gl"� DOUGLAS aLIDAY JR.
Pie
1. Notary Public to of Florida
• My Comm. Expires Jun 17, 2014
P.
%;rte +`-i.°�' Commission # EE 2181
��•FOF aoo`
�i*� Bonded ThroLgh Nations! Notary c,.
Owner(st
Initl�ls
c7
Signature of person taking acknowledgment
�-1GI YJc? i •5T�' r7 c
Name typed, printed, or stamped
Marco A Telles
SPECIAL POWER OF ATTORNEY P w2 2 of ;
EXISTING FLOOR PLAN
Family Room
FLOOR PLAN - BUILDING DETAILS
270 NE 100th St, Miami Shores, FL, 33138
BUILDING NOTES-
1
BATHROOM RECEPTACLE ON 20 AMP CKT
AND G.F.I PROTECTED
Kitchen
Build a new walk in closet for the master
bedroom, using part of the family room;
Close the existing master bedroom walk -in
closet door;
Build a new shower enclosure /shower pan and
reposition the shower drain where the old
closet was;
Reposition the toilet and toilet drain;
Add a double -sink;
BUILDING SCOPE OF WORK
Remodeling of the master bathroom, making it
bigger.
Building a walk -in closet using part of family room
area.
DRYWALL DETAILS
Rough details:
—> 16" to 24" apart horizontal 3-5/8" 25 -Gauge Galvanized
Steel tracks, attached to the concrete ceiling by 1 -1/2" low
velocity powder fasteners spread every 8" to 12" apart,
according to ASTM C754 and/or wood ceiling using 1 -1/2"
long drywall to wood course screws.
— > 16" to 24" apart vertical 3-5/8" 25 -Gauge Galvanized
Steel studs attached to one another by sharp pan head
framing screws (7xg").
— > in drywall sheets, installed to framing, attached using
ADD SMOKE/CARBON MONOXI EIDETE ngCTO drywall screws every 8" to 12 "apart.
ANY AND ALL CLOTH AN RUBBER DETECTORS.
INSULATED CONDUCTORS TO _REPLACER
N = New
PROPOSED FLOOR PLAN
Family Room
RECEIVED
AUG 0 2 2012
Y'=
RC- l2- its-S
1OlaO2Id 1VNOILVOfla3 )IS3aOlf V NY AS a3OflaOad
n in ..T
EOT i 0 C(_ (,..!PI it \f iCE WI rH
PL' dk g
-okpe7-
Kitchen
5� f 4,449
E�
EXISTING FLOOR PLAN
ELECTRICAL NOTES
Install 2 GFCI outlets above the sink
countertop at the master bath;
Connect the existing walk -in closet ceiling
light to the same circuit/switch as the 2
existing bath ceiling lights;
Connect the new walk -in closet ceiling light
to the master bedroom ceiling light existing
circuit;
Install mlereonnectedSMOKE -
DETECTORS on all 3 bedrooms and
bedroom's hallways, per FL Bldg Code.
FLOOR PLAN - ELECTRICAL DETAILS
270 NE 100th St, Miami Shores, FL, 33138
ELECTRICAL SCOPE OF WORK
Remodeling of the master bathroom, updating outlets
to GFCI and updating ceiling light circuits.
Building a walk -in closet. installing a new ceiling
light.
Installing smoke detectors in all 3 bedrooms and both
bedrooms hallways.
NOTE TO ELECTRICIAN
Electrician to perform work according to the Florida
Building Code and per the Village of Miami Shores
requeriments, whatever is more restrictive.
Since there is no electrical floor plans available,
Electrician to evaluate circuits capacity in locu, and
update them accordingly.
PROPOSED FLOOR PLAN
0
Family
Room
NEW
W/I
Closet
Master
Bedroom
Masi
ath
O
Kitchen
BATHROOM RECEPTACLE ON 20 AMP CKT
AND G. I PROTECTED
ADC: SMOKE/CARBON MONOXIDE DETECTORS.
ANY AND ALL CLOTH AND RUBBER
INSULATED CONDUCTORS TO BE REPLACED.
ionaO2ld 1VNOLLVOfla3 NS30OlflV NV AEI a3aflaoad