RC-12-1869Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 181236 Permit Number: RC -10 -12 -1869
Scheduled Inspection Date: November 07, 2012
Inspector: Bruhn, Norman
Owner: LOPEZ, GUSTAVO & SHEILA
Job Address: 575 NE 95 Street
Miami Shores, FL
Project: <NONE>
Contractor: AJIL CONSTRUCTION INC
Permit Type: Residential Construction
Inspection Type: Foundation
Work Classification: Patio
Phone Number 305/757 -8118
Parcel Number 1132060140760
Phone: (305)207 -9416
Building Department Comments
INSTALL 400 SQFT OF FLAGSTONE ON CONCRETE
SLAB AND CONSTRUCTION
Infractio Passed Comments
INSPECTOR COMMENTS
False
Passed
9//1-
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 181091. NEED LETTER FROM
PROFESSIONAL ENG FOR FOOTINGS. JR 11/5/12
November 06, 2012
For Inspections please call: (305)762 -4949
Page 18 of 19
Jofre Engineering Inc.
Claudio A. Joffe P.E.#28531
334 NE 102 Street Miami Shores, Florida 33138
786 -382 -1695 ; Fax:305- 835 -0951
E -mail: cjofre@bellsouth.net
November 6, 2012
Job Address: 575 NE 95 Street.
Miami Shores, Florida. 33138
RE: Engineering Certification Letter for Structural Slab.
TO WHOM IT MAY CONCERN:
Our firm did an inspection, on Monday, November 5, 2012, of a barbecue grill
under construction, at the address above, for the certification of a structural slab.
We certify the following:
1. Slab thickness: Average thickness is: 6"
2. Reinforcing: Re -bars are: #5 at the bottom @ approx 24" O.C.
3. Top finish: Stone and small pebbles paving. Note: stones paving was
correctly removed in the area where grill was built.
We certify that these structural specifications are existing, and stronger than the
minimum required to build the grill shown in the structural plans.
Sincerely
Claudio A. Jofre P.E. 28531
f
4
It -6 -i2
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
BUIL�G�
PERMIT APPLICATION
RECEIVE,.._..
OCT 09Z01Z
FBC 20 LLD
Permit No.
Master Permit No. Q- ' S-Ci0�
Permit Type: BUILDING IMIDERS1G
JOB ADDRESS: 6-2( /1/-.g•
City: Miami Shores County: Miami Dade Zip: 3 : / 3 a
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder):
Address: /�/
City: / /7% /f! ,5 �IC3 State: - Zip: 53 / 3 S
Tenant/Lessee Name: Phone #:
Email:
-5h 42/k ./o/c
Phone#: .3C6'
- 757 81/8
CONTRACTOR: Company Name:
Address: 5503 6w 13r
City: et r'^;
Qualifier Name: Peary L •
State Certification or Registration #:
Contact Phone #:
DESIGNER: Architect/Engineer:
A J 11- Gnh s +n.;d(o n, -Too. Phone #: 30S- 207- 14 /6
GT
State: FL
/-4oco is
C4G l5,544 9
Email Address:
Zip: 33/ 75
Phone#: 78(0 - 547 -2616
Certificate of Competency #:
a' ;lc oins +roc4T 1100. aorr,
Phone #:
Value of Work for this Permit: $ 3C .4'2 Square/Linear Footage of Work: 100%97
Type of Work: ❑Addition Alteration New ❑Re /Replace / ❑Demolition
Description of Work:* j � SI �® 511 ' , ()J CI Rep or
Ep 9-17 wwi � y cry o N &v 1
iM bKa NbeC °
C oomLoc/ 1 ' o�
Color thru tile:
** ****** ***** **x: *****+ x** *+ x*** **+ x* ******F *Feeessj�xx�+��x�x **** **** x�x* �x�x+ x�x�x�x* * **�x�x�x *�xx��ra�u��xn��x�u�x� ***
Submittal Fee $ +� Permit Fee $ //t/ O�J CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology 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. 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.
Signature
Signature
er or Agent ontractor
The foregoing instrument was acknowledged before me this 5 The foregoing instrument was acknowledged before me this 5
day of 064010+/ 20 12,, by 5 h € 14 S w ee n e , day of .064D b.Pt , 20 12 , by Qe d:ro L. t4 o ra (ed,
who is personally known to me or who has produced C.1- I PL. who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: iC�C
Print: 4 YYZ G 1 cc' el) Cq 41 ,/1C
My Commission Ex fires:
ekok. AMALIA BOCANEGRA
MY COMMISSION N DD901952
14004-NOTARY Ti L `o.
APPROVED BY
Sign: //��
Print: A'r us% r'i I70 cot n eery
My Commission Expires: 'l Z 11 13
'' AMALIA BOCANEGRA
MY COMMISSION 0 DD901952
EXPIRES: September 21, 2013
**** **'* *** * ** ********** ********** '�rA '�`" ialle#t1 Pl'l a **a:aumx:
Plans Examiner Zoning
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Clerk
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: 03/30/2012 EXPIRATION DATE: 03/30/2014
PERSON: PEDRO L MORALES
FEIN: 208282311
BUSINESS NAME AND ADDRESS:
AJIL CONSTRUCTION INC
5503 SW 138 CT
MIAMI, FL 33175
SCOPE OF BUSINESS OR TRADE:
1- CONTRACTOR - PROJECT MANAGER, CO 2- CERTIFIED GENERAL CONTRACTOR
IMPORTANT
OPursuant to Chapter 440.05(14), F.S., an officer of a corporation who
elects exemption from this chapter by filing a certificate of election
L under this section may not recover benefits or compensation under this
D chapter.
Pursuant to Chapter 440.05(12), F.S., Certificates of election to be
H exempt.. apply only within the scope of the business or trade listed on
E the notice of election to be exempt.
R
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 :o 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? (850) 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 01 -11
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: 05/03/2012 EXPIRATION DATE :• 05/03/2014
PERSON: AMALIA BOCANEGRA
FEIN: 208280311
BUSINESS NAME. AND . ADDRESS:
AJIL CONSTRUCTION INC
5503 SW 138 CT
MIAMI, FL 33175
SCOPE OF BUSINESS OR TRADE:
1- CONTRACTOR- PROJECT MANAGER, CO
IMPORTANT
®Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who
elects exemption from this chapter by filing a certificate o= election
L 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
the 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? (850) 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 01 -11 .
06/16/2012
The -GENERAL CONTRCTOR
Named below IS CERTIFIED
Under the provi3ion6 of Chapter ,4$9 FS
Expiration date: AUG 31, 2014
. ,
MORALE, PEDRO LUIS
AJIL CONSTRUCTION.
5503 SW 138TH CT • -
MIAMI FL 33175-6026
VINKTOMMWMIEMETWISONIWIMi_ 'ffErri-zreffiArd-rt.
STATE OF FLORIDA
-.1DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY ..ICENSING: BOARD
SEQ#L12061600235
LICENSE NBR
118199173 CGC1515449
RICK SCOTT
GOVERNOR
DISPLAY AS REQUIRED BY LAW
----- --
KEN LAWSON
SECRETARY
8 "x16" CINDER
BLCK. STRUCTURE.
Mrs. Shelia Lopez
579 NE 95th Street.
Miami Shores, FL. 33138
BARBECUE GRILL DETAIL
#5 RE —BAR 0 16" O.C.
IN FILLED CELL, TYP.
1
GRILL
NICHE
2' -6"
FLOOR PLAN
Scale: 1/4" = 1'-0"
3" COUNTER TOP,
W. #4 BARS 0 16"
GRID LAYOUT.
4" WIDE BLOCK
INNER WALL.
SECTION DETAIL
UPPER SECTION: 4 "x16" BLOCKS.
#5 RE —BAR EMBED 4"
WITH EPDXY, INTO PATIO
SLAB.
SECTION DETAIL
Scale: 1/4" = 1' -0"
Q.30-it
CLAUDIO A. JOFRE P.E.
FL. REG.# 28531
334 NE 102ND. STREET.
MAIMI SHORES — FL. 33138
786 - 382 -1695
SCALE: 1"=20'
SPECIAL PURPOSE SURVEY LOCATION OF EXISTING POOL
9' Asphalt -
75.00' W p.p. 15' ALLEY
W.M.
riacEivED
oCT 092012
FND.I.P.1/2°
(NO ID)
3' CBS Wall On/P
LOT 21
BLK 54
0.21,
CL
0 'C -.Pv,Ir' 'A: iCF MPH ALL FEDERAL
FND.I.R.1/2"
(NO ID)
e Y 6474 C ,) re 4
s 4� A,.s /id -
4, 44
fe_cati s , -tee dieaor' $Q. 6/urd
A10 A/091.4//1
Al' s €6J -7?„.
p L ef/1 %
6' Wood F.
5.00' )`'914,4,
Asphalt co
Driveway
LL
J
0
26.40'
LOT 22
E.M.
10.20'
AIC
10.00'>
12.
16.80'
.80'
to. 1- 4
12.30'
13 0t
POOL
71 7.00,
ti
o.7o,
ii `fir ✓ /
0.75' Pool
Cupling
12.60'
27.00'
W 25' LOT23
M
20.30'.
Condrete
ONE STORY CBS
RESIDENCE # 675
21.90'
Conc.
cD
23.00'
N 12.90'
17.40' 1
V 51.50\
8
S POOL
Pump
\A/C
S
r
5' Conc.Walk
75.00'
x
x
FND.I.P.1/2"
(NO ID)
.30'
CL
Remainder Lot 23
BLK54
0.30'
90
1198 ,
4
FND.NAIL A
(NO ID)
x-
25' Parkway
Q
` 25.00'
8
Asphalt Driveway
20.00'
22.00'
N.E. 6th AVENUE
79.38' (-IBC
FRD.I.P.1 /2"
(NO ID)
20' Asphalt
Q N.E. 95th STREET
80.00' Total R/W
FOR SHELIA LOPEZ
PROP. ADD: 575 NE 95 STREET, MIAMI SHORES, FL 33138
CERTIFIED TO:
SHELIA LOPEZ
JOB NO 0212 -028A
FIELD DATE: 07 -24 -2012
LEGAL DESCRIPTION:
LOT; 22, W 1/2 OF 23 MIAMI SHORES
BLOCK; 54 SUBDIVISION: SECTION No. 2
PLAT BOOK: 10 PAGE: 37 OF: MIAMI -DADE COUNTY, FLORIDA.
SURVEYOR'S NOTES;
1.) THE SURVEY OF THE PROPERTY SHOWN HEREON IS IN ACCORDANCEVNTH THE
DESCRIPTION FURNISHED BY CLIENT.
2.) UNLESS A COMPARISON IS SHOWN, ALL BEARING, ANGLES AND DISTANCES SHOWN
ARE THE SAME AS PLAT VALUES.
3.) THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENTS OR OTHER
RECORDED ENCUMBERANCES NOT SHOWN ON THE PLAT AND THE SAME, IF ANY MAY
NOT BE SHOWN ON THE SKETCH.
4.) UNDERGRAUND PORTIONS OF FOOTINGS, FUNDATIONS OR OTHER IMPROVEMENT
WERE NOT LOCATED.
5.) FENCES TIES ARE TO THE CENTER LINE OF THE SAME.
8.) WALL TIES TO THE FACE OF THE SAME.
7.)ELEVATION WHEN SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM
(1929) UNLESS OTHEI? MSE NOTED.
8.) THERE NO ABOVE GROUND ENCROACHMENTS OTHER THAN THOSE SHOWN.
(FLOOD ZONE INFORMATION)
ZONE: X COMM' 120652 PANEL:12086C0306SUFFIX: L DATE:9- 1 1- 20098ASE: N/A
NOTE: DETERMINATION OF FLOOD ZONE LINES WERE BASED ON SCALING OF FEMA MAP LISTED ABOVE
NOTE: ALL BEARING HEREON ARE BASED TO THE PLAT BEARING OF
ON THE CENTER LINE OF PROPERTY LINE,
EASEMENT VIOLATIONS; ❑ YES X NO
APPARENT VISIBLE ENCROACHMENTS: ❑ YES rX NO
COMENTS;
ABBREVIATIONS;
SWK= Sidewalk, CBS= Concrete Block Strucb re, CLF= Chain Link Fence,
PL= Property Line, DUE = Drainage Utility Easement, IP= Iron Pipe,
A/C= Air Conditioner Pad, P /C= Property Comer, DIH= Drilled Hole,
W/F= Wood Fence, RE S= Residence, CL= Clear IR= Iron Reber, UE= Utilty
Easement, CONC= Conc. Slab, R/W= Right of Way, DE= Drainage Easement,
C/L= Center Line, C= Diameter, TYP= Typical M= Measured, R= Recorded,
ENCR= Encroachment, COMP= Computer, AS�PH= Asphalt, N/D= Nail & Disc.,
S= Set, FFE= Finish Floor Elevation, 0 /S= Offset, P/P= Power Pole,
0I-IP= Overhead Pawerllne, WM= Water Meter, VPP= Wood Power Pole,
E.M. = Electric Meter, M.F =Metal Fence, P.F. = Plastic Fence, D.M.E =Drainage
Maintenence Easement, C.M.E. =Canal Maintenence Easement, LM.E. =Lake
Maintenence Easement, M.E= Maintenence Easement, B.C.= BIockComer,
P (: =Pnint of r:Unrafiuw FNfl= nt,nd Nf) II'l -Nn Idantifiratinn
GL561 BAL
MENSIONS INC.
Land Surveying Services
OFFICE:
14770 SW 43rd WAY,
MIAMI, FL 33185.
PHONE: (305) 512 -4225
FAX: (305) 512 -1914
I HEREBY CERTIFY:
Menthe aiteched 1BOUNDARY SURVEY' of the lands sharer hereon Is true IOW correct
to the best of my Io, wladxe and beget as mangy surveyed and drmvn under my
supengslon and 9 °the Madman
Standards adopted bythe Florida �a Rood of Prof Stamm � Mappers
as cmrhbad trr Chapter 6J-17, FloridaA�Ydsbative Code, pursuant to Chapter
472.027, Florida StaMe°.
J)1LkJLC4, �� 1
DAVID L. DUTCH
REGISTERED LAND SURVEYOR # 4843
STATE OF FLORIDA
LB # 0008874
Note: Not Valid Unless
Signed and Sealed.
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