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DS-12-1867Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 179585 Permit Number: DS -10 -12 -1867 Scheduled Inspection Date: November 06, 2012 Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Owner: , Work Classification: Addition /Alteration Job Address: 190 NW 102 Street Miami Shores, FL 33150- Inspector: Bruhn, Norman Project: <NONE> Contractor: APC ENGINEERING ENTERPRISES INC Phone Number Parcel Number 1131010230090 Phone: (305)219 -8267 Building Department Comments INSTALL PAVER DRIVEWAY AND WALKWAY Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. November 05, 2012 For Inspections please call: (305)762 -4949 Page 13 of 34 PERMIT # CONTRACTOR: VC_ SUBMITTAL DATE: I D I ci ! 2, c. ADDRESS: 19 0 NW 102 S-7 NAME: A- u-c) H 1 Nv , RESUBMITAL DATES: )/ Z< J 2- PROJECT TYPE;-,,,, ^ ' °) \� _ /� /f FIRE _ STRUCTURAL IMPACT FEES ELECTRICAL HRSIDERM PLUMBING NOC MECHANICAL If G It �1 ` / Y / ,'i►; , P �� 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 Permit Type: BUILDING RECEIVED OPT 0 0 g91g FBC 20 LC Permit No.t� Master Permit No.PS 12 -- 1 ROOFING JOB ADDRESS: 1I b N . w • 1 C) 2. S+ City: Miami Shores County: Miami Dade Zip: 33 1 3 e Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): \ K vtstrh hone#: Address: City: State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: A- ec E hi t w .per -►�► �i V► - Phone#: 303- S 5 3 7 Address: 02 l C 0 (4 • L. 0 t qv' City: IA % A Ce A 1,- 4 State: F� Zip: 33o / 0 Qualifier Name: ` 4 b a J+ Zo l e to j 11, a.. Phone#: State Certification or Registration #: C &C, L St ' St 43 1 g 7 Certificate of Competency #: Contact Phone#: 30 S 2 l 44 — 2 2 (®1 Email Address: del, v 1 d 4 q p e- ®3044/i. c fd p, DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ Weis , 4'' Square/Linear Footage of Work: /6)6, g �/' 0 Type of Work: ❑Addition ❑Alteration mew ❑Repair/Replace ❑Dem 'tion Descrip ®,f- 4 104 vv"- o 0.) 'r_r5_,, , -till '� ?kw. I E>04^ ♦ 0. 64_ * * ** **+x*+x************* ++x*******a:*******Fees ** ****** * *** : ********u+ ****************** Submittal Fee $ 50 - Permit Fee $ /SS 424 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ J • 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 O%` Agent The foregoing instrument was acknowledged before me this 10 day of (�7 ,, 20_11.; by V. < OA g tt a t 4 Lir who is personally known tb me or who has produced As identification and who did take an oath. NOTARY PUBLIC: C6 J Sign: Print: ��. 4- �- My Commis 1 1 1 o °''' SANDY ROMERO 1 Mabry Public • State of Florida My Comm. Expires Jul 26, 2015 Commiss • EE 116040 APPROVED BY Signature" Contractor The foregoing instrument was acknowledged before me this 1 day of 0 , 20 t 4.by .0", who personally knowwnIo me or who has produced as identification and who did take an oath. NOTARY PUBLIC: /09;2 L Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Sign: VI CAC Clerk ACOR© ., CERTIFICATE OF LIABILITY INSURANCE °A'�`�°'°°""""' 10/24/2012 TYPE OF INSURANCE PRODUCER (954) 966 -9993 Gulfstream Insurance Agency, Inc. 5833 Johnson Street Hollywood FL 33021- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION TH ONLY HOLDER.NTHISOCER CATERDOES OTOAMEEND, CEXTENDAOR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED All Pro Contracting Group Inc. dba APC Engineering 2150 West 10th Ave. Hialeah FL 33010 - INSURER A. State National INSURER B: Floria Citrus 'Business LABILITY COMMERCIAL GENERAL LIABILITY INSURER C: Industries Fund INSURER D: 10/20/2013 / / / / / / INSURER E: $ 1,000,000 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTIMTHSTANDING 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 OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR J INSRD TYPE OF INSURANCE POLICY NUMBER — PE DA ((MMIDD j POLICY N DATE(EMD6YY) UNTS A GENERAL LABILITY COMMERCIAL GENERAL LIABILITY 67913 10/20/2012 / / / / / / 10/20/2013 / / / / / / EACH OCCURRENCE $ 1,000,000 X P SES (F.Ra occurrence) $ 100, 000 1 CLAIMS MADE Iii OCCUR MED EXP (Any one Perm) $ 5 , 000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATjE LIMIT APPLIES PER- POLICY f GJERC -^ LOC PRODU TS - COMP /OP AGO $ 2,000,000 i1 HOB AUTOMIDBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS / / / / / / / / / / / / / / / / COMBINED SINGLE LIMIT (Ee accident) $ _ BODILY INJURY (Per person) $ — BODILY INJURY (Per =Went) $ PROPERTY DAMAGE (Per =Ideal) $ GARAGE UABILITY ANY AUTO / / / / AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGO $ EXCESS/UMBRELLA LIABILITY OCCUR Li CLAIMS MADE DEDUCTIBLE RETENTION $ / / / / / / / / EACH OCCURRENCE $ AGGREGATE $ $ $ $ B WORKERS COMPENSATIONAND EMPLOYERS LABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBEREXCLUDED./ If yes, describe ender SPECIAL PROVISIONS delve 10650721 10/11/2012 / / 10/11/2013 / / WCO ggTr X ITORYLIAMRSI IOETRH E.L. EACHACCIDENT 1,000,000 $ E.L DISEASE - EA EMPLOYEE $ 1,000,000 Et DISEASE - POLICY LIMIT 1,000,000 $ OTHER / / / / / / / / / / / / DESCRIPTION OF OPERATIONSILOCATION SNEHICLES/EXCLUSIONS ADDED BY ENDORSEMEN17SPECIAL PROVISIONS CANCELLATION ,., r,.a anvn ac rwlL, .r% ( — ( ) — SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEPORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL /U DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT Ci ty OF Miami Shores FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OP ANY KIND UPON THE 10050 NE 2nd Ave INSURER ITS AGENTS OR RESE ATNES AUTHORIZED REPRESENT E Miami Shores FL 33138- ACORD 25 (2001108) INS025 (0108).0 ® ACORD CORPORATION 1988 Page 1 Of 2 PERMIT . Oi2 —IN1 Miami Shores Village Building Department RECEIPT I, (D610.4 Contractor Owner ArcItect her) Like) p 2 sets of plans and 11,, ll Cam Address: �W 12'6 t , DATE: 101 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 From the building department on this date in order to have corrections done to plans And /or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged by: --J 'rte PERMIT CLERK INITIAL: RESUBMITTED DATE: ) 0 LO 1 PERMIT CLERK INITIAL: Rick Scott Governor John H. Armstrong, MD, FACS State Surgeon General October 24, 2012 Richard Hector 2150 W 10 Avenue Hialeah, FL 33010 RE: Contingency Letter Application Document No: API086103 Centrax Permit Number: 13 -SC- 1435397 OSTDS Number: 190 NW 102 St Miami, FL 33150 laggovn at OCT2eNit pi c 1L' ) g'i Lot:1 -4 Block:2 Subdivision: Bonmar Park Dear Applicant: This will acknowledge receipt of an application dated 10/16/2012 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 that your existing system is adequate for the proposed use (installation of a paver driveway and a walkway in the North West side of the property). If you have any questions on this matter, please call our office at (305) 623 -3500. Enclosures cc: Sincerely, Jose pecialist I I 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 F R 0 N T V E W CERTIFIED TO: ALYKAY INVESTMENTS ITS'SUCCESSORS AND /OR ASSIGNS AS THEIR INTEREST MAY APPEAR. Community Number: VILLAGE OF MIAMI SHORES 120652 Panel Number: 12086C0302 Suffix: L Date of Firm Index: 9/11/2009 Flood Zone: X Base Flood Elevation: Date of Survey: 10/5/2012 Legal Description: THE WEST 75 FEET OF LOTS 1,2,3, AND 4, BLOCK 2 OF BONMAR PARK ADDITION, RE -SUB ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 24, PAGE 71 OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY, FLORIDA. PROPERTY UNE Surveyor's Legend — 0= STRUCTURE Ll a L.I.E. LAKE LANDSCAPE MAW. ESMT. ESMT. EASEMENT CONC. BLOCK WALL or R.O.E. ROOF OVERHANG EASEMENT D.E. DRAINAGE EASEMENT P.P. POWER x CHAIN -LINK or MARE FENCE POLE ES WOOD FENCE ®C.B. CATCH BASIN P.P. POOL PUMP LB.E. LANDSCAPE BUFFER MT. /1 1/ PL. PLANTER OR PROPERTY UNE LA.E. UMITED ACCESS EASEMENT C.U.E. COUNTY UTILITY ESMT. 1.D. IDENTIFICATION TEL TELEPHONE FACILITIES 0 0 o IRON FENCE LE./E.E. INGRESS/ EGRESS ESMT B.C. BLOCK CORNER U.P. UTILITY POLE --- -- --- — EASEMENT U.E. UTiUTY EASEMENT E.U.B. ELECTRIC UTILITY BOX FND. OR F FOUND IRON PIPE/ B.R. BEARING REFERENCE PIN AS NOTED PLAT CENTRAL ANGLE or DELTA E'• SEPTIC TANK — CENTER UNE ON LB�j UCENSE i - BUSINESS R RECORD OR RADIUS D.F. DRAIN FIELD RADIAL AC AIR CONDITIONER ,r A WOOD DECK N.R. NON RADIAL CSW CONC �DEWALK CALL CALCULATED SURVEYOR N.R. SET SET MONUMENT TYP. TYPICAL DWY DRIVEWAY • 474: . SCR SCREEN CONCRETE • CONTROL POINT I.R. IRON ROD GAR, GARAGE I.P. IRON PIPE OAR. GARAGE • CONCRETE MONUMENT ELEV ELEVATK?N N&D NAIL & DISK ASPHALT P.T. POINT OF TANGENCY PK NAIL PARKER -KALON NAIL N.T.S. NOT TO SCALE D.H. DRILL HOLE F.F. FINISHED FLOOR P.C. POINT CURVATURE BRICK /TILE P.R.M. PERMANENT REFERENCE MONUMENT ® WELL T.O.B. TOP OF BANK t7 FIRE HYDRANT E.O.W. EDGE OF WATER P.C.C. POINT OF COMPOUND CURVATURE E/P OR E.O.P. EDGE OF PAVEMENT y�/ P.R.C. POINT OF REVERSE CURVATURE O M.H. MAN HOLE WATER O.H.L OVERHEAD ONES C.V.G. CONCRETE VALLEY GUTTER P.O.B. POINT OF BEGINNING TRANSFORMER B.S.L BUILDING SETBACK LINE P.O.C. POINT OF COMMENCEMENT CAN CABLE TV RISER S.T.L SURVEY TIE UNE �.._._.�""- APPROXIMATE EDGE OF WATER P.C.P• PERMANENT CONTROL POINT W.M. WATER METER ET CENTER UNE M FIELD MEASURED P/E POOL EQUIPMENT R/W RIGHT OF WAY P PLATTED MEASURMENT UTILITY 1 CONC CONCRETE SLAB R.O.E. PUBLIC EASEMENT 1 COVERED AREA D DEED C.M.E. CANAL MAINTENANCE EASEMENT C CALCULATED A.E. ANCHOR EASEMENT General Notes: 1) LEGAL DESCRIPTION PROVIDED BY OTHERS. 9) BEARINGS REFERENCED TO LINE NOTED AS B.R. 2) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO 10) BOUNDARY SURVEY MEANS A DRAWING AND /OR GRAPHIC REPRESENTATION DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING PROPERTY. OF THE SURVEY WORK PERFORMED IN THE FIELD, COULD BE DRAWN AT A SHOWN 3) THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENT OR OTHER SCALE AND /OR NOT TO SCALE. RECORDED ENCUMBERANCES NOT SHOWN ON THE PLAT. 11) NO IDENTIFICATION FOUND ON PROPERTY CORNERS UNLESS NOTED. 4) THE PURPOSE OF THIS SURVEY IS FOR USE IN OBTAINING TITLE INSURANCE AND 12) NOT VALID UNLESS SEALED WITH THE SIGNING SURVEYORS EMOSSED FINANCING AND SHOULD NOT BE USED FOR CONSTRUCTION, PERMITTING DESIGN, OR ELECTONIC SEAL. OR ANY OTHER PURPOSE WITHOUT THE WRITTEN CONSENT OF ONLINE LAND 13) DIMENSIONS SHOW ARE PLAT AND MEASURED UNLESS OTHERWISE SHOWN. SURVEYORS INC. 14) ELEVATIONS IF SHOWN ARE BASED UPON N.G.V.D. 1929 UNLESS OTHERWISE 5) UNDERGROUND PORTIONS OF FOOTINGS, FOUNDATIONS OR OTHER NOTED. IMPROVEMENTS WERE NOT LOCATED. 15) THIS IS A BOUNDARY SURVEY UNLESS OTHERWISE NOTED. 6) ONLY VISIBLE AND ABOVE GROUND ENCROACHMENT LOCATED. 16) THIS BOUNDARY SURVEY HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF 8) FENCE OWNERSHIP NOT DETERMINED. THE ENTITIES NAMED HEREON, THE CERTIFICATIONS NOT EXTEND TO ANY 7) WALL TIES ARE TO THE FACE OF THE WALL. UNNAMED PARTIES. SURVEYOR'S CERTIFICATION: I HEREBY CERTIFY THAT THIS BOUNDARY SURVEY IS A TRUE f ."--') ( n1 neLand Online Land Surveyors y 7925 Coral Way, Suite Miami, FL 33155 -6524 PHONE: (305) 910 -0123 FAX: (305) 675 -0999 LB#: 7904 INC. Inc. 101 AND CORRECT REPRESENTATION OF A SURVEY PREPARED UNDER MY DIRECTION. THIS FLORIDA O BWITH D OF PROFEMICINEAL Lag I STANDARDS, AS SET IN CHAPTER 61{G17 6, STATE ADMINISTRATIVE CODE1/4POR T0/472 21,, f ®ORIDA STATUES. =ms h • s NO.529�' _ • � LL! .- SIGNED ' R° y''. STATE ®F ; • ��� FOR THE FIRM FERNANDO , 0 El....••• "' � „.• STATE OF FLD`Ris'" SURV_,0 -c- . P.S.M. No. 5259 NOT VALID WITHOUT AN AlfT4TEIII 19 FILB(1 ONIC SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL, AND /OR THE SIGNATURE AND /OR THE ORIGINAL RAISED SEAL OF A LICENSED SURVEYOR AND MAPPER. THE SEAL APPEARING ON THIS DOCUMENT WAS AUTHORIZED BY FERNANDO V. GOMEZ, P.S.M. NO. 5259 ON THE SURVEY DATE NOTED HEREON. Survey Date: 10/5/2012 Survey Code: 0 -7488 Page 2 of 2 Not valid without all pages. • ••••••• .•01°110,6.. 611'11 6• °b '° .. 1111. •� °' .. ,. °. .1111. °11°...110 <.. W. 102nd STREE .........°. °•.•.••••• °.•.. °•..•.•......... .11..11. °.. •�� •° 50' RIGHT —OF —WAY (BY PLAT) °• °. ° 16't ASPHALT PAVEMENT , • 1111 °1111.. F.I.P. 1/2" (No I.D.) 4 17.0' PARKWAY 75.00' (R &M) 7.9• 090840 35.00' 10.13' �n 14.00' F.I.P. 1/2" (N0 1.©.) 0.12' ONE STORY CBS RESIDENCE # 190 0' 10' 20 1 inch = 20' ft. REMAINDER OF LOT 1 BLOCK 2 REMAINDER OF LOT 2 BLOCK 2 � REMAINDER OF LOT BLOCK 2 0.02' REMAINDER OF LOT 4 BLOCK 2 35.00' F.I.P. 1/2" (NO 1.0.) r761: 75.00' (R &M F / P. 1/2 I I'ami Sho ' `',11z41.r. B.C. F.I.P. 1/2" ® NO I.D. MIAMI -DAD= COUNTY H TH DEP PERMIT #; ARTME AAr Z. 14 • Notes: NO VISIBLE ENCROACHMENTS ON THIS PROPERTY. Property Address: 190 NW 102 ST MIAMI, FL 33150 LOT 5 BLOCK 2 DATE: IT 10 NIPIJANCE WITH ALL FEDERAL ND C UNNi'f'RULES AND REGULATIONS VJ a I HEREBY CEERTIFY THAT THIS BOUNDARY SURVEY IS A TRUE w COMP REPRESENTATION I Hfl IA AL iii NDARDS AS SET FORTH BY THE STATE OF 0ov- r art !4, weA.Li wg4 �,jN N� STATUES; i FLORIDA BOARD OF PROF LuW 1 . U�nYORS IN CHAPTER 61G17 -6, FLORIDA � f- ADMINISTRATIVE COPE W 19.7 ..v3 Fh9RI❑ - in Dt ✓i<+ s a -9% r 14'T vg- ti s -0 5259 .11... p� (4.9_ g W - OCT 0 0 20Ia 01 i e .e l� i k- Ire at 1 �j�y A.. 44sIC °'d �' STATE OF '• �4 1 • —�l/1$ c� ••••.....•••• FLORIDA •. • 4 ;. '�`� '`/� e'SIGNED , Dti� " FOR FERNANDO V.60 STATE OF FLORID nlineLand SURVEYORS, INC. 2TuRVE`I •`, f i i , ti't P.S.M. No. 5259 NOT VALID WITHOUT AN AUTHENTIC ELECTRONIC SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL, AND /OR THE SIGNATURE AND /OR THE ORIGINAL RAISED SEAL OF A LICENSED SURVEYOR AND MAPPER. THE SEAL APPEARING ON THIS DOCUMENT WAS AUTHORIZED BY FERNANDO V. GOMEZ, P.S.M. NO. 5259 ON THE SURVEY DATE NOTED HEREON. Survey Date: 10/5/2012 Survey Code: 0 -7488 Page 1 of 2 Not valid without all pages.