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DS-11-855
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: INSP - 179229 Permit Number: DS -5 -11 -855 Inspection Date: October 01, 2012 Inspector: Bruhn, Norman Owner: DAVITAN, GEORGE Job Address: 85 NW 102 Street Miami Shores, FL Project: <NONE> Contractor: CHAMBERS CONTRUCTION COMPANY Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: New Phone Number Parcel Number 1131010180080 Phone: (954)610 -5325 Building Department Comments 6" CONCRETE FOR DRIVEWAY REINFORCED W/WIRE FABRIC CHANGED EXPIRATION DATE FOR MAY REPORT. 5.24.12 permit renewed only to print new permit card. permit not renewed Infractio Passed Comments INSPECTOR COMMENTS True yot8/3/12 permit renewed 8/9/12 Passed // Inspector Comments CREATED AS REINSPECTION FOR INSP- 159690. FINAL FAIL NEED TO REVISE PLANS TO INCLUDE NEW SECTION OF DRIVEWAY ON THE NORTH SIDE. I.NARANJO Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until October 01, 2012 For Inspections please call: (305)762 -4949 Page 1 of 1 PERMIT # CONTRACTOR: CA-1 6 "J co\l's ` 4)clt oki SUBMITTAL DATE: '7012, ADDRESS: s'5 iNki3 1 b NAME: DA-NI I LA"' RESUBMITAL DATES: PROS ECT TYPE: ` Vagl tii ,P i * FIRE STRUCTURAL IMPACT FEES ELECTRICAL HRSIDERM PLUMBING NOC MECHANICAL BLDG Miami Shores Village Building Department 0050 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 FBC 20 Permit No. JS- 1 1 Master Permit No. Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder):(IECIEGie DM, TIAN Phone#:t0S) 2062* 1 (.c 0J Address: I 2 140 N.W. 1 .13I STREET City: 1:71-ANTAT 1014 State: f1.02/1:511/4 Zip: °b 32_3 Tenant/Lessee Name: Email: igik a ao I . corn Phone#: JOB ADDRESS: S5 tsl.w. 1D2- STIME-r City: Miami Shores County: Miami Dade Zip: 331 SO Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name414441REAS CON STII OCTI ON CV 11 PANT Phone#: (354. coi s szs Address: 1022:0 S.W.. 1 511 STREET City: IFiltigagoike PitJe s State: fog Zip: '203 Qualifier Name: Name: ,A,P_L-701%1 State Certification or Registration #: C4C OSbPG 1 - Certificate of Competency, #: ContaCt Pliona: qS4i C,tO .ssz 'Emi1 Address j4', erift (A4' 154140 (AA /lid% DESIGNER: Architect/Engineer: ...04L.12.41014 Phone#: cM4',GIC>S52.S. t Value of Work for this Permit: $ 00 Square/Linear Footage of Work: 34.0.F. Type of Work: DAddition UAlteration UNew NtRepair/Replace UDemolition, Description OfW6rk:' To gl.is-riti conlc.tere, /5ei UJ44f Phone#: qs4.IOEZ5 ,, A _,-d , ;, , **************14******** ************F ****************** ees ***********14*********** ,--, (36 Submittal Fee $ Permit Fee $ 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 • = approved and a reinspection will be charged. Air Signature off Signature i Owner or Agent Contractor The foregoing instrument was acknowledged before me this j 2.. The foregoing instrument was acknowledged before me this % 2. day of ‘1,1 , 20 11, by a4.p r'g 4 S, 3) 4_, D: 44 c day of , 20 L 1 , by .., .1 vt. C-4-04040 who is personally known too me or who has produced D /'- who i ') 135.4/7 - _I(P4 .s identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: CARY(ON L. WALLACE 4Y (Or4k4 +,14.e.):1 R DO 957502 its': t1 S i-tt 14, 2014 Bonded Mru Notary Punic Under/den to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expir '.ypy�'..,, CARYLON L WAUACE ;,s MY COMMISSION # DD 957502 EXPIRES: February 14, 2014 • �:' Bonded Tbru Notary Public Underwriters *************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Div * * * * * * * * ** * * * * * * * * * * * * * * * * ** * * * * * * ** APPROVED BY 77;1D161/1— S 1— Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07XRevised 06 /10 /2009XRevised 3/15/09) 5111111 - caa.nom 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 FBC 20 17..,E v mAy L 2011 Master Permit No. Permit Type: BUILDING ROOFING / / OWNER: Name (Fee Simple Titleholder): Gr;I'� , 0 A✓ d % J4,// Phone #: 305- �b /kr Address: J,2 / 4 0 iv- tJ /p2 $' j City: Z.- / 74 /DA/ State: ��4 . Zip: 3332 Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: /ULui / ®Z S' City: Miami Shores County: Miami Dade Zip: 33) S'c 7 Folio/Parcel #: Is the Building Historically Designated: Yes (1O Flood Zone: CONTRACTOR: Company Name 1-IAh1E£QS G.C*15T2 T I Phone #: cPS • Lol U• S32,6 Address: 102Z0 S.W. (S SUM?' City: 111 , PJt4' 5 State: FLO/Z1DA Zip: '63025 Qualifier Name: �_,4R.L7bN CIZAV.JL Phone #: /S 9' (010* 5325 State Certification or Registration #: CLIC OS& Slot Certificate of Competency #: Contact Phone #: Email Address: cQA GPRtA.,(@ bJ1 SD •npj- DESIGNER: Architect Engineer: 2L7oN Phone #: 41S+ 1 Co S 3 ZS- Value of Work for this Permit: $ /,Z 0. 019 Square/Linear Footage of Work: 15-4 S'.% X 7 Type of Work: ❑Addition OAlteration New URepair/Replace ODemolition Description of Work: 4" Y e0islei L-' r'r 6=11 2 A ✓ /fid44-y • QEIH Fo2,C.eD Go 1 Co X 1p u4.4/+.v 1,4 W1P.. FAE,Erc . *** ******** * ******* * * ** * ***** ** * *** ees. n*+ x* ***** *****• x**** *+ x*** ** *** *** * ***:x*+r:x **** Submittal Fee $ Permit Fee $ fff/ ©J Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ _____,Structural Review $ V571.00 CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ Ilea Bonding Company's Name (if applicable) Bonding Company's Address City State Zip NIA Mortgage Lender's Name (if applicable) h! /Ac 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 CONDMONERS, 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 ofcommencement must be posted at the job site for the first inspection which occws even (7) d #ys after the building permit is issued. In the absence of such posted notice, the inspection i { no be approved ction e will be charged. • Signature The forego day of h ...A ' �s�,�(:).i °oo�Signature Owner or Agent ,\Ii. , *4913'x' °" wled = ,� �r fo The forego" %�1 , r�,� day of instrument was 20 1 Contractor instrument was ac ,20 Ul ,b known to me or who has produced Identification and who did take an oath. OTA ;,.. P t LIC:• me or who has NOTAR PUB IC: who is ntification and wwo did take an oath. , —0 Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * ** APPROVED BY Sign: Print: My Commission Expires: i5( ' u aU ' :nT 17�p21 Col ' ..3, 1110 0.— svADII) ************************************************ ** * * ******* ********* * ** * * * ** *** ** *** 7 /It th, /,7"/ Plans Examiner �/� � Zoning Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Clerk FROM : FAX NO. : Sep. 27 2012 12:04PM P2 STATE OF FLORIDA DEPARTMRN'T OP BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 CRAWL, CARLTON CHAFERS CONSTRUCTION COMPANY PEMBROKE 15TH FL 33025 Congratulations! licensed Department one nearly ns y the o Bus ness nd Professional nal Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and leam more about the ' Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE THIS DOCUMENT HAS A COLOR p 5AGKGROUNr +MICRoPRrNTING t LINEMARK' ' PATENTEE) PAPER STAT: GtJLATI.ON $OARA SEi> .!+120830028].5 lei, J..�'�F! �1.'7R O`�' '•� i = Un ez'tUe:. : bvr.:' ,-0a •33025 GOVERNOR izl.�2G1l.AV AR RF&' itiRi=tn`F=V I AW lam . Lrt WSON SECRETARY FROM : FAX NO. : Sep. 27 2012 12:05PM P3 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954 - 831 -4000 VALID OCTOBER 1,2012 THROUGH SEPTEMBER 30, 2013 DBA: CHAMBERS CONSTRUCTION CO Business Name: Receipt #:GEBNERAL CONTRACTOR Business Type :CONTRACTOR) Owner Name: CARLTON CRAWL Business Opened:05 /19/1993 Business Location: 10220 SW 15 ST State/County /Cert1Reg:CCC056861 PEMBROKE PINES Exemption Code: Business Phone: seats Employees 1 Machines Professionals Number of Machines' For Vending Business Only • (GENE Tax Amount Transfer Fee NSF Fee Penalty _...8 . ,,._. 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 WHEN VALIDATED Mailing Address: CARLTON CRAWL 1022Q SW 15 ST PEMBROKE PINES, FL 33025 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 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. This raosipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. 2012 - 2013 Receipt #02A- 11- 00006754 Paid 09/20/2012 27.00 1- Permit No: 11 -855 Job Name: July 16, 2011 Miami Shores Village Building Department Building Critique Sheet Rev 1) Plans must be approved by HRS for the septic system. 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Plan review is not complete, when all items above are corrected, we will doa complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 PERMIT #: 1 I, TOt4 12A IL Miami Shores V Building Department RECEIPT DATE: 1) 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Contractor D Owner Architect Pic ed up 2 sets plans and (othe Address: Comnr/tS k) Mak Cf91{-efit) Of)S RO 02-S4 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: PERMIT CLERK INITIAL: RESUBMITTED DATE: dL PERMIT CLERK INITIAL: 1 1cL 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 Permit NO. DS -5 -11 -855 Issue Date: 5/17/2011 Expires:5 /17/2011 Folio Number:1131010180080 Owner's Name: GEORGE DAVITAN Job Address: 85 102 Street Miami Shores, FL Owner's Phone: Total Square Feet: Total Job Valuation: 154 $ 1,250.00 Contractor(s) CHAMBERS CONTRUCTION COMPANY Phone (954)610 -5325 Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: No Comments: FLARES MAX 2 FEET. PLEASE IDENTIFY SCOPE OF WORK ON THE PLANS. Date Denied: Project Address Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 85 NW 102 Street Miami Shores, FL Owner Information Address Parcel Number 1131010180080 Block: Lot: Applicant GEORGE DAVITAN Phone Cell GEORGE DAVITAN 85 NW 102 ST MIAMI SHORES FL 33150 -1229 Contractor(s) Phone Cell Phone CHAMBERS CONTRUCTION COMPAN (954)610 -5325 Valuation: Total Sq Feet: $ 1,250.00 154 1 Approved: Yes Comments: FLARES MAX 2 FEET. Date Approved: 5/12/2011: Yes Date Denied: Type of Work: DRIVEWAY Bond Retum : Scanning: 1 Additional Info: CONCRETE Classification: Residential Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $1.20 $2.25 $2.25 $0.40 $150.00 $3.00 $1.60 $160.70 Pay Date Pay Type Invoice # DS -5-11 -40913 05/19/2011 Credit Card 05/12/2011 Credit Card Amt Paid Amt Due $ 110.70 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Sidewalk Landscaping Foundation In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy iVlay 19, 2011 Date May 19, 2011 1 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 CRAWL, CARLTON CHAMBERS CONSTRUCTION COMPANY 10220 SW 15TH ST PEMBROKE PINES FL 33025 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you_ caniind _more..information..about ourAvisions. and .the regulations_ that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE (850) 487 -1395 etjg kl- -ICH UMEr -r? ��R'i F,di rot 21.4 ra; "° 4 nor -. 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954 -831 -4000 VALID OCTOBER 1, 2010 THROUGH SEPTEMBER 30, 2011 • DBA: Business Name: CHAMBERS CONSTRUCTION CO Owner Name: CARLTON CRAWL Business Location: 10220 SW 15 ST PEMBROKE PINES Business Phone: Receipt #:180-4148 Business Type. CONTRACTORNTRACTOR (GE Business Opened:05/19/1993 StateICounty /Cert/Reg: CGC 0 5 6 8 61 Exemption Code :NONEXEMPT Rooms Seats, Employees Machines Professionals 1 Tax Amount Number of Machines: For Vending Business Only 27.00 Transfer Fee 0.00 NSF Fee Penalty Vending Type: Prior Years Collection Cost 0.00 0.00. 0.00 0.00 Total Paid 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: CARLTON CRAWL ;10220 SW 15 ST PEMBROKE PINES, FL 33025 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 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. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. 2010 - 2011 Receipt #03A- 09- 00024121 Paid 09/24/2010 27.00 ACS CERTIFICATE OF LIABILITY INSURANCE PRODUCER HIGHPOINT RISK SERVICES, LLC 14160 DALLAS PARKWAY #500 DALLAS, TX 75254 (972) 715 -0900 DATE (M M/DDIYYYY) 12/17/2010 THIS CERTIFICATION IS ISSUED AS A MATTE ti 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 INSURED CHAMBERS CONSTRUCTION COMPANY, CGC 056861 10220 SW 15TH STREET PEMBROKE PINES, FLORIDA 33025 (954) 610 -5325 - TEL. (954) 435 -2051 - FAX INSURER A: Companion Property and Casualty Insurance Co INSURER B INSURER Q INSURER D: INSURER E: RAGES 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 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. INSRADD'L LTR INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ PREMISES (Ea occurence) $ MED EXP Any one person) $ CLAIMS MADE I l OCCUR PERSONAL& ADVINJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC PRODUCTS - COMP /OP AGG $ $ —I AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ —__, AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY OCCUR I. I CLAIMS MADE DEDUCTIBLE RETENTION $ - EACH OCCURRENCE $ AGGREGATE $ $ $ $ A WORKERS EMPLOYERS ANY OFFICER/MEMBER 5 yes, SPECIAL COMPENSATION AND LIABILITY PROPRIETOR/PARTNER/EXECUTIVE EXCLUDED? describe under PROVISIONS below WC200499802 12/17/2010 12/17/2011 VJC STATU- I OTH- X TORY LIMITS I ER E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYEE $ - 1000000 E.L. DISEASE - POLICY LIMIT $ 1000000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS n A •1nrn 1 A TIr1Al Miami Shores Village Building Department 10050 N.E. 2nd Avenue Miami ShoresFiorida 33138 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 HIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE n Arf1Rn f1TRPfRATION 1988 ACORD 25 (2001/08) AC R ®TM CERTIFICATE OF LIABILITY INSU a'; ,'• CE DATE (MWDD/yYTY) 10/22/2010 TYPE OF INSURANCE PRODUCER 305 836 -5206 C. BRIAN HART INSURANCE CORP. C. BRIAN HART 7954 NW 22 AVENUE MIAMI, FL 33147 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 CARLTON CRAWL DBA CHAMBERS CONSTRUCTION 10220 SW 15 STREET I PEMBROKE PINES, FL 33025 INSURER A: SCOTTSDALE INSURANCE 10672 _ INSURER B: 10/20/2010 INSURER C: CU ----- __ _ __ INSURER 0: —` INSURER E: 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 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 ADD'L NSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DDTYY) POLICY EXPIRATION DATE (MMIDD/YY) LIMITS A X GENERAL LIABILITY CPS1105576 10/20/2010 10/20/2011 CU $ 300,000 X COMMERCIAL GENERAL LIABILITY DAMAGE RENTED PREMISES (Ea occurence) $ 100,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 300,000 -1 GENERAL AGGREGATE s 600,000 GEN'L X AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 300,000 POLICY [ jFa LOC AUTOMOBILE _ _ LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ $- PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT - $ ANY AUTO 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? WC STATU- OTH- TORY LIMITS ER EL. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes. describe under SPECIAL PROVISIONS below E.L. DISEASE • POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS General Contractor TI FICA TE HOL CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 N.E. 2ND AVENUE MIAMI SHORES, FLORIDA 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN M01ICE TO THE CERTIFICATE HOLDER NA -• TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR L >'-7•F ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. /,,. AUTHORIZED RE 't';' % ".6" ACORD 25 (2001/081 © ACOFID CORPORATION 1988 . • • • • • • • • • • • ".".".".".•••••• Boundary Sturvey 25.00 S8g39'56'W 0.e, Y2' FIP No Id • • • • - • • • • - - • - • • • " • • • • • • • • • N90600'00'E 70.00' CBS Wall Y2' FIP No Id Sheet 2 EWE 2 0.C. a.e. F/N . •••.• • ' . . . . . . . . . . D-89`39'56' •..................... T24.85 ..................... 22.74' 4' CLF to.) r...>" West 15.00' --I - 0 1.._ Lot 1 8 A/C 1 3.0 o 1 o P ill 6.0 L22.21' 5,....77...ww.., 25.05 .....,./m-A 2.7 N.0‘1Pe■S"- 01 22.87' %. ONE STORY CBS CD ,%,, HOUSE RES. *85 %. 4.50 1 Q. roote,A,,',e,3.0. 8,,, „,.;:,...* (.5.35.• : slex OP? 1,1 soe ■:. ‘:::COnc....!..., ii. ....'-i -, ...e(fl. -.1.t....::ii.....7::.:1 , -.. 8-'09-ef ',ye,. 25.05.-4.,,,,,..4 a 22 08' 3.0 Conc. Walk ........... 3.2* FIP No Id J0- ....... ............. 4, 0 '12 Conc. Stripe 1.15' CL WUP 35.00' 8 1.43' CLF Y2' FIP No Id F/N N9000'006 45.15 OWN 17.05' Parkway g 8 I rri • • - • • • • . - • - • • . • - - • • • • • . • • . • • • .. ." . ....... .......... JOB # 09-646 DATE 12-16-2009 13B 12-59 Surveyor Notes: Survey is incomplete without sheet! of 2 _R.-ale of Drawing 1=20' Drawn By: A. Torres Dale: 12-16-2009 Completed Field Survey Dare: 12-15-2009 AFA Sr COMPANY, INC. LB # 7498 Professional Land Surveyors and Mappers 13050 SW 133rd CT Miami, Florida 33186 PH: 305-234-0588 FX: 305 234-0423 AFA Company, Inc 1 1 • • • \\\ The.onrate rorebentanon thereof to the best e sketch hereon is a true and A of inxiareleailelalinthet.t.•;object to notes anti iNtbratiofts stiowri hert'ort. er"-- fessfonal Sure rapper #15.5.26 Slate a/Florida Nor Valid maim- ,S'ikriecl & Stamped with Embosser/ Seal ranuaAV saM JON ItlV1 1.1 IVY4Vr. 1V16.0 1 %e1 vt.l vvt 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 ' 20 0 21 22 23 24 re -47 17 r 18 19 Northwest 102nd Street PROPERTY ADDRESS: 85 Northwest 102nd Street Miami Shores, Florida 33150 SURVEYOR NOTES #1 Lands Shown Hereon were not abstracted for Easement and/or Right of Way Records. The Easement 1 Right of Way that are shown on survey are as per plat of record unless otherwise noted. #2 Benchmark Miami -Dade Comity Public Works Dep. BM Loc. 3100; Name: N-567; Elev. +10.54' #3 Bearings as Shown hereon are Based upon Northwest 103rd Street. N90°00'00'7 #4 Please See Abbreviations #5 Survey is incomplete Without Sheet 2 of 2 #6 Drawn By A. Tortes Date: 12 -16 -2009 #7 Complete Field Survey Date: 12 -15 -2009 #8 Disc No 2009, Station Surveing Scion #9 Last Revised: 410 Legal Description Furnished by client. 411 This Certification is only for the lands as described. It is not a certification of Tide, Zoning, Easements, or Freedom of Encumbrances. ABSTRACT NOT REVIEWED. #12 There may be additional Restrictions not shown on this survey that may be found in the Public Records of Miami -Dade County, examination of ABSTRACT OF TITLE will have to be made to determine record instruments, if any affecting this property. 413 ACCURACY:The expected use of the land, as classified in the Minimum Technical Standard (61017-6FAC), is "Residential'. The Minimum relative distance accuracy for this type of boundary survey is 1 foot in 10,000 feet. The accuracy obtained by measurement ofa cued geometric figure was found to exceed this requirement #14 Foundations and/or footings tint may cross beyond the boundary limes of the parcel herein described are not shown hereon. #15 Not Valid without one signature and the original raised seal ofa Florida Licensed Surveyor and Mapper. Additions or deletions to Survey reaps or reports by other than the signing party or parties is prohibited _ - _ without written consent of tbesignigg party orparties. #16 Contact the appropriate authority prior to any design work on information. #17 Underground utilities are not depicted hereon, contact the appropriate authority prior to any design work or construction on the property herein described. Surveyor shall be notified as to any deviation from utilities shown hereon. #18 Ownership Subject to OPINION OF TITLE. JOB # 09 -646 DATE 12 -16 -2009 PB 12 -59 ABBREVIATIONS A ARC DISTANCE AVE. AVENUE ASPH - ASPHALT AC -AIR COMMONER at.DO - EUILDING B.COR. -BLOCK CORNER C.B. -CATCH BASIN CLF -CHAIN LINK FENCE CONC.- CONCRETE COL. •COLIDE4 C.VB.- CONCRETEUTIUTVPOLE C.L.P. .CONCRETE LIGHT POLE CBS ■'ANLRETEBLOCK StRUCiURE C.M.E -CANAL MAINTENANCE EASEMENT D - DlRECtER4 DIW -DRIVEWAY D.M.E- DRANAPE& MAD TENANCE EASEMENT ENC. *ENCROACHMENT ET.P..E ECTRIC TRANSFORMER PAD F.P.L. ...FLORIDA POWER AND Lion F.H. - PIBEHYDRANr FLP. -POUND IRON PIPE F.F. -FINISH FLOOR F.D.H. -FOUND DRILL HOLE F.R. -SOUND MBAR FID -FOUND DISC RN - POU&1DNAB. 115 -IRON FENCE L - LEBGrH LE. - WOHTPO E MEAS.- MEASVAFD ME. - MANHOLE NO VD..NATIONAL OEODEIIC VERTICALDAWM N.TS. MOTTO SCALE O.E - OVERHEAD ELEtRICLNE OIL •ONLINE P.C.P. - PERMANENT CONTROL POINT P.C. •POINTOFCURVATURE R -RADIUS RES - RESIDENCE SDWLK - SIDEWALK T TANGENT U -many EASEMENT WIP -WOOD FENCE W.V. WATER VALVE W.U.P. WOOD UTILITY POLE -- P --O-"S -RONFENCE -CEAN LINK FENCE -WOOD FENCE -CHS WAIL - OVERHBADELEC. - CENTERLNE • - DENOTES ELEVATIONS - ammo - DtsrANCE =re= ano3 iwen lsamgpoN ELEVATION I NF O R MA TIO N National Flood Insurance Program FEMA Elev. Reference to NGVD 1929 Comm Panel Panel # Firm Zone: Date of Firm: Base Flood Elev. F.Floor Elev. Garage Elev. 120652 0302 IrXIt 039 -11 -2009 N/A 11.50' N/A Suffix: "L" Elev. Reference to NVGD 1929 CERTIFIED ONLY TO: Hmayak Intoyan LEGAL DESCRIPTION: Lot 17 and the West 15.00' feet of Lot 18, Block 1 of: "NAVARRO" according to the Plat Thereof as Recorded in Plat Book 12, Page 59 of the Public Records of Miami -Dade County, Florida. Pro fessional Surveyors & Mappers LB 7498 13050 S.W. 133rd Court Miami Florida, 33186 Ph. # (305) 234 -0588 FAY # (fl 714_(1471 This certifies that the survey of the pi'aparty described hereon was made under my super- vision & that the survey meets the minimum technical standards set forth by the Florida Board of Professional Land Surveyors & M a p p e r s inChapter 61G17 -6 of Florida Administrative Code, pu sujni to Section 472.027, Florida :Statutes: & That is Sketch haragu u1 a truiand actaitate representhttlion thereof fp the bast of my knowledge and Belief, s(tjeat 10 notes and notations shown hereon. (Armando F. Alvarez ea eel Surveyor d1 Mapper # SS26 State efFlorida