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DS-13-613Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 188211 Permit Number: DS -3 -13 -613 Scheduled Inspection Date: April 25, 2013 Inspector: Rodriguez, Jorge Owner: SWAN, ROBERT Job Address: 770 NE 98 Street Miami Shores, FL 33138- Project: <NONE> Contractor: CHAMPION CONCRETE Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)471 -1734 Parcel Number 1132060142310 Phone: (305)252 -8055 Building Department Comments REPLACE EXISTING DRIVEWAY AND SIDEWALK WITH PAVERS. SAME AREA/ LOCATION AND CONFIGURATION AS EXISTING SIDEWALK AND DRIVEWAY Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 25, 2013 For Inspections please call: (305)762 -4949 Page 10 of 49 PERMIT # CONTRACTOR: \,...11/ L"""V ri 1 -- %iv N3C.I vJ% SUBMITTAL DATE: Z6 )3 ' ADDRESS: -TM N O1 gST NAME: SAW , 3 RESUBMITAL DATES: PROJECT TYPE:i�_ it 1 rj ZONING , FIRE STRUCTURAL IMPACT FEES ELECTRICAL HRS/DERM PLUMBING NOC MECHANICAL BLDG - BUILDING a�n Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 SPECTION'S PHONE NUMBER: (305) 762.4949 Permit No. MCIEVZI MAR 272013 C 2060 tat PERMIT APPLICATION Master Permit No. Permit Type: LBUILDING� JOB ADDRESS: g70 ROOFING City: Miami Shores County: Miami Dade Zip: 33/3e Folio/Parcel #: 1/ -40k 6/ Q-3 /0 Is the Building Historically Designated: Yes NO X Flood Zone: OWNER: Name (Fee Simple Titleholder): g09.. c: > -�� Phone #: 3 D S °.! S ' Y,3 Address: 7 70 /- 9 8 Sf4- 7 City: h) ® 5,111) .0 State: C® Zip: s> 3)28 Tenant/Lessee Name: Phone #: Email: GOP/491,d CONTRACTOR: Company Name: 6/4-,,,-,,,p 1 O vJ CotseV -iey Phone #: 714 - V02- ' 440© Address: /00 Nui o' 3 714-/ 0 j / City: 1 /'f d' — state: Zip: 3 3 6 7 Qualifier Name: °,,../.417 /1- Phone #:.3 (95- 4270- ° Vj. State Certification or Registration #: Certificate of Competency #: CC ®54300 `6 Contact Phone #: 78, - SAO - 030 - Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 7*- -- v2P Square/Linear Footage of Work: /17,5-4.71-7. Type of Work: ❑Addition *Alteration ❑New ❑Repair/Replace UDemolition Description of Work: /�,t,.,a /STS -1't& e4-,N)b -Ps E.- tug P ?et &'c 6 17 —t9' S , 6- 9 /�co?ro,.0 4':) ceA) 7%.0.� 4-.r f trz'e,1 .f7.0z e.k.4-1.IG ,q- kj ye.,c y . Color thru tile: **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * ** Fees************* ** * * * * * * * * * * * * * * * * * * * * * * * * * * *** co Submittal Fee $ Permit Fee $ ��D CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ l Q 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 ,( •sted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the abse e of s < posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this The foreg ' g ins ment was ackn ledged befor day off 20 15, by t[. ),,G'Z -� S , day o 20 � 5by�� Signature Contractor who is personally known to me or who has produced rt ``_D NOTARY PUBLIC Sign: Print: As identification and who:: rs.....4;o://,,th. 1 i, ttk ®� � 0 �1 q_ 016 • - J . ..e d Sign: ▪ Commissipo : Print: �,,9� .#.......t: �® \,� My Co �'.rrirri FLttl�`�� ' rso y cno o me or who has produced ` as identification and who did take an oath. NOTARY PUBLIC: t . My Commission Expires: APPROVED BY C.;,..)/3 Plans Examiner Structural Review (Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06 /10 /2009)(Revised 3 /15 /09)(Revised 7/10/2007) ss1 Notary "F 13 es rt My C,pmm Expires Sep 23, 2015 5 Commission # EE 128810 K ° Bonded Through National Notary Assn. * * * * * * * * * ** * * * ** * * * * * * ** i °— 4 ()Zoning Clerk Whereas, (owner) Miami7hores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY hereinafter referred to as the owner of the following described property (address): —.7/ 0 e ff % o 433/3/j. Legal Description Lot Folio # Requests permission to install (describe work): AQ-vr4 S Block Subdivision Within the public right of way of (address) 7) t� /C / CP-St -- 17d)404ti 9/1a/r3 *5/a /7 IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows: 1. To maintain and repair, when necessary, the above- mentioned item(s) installed within the dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall constitute a lien against the above described property until paid. 2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any and all liability, which may rise by virtue of permitting the installation of these items within the public right of way. 1 3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the removal and disposal of the item(s). 4. The undersigned further agrees that these conditions shall be deemed a covenant running With the land and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County, Florida by the Village Manager of Miami Shores Village (or his fully authorized representative). SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this SI 2 e presence of: day of 1)74-fr -e-fri , 201$ CLAUDIA . 1 • lLLOS Notary Public - State of Florida \` My Uumm Ezplies Sep 23, 2015 Commussion # EE 12$810ssn. Bonded Through National Notary (Owner's Signatur 12123/2010 16:29 FAX �j OG31003 STATE OF FLORIDA Fir tux DEPARTMENT OF HEALTH APPLIC. ‘''ION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERM! . ._ ' Permit Application Nutt "r' '�' - } �'�- i ;1: • Scale: Each block rep E Bents 10 feet and Notes: i -SITERAN- inch ch = 40 feet. 1111111=11111111121M .1=114.171.1.1".." 1111PMEIMIMIPLIPII �p� ' 311111411111Pa `.46222122311111111111111111 1111111111i NIIIIIIIIMI1111111111111111 11.1, 11111111111111 11111111Mitiliairdillilifffilllig II_ MIN RIB= awn ill 12 ai '.. i li1i ■ 1111111111111 II 11031INII 11111111111111111 EMI MEM 21111g11111 MEM MM. .f�`14 I 40111 111 E --r--- -rte- --� -- f ; Site Plan submitted by:_ /Flan Ap Date County Health Department ALL CH l NOES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 015. 14115 (Races HRS- 1 =arm 4016 which may be used) (Stook Number, 8744- 00d4ot& Page 2of4 12/23/2010 18:28 FAX IA 001/305 (g15)893-02.-io � � ,)� 8TifF] o]i F truce. DE =.I TT Os »At.Ti3 OZ 1 :1 TREATHENT AND DISPOSAL D_ a. ssRie=7 tt :13- 90.1292734 1 A?8LIC11TIOtt 4: Ae988066 APPLICANT: Robert ;.wan PROPERTY ADDRE $$ : 770 NE 98 8t 3UCS: ]'0 PROPERTY rn t: 111.3206. 0142310 LOT: 3 Mien!, FL 33138 SOSaO/VISION! DATE PAID: PAX 21AI27: ,—...... RICSIPT Se mca'r #: PR$ 9938 (SECTION, romans, SAM, PARCEL =MOO lou TAX ID 1R) OMSK MUST SE CONSTRUCTED XE ACCORDANOS WITS SPECIFICATIONS AND STANDARDS or CTI391 -0065, F. a., CSAPTER 64S -6, F.A.C. DBFART ANT 08 SYlTIm[ DOSS MOT COMMUTES YZR.:9ANCE TOR ANY 0PZCTFIC PXRZO O8 TZ1 MICR SERVE.*? AS . MASIS FOR ISSUANCE OF ISIS SsAMIT, ANT CHANGE IN ttMO 77AC1�, PBPKST APPLICiaTIC ' 8UC1 aa!?IFICATIONKI KAY &/IDLY TAP APPLICAl4T To MOD'H'Y Tsai ISSUANCE OF TBI STATE, OR LOCAL SYSTEM DESIGN AND T N IN TEES PEI' T SZZNG awe s-- AND VOID. BERKET DOZE NOT T88 API7LICAl4T > COMPLEANCE 1P[Z'Fl on= F$tSZRi►L, PS rinlIfG rotat iii rem =most= or vms batassit'PY. 780 1 GAL 0 l GAL' 0 ] 4MZL Quart D ! 150 l s{ A 1 0 ] St1R7AF A TYPE SYSTEM: I CCL�BIGURATTON: 27 ✓ LOCATION OP' SENC x ELA" VATIGN Of • 90TTOA Or DRAINS' L 0 1- Exisnnp Tho Pei. ., TOTTICATICNS CIS / GPO C (S / CPO •I. 1 GREA E INTIOmmATOR CAPACITY 1. , DOSING TANK CAPACITY t Seodc CAPACITY CAPACITY Latax a2d CAPACITY SINGLE t'ANX:125O GALLONS] :GLUONS 8 t :DOSES PER 24 ORS Chimps J many ` Grants is tx] sums= t] SIu o 1 1 NpU2lD i] DO TREWS t ] SSD t ] AI+iC: F.F E.: 11.10' NOVD 7R0: C 12D SYSTEM RITE 28.40) y rao'cga� FT ] 1 A CV C TO /misMZSICE POINT t 56.40 ] INC FT ] t ASCVE POINT i 0.001 mums EaaAVArION RE9I IREa: f_ 30.00 3 maze • )tic tang coddled by " Bob's Septic & Drain Inc." on 12/20/2010 to remain. 2- Install 150 sf • of • tiyuratttm. & Perimeter of excevallon area shall be Wisest 2.11 molder and tonQer than the proposed rt elevation of dratntold t0 tea no loss than 8.9C' Nl3VD.; 5. @ottam of dtsinbeid elevation to be no i ] drainneld In tench t T absorption bed. loss than 8.40` NGV THIS PERMIT 19 Nt " FOR ADDfFION(s SPECIFICATIONS PI APPROVED SY REPAIR � uNtN61.0 DSP DATE IssuS:`. 12122/2010 DR 4016, 08/09 (0/4 : ,etee all preview editions which now not be teed) Incorporated: 64X-1f 003, me Y 14.4 h@968066 ZMATION DATE: ua:a:ui� Page 1. of 3 STATE OF FLORIDA. DEPARTMENT OF .HEALTH ONSITE Sl WAG .TREATMENT_AND. AND-1w% CONSTRUCTION INS `It N A 7 FI1 iL APPLICANT: • AGENT: ✓�— .ea: ..�i: PROPERTY ADDRESS' / _" (-� A/. �= RJR, RMIT NO�p f + DATE PAID* - FEE•PAID • RECEIPT # <t LOT: -- BLOCK: 70 SUBDIVISION:, `Ekf� [X] ITEMS ARE NOT IN 'COMPLIANCE WITH .STATUTE OR RULE AND MUST BE ...CORRECTED: TANK INSTALLATION •• PROPERTY ID •f %^- 3 -z4C.° Ot (( [01] [02] [03] [04) [05] [06] [07] [08) [09] TANK SIZE j TANK MA OUTLET DEV MULTI -CHAM OUTLET FILT LEGEND WATERTIGHT LEVEL DEPTH TO L DRAINFIELD NSTALLATION ] [10] AR: [14.,f[2] / S 0 SQFT [11] DI ! ' IBUTION BOX HEADER ] [12] NU BER.OF DRAINLINES NUNE SEPARATION ,. ] ` [14? ti p NUNE SLOPE ] [15] D • [16] ELlikilATIO [17] SYSTEM L [18) DOSI 6 [19) AGG {20] • AG [21]3 -{ A E CESSIVE FINES EPTH h/ ) FILL/ EXCA • ON MATERIAL [22] FILL AMOUNT 4/.Z [23] FILL. TEXTURE [24] EXCAVATION DEPTH - [25) AREA REPLACED „ [26) REPLACEMENT MATERIAL EXPLANATION OF VIOLATIONS / REMARKS: [ [' l [ l SETBACKS' [271_ . SURFACE WATER FT [28] : BITCHES FT [29] • PRIVATE. WELLS` FT [30] PUBLIC-WELLS FT [31) IRRIGATION WELLS FT [32] POTABLE WATER LINES FT [33] -. BUILDING FOUNDATION : A "• FT [34] PROPERTY LINES %..4 FT [35] OTHER FT FILLED/ MOUND SYSTEM [36] DRAINFIELD COVER [37) , SHOULDERS [38] SLOPE$. [39] STABILIZATION ADDITIONAL INFORMATION [ ✓] [40] UNOBSTRUCTED AREA ..:: [ ,,} [41] STORMWATER RUNOFF . [ ] [42] ALARMS. [ l` • [43) MAINTENANCE AGREEMENT [ ✓]• [44] BUILDING AREA [ .} [45] LOCATION CONFORMS WITH SITE PLAN. [ y..]- [46] FINAL SITE GRAD DIG I ] ' [47] CONTRACTOR. [ I [48] OTHER r, ABANDONMENT [49]: . TANK PUMPED_ %�' I- [50] TANK CRUSHED & FILLED I CONSTRUCTIO 'APPROVED -1SAPPROVED v CHD DATE: / .. _ �0 I ISAPPROVED] Arlo' ,�. -t�-.� p -- CHD DATE /' esZa Page 2 of 3 DH 4016 (Page 2), 10/97 (Previous Editions May He Used) Stock Number. 5744- 002 - 40164 . PT 1: Applicant NOTICE OF CO ENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. I 3 ---(0 1 3 TAX FOLJO NO. /7-5201e, 019031 a STATE OF FLORIDA: COUNTY OF MIAMI-DADE: THE UNDERSIGNED hereby gives notice that 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. 1, Legal description of property and street/address: 770 94119 ,s1frode.ste, 3.3, 2 P3 2. Description of improvement: REP 111111111111111111111111111111111111111111111 CFN 2013R024-4-368 OR Bk 28556 Ps 0854; (1Ps) RECORDED 03/29/2013 155156 HARVEY RUVINv CLERK OF COURT MIAMI-DADE COUNTY FLORIDA LAST PAGE Space above reservecl for use of recording office Owner(s) name and address: gefet- -rzei 721E9 "I I- 9,r,r, Interest in property: Name and address of fee simple titleholder: v 4. Contractor's name, address and phone number CP,f0".1 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number: Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1Xa)7., Florida Statutes, Name, address and phone number: 7(eP.4 540 t. r STATE OF FLORIDA, COUNTY OF DAOE • rift . 8. In addition to himself, Owners designates the following person(s) to uir.• -11°IvnivlirtnC47the 713.13(1)(b), Florida Statutes. Name, address and phone number: • Y el 'of as provide ..4y.1,44. A Tto Ate ; 4," cros FM AVM ".$3 lalaWf%74111 9. Expiration date of this Notice of Commencement: (the expiration date Is 1 year from the date of recording unless a different date Is specifiecl) WAFINING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART L SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTIC OF COMMENCEMENT. Signature(S) of erf or Owner(s 'Authorized Officer/Director/Partner/Manager 07 ...co-AP-3 Prepared By Prepared By !Print Name Print Name Title/Office Title/Office STATE OF FLORIDA COUNTY OF MIAMI-DADE The for oing instrument was acknowledged before me this day of Til/ix2-6.11-i &Actually or fa as for la Personally known, or prOduced the f011owing type of identification: Signature of Notary Public: Print Name: 4S2-LaNik. (SEAL) VERIFICATION PURSUANT TO SECTION 92.525, FLORIDA STATUTES Under penalties of periLiry, I declare that 1 have read tie foregoing and that the facts stated in it are true, to the best of my knoWledge and belief. 4C) L_ L 7,7 P cv 4421 t. S ° A, E .--t t -,7/4 • vti, • ea/ Signature(s) of Owner(s) or Owner(srs Authorized Officer/Director/Partner/iVianager who signk, By 01111111100 By 4z-ex-, i-e-Ase„, 123.0142 PAGE 3 3/10 4,/ .0 RID \\'■\ ri4R232,11:;efi N.E. 98th STREET ROVED 34.1" 50' 7) ,/ 50' ,7-3 cvt? 5 6 7 711 8 -I- 1:, 47.7'. 50' /1 3, 50:1 N.E. SIUBJE riMG D- r 0 44. Y-V1-4,144111V-t 4N7 -234' re srY,") V1'Pt9Qt ir;ASM ,-5191" 701972,14 (Averv-kwo— ?tittNe3 — PiLiviyat NO2 91v1773G17V(vi:. FO 0.59' ENG 02' GLR LEGAL DESCRIPTION: LOT 3, BLOCK 70, "MIAMI SHORES, SFCTION NO. 3" ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 10 AT PAGE 37 OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA. 60' 20 FEET A. R. TOUSSAINT & ASSOCIATES, INC. LAND SURVEYORS FLORIDA CERTIFICATE OF AUTHORIZATION NO. LB-273 620 N.E. 126 Si. NORTH MIAMI, FLORIDA 33161 TEL (305) 891-7340 FAX: (305) 883,-0325 EGEND: A.C. = AIR CaNXIDER C.B.S. = MOIRE BLOCK MOM CONC = CONCRETE C = CENTRUM U? = CLEAR E/f EDGE 0f FOMENT ENCRMCHMENt- FD. — FOUND I.P. = RCN EWE 12 = IHW =WON MISPESS PIL J&S PRIZEZ LAM =MDR No. SKETCH OF SURVEY FB: 550 PG. 68 FILE: 2011/11X17/14689 97th STREET LOCATION MAP: SECTION 6 lii/P. 53 S. ROE 42 E. SCALE: i'•=icxe Lai LaJ 60' .SURVEYR'S 1 ATION: WE HEREBY CERTIFY THAT SKETCH OF SURVEY IS TRUE AND CORRECT" TO TI-: BEST OF OUR KNOWLEDGE AND BEUEF AS RECENTLY SURVEYED AND PLATTED UNDER OUR DIRECTION AND THAT THIS SURVEY. COMPLIES WITH THE MINIMUM TECHNICAL STANDARDS FOR LAND SURVEYING IN THE STATE OF FLORIDA, UNDER RULE 5J-17 FLORIDA ADMINISTRATIVE CODE, CHAPTER 472.027 FLORIDA STATUTES. NOT VAUD WITHOUT THE SIGNATURE AND RAISED SEAL OF THE REGISTERED LAND SURVEYOR SHOWN HEREON. A.R. TOUSSAINT & ASSOCIATES, INC. ALBERT R. 10USSAINT REGISTERED ENGINEER NO. 8939 REDISTERED SURVEYOR AND MAPPER NO. 907 STATE OF FIDRIDA FLORIDA CERTIFICATE OF AUTHORIZATION LB-273 DATE: 07/06/2011 sem": AS • SHOWN DAM: JULY 6, 2011 SCALE: 20' 1» 770 N.E. 98th STREET MIAMI SHORES, FLORIDA 33138 MIAMI-DADE COUNTY DRAWING NUMBER I SHEET 14689 1 1 OF 1 DRAWN. BY:- - WI