FW-12-1731Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
nspection Number: INSP - 178609
Permit Number: FW -9 -12 -1731
Inspection Date: May 31, 2013
Inspector: Rodriguez, Jorge
Owner: BASURTO, CESAR
Job Address: 146 NE 98 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: ULTRA FENCE INC
Permit Type: Fence/Wall
Inspection Type: Final
Work Classification: Wood Fence
Phone Number
Parcel Number 1132060132390
Phone: (305)592 -4578
Building Department Comments
WOOD FENCE 5 HIGH
Infractio Passed Comments
INSPECTOR COMMENTS False
Passed
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
May 30, 2013
For Inspections please call: (305)762 -4949
Page 1 of 1
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) 762.494
BUILDING
PERMIT APPLICATION
FBC 20
Permit No.
Master Permit No. F ' 01-1-115)
Permit Type: BUILDING 1
OWNER Name (Fee Simple Titleholder): (�t - r �r ���-i �t� "C "i� Phone#:
Address: j Lk() K) cicC
City: l G YYl I bin Ore. State: r Zip:
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: + 410 tD b
City: Miami Shores County: Miami Dade Zip: 7-.5=5
Folio/Parcel #: 1 t 2 OLP I Ci d
Is the Building Historically Designated: Yes NO Flood Zone:
P,
CONTRACTOR: - ACTOR: Company Name: l CA Phone#: CAS
Address: "14 \
Zip: 3,37 h LOW
Phone#: 3 5 °a
Certificate of Competency #: 10 650042-C)
Email Address:
Phone#:
City: l C't &. l State:
Qualifier Name: 1-4-172.0 T o eS
State Certification or Registration #:
Contact Phone#:
DESIGNER Architect/Engineer:
Value of Work for this Permit: $ . C d\ Square/Linear Footage of Work:
Type of Work: °Address °Alteration
Description of Work:
UNew °Repair/Replace °Demolition
/
/2e4 ee .Aa (
COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by:
**** ****** *** * ** *** ********* ******* ***F *** ***************** ** ** *** ** ** * ** *+err** * **
Submittal Fee $ Permit Fee $ /0c0
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
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 4 permit and that all work will be perfornned 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: Asa 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
Owner or Agent
The foregoing instrument was acknowledged before me this 23
day of ' , 2013 , by
who to me or who has produced
cation authatentiSiBtke an o
+'= Notary Public • State of Florida
NOTARY PUBLIC r : .� ; I My Comm. Expires Jul 7, 2015
��
'F Commission # EE 110471
Bonded Through National Notary Assn.
Sign:
Print: A a q Tor ir0
My Commission Expires:
Signature
The forego
tractor
acknowledged before me this
day of rfc , 2013 , by
who is ¢ems nally known t le or who has produced
d
NOTAR
Sign:
,,, p''o ANA M. TORRES
Notary Public - State of Florida
.at 1411_ • i My Comm. Expires Jul 7, 2015
Commission # EE 110471
ugh National
an oath.
Print: PV )4 tairrts,
My Commission Expires:
Or**************************** it* *******•****************** *** **r** * * *** *,r. ** * * * ** ** * ** ## *rant ** * **** * ** * ***
APPROVED BY
(Revised 07 /10 /O7)(Revised 06110/2009)(Revised 3/15109Xrev6 /4/10)
Plans Examiner
Structural Review
Zoning
Clerk
o Shadow Box
o Vertical Picket
eu(Board on Board
M iami Shores Village
Building Department
WOOD FENCE DETAIL
4x4 Post Spacing
Fences <= 5' high posts spaced at 5' on center maximum
Fences <= 4' high posts spaced at 6° on center maximum
Fence must not exceed 5' in height
May 2009
4x4 pressure treated .
posts embedded 2' into
concrete footing 10'
diameter x 2'deep
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
1x pickets hastened
with two corrosion
resistant fasteners per
connection
ALL wood must be pressure treated
All fasteners must be corrosion resistant
No Tess than two fasteners in any connection
2x4 horizontal
pressure treated
wood members
with two corrosion
resistant fasteners
per connection
alb
fage f of 2 .
17,7,77,T,7R-7 hc.177.4. "
Mami-Shores Village
APPRO\r ED
' ZONING DEPT
BLDG LiFPT
SUBJECT i 0 CC MPI .IANCE WJrH ALL FEDERAL
TATE AND CC,UN I FIULES AND REGULATIONS
rH.EukL,IVED
SEP 1 8 2012
13Y°
This property described as:
All of Lot 8, and Lot T, kiss
West 10 feet, Block 18
AN AMENDED PLAT OF MIAMI SHORES
SECTION NO. 1,
according to the Plat
thereof, as recorded in
Plat Book 10, Page 70
of the Public Records of
Miami-Dade County, Florida.
the
-.097/4=:)A./
PROPERr(OF :Basurto, Cesar, 146 N.E. 98th Street, Miami Shores, Florida
33138
Wfr VAUD WITUOUT m $1,47t4TUSIE
Aree THE URIGZIAL. Lane, sX..t.
',toxin.. Li i'Vettn
Nirapit
LANN ES AN D GA RCIA. INC.
:098
• -SURVF.YORS-MAPPERS-I ;NI) PLANNERS
.yri 4-• 5Z3&
Office address: .159 Alczzar Avenue, Corzl Gables. Suri4s 1.1134
(-105) <144-79u1 95.4) 546
FIE.L1) DATE 1 SCALE
:04/ 2 //031 P =2 0
DRAWN SY DRVii:. ;NU I
- 148797 .‘
BII�ILDING�w`l
PERMIT APPLICATION
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Permit No. 'L— Il 31
Master Permit No.
FBC 20 lC)
Permit Type: BUILDING l
OWNER: Name (Fee Simple Titleholder):1/n� .ECT 1t CAD Phoneil
RECEIVED
SEP182012
Address: N{ fj fl E iCr5 nJ'
City: M cst rY11 3y
State: Pt
Zip: 8
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: t 41P (13- cice t 7A—
City: Miami Shores County: Miami Dade Zip: 3---6
Folio/Parcel #: 013 Z1D
Is the Building Historically Designated: Yes NO Flood Zone:
� 1 I
CONTRACTOR: Company Name: (J 14(4 fP C Phone#:
Address: )q u-I 1)(A) (DU St
City: 1(11 c rn I State:
Qualifier Name: Len _ O Y Q G r- r t"-&
State Certification or Registration #:
Contact Phone#: t5 5q 2 L 1$ Email Address:
DESIGNER: Architect/Engineer:
0S,SgZ )Y
Zip: 3N l o(//2
Phone#:
Certificate of Competency #:
L r 6► i 5tut
Phone#:
Value of Work for this Permit: $ S ° bt) Square/Linear Footage of Work:
Type of Work: °Address DAlteration °New
Description of Work: 116 C) C -f:? \Cf r) L [, H
ORepair/Replace °Demolition
COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by:
*** * *** *** * *****r****** ** *apt * * * * * * *****F ************* ****** * **x**** * *** * ****** ** * ***
Submittal Fee $ ° Permit Fee $
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
//90 CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
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 CC:46,61/- Paa
Owner or Agent
The foregoing instrument was acknowledged before me this �.
day of , 20 U.., by .,,e,, Tb.i Sulam)
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Contractor
The foregoing instrument was acknowledged before me this t7
day o ' ! , 2012,E by jjaza1neift
who iscrte or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Si
daribl
Cr N `ar:7
7f ll-
FIC A tlt
Y omm. Expires ul 7, 2015
_, E7gplission # EE 110471
° '° "'' Bonded Through National Notary Assn.
* * * * * ********* *** * *** * ******* * *, ************************ ****** * ***** **** * * *** ** ******r. **took*** •* ***********
APPROVED BY
Plans Examiner
' mooning
Structural Review Clerk
(Revised 07 /10/07)(Revised 06/10 /2009)(Revised 3/15/09Xrev6/4/10)
STATE OF (FLORIDA)
COUNTY OF (DADE)
Miami Shores Village
Building Department
SURVEY AFFIDAVIT
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Ce5ct`c�
The undersigned Affiant, (� -c� ,does hereby attest that
(Property owner)
The attached survey, performed by La 19 in f, and ct
(Name of surveyor's company)
For address: 2 14
Performed on 9)2, i&.3 (date of survey) is an accurate representation of the existing conditions and
locations of all structures on the property as of this date.
The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property
without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to
remove or obtain permits for any structures which now may exist on the property which are not permitted or which
may violate zoning or building code regulations. The Affiant further understands that the existence of any such
structures may affect final inspections as applicable to this or other permits.
Further, Affiant sa eth naught.
Property Owner Signature
SWORN TO AND S.UBSCRIBED before me this 1 6 day of
me, produced
Affiant is pe
Revised on 5122/2009/ Revised on 6112/09
CQS isur +-
Property Owner Print Name
as l(ti4�
®`2+=, Notary Public - State of Florida
4 My Comm. Expires Jul 7, 2015
z E1 71
•
•.i 7 T• r, • a r:
..iromp —w
Ja }° V:J tL V'4., I! vn(VieTAlt tratatt.S
PRODUCER INAAM Insurance Agency
10637 SW Enth St Ste 7-1
ItEsint FL 33176
(305)2744353
CERTIEJ AT
41 ULTRA FENCE INC.
7941 NW STREET
Want FL. 33113
Fax (3
01,10- 00G-0f f / P.
OF A IL INSURANCE l DAT ofY
09606!92
MSS CERTIFICATE 151ssue) A3 AMATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERT IRCATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIL #
ttisLJ RERA: NOVA CASUALTY COMPANY
INSURER $ '_
_INSURER C:
INSURER O;
TNsuBER : NSUR E E CO INSURER F: I!
THE POLICIES OF INSURANCE LISTED HAVE BEEN 'ISSUED THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIRI3 EN , TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT Wrni RESPECT TO WHICH THIS CERTIFICATE MAY ISSUED OR
MAY PERTAIN. THE INSURANCE .AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO AU. THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE UNITS SHOWN MAY NAVE BEEN REDUCED BY PAID CLAIMS.
IMBR ADD L I;p{�
L?R LID TYPE OF 1MSURANCE ! POLICY NUMBER POLICY EFFECTIVE POLICY EIPIRA
GENERAL LIABILITY CATti IMPSO NYt DkrE{ytUDi_JY1'
COMMERCIAL GENERAL LIABILITY
F10 CLAIMS WOE lY OCCUR
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GENkAGGRL_GATE.LIMITAPPLIES PE
[Vi POLICY L] PROJECT 1 1 LOC
AUTOMOBILE LIABILITY
C.? ANY AUTO
r.] ALL OWNED AUTOS
.� SCMEOULEDAUTOS
HIRED AUTOS
1-T1 NON OWNED AUTOS
--I
GARAGE UASeuTY
ANY ALTO
B
ML §R
n OCCUR i1 CLlis MADE
L? DEDUCTIBLE
I- RETENTION $
WORKERS. COMPENSATION AND
EMPLOYERS' LIABILITY
ANY QROPRIE OR 1 PARTNER J EXECUTIVE
OFFICER /MEMBER EXCLUDED?
If yes, describe wide!
SPECIAL.. PROVISIONS beivw
OTHER
09AL066682
08/04/12
LLMfTS
EACH OCCURRENCE
08/04/13 PREMISS( (Ea o nce)
MEP EXP (Any one person)
PERSONAL 8 ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMPIOPAGG
COMBINED SINGLE LIMIT
(Ea aactdent) .....
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident}
PROPERTY DAMAGE
(Per accident)
AUTO ONLY -EA- ACCIDENT
OTHER THAN EA ACC
AUTO ONLY: AGG
EACH OCCURRENCE
AGGREGATE
1 f000,00o
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DESCRIPTION OF OPERATIONS f LOCATIONS (VEHICLES 1 EXCLUSION$ ADDED Y ENDORSEMENT 1 SPECIAL PROVIS IONS
CERTIFICATE BOLDER
City of Miami Shores
10050 NE rd Avenue
ACORD 2S (2OtQ1/OSj CIF
CANCELLATION
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 PAILURE TO Do SO SHALT. IMPOSE NO .OBLIGATION OR UABIUVf
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES_
AUTHORIZED REPRESENTATIVE
WILVER ALMARALES
ORD CORPORATION 1&B8
RST' !ASS
U.S. POSTAGE {
PAID
4hlk FL
* 1P. 231
Tai
T A . T PAY
'4 ST
DADE C
ULTRA F
AC R
TT
PAYMENT NECEA O
MIANI•DADE COUNTY TAX
COLL CTOR:
08/22/2012
02270011001
T F
ULTRA 'FENCE INC
LAZARO TORRES
7 941 NW 64 . ST
MIAMI FL 33166
CoP structon Tra
US!NESS CERTIFICATE 0
T
ES LAZARO
fir the r ?ns of Ci
1 G
rti
TENCY
10 Of
* * eERTWF1CATE fl
08 -15 -2012
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS' COMPENSATION
ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law.
EFFECTIVE DATE:
PERSON:
08/15/2012
TORRES
FEIN: 412215274
BUSINESS NAME AND ADDRESS:
ULTRA FENCE INC
7941 NW 64 ST
MIAMI FL 33166
SCOPES OF BUSINESS OR TRADE:
1- FENCE ERECTION -METAL
EXPIRATION DATE: 08/15/2014
LAZARO
* *
IMPORTANT: Pursuant to Chapter 440 . 05(14), F,S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this
section may not recover benefits or compensation under this chapter. 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. 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
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: 08/15/2012 EXPIRATION DATE: 08/15/2014
PERSON: LAZARO TORRES
FEIN: 412215274
BUSINESS NAME AND ADDRESS:
ULTRA FENCE INC
7941 NW 64 ST
MIAMI, FL 33166
SCOPE OF BUSINESS OR TRADE:
FENCE ERECTION -METAL
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
exempt... apply only within the scope of the business or trade listed on
Rthe 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
PERMIT #
CONTRACTOR: ULT2' J�`Z_. I
SUBMITTAL DATE:
C4 I 1 Y1 ."7ra-.
ADDRESS: \Lk. co
ti-- ' Y1
NAME:
RESUBMITAL DATES:
PROJECT TYPE:
�--h1 �..
a , /
FIRE
STRUCTURAL
IMPACT FEES
ELECTRICAL
HRSIDERM
PLUMBING
NOC
MECHANICAL
qc
BLDG
* x * * * * * * X R X $ x * * %
MIAMI -DADE COUNTY TAX COLLECTOR
140 W. Flagler Street
Miami, Florida 33130
Please keep your receipt for
future reference.
Thank you and have a nice day.
10/10/2012 1300/222/OO1MDM 0012 -0001
Last Seq.# :0001 WI LBT #:30 290395 -4
Local Business Tax $175.00
CK $175.00
CHANGE
$0.00
MIAMI -DADE COUNTY TAX COLLECTOR
LOCAL BUSINESS TAX SECTION
140 W. Flagler St. - 1st Floor
Miami, Florida 33130
TEMPORARY RECEIPT
2012 -2013
MUNICIPAL CONTRACTOR TAX
Local Business Tax# :30290395 -4
State /CC # :10BS00420
Issued to:
ULTRA FENCE INC
Type of Business:
SPECIALTY BUILDING CONTRACTOR
SEE BACK OF OFFICIAL RECEIPT FOR
NONPARTICIPATING MUNICIPALITIES
THIS RECEIPT IS ISSUED AS EVIDENCE OF
PAYMENT FOR YOUR LOCAL BUSINESS TAX
OR PERMIT.
YOUR OFFICIAL RECEIPT WILL BE MAILED
TO YOU WITHIN 10 DAYS FROM THE
VALIDATION DATE ON THIS RECEIPT.
Payment Received as Certified Above
Miami -Dade County Tax Collector