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DS-13-1649 0 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-199553 Permit Number: DS-7-13-1649 Scheduled Inspection Date: September 26,2013 Permit Type: Driveways/Sidewalks/Slabs Inspector: Rodriguez,Jorge Inspection Type: Final Owner: MIAMI,ARCHDIOCESE OF Work Classification: Addition/Alteration Job Address:9401 BISCAYNE Boulevard Miami Shores, FL Phone Number (305)762-1033 Parcel Number 1132060490010 Project: <NONE> Contractor: GANTT BUILDERS LLC Phone: (954)639-1259 Building Department Comments REMOVE AND REPLACE EXISTING CONCRETE Infractio Passed Comments WALKWAY INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-195729. No permit posted INPECTION ADDRESS IS 425 NE 105 ST Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 25,2013 For Inspections please call: (305)762-4949 Page 13 of 34 a • i Miami Shores Village JUL232.a3 Building Department X004 00004°00000000000 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 No.VP) ) PERMIT APPLICATION Master Permit No. Permit Type: BUILDING ROOFING JOB ADDRESS:S+ RSQ a;L i M4 S C 6. 1 2.5' N 6 10 sue° 9-1 City: Miami Shores County: Miami Dade Zip: 3 313 P Folio/Parcel#: it — 2 2 3 G q3 Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Sim lepTitleholder): rA 7 l Og mss YV h F P' Phone#: 3 b'Si S7•G 2'1 1 Address: 7f Y t SC'Gt hQ f3l V City: 10. (e State: .�� Zip: 0 .? J 0 2 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Compan Name: �D�6°t4 /1�t C� Us_ Phone#: " d`7'3ZO Address: City: State: J:,(— Zip Qualifier Name: o '4• �7� Phone#:-M° 91-7_32(eJ State Certification Qorr�,Registration#: 5o Certificate of Competency#: Contact Phone#: t 3`f-0 3 f"JZS� Email Address: , �°�� c�I com- DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ /c Square/Linear 7epair/Replace a of Work:] Type of Work: ❑Addition DAlteration ONew ❑Demolition Description of Work: T = �V�. Color thru tile: 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 the job site for the first inspection which occurs seven (7) days after the building permit is iesnedIn the abse of such posted tice, the inspection will not be approved and a reinspection fee will be charged. Signatures Signature ✓ Owner or Agent 61---1 Con The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 9�"As .� t� -• day of 20 byor who has produced who is personally known to me r who has produced ification and who did take an oath. as identification and who did take an oath. NOT PUBLIC: NOTA PUBLk- NN Sign: r Sign• Print l Print: CA My Commission Expires: )Z �T�RY PUBLIC My Commission Expires: PUBLIC $1'A OP PLORIDA OF FLl.RIDA • CoeW#000946303 1 9219013 APPROVED BY 13 Plans Examiner Zoning 4 Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) REGISTRATION,t.44 ►" ano Cif ®, � ar� b a asine, t� Lei Fforida's watmegt Welcome 1?' } NEW (RENEWAL OWNER DATE WUED t ACCOUNT N0. 'IRE GISTRA7ION 24 SUMNE$S NAME I A ..4 - D ELIN©U ENT CHO. LOCAMN p 1301 .N 4 T =0 11 TRANSFER.F!E �r 0 ASBIF'ICATION TOTAL.AMOUNT PA10? � . 2149 �� G1`IYE IAAT'E I�+IRATiON SP 1pA I T 366ER` t q� 4 I' 1 BCIS I� NIfBT 43�1SLif DiSFLA 7M C H" F TAB FiEGE1PT TO P41BUC i/iEMV AT,;_ � t3O�MTRACTSIRS 8IlUST pAA1NTAIN ON fiLE UGENSM Atop VMRAbJCt. NOTICE'A MEW APPLICATION AA(J5T IM FILEq THE RU8d11ESS NAIL;OWH 0R A0ORE8818` NQEb,'THE ISSilANCE OF A BUSINESS TAX RECEIPT SHALL NOT ` BE OEE M A WAIVER OF ANY PROVISION OF THE CITY CODE NOR SNALI YHE OF A MINES0 TAX RECEIPT BE 60NWMM TO BE A JU OUIENT OF THE CITY, �` AS TO TkIR COMPETENCE OF THE APPLICANT TO TRANSA$T BUSINESS.' . 10611 GANT-01 OP ID: E2 A�RO CERTIFICATE OF LIABILITY INSURANCE 707118/13/YYYI� THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 954-776-2222 NAME: Brown&Brown of Florida,Inc. 954-776-4446 PHONE — FAX 1201 W Cypress Creek Rd#130 Arc o Exit ac N°y: _ P.O.Box 5727 Ft.Lauderdale,FL 33310-5727 ADDRESS: Commercial Lines House INSURERS)AFFORDING COVERAGE NAIC# _ INSURER A:*Essex Insurance Company+ _ 39020 INSURED Gantt Builders,LLC INSURER 13:*FCCI Insurance Company+ 10178 Attn:Sergio Tio INSURER C:Valley Forge Ins.Co.+ 20508 1301 W.Copans Rd,Bldg D#11 -- — — -- Pompano Beach,FL 33064 INSURER 0: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ INSR I TYPE OF INSURANCE POLICY EFF POUCY E_X OMITS -� LTR POLICY NUMBER MMIDDIYYYY MMIDD GENERAL LIABILITY EACH OCCURRENCE S 1,000,00 A I X COMMERCIAL GENERAL LIABILITY 3DP6852 07/03/13 07/03/14 PREMISES IE a ocaurenreL $ 100,00 CLAIMS-MADE a OCCUR MED EXP(Any one person) S_ _ 5,00 PERSONAL&ADV INJURY $ Y 1,000,00 GENERAL AGGREGATE $ _ 2,000,00 GEN-L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1.000+00 17-1 POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00 Ea accident) C X ANY AUTO 85085470796 09/21/12 09/21113 BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS -------------- NON-OWNED PROPERTY DAMAGE' $ HIRED AUTOS AUTOS Per accident S UMBRELLA UAB OCCUR EACH OCCURRENCE $ L �=R B CLAIMS-MADE AGGREGATE ETENTIONS $ WORKERS COMPENSATION TOCR TS STATU- OTH- AND EMPLOYERS,LIABILITY YIN B !ANY PROPRIETORIPARTNERIEXECUTIVE 001 WC13A67020 07/08113 E.L.EACH ACCIDENT _ S ___ 500.00 OFFICERIMEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 u es,describe under 500 00 DESCRIPTION OF OPERATIONS glow E.L.DISEASE-POLICY LIMIT $ r i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Fax to.305-756-8972 CERTIFICATE HOLDER CANCELLATION MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Adenis 10050 NE 2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores,FL 33138 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD GANT-01 OP ID:E2 RO® CERTIFICATE OF LIABILITY INSURANCE 1 DATE 0 IYYYI(J 07/103/03113 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 954-776-2222 REACT Brown S Brown of Florida,Inc. 954-776-4446 PHONE FAX 1201 W Cypress Creek Rd#130 ac No Ell: A/c No: P.O.Box 5727 E-MAIL ADDRESS: Ft.Lauderdale,FL 33310-5727 Commercial Lines House INSURER(S) AFFORDING COVERAGE NAIC# INSURER A:*Essex Insurance Compan + 39020 INSURED Gantt Builders,LLC INSURER B:*FCCI Insurance Compan + 10178 Attn:Sergio Tio INSURER C:Valley Forge Ins.Co.+ 20608 1301 W.Copans Rd,Bldg D#11 Pompano Beach,FL 33064 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MTSR TYPE OF INSURANCE DL UB POLICY EFF POLICY EXP R POLICY NUMBER M/DD M/DD LIMA GENERAL LIABILnY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY 3DP6852 07103113 07103114 PREMISES Ea ocairrence $ 100,00 CLAIMS-MADE [)(] OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 1,000,00 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accdent $ 1,000,00 C X ANY AUTO 85085470796 09121112 1/13 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED P Y(D OILY INJURY accident $ AUTOS AUTOS / B ) NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident f, $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'UA13UN YIN T Y M E B ANY PROPMETOR/PARTNERIEXECUTIVE 001 WC12A67020 07108112 07108113 E.L.EACH ACCIDENT $ 500,00 OFFICERIMEMBER EXCLUDED? NIA (Mandatory in NH) E.L DISEASE-EA EMPLOYEd$ 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is regulred) CERTIFICATE HOLDER CANCELLATION MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Building Dept. 10050 NE 2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores,FL 33138 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD CFN 20138 &21277 OR Bk 28761 Ps 2379i QP9) RECORDED 08/07/211.13 10.'38355 NOTICE OF COMMENCEMENT HARVEY RUVINY CLERK OF COURT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION MIAMI-DADE COUNTY FLORIDA LAST PAGE PERMIT NOJJ- 1 I TAX FOLIO NO. 11-2-4 31 13 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. Space above reserved for use of recording office 1 Legal description of property and streettaddress: LOS N t': 105-16 33 34P 3i 52, U I R Lq AC Am PA te s s4,a A C 5* Pig 2.Description of improvement: 3.Owner(s)name and address: Ar 6i, W@ ,%SyCll, qqo) 13#Sct Anatz" n Interest in property: Name and address of fee simple titleholder: 4.Contractor's name,address and phone number: C-pk&rm %.J b*I cr-s t`C, 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(1)(a)7.,Florida Statutes, Name,address and phone number: 8. 16 addition to himself,Owners designates the following person(s)to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. Name,address and phone number: 9.Expiration date of this Notice of Commencement: (the expiration date Is I year from the date of recording unless a different date is specified) WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENTARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13. FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECO D A P S HE JOB SITE HE FIRST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING,CONSULT RE COM I OR RECORDING YOUR NOTICE OF COMMENCEMENT, I HERBY Signature(s)of er?W Officer/Director/PaR�m a D 120 Prepared By IV UL Pre Z11,11 Print Name AV+1A-J10- CAVII-C W 74 Title/Office PH I Wz=41: tAA- PA&V'A!f-r- Title/ ic STATE OF FLORIDA COUNTY OF MIAMI-DADE The foregoing instrument was acknowledged before me this day By U Individually,or LI as for A 'Wersonally known,or Ll produced the following type of identification: Signature of Notary Public: Print Name: (SEAL) VERIFICATION PURSUANT TO SECTION 92.525,FLORIDA STATUTES Under penalties of perjury,I declare that I have read the foregoing and that the facts stated in it are true,to the best of my knowledge and belief. Signature(s)of Owner(s)or Owner(s)'s Authorized Officer/Director/Partner/Manager who signed above: By By 123.01-82 PAGE a aM a ♦ OR I ons nm� Miami Shores Village Building Department �R�pp► 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT#. J I DATE: �3 (NAME) ontractor • Owner •Architect Picked up 2 sets of plans and (other) Address: g 4 0 I l' o l 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 ntinue permi ing process. Acknowledged by: (Sig PERMIT CLERK INITIAL: RESUBMITTED DATE: .� PERMIT CLERK INITIAL: Miami Shores Village S� "�s Building Department N� u 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 �ORIUA Fax: (305) 756.8972 August 8, 2013 Permit No: DS13-1649 Buildinq Critique— MEHDI 1. The details are OK but stickies are not permitted because these drawings are microfilmed and also the stickies may come out. Please draw the details using a pen. Plan review Is not complete, when all Items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revise sheets and Include one set of voided sheets In the re-submittal drawings. SB I OR iXC. 9aa ••• no�� Miami shores Village � Ho�o Building Department tpRrpA 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT#: � ! �LJ " �D `1 DATE: /13 (NAME) ontractor • Owner •Architect Picked up 2 sets of plans and (other) Address: NE )' T Y 4 S E� 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 t n ermitting process. Acknowledged by: igna re) PERMIT CLERK INITIA RESUBMITTED DATE: A—/) PERMIT CLERK INITIA . ORS � s Miami Shores e Villa 9 ,S,�tC.,93a Building Department Emig nuo" 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 ORIDp' Fax: (305) 756.8972 June 29, 2013 Permit No: DS13-1649 Building Critique Review . 1) Show the length and the width of the walkway on the plan. . 2) Provide a section through the walkway showing the thickness, reinforcement, grade of concrete, degree of soil compaction. Please note that � the degree of soil compaction shall be at least 95% on the Proctor scale. 3. 3) Show on plan, expansion and construction joint with details. Plan review is not complete, when all items above are corrected, we will do a 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.