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DS-13-2602 a Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-203191 Permit Number: DS-11-13-2602 Scheduled Inspection Date: November 27, 2013 Permit Type: Driveways/Sidewalks/Slabs Inspector: Rodriguez,Jorge Inspection Type: Final Owner: SENA, CATHY Work Classification: Repair Job Address: 1301 NE 104 Street Miami Shores, FL 33138- Phone Number Parcel Number 1122320300040 Project: <NONE> Contractor: NIEBLAS AND SONS PAVING ENGINEERING INC Phone: (305)253-5354 Building Department Comments RE-SURFACE EXISTING ASHPALT 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. November 26,2013 For Inspections please call: (305)762-4949 Page 9 of 23 Miami Shores Village Building Department BY. 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 F13C 20 BUILDING Permit No. PERMIT APPLICATION Master Permit No.) Permit Type: WELDING ROOFING JOB ADDRESS: 1301 hie.- 10L 5+- City: Miami Shores County: Miami Dade Zip: 33152 Folio/Parcel#: 0�" Z.�1i►3 7.r 8 3�"" 00 0 Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder): CQ{41 Y1! Phone#: 305, I A, Address: 1101 A)e_ I 0 LA 5+- City: 1 VI i*Y < Sh oI'te.S State: 'F L zip: 3313 8 TenandUssee Name: Phone#: Email: CONTRACTOR:Company Name:h93,1rt S g QiAv'w�a �b�a QioB ��l�irT hone#: 305.153. 54?5"f Address: 1011-10 Sy1 C*' City: 4411", State: '1~1_ Zip:. Qualifier Name: 361f- 1.., Al 1'G b 195 Phone#: 303---, .2. State Certification or Registration#: Certificate of Competency* Cggl yQ0 Contact Phone#: Email Address: Sa Its &i go c1_y tY►S. co✓H DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ i 1 L40® Square/Linear Footage of Work: 2-150 S,F, Type of Work: DAddition OAlteration ONew Ofepair/Replace ODemolition Description of Work: ?*45U- A0j C.0- e 6 S4 i3 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$ I 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 MPROVEMENTS 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issue In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Signature er or Agent Contractor The foregoing instrument was acknowledged me this The foregoing instrument was acknowledged before me this day of W� ,20 iI,by CT•'q Se day of J110✓$Wl�J�t/',20�,by���5+�_�. �i�lolv5 , who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: BLE Sign CAUBLE Print: NOTARY PUBLIC Print: r. NOTARY PUBLIC DA FLORIDA My Commission Expires: 3 Iq r�� %C%MRComm#DD985494 My Commission Expires: ���/ Comm#DD965494 Expires 3/9/2014 �� Expires 3wo14 APPROVED BY `/ Plans Examiner Zoning Structural Review Clerk (Revised 3/1212012)(Revised 07/10/07)(Revised 06110/2009)(Revised 3/15/09) ASH � Miami shores Village a..," Building Department 10050 N.E.2nd Avenue Miami Shares, Florida 33138 tpR1UA Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner)_C! _111 V S e_no� hereinafter referred to as the owner of the following described property(address): 1301 Alf 104 S+- AA A wi( PL 3313 fj Legal Description Lot--��-`�Block 1 Subdivision AIV+E 9r Folio# Requests permission to install(describe work): A oh 1T �-�- / 1 cEf r/VGw�i.► 9,OA S Vv Within the public right of way of(address) A3d l &9 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 ti 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 / day of i ov. 2013 (Owner's Signature) SIGNED,SEALED,AND DELIVERED in the presence of: JEREMY CAUBLE NOTARY PUBLIC STATE OF FLORIDA Comm#DD965494 Expires 3/9)2014 2 R ' ... p.. Miami shores Village Building Department ZOR1 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A$30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE(CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION(EITHER CERTIFICATE OR EXEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. X COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. X COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. X COPY OF LIABILITY INSURACE(CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D..x COPY OF WORKER COMP INSURANCE(EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33138 ■■■■■■■■■■■■■■■■■■■■■■r■■■■■■■■COMPLETECONTRACTOR'SINFORMATION••••••••••••••■••••••••••••••• BUSINESS NAME: Nieblas & Sons Paving Engineering Inc. d/b/a Rodwins Paving BUSINESS ADDRESS: 19270 SW 185th Ct. CITyMiami STATE FI ZIP CODE 33187 BUSINESS PHONE: 3( 05 ) 253-5354 FAX NUMBER 3( 05 ) 233-8831 CELL PHONE 7( 86 ) 298-1684 QUALIFIER'S NAME: Jose L. Nieblas QUALIFIER'S LIC NUMBER: E941400 E-MAIL ADDRESS OF APPLICABLE): sales @rodwins.com Created on MOM BY MLDV I RV 312M MLDV ';'..: ham' _,; ,' , G, 4S � i. '.: .. :;` - f,. • •;. •_,.: .,j7 M• ^'a'.0 �a ^.c �'Y:. - M�_� •• 1:.�' i?: 1-] •a �f i - i. 71 1 ,. ..:i�.�.. : .;.. �. :r: 1•:'. �'.a:..: is ;.i':'..;' �l E!.r.:: 1'1 k; tC - i' _ • -'!any •. i,-� - .,ti' �► • - :�X�- ,:.:. :at • -.t -�• _��Y :s !- '�!: -a":t-t E s!:, ,y �► ,^'! .. ,� .,:�!�...G ,..,. '1... it"t��:�. �'i` i-" •�(!, :i • -�,': •, ...._ �:. • i. •. 1'•, '1 � • .. � •y c.�•,. '..it t..i{,. a�- t� '!• .hl .! ` `.�i' ' 3t iR ■! ,rt f f:t ra- c•c--i'c, I. 1 i� J.. .,•- ".a< 11`, 1:I:t ■ ,::.,.ate ��� La � Miami Shores Village Building r -a. Dept ,- 10050 ME 2nd Ave. Miami Shores,Fl 33128 11.1.` ►;.��. !. h t:'i't ' `1.... � e. - IT— ,. .X Q-,77717-1 7 PRODUM 870 74th Aveme North 'J.- St. Patersburgs FL 33702 Owim 19270 SSW 185 Court •1 , Kiami, FL 33187 UA .; c �• �-._. i. -r: '.Y;�r 1.. ti. i- w. !:` ;• :�� a".= _.�... _>,~c �. � ♦ i, tv €-„�! .., s :••=- y.= _•; '.I b• 3<►• i:;;• .�;l Yt e!' f1. ._ k` ,; !•+ •, h, I.:i .,� t".. -"`.'i :^.1. ''f5�, .'! F ■ D. PARKING AREA,SIDEWALK PAVING AND REPAVING Dept.Miami Shares Village Building 10050 NE 2nd Ave. II Miami Shares,FI 33138 CT Q B Construcf3on Trades Qyk►g Bid sBU81NESS CERTIFICATE OF COMPETENCY ^ t E%1400 �k AW&M PAYINS EW0190t=WC B.A►.:R0DWINS PAVING NIEBLAS JOSE 1. Is certified under the WwWm of Chapter to Cary 5 QUALIFYIWG TRADE(S) 0007 PAVING ENGINEERING 1009 EXCAU&GRADING ENG Curbs ORMW P.E. S-WWV ofUm BOW Local Business Tax Receipt Miami—Dade County, State of Florida THIS IS NOT A BILL-DO NOT PAY LBT 3176179 BUSINESS NAMEILOCATION RECEIPT NO. EXPIRES RODWINS PAVING RENWA1. SEPTEMBER 300 2014 19270 SW 185 CT 3312245 Must be displayed at place of business MIAMI,FL 33170 Pursuant to County Code Chapter SA—Art,9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT.RECEIVED NIEBLAS&SONS PAVING ENGR INC 196 SPECIALTY ENGINEERING BY TAX COLLECTOR CONTRACT .QO Q9 18 75 / /2 013 Worker(s) 1 E941400 0227-13-001501 This Local Business Tax Receipt only eon Ihms payment of the Local Business Tau.The Racelpt is not a License. permit,or a certification of the hoidor's qualifications,to do business.Holder must comply with say governmental or nongovernmental reguistory,Ism and requirements which apply to the bmhmm The RECEIPT NO.above mast be displayed on all commercial vehicles—Nami—Dade Code See 88—M a Far more inImmotian,visit Municipal Contractor's Tax Receipt Miami—Dade County, State of Florida THIS IS NOT A BILL-DO NOT PAY M C CC NO. E941400 BUSINESS NAMEMOCATION RECEIPT NO. EXPIRES RODWLNS PAVING NEW BUSINESS 3EPTEMEER 30, 2014 19274 SW 185 Cr 7437414 MIAMI,FL 33170 Must be displayed at place of business Pursuant to County Code Chapter BA-Art.8&10 OWNER TYPE OF BUSINESS NIEBLAS&SONS PAVING ENGR INC SPECIALTY ENGINEERING PAYMENT RECEIVED CONTRACTOR BY TAX COLLECTOR 200.00 09/18/2013 0227-13-001501 M For more information,visit wymmlembladtamftmil --6- T wr FlIZ WOOD i 1; A i,; A, A WOOD i NO\]PYLON PYLON IVEY, 71 CORAL C A/ 0.451E 5( i POOL O/S 98-S w� 0.371 4f FE 15.44' -SSA 0.29T 25' STRIP EASEMENT (PER PLAT) LOT, 5, BLOCK 1 "V U77UTY 23.0 ROOM 04 5 vim. TWE-�EST rc 49.17-N LOT-6, 0.4 3 20.30' BLOCK 1 < ,-0W-Q'T0RY w 1301 z 19.42' 54.61' 15.40'cd I w 75.40' a COLUMN r. ;,A!WHXT 7 �6. A (p)(M) FIP 1/2& 75,00' -4 SIDEWAX. TZ 0 PAR Y koo'• Uj IL 2 \ U Z) C-f- AtsurFq As plici t-� Dr 0 Q LLJ Lli 0 W .Tc N m cn a- *C0ftMGW2MPRWM r ` • c .B A D � D)UJONG.E.1 Q=NG {3MPAC ED AWAT RESURFACE 0V'E#t MSTI G D VE'W'AY - .