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DS-13-1971Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 198232 Permit Number: DS -8 -13 -1971 Scheduled Inspection Date: January 02, 2014 Permit Type: Driveways /Sidewalks/Slabs Inspector: Rodriguez, Jorge Owner: MANUEL DEL MONTE, LESLIE cwUIr UOIY Job Address: 480 NE 91 Street Miami Shores, FL 33138- Project: <NONE> Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060190020 Contractor: BRICK PAVERS GROUP Phone: (305)591 -8700 comments INSTALLATION OF PAVERS ON DRIVEWAY AND APPROACH INSPECTOR COMMENTS False January 02, 2014 For Inspections please call: (305)762 -4949 Page 2 of 13 Inspector Comments Passed Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. January 02, 2014 For Inspections please call: (305)762 -4949 Page 2 of 13 SEC E YVED t p O� a re.�o�r6�t� �o,�cre� -� -CWps (A1jk1�ii4J ) u4d SEP 0 0 2013 41 101941 1 CW4 AMP 1`®0.Li ! ILve.ie^ x 7i1' � @ f,t.E 6ta� e cow= rAvOgg C- D- t— peL67,Kj 01-Clr toll ��: A a 3 g r r Are. 2,. Z X Il LOCATION MAP SKETCH OF SURVEY 8GhlE A 2d• LxJ 1Jr• 9th 5TFAF–" m Ng. 91' " bT �i a 50 ` k 4.5' 7 6 5 i Of � V n . ui tr s R LU 91 Street Miami Shores, Florida 33138. `� w'O 3 P� I t sad the 101, a the )Bock I, -EL of POBTALd according o the }at �4°� V-14 �x3' a a � atPage 101. of the Public Records ofMiami Dade Comity, Florida.. ®eR R L SLIE j sVmE & DEL MONTE \ 1 {y ZiF Z TO: A CIiFI & MANUEL DEL MONTE. Q LLJ F- ERVICES, INC. t`' i %a j Q W F BANK, TITLE INSURANCE COMPANY 14 �, Q EIS ANK, N.A, its successors atWor assigns, as their iaterest may appear. t� C z � Lu {W¢� �1 J 9 t03Dt } Lot >) I e, m Mcnim tw ba facet. or a'eaml>p tauj' m/ r eoi b1e0.1 to aftm.b a..qJ �.. 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Ram. m u a•�C .S} {,c �«am a. ,. by aL �`"'ienra ate. am a e�..�.°0i o boar «'mat .wearmr a n` 3 a gt. M Q m� sm—t. , « b. .Nds bbmmCe .m a.e b C ,- d-loop ts) o.md IM . madWa stir to wd p sit m an b.naa -6mb./ iacd b• e.W¢4 as ZoAbY / ( • F f bid lm0 SA m/ VOW b e.poaabi. vmya aetmm ae[ t8 list. Slate M N.M . ¢ iei A t •^• M tbb ..vq b mt reed .4b.at Cs .tWObr. ma ae .rl.e/ .m of o shift ec.o.a tm/ awg ad Mwoa• • i Nb•! 'G.�i ' b as am.d a a a. « °-_ `�aa� o. rramr .� m�ap�aa ..ror � a.ael� d.o� aw+. s. assets r�tl0amaad wt a �� s,......«..e..•. ,e �.., ! _ - - /v~ 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 Permit Type. BUILDING JOB ADDRESS: 480 N E 91 st Street, AUG 2 9 206 MM FBC 20 Permit No. Master Permit ROOFING City: Miami Shores County: Miami Dade gip: 33138 Folio/Parcel #: Is the Building Historically Designated: Yes OWNER: Name (Fee Simple Titleholder): Leslie Sanchez AAA-.,. 480 NE 91st Street City: Miami Shores NO Flood Zone: State: Florida Tenant/Lessee Name: Phone#: Email: delmonte.home @gmail.com 305 -450 -5307 33138 CONTRACTOR: Company Name: Brick Paver Group Phone#: 305 -591 -8700 Address: 350 W. Park Drive, #101 city Miami Shores State: Florida gip. 33172 Qualifier Name: Jose Fernandez Phone#: 305 - 591 -8700 State Certification or Registration #: Certificate of Competency #: E0900115 Contact Phone#: 305 -591 -8700 Email Address: Wendy @bdckpavergrp.com DESIGNER: Architect/Engineer: Value of Work for this Permit: $ 3,270.30 Square/Linear Footage of Work: 620 Sqft Type of Work: DAddition DAlteration New ORepair/Replace ❑Demolition Description of Work: Installation of pavers on driveway and approach Color thm tile: Submittal Fee $ Permit Fee $ CCF $ CO /CC $ Scanning Fee $ C� _ Radon Fee $ DBPR $ S 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 Mortgage Lender's Name (if applicable) Mortgage Lender's Address City N/A N/A State Zip 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 =e ing $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien latm hure 11 be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of co must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. s ce 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 day of :ry� 20 13 , by L eS 1% �° S�y1 c_Je who is o me or who has produced As identification and who did take an oath. o0 "Y P" Yilan P. Navarro NOTARY PUBLIC: ' 4"a � .' -, C�'MMISSION #EE030439 �i EXPIRES: SEP.28,2014 /l � www.AARONNOTARY.com Sign: Print: 1 r /0� 2-7 P /(ice via l7h !/ My Commission Expires: -5:kI .9 F_ f® /,V . f The foregoing instrument was acknowledged before me this %5� day of �4 P1 20 / 3, by e j e Jl ?9 ,9 71 �eZ who is pe orally knowne -rye or who has produced APPROVED BY ( / 16 r-> Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) As identification ,who take ch -- ���ppY PVB ,, Yi an I� NOTARY PUBLIC: - �CAMMISSION#EE030439 EXPIRES: SEP.28,2014 /� WWW.AARONNOTAR'fcom Sign: (J46;,7. � Print: t/ g�E.�/F h ri w P A1,4 C/ a -" el My Commission Expires: -�-�� V y — �W Zoning Clerk 16 Miami shores Village 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 Whereas, (owner) Le_6 i:e 90j)IJ ez- hereinafter referred to as the owner of the following described property (address): IAIAO NCi N s� lie Legal Description Lot 3 Block —1 Subdivision Folio # Requests permission to install (describe work):, Within the public right of way of (address) �t e e nd A)PP(-0W__V\ . 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. i , ft 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 items) 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 lquJL , 2013 A 7 . (Owner's Signature) SIGNED, SEALED, AND DELIVERED in the presence of: ,� jf �� �� C-4 Q ........ Yilan P. Navarro COMMISSIONRE030439 oe°e EXPIRES: SEP.28,2014 '•�u n�`� WWW .AARONNOTARNcom 2 Miami shores Village Building Department 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. �, COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. ---*COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. __LZCOPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. `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 COMPLETE CONTRACTOR'S INFORMATION BU ESS NAME: PcLoa 17M . � Q84e BUSINESS ADDRESS: '350 to, loq roc p-iVQ CITY !GL-rr) STATE FL ZIP CODE _ �T BUSINESS PHONE: (�) 591- TIM FAX NUMBER ( ( �) 01 CELL PHONE L_) QUALIFIER'S NAME: ��o -4E:- � Z� QUALIFIER'S LIC NUMBER: g®ci ® 0 1 � 5 E -MAIL ADDRESS (IF APPLICABLE): Sri Created on 3119109 BY MLDV I RV 3126109 MLDV CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DONYYY) 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, 08/28/13 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 poilcy(tes) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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 Excellence Insurance Agency 3801 SW 107 Avenue CONTACT NAME: Marcos Alvarez PHONE FAX Cam. NLo. xt): (305)226-3900 No . (305)226 -3997 E MAlvarez @Excellenceinsurance.net Miami, FL 33165 Phone (305)226 -3900 Fax (305)226 -3997 _ � INS S AFFORDING COVERAGE NAIC9 INSURER A : MAPFRE Insurance Company 34932 INSURED Brick Paver Group Inc. INSURER 8: Technology Insurance Company 42376 INSURER C: _ 350 West Park Drive #101 INSURER D : 0 COMMERCIAL GENERAL LIABILITY INSURER E:. Miami, FL 33172 305 - 554-6570 INSURERF• rnvr:oer_re � ,,,..,,.r,_,_ "_�- ..._____ T 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. ILTR TYPE OF INSURANCE __ �D UBR POLICY NUMBER POLICY EFF Mo PI M LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 0 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED P MI$�$ Ea �currenca $ 50,000.00 CLAIMS -MADE © OCCUR A Contractual Uab. Y Y CP 0000323980 j 08/18/2013 08MED ExP (Any one person) $ 5,000.00 PERSONAL BADVINJURY $ 1;000,000.00 RV XCU Included GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER ❑POLICY Q PRO- ® LOC PRODUCTS - COMP /OP AGG $ 2,000,000.00 Blanket AddiUonallnsd. $ AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMfr Ea dent, 1,000,000.00 F1 ANY AUTO I BODILY INJURY (Per person) $ A ALL OWNED SCHEDULED E] ALL AUTOS Y Y 4150130008801 08/21/2013 0821/2014 BODILY INJURY (Per acc dent; $ Q NON -OWNED HIRED AUTOS AUTOS Pd.0PERTY DAMAGE er acadeM $ ❑ Hired/NonOWned Auto $ 500,000.00 © UMBRELLA uAB ❑ OCCUR A ❑ EXCESS LIAR � CP 0000323980 EACH OCCURRENCE $ 3,000,000.00 i AGGREGATE $ 3,000,000.04 CLAIMS -MADE Y Y 08/172013 08!172014 ❑ DED ❑ RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY YIN — WC STATU OTH ❑ B ANY PROPRIETOR /PARTNERIEXECUTNE OFFICERIMEMBER EXCLUDED? NIA Y TWC3367710 108/172013 08/172014 E.L. EACH ACCIDENT $ 1,000,000.00 EL DISEASE - EAEMPLO $ 1,00D,000.00 (Mandatory In NH) K describe und DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ -T DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 1011, Additional Remarks Schedule, If more space is required) INSTALLATION OF BRICK PAVERS ENDORSEMENTS ATTACHED TO POLICY: CG 2010 SCHEDULED ADDITIONAL INSURED I CG 2404 LIABILITY WAIVER WC 0003 WORKERS COMP WAIVER 'CERTIFICATE HOLDER IS ADDITIONAL INSURED PER BLANKET Al ENDORSEMENT (CG 2033) CERTIFICATE HOLDER I Miami Shores Village I Building Department 100500 NE 2nd Ave Miami Shores, FL 33138 CANCELLATION SHOULD ANY OF VAB DESCRIB ED POLICIES BE CANCELLED BEFORE THE EXPIRAT1O EOF, NOTICE WILL BE DELIVERED IN ACCORDAN WI LICY PROVISIONS. J/ 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) QF Jr The ACORD name and logo are registered marks of ACORD • .,.. ►v�rv�a anTAX y FIRST -CLASS U.S. POSTAGE 9 PAID NIIAW FL PERMIT NO. 231 640234 -1 THIS IS NOT A — DO NOT PAY RENEWAL BUSINESS NAME LOCATION _ RECEIPT NM 667043 -5 BRICK PAVER GROUP INC CC # E0900115 350 W PARK DR 101 33172 UNIN DADE COUNTY OWNER BRICK PAVER GROUP INC WORKER /S Sac. T of Business 196 SPECIALTY ENGINEERING CONTRACT 1 DO NOT FORWARD pouff ON uucmm BRICK PAVER GROUP INC WMAl sv t auv. nas ;me cLDOM Q CA-- JOSE A FERNANDEZ PRES MONS. 350 W PARK DR 101 P nnao�E w��mTax MIAMI FL 33172 couecTM 08/03/2012 60000000293 ??�� 000075.00 �ss�{ sssssaa��` ssa�aa�a�aaa�t�sss�aa {ss�s�ss�a�s��,tit�a�s� i SEE OTHER SIDE _— _Y_ —_ - - -- •' LA CTQB } , , Condon Trades Quakft Board BUSINESS CERTIFICATE OF COMPETENCY -• E0900115 ;KABRICK PAVER GROUP INC D.BA.: FEET J OSE A is c taut the polsions of Chapter 10 of Nye Cotuq VAUD FOR CONTRACTM UNTIL 2013 ` Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT#.--j�LS 13 - H AA E: f —6 -/-3 U11 4750tr M • Contractor (NAME) • Owner • Architect Picked up 2 sets of plans and (other) Address: Z'le v t)'e f/ 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 b) PERMIT CLERK RESUBMITTED DATE: q—q- 13 PERMIT CLERK I Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 September 5, 2013 Permit No: DS13 -1971 Buildina Critique Review 1. Provide detail and specifications for paver installation. Please note that pavers on a driveway and approach should be set over 2" leveling sand over 6" thick compacted limerock base. 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.