CC-10-1956uc
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
nspection Number: INSP- 169306 Permit Number: CC -11 -10 -1956
Inspection Date: January 31, 2012 Permit Type: Commercial Construction
Inspector: Bruhn, Norman Inspection Type: F. Elevation Certificate
Owner: , SHORES SQUARE INVESTMENTS Work Classification: New
Job Address: 9005 BISCAYNE Boulevard
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060110060
Project: <NONE>
Contractor: RIZNICK CONSTRUCTION CORP Phone: (954)584 -0363
Buildina Department Comments
CONTRUCTION OF NEW BANK
Inspector Comments
Passe
CREATED AS REINSPECTION FOR INSP- 169151. Elevation certificate is
�.
incomplete and incorrect. The owner portion (F) should not be completed.
NB
Failed El
Correction
Needed ❑
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
For Inspections please call: (305)762 -4949
January 31, 2012 Page 1 of 1
f 0 Sege{ -lo kao
RE: Permit# R-/C- 1.5 -��
Miami shores Villauv
Building Department
INSPECTION AFFIDAVIT
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
DATE: -07—/O— 0
1 '9" 4?64 6A licensed as a ( Contractor ngineer /Architect,
(Print name and circle License Type) FS 468 Building Inspector
License #: C.(C - 050 01740
On or about (96 z -- 13 ,1 did personally inspect the roof deck nailing and
(Date & time)
Secondary water barrier work at /-/g �� /a 9 cs%4E257
(Complete Job Site Address)
Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
Manual (Based on 553.844 F.S)
(� 91�
Signature
State of Florida
County of Dade:
The undersigned, being the first duly swom, deposes and says that.W /she iRAp, /contractor for the above property
mentioned. lS. �''�%,,�
Sworn to and subscribed before me this � _ da m CD
�Q ti tea: Gj•�
Notary Public, Sate of Florida at Large '�o�
..........
•
`General, Building, Residential, or Roofing Contractors or any individual certified under 468 F.S. to make such an inspection. Include photographs of each plane of the roof with
permit # and address # dearly shown marked on the deck for each inspection
Revised on 5121/2009
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Nami Shores, Florida 33138 ------ ----- ---- --
Tel: (305) 795MW Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 7614949
rt BUILDING FBC
P
PERMIT APPLIC Master Permit xo.
Permit T i ING ROOFING
JOB ADDRESS: Z. !�
city: _ bfiami shores _� County: Miami Dade Tp; 13
Folio/Parcel#:
Is the.Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder):
Address:
City: &zC Zip: , e
Tenant(Ussee Name: )
Phone#:.
Email:
CONTRACTOR: Company N —Phone*,: bD2 140D
Address: q9-1
City.. State: —F-7
Qualifier Name:
state 'fication . 'on #: � LAq Certificate of Competency #:
Contact. �� �`t �� Email Address:
DT�5 G �e
F. Phone#:
Work for this Permit: $ O C SgaareffAm r Footage of Work:
Type of Works OAddition Alteration New C]Repair/Replace ODemolition
Dmrlptloa of Work; U akIJKILAVIA.vIA
Color thru d&:
Submittal Fee $ Permit Fee $ CCF $ CO /CC $
Seaaning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ �_ Technology Fee $
Double Fee $ Sbvctnrai 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 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 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.
The foregoing instrument was ac owledged before me this i 1 The foregoing instrument was acknowledged before me this
day of - , 20 �, by S �ca �P day of 20 =� by _ i� 1 (� p
who is personally known t m or who has produced who is known to me who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
APPROVED BY
NOTARY PUBLIC:
Sign: tLL
Print: d U G
% 00V pu?� a, My Commission c ' puw Ste° °t
B 4RY,co� 0 � •_ y Ces oso 018
Plans Examiner,
Zoning
Structural Review Clerk
(Revised 3 /1=012)(RevisW 07 /10M70evised 06/10=W)(Revised 3/15/09)
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
k 001
PERMIT NO. TAX FOLIO NO. 11 -2136 -000 -0050
STATE OF FLORIDA
COUNTY OF MIAMI -DADE
THE UNDERSIGNED hereby gives notice that improvement 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.
OR Bk 28740 Ps 31981 ( ips )
RECORDED 07/25/2013 10:48:56
HARVEY RUVIldr CLERK OF COURT
MIAMI —DADE C.:OUNTYP FLORIDA
LAST PAGE
1. Legal description of property and street address: 11300 NE 2nd Ave Miami Shores, Florida 33161 -6628. The SE 1/4 of NE 1/4 less E
35 ft and less W 40 ft.
2. General description of improvement: Bathroom renovations of Weber Hall.
3.Owner(s) name and address: Barry University 11300 NE 2nd Ave Miami Shores, Florida 33161 -6628
Interest in property:
Name and address of fee simple titleholder (if other than owner): Barry College
4. Contractor's name, address, and phone number: Mass & Associates 2101 N. Andrews Ave Suite 300 Fort Lauderdale, F1904gAaal 1
954 -X §LTA W FL A, COUNTVD70AM
5. Surety: (Payment bond required by owner from contractor, if any) ' HEREBY CER77 Y that this is a trugeItopy or day of aVJ` c ► :�. O�
Name and address:
,rigmal filed in this office o
Amount of bond: $
6. Lender's name, address, and phone number.
my
7. Persons within the State of Florida designated by Owner upon w - irffPIV iFfee Wby-jk*Crrf—
713. 3(1)(a)7., Florida Statutes:
Name, address, and phone number: Sherry Wemer. Sr Project Manager Moss & Associates 2101 N Andrews Ave Suite 300 Ft
Lauderdale, Florida 33311.954- 769 -8107
8. in addition to himself or herself, Owner 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: Moss & Associates 2101 N. Andrews Ave Suite 300 Fort Lauderdale, Florida 33311
IFICATION PURSUANT TO SECTION 92.5 FLORIDA STATUTES.
U er penaltie of erjury d clar have read the foregoing and that the facts stated in it are true to the best of my knowledge
Signature of ;rural Person Sig6g Above
Turn Over for Instructions
U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660 -0008
Federal Emergency Management Agency I Expires March 31, 2012
National Flood Insurance Program Important Read the instructions on pages 1 -9.
SECTION A - PROPERTY INFORMATION 1,77oonsur ce papy use.-:, 771
FIT-
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.n
9005 BISCAYNE BOULEVARD`.
City MIAMI SHORES State FL ZIP Code 33138 u Fl
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) °`
PARCEL NUMBER 11- 3206 - 011-0060
0
A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) NON- RESIDENTI& Y. ----- -----------
A5. Latitude/Longitude: LaL 26 *51'28.3"N Long. 80 *11'01.6`W Horizontal Datum: ❑ NAD 1927 ® NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
AT Building Diagram Number 1B
A8. For a building with a crawispace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawispace or enclosures) WA sq ft a) Square footage of attached garage WA sq ft
b) No. of permanent flood openings in the crawispace or b) No. of permanent flood openings in the attached garage
enclosure(s) within 1.0 foot above adjacent grade WA within 1.0 foot above adjacent grade N/A
c) Total net area of fled openings in A8.b WA sq in c) Total net area of float openings in A9.b WA sq in
d) Engineered flood openings? ❑ Yes ❑ No d) Engineered flood openings? ❑ Yes ❑ No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number B2. County Name B3. State
MIAMI SHORES 120652 TDADE I FLORIDA
B4. Map/Panel Number
B5. Suffoc
B6. FIRM Index
B7. FIRM Panel
B8. Flood
B9. Base Flood Elevations) (Zone
12086CO306
L
Date
Effectiva/Revised Date
Zone(s)
AO, use base flood depth)
❑ feet ❑
❑ meters (Puerto Rico only)
9- 11-09
9-11-09
AE
8
B10. indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe)
B11. Indicate elevation datum used for BFE in Item 139: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe)
B12. is the building bated in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes No
Designation Date ❑ CBRS ❑ OPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations - Zones Al A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, AR/AE, AR/A1 -A30, AR/AH, AR/AO. Complete Items C2.a -h
blow according to the building diagram specified in Item A7. Use the same datum as the BFE.
Benchmark Utilized MDED# B-5QVertical Datum NGVD 1929 ,
Conversion/Comments ELEV. =10.02
Check the measurement used.
a) T
Top of bottom floor (including basement, crawispace, or enclosure floor) 9.9 ®
® feet ❑
❑ meters (Puerto Rico only)
b) T
Top of the next higher floor _
_WA.. ❑
❑ feet ❑
❑ meters (Puerto Rico only)
c) B
Bottom of the lowest horizontal structural member (V Zones only) W
WA. ❑
❑ feet ❑
❑ meters (Puerto Rico only)
d) A
Attached garage (top of slab) _
_N A. ❑
❑ feet ❑
❑ meters (Puerto Rico only)
e) L
Lowest elevation of machinery or equipment servicing the building 9
9.29 ®
® feet ❑
❑ meters (Puerto Rico only)
(Describe type of equipment and location in Comments)
f) L
Lowest adjacent (finished) grade next to building (LAG) 9
9.2 ®
® feet ❑
❑ meters (Puerto Rico only)
g) H
Highest adjacent (finished) grade next to building (HAG) 9
9.24 ®
®feet [
[I meters (Puerto Rico only)
h) L
Lowest adjacent grade at lowest elevation of deck or stairs, including 9
9.2 ®
® feet ❑
❑ meters (Puerto Rico only)
structural support
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
l ed I 1 d hitect u
This certrfic afro" rs to b *IV" and sea ed by a an surveyor, engineer, or arc a orrz y w o
information. I certify that the information on this Certificate represents my best efforts to interpret the data avallable.l
understand that any false statement maybe punishable by fine or imprisonment under 18 U.S Code, Section 1001.0
Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
licensed land surveyor? ❑ Yes ® No
Certifiers Name SCOTT A UZZI License Number 5108
W17. MW
$-
Date 1-6-12
See reverse side for continuation.
ZIP Code 33351
Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding Information from Section A. For insurance Company Use:
Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. Policy Number
9005 BIS�AYNE BOULEVARD
City MIAMI SHORESState FL ZIP Code 33138 I
GO NM IVurmb�sr
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments MACHINERY ELEVATION (C2e) IS FINISHED FLOOR OF BUILDING (NO EQUIPMENT BELOW THIS ELEVATION). LAT. / LONG. (A5) PER
GOOGLE EARTH. CROWN OF ROAD (BISCAYNE BOULEVARD) ELEVATION= 7.60
Signature Date 1-6-12
❑ Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR -F request, complete Sections A, B,
and C. For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement, crawispace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) Top of bottom floor (including basement, crawispace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and /or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community s floodplain management
ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA - issued or community- issued BFE)
or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.
Property Owner's or Owner'A Authotized Representative's Name
Address City State ZIP Code
Signature, Date Telephone
Comments
Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E),
and G of this Elevation Certificate. Complete the applicable items) and sign below. Check the measurement used in Items G8 and G9.
G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO.
G3. ❑ The following information (items G4 -G9) is provided for community floodplain management purposes.
G4. Permit Number I G5. Date Permit Issued I G6. Date Certificate Of Compliance /Occupancy Issued
G7. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters (PR) Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum
G10. Community's design flood elevation ❑ feet ❑ meters (PR) Datum
Local Official's Name Tile
Community Name Telephone
Signature Date
Comments
Check here if attachments
r=r =AAA Fnrm Al-'Al Mar 110 Aanr�nco oil -Ai+.—
i
Building Photographs
See Instructions for Item A6.
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number'
9005 BISCAYNE BOULEVARD
City MIAMI SHORES State FL ZIP Code 33138 Company NAIC Number
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to
the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View "; and, if required, "Right
Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page,
following.
Front View — 1 -06 -12
Rear View — 1 -06 -12
A
Building Photographs
Continuation Paae
Company
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
9005 BISCAYNE BOULEVARD
CitV MIAMI SHORES State FL ZIP Code 33138 Company NAIC Number
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all
photographs with: date taken; "Front View" and "Rear View "; and, if required, "Right Side View" and "Left Side View."
Left Side View — 1 -06 -12
Right Side View- 1 -06 -12