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Ds-13-1479Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 194518 Permit Number: DS -7 -13 -1479 Scheduled Inspection Date: March 12, 2014 Permit Type: Driveways /Sidewalks/Slabs Inspector: Rodriguez, Jorge Inspection Type: Final Owner: POLLA, LAWRENCE Work Classification: New Job Address: 121 NE 92 Street Miami Shores, FL 33138 - Phone Number (305)205 -2711 Parcel Number 1132060133160 Project: <NONE> Contractor: DAVID HESLER INC Phone: (786)294 -0954 comments REPLACEMENT OF EXACT SIZE CONCRETE WALKWAY ' "°V -- INSPECTOR COMMENTS False March 11, 2014 For Inspections please call: (305)762 -4949 Page 1 of 34 Inspector Comments Passed Failed Correction Needed ❑ Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 11, 2014 For Inspections please call: (305)762 -4949 Page 1 of 34 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. C 24 1 17-� Master Permit N+a:,D�-> - -3 JOB ADDRESS: N City:. Miami Shores County: _ Miami Dade Zip: Folio/ParceW 1�' Is the Buitlding, Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titlet Address: City:t11 A rM Tenant/Ussw Name: Email: CONTRACTOR: Company blame: Address': , ;k. a _ City: — Dft �, . Qualifier Name: ID V State Certification or Registration #: Contact Phone #: — DESIGNER: Architect/Engineer. _ State. _ L Zip. rjgjp,jq - 1;-L Zip: 14 1711 r Value of Work for this Permit: $ SquarelLit►ear Footage of Work: Y Type of Work- ClAddition ©Alteration ONew I#Rtp, air/Replace Memolition Descriptio -n of Work: b i_ k4l )- _ 00-kIr thru We: �ar��,��x��,ra�x��r�rxu�: sr�����tr����r�F���x�• �����$ re, u���, � ,��x��•r�,�s�+acs:r���mx,�a� 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 $—... V ° Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State i® 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 witb.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 certifted copy of the recorded notice of commencement must be posted at t+ job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of s4ch posted notice, the inspection will not be app oved acid a reinspection fee will be charged igttature Stgnature LA The foregoing instrument was ac � tknowledged before me thi day of ��4ar�� ,20 by L u)t -ertce R la.. —Jw > who is personally known to me or who has produced t ara ego dnUe �+ i�x1�e- As identification and wbo did take an oath. NOT.&RY PUBLIC: Sign: I'LJ'Aa, Print: L -vet-4-@ itc4,#,l My C madssion Expires: 6 ill p� ���EM4CHO �i S; my �� mpg, 2014 ntractor The foregoing instrument was acknowledged before me this day of WAVC11 20 A by _DaVl d �2S4w who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: �Z Print: sWy Pbn. My Commission Expires: W COMMISSION 8 EE X149 �r EXPIRES: September 12,416 APPROVED BY �� y c :Z Plans Examiner Zoning Structural Review Clerk (Revised. 5/2 12)(Revised 31 1212012) ).(.Revised Od1lU/2(09)( tevimd 31 S104X12evised 7110nM7) • Miami Shores village Building Department 10050 NE-2nd Avenue, Miami Shores Florida 33138 Tel: (305) 795.2204 Fag: (305) 756.8972 l INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: BUILDING D J,� JUL ®1263 1 FBC 20 Permit No. Master Permit No. ROOFING JOB ADDRESS: I ZI (JF— 92hd .i'7- City: Maw SLOM County: Miami Dade Zip: :3 312 7 Folio/Parcel#: Is the Building Historically Designated: Yes NO _ Hood Zone: h% e OWNER: Name (Fee Simple Titleholder): L niwc,4 0 t, Phoned;.. `3 D S' 2o �° a? ( d Address: 'I29 6z iF Q_2n"� g;;– City:. 1MAg" .�1 �� state:- Zip: Tenant/i.essee Name: Phoned: Email: CONTRACTOR: Company Name:._. t>qi1hl �[ a l , honed: c °��` Address: _() A3E 1 [ 5ti± City. H 1 State: Qualifier Nam: . 117�) State Certification or Registration #:a t , s -2 ff Certificate of Competency #: Contact Phone#: Email Address: Architect/Engineer: Phone#: Value of Work for this Permit: Spue/Linear Footage of Work: _ d Z SL Type of Work: OAddition DAlteration ONew V YRepair/Replace ODemolition Description of Work:. _ Dip ®14 c' 4d Q l >::W-4,,1 lkk Art VA V'P Color thru tile: Submittal Fee $ Permit Fee $ a CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Educadon 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 AV 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, BOMERS, 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 post notice, the inspection will not be approved and a reinspection fee will be charged. Si gn Si store -� � Owner or Agent The fore ' g instrument was acknowledged before me this L day of ` 20 t'3 by &--i "VCV r' A44111- who is personally known to me or who has produced j! rj /O As identification and who did take an oath. Contractor The foregoing instrument was acknowledged before me this day of 20 1---3, by _ "tIw �eQ ti gst4l_ ; who is personally known to me or who has produced —E—;5 `- as identification and who did take an oath. NOTARY PUBLIC: ��� iiiniuiii NOTARY PUBLIC: a sign: ~� ``e Oe`� ���' �% Sign: Print: -� �� ° = Print: r P a , ., M Commission Expires: MY COMMISSION 4 EE 114998 Y o� My Commissio�a sT Q EXPIRES: August 8, 2015 9"FOF FlAR�� &Wed Tin Budget No" SBN = APPROVED BY ,� ��J Plans Examiner Zoning Structural Review Clerk (Revised 3/12f2012)(Revised 07/1 0/07)( tMu d 06/10n )(Revised 3/15/09) STATE OF (FLORIDA) COUNTY OF (DADE) Miami Shores Village Building Department SURVEY AFFIDAVIT The undersigned Affiant, 1, a, h -,does hereby attest that The attached survey, performed by (Property owner) (Name of surveyor's company) For address: L24 A.1 g ol1P, ft` 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Performed on (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 Affiantsw e h naught. Property Owner Signature, Property Owner Print Name . SWORN TO AND SUBSCRIBED before me this�\�`��� Affiant is , 'personally known to me, produce �� '' Q1f es a as identific 'on. mis%- Ot t '� •'••G0F�113fl59:'o �. Notary s '° ........ ° Revised on 5/22/2009! Revised on 6112A9 "4TE i I 4 CITY JUL 0 12013 COPY PERMIT #: Miami Shores Village APPROVED BY DATE ZONING DEPT BLDG DEPT SUBJECT TO CGMPLIANCE WITH ALL FEDERAL STATE AND CCUMY RULES AND REGUL.AnoNS 12Xl2X2 CgJCRETE P\ ii E SAND 90 BBAIM OF WSTALLED PAVER V) 22'-D" 0 V) MW SOW" Q Dame FRONT PORCH Li I #-# cn 0 z C14 (7) REMOVE DETENGRAIED 3722' CONCRETE WALKWAY AND RMECE KITH CONCRETE PAYERS Ld z 0 CL Ld 0 9 ArAWA CNMM W= XCR PAMM OMM IM 0 s"m wam A4%m 36-4 = SW BW FW tMW 0 IZP SM EM IM W Or PAM W MW MM QF BM wsw PERMIT #: Miami Shores Village APPROVED BY DATE ZONING DEPT BLDG DEPT SUBJECT TO CGMPLIANCE WITH ALL FEDERAL STATE AND CCUMY RULES AND REGUL.AnoNS A SKETCH OF BOUNDARY SURVEY SCALE; 11" =20' 96A (I 1 u-4 J2 17 Al;l 1 IL, Ei.F1 -tee t! f4k x -41 LOT 1&, toL 7, 00 20"ia, T10 41 ry 0.20 pwg VA ABPREVIAT';C�'N!v (cr' �y APPLX.)) aw . W.9.t - WALL MAW. 6 DR&WAOX LEGAL DESCRIPTION: <go- 11-L pr, ADS 16. ''t'LA, pe L,,o< 1,7 BLOCK s3 SUBDIVISION 4P ?14*f 0r, WIWI o%t4-p *,�o 00 1 ACCORDING TO THE PLAT THEREOF AS RECORDED IN FLAT BOOK AT PAGE OF THE PUBLIC RECORDS op___VI ALAi- QA Q0 Z;OUNT-, FLORIDA. LOCATION SKETCh SCALE I" -tat0" lcl 06 a 40117 91,0c-'ek !URVEY CERTIFY 10; ---------- NIF A!17ACi,11-D SKEric."i OF DGUNDARV cl: 111-. 1:-- A -RI'F .41,1D RS iv!:,,� , MAZE UND-:z V), DIREC-110-Y AY MLETS lllt'� MXIMU�,,* "ECHNI'M PRFSENTATION OF A 17E!1� St.; AS FORT!! RV :10WJA BOAZ!-'-� i"i A-V,. ';CTIOY 472 �-2' FLOPIE-A 6 A,17 --6 FLORIDA AI)2,,' NIS'! F,,t i:V', Tr-,-. 'ATE 0!- THE T.B. & DFAWN 131: CFECKED riY E. BELTRAN & ASSOCiATES, INC� VIAM-1. FLORMA 331?5 A1:-*-!C,-,:2A11" SUMBEF IF ZURVFYOR,s NOFL�i .X.GAL N WAS FURSISMZ BY MAM ATION Or 'IM AM-.. k, Of 'n", : W71i RAW 13E MADv 1*0 DVA-IMIN'r AN%' TIMU ARE No -.1311312 ENCR0AC!�-­i;;3M-U -KOSE, :51OWN, LEGAL DISCRI)MON SLWELT TO ANY DEDICATION !-W'TA!73N!;, REJTR1M,-GN!$ RESERVATLJN-' "R REcZlW, NO LINDENG.RoUbri INSTAUATIONS OF IAVV-' BEEN LWAM, M—EP! AS NOM rMiCE OWNMRSPW BY VIS".1AL KW'-: O^Y :r, A") '—EXA, CWNkRsmp NCI rETEMMED.