DEMO-12-1413Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 185393
Scheduled Inspection Date: April 10, 2014
Inspector: Rodriguez, Jorge
Owner: ,
Job Address: 571 NW 113 Street
Miami Shores, FL 33168-
Project: <NONE>
Permit Number: DEMO -7 -12 -1413
Permit Type: Demolition
Inspection Type: Final
Work Classification: Building
Phone Number
Parcel Number 1121360211140
Contractor: MG EXCELLENCE SERVICE CORPORATION Phone: (786)247 -7067
uunama uegartment comments
DEMOLITION OF AN EXISTING ILLEGAL ADDITION TO I "... "'" `.---
THE ORGINAL DUPLEX. INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP - 176460. No plans or permit on
,uM-- site. NB
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
April 09, 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
BUILDING
PERMIT APPLICATION
Permit Type: BUILDING
JOB ADDRESS: sw N Vy 1 1 3 S�_
'• ^,✓ 1iN11
APR 03 20W
FBC 20 ( t
Permit No.
Master Permit No. y Q k A P1 '1 1
ROOFING
City: Miami Shores County: Miami Dade Zip:
Folio/Pazcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: OAddit on nDAlteration ONew OR p.
Description of Work: 1 �✓1� X/� ��i� �l
Demolition
Color thru tile:
Submittal Fee
Scanning Fee $
Permit Fee
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
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 apprgved and a reinspection fee will be charged.
er or Agent
The foreg ' g ins t w ac�ledged before me this
day of 20 y C7 A
who s rsonally known me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign: v
Print:
My Commission Expires:
APPROVED BY
"Ode
%yid p 8� 1ODA,
N�T.acn *_°�,'e16 - ,
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of , 201, by
o is personally known to m ho has produced
as identification and who did take an oath.
NOTARYrRUBLIC :_
Plans Examiner
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /o7xRevised 06/10/2009)(Revised 3/15/09)
My Commission Expires: N�rypJP��1�011
Zoning
Clerk
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. nEa t) - .lit -YttM FOLIO NO.94?-29-to
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.
C F N 'fits 12 R 5 a 038
OR Bk 28229 Ps 3834; (fps)
RECORDED 08/15/2012 14 :08 :36
HARVEY RUVINP CLERK OF COURT
MTANT -DADF CnUNTY► FLnRIDA
d Space above reserved for use of recording office
of proper . and street/address: a(e o n -T� ! Gal ib 1.0 0 )-O d �o
2. Description of improvement:
3. Owner(s) name and address:
Interest in property: d `T
Name and address of fee simple titleholder:
4. Contractor's name, addresp and phone n
¢ — I rtwai - Rr C_ . '-! 3 t (&.. o
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. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor'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 1 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 COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOI a,
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE TH
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WOR
OR RECORDING YOUR NOTICE OF COMMENCEMENT. t�Pi
Signature(s) of Owner(s) or Owner(s)' Authorized Officer /Director /Partner /Manager 42 va
Prepared By Prepared By
Print Name T IV-J i e- Print Name
Title/Office 19 Title/Office
STATE OF FLORIDA �.
COUNTY OF MIAMI -DADE
The fo ing my rument we acknowledged before me this � day of r Z �� A
By li'�/�c� ✓2 7 �V.,k i l� Ct %,--"
i
❑ �Yidividually, or L) as for
Personally known, or U produced the following type of identification:
Signature of Notary Public: • " " "�
Print Name: t
(SEAL) _ P:r Commission DD 889593
VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES '?„'e9 �c 'm Expires AM 19, 2013
Under penalties of perjury, I declare that I have read the foregoing and BOf Nofiofrot NotarYAssn
that the facts stated in it are true, to the best of my knowledge and belief.
Signature(s) n r ner(s)'s ALftorized Officer/Director/Partner/Manager who signed above:
By By
123.01.52 PAGE 3 11 or
&) zrl"" kr_ � f >" A-1-
Miami Shores Village
Building Department
90050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
DING Permit No.
PERMIT APPLICATION
�uL 4 � 2A1a
Hit.
FBC 20 lD
Master Permit NoOk Mo 11, 112>
Permit Type: BUILDING ROOFING
JOB ADDRESS: , I 'V Lx-,q 16 3
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee
�KWO �
)OL _\ 6 0 va l e W I L-"qV f- Phone#: -7 t 3 7 —110 eD
21
City: ) p A N Ka- State: V L Zip: 3316
Tenant/Lessee Name: Phone#:
Email:
I,
CONTRACTOR: Company Nam /,e: ue C i
Address: 0 (?- '" L
City: State:
Qualifier Name
State Certification or Registration # L-0 U TQ - I `1 "� ( W Certificate of Competency #:
Contact Phone#: _ ) f - oZ 7 4 :_ '7 ® A -? Email Address:
Zg3_Wj
DESIGNER: Architect/Engineer: Phone# 7 ��� -7 3
Value of Work for this Permit: $ Square/Linear Footage of Work:
Description of Work
Submittal Fee $ ✓ Permit Fee
Scanning Fee $ r_K
Radon Fee $
Notary $ inil�awng/Fiducation Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ to 0'! !-'
/J
of
PERMIT #
CONTRACTOR:
SUBMITTAL DATE:
ADDRESS: 11 I I
NAME:
RESUBMITAL DATES:
PROJECT TYPE:
ZONING f
FIRE
STRUCTURAL
IMPACT FEES
ELECTRICAL /L
HRSIDERM
PLUMBING
NOC
MECHANICAL
�L
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 EI ECT`RICAL 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must b posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of h posted notice, the
inspection will not be approved and a reinspection fee will be charged. Z�-
Owner i
The foregoing instrument was ackn wledged befo me this ZG The foregoing mstrumdnt wasgckn
day of , 20 , by ? r �kA ��� day of 20 i2, by
who i( personally knowAo me or who has produced who is(rersonally known)o me or
NOTARY
Sign:
Print:
My Commission Expires:
APPROVED BY
and who did take an oath.
COMM#
Plans Examiner
NOTARY PUBLIC:
Sign:
Print:
My Commission
before me thi
/C
has produced
Id who did take an oath.
r4aJ r ARY PUl8U0
STATE OF FLORIDA
COMM* 000917218
ExpiraS C/7/2015
Zoning
Structural Review Clerk
(Revised 3 /1212012)(Revised 07 /10107)(Revised 06 /10P2W9)(Revised 3115/09)
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THIS IS MOT BUI - DO € AY .:` RENEWAL ,
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SERVICES CORP STAT -49d
180 E 19` ST
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33010 HIALEAH
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SERVICES : CHIRP '.
WORKF-9 /S
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180 E 19 ST
HIALEAH FL 33010
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Every day we work to improve the way we do business In order to serve you better.-C
For i Ibmistion about our services, Please log orrto www:ml aridaiicense com
There you can fInd rr+ors ir►fa tlon about our divisions err tt"-regul wn=Mm the
bTgmd you, subscrft to department newdeltem and tmn mm about the
Deparhme Ws Ititiatives.
_
O fission at the Deparhrr$rd is. Uc en" Effidm*, Regulate Fairly. We
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constantly shtwe to serve you better so that you cm serve your customers.
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Thank you for doing bu*mw ° in Floride, wW congratulations on your new license!
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CERTIFICATE OF LIABILITY INSURANCE
�. v i
`"o7/20/1122"Y'
PRODUCER Florida Bankers Irnnuance
7278 SW 8 Shed
Miami, FL 33144
Phone (305)2666493 Fax (305)262-0679
EXPIRATION DATE THEREOF, THE ISSUING MUM WILL ENDEAVOR TO MAIL
THIS CERTIFICATE IS ISSUED AS A (MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED M.G. EXCELLENT SERVICES CORP.
7221 NW 174 Terr Apt #102
HIALEAH, FL 33015
INSURER A: FEDERATED NATIONAL INSURANCE
MIAMI SHORES, FL. 33138
INSURER B:
INSURER C:
:.... ;..
: :::. ::.....:........ .....: -:...
INSURER D:
INSURER E:
COVERAGES
INSURER F:
THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POLICYPERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANYCONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAYBE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAYHAVE BEEN REDUCED BYPAID CLAIMS.
wR
L RINSp
R
TYPE OF INSURANCE
POLICY NUMBER
POLICY p
EXPIRATION
POLICY I �
LRAI.r.$
A
❑
GENERAL LIABILITY
Q COMMERCIAL GENERAL LIABILITY
❑❑ CLAIMS MADE 0 OCCUR
❑
GL -05040006840-01
02109/12
02109/13
EACH OCCURRENCE
1,000.000.00
DAMAGE TO RENTED
PREMISES occwer�
100.000.00
MED EXP (Any am person)
5.000.00
PERSONAL & ADV INJURY
1,000.000.00
❑
GENERALAGGREGATE
2,000.000.00
GEML AGGREGATE LIMTTAPPLIESPER
® POLICY ❑ PROJECT ❑ LOC
PRODUCTS- COMPIOPAGG
2,000.000.00
❑
AUTOMOBILE LIABILITY
❑ ANYAUTO
❑ ALL OWNED AUTOS
❑ SCHEDULED AUTOS
❑ HIREDAUTOS
❑ NON OWNED AUTOS
❑
COMBINED SINGLE LIMN
(Ea —M -d)
BODILYINJURY
(Perperson)
BODILYINJURY
(Per- ciderd)
PROPERTYDAMAGE
(Per —lderd
❑
GARAGE LIABILITY
❑ ANYAUTO
❑
AUTO ONLY- EA ACCIDENT
OTHERTHAN EAACC
AUTO ONLY: AGG
❑
EXCESSAIMBRELLALIABILITY
❑ OCCUR ❑ CLAIMS MADE
❑ DEDUCTIBLE
❑ RETENTION $
EACH OCCURRENCE
AGGREGATE
WORKERS COMPENSATION AND
EMPLOYES LIABLITY
ANY PROPRIETOR 1 PARTNER I EXECUTIVE
OFFICER 1 MEMBER EXCLUDED?
If yes, dowbe under
SPECIAL PROVISIONS below
❑ WY�S ❑ QR H
E.L. EACH ACCIDENT
E.L. DISEASE -EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
OTHER
DEBCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
ACORD 25 (2MI08) QF WACORD CORPORATION IMW
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING MUM WILL ENDEAVOR TO MAIL
CITY OF MIAMI SHORES
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO
10050 NE 2 AVE
THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
MIAMI SHORES, FL. 33138
AUTHORIZED REPRESENTATIVE
FAX # 305- 402 -0123
:.... ;..
: :::. ::.....:........ .....: -:...
ACORD 25 (2MI08) QF WACORD CORPORATION IMW