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FW-14-1178Miami Shores Village JRIF�- Building Department JUN- ° 6 2014 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 $�`: _ ;ok Tel: (305) 795.2204 Fax: (305) 756.8972 — INSPECTION'S PHONE NUMBER: (305) 762.4949 FBC 20 to BUILDING Permit No. PERMIT APPLICATION Master Permit No. Fuj I --i —11-1 Permit Type: BUILDING ROOFING JOB ADDRESS: q z 50 N E L C) City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): !S h1� C Phone#: 3 O, ?, - % S y I Address: TI -5 D tJ 0 Lo CT City: [ A - V-, State ►� �— Zip: 13 Tenant/Ussee Name: Email: CONTRACTOR: Company // Nllame: —ES, l �n-ce 0 ''� � � - Phone#: 305 9FY q0`2#0 Address: -111 � D tic 0 h z?t_- City: r L__ Zip: -- Qualifier Name: &C, ( QtQ CO 0 e,2, Phone#: State Certification or Registration #: Certificate of Competency #: C) 6 q2 Contact Phone#: �()5 �9 Q q U Email Address: eU_44 A-0 l 5 lG �-�`®W) DESIGNER: Architect/Engineer. Phone#: M t 0t> �� Value of Work for this Permit: $ 1 Z-00 ® Square/Linear Footage of Work: Type of Work: OAddition DAlteration gNew ORepair/Replace ODemolition Description of Work: Color thru d1e: Submittal Fee "� Permit Fee $ Scanning 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. absence of su osted notice, the inspection will not be approved and a reinspection fee will be charged. The foregoing instrument was acknowledged before me this day of 20 4, by ►r2� , who is perso y known to me or who has troduced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: M Commission Ex it ' " o I PASO Y P ��MY COl�lla&101`i # FF 10 ' EXPIRES: January 2, 2018 edThralloten PubkUnd rs APPROVED BY rvH .el -1 The foregoing instrument was acknowledged before me this day of 201PP .x, b4 P lt-C JdD Cp who is pe y kno to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: 11 YN L PASCAL My Co x MIISSION # FF 050710 ' .....;Qr EXPIRES: January Z 2018 oc ak o Bonded Thru Notary Publa Undewftem Plans Examiner On 6 /(f ( (-/ zoning Structural Review Clerk (Revised 5/2/2012)(Revised 3/12/2012) XRevised 06/10/2009XRevised 3/15/09)(Revised 7/10/2007) '` ,,.`oft"' CERTIFICATE OF LIABILITY INSURANCE DATE06/05D"'YY"'� CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 08/06/14 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. I IMPORTANT: Uthe certlRcae holder Is an ADDITIONAL INSURED, the poilcy(ies) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorownent. A statement on this cergHeste doss not confer rights to the ! certi<Icate holder in lieu of such ®mss). PRODUCER CONTACT- -- Jeremiah Perar: Insurance Group Corp 8415 Sunset Drive Suite 151 FL 33173 Phone (305 275.1777 _ Fax (305} 275-1719 _ P HONE F -(30— 5)2 75-1711 . j(p3e0re5z)�27my-a1b7sO7l7u-heahoice coo M AFFORDING COVERAGE NAIL / INSURER A : Amtrust Associated Indusbies Irnurance Company 23140 INSURED Paklame Investment,ino DBA Island Fence of Dade/ Island Fence of Broward INSURER B INSURER c : INSURER 0: _ 711 E OKEECHOBEE RD INSURER e: -- HIALEAH, FL 33010 (305) 888-9 p _ CERTIFICATE NUMEIER ramnahnar im u.ecn. — THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE MURNAMED ABOVE FOR THE POLICY PERIOD - - j 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. aj I TYPE OF INSURANCE AD° POLICNUMBER POLICY'NUMBER UC USF i GENERAL LIABILITY EACH OCCURRENCE ^ I ❑ CQI�RCIALGENERAL LIABILnY i ---- Ake©E RENT $ ED PPAVISES (a ❑ SDE ❑ OCCUR �- MED BIP am perms $ ❑ i I +❑ -- I ❑ i PERSONAL a ADV rN,RIRY S i i 1 AGGREGATE i $ i GENt. AGGREGATE LIMIT APPLIES PER: I � �_ ❑ POLICY ❑ ❑LOC I 1 ......... PRODUC I � PRODUCTS-COMPIOPAGG! $ t .r>=Cr __.I- -------• — -AUTOMOBILE 1 a LIABILITY —�--�— ❑ ANYALrro I BODILYINJURY (Par'Person) i $ ALLOWNED t SCHEDULED ❑ AUTOS f.J� AUTOS ! BormLYINJURY (Per adddeni $ ! I ❑ HIREDAUTOS ❑ AWN® j ! F�PE?TYpAMA�--- $ _..- r UMBRELLALJAB OCCI i ❑ EXCESS UABCLWAS❑I I I i 'EACHOCCURRE[NCE i$ -- __ _ I AGGREGATE $ -- - i I I ❑ DED El RETENTION WORKERS COMPENSATUIN�- AND EMPLOYERS' LIABILITY YINI. — - --------- wC STATU- El-- OTw ANY PROPRIEfORIPARTMMUE)ECUTIVE I I ! A OFFICER✓ME�EXCLUDED? N/A' Y (Mandatory In NHkis S Y ? AWC1017271 i ! EL EACH ACCIDENT $ 1,000,000.00 I 10/28/2013 i 1012842014 �---� E.L. DISEASE EA EMAI 1,�, ' yyam�,, d DESCRIPTION OF OPERATION beef �— j - O $ III I — I E.L. DISEASE - POLICY LIMIT $ 1,000,000.00 i I 13ESCRPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, AddlHonsi Remarks I&hadufa, N Moro Space In rMfired) Fence Installation Company for Residential and Commercial. V GR 1 It-IIII'I I G fly W GR Miami Sham VIINW Building Department 10050 NE 2 Avenue Miami Shores, FL 33138 ACORD 28 (2010405) OF GANCE1LJJ►TK7N ! SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISION& i J AUTHORIZEDREPRESENTATti%E 0 010 ACORD CORDO N. All rights reserved. The RD name and logo are registered matt of ACORD TE "'� CERTIFICATE OF LIABILITY INSURANCE DA 06/0514rn PRODUCER Blanco Insurance Associated Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1460 E. 4th Ave. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Hialeah, FL 33010 Phone (305) 888-0524 Fax (305) 883.6218 INSURED Paldama Investment,Inc.DBA IslandFence of Dade/Islan Fence Of broward 711 E Okeechobee RD i hialeah,fl 33010 COVERAGES INSURERS AFFORDING COVERAGE NAIC # wsuRFR A. ARCH INSURANCE GROUP 30830 E: THE POLICIES OF INSURANCE LISTED 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYYYY POLICY EXPIRATION DATE MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE 1,000,000 © COMMERCIAL GENERAL LIABILITY AGL0006762-00 11/24/2013 11/24/2014 DAMAGE TO RENTED 100,000 PREMISES Ea occurrence MED EXP (Any one person) 10,000 ❑ ❑ CLAIMS MADE R1 OCCUR A ❑ PERSONAL 8 ADV INJURY 1,000,000 GENERAL AGGREGATE 2,000,000 ❑ PRODUCTS - COMP/OP AGG 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: © POLICY ❑ PROJECT ❑ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ❑ ANY AUTO (Ea accident) BODILY INJURY (Per person) ❑ ❑ ALL OWNED AUTOS ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON OWNED AUTOS BODILY INJURY (Per accident) ❑ ❑ PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ❑ ❑ ANY AUTO OTHER THAN EA ACC ❑ AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE AGGREGATE ❑ OCCUR ❑ CLAIMS MADE ❑ ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND ❑ WC STATU- ❑ OTH- EMPLOYERS' LIABILITY YIN ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? n (Mandatory in NH) TORYL TORYITS ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Fence erection contractor. CERTIFICATE HOLDER CANCELLATION Village of Miami Shores 10050 NE 2 ave Miami shores, FL 33138 ACORD 25 (2009/01) QF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL_ IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS A6fflM11D@r1NW#ASfflffAWM& MARIA ALMOLDA ©1988-2009 12:39,11-04W reserved. The ACORD name and logo are registered marks of ACORD STATE OF (FLORIDA) COUNTY OF (DADE) Miami Shores Village Building Department SURVEY AFFIDAVIT The undersigned Affiant, Stt��t ERA -2-0 , does hereby attest that 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 (Property owner) The attached survey, performed by L-cwes (yid (-�a AC., C12,50 (Name of surveyor's company) For address: C1 2, 50 IJE 1 C� Performed on 5 -at 1 q (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, Affiant s2v eth naught. 11 Property Owner Signature Property Owner,Pdnt Name . SWORN TO AND SUBSCRIBED before me this a -,Z day of KN Affiant is _personally known to me, _produced b L- as identification. EVELYN L PASCAL V - MY COMMISSION 5 FF 050710 EXPIRES: January 2 2018 Bonded ThM PUM USB ro No Notary Revised on 5/22/2009/ Revised on 6/12/09 v� a Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 WOOD FENCE DETAIL o Shadow Box 0 Bo�'Board 4x4 Post Spacing Fences <= 5' high posts spaced at Yon center maximum Fences <= 4' high posts spaced at 6" on center maximum Fence must not exceed 5' in height 4x4 pressure treated .. posts embedded 2'into concrete footing 10" diameter x 2'deep ALL wood must be pressure treated I All fasteners must be corrosion resistant L No less than two fasteners in any connection with two corrosion resistant fasteners per connection 2x4 horizontal pressure treated wood members with two corrosion resistant fasteners per connection Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 REQUIREMENTS FOR FENCE PERMIT Permit application must be accompanied by: ❑ 2 copies of your survey (not older than 7 years). ❑ If survey is older than 7 years fill out Survey Affidavit form. ❑ If owner is doing the job, owner must fill and notarize Owner Builders Disclosure form (This form must be signed and notarized in the building department only). ❑ Show the proposed size on survey including, required 40 sq ft of garbage area, location of gates if any, and height (can not exceed 5' ft height). ❑ Include wood or chain link specs form (one with each survey). ❑ $50.00 submittal fee when submitting your permit. NOTICE: ALL OTHER TYPES OF FENCES WHICH DO NOT COMPLY WITH ESPECIFICATIONS MENTIONED ABOVE, MUST PROVIDE 2 SIGNED AND SEALED ARCHITECTURAL OR ENGINEERING DESIGNED DRAWINGS, OR MIAMI DADE COUNTY PRODUCT APPROVALS. Revised on 5/22/2009 7Yo1- Z 7H t .� o� N IN O 2 t o./5otr ri2 5r/ 5 T9. 50 N �J::�� urri 'JUN ®6 -- This property described as: Lot 27, less the North 15.5 feet h and the North 30 feet of Lots 23, 24 .� 25 and 26, Block 3, ' BELVIDERE PARK, according to the Plat thereof, as recorded in Plat Book 16, Page 71 of the Public Records of Dade Couxlty, Florida.. 7,00 �Alo /,��� PROPERTY OF: Erazo, David G. and Shay H., 9250 N.E. 10th Court, Miami Shores, Florida 33138 %r)TYALIuwriatotrnotsiru Uitr A RfimanARV .SURVEY 4muTUEDRIGINALRAISEDSEALOF t 11ef�, �' Lha: the survey repro- I.ANNES AND GARCIA, INC. - FLORIDA LICENSED SURVEYOR atvD Atwrrtt » serited hereon whnicaf standardsnse�t forth by the Board the rounarnurn L I3. f# 2098 of Land Surveyors in chapw 6tG17-6 SURVEYORS -MAPPERS -1 -AND PLANNERS Florida Adoninistrative Code pursuant to Section 472-O77. fla. Statutes There are 11D RENE Alt:l)t:tiVl%'E1 F.S.M. tl 1327 ' enooa Novenm o•erfaps. easements appeari on the Plat. adw than as shown eto._ /' Office address: 3S9 alcazar,lsenue, Coral (;ables, Florida 3304 i/ ' f `v�??iz ` (305) 666-7909 1954) 523-1f643 R solor.xmvtvmAMesiwMRNo���' FUD DATE SCALE DRAWN 13Y DRWG. NO 11 yam /'c 82900 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INS'P-213720 Permit Number: FW -6-14-1178 Scheduled Inspection Date: July 29, 2014 Permit Type: Fence/Wall Inspector: Rodriguez, Jorge Inspection Type: Final Owner: ERAZ0, SHAY Work Classification: Wood Fence Job Address: 9250 NE 10 Court Miami Shores, FL Phone Number (305)756-5470 Parcel Number 1132050150250 Project: <NONE> Contractor: ISLAND FENCE OF DADE Phone: 305-888-9090 comments 39' WOOD FENCE 5' BOARD ON BOARD INSPECTOR COMMENTS False July 28, 2014 For Inspections please call: (305)762-4949 Page 7 of 40 Inspector Comments Passed Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. July 28, 2014 For Inspections please call: (305)762-4949 Page 7 of 40