FW-14-1867L� �t� Miami Shores Village RFCFTNJT
`� BuildingDepartment p Au s 204
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 l �f�•
INSPECTION'S PHONE NUMBER: (3057 762.4949
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: BUILDING
Permit No. ui ® � —I
Master Permit No.
OWNER: Name (Fee Simple Titleholder):_ _ 4 j m x 1� Z, C4 ^ poi Phone#: % 3 6 - 1-1 /7 " 0,,2.5 3
Address:61 S 0 9 /`/VQ .
City: eM , u i^ ► S ti nr Q S State: FL Zip: 3 3 f fy
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: q 5 O q A,, . /" ► 41 ' 1 / ► >rc
City: Miami Shores County: Miami Dade Zip: 3 3 6
Folio/Parcel#• 11-32o6-013- 0 7
Is the Building Historically Designated: Yes (NO) Flood Zone:
CONTRACTOR: Company Name: ,d d V & Itl e Q �Qti-c 2 65A -df 7'1rT►; a, Phone#: 796-3-21-2979
Address: KI 6 S 1 -7o 7'e/.
City:'64rg,- 1 S State: F Zip: .3318
Qualifier Name: Phone#: '% X 5-7 91 7 Y
State Certification or Registration #: Certificate of Competency #: 0!9S O D i
Contact Phone#: � 6 - �,� 1 -76 7L( Email Address: �/�NT�%/"►Og A _TA 0904 - e o�
DESIGNER: Architect/Engineer: ��/� Phone#:
Value of Work for this, Permit: $ 9 ► 61 b - o ® Square/Linear Footage of Work: i ® 6 L FT
Type of Work: ❑Address ❑Alteration 'ONew ❑Repair/Replace ❑Demolition
Description of Work: I-rs (A,(e ► H IIIykc%S-44 5#.d dn° 404,j F►A-iS�ic/
::.�P.fL c►.; .,,t- Cl) �!' �5' `tide sit C1 /0 'AK
COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by:
Submittal Fee $�J Permit Fee $ (0 Co CCF $ � � CO/CC $ 0
Scanning Fee $ 9 Radon Fee $ • DBPR $ • 00 Bond $
Notary $ Training/Education Fee $ 0 Technology Fee $ Q - �-$
Double Fee $ 0 Structural Review $
TOTAL FEE NOW DUE $ 4 S ` 2j 0
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 App ant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in go faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose pr jer� is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at thejob site
for the section which occurs seftn (7) days after the building permit is issued. In the absence of such posted notice, the
inspectio of be approved and a ref ection fee will be charged.
The foregoing instrument was ackAowledged before me this ;"
day of , 20 N by Z lie A Z• Cj ,
who is personally known to me or who h produc
#Wexti,-^ JL
at 't `? As identification and who did take an oath.
NOTARY PUBLIC:
Sign: <
Print: Ed f firlo
SANTAMARIA
My Commission Expires: NOTARY PUBLIC
STATE OF FLORIDA
CMMW EENN12
APPROVED BY
Signature
Contractor
The foreg g in ent was ackno ed bef reMthi
rY"
day of 20 �by Ar Awho is pers ally known to me or who has produced .
S as identificationyy d who did take an oath.
NOTARY PUBLIC: k , e
` ILI Plans Examiner
Structural Review
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)(rev6/4/10)
Sign:
Print:
My Commission Expi rl..;ot,�. A`'#�—, ALFONSO A. JIMENEZ
?
Notary Public - State of Florida
My Comm. Expires Jan 2, 2017
�'•%��OFF��p°
Commission # EE 862114
Zoning
Clerk
ARCBIPT NO. ]EXPIRE5
RMEWAL SEPT M,30,::20- 15
j.sccn� err v ��� 68855 Met be O►aP�Y� at,plece of bwgirtess
MIAMI Fi. 33187 Puta%W t to CourtY Code
Chapter 8A— Art. 9 & 1#i
OWNER SBC. TY OF BUSINESS PAYMENTREC6N6D
ADVANCED FENCE CONSTRUCTION LLC 196 SPECIALTY BUILDING CONTRACTOR BY TAX COLLECTOR
09BS0025Q
dliorker(s) t $15.00 07f10/2014
CREDITCARD-14-025675
This tcoai Bosins Tax Raceipt ooN amdbms paymoat of thO La08I Business Tex. The Ramis nota It
powx or a certification of dw holders qualifications, to do busiaess. Holder meet comply with OR gova i
- or nougoaa►nmeateI regulatory fairs and requirements wbicb apply to the business
Tba RECEIPT N& above mast be displayed on all commarolel vehicles -Mia ni—Dam Gods Sec 8a -VL
For more information, vhdtwv ndanldsd"w to WIedw
Municipal Contractor's Tax Receipt
Miami-Dade County, State of Florida
THIS IS NOTA BILL -DO NOT PAY M I C
CC NO: 098500250
WXVA"E RECEIPT NO. EXPIRES
FENCEWNMON LLC NEW BUSINESS
152156 SW 170 TERR 7440016 SEPTEMBER 309 2014
MIAML R- 33187 Must be displayed at place of business
Pursuant to County Code
Chapter &A'- Art. 9 & 10
OWNER TYPE OF BUSINESS
ADVANCED FENCE CONSTRUCTION SPECIALTY WILDING CONTRACTOR PAYMENT RECEIVED
LLC BY TAX COLLECTOR
175.00 10/25/2013
0221-14-000420
woFor more o_ftxesUector
8/26/2019 12:37 PM FROM: Fax Beacon Insurance Group, Inc TO: 305-756-8972 PAGE: 002 OF 002
7 ' CERTIFICATE OF LIABILITY INSURANCE
DATE
2oi4
20DUCER
BEACON INSURANCE GROUP INC
8567 Coral Way #301
Y
Miami, FL 33155
(305) 266-7776
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#
ISURED ADVANCED FENCE CONSTRUCTION, LLC
15266 SW 170 TER
MIAMI, FL 33187
INSURER A: ACCIDENT INSURANCE CO.
INSURER B: GRANADA INSURANCE CO
INSURER C:
INSURER D:
INSURER E:
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.AGGREGATE LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS.
iFi
R
DILPOLICY
INGRD
TYPE OF INSURANCE
POLICY NUMBER
EFFECTIVE
DATE MM/DD/YY
POLICY EXPIRATION
DATE MM/DD/YY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY
PREMISES (Es occurence) $ 50,000
CLAIMS MADE a OCCUR
MED EXP (Any one person) $ 1,000
A
AC5713942
11/05/13
11/05/14
&ADV INJURY $ 1,000,000
-PERSONAL
GENERAL AGGREGATE $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS -COMP/OPAGG $ 1,000f000
POLICY JECT LOC
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
$
ANYAUTO
(Eeaccident)
ALL OWNED AUTOS
X
SCHEDULED AUTOS
BOD(Per person) ILY
sonINJURY $ 10,000
B
HIRED AUTOS
FL00018642714
11/05/13
11/05/14
NON-OWNEDAUTOS
BODILY INJURY
(Pereccident) $ 20,000
PROPERTY DAMAGE
$ 10,000
(Pereccident)
GARAGE LIABILITY
AUTO ONLY- EAACCIDENT $
ANYAUTO
OTHER THAN EA'4CC $
AUTO ONLY: AGG $
EXCESSJUMBRELLA LIABILITY
EACH OCCURRENCE $
OCCUR El CLAIMSMADE
AGGREGATE $
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
TORY LIMITS I ER
E.L. EACH ACCIDENT $
ANY PROPRIETMIRARTNEROECUTNE
OFFICBWMEMBER EXCLUDED?
E.L. DISEASE - EA EMPLOYEE $
ityes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE- POLICY LIMIT Is
OTHER
SCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
CONTRACTORS LICENSE #09BS00250
C�T�C�we T� •w• w.w
MIAMI SHORES VILLAGE
10500 NE 2ND AVE
MIAMI SHORES, FL 33138
.CORD25(2001/08)
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 AGENTS OR
OACORD CORPORATION 1988
RdONVA 'jap*.fldfs.com/crreportvieweNreportveweraspx?data=kdvpginc9D7Q3gH6TER6eP1KMZ%2fSz5bXKYfBxkrekeESoPVy1v4NP...
" * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * •
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensalon law.
EFFECTIVE DATE: 8/1412014 EXPIRATION DATE 8/13/2016
PERSON: SANTAIMARIA EDUARDO
FEIN: 113769538
BUSINESS NAME AND ADDRESS:
ADVANCED FENCE CONSTRUCTION LLC
15266 SVV170TH TER
mm FL 33187
SCOPES OF BUSINESS OR TRADE
LICENSED BUILDING FENCE INSTALLATION
CONTRACTOR AND REPAIR-
DFS-F2-DWC-262 CERTIFICATE OF ELECTION TO BE IDEMPT REVISED 07-12 (WESTIONSt (860)4134809
Page 1 of 2
AUG 2 6 20%
MV
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
SURVEY AFFIDAVIT
STATE OF (FLORIDA)
COUNTY OF (DADE)
The undersigned Affiant, r' JZ'e A Z • C k- e a) ___j does hereby attest that
(Property owner)
The attached survey, performed by 7. kA— � �9 rr � / / 56,s c j % JeJ
(Name of surveyor's company)
For address: _ S 0 M a r� i vie r f'� r �.M; h �L 33/SO
Performed on Pl•/atll 3 (date of survey) is an accurate representation of the
existing conditions and locations of all structures on the property as of this date.
The purse 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
r m\vt or obtain permits for any structures which now may exist on the property which are not permitted or which
ay viAlate zoning building code regulations. The Affiant further understands that the existence of any such
tructurA may affect n inspections as applicable to this or other permits.
urthr, Affiant say eth
��► C� S
[�
Property Owner kignature Property Owner Print Name
SWORN TO ANDISUBSCRIBED before me this day of 4 v t ((
Affiant is _personally known to me, L as identification.
01- 12'131
).NOTARY PUBLIC
STATE OF FLORIDA
Comm# EE883612 Notary
Expires 3/30/2017
Revised on 5/2212009/ Revised on 6/12109
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v( Board on Board
May 2009
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
40 Post Spacing
Fences <= 5` high posts spaced at Yoncenter maximum
Fences <= 4' high posts spaced at 6° on center maximum
Fence must not exceed Yin height
4x4 pressure treated
Posts embedded Tinto
concrete footing Wr
diameter x 2'deep
ALL wood must be pressure treated
All fasteners.must be corrosion resistant
No less than -two fasteners in any connection
0000
A id is fastened•
wi,h two corroslgn • •
rUI*jVpj fasteners per
coppertion .. .
fees a ..
0000.. 000•
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• wood mein rs
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with two corrosion
resistant fasteners
per connection
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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
0000.. 0000 .Q,s&
.: .;.;;. :•sure form (This form must be signed and notarized in the building
• ••department only).
0000..
• 0• 0600
000:•• '••' d'•�w the proposed size on survey including, required 40 sq ft of garbage
0•
0000. 66 000000
0Oe.. .
' ::0;6A, location of gates if any, and height (can not exceed 5' ft height).
:::��: •:•••; ❑:.Include wood or chain link specs form (one with each survey).
• 0 000: o $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
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-218562 Permit Number: FW -8-14-1867
Scheduled Inspection Date: September 05, 2014
Inspector: Rodriguez, Jorge
Owner: LIZETH ZEPEDA CAMPOS, ENRIQUE
flAWWMwe
Job Address: 9509 N MIAMI Avenue
Miami Shores, FL 33150 -
Project: <NONE>
Contractor: ADVANCED FENCE CONSTRUCTION
euliai
comments
Permit Type: Fence/Wall
Inspection Type: Final
Work Classification: Wood Fence
Phone Number
Parcel Number 1132060130670
Phone: (786)521-7674
WOOD FENCE 5" PRIVACY STYLE BOARD ON BOARD ""'p""" r-�`" """""o"w
FINISHED SIDE FENCE OUT WITH ONE 4X5 SINGLE INSPECTOR COMMENTS False
GATE AND ONE 10X5 DBL GATE.
Passed
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Inspector C mment
'7
SEC.*
September 04, 2014 For Inspections please call: (305)762-4949 Page 14 of 26