FW-14-165Miami Sh es 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 No.
Master Permit No
FBC 20 10
Permit Type: BUILDING ROOFING
JOB ADDRESS: _10(o f o A16 ` At/.
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: l I ZZ 32 ® 0z 9 ® 3 -z®
Is the Building Historically Designated: Yes
NO
Zone:
OWNER: Name (Fee Simple Titleholder):,4*Af I/t0— 7(!-7-S Phone#: 305-41664"1 202.
Address: 2o! on Aeon 3 c? Ay.
City: " State: F'L- Zip: .53180
Tenant/Lessee Name: Phone#:
Email:�U-&T�°t%J0 QDWoa- V W.QPr- a
CONTRACTOR: Company Name: QJGj rM-Z.AQa P -"2-T G:TWeghone#: 3OS-4j4 -4.243
Address:209W AVi- 50 0 *(,9fj 41
City: I6-MA4 State: fie- Zip: 3340
Qualifier Name:. U % V, t 2- Phone#: 705- '"404.5
State Certification or
Contact Phone#:
DESIGNER: Architect/Engineer:
#: C674- ® 37 330 Certificate of Competency #:
Email Address: 7�h/®� l!����Ans -eoly
/U/A Phone#:
Value of Work for this Permit: $ ®®- Square/Linear�Fo tage of Work:
Type of Work: ❑Addition ❑Alteration ElNew JZepair/Replace ODemolition
Description of Work: PtM.A Z SXAS�" PIJ6 C, $ o club Q.JAC r—M CC- ` O a-5
�U®®Q
Color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ tU
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
0
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 subjectto attachment. Also, a rgfled copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) s after the building permit is issued In the absence of such posted notice, the
inspection will not be app ved and a reinspection ee will be charged
Signature Signature�—
ONCer or Agent Contractor
The foregoing instrument was acknowledged before me this9T The foregoing instrument was acknowledged before me this
day ot AIV 20 4, by rYa ti -W "A#00054C /, day of , 20,f4— by Bi611cZ Al2,,
who is personally known to me or who has produced who is ersonally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Si
Print: 4! 4
NOTARYP LI AI—
My Commission Expires:••�•.Gustavo Gomez
Commission # EE018480
V,)Expires:
AUG.18, 2014
nnn-nED Mr.. ATLpLN71c BONDD;G C0JXC.
APPROVED BY
�s®l`
Plans Examiner
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
as identification and who did take an oath.
NOTARY PUBLIC:
Si
Print: ---,I 6 ®A1t:2
My CommissioAMV LIC -STATE OF FLORIDA
Gustavo Gomez
Commission # EE018480
ATTG.18.2014
Zoning
Clerk
'4# br CERTIFICATE 4F LIABILITY INSURANCE
10/2 /2o 3
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.
IMPORTANT: If the Certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCERNAME:
SPECIALTY COIIMRCIAL BROKERS LLC
5835 Blue Lagoon Drive, #304
Miami IrL 33126
y Ma lin Martinez
PHONE . (305) 403-4070 1 FAC No: (305)403-4072
mmartinez®scbins;urance.com
INSURER(S) AFFORDWG COVERAGE NAIC #
INSURERA:EvanstOn Insurance COMPanY 35378
INSURED
Weintraub Ruiz Construction Corp
20900 NE 30th Avenue, #318
Aventura FL 33180
INSURERS:
INSURERC:
INSURERD:
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER:CL138103309 REVISION NUMBER:
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
D
SUBR
POLICY NUMBER
POLICY EFF
M/
POLICY EXP
MMi
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE $ 1,000,000
DAMAGE ENTED
PREMISES a occurrence $ 50,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ® OCCUR
3CO4672
/8/2013
/6/2014
MED EXP (My one person) $ 1,000
PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG $ 1,000,000
$
X POLICY PRO-- LOC
AUTOMOBILE
LIABILITY
Ea accident
BODILY INJURY (Per person) $
ANY AUTO
ALL
AUTOSUIED
BODILY NJURY (Per accident) $
PROPERTY DAMAGE $
Persocident
HIRED AUTOS NON-OVWED
AUTOS
UMBRELLA"
HCLAIM&MADE
OCCUR
EACH OCCURRENCE $
AGGREGATE $
EXCESS LIAR
DED I I RETENTION
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
NIA
I f STATU- OTH-
ORY L
E.L. EACH ACCIDENT $
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE $
f yes, describe under
"gas
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is requlreq
Certificate holder is listed as an additional insured with regards to the General Liability policy.
rrirnpiraTF Nnl nF'Ia ramrcl 19TIn1U
ACORD 25 (2010105)
INS025 (201005).01
U 1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Miami. Shores Village
ACCORDANCE WITH THE POLICY PROVISIONS.
Building Department
110050 NE 2nd Avenue
AUTHORIZEDREPRESENrATNE
Miami shores, FL 33138
Martinez/NAYLIN
ACORD 25 (2010105)
INS025 (201005).01
U 1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
CERTIFICATE OF LIABILITY INSURANCE
1/"ale
Producer: Lion Insurance Company
This CeMncate is Issued as a matter of information only and confers no
2739 U.S. Highway 19 N.
rights upon the certificate Holder. This Certtflcate does not amend, extend
Holiday, FL 34691
or alter the coverage afforded by the policies below.
1
Insurers Affording Coverage MAIC #
(727) 938-5562
Insured: South East Personnel Leasing, Inc. 8r Subsidiaries
2739 U.S. Highway 19 N.
Holiday, FL 34691
Insurer A: Lion Insurance Company 11075
Insurer B:
Insurer C:
Insurer D:
Insurer E:
Coverages
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
lin*& shown may have been reduced by paid claire.
INSR
LTR
ADDL
INSRD
Type of Insurance
Policy Number
Policy Effective
Date
Policy Expiration
Date
Limes
(MM/DD/YY)
(MM/DD/YY)
GENERAL LIABILITY
Each occurrence
$
Commercial General Liability
Claims Made 1:1 Occur
Damage to rented prendses (E4
occurrence)
Med Exp
Personal Adv Injury
General aggregate limit applies per
r.
Policy ❑Project
1:1LOC
General Aggregate
Products - Comp/Op Agg
AUTOMOBILE LIABILITY
Combined Single Limit
Any Auto
All owned Autos
Scheduled Autos
(EA Accident)
$
Bodily Injury
(Per Person)
Bodily Injury
Hired Autos
Non -Owned Autos
(Per Accident)
Property Damage
(Per Accident)
EXCESS/UMBRELLA LIABILITY
Each Occurrence
Occur ❑ Claims Made
Aggregate
Deductible
A
Workers Compensation and
WC 71949
01/01/2014
01/01/2015
X
I wcstatu-
OTH-
Employers' Liability
tory Limits
ER
E.L. Each Accident
$1,000,000
Any proprietor/partner/executive officer/member
E.L. Disease - Ea Employee
$1.000,000
excluded? NO
If Yes, describe under special provisions below.
E.L. Disease -Policy Limits
$1.000,000
Other
lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616
Descriptions of Operations/LocadonsIVehicles/Euclusions added by EndorsementfSpecial Provisions: Client ID: 84-65-810
Coverage only applies to active employee(s) of South Fast Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company":
Weintraub Ruiz Construction Corp.
Coverage only applies to injuries Incurred by South East Personnel Leasing, Inc & Subsidiaries active employee(s), while woridng in: FL
Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity.
A list of the active employee(s) leased to the Client Company can be obtained by MAng a request to (727) 937-2138 or by calling (727) 938-5562.
Project Name:
FAX(305) 756-8972. ISSUE 12-10-13 (EPy REISSUE 01-29-14 (TLD)
Benin Date 3/22/2012
CERTIFICATE HOLDER CANCELLATION
VILLAGE OF MIAMI SHORES
BLDG DEPT.
Should any of the above described policies be cancelled before the expiration date thereof, the Issuing
insurer will endeavor to mail 30 days written notes to the cartfficate holder named to the left, but failure to
do so shall Impose no obligation or liability of any kind upon the insurer, its agents or representatives.
10050 NE 2ND AVE.
MIAMI SHORES, FL 33138/
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MIAMI SHORES, FL 33138
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$URVETORSwCHAPTERP47.FLOF,,R, JaNro"fk{kTroe CODE: PURSOAHT TO 472.027, FLORIDA$TATUTES. 4 10665 SW I 90T I Street
Suite 3110
i u MIAMI, FL 3315
SIGNED
FOR PHONE:(305)7 EJECT TO COMPLJANtf LL
A T5L 9:F=SA au+c r ` 1
S�OOTTr`'� P.S.M. ND. 5101 FAX #:(305) 86 190
UHiB V�AfJO 1MTHdwr 1� s °E ,• l�,p 111E ORIGINAL "SO SEAL OCATED ELECTRONIC
A uCEHSED�� Ro R 1 LB #8463 — —
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120652
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'
Suffix:
L
Surveyor's Legend
9111/2009
Flood Zone:
AE
Base Flood Elevation:
8.0
Date of Field Work
6/13/2013
Date of Completion:
6/1412013
PROPERTY UNE
STRUCTURE
B.R.
BEA RING REFERENCE
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FOUND IRON PIPE /
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CENTRAL ANGLE OR DELTA
U.P.
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Property Address:
10659 N.E. 11 AVENUE
MIAMI SHORES, FL 33138
Flood Information:
Community Number.
120652
Panel Number.
1208600306
Suffix:
L
Date of Firm Index:
9111/2009
Flood Zone:
AE
Base Flood Elevation:
8.0
Date of Field Work
6/13/2013
Date of Completion:
6/1412013
1. The Legal Description used to perform this survey was supplied by others.
This survey does not determine or is not to imply ownership.
2. This survey only shows above ground improvements. Underground
utilities, footings, or encroachments are not located on this survey map.
3. If there is a septic tank, well, or drain field on this survey, the location of
such items was shown to us by others and the information was not verified.
4. Examination of the abstract of title will have to be made to determine
recorded instruments, if any, effect this property. The lands shown herein were
not abstracted for easement or other recorded encumbrances not shown on 11
the plat.
5. Wall ties are done to the face of the wail.
6. Fence ownership is not determined.
7. Bearings referenced to tine noted B.R.
a. Dimensions shown are platted and measured unless otherwise shown.
9. No identification found on property comers unless noted.
10. Not valid unless sealed with the signing surveyors embossed seal.
It. Boundary survey means a drawing and/or graphic representation of the
survey work performed in the field, could be drawn at a shown scale and/or nota
to scale.
12. Elevations if shown are based upon NGVD 1929 unless otherwise noted. t
13. This is a BOUNDARY SURVEY unless otherwise noted.
14. This survey is exclusive for the use of the parties to whom it is certified.
The certifications do not extend to any unnamed parties.
Legal Description:
LOT 4, BLOCK 3, OF SUBDIVISION MIAMI SHORES ESTATES, ACCORDING TO THE PLAT THEREOF AS RECORDED
IN PLAT BOOK 47, PAGE 58, OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA
s
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ABILITY COMPANY; ALEX D. SIRULNIK, P.A. ; FIDELITY
TIONAL TITLE INSURANCE COMPANY; ; . Its'successors
ilor assigns as their interest may appear.
M.E. LAMB SURVEYING, INCA !
10665 SW 190TH Street, Suite 3110 MIAMI, FL 33157 T
PHONE:(305) 740-3319 FAX #:(305) 669-3190 LB # 6463
Tip
WAELANDSERVICES.CO
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Survey:A-40187 Client File M CL 13 070 Page 2 of 2 Not valid without all pages.
o Shadow Box
o Vertical Picket
o Board on Board
May 2009
Miami shores Village
Building Department
WOOD FENCE DETAIL
4x4 Post Spacing
Fences <= 5' high posts spaced at Ton center maximum
Fences <= 4' high posts spaced at 6" on center maximum
Fence must not exceed 5' in height
4x4 pressure treated ,
posts embedded Y 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
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
1x pickets fastened
with two orrosion
resistant fasteners per
connection
2x4 horizontal
pressure treated
wood members ta�
with two corros� ion
resistant fasteners
per connection