DS-13-499Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number. INSP-187290 Permit Number: DS -3-13-499
Scheduled Inspection Date: April 01, 2014
Inspector: Rodriguez, Jorge
Owner: GLINN, MacDAM & DENISE
Job Address: 1201 NE 102 Street
Miami Shores, FL 33138 -
Project: <NONE>
Contractor: ARTISTIC CONCRETE GROUP INC
Building Department Comments
CONCRETE DRIVEWAY
Permit Type: Driveways/Sidewalks/Slabs
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number
1132050250160
Phone: (305)888-9095
Infractio Passed Comments
INSPECTOR COMMENTS False
March 31, 2014 For Inspections please call: (305)762-4949 Page 1 of 60
Inspector Comments
Passed 5D
Failed
Correction
Needed ❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
March 31, 2014 For Inspections please call: (305)762-4949 Page 1 of 60
Miami Shores Village 1 -
Building Department MAR 5 014
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fag: (305) 756.8972 BY:
INSPECTION'S PHONE NUMBER: (305) 762.4949
a�
FBC 20 C
BUILDING Permit No.
PERMIT APPLICATION Master Permit Noy151 j — .9 i
Permit Type: PLUMBING
JOB ADDRESS: 1-3 O 1 rU F 0 SA
City: Miami Shores County: Miami Dade Zip: I _
Folio/Parcel#:
Is the Building Historically Designated: Yes NO Flood Zone: o
OWNER: Name (Fee Simple Titleholder):: �r rz � �s ` � � Phone#: _!� t a. g _01 90 W
Address: k ) d J. $-)� t (3;)
State: ��� Zip: , 13 _
Tenant/Lessee Name: Phone#:
Email: PO o ;" G Pin- A(,- la1 �c ,
CONTRACTOR: Company Name: Phone#:
Address:
City -State: Zip:
Qualifier Name: Phone#: _
State Certification or Registration #:
Contact Phone#: Email Address:
Certificate of Competency #:
DESIGNER Architect/Engineer. Phone#:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: DAddress OAlteration ONew ORepairMeplace ODemolition
Description of Work: - , e ✓tee e^ ALk CA
-
��,�,kxu�,��u,�x�,�,���,��,�,���x�����,�,��,r��u��,Fees,��,u,���,�,����,��,��,u�,��,���,����,�,���,��,���,�,u���,���
Submittal Fee $ Permit Fee $ ' CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Notary $ TraininglEducation Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ VD
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 w ich occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be moved andinspection fee will be charged.
Signature
t Owner or Agent
The foregoing instrument was acknowledged before me this
day ofd - , 20N bv'MACAVA-'l
who is personally known to me or who has produced CLA, _r:;>
As identification�agnd,'�i did take an oath.
NOTARY PUBLIC: ;`������►f u '�,,,
- 0
Sign: _
Print:
E� 1 N
My Commission Expires: ......
OF
APPROVED BY
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of .20 by
who is personally known to me or who has produced
Plans Examiner
Structural Review
(Revised3/12/2012XRevised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Zoning
Clerk
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: L V k 1- DATE: 3 L
ADDRESS:y \ tj `G 1 u SA- tA,
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, RS 489.103(7).
And I have read and understood the following disclosure statement, which entities me to work.as my own contractor, I further
understand that I as the owner must appear in person to complete all applications.
State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The
exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must
supervise the construction yourself. You may build or improve a one -family or two-family residence. You may also build or improve a
commercial building at a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and
occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the
construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may
not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have
licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not
licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.CA and with-
holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all
applicable laws, ordinances, buildings codes and zoning regulations.
Please read and initial each paragraph.
1. 1 understand that state law requires construction to be done by a licensed contractor and have applied for an owner -builder
permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my own
contractor with certain restrictions even though I do not have a license. r
Initial 4t���
2. 1 understand that building permits are not required to be signed by a property owner unless he or she,. is responsi Is lo the
construction and is not hiring a licensed contractor to assume responsibility.
Initial
3. 1 understand that, as an owner builder, I am the responsible party of record on a permit I understand that I may protect myself
from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead my own
name. I also understand that the contractor is required by law to be licensed in Florida and to list his or name?
u is n
permits and contracts.
Initial
4. 1 understand that I may build or improve a one family or two-family residence or a fans outbuilding. I may al build or improve
a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may
not be built or substantially improved for sale or lease. If a building or residence that I have built
myself is sold or leased within 1 year after the construction is complete, the law will presume ti
improved itfor sale or lease, which violates the exemption.
5. 'I understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons worsting on my buil ' or
residence. it is my responsibility to ensure that the persons whom I employ have the license required by law a by u or
municipal ordinance.
In
T. 1 understand that it is frequent practices of unlicensed persons to have the properly owner obtain an owner -builder permit that
erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner -builder, may be held
liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees ile
working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully actin as a
owner -builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
Initial
B. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is n licenses to
perform the work being done. Any person working on my building who is not licensed must work under my direct supervision
and must be employed by me, which means that I must comply with laws requiring the withholding of federal income t and
social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compen 'on r
the employee. I understand that my failure to follow these may subject to serious financial risk.
Initial
9. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable
laws and requirement that govern owner -builders as well as employers. I also understand that the
Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations.
Inti Oi
10. 1 understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the
United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may co
Florida Construction Industry Licensing Board at 850.487.1395 or h J/www.m oddalicense.com/db r/ ro/cilbfind
Initial
11. 1 am aware of, and consent to; an owner -builder building permit applied for in my name and understands that I a the pa
legally and "financially responsible for the proposed construction activity at the following address:
15-A ( IV L %Q�- %t ACL --% PC ? -� 3X
Initial
12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the inform n at l
have provided on this disclosure.
Initial
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does of have a
license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to
assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to
understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may
be held liable for damages. If you obtain an owner -builder permit and wish to hire a licensed contractor, you will be responsible for
verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage.
Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and
returned to the local permitting agency responsible for issuing the permit A copy of the property owner's driver license, the
notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when
the permit is issued.
Was acknowledged before me this _day of Mcn,.. , 20-_
Bye who was Dem Wally known to me or who has
Produced there License or as identification.
Miami Shores Village
Building Department Mir a'
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
FBC ML-"
Permit No.
PERMIT APPLICATION
Permit Type:
JOB ADDRESS:
BUILDING
Master Permit Nolpsj j — 9,1-2]
ROOFING
City: Miami Shores County: Miami Dade Zip: I
Folio/Parcel#:
Is the Building Historically Designated: Yes
NO Flood Zone:
OWNER: Name (Fee Simple
TenanvLessee Name:
Email:
CONTRACTOR: Company Name:\ Phone#: "SOK - F599 —90ci
Address -,G9 3 Ae_
City: State: F L Zip: 33 16 L
Qualifier Name: Phone#: r1g,K- ?,n 6 - g r 6�_
State Certification or Registration #: Certifi ate of Competenc #-
Contact Phone#: QS'A -306 -- a- 6> _Email Address: Oks� 1 3w�i�ez
DESIGNER: Architect/Engineer- Phone#:
ev
Value of Work for this Permit: $ _� a Square/Linear Footage of Work:
Type of Work: ❑Addition ❑Altera 'on ❑New ❑Repair/Replace ❑Demolition
Description of Work: (10'tA 1'� a.
Submittal Fee $5�0 ' C4421 Permit Fee $
Scanning Fee $ Radon Fee $
Notary
O.a
CCF $ CO/CC $
DBPR $ Bond
Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
c, Uv
TAL FEE14OW DUE $
1 0 WAV (Marig
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 appAved and a reinspection fee will be charged.
Owner or Agent
The foregoing instrament was ac o edged before me this rm,
day of 01 r , 0 L3, by Q` G G
who is personally known to me or who has produced
Signature
Contractor
The fore o• g insent was acknowledge before me this
day of Ck , 20 , byL ,
who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
a
Sign:.('X A IL �-) —ft–1 —Sign:
Prin . ARIA DE BRUNS P
Pue<% - otar Public - State o ++ ;+•,,, MARIA DE BRUZOS
My _
M. ; npires Aug 20, 2013 M _ J�®n #OVN tic - State of Florida
Commission # DD 918432 ' • ; My Comm. expires Aug 20, 2013
OF,, � Bonded Through National No As4n•
'',FF L�:� Commission # DD 918432
o led 4"ie®�
APPROVED BY ��/ Plans Examiner 1,2, � Zoning
Structural Review Clerk
(Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009XRevised 3/15/09)(Revised 7/10/2007)
STATE OF (FLORIDA)
COUNTY OF (DADE)
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
SURVEY AFFIDAVIT
The undersigned Affiant, a _ Dom 6-t 11*oes hereby attest that
(Property owner)�j
The attached survey, performed by 15ve20Lvr� d-- r Vert,, 5
(Name of surveyor's company)
For address: 12-01 102-5-f
Performed on /0 o '2—(date of survey) is an accurate representation of the
existing conditions and ocations 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.
Furth ant say
AtCA®A,, V1
Pro pe Owner Signature Property Owner Print Name
SWORN TO AND SUBSCRIBED before me this 6i Ta day of C4 7,0 I �j
Affiant is _Az rsonally known to me, _produced . as identification.
Revised on 5/22/2009/ Revised on 6/12/09
PL;�
MARIA DE BRUZOS
Notary Public - State of Florida
=a2°Rr
. �; •=
My Comm. Expires Aug 20, 2013,
Commission # DD 918432
Bonded Through National Notary Asan.
Notary
PERMIT # L l..
CONTRACTOR: k,,T I ✓-T, C-, C Ac
SUBMITTAL DATE: ' 1 Z, I
I s
ADDRESS: U,S-i
NAME: �-1
RESUBMITAL DATES:
PROJECT TYPE:
FIRE
STRUCTURAL
IMPACT FEES
ELECTRICAL
HRS/DERM
PLUMBING
NOC
MECHANICAL
g
Miami Shores Village
10050 Northeast Second Avenue
Miami Shores, Florida 33138-2382
Telephone: (305) 795-2207
Fax: (305) 756-8972
www.miamishoresvillage.com
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
WHEREAS, �&,. 0&1-'\ G L-1 INv-\ , hereinafter referred to as the Owner of the following
(owner)
described property: X20 ` u is ! y Z'
Legal description/folio#:
Lot a
Tax Folio #:
Requests permission to install:
Asphalt, concre brick pavers
❑ Landscaping
❑ Other
Block (� Subdivision &ill
Within the public road right of way of N6- 10'2- r—r_r
(address)
IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows:
1. To maintain and repair, when necessary, the above-mentioned item(s) installed within the dedicated right of way.
If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said items within
public right of way including restoration of street by reason of the Owner's failure to do so, such expense shall be
paid by the Owner or shall constitute a lien against the above described property until paid.
2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any
and all liability, which may rise by virtue of permitting the installation of these items within the public right of way.
3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 -days notice
by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s) to be
removed and a lien being placed on the property and/or assessed against the Owner for all costs incurred in the
removal and disposal of the item(s).
4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land and
shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until such time as
this obligations has been canceled by an affidavit filed in the Public Records of Dade County, Florida by the
Village Manager of Miami Shores Village (or his fully authorized representative).
SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this -T day of l4, X eLa
SIGNED, SEALED, AND DELIVERED in the presence of:
70' -'
MARIA DE BRUZOS
tary Public - State of Florida
Comm. Expires Aug 20, 2013ommission # DD 918432
ded Through National Notary As n.
A 29COY`1. 191 COPY uSW W II BE PO SM ON TIU JOB 1711E Al TOM OF rll{W INSPECTION
PST NO. TAX FOLIO NO.
STATE OF FLORIDA
COUNTY OF RADE
TIRE UNDERSIGNED hereby gives notice that improvements will be made to
certain real progeny, and in accordance with Chapter 713, Florida Statutes,
the following information is provided in this Notice of Commencement:
1. Legal description of property and street
address: L,-(/0 L., r -
LA I K. 1 e / 4i LJ1'5 dl� 1 //i J i U-45_'
2. Description of improvement: Cwy%,C4 ' �rf^
!
CFH-7013RO2 11736
OR 131: 28537 Ps 44031 QP9 )
RECORDED 03/1912013 15:01:45
HARVEY RUVINY CLERK OF COURT �.
MIAMI-DADE COUNTYr FLORIDA {:
LAST PACE
3
:�
3. Owner (s) name and address: ",& G -A- 0 AV. --L (51 C • L vl V1• i 'Lo L V015- io
�tpwt�t S5 �' "��1�8 •
Interest in property:
Name and address of fee simple titleholder.•�/+-
4. Contractor's name and address: � or L ri [ -�'L�� ��► �''-'� - S^' '2-
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond: $
6. sender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other docmnents may be served as provided by Section 713.13
(1) (a) 7., Flod& statutes:
Name and address:
81n addition to himself, Owner designates the following person (s) to receive a copy of the L Tenor's Notice as provided in Section 713.13 (1)
(b) 7., Florida Statutes:
Name and address:
9. Ercp. ' date of this Notice of Commencement (the date is 1 year from the date of recording unless a different date is sped)
Siof Owner
Print 's Name H A, LSD A,4 +t 6 f\t 5 6 W Vt �i . Prepared by:
Sworn to and subscribed bef day of _, 20
No Address:
°Q` B` • No ry Public - r
:, � $ � •'s Aua 20.2013
as Qc' Ission # DD 918432
'e,un8 f I HERBY.
jfip'p� FIV
2013 *rM 1131 Ni D R ER CmtrKtcr Uc Sect 785 3152454
-
-MM COEMW
VMLIC HORKS DEBUTMM
'60ST8
1La fast IST 8TZMrj 15310
MMT, n 33188
14081 375-2705
OODITRA=M'8 SU$n99'diRTI8.L[*AT6 00' COMTMV
law= gfarvr®sr+.. Dar 200lf
•P
c>
4
•
1S{XB XI '80 Mm= TE&T ARTISTIC COliCR = gnaw. =a.
oarro al, CCRXPICATB NO.i 80900060
TR=l
CBF=uxchm W&UWapmr � os/ao/ao17
FkV= MW TM COG® RiS00I1t MMM 00' IdLVC-DAC® COMM, AV P=Wob,
29 C8ATIMM A9 A CUMMOR >l MM 80I7AWJM CATHOMY18) o
0001
W= ALL Van TO Be wo =a =I' 91WERVx8. 111 =WIT= am CMTRDL
Or QGALIr'lMw AMT 339 B.B.t;. - -7907
AL170Z AW, RWRM GRI001 OR TRUGM OV TUN M)RT=BICATB I6 HJEO MITBD.
98C&!@1�ARY » 83'Ai1C'1'7COt9 'IA11G8B amwrr= 8Q1RD
ARri=c cmumm =our, Inc.
6.M48 ?1K 51 TEMME
nam sL 31MF
pBD FM TUA CMTMCATB VJ P= O8 MC8@8 NO. T80311a19938
r• •-
M
GTOT INkV Board
i
Bumes3 CFRTIFlCA7E OF COMPETENCY
E0900ON
TISTIC ¢ONCRECE GROUP; INC.
IR1uE H�GrOn rd '
1ameMBleraeebPlR@t�BdinKnl.�l�rsOatF•NNes�lede�$uillj!
i
QUALIFYING TRADE 3)
0001 GENERAL ENGINEERING
f
IL
J
t
C
C� Po�vY
i
o
ao
as
•
C -
O
V
�•
V
ri
M
O
%O
M
O
CV
CSS
a
GTOT INkV Board
i
Bumes3 CFRTIFlCA7E OF COMPETENCY
E0900ON
TISTIC ¢ONCRECE GROUP; INC.
IR1uE H�GrOn rd '
1ameMBleraeebPlR@t�BdinKnl.�l�rsOatF•NNes�lede�$uillj!
i
QUALIFYING TRADE 3)
0001 GENERAL ENGINEERING
f
IL
J
t
C
C� Po�vY
i
Apr. 19. 2013 6: 03PM
Artistic concrete group
g, eqn.:. PAID
ly0.d G an„at'�h:•;ii•`• 1"al FL
12101
y�g Fg 1t0.28i
CEtP<rw
50-67 06064 CC NOAeI E(149000 PAY
SU60NE58 NAME I LOCATION PMEIPT H=M MAY DO
ARTISTIC CONCRETE 9ROUP INC allwO AsACONTRA R
6945 NW 53 TERR AS SPMM HSAWN.
OWNER +ARTISTIC CONCRETE GROUP INC
DENERAi. ENGINEERING CONTRACTOR
A LIST OF NON -PARTICIPATING
MUNICIPALITIES
Reampl l er m yet DO NOT PUMARD
ay.>newdw ARTISTIC CONCRETE GROUP INC
a»ewadcW%bo ROBERTO TONSO PRRS
6949 NW 53 TERR
MIAMI FL 33166
3'fx2
UZZ54520001
000300.00
Is.
1. L
ate:4/22/2013 Time:9:50 AM To: 8 3057568972 305-828-2776 Page:002
a� 1'® CERTIFICATE ®F LIABILITY INSURANCE
DATE (MMIDDNYYY)
/22/2 13
4/22/2013
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 pollcy(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).
PRODUCER
Keen Battle Mead & Cully
7850 Northwest 146th StreetAnno
Suite 200
Miami Lakes FL 33016
NAMEAcT : Claudia Reutlinger
PHONE . (3055) 558-1101 FAC No: (305)822-4722
144 IP
oreutlinger@kbmao.00m
INSU S AFFORDING COVERAGE NAIC 0
INSURERA Essex Insurance COnPanV
INSURED
Artistic Concrete Group Inc.
6945 NN 53rd Terrace
Miami rL 33166
INSURERS:
INSURER C:
INSURERD:
INSURER E :
INSURERF:
C'AVFRaPFS C'FRTIFIC6TF NHMRFR13-14 GL RFVISInN NLIMRFR
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 PAI�DI CLAIMS.
LTR
TYPE OF INSURANCE
POLICY NUMBER
PM/LDID F
WPM0 Y EXP
fD
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE Ex -J OCCUR
3DG8746
/20/2013
/20/2014
EACH OCCURRENCE $ 1,000,000
DAMAGE 10 RENTE17-
$ 100,000
MED EXP Any one person) $ 5,000
PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN L AGGREGATE LIMIT APPLIES PER:
X POLICY PRO LOC
PRODUCTS - COMP/OP AGG $ 1,000,000
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
COMBINED SINGLE LIMIT
Ea accident)
BODILY INJURY (Per person) $
BODILY INJURY (Per accidenq $
PROPERTY DAMAG $
UMBRELLA LIAR
EXCESS LIAR
OCCUR
CLAIMS -MADE
EACH OCCURRENCE $
AGGREGATE $
DED I I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITYMrs
ANY PROPRIETOR/PARTNER/EXECUTIVE Y Y N
OFFICER/MONBER EXCLUDED?
(Mandatory in NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
1 101&1-1
EL. EACH ACCIDENT $
EL. DISEASE - EA EMPLOY $
El. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS Y LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, U more space is required)
Blanket Additional Insured applies. Blanket Waiver of Subrogation applies.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE MILL BE DELIVERED IN
City of Miami shores ACCORDANCE WITH THE POLICY PROVISIONS.
Building Department
10050 NL 2 Avenue AUTHORIZED REPRESENTATIVE
Miami shores villag, 8'L 33138
lAlex Perez/CLAUDI-��`—"`
25 (2010/05) O 1988-2010 ACORD CORPORATION. All rights reserved.
rrvQuIED 17010115101 Tho aRnpn ramp and Inns aro ran)a4orprl marks of ar npn
I111halon:
To protect, promote & Improve the heaRli
of all people in Florida through Integrated
state, county & community efforts.
Vision: To be the Healthiest State In the Nation
April 15, 2013
(Artistic Concrete Group)
6945 NW 53 Terrace
Miami, FL 33175
RE: Contingency Letter
Application Document No: AP1102782
Centrax Permit Number: 13 -SC -1464200
OSTDS Number:
1201 NE 102 St
Miami, FL 33138
Lot:8 Block: 186 Subdivision: Bay Breeze
Dear Applicant:
Rick Scott
Governor
John H. Armstrong, MD, FACS
State Surgeon General & Secretary
This will acknowledge receipt of an application dated 04/01/2013 for a permit to use an
existing onsite sewage treatment and disposal system located on the above referenced
property.
From a review of your completed application, it has been determined your existing system is
adequate for the proposed use.
This permit is granted for the construction of a 10' and a 16' driveway. There will be no
increase in sewage flow or characteristics and no impact on the unobstructed area.
*********************APPROVED*********************
If you have any questions on this matter, please call our office at (786) 315-4444.
Sincerely,
A'--ivo -
Astrid Edwards, Engineer Supervisor III
Enclosures
cc:
Florida Department of Health www.FloridasHealth.com
In DADE COUNTY TWITTER:HealthyFLA
1725 NW 167 St, Opa Locka, FL 33056 FACEBOOK:FLDepartmentofHealth
PHONE: (305) 623-3500. FAX: (305) 623-3645 1 YOUTUBE: ildoh
Miami shores Village
Building Department
RECEIPT
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
PERMIT #: p DATE:
I, He -v%"
contractor
Owner
zo Architect
Picked up 2 sets of plans and (other)
Address:
From the building department on this date in order to have corrections done to plans
And/or get County stamps. I understand that the plans need to be brought back to Miami
Shores Village Building Department to continue permitting process.
Acknowledged by:
PERMIT CLERK INITIAL:
RESUBMITTED DATE:
r
PERMIT CLERK INITIAL:
03/19/2013 15:48 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES
TRANSMISSION OK
TX/RX NO
RECIPIENT ADDRESS
DESTINATION ID
ST. TIME
TIME USE
PAGES SENT
RESULT
TX REPORT ***
3363
83058884366
03/19 15:47
00'17
1
OK
Miami%Qohores
Building Department
10050 N.E.2nd Avenue
-Kanfl Shores, Florida 33138
Tol: (30 5) 795.2204
Foix: (306.) 756.8972
March 19, 2013
Permit No: D$13-499
Building Critique
'I. Provide HRS/DOH approval
Planning Critique
1. 10 FT CIRCULAR DRIVE 2 FT FLARES MAX, 5 FT FLARES UNDER NEW
CODE IF AND WHEN APPROVED.
[a 001
**
2. DRIVEWAY 16 FT WIDE WITH 2 FT FLARES OR 5 FT FLARES UNDER NEW
CODE IF AND WHEN APPROVED.
P
ARTISTIC
CONCRETE GROUP
6945 NW 53 Terrace Miami, FI 33166
Dade. 345-888-9095 • Broward: 954-962-0243
Fax: 305-888-4366 • Toll Free: 1-888-326-9331
www "S icconcrete roup.com
PROPOSAL a CONTOXCT
ijlsa
CD
PROPOSAL EMITTED HOME PHONE DATE
ADDRESS 1 Zp t N � WORK PHONE CELL PHONE
CqvAI& STATE ZIP CODE JOB LOCATION
Ltt
TOTAL PRICE $,�,3
DEPOSIT $ I Cot
BALANCE $ --R� L
Balance $ to be paid as follows:
50% to Start 40% to Pour 10% to Seal
r r. em
* SEE Wlf�7,E FOR TERMS & CONDITIONS
We have goin c act and accept the same In the event thatthedeposft is given in a alit card payment and the buyer fres trot made payment
within 72 hours of jb completion the full baler= will be applied to said credit card without further notice.
on the terst
Purchaser Approved by
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RECEIPT
PERMIT* DATE: 2�
I,
Contractor
• Owner
• Architect
Picked4�9�� er� •
Address: �f n
From the building department on this date in order to have corrections done to plans
And/or get County stamps. I understand that the plans need to be brought back to Miami
Shores Village Building Department to continue permitting process.
Acknowledged by:
PERMIT CLERK INITIAL:
RESUBMITTED DATE: l�
PERMIT CLERK INITIAL:
Miami sh*ores"Vill'age
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
March 19, 2013
Permit No: DS13-499
Building Critiaue
1. Provide HRS/DOH approval
Planning Critique
1. 10 FT CIRCULAR DRIVE 2 FT FLARES MAX, 5 FT FLARES UNDER NEW
CODE IF AND WHEN APPROVED.
2. DRIVEWAY 16 FT WIDE WITH 2 FT FLARES OR 5 FT FLARES UNDER NEW
CODE IF AND WHEN APPROVED.
Norman Bruhn CBO
305-762-4859
Plan review is not complete, when all items above are corrected, we will do a complete
plan review.
If any sheets are voided, remove them from the plans and replace with new revised
sheets and include one set of voided sheets in the re -submittal drawings.
�t
%f'nugm
31
. t
Miami
Shores Villa
e
APPROVED
BY
DATE
ZONING D
-
3
BLDGDIEPT
SUBJE IDC
MPIJONCE W H AL1 FEUE
STA ANv C:r I,JN t t rILLiS AND REGU PION /
lAAR 1 2 T-
c
MESH IZLSIAF.
r ---------- -----------T
R I
I R
W CE=,v
T I L
I �
I
PAN
EJB$T. EM
AM
2
/ LOCATION CF SOL PRO S Y
i P �
W
/
W Lue
Y OA ALL LPES
W 667 SF DRAPPELD W/ WA 56
W W 66-9 W X 46-V LF. r
x v VE N ALVE BOX
g NEW C0NIIE=C N r W Tm N(ETE2 A
-•----- � ----- 1 --- 17 JATI
v I
T H D �GROLTD ERI�ACE
I
BEV.9A6' NGVD FNVSHED GRADE
BACKFU
------------------J CES' LM DEPTI6
SECTION HEV. 8.96• NWD TOP CF DP
' AAAA+++0+++++++
+ + + + + + + + + + +
It A®V37ALAGG AAAA++++++++++++++i
58' MSV DiPTI-0+ + + + + + + + + + + +HAr RIES' NGY:1 B0T7ON OF DEP
GAL. 750 900 1080 I M?R gpnONS�ACg 0
W -6 - T - Ir 4'- Y. DRAQNF®D.
L7-2 S- -S -O
H - 4•-
994 4'-10• -IO" d -IO -
T 3'
OfMND S -O' d -O'
Tom. 6 X 610/10
CANG 3000 PSL 2B DAY VET SEASON WATER TABLE
GOISID
NOM LRNBATISPACTORY
NFT.LlE N Y INVERT BHN.L Be r MN/ T MAX. ABOVE fffLLENT RNVHRT '
MYVAT1Od SOILMATER TABLE SITE EVALUATION CRITERIA
SEPTIC TANK DETAIL MIR
MTB.
I
•4
0
L THE CONTRACTOR BySLL ftUNGi ALL LABOR. MATERIALS AND EGLMO Jf
NARY FOR THE MA LAATIOV 0: A MJFLETE P MING SYSTEM N
ACCORDANCE WISH TRESS DgAWIN85 TI£'APPLICASIE EDITION CF TINE
FLORIDA S ILDING CODE 20D ALL MER APPLICABLE STATE. COLNTY
AM LOCAL CODES AM ORDINANDES,
2 T14E CONTRACTOR SHALL. PAY ALL LOTION F83. ALL OW, aP
PEMM AAD ALL OTH COM @.D OEMAL TO RHE COMPLETION AND
TEPP CP 11-M WORK LPIN FWAL ACCEPTANCE A CERF=TE
FROM TIE LOCAL DWECTICN AUhCRITY 84ALL BE FLS TO THE .
MIST.
9 ALL IdMMALS A O IVIS S ALL BE SBM. CF LIS MANPACTLRER
AHD CP GOOD QUALM OF RESPECTIVE JOND AM GLADE. AHD M JST BE
FL SIMS) SO AS TO PREVENT Atm DELAY N THE PROGRESS CF RHE
WORK ALL WORK 7H� SHALL ES PERFORMED N A WCRKMAN-
LUE MANNER BY SIFFlCENT KAISER OF BMW WO1L01
4 TFE CONTRACTOR SHWLL VOT THE SITE AM RLll®q ALL PL IMAM VT LITUTT
DRAWINGS TO FAMLLAR12E HMSH.F VATH THE LOCATION OF ALL PXISTNG
ANDIOR PRS LIMJTY STLB CUM PPNB L MMNEVT. ETC, AND
MAKE DIE ALLO� FOR ANY CONDITION AFFBCTND HM WOOL.
5 ALL LADI GMM SANITARY E STORM DRARJH2 PIPNIG AM WTTINDB
SHALL BE PVC -DVN (ASIM 0-2%2/D-3034.
A. ALL ABOVE G20Um SANTARY E STORM DRARIM SMAIQ34 E VENT PIPES
AM PITTING SHALL. IE PVC -M (AM D96671D-3000
7. PROVIDE C LEAMUf (WITH CHROME FATED WALL OR FLOOR ACCESS FRAME
AM COVERS AS REMSM AT THE BASE CP ALL WASTE AND/OR VENT STACKS
PROVIDE ARCH PANS E LEADS FLABHAG FOR ALL SANITARY SYSTHO VENDS
8. ALL HOPMONTAL WASTE PPA9 SHALL BE MOPPED AT VB PER FOOT, LN.ESS
071- sm No
9. CONTRACTOR SHAM. VERIFY SLOPE AM DEPMS AM LOCATIONS
O' COMELMON POINTS TO EXISTING PRES.SLJRE OR DRAINAGE LPE6
BEFORE STARTING WORK
ON SrM caMeM SYSTEM I AUC R eTM AS PM 64E6o08 (20� mmaAn
DATA) 3 BEDROOMS Wr2385D SF CF CONDITION SPADE
TBI - MOD SP OF BLOB AREA 406 SPD. EiM70 SBNAGE FLOW
!3�'IIf. TANKS AS PHR TAKE ND B f�TIL` TANK ALD PULP TMMC CAPA(9TYI
301-400 GM IC%O GAN. OAP. SEPTIC TANG 6IECAGRED.
ORAffMD AS P@ TABLP N O M
BED SYSTEMS CA MAX SEWAGE I OANDING RATE
t3TIAM.7ED SEWAGE PAW W fGPDI • AAM . 667 SF OF MAN21ELD AM
RATE ABBOL9ON N GPDISF/DAY OA
WOOA Sr RESERVE U40UTZJClM AIREA ARE MTD.
ELY PL U BIiNCd SYMBOL L.E030
SYMBOL DESCRITION
SAMMY SMiM LINE
—181 CLEANOUT TO GRADE
p—'[��',�' • LAT 81izb� X 2500 0P0
UM SPY
X UM GAD
✓ �1vV W- • h Jt, l/� •670.4 CPD
�0, ^ ^ �,� l , Y�•"—
PROPERTIES
NO PERTNEAND
TME
OIJVIAT MAY Vf
if !Y PROP6Rf� AND AO?()63 TFE SfRt$S THAT MAY
1 AFFECT hE ONSITE BEN TIREATNEU NO
DISPOSAL SYSTEM NSTAU ATX N
LEGAL DESCRIPTMN
_ / !// !`'tel V `'�`� - • �' O LOT 8. IM OCK M6 CF BAY BR!$
PLATE BOOK Cl�NTPAOEPi
PL
i� �
Tb Fje 4t1 49k� Cie
w
A?.Q:�';,- Nr••;'
' i N0.60T86 5�
ALL
&M -Ma BLatene, PE,
LEER 6SAP
UNULTBIP UNGINEEM
1660780-t'@GL4WIGLL.
!498 au BK4
MIM IL PkrtdA 90199
OcnmCWO S64-4040
Pam t9�A88-S8m
Interior renovation
• GRnn ResIdence
1201 NE 2nd Street
Miami Shores,
Florida 33138
SP -1.0
1 OF 1