DS-14-1073Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-213039 Permit Number: DS -5-14-1073
Scheduled Inspection Date: September 12, 2014 Permit Type: Driveways/Sidewalks/Slabs
Inspector: Rodriguez, Jorge Inspection Type: Final
Owner: CASTANEDA, DAVID & KARA Work Classification: Addition/Alteration
Job Address: 9525 NW 1 Court
Miami Shores, FL Phone Number (786)281-1825
Parcel Number 1131010240300
Project: <NONE>
Contractor: CHAMPION CONCRETE Phone: (305)252-8055
sunamg uepartment comments
DRIVEWAY PAVERS
INSPECTOR COMMENTS False
September 11, 2014 For Inspections please call: (305)762-4949 Page 10 of 35
Inspector Comments
Passed
Failed
Correction
Needed ❑
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
September 11, 2014 For Inspections please call: (305)762-4949 Page 10 of 35
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:
+mm+''44 2J/�0�/�f1 (AA�
f ,.IR� � � 60 1 i A
FBC 201 0
Permit No. l
Master Permit No ) �l
ROOFING
I
City: Miami Shores County: Miami Dade Zip: -3
Folio/Parcel#: '3 1 C7/ — 0Zq— 0300
Is the Building Historically Designated: Yes
NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): D M 9� a `A:5-(A'
Address: 4_52_.</V AJ /CT
City: h .5yolw5 State:
Tenant/Lessee Name:
Email:
CONTR
Address:
City: Q
Qualifier
35150
State Certification or Registration #: Certificate of Competency #: CC
Contact Phone#: i rb1-k 0Z - L/A Email Address: t7 Z—' Y 00.- .
DESIGNER: Architect/$ngipeer: Phone#:
Value of Work for this Permit: $�_ � Square/Linear Footage of Work 147 [
I'1z
Type of Work: ❑Addition DAlteration ONew ORepair/Replace ODemolition
Description of Work:
. Color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
W
CCF $ CO/CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
i
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 wgrk will be done in compliance with all
applicable laws regulating construction and zoning. .L,
"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 ust be posted at the job site
for the first i ction which occurs seven (7) days after the building permit is issued. In the abs of such posted notice, the
inspection will no * approved anA4 a reinspection fee will be charged.
uvvfer or � nt
The fo oing i ment was ackno 1 g�
day of '20 by v
who is personally known to me or who has
Contractor
me this 30 The foregping instrument wasacknowledged bgfore me this&
bd20 ,y C ?mo
ay of IV T
who ide'rsonallykC �i
me or who has produced
(2,1 JA6I =7k' 3;D-0 As identification and who did take an oath.
NOTARY PUBLIC: a°t�'•:;Bvn AILYN RAYELO
# * MY COMMISSION # EE 055604
EXPIRES: January 18, 2015
�, `gq OFtt�A�OP ftidW Thru B Notary Senfi�
S' n:
Print: l/
My Commission Expires:
/ --/,0_a?®%s,
APPROVED BY
Plans Examiner
identification and who did take an oath.
NOTARY PUBLIC: AILYN RAVELO
MY COMMISSION # EE 055604
* * EXPIRES: January 18, 2015
9 pP��P SomW TNru SU pt Notary S91m
S'
Print: AM
My Commission Expires: �•
'r
,/ Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
STATE OF (FLORIDA)
COUNTY OF (DADE)
Miami Shores Village
Building Department
SURVEY AFFIDAVIT
The undersigned Affiant, -h , does hereby attest that
(Property owner
The attached survey, performed by
(Name of surveyor's company)
For address: I _5m- r- 4 4
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Performed on 3—U-1(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
may affect final inspections as applicable to this or other permits.
crop19 uwnerpign a Property Owner Print Name
SWO TO AND SUITRIBED before me this day of
Affiant is personally known to me, produced j4Cge j&,e_ as identification.
ter vue�. AILYN RAVELO
MY COMMISSION # EE 055604
* EXPIRES: January 18, 2015
�9 OF�oPov BoWThruBW90NOWrSWI" Notary
Revised on 5122/2009/ Revised on 6/12/09
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
Whereas, (owner) _ hereinafter referred to as the owner of
the following described property (address):
#V e -44i" rC4w__ -3 3 ts-d -
Legal Description Lot Block Subdivision
Folio #
Requests permission to install (descr be work):
Within the public right of way of (address) j�5 A/P1 1,!5j
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 items)
: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 or
SIGN , SE D, A E V ED in the presence of:
, PUgI� AILYN RAVELO
��y�' c* MY COMMISSION 4 EE 055604
EXPIRES: January 18, 2015
`%.r���oc•�O� Bonar TMu 8udg� NAY Services
2
Mission: "
To protect; promote & Improve the health
of all people in Florida through integrated
state, county & community efforts.
Jaime Basilio
9525 NW 1 Court
Miami, FL 33175
Vision: To be the Healthiest State in the Nation
July 07, 2014
Rick Scott
Governor
John H. Armstrong, MD, FACS
State Surgeon General & Secretary
RE: Modification to a Single Family Residence - No Bedroom Addition
Application Document Number: API 150470
Centrax Permit Number: 13 -SC -1544491
9525 NW 1 Court
Miami, FL 33175
Lot: 11 12 Block: 5 Subdivision:
Dear Applicant,
This will acknowledge receipt of a floor plan and site plan on 06/16/2014 for the use of the existing
onsite sewage treatment and disposal system located on the above referenced property. No Objection
issued by Y. Martin and B. Olmino on 7/7/2014 for a driveway.
This office has reviewed and verified the floor plan and site plan you submitted, for the proposed
remodeling addition or modification to your single-family home. Based on the information you provided,
the Health Department concludes that the proposed remodeling addition or modification is not adding a
bedroom and that it does not appear to cover any part of the existing system or encroach on the
required setback or unobstructed area. No existing system inspection or evaluation and assessment,
or modification, replacement, or upgrade authorization is required.
Because an inspection or evaluation of the existing septic system was not conducted, the Department
cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use.
You may request a voluntary inspection and assessment of your system from a licensed septic tank
contractor or plumber, or a person certified under section 381.0101, Florida Statutes.
If you have any questions, please call our office at (305) 623-3500.
Sincere[ ,
Betsy Olmino
Engineering Specialist II
Department of Health in Dade County
Florida Department of Health www.FloridasHealth.com
in Dade County • • , Florida i ' TWITTER:HeaithyFLA
PHONE: (305) 623-3500 FACEBOOK:FLDepartmentofHealth
YOUTUBE: fldoh
5582 N.W. 7th ST
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;ELEPHONE: (304 294,�66a � • � � � � �° L6 � � � � � �� ,.:J � � .
FAX: (3r5) 264-0229 • + • • w • • • • s •
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DRAWA! BY: AL. AND SURVEYORS
SURVEY No. 14-0000420-1
SHEET No. 2 OF 2
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