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DS-14-1970Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-219288 Permit Number: DS -9-14-1970 Scheduled Inspection Date: September 29, 2014 Inspector: Rodriguez, Jorge Owner: , Job Address: 957 NE 99 Street Miami Shores, FL 33138 - Project: <NONE> Contractor: ACA CONSTRUCTION INC tsuuamg uepanment comments FIX CRACKED SIDE WALK Permit Type: Driveways/Sidewalks/Slabs Inspection Type: Final Work Classification: Addition/Alteration Phone Number Parcel Number 1132060340260 INSPECTOR COMMENTS False Phone: (305)788-8914 September 26, 2014 For Inspections please call: (305)762-4949 Page 13 of 29 Inspector Comments Passed Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. September 26, 2014 For Inspections please call: (305)762-4949 Page 13 of 29 BUILDING PERMIT APPLICATION Miami Shores VillageRJE RWED Building Department artment 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING ❑ ELECTRIC ❑ ROOFING r-1 PLUMBING ❑ MECHANICAL QPUBLIC WORKS FBC 20 C� Master Permit No. Us 1 Ll — Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS:�- City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes Nd� Occupancy Type: Q Z ` Load: Construction Typ&CAa , Flood Zone: BFE: FFE: j OWNER: Name (Fee Simple Titleholder): �-- �a1� tCQ�,T hone#: Address: - City: rYl i State: L— Zip: Tenant/Lessee Name: Email: ne#: 'E"0 5 r a lC, CONTRACTOR: Company Name: _Phone#: Address: I Q-5 f'\I/-}-e-✓i City: State: L— Zip: 33r Qualifier Name: ,1�-,�-�C� i _.�v�c_ f Phone#: 3Of '-�- k 9 - '34-18, State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: hone#: Address: ,/ City: State: Zip: Value of Work for this Permit: $ '95 0 Square/ ear Foo a of work: 5 Type of Work: ❑ Addition ❑ Alteration New c Demolition PAINATDescription _- to 11101 d1611111111 � . )y�•yml�I L1194 Specify c Y' bi i► >e - Submittal Fee $ 00 Permit Fee $ too � I CCF $ CO/CC $ Scanning Fee $ - Radon Fee $ d DBPR $ ` 00 Notary $ Technology Fee $ (:�j Training/Education Fee $ 0 • W Double Fee $ Structural Reviews $ (Revised02/24/2014) Bond $ TOTAL FEE NOW DUE $10 t Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Zip Zip Is 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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 approved and a reinspection fee will be charaed. or The foregoing instrument Sivas acknowledged before me this day of tC--n".5' . , 20 by r'—Yi 1 C4- c 1 1 o iLpgLsQ1iAIIy known to J ---- me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign Print Seal Signature CONTRACTOR The foregoing instrument was acknowledged before me this I day of , 20 14- , by //�� l ry-,A.e--r �. , w is personal) nown to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: X 7a ��J019 A. 91 �`a o (wry Pu Print: Commission N Seal: ''•.',;,a�t�":•` Branded Throes APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) The GENERAL CONTRACTOR Named below 1S CERTIFIED f lcss9�r fhc aRrrisri ya�r.c a.f 1*4 .« �. rr:or2 s i+ ISSUED: OW 5/2014 €t03123 KIEN a 79SSIONAL AEG Miami SIs hore s 11/ ills e 9 Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. §-440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corpora elect to be exempt if te officers or members of a limited liability company (LLC) in the construction industry may 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore. you maybe insurapersonce liable for the worker compensation WjUries of anv person allowed to work under this permit Please check with your insurance carver since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Print Name: Print Name: Signature: �ii:-2: a `0 Q LL U Signature:Ag=ld — State of Florida) ) Z o o State of Florida) County of Miami-Dade N Il C O County of Miami -Dade) Sworn to and subscribed before me this 6– Z Sworn to and subscribed before me this l day of �'- � 4– , 20 1 Z 2 a I G U a day of , 20�� =3 By By (SEAL) e t (SEAL) Type of Identification roduce s Type of Identification produced zw,,,fi°c.,� d� MAP OF BOUNDARY SURVEY !A k ;kP1v-R ED BY DATE fE ZON: G SiRUC RAL .. I EL PL MECH B'DG. 11 �6— 1 5(" 7 U_J�_ TO C'.�WLIANd M ia ALL ! EUN,L 14T]ED LUUNTY RULES AND REGJLAOO,�S 19 '170 10.00, c6 V- Lu LE 04 F� CD 11 c/) 11 717 (50.00') LOT LINE LOT 20 BLOCK 170 cr) 10.01 (so.ow) LOT FINF f WINOF 4, mspwg��H� 170 Lu 12.4' ONE S I RES. # 957 co - PL ;t ci cd Oil 1.6 10.6 7�—T F I R �4" 3 NO, IDO 6'SWK 112 --c'PIC�cc cte-go"�'-C-cAeky Lo 4-15 17.1' AIC 1:1 CBS WALL 0.10, CBS WALL P�31 — --:::T NO ID LOT 21 BLOCK 170 cv) 957 NE 99 STREET� MIAMI SHORES, FL 33138 0) PC POINT OF CURVATURE LEGAL DESCRIPTION. 06 PCP PERMANENT CONTROL POINT PE POOL EQUIPMENT PAD LOT'20 AND THE WEST HALF OF LOT 21, BLOCK 170, OF MIAMI SHORES LU SECTION 8, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT P POINT OF INTERSECTION BOOK 14, PAGE 33. OF THE PUBLIC RECORDS OF MIAMI—DADE COUNTY, LU FLORIDA. POC POINT OF COMMENCEMENT FLOOD ZONE INFORM01770N.' PRC POINT OF REVERSE CURVATURE PRM PERMANENT REFERENCE MONUMENT BASED ON THE FLOOD INSURANCE RATE MAP OF THE FEDERAL C-4 EMERGENCY MANAGEMENT AGENCY REVISED ON 09/11/09 AND INDEX r-. R US DISTA RAD, c1*4 cd (R) RECORD SHOWN ON THIS MAP OF SURVEY IS WITHIN ZONE X BASE FLOOD b — I C) SIP SETIRON PIPE PIA CLF ON LINE 1\__c_0L- FIR 3/4" 1 LOT 22 BLOCK 170 NO ID 175.00' (50.01 OT LINE A LOT LINE b& -E 75*. cm LO �pffi/'E N 90*00100" E LU z LU z FIR 3/4" NO ID BLK COR LEGEND ABBREMT7ONS. A = ARC DISTANCE A C � AIR CONDITIONER PAD B/CR BLDG:BROWARD COUNTY RECORDS BUILDING BM = BENCH MARK BOB = BASIS OF BEARINGS CBS - CONCRETE BLOCK & STUCCO (C) = CALCULATED C&G = CURB & GUTTER CLF = CHAJUNUNK FENCE COL = COLU CONC = CONCRETE 6E==DDRRAA' D VIAGGEETSMEAMMANCE EASEMENT D/W - DRIVE—WAY EB = ELECTRIC BOX ENC. = ENCROACHMENT EP — EDGE OF PAVEMENT EW = EDGE OF WATER FDH = FOUND DRILL HOLE FF = FINISHED FLOOR FIP = FOUND IRON PIPE FIR = FOUND [RON ROD FN — FOUND NAIL (NO ID) FND FOUND NAIL & DISK FPL FLORIDA POWER & LIGHT TRANSFORMER PAD LE = LANDSCAPE EASEMENT LME LAKE MAINTENANCE EASEMENT (M) MEASURED MDCR=MIAMI—DADE COUNTY RECORDS NH ==MONUUOLE L ENT LINE (P) = PLAT IAII 111AI'M f.LB-7104 �urztrv3om �Ljr-v4ayi r_j 0 Inc�. 15190 SW 136th Street, Suits 20, Miami, Florida 33196 Tel: 305.596.1799 Fax: 305.596.1886 www.suarersurvayIng.cc2rn PLATIMAGE. NOT TO SCAIF q=v PB PLAT BOOK 957 NE 99 STREET� MIAMI SHORES, FL 33138 PC POINT OF CURVATURE LEGAL DESCRIPTION. PCP PERMANENT CONTROL POINT PE POOL EQUIPMENT PAD LOT'20 AND THE WEST HALF OF LOT 21, BLOCK 170, OF MIAMI SHORES PG PAGE SECTION 8, ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT P POINT OF INTERSECTION BOOK 14, PAGE 33. OF THE PUBLIC RECORDS OF MIAMI—DADE COUNTY, PL PLANTER POB POINT OF BEGINNING FLORIDA. POC POINT OF COMMENCEMENT FLOOD ZONE INFORM01770N.' PRC POINT OF REVERSE CURVATURE PRM PERMANENT REFERENCE MONUMENT BASED ON THE FLOOD INSURANCE RATE MAP OF THE FEDERAL PT POINT OF TAAGENCY CE EMERGENCY MANAGEMENT AGENCY REVISED ON 09/11/09 AND INDEX R US DISTA RAD, MAP REVISED ON 09/11/09 THE GRAPHICALLY DEPICTED BUILDING(S) (R) RECORD SHOWN ON THIS MAP OF SURVEY IS WITHIN ZONE X BASE FLOOD R/W RIGHT OF WAY RES. RESIDENCE ELEVATION VA COMMUNITY NAME & NUMBER VILLAGE OF MIAMI SIP SETIRON PIPE SHORES 120652 MAP & PANEL NUMBER 12086CO306 SUFFIX L SND SET NAIL & DISK (PK) STIL SURVEY TIE LINE SURVEYOR'S NOTES. SWK SIDEWALK 1. ELEVATIONS WHEN SHOWN REFER TO 1929 NATIONAL GEODETIC (TYP)= TYPICAL VERTICAL DATUM (NGVD 1929). 2. NO ATTEMPT WAS MADE TO LOCATE UB UTILITY BOX FOOTINGS/FOUNDATIONS, OR UNDERGROUND UTILITIES UNLESS UE UTILITY EASEMENT OTHERWISE NOTED. 3. THE LANDS SHOWN HEREON HAVE NOT BEEN W/F WOOD FENCE ABSTRACTED IN REGARDS TO MATrERS OF INTEREST BY OTHER SYMBOLS." PARTIES, SUCH AS EASEMENTS, RIGHTS OF WAYS, RESERVATIONS, ETC. [D = TELEPHONE RISER ONLY PLATTED EASEMENTS ARE SHOWN. 4. THIS SURVEY WAS = CABLE TV RISER PREPARED FOR AND CERTIFIED TO THE PARTY(IES) INDICATED HEREON = WATER METER AND IS NOT TRANSFERABLE OR ASSIGNABLE 5. THE INTENT OF THIS X 0.00 ELEVATION SURVEY AS COMMUNICATED BY THE CERTIFIED PARTIES IS FOR (001 ORIGINAL LOT DISTANCE REAL—ESTATE TRANSACTION OR MORTGAGE REFINANCING, THIS SURVEY A CENTRAL ANGLE IS NOT TO BE USED FOR ANY OTHER PURPOSE OR PARTY(IES) WITHOUT THE AUTHORIZA11ON OF THIS F1RM. 6. THIS SURVEY IS NOT CENTER LINE INTENDED FOR NEITHER DESIGN NOR CONSTRUC71ON PURPOSES. FOR wy THOSE PURPOSES. A TOPOGRAPHIC SURVEY MAY BE REQUIRED. 7. ALL M WATER VALVE BOUNDARY LIMIT INDICATORS SET ARE STAMPED LB# 7104. 8. THE WW CURB INLET BOUNDARY LIMITS STABLISHED ON THIS SURVEY ARE BASED ON THE LEGAL DESCRIPTION PROVIDED BY CLIENT OR ITS REPRESENTATIVE 9. FIRE HYDRANT FENCE OWNERSHIP NOT DETERMINED. 10. ADDITIONS OR DELETIONS TO SURVEY MAPS OR REPORTS BY OTHER THAN THE !%QW PARTY OR LIGHT POLE PARTIES IS PROHIBITED WITHOUT WRITTEN CONSNT OF TNE SIGNING PARTY OR PARTIES. 11. BEARINGS -t%�VOWN ARLP"IAN ASSUMEM- CATCH BASIN MERIDIAN AND THE CENTERLINE Ee 99TH ;TRE" HAS BEEN UTILITY POLE ASSIGNED A BEARING OF N 90*00'00 E. DRAINAGE MANHOLE a .......... 2.20A 10 SEWER MANHOLE CERTIRED TO.- 0 so :09 0 :&*1 --o— — ]RON FENCE B&L REALTY HOLDINGS� LLC 1: 13 = WOOD FENCE 0000 0 a :00*:e offee 0 = CHAIN LINK FENCE = OVERHEAD UTILITY WIRE 0 0*64 REVISION(5): a 0 0 00:0 0 0094 *00900 Of *0 *fee 00*4 ASPHALT CONCRETE PAVERS TILES COVER :00:0: SURVEYOR'S CERT7RCATE. :90660 0 9 0 KtUtN I LTO 0 0 SURVEYED AND DRAWN UNDER MY DIRECTION AND MEETS THE MINIMUM TECHNICAL STANDAMS stT FORTH V*?A FLOR119A STATE BOARD OF SURVEYORS AND MAPPERS IN CHAPTER 5J-17 FLORIDA ADMINISTRATIVE CODE PURSUA116T& W% SECTION 472.027 FLORIDA STATUE. . & Juan A. DA 7E OF SUR VEY- AUTHENTIC COPIES OF THIS u AW, 0610712014 SURVEY SHALL BEAR THE Suar�z Suarez JOB gf. 140619855 ORIGINAL SIGNATURE AND FILE 1. C-14923 RAJSED SEAL OF THE JUAN A. SUARE z ATTESTING REGISTERED PROFESSIONAL SURVEYOR & MAPPER CAD FILE(J):B&L SURVEYOR AND MAPPER STATE OF FLORIDA LIC. # 6220 SHEE T I OF I