DS-14-1122Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-213362 Permit Number: DS -6-14-1122
Scheduled Inspection Date: November 04, 2014
Inspector: Rodriguez, Jorge
Owner: ALONSO JR, SILVIO
Job Address: 145 NE 110 Street
Miami Shores, FL 33161 -
Project: <NONE>
Contractor: AMERICAN STAMP CONCRETE
tsuuamg vepanment comments
CONCRETE DRIVEWAY
Permit Type: Driveways/Sidewalks/Slabs
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number 1121360040190
INSPECTOR COMMENTS False
Phone: (305)226-8983
November 03, 2014 For Inspections please call: (305)762-4949 Page 7 of 33
Inspector Comments
Passed
Failed
Correction
Needed ❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
November 03, 2014 For Inspections please call: (305)762-4949 Page 7 of 33
, A
Miami Shores Village
Building Department jum 0 2 2014
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 N;
bl�l I Tel: (305) 795.2204 Fax: (305) 756.8972 13Y'
INSPECTION'S PHONE NUMBER: (305) 762.4949 r
FBC 201 6)
BUILDING Permit No.
PERMIT APPLICATION Master Permit No. � &-- �H9
Permit Type: UILDING
ROOFING
JOB ADDRESS: / N,' NE I 1 Q —,S 4'
City: Miami Shores County: Miami Dade Zip: /
Folio/Parcel#: 1f - - 2, 1 'J ( - (Do V - 0 15 U
Is the Building Historically Designated: Yes
NO �KlooZone:
OWNER: Name (Fee Simple Titleholder): S 1 1 V B U c) n :- C) Phone .
Address:
City: `Y, 1 lire &)-Ian� State:
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name:
Address: -L
City:
Qualifier Name:
State Certification or Registration #:
Contact Phone#:AAi)9?6 o?Clb(l Email Address:
DESIGNER: Architect/Engineer:
Certificate of Competency #:
3',�,13-f"
Value of Work for this Permit: $ S � o Square/Linear Footage of Work: ®(�
Type of Work: ❑Addition Alteration ONew gRepair , lace ❑Demolition
Description o"i W"o"riii C 117,f -,k" r ;5
Color thru We.-
Submittal
ile:
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO/CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $Ld n T .
Bonding Company's Name (if applicable)
Bonding Company'sAddress
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
Zip
r -
j
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 ,I approved and a reinspection fee will be charged.
�1
Signature / Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me thi
day ofA, 20, by&& L°y !%l'! day of tC:' , 20, bydsj' �(/� 1p�,
who is personally known to me or who has produced/— /61Q who is personally known to me or who has produced Ify�
J h 9-e-2 - As identification and who did take an oath. -L&)67ao as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
My Commiss: Joanna M Feliciano
My Commission FF 082753
�w Expiras 01112!2018
NOTARY PUBLIC:
Sign:
'� Notary Public Stets of Florida
My C ] �► M Feliciano
MY Commission FF 082753
w, E"801/12/2018
APPROVED BY ! P � Alg 4 Plans Examiner
Structural Review
(Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007)
JG 1
Zoning
Clerk
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) A 1 1 (2L [2 4a I oy, hereinafter referred to as the owner of
the following described property (address): I �® �r /10 ct—
Kl-� Lcr� S > J-2, k
Legal Descriptio l If f_ Lot 20 Block / Subdivision
Folio # 1'5 O
Requests permission to install (describe work):�-C� - i��'l 6/'
(Zo L.-)
Within the public right of way of (address) /143— /-1 'tf— I / (D S I-'''
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.
OR
3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 6& 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).
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this day of , 20 _, by
who is personally known to me or who has produced As identification and who did take
an oath.
NOTARY PUBLIC:
Sian:
Print:
My Commission Expires:
2
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,5l I V 10 u 05 9 does hereby attest that
(Property owner)
The attached survey, performed by A n t (�/'1, U
(Name of surveyor's company)
For address: i' �� / lc' 5
Performed on '7-3)— i Z (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
structures may affect final inspections as applicable to this or other permits.
*ropeoWwner
ay eth naught.
SignatureProperty Owner Print Name
SWORN TO AND SUBSCRIBED before me this 0�? I day of &'—y
Affiant is personally known to me, produced yS27FZ29V364dentification.
ade
Notary Pub1k Stlilld��
Revised on 5/22/2009/ Revised on 6/12/09+ Joan^a Fo1i 082753
Ion
o Exp"$ pm1�11s2120i
Local. Business Tax Receipt
Miami—Dade County, State of Florida
-THIS IS NOT A BILL - DO NOT PAY
BUSINESS NAME/LOCATION
AMERICAN STAMP CONCRETE CORP
11362 SW 7 ST
SWEETWATER FL 33174
OWNER
AMERICAN STAMP CONCRETE CORP
Worker(s) 1
RECEIPT NO. EXPIRES
RENEWAL SEPTEMBER 30, 2014
6138416 Must be displayed at place of business
Pursuant to County Code
Chapter BA - Art. 9 & 10
SEC. TYPE OF BUSINESS
196 SPECIALTY ENGINEERING CONTRACTPAYMENT RECEIVED
BY E0601139 TAE COLLECTOR
$45.00 08/27/2013
ECHECK-13-006281
This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license,
permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or
nongovernmental regulatory laws and requirements which apply to the business.
The RECEIPT N0. above must be displayed on all commercial vehicles - Miami -Dade Code Sec Sa-276.
For more information, visit www.miamidade.govkaxcollector
Municipal Contractor's Tax Receipt
Miami—Dade County, State of Florida
-THIS IS NOT A BILL - DO NOT PAY
CC NO: E0601139
BUSINESS NAME/LOCATION
AMERICAN STAMP CONCRETE CORP
11362 SW 7 ST
SWEETWATER, FL 33174
RECEIPT NO. EXPIRES
NEW BUSINESS SEPTEMBER 30, 2014
7438019 Must be displayed at place of business
Pursuant to County Code
Chapter BA - Art. 9 & 10
OWNER TYPE OF BUSINESS
AMERICAN STAMP CONCRETE CORP SPECIALTY ENGINEERING PAYMENT RECEIVED
BY TAX COLLECTOR
CONTRACTOR 175.00 09/25/2013
0228-13-001928
ollector
`CTQB
Construction Trades Qualifying Board 4
BUSINESS CERTIFICATE OF COMPETENCY
E0601139 ..
STAMP CONCRETE CORP
D.B.A.:
LEYVA DANILO I
Is certified under the provisions of Chapter 10 of Miami -Dade County.
J
MAY -30-2014 FRI 10:42 AM VULTILINES RISK UNDERW FAX No. 3085987881 P,00
amDr CERTIFICATE OF LIABILITY INSURANCE 5/30/2014
THIS CERTIFICATE 18 ISSUED AS A MATTIR OF SNFORUATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CEERTIFICATE DOES NOT AFFIRMATIVELY OR NSQATNELY AMEND, EXTEND OR ALTER THS COV11RAGIE AFFORDED BY THE POLICIES
Sbd,OW. THIS CERTIFICATE OF INSURANCE DORS NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(B), AUTHORIZED
R&RESENTATIVE OR PRODUCER, AND THE CERTIFICATE! HOLDlR.
INPORTAIM If the OWIffeate holder is an ADDITIONAL INGURED, the pollsy(les) must be Blldf me& If SUBR03ATION 18 WAIVED, subject to
the terms and conditions of the policy, imrteln poltcles may require an andomement A statement on this ownflants does not confer rights to the
aertlfa4e ho[der In 11eu of Such andonsamrittal.
PROMMR
Ti LINES RISK UMER 1°SRS INC (305) 59$-1411 N :(305) 1398-7851
10230 5W 55th 3t #C202 RE mlinesQbellsouth.not
K11.>S.tt13, FL 33165 iffluaamm MINU mIN MORME soca
INSURED
0027.
Inm=ance Co.
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11362 Sly 7 tit MURERD:
Miall FL 33174 NUPARE;
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— TH16 13 70 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REOUIREMENT, TERGA 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 DESCR93ED HEREIN IS SUBJECT TO ALL THE TERMS,
E C USIONSAND CONDI'T'IONS OF SUCH POLICIES. LIWM SHOWN MAY HAVE I399N REDUCED BY PAID CLAIMS.
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TYPE OF INSURANCE
NM
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LIMITS
GENERAL LIASIUIY
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CLAIMS—OCCIA
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9-19-1
9-10-14
WH OOGLRqEWE c 1,000,000
PREMISES �e oaourceroel $ 30,000
MED W (Any one person) B 11000 I
PERBONALBADVwjuRv e 1,000, 000
QENERAL at33FEGATE s 2,000,000
GEWL AGGREGATE LENT APPLIES PEI
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DESt FnQN OF OPMATIOM I LOCATIONSI VEHiCLE°S (AilgM ACCO 901. Adtftyral Remarks S tsdute. If mom epees Is r6WIMd)
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WITH THE P LILY NROVISIONS.
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AGORD25(2010W The AGORD name and logo aro registered marks ofACORD
7210 SW -12M coag Aniano J. Garcia,' ` PLSM Ph (3m) w,45ss
iF i� Fc (W5) 595-1454
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is
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.15' Wide Ailey
S 8958'04" E 75.16'
Lot
BIG
Asphalt Pavement —
o' FIP
O �-
well
Pump '
e°
1" Sidewalk
S
E 75.00'
Property Address:
145 NE 110tH Strwt,
:, Florida 33161
Leal Q"Pm hQn:
Lot 20, Block 1, of "COLLEGE
HEIGHTS", according to the Plat
thereof, as recorded in Plat Book 42,
at Page 8, of the Public Records of
Miaml-Dade County, Florida.
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Parkway b
s
-V ,
As*lt Pavement —
N _ 1 Vth Street
(75' Total R/w) —
Yisual Encroachments Noted:
) — Concrete Fence Wall and Chain Link Fence encroach 'For
0.15 feet and, 0.95 feet, respectively, into the subject property. kvio Alonso, Jr; Old
LEGAL NOTM-- Date "o ►els Work 07-31-2012 Re ublic National Title
ftSar does rA rellect or deterrcdne ownaft of ft �trast of M will I urance Company;
bm is be made to ff aq. dleft f t tr. ft oAnion erez—Mena &Gonzalez,Sris : to datlens, 6a5m r
Leo Destvit4m provitted by client ilre Liability of rids Sw" is lid to the cad of the LLC; Regions Bank
S ffM � f ar uft I mq, me W ohm % ram to nd attsnpted to Not valid " witho signature
kc* loaft mal/or f Otaa andler wWagrwd of my rsatu H dl and the original rai seat d/b/a Regions Mortgage
Ike a1! mkffW to an t I tom►. me mewed to Nabo of a Florida license surveyor Order NO 12-0213
6 o W" Ma of 11M (lam 110) ma
A Pro Length AC - Mr CondRToner AE - Anchor Easement; 13C - Stook Corner; OM - Bench Marta BOB - Basis Of asarings; (C) a Cakaektted Dimension; C8
Baste; CBS - Concrete Slosh Sbuatw, CFV - Concrete Fence wall; CH– Chard Length: CHS - Chard Bearing; CI -Clear, CML - City Monument Line;
Q CME - Carrol btWrrtermrtoe Eaeemertt; Cam - Conaet� DE - OraMage Easement: DME - & Mabrtanarce Easement; Dr - Drive; E - East; Elov -
Elevation; ENCR - Enaoached; ETP - Electric TrcrWormen FDH -Found Drill Hale; FIR - Pou terns Rad; FFE - Finished Floor Elevation; FH - Fire Hydras FlP
® Found U n Pipe; FN - Found Nall; FT - Feet; LME - Lake Maintenance Easemerrq, LB - Lim Business;LFE - Lowest Floor Elevation; LP -
Q -Measured Dimenstac; ME - Maintmcance Easement; MOPS - Monurnent: N - NoAh; NM 19a9 - Natiarrol t Vertical Datum of 1928; NTS - hfat To S
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= Overhead Cabiee: OH = Over ; ORB - Official Record Book; 0 S ® Off Set; Pb - Plat Book: PC - Point of Curvature; PCC - Point Of
Curvature; PCOR - Property Corner, PCP - Permanent Central Point Pg Page; PL - Planter or Prouty Line; PLS - Professional Land Surveyor, -
t3 it Professional Land Surveyor and Mapper POO - Point Of Oegin"-. POC - Point Of Commencement; PRC - Paint Of Reverse Curve; PRM - Permanent Reference
W m Monument; • PT - Point Of Tangency; R - Radice (R) - Recorded Dimension; RLS - Realstorarl land Surveyor and Mapper, R/R - Ran Road; R/w - RVd Of
way, Sea - Section; T - Tangent; S m South; SIP - Set Iron Pips with Cap Stamped TIT UE - UtUity Easement; UP - UtdGty Pole; UTY -Utility,
W - west; WF - wood Fence; WM - water Meter WV - water Valve; - Centerikre; -x- - Chain Link Feriae; ts� - Concrete Wan; ' - Oegrow, e - Central
Angle; 0 - Diameter; - Existing Elevation; ' - Minutes; ° - Seconds: -a- - wood Fence