DS-14-1558Inspection. Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-216214
Scheduled Inspection Date: November 26, 2014
Inspector: Rodriguez, Jorge
Owner: MONTERO, JULIAN & DEBRA
Job Address: 465 GRAND CONCOURSE
Miami Shores, FL
Project: <NONE>
Permit Number: DS -7-14-1558
Permit Type: Driveways/Sidewalks/Slabs
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number
3051685-0412
1132060170320
Contractor: CHAMPION CONCRETE Phone: (305)252-8055
tcunamg uepartment comments
CONCRETE SLAB
INSPECTOR COMMENTS False
November 25, 2014 For Inspections please call: (305)762-4949 Page 9 of 48
Inspector Comments
Passed
Failed El
Correction
Needed ❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
November 25, 2014 For Inspections please call: (305)762-4949 Page 9 of 48
Rick Scott
Missions
Teo protect promote & improve the health Governor
of all in Florida through
state, counity & community effortsintegrated.
FUrfi-d"a John H. Armstrong, MD, FACS
HEALTHState Surgeon General & Secretary
Vision: To be the Healthiest State in the Nation
Glasshammer Engineering
19341 Sterling Drive
Miami, FL 33157
October 14, 2014
RE: Modification to a Single Family Residence - No Bedroom Addition
Application Document Number: AP1160522
Centrax Permit Number: 13 -SC -1561309
465 Grand Concourse
Miami, FL 33138
Lot: 23 25 Block: 87 Subdivision:
Dear Applicant,
This will acknowledge receipt of a floor plan and site plan on 09/22/2014 for the use of the existing
onsite sewage treatment and disposal system located on the above referenced property. Proposed
driveway.
No objection letter was issued by C. Icaza on 10/14/14.
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
ent of Health in Dade County
Florida Department of Health www.floridahealth.gov
In Dade County • -, Florida TWITTER:HealthyFLA
PHONE: (305) 623-3500 FACEBOOK:FLDepartmentofHealth
YOUTUBE: fldoh
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: ®C�� 6(-a KI 4i
Permit No.
JUL 18 204
FBC 20 t(D
Master Permit No pcs 1 4 --iss cts
ROOFING
City: Miami Shores County- Miami Dade Zip: 3 3 f 3 k
Folio/Parcel#:
Is the Building Historically Designated: Yes
NO Flood Zone: /L0
OWNER: Name (Fee Simple Titleholder).N Ij !( Q ky1 OC4r%A / '�'' �; �`�� Phone#: . 7y3.13 7
Address: %S— 612.
City: f[!0t-V4 f
Tenant/Lessee Name:: V/—+
Email: -,A(j f� P� W 1 0— %4
State: FL, Zip: 3�3 t3 0
CONTRACTOR: Company Name: r (4p p l ay to /u oy9n Phone#: 305 Z52 2?40:-5
Address: Y Q 0 ( MU Q"Q 'jFr
City: J (20 State: Zip: -3-3 r7d'
Qualifier Name: 1,4-141-e i4sl IJl Phone#: -tea q0Z LtdodZ_
State Certification or Registration #: Certificate of Competency #: Cc DS 6_500"?1S
Contact Phone#: _1P;4 _ 6A-511 0 Email Address:-IAYJIz°C- A-1 i94'114100-40Cf
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ 5 Square/Linear Footage of Work: -51e
0
Type of Work: ❑Addition ❑ teration ❑New ❑Repair/Replace ❑Demolition
Description of Work:
Submittal Fee $ ermit Fee $ - CO CCF $ 1 ` & 0 CO/CC $
Scanning Fee $ Radon Fee $ & co DBPR $ C"Lm Bond $ tfM ,
Notary $ Training/Education Fee $ G G O Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
Gy --� ' C��
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 deliver d to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be po ed at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absenceff suc osted notice, the
inspection will not kapproved and a reinspection fee will be charged.
The fo�reov
fg
day of��
who ' persc
NOTARY
Sign:
Print:
Owner or Agent
instrument was acknowledged J�efore,me this f q A
20 �, byJ o ),kms 4w �
Signature.
Contractor
The foregoing instrument was acknowledged before me this
day of �-'�'✓ , 20 jA, by JAJ1n1-- ql,41�-03
.n # me or who has produced 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.
My Commission Expires:'
APPROVED BY
W COMEWN
MIS i 155840
NOTARY PUBLIC:
i 1l 1 �wi ,
\\\`��%w
Sign:
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Print:
- 1pR� PU9lIC
Q
My Commission Expires:
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(6/02./
Plans Examiner
Structural Review
(Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007)
%4%
_ z6ning
Clerk
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\, 0 does hereby attest that
(Property owner)
The attached survey, performed by
(Name of surveyor's company)
For address:ter/ ,i T 6/a 4 � � dam, o4 S`Q-y , r'C 3.3
Performed on J�q 2Pi3 (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
affect final inspections as applicable to this or other permits.
r
say eth naught. J
PAF6perty Owner Signature Property Owner Print Name
SWORN TO AND SUBSCRIBED before me this day of���`�
Affiant is personally known to me, produced as identification.
Notary
Revised on 5/22/2009/ Revised on 6/12/09 �! •,, ANAE SHARP
*. *3 W COMMISSION R EE 155840
EXPIRES: Oeowdw28,MIS
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00 TION
Florida Health Miami -Dade Count`
O.S.T.D.S. & Well Program
pplication No.: 1N 6
�Date:
-� ; Signa