DS-14-2548Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-223613 Permit Number: DS -11-14-2548
Inspection Date: December 03, 2014 Permit Type: Driveways/Sidewalks/Slabs
Inspector: Rodriguez, Jorge
Owner: NORA LANGE, KENNETH LANGE
Job Address: 70 NE 96 Street
Miami Shores, FL 33138 -
Project: <NONE>
Contractor: MIAMI PAVING CORP
Buildina Department Comments
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number 1132060130620
Phone: (305)786-4240
REMOVE EXISTING CONCRETE WALKWAY & INSTALL
Infractio Passed Comments
INSPECTOR COMMENTS False
INTERLOCKING CONCRETE PAVERS.
Inspector Comments
Passed
Failed
Correction
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
For Inspections please call: (305)762-4949
December 03, 2014 Page 1 of 1
BUILDING
Miami Shores Village
4
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
PERMIT APPLICATION
UILDING ❑ ELECTRIC ❑ ROOFING
❑PLUMBING ❑ MECHANICAL ❑PUBLICWORKS
JOB ADDRESS:
I�1 � � �4i Eyl
FBC 2�i
01
Master Permit No. TG (kkla- OLS q
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County: Miami Dade Zip: 3 gas
Folio/Parcel#: L®773,!j 1$g, arc 6 AAJ& Pr _"i Z Is the Building Historically Designated: Yes _�,/ NO
Occupancy Type: _ Load: g_C" Construction Typcxe: ✓ G®„ S Flood Zone: AtO BFE: 6M FFE: A(A
Fi�s+wd2.ys �,�mN�A-rt®�a a®nee�'��
OWNER: Name (Fee Simple Titleholder): AIW A L,q 6,6GF Phone#:306-73-1-59"
Address: `'j2 A/E
City: d G � y o gj.� . �,/ State: P-7 Zip: .3 3 1.34?
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name:
Address: .13 0 It 3
City: r -A /
Qualifier Name:
State Certification or Registration #:
State: t
305 - 3A- elzVo
,;) 3I .'i
Phone#: zq®�
Certificate of Competency M 22 -3
DESIGNER: Architect/Engineer: Phone#:
Add
City: —State: Zip:
ej
Value of Work for this Permit: $ i®p ®`A Square/Linear Footage of Work: X
Type of Work: ❑ Addition 1� Alteration ❑ New V Repair/Replace ❑ Demolition
Description of Work:
ego#-l/cc��t
Specify color of color thru tile: 3
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ 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
I
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 charged.
Signature Signature
—&Zt��/—
OWNERr AGENT CONTRACTOR
The foregoing instrument was acknowledged before me
NO
this The foregoing instrument was acknowledged before me this
day of AI ✓� �T 0 &nZ . 20 1 , by / y /day of O V 64 20 )Y' . by
/1)O e.4 c-�� 6-P
, who is personally known to 2n -k /`7 Gi 4 n .e2- . who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
c
Print:
Seal:'`.� LUZ IYD ANGELES
''' '": MY COMMISSION # E.E834022
' , .. � . EXPIRES September 17, 2016
APPROVED BY
(Revised02/24/2014)
as
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
C� 5 Print:
Sea I:Vwii'.
MY COMMISSION # EE834022
EXPIRES September 17, 2018
as
Plans Examiner �( Zoning
Structural Review
Clerk
ivuv to i,r+utaop
�-' 4196 496 ' ,TCB �,
a 1 TE OF eTENCY
E1333
` MIAM PAVWG CORMRATM
M ..: a.e.A.:
ART
ROBERTO
�+rntkr�p,�d�0 afe caow�tq
VALID FOR CONTRACTING UNTIL 0913012015
QUAUFYING TPACgS)
0007 PAVING ENGINEERING
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Local. Business Tax- Receipt
Miami -Dade 'Courity; State . -of * Florida
US 'IS KOTA !RLL — DO NOTPAY
938671
LUSNAMMCATMN
MIAMI PAYING COW
13011 SAY 83 Si
MIAMI FL 33183
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Municipal Contractees Tax Receipt
.Miami—Dade County, State of Florida
-1=18 Nor A WLL-D0 NarFAY
.CCNO: E1333
lr 4 P1DnW CORP
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'13011 SW 63 ST NEW SEOTEi :ER 30, 2015
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A CERTIFICATE OF LIABILITY INSURANCE
IVIOMM4
IMS CER!MCA1% 15 MM AS A II KWM OF INFOIRMA-MM ONLY AM CONFERS NO MGM UPON IF E HOLDMINIS
CMTNWAYE GOES MOT AFMMTWELY OR INEGAMELY AMMM. MM OR ALTER THE COVE GE AFFOROW BY THE POUCM5
BELOW TRIS CERTIMATE OF SIMUM"M DOES NOT CONSTITURE A CONTRACT BETVVEM THE MSUUMI INGUIRERM AUTHORIZED
REPRESEWATME OR PRODUCISL AND THE CERT09"M HOU3M
MMUANT; If dw cartMcdc bolder Is an ACCIMONAL INSINV^ Ow pal"" must be wdorwwL It SUIBROGAIMM 13 WAMM, suite to
the teff and COndffb= Of the pofty. Ceftlin VOICkS Mft require an endwasmant. A stahmorit w this coUlcate, does nut caufm Fk6ft to We
cardscate. hotda In ftu of such andameatMICS16
PRODUCER
Pablo M CMwe
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8796 SW 8 St
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13011 S.W. 83rd Street
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LISMI FL 33183
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THIS IS TO CERTIFY TMT THE POUVES OF MUM= u0W G&MV PM SM MUW 10 nM DIMURM WMM AOM FOR THE PM= PEMW
IMICATED. 110=7MAMMING AW REMMMM 19ft OR CONWIM OF ANY CONMACT OR OSiM COMMW WON A98PEW TO VAIICH UIS
CERIFOCKM MY BE ISSUED OR MAY P9WAK TIM MUMUME AFFOM90 BYTES POME-11 OE 2MM HERISN IS StMMCT'TO AIL ME TMM.
MECLUSIONS AMCOAKIWIMS OF SUCH FOMES LPMSHOM MAY MVE BEEN RZOMM By PND CLAM.
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-Miami Shores Viflage
Building Department
10050 NE 2nd Ave
THg ExpMTON O^TG I a0F. INUMS VOILL BE GIMAROM IN
ACCORMIANCE WM THE POLOT PROVSHUM
Miary4 Shores, FL 33138
AUTHORMIUVOSSENrATM
Q 11154HZI073 AGO" UUKrUKR I MAIL AN VARRIN Mswvw-
ACORD 26 (M3104) The ACORD name and Ingo are mg1sWed marks of MORD
�_-
SKETCH' OF, SURVEY
Miami Shores Village
APPROVED
Y
DATE
ZONING DEPT
i
a
BLDG DEPT
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SKETCH' OF, SURVEY
Miami Shores Village
APPROVED
Y
DATE
ZONING DEPT
BLDG DEPT
•
p
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SUBJECT TO COMPLIANCE WITH ALL FEDERAL
STATE AND COUNTY RULES AND REGULATIONS
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LEGAL
DESCRIPTION
A/0
ACCORDINGf' THE 7 PLAT THEREOF AS R . ECORDED I IN PLAT BOOK /'!LAT PAGE.76)
OF THE PUBLIC RECORDS OF COUNTY, FLORIDA. (Subject to all restrictions,
reservationst easements and right-of-way of record.) 7-17is I -o/ Lays il-)
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•• • ••••
G.A. LOBAINA CONSULTING ENGINEERING INC.
7390% e r
STATE OF (FLORIDA)
COUNTY OF (DADE)
Miami shores Village
Building Department
SURVEY AFFIDAVIT
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
The undersigned Affiant, APQ&A A . does hereby attest that
(Property owner)
The attached survey, performed by GA - LQFn/G v �► � � I
(Name of surveyor's company) 0
For address: 7-3 9 49 _ r'i 9 gg R . nn tA fn; P/ i��: ....
...... . ......
Performed on - (date of survey) is an accurate representation of the existing cvaditions 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 buildint'pdrfnit for tWorbperty "
without first providing a survey less than seven (7) years old old. The Affiant, as property owner- furthq.WVVs to 9000:0
remove or obtain permits for any structures which now may exist on the property which Ai aermitted ver 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.
Further, Affiant say eth naught.
e
Property Owner Signature Property Owner Print Name
SWORN TO AND SUBSCRIBED before me this day of A46ye_th 6e -y 20/%4
Affiant is ->!c,—personally known to me, produced as identification.
Revised on 5/2212009/ Revised on 6112109
MY COMMISSION 0 EE834022
EXPIRES September 17, 2016
SPECIFICATIONS r
SF X PALLET: 98
PCS X PALLET: 272
PCS X SF: SIA
1-1
6V4X 9112 6114 6114
The charm of the ftew'Miami
paver comes from its "Aged"
appearance. Some say it is,
"Technology creating
tradition". It is actually
returning to the old with the,
new.
El encanto del New Miami
proviene de su apariencia
envejecida. Algunos opinan
que es "Tecnologia haciendo
tradition ". Es, de hecho, un
regreso a to viejo por medio
de to nuevo.
T - Pattern
Random
PCS X PALLET 6X8= % -6X9= 976
PCS X SF:
6X6= 4 6X9= 2.66
GEM PAVER
SYSTEMS, INC.
MANUFACTURERS OF INTERLOCKING BRICK PAVERS
D,V orange / Tan *@I" bal
•••• ••••••
9845 N.W. 118th Way. Medley, FL. 33178 • Tel: 305-805-0000 * Fax: 305-805-000