Loading...
RC-13-1792Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-225166 Scheduled Inspection Date: December 16, 2014 Inspector: Rodriguez, Jorge Owner: CURZON, ANDREW Job Address: 10050 NE 12 Avenue Miami Shores, FL Project: <NONE> Contractor: LASORSA ENTERPRISES INC Building Department Comments REMOVE WALL AT ENTRY, NEW KITCHEN AND BATHROOM REMODEL 05-08-14 Per owners request the permit has been extended for 180 days. Permit Number: RC -8-13-1792 Permit Type: Residential Construction Inspection Type: Final Building Work Classification: Addition/Alteration Phone Number Parcel Number INSPECTOR COMMENTS False 1132050190370 Phone: (305)776-5109 December 15, 2014 For Inspections please call: (305)762-4949 Page 36 of 51 Inspector Comments Passed Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. December 15, 2014 For Inspections please call: (305)762-4949 Page 36 of 51 Miami Shores Village Building Department 1W50 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762A949 BUILDING PERMIT APPLICATION Permit Type: JOB ADDRESS: BUILDING 1 71171 0 6 26B a y� -- ----------- FSC 20 Permit NoY—Cl Master Permit No. ROOFING City: Miami Shores County: Muni Dade -Zip: Folio/Parcel#: 1'�'�C -o3/70 Is the Building Historically Designated: Yes I NO _ k- Flood Zone: OWNER: Name (F6 Address: City: Tenant/Lessee Name: Email: CONTRAC^^TO��R: Company Name: Address: D (! I -:-pW I �V _ x"Z w L State Certification 2,orr Registration #: Contact Phone#:'1506-'/'!�O M -6-1G DESIGNERc 'tect/Engineer: -M6 1 a Value of Work for this Permit: i Type of Work: OAddition Deseniptiou of Work: Address: J L-1 Color thru tile: Of � quare/Liaear Footage of Work: ONew )Rfxpair/Replace .r ODemolition Submittal Fee $ Permit ee ' 1 _WW%;*jfttF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Treining/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ 02 8010 TOTAL FEE NOW DUE $ • Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address Zip City State 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 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 �he absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. /-),I � A Signaturd,-1--' AL—�� caner or Agent The foregoing instrument was ac owledged b a me thiv—�g day o , 20 (-, by , who i rsonally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: / Print: / e, 9Ah W O"l My Commission Expires: Notary Public state of Florida Diane Schwartz a My Commission EE 195926 ovtio' Expires 05/06/2016 Contractor The foregoing instrument was acknowledged before >me� this day of 20 �, by/l,�/>z who si nal own tc or who has produced as identification and who did take an oath. APPROVED BY zr4�/J �/ 1 Plans Examiner —T� �V IF 4. Structural Review (ReAr w /1V%X vmsecb07/10/07)(Revised 06/10/2009)(Revised 3/15/09) NOTARY PUBLIC: Sign:a� (.d..t'✓i-A- Print: D tq n Q My Commission Exl Notary Public State of Florida t' Diane Schwartz s a My Commission EE 195926 Fos n Expires 0sAW016 Zoning Clerk Jun 22 12 07:12a RMTHOMY LHSORSR 561-366-5244 p•1 STATE OF FLORIDA DEPARTMENT OF BUSiNBSS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH N3kqROE STREET TALLAHASSEE FL 32399-0783 LASORSA, ANTHONY LASORSA ENTERPRISES INC 383 SW 12TH ST - BOCA RATON FL 33432 :sT�re o�ior�aAU Congratulations! With this license you become one of the nearly one Million •' DEPXRT1 CF' SUSZ Floridians licensed by the Department of Business and Professional Regcriaiion.•.: . $ROF$SSIOlgiL; R'!?at•LOLATI[ .. Our professionals and businesses name from architects to yacht brokers, from - s boxers to barbeque and they keep Florida's economy strong. : CGC03149i7 ' 06/.08%12: 1:10420872 Every day we work to improve the way we do business In order to serve you better.. For knf�nation about cur services, please log onto rower tcense.com. • :'CSBTIF'ISD CTOR There you can find mote inforrnation about our divislons an ane r guiations that LASflRSA, : a�18TSONY irrnppa�c�tt you, subscribe to department, ieiters and learn more about the Department's initiatives. Our mission at the Department is: License Elficiently, Requi a Fairly. We constarrtiy strive W serve you better so #W you can serve your c usiomers.m Thank you for doing business in Florida, and cohWatulations on your new license! Xs: ZF� the � q... pkj4z 9 VS:: ' Es xaeloa dace! .�VG'33., 201-4- : &200-088r*009 u DETACH HERE AC# 61.572.14-.. _ STATE OF FLORIDA CM • 7'$BC"IIPO-N,•'. �II TRY?C�TSOYNG BONRL ARDIILAT ON ,. SEQ# L3.2060800909 i �06l08l2 ]:2'11, .087 1C000I. The- CQAFT$COR Named. . hel•'o� Under the: -p ovisi6m' s of .Chasp tt`es 489 FS. _ Expiration date: AUG 31, 201--'* .LASORSA;..ANTHONY . '' K• -LASORSA' RISES :-INCA' "'383 SW-'12TH"ST BOCA RATON FL 33432' i3TCR' SCOTT REN LAWSON SECRETARY DISPL-M'AS REQUIRED BlTAW Jul.26, 2013 9.43AM ' ultstream Insurance AG-0i?D- CERTIFICATtOF LIABILITY INSURANCE PRODum '(954) 966-9993 THIS CERTIFICAU IS ISSUE[ GUlfstreM MW=aace Agmey, xac. ONLY AND CONFERS NO 5833 V®LWRoiu 6tre t HOLDR'CHis CRRam AA IMn -ft— a��i �ooci FI. 33121- lNSUR 10500 sa Enterprises, =ffic. 2071 SW 70th Ave=e B y G-19 Davie 3 No. 8218 P. 2 DATU (pJ{1LIDWf" 07/26/2013 C• f L 3317- COVIERA NSURM R THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDr-ATED. NOTWITHSTANDIM ANY AREMEMENT, TERM OR EQtI1CONDITION OF ANY CONTRACT OR OTHER DOCUMENT THE INSURANCE AFFOADEp BY THE POLICIES DESCRIBED HEREIN WITH RESPECT TO WHICH THIS CER77FlCATE MAY BE ISSUED OR MAY PERTAIN, IS SUBJECT At3GREGATE UMITS SHC WN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, NSR L TYPE OF MOURAIME POLICY NUMBER OTE pA7E N AL GENERAL VABLLfTY CFRODOD907 01 01/27/3013 01/27/2014 LNLlTS CHA S 11000,000 8 G6vERALUABiUTY DAMAp�D $ 100,000 CLAMMOM; I u I OCWR / ! / / M�EX, $ 5,000 PWWOLILADVEAW $ 1,000,000 CaEN'L AGCiRC{IATE LtplpT'AppI,IFy Pot ENERALAQQfMMA $ 2,000,000 Iey :� a,000,000 AUTOMOBILE LIAMLRY ANY AUTO ir�LOaIT ALLOWNEDAUT09 / / % / UIEDAUTOS) BODILYNUURY $ HIRM AUTO$ NONQVVMAUTOS EODILYINIURY $ (P�aommrd) PROPERTYDAMA4E $ GAAAft LMBUM (Parte ANYAVM AMW&Y•EAAO=Wr 5 OTK RTHAN $ AUTOONLY: L4181LdTY 41/ / / / EACH E $ ADAC O=R CWMSMAOE AGGREGA $ DEDUcneI,E / / / / R4ZEMI7ON $ $ 7MN AND 1 1F1!*1=Z ' UA6 ANY PROPMETOWAITrNERiq{ECUTPm DE1cC4U4E0? ELL EAgiACQ1DENr _ $ ��� E.L DISFj1s6 •64TPI.OYE $ .>=ciAL stoNs below O7HER E:LDIWASE-POLICYUdNr $ SCRIPT" OF CLU�ONB BY �NpONSEMMUSPEQAL PROVI$IOM t ? - Miami shores villiage Dept. 10050 NE tail Ave ACORD 25 (2Q 1N (0100.06 SHOULD ANY OF THE ABOVE DESMMM POLL BE CANOBLI I MOM TM EXPIRATION DATE THEREOF, TPD: ==a mw&R WILL ENDEAVOR To MAIL 10 DAYS WRTTT@N NOM TO THE CERT&VATE MMER MU= TO THE LF T; UUT PAILURE TO DO 50 SNALL MPDSH NO OBLMATM OR LIABILITY OF ANY Ick UPON THO MUREIL Iib AGEWs oR RMRA "ramree DN 19$1 Pam 1 rA2 Jun jjG 11 07:10a ,1EFF ATWATER G E F FRU MCLAL C» ANTHONY LRSORSR 561-368-5244 STATE OF FLORIDA pEPARTA1E3VT OF FINANCIAL SERVICES DIVISION CIF WoRKERW COMPENSATION 05-24-2011 P.1 * * CERTIFICATE OF i1.M10)p1 TO M EXgffT FROM FLORIDA WOKS' C SATWM LAW CONSTRUCTION INDUSTRY aEM non This certifies that the individifal listed below has elected to be exempt from Florida Workers` CompleLlsation law. EFFECTIVE DATE 0512412011 r��'�:;? FEIN: 591825354 BUSINESS NAME AND ADDRESS: LASORSA ENTERRRISES INC 383 SM 12TH STREET SOCA RATON FL 33432 EXPIRAT70N DATE: 05123/2013 ANTHONY SCOPES OF BUSINESS OR TRADE: 1- ORAL CONTRACTOR 2- ZTRUCTION MANAGEMENT 3- PL MIM 44D - 05!34% F.S., m office of a CUMMUan who eleas eumpd- fres WS cispter ay fitly a cettHiseta of ofeydeo sw rids sevaTAIR n rec d to eadw 440.05I12t F.S.. Certaiams of ekaiee m be eta�pt . epp1Y e�Y sii6ia Urc section oaf rot n benefits or eider Iet elspter. Persaeel m Chapter 440.n5I13L f.S.. Notiem a ehmaze to be exempt ad comteem of scope of o exeess at tribe Kdedsae " the a of of Neaim m be ft" a . Pnrswot m C6sptee imsed an So KWM or elem certgoe m , exempt sm me sale" m and tbbn 8, a ley sm slmr am Iafey of the oetice or e5e �Ee a Maoat my � for 12 iore of the perseo cerUtidRe ov loagar meets >te regoiteotaets of lids seafoe for ireaece d s certitictte• �e 4ap�QM named sn Oe cetMk de m aea The raptirMmb et this Smut . QUEST04V (850) 413-16 MC -252 CSITIFICATE OF ELECTION TO BE EXENPT REWSED 01-19 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OFFLORIA DWARTKUMOFFRUNCIALSBWNCES � _ 1DUi T CB%MCATE OF ELECTION TO BE EXEMr FROM FLORIDA SCOMPENSATION LAW EFFECTMr= 05/24/2011 EXPIRATION DATE: 05/2312013 pSgSot* ANTHONY ONY LASORSA FEIN: 591825354 BUSINESS NAW AND ADDRESS: tASOMA arms MC 383 SMI IMSTREET BOCA RATON, Ft 33432 SCOPE OF BUSINESS OR TRADE I-, G9118RAt. CONTRACTOR 2- COUMVI WN MAaAGEMM 3- PWMBM IN930 TAM F p to Cfiepter 4MO914. F.S. an officer of a anwatian taho O elects exemption from this Chapter by filing a certificate of election L under this section amt► not remm Llewfits m common under t& D chapter. Ptitstimrt to chapter 44LOS(12L F.S., Certificates of election to be H exempt-. apply only witt+in the scope of dw busilrm or trade tilted an E the notice of election to be exempL R E Pura nt to Chapter 440.05(13), F.S., Nortices of eleWen to be exempt and certificates of eheeCm to be t xettgit shag be subject to MWO5600 if, at any time after the filing of the notice or the isscrdtrre of the cartif'ttete the Person RantedI on the +wtice or terdffcate no lomeer meet: tba requirements of this section for inueoee of a certificatt The departnent shall revoke a certificate at any time for failure of the person named on the certificate to meet the re*dreft eM of the secdom QUESTtt W 1850 413-1609 CUT HERE re Cwry bottom portion on the job keep upper Portion for yovpr records. DW -252 CERTIRCATE OF ELECTION TO BE EXIT RMSED 01-11 Aug 06 13 05:40p ANTHONY LASORSA 561-368-5244 p.1 x • a4Eo ..e s+44 JEFF ATtAdATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES' DIVISION OF WORKERS' COMPENSATION • CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW' • CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 512312013 EXPIRATION DATE: 5/23/2015 PERSON: LASORSA ANTHONY FEIN: 591825354 BUSINESS NAME AND ADDRESS: LASORSA ENTERPRISES INC 383 SW TREET BOCA RATON FL 33432 SCOPES OF BUSINESS OR TRADE: Al LICENSED GENERAL CONTRACTOR Pursuant to Chapter 440.05(14). F.S.. an dkw of a corporation who elects exemption from this chapter by filing a cedroate of election .alder this sedan may not recover benefit or compensation under this chapter. Pu nawd to Chapter 440.05(12), F.S.. Certificates of eiectton to be erxempt.., appy only within the scope of the business or trade Bated on Vw notice of election to be exempt. Phm uwd to Chapter 440.05(13). F.S.. Notices of election to be exempt and certifh-les of election to be exempt shaft to subject to revDC8&m if at. WW tlme atter the drag of the notice oribe Issuance ort Ure oertiRrate. Uta person named an the notice or catOficate no longer meets the requiriments of this section for issuance of a certificate. The department shall revoke a owiiflcate at arry One fbr b&m of the person named on the certificate to meet the requirements or" section. DFS-F24MC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS? (850)413.1809 F Aug 30 13 05:45a ANTHONY LRSORSR 561-368-5244 p.2 i BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A -1 q0, Ft. Lauderdale, FL 33301-1895 - 954-831-4000 VALID OCTOBER 1, 2013 THROUGH SEPTEMBER 30, 2014 DBA: Receipt#:182-2NPLUMBI846 SPRNKL/CONT Business Name' LASORSA ENTERPRISES INC Business Type: (pLumBING) Owner Name:mvioNY LASORSA Business Opened, 05/01/1982 Business Location: 2071 SW 70 AVE G19 State/County/Cert/Reg:CC#80-CMP-533-X DAVIE Exemption Code: Business Phone: 9 54 - 4 74 - 5 5 3 7 ; Rooms seats Employees Machines Professionals 1 For Pending Busln®ss only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Pail 27.00 0.00 0.00 o.aa o.00 o.00 27.00 — -I I THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is iton-regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when ; the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: i Receipt #OlC-12-00011976 ANTHONY LASORSA 383 SW 12 ST Paid 07/03/2013 27.00 BOCA RATON, FL 33432 07/01/2013 Effective Date 2013 -2014 A M,OFM-w �- v ry, ��AN 3� t M, IN I N E-1 M 16 1 W D1 Y 3A M Z11 D IM WRMCATTON WORK SHEET In accm-dance with FEMA regulation and Nrmmi Shores Village Flood Damage Prevention Ordinance the costs of all improvements moist he monitored. The costs of any improvements in the past 12 months and the costs of any proposed improvements most be shown on the worksheet. The cost of m4mvements must include demolition, raw and finished materials (include those donated), Labor (including volunteer and self -performed.), construction supervision and management, and overhead and profit.. A fig of item the costs of which are to be included as well as those excluded is attached for your reference. (A Copy of the Conhad must be aftwhed) PROPERTY OWNER: -A...v,) d rao r r"N ADDRESS: \ 00�at2 I c)- AVZ� L,f FOLIO NUMBER:tj-DS Q(� Q% FLOOD ZONE, tr->zI A�-7- Q BASE F11-001) ELEVATION --- FREEBOARD: -EAST OF FL.CCCL: COST OF PAST IMPROVEMENTS (12 MONTHS): jEb COST OF PROPOSED IMPROVEMENTS:. c�'�4z7 4 (ATTACH 4-1pry ur CON'rRACT) TOTAL CUMULATIVE COST OF IMPROVENWM 4ed and pmposed) VALUE OF PRINCIPAL STRUCTURE (attach apprafsW): � � 6 t a 0Vff4KRS SIGMA PLAN REVIEWER SIGN Created on June 2009 Property Search - Report Property Information: Current Previous Previous 2 Folio 11-3205-019-0370 Property Address 10050 NE 12 AVE Owner Name(s) ANDREW CURZON Mailing Address 10050 NE 12 AVE MIAMI SHORES FL 33138 - Primary Zone 1400 SGL FAMILY - 3001-3250 SQ Use Code 0001 RESIDENTIAL - SINGLE FAMILY Beds/Baths/Half 3/2/0 Floors 1 Living Units 1 Adj. Sq. Footage 2,380 Lot Size 12,148.78 SQ FT Year Built 1953 Full Legal Description _ MIAMI SHORES SEL; 8 REV PB 43-67 LOT 1£ 8 E3t OF LOT 15 BLK )-/, LOT SIZE IRREGULAR OR 13310-331 0587 1 Assessment Information: Sales which are qualified Current Previous Previous 2 Year 2013 �2012 2011 Land Value $221,527 $175,596 $146,330 Building Value $161,364 $180,209 $180,209 Market Value $382,891 $355,805 $326,539 Assessed Value $382,891 $355,805 $326,539 Benefits Information: Current Previous Previous 2 Benefit Type 2013 2012 2011 Homestead Exemption $25,000 $0 $0 Second Homestead Exemption $25,000 $0 $0 Note: not all benefits are applicable to all Taxable Values (ie County. School Board, Gity, Pei;i :+nal). Disclaimer: Page 1 of 2 MIAMI-DADE COUNTY OFFICE OF THE PROPERTY APPRAISER PROPERTY SEARCH SUMMARY REPORT Carlos Lopez-Cantera Property Appraiser ji' Aerial rrotographv 21.'1.2 Taxable Value, Information: Current Previous Previous 2 Year 2013 2012 2011 Exemptioni Taxable Exemption/ Exempti� ,/ Taxable Taxable County $50,000/$332,891 ;0/$355,805 $0/$326,539 School Board $25,000/$357,891 $0/$355,805 $0/$326,539 City $50,000/$332,891 $0/$355,805 $0/$326,539 Regional $50,000/$332,891 $01$355,805 $01$326,539 Sale Information: Date Amount OR Book -Page Qualification Code 3/2010 $410,000 27212-4604 Sales qualified as a result of examination of the deed 5/1987 $133,200 1 13310-0331 Sales which are qualified The Office of the Property Appraiser and N40 -1 -Dade County are continually editing and updating the tax roll and GIS data to reflect the latest pror, , r, ;nformation and GIS positional accura. , No warn ntie ., expressed or implied, are provided for data and the positional or thematic accuracy of wf! data °^jrein, its use, or its interpretation. Although this website is period rally updated, this information may not reflect the data currently on file at Miami -Dade County's systems -of record. The Property Appraiser and Miami -Dade County ;assumes no liability either for any errors, omissions, or inaccuracies in the information provided regardle: s of the cause of such or for any decision made, action taken, or action not taken by the user in reliance upon any information provided herein. See Miami--..ade C.:unty full disclaimer and User Agreement at hrip:ilwww.miamidade.gov/info/disclaimer.asp. Property information inquiries, comments, and suggestions email: pawebmail@miamidade.gov GIS inquiries, comments, and suggestions email: gis@miamidade.gov Generated on: Thu Jul 25 2(113 http://gisweb.miamidade.gov/PropertySearch/printMap.htm 7/25/2013 Page 3 of 3 (not valid without all Building Photographs FL1002.0413ECSee Instructions for Item A6. For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 10050 NE 12TH AVENUE City State ZIP Code Company MAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and `Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the reverse. Front Property Picture 2/10/2010 Rear Property Picture 2/10/2010 Right Property Picture Left Property Picture :e U.S. DEPARTMENIT OFtHOMELAND SEC URITY ELEVATION CERTIFICATE Federal Emergency Management Agency National Flood Insurance Program Important: Read the instructions on pages 1-9. Al. Building Owner's Name OMB No. 1660-0008 Expires March 31, 2012 FL1002.0413EC SECTION A - PROPERTY INFORMATION i Fof' ihsui0hcaComp8ny Use: J A2. Building Street Address (including Apt., Unit, Suite, andtor Bldg. No.) or P.O. Route and Box No. city State ZIP Code MIAMI SHORES Florida 33138 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENCE A5. Latitude/Longitude: Lat. N25d52'05.61 Long. W80d10'25.43 Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 8 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 1862 sq ft a) Square footage of attached garage1� 7 sq ft b) No. of permanent flood openings in the crawlspace or b) No. of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade 14 within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 1512 sq in c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑ Yes ❑ No d) Engineered flood openings? ❑ Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Numberunty Name B3. State 82. Co VILLAGE OF MIAMI SHORES 120652 MIAMI-DADE I Florida B4. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone Date Effective/Revised Date Zone(s) AO, use base flood depth) 12086C - 0306 L 9/11/2009 09/11/09 X and AE 8 NGVD1929 (Zone AE) 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM Community Determined ❑ Other (Describe) B11. Indicate elevation datum used for BFE in Item 89: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) 812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction- ® Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1430, V (with BFE), AR, AR/A, ARAE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized B-400 : AC4679 : 6.72 Verfical Datum NAVD1988 Conversion/Comments THE E ELEVATIONS SHOWN BELOW HAVE BEEN CONVERTED TO NGVD1929 Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 11.20,x feet meters (Puerto Rico only) b) Top of the next higher floor N/A feetH meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) N/A._Q feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) 9.92._0 feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 9.99._© feet ❑ meters (Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 9.69._0 feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) 9.77._0 feet ❑ meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including N/A _E] feet ❑ meters (Puerto Rico only) structural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify that the information on this Certificate represents my best efforts to interpret the data available. Of FLokd I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. y` ��� M vacen A Q Check here if comments are provided on back of form. Were latitude and longitude In Section A provided by a licensed land surveyor? ❑Yes ® No -•=1111 � Form 81-31, Mar 09 Name 1/2010 P: 305 See reverse side for continuation. No. 4512 2/1312010 Replaces all previous editions Page 2 of 3 (not valid without all three pages) IMPORTANT: In these spaces, copy the corresponding Information from Section A. For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. olicy Number 10050 NE 12TH AVENUE City State ZIP Code Company NIC Number SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agenticompany, and (3) building owner. Commentsi-his Elevation Certificate and the information hereon is for floodinsurance purposes only. It is only valid for the person or persons named on this certificate and it should no be d for planning or constriction FL1002 0413EC (rev.0 2/13/2010) Centerline Road Elevation: 9.31 XZ0947,!�` .. _ 2/13/2010 ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is NIA _ ❑feet ❑meters ❑above or below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is N/A Deet []meters ❑above or Ljbelow the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Sectsgp* Items 8 and/or 9 (seees 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is NIA . _ ❑ feet u meters [3a above or below the HAG. E3. Attached garage (top of slab) is N/n ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is NIA _ ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, 8, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B. C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in items G8 and G9. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. G3. ❑ The following information (Items G4 -G9) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7.. This permit has been issued for: [-]New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building ❑ feet ❑ meters (PR) Datum •G9. BFE or (in Zone AO) depth of flooding at the building site ❑ feet ❑ meters (PR) Datum G10. Community's design flood elevation ❑ feet ❑ meters (PR) Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑ Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SI' E AT 7W OpFMST =pECyION I e-'? — -10 PERMIT NO, r -'L TAX FOLIO STATE OF FLORIDA: COUNTY OF MIAMI-DADE. THE UNDERSIGNED hereby gives n6fft* that ft%Pr0V6rh&ft will be made to -certain real property, and In accordance with Chapter 713, Florida Statutes, the following hililbl" -ion Is provided In this'Notice of Commencement I 1. Legal 2. 3. Ownor(s) name and address: Interest In property: .. --9 6(JA fiegE Name and address of fee simple tRIeholder. 4. 001"ItractOr's naMq,,j90drqR and phone number. CFN 2013RO475354 OR Bk 28679 Ps 2840; (fps) RECORDED 06/14/2013 11:36:41 14ARVEY RlJVINr CLERK OF COURT nIAnl-DARE COUNTYP FLORIDA LAST PAGE Since above reserved for We of recordft amee 5. Surety;,,(P8yment bond req4lreo by owner,from contractor, If any) Name, aq,0ress and phone num Amount of bond 6. Lenders name and address: 7. Persons within the State of Florida. designated by Owner upon whom notices or other documents may be served as lirovided by Section �13.13(ixa)7., Florida Statutes, Name, address and phone number B. In bidifklibft tt himself, Owners designates the following person(s) to receive a copy of the I.Jences Notice as provided In. Section 713.121(1i(b), Florida Statutes. Name; address and'0-hone'number- 9. EX1011101tiondtite ofth1s'NdtIc6 of Commencement (ft 600M date Is I year from the date of W*" a 0101enft date Is speoffhad) WARNING TO OWNER: ANY 0AYMENTS MADE BY THE OWNERAFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER! PAYMENTS -UNDER CHAPTER 713; PART I,.SECTION1 713.13. FLORIDA STATUTES, YOUR- UTES, AND CAN'-RESULT'IN'YO'U'R PA'Y*IN(-3'TVWCE FOR PROPERTY. A NOTICE OF. COMMENCEMENT �mUgp BE piEt6Rbtb AND` 006tEb ON THE JOB` tITE'kFbRE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCI ' NG, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING OR RECORDING YOUR NOTICE OF COMMENCEMENT , WORK Sign atote(s)'of Ow!nG') r Owneqs)'Ikported Ofliper/DWector/Partner/Manager Prepared By ,11krad Title/ Print Name Print Name Offi stAltbF FLOki1DA TRIWOMCIR". The was awcnov U F eraofially kn 41i6 folk Signature of me this Z 6) day for Prht-Ngme: VERIFIC" ..........PL UTANT TO SgeiiOm`92E16 C1 nft"%A &'rA'Vnl Notary PuNic State of Florida Under 06fialtibs' of pb7d*, I deblakftt-I -have nkd-fti -461666ing and Diane Schwartz that the facts, stated In It are true, to the best of my kn MY Commission EE 1959n oWledge and bellef. Qvo"4) Ole Expires OS/M2016 Signatures) of Oqdqs) or Omeqs)'s Authorized Officer/Director/Partner/Manager - - - V%^A who signed above: By By 12LOl-62 PACE a SA -11 MIAMI-DADE COUNTY CONSTRUCTION LIEN LAW FOR OWNERS NOTE: IF YOU SIGNED AS THE OWNER'S AGENT YOU ARE RESPONSIBLE FOR DELIVERING THIS INFORMATION SHEET TO THE OWNER OF THE PROPERTY. WARNING TO OWNER Florida's Construction Lien Law (Chapter 713, Part One, Florida Statutes) requires the recording with the Clerk of the Courts a Notice of Commencement for real property improvements greater than $2,500.00. However, it does not apply to the repair or replacement of an existing heating or air conditioning system les than $5000.00 in value. This notice must be signed by you, the property, owner. Under Florida low, those who work on your property or provide materials and are not paid, have a right to enforce their claim for payment against your property. This claim is known as a construction lien. YOU MUST FILE A NOTICE OF COMMENCEMENT For your protection under the Construction Lien Law and to avoid the possibility of paying twice for improvements to real properly, you must record a Notice of Commencement in the Clerk of the Court's Office. You also must provide a certified copy of the recorded document at the construction cation site. The Notice of Commencement must be signed by you, the owner contracting the improvements, and not by your agent. The Notice of Commencement form, provided with this information packet, must be completed and recorded within 90 days before starting the work. A copy of the payment bond, if any is required by you and purchased by the contractor, must be attached as part of the Notice of Commencement when recorded. If improvements described in the Notice of Commencement are not actually started within 90 days after the recording of the Notice, a new Notice of Commencement must be re&rded. You lose your protection under the Construction Lien Law if the payments are made to the contractor after the a giration of the Notice of Commencement. The Notice is good for one year after the recording date or up to the date specified under item nine of the form. Florida law requires the Building and Neighborhood Compliance Department to be a second source of information concerning the improvements made on real property. The Building Permit Application (included with this packet) has been expanded to indude information on the construction lender and the contractor's surety, 6 any. The new application require your signature or your agent's, to inform you of the Construction Lien Law YOU MUST POST THE NOTICE OF COMMENCEMENT AT THE JOB SITE By low, the Building and Neighborhood Compliance Department is required to verify at the first inspection, after the building permit is issued, that a certified copy of the recorded Notice of Commencement, with cttadned bonds if any, is posted at the construction site. Failure to show the inspector a certified copy of the recorded Notice will result in a disapproved inspection, (Florida Statute 713.135(1)(d)). IM01-M PAGE 6 MO NOTICE TO OWNER FROM SUBCONTRACTORS AND SUPPLIERS You may receive a Notice to Owner from subcontractors and material suppliers.. This notice advises you that the sender is providing services or materials. Subcontractors and supplier must serve a Notice to Owner within 45 days of commencing work to preserve their ability to lien your properly. If your address changes from that given in the Notice of Commencement, you should record a corrected Notice reflecting your current address. This is done to help ensure you will receive all notices. RELEASE FROM LIEN FROM CONTRACTOR Prior to paying the contractor, you need to receive a Release of Lien and Affidavit to the extent of payment from the general contractor. The Release of'Lien' and Affidavit shall state either that all the subcontractors and suppliers have been paid or list those unpaid and the amount owed. The contractor is required to list on the Release of Lien and Affidavit any subcontractor or supplier that has not been paid. That amount may be withheld from the contractor's pay and paid directly to the subcontrador or supplier after 10 days written notice to the contractor. If the balance due 'to the' contractor is not sufficient to pay in full all subcontractor and suppliers listed on the contractor's affidavit, you may wish to consult an attorney. The general contractor shall furnish a final Release of Lien and Affidavit to the owner indicating all subcontractor and suppliers have been paid at the time he requests fir payment. You can rely on the affidavit in making final payment to the general contractor. If you make .final payment..to the general contractor without obtaining the affidavit, your property can be liened, for non-payment if the general cor*ador� fails_to. PeYy the succor tractors or, suppliers. You should a6cA obtain a Release of Lien'cnd Affidavit -from the contractor to this extent of°any payments RELY ON YOUR LENDER FOR COMPLIANCE WITH CONSTRUCTION LIEN LAW if you have a lender, you may rely on the lender to handle the recording of the Notice of Commencement. team amore about the Construction Lien Law by contading_,an charms►; your lender, or the Florida D�ortnmt of Agriarltural_and Consumer Services, Division of Consumer Services. Doo menta are recorded at tiles HOUSE Us& 4 Nye Courts, MI, -DADE COUNFY; RECORD„ER,, COU14FAST, 22 N.YV. Fust Strrmet, 1 st Floor, IMiami, FL 33 ,You can record the Notice of Commencement by mail. The original Notice should be sent to the County Recorder, P.O. Box 011711, Flogler Station, Miami, Florida 33101. Please, snake sure llie ongmal Nohoe is.'sig ned and notarize, .Also, remember to enclose the recording fee (for -a single copy) and written instructions for recording and returning a certified copy of the recorded documents. For additional information on Bees and recording documents call (305) 275-1155.