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DS-08-1862
-- Miami Shores Village RECEIVFD Building Department DEc �1�7'2014 10050 N.E.2nd Avenue, Miami Shores, Florida 33138x; Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 l� BUILDING Master Permit NO. %6 &462 PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ENEWAL ❑PLUMBING [:]MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP n!.� /J CONTRACTOR DRAWINGS JOB ADDRESS: ' " (1 p- - City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type:Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): C-UA41 beF) 7452 - a Phone#: Address: City: State Zip: Tenant/Lessee Name: Phone#: Email: II CONTRACTOR: Company Name: CDWU-rS ®t— fx— Phone#: �O� Address: , o Ajo sm city: r Stater Zip: Qualifier Name: Vic—Qly- Leo 1j ( Phone#: -;);6 State Certification or Registration #:60��P77/ Certificate of Competency M DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ (gam Square/Linear Footage of Work: ' L7;k Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Re pairj/Replace ❑ Demolition Description of Work: C ' C, . 1+ An Specify color of color thru tile: C Submittal Fee $ Permit Fee $ J - (� CCF $ CO/CC $ Scanning Fee $ _� • C7� Radon Fee $ 2.D�BP�R $ 2 .'w Notary $ s• L Technology Fee $ 2 Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ U TOTAL FEE NOW DUE $ 1' • - (Revised02/24/2014) 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. i Signature Signature OWNER or AG NT , CONTRACTOR The foregoing instrumeen�tt was acknowledged before me this The foregoing instrument was acknowledged before me this day of . 20 by day of , 20 �� • by Z'&-ZiA,(L , who is personally known to N , who is rsona y mown me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: �otyR % KELLE LANE JACKSON Seal: s, oP EXPIRES: July 1, 2015 9oFct��� Bonded Thru Budget Notary Services as me or who has produced identification and who did take an o�t;h)"" I�iii�����%io, NOTARY PUBLIC: Ilk,' :U-; �o Sign: Print:%. c�`v• 'c��,` Seal: as APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) A� CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 17/17/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Heritage Insurance Services LLC PO Box 1508 CONTACT Tiffade Ellis PHONE (941) %23-1400 (AAX ICC. No): (941) 723-1440 Palmetto, FL 34220 E-MAIL:Rtiffanie@heritageflacom INSURERS) AFFORDING COVERAGE NAIC as INSURER A: North Pointe Insurance Co 27740 04/22/2014 INSURED Building Concepts of Florida 8089 NW 67th ST INSURER B: DAMAGE TO RENTED 1 PREMISES Ea ocaurenoe $ Miami, FL 33166 INSURER c INSURER D : INSURER E: PRODUCTS - COMPIOP AGG $ 2,000,000 INSURER F COVERAGES CERTIFICATE NUMBER- REVISION NUMBER-- THIS UMBER_ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAIVVED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM 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 DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADS SUER POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDDIYYYY LIMITS A GENERALLUIBILITY COMMERCIAL GENERAL LIABILITY CLAIMS4VIADE F71 OCCU2 8090020943 04/22/2014 04/22/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 1 PREMISES Ea ocaurenoe $ MED EXP (Any one person) $ 5,000 PERSONAL 8 ADV NAM $ 1,000,000 GENERAL AGGREGATE $ zw0,0w GENL AGGREGATE LIMIT APPLES PER: POLICY PRO LOC _CTAUTOMOBILE PRODUCTS - COMPIOP AGG $ 2,000,000 $ LIABILITY ANY AUTO ALL OVMED SCHEDULED AUTOS AUTOS HIRED AUTOS NON-OVMNED AUTOS COMBPED SINGLE LIMIT (I, ,M BODILY NAM (Per person) $ BODILY MW(Per accident) $ PROPERTY DAMAGE $ Per acddent $ UMBRELLA LIAB OCCUR EXCESS LIAR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N AOFNYFlCER/MEMPROPRIEBMRER/PA EXCLUDEILUDE/EX£D? CUTNE F (Mandatory In NH) r yes� deVbe under DESCR�TION OF OPERATIONS below N / A VAC STATU- I OTH- LMTS EL EACHACCIDENr $ EL DISEASE -EA EMPLOYEE $ EL. DISEASE -POLICY LIMIT Is DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required) Victor Leoni Building Contractor Ucence#CBC031847 CERTIFICATE HOLDER CANCELLATION Fax#. (305) 756-8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WLL.L BE DELIVERED IN 10050 NE 2nd Ave ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores, FL33138 AUTHORDED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Dec, 17. 2014 9:42AM . 1 No. 4862 P. 1 x17866 ' y:rt • sf+...rr—,1"r• ——...>�• �:'A+-..:.*m r, r:.'•"- 7. f y., ; .. t._ �:q1•r n,•. •. 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The Rami" b Data l etaoertlE boo ppaayy�maaa p� [a asi;.'.:,- peindt ' c"whlthe Itler:a,gWIRaat[pna, to do budum Holdapmust ly oftany povgeamdataL araoaeoFemnedalraeulabyiavy�aodre creme,�1� t�..r�f.���,�1, nf1fff1fh,�' i;»::•^;,`:,;::: • p.,,; :.:n: .; :.•�., t.:.:..:: p.::+•1,^t. � ft!y<,•,S,]M�!f!y.�oyfl to tha�QeJ�,,:.. :..'.i:•°',.,: 1:: �>...._�I••y ; .:-Tha•RECEIPT NUbovam*.44laplayaltioUl'dogti6iioalvahlolia=.IiRtmof Dili cdaBaoBa 47A. ::�' n:' 1, >> FarmblraFoWmAtIonftt&{i.,.••4,:':.`.: 'y. ,t' l}``i°"•:?2._:; i•'?,• a a. . . . CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 12/17/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy (las) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER FrankCrum Insurance Agency, Inc. 100 South Missouri Avenue Clearwater FL 33756 CONTACT NAME: PHONEN No E)d : 1.800277-1620 x4800 FAX No 797-0704 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAICR INSURERA: Frank Winston Crum Insurance Co. 11600 INSURED FRANKCRUM UC/F BUILDING CONCEPTS OF S FLORIDA CORP 100 SOUTH MISSOURI AVENUE CLEARWATER FL 33756 INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: 4UVERAGE.D CERTIFICATE NUMBER: 226915 RFVISIYTNI NIIIMRFR- 7 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSRD SUER WVD POLICYNUMBER POLICY EFF (MMIDON" POLICY EXP (MMIDDJYYYY) LIMITS GENERAL LWEIUTY EACH OCCURRENCE $ DAMAGE TO RENTED $ P 9 oaaarenae COMMERCIAL GENERAL UABILIY CLAIMS -MADE =OCCUR tv1ED EXP (Arty me person) $ PERSONAL&/OVINJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPUES PER: PRODUCTS•COMPIOP AGO $ POUCY PROJECT LOC $ AUTOMOSILELIABILJTY CONIINE% SINGLE UINT $ ANYAUTO ALL OWNED SCHEDULED BODILYINJURY ar ersan $ BODILYINJURY (Per aoddenQ $ AUTOS AUTOS PROPERTY DAMAGE $ HIRED ALTOS NOW -OWNED AUTOS(Peracoldenll E UMBRELLA UAB OCCUR EACH OCURFENCE AGGREGATE $ EXCESSUAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSAna AM EMPLOYERS, LIABILITY YIN ANY PROPRIETOR/PARTNERWECUTNE OFFICERMEMSER EXCLUDED? Q N/A WC201400000 01/01/2014 01/01/2015 X w�sTLl�rrs RY R- E.L. EACH ACCIDENT $1,00DAW (Mandatory In NH) If yes, desodbe rmdar EL DISEASE -EA EMPLOYEE $1,000,003 DESCRIPTION OF OPERATIONS below ELDIB POUCYLUT 81.000.800 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Addrdonai Remarks, Schedule, H more space is required) EFFECTIVE 08115/2011, COVERAGE IS FOR 100% OF THE EMPLOYEES OF FRANKCRUM LEASED TO BUILDING CONCEPTS OF S FLORIDA CORP (CLIENT) FOR WHOM THE CLIENT IS REPORTING HOURS TO FRANKCRUM. COVERAGE IS NOT EXTENDED TO STATUTORY EMPLOYEES. GERTIFICATE HOLDER CANCFI.I.A nnm ©1688-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010106) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WTH THE POLICY PROVISIONS. AUTHORMED REPUSENTATIVE MIAMI SHORES VILLAGE 10050 NE 2ND AVE. MIAMI SHORES, FL 33138 ©1688-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010106) The ACORD name and logo are registered marks of ACORD I 05TUIT, Ml OCT 2 1 2398 SY L ILu but:) tm- C,6%WN �� *M e - t4 c '91 it -74 g �- APPROVED Y uAlt Rp I ZONING DEPT to/ oh PC r BLDG DEPT L SUBJECT TO COMPLIANCE NTH ALL FEDERAL STATE AND COUNTY RULES ES ANn REGULATIONS ATIM10 nlc- li ml;-�- 000, E R M I T #J-2S�- 16, Miami Shores Villac;� FOB I ql,{A pRcLE-SU1TEf0o THOMAS ORAL 011 ES. FLA. 33134 oawc:Il051•••-rss: :tJoot•a-6494 LAND seas: /aosl rn- scss rax SURVEY OF LOT., 0_U4* T. KELLY, INC. SURVEYOR 511801vtsION IN FLAT_900x No - ACCORDING TO THE PLAT TME ' IOF A REC'KlOEO COUNTY. FLORIOA. PUBLIG REf3}A0.g OF FOR. OATS: -LOCATION SKETCH SCALE: 1'*Afi- 4Vt4 tSrQ04.-�lfyJ gw AGI �. JZ vi tis 9 i `� Q _ - t3 16 11 is 3. • Fft CIL m . 29.10' F�ppp.�SSs MS •r � 'p tib'-'.• �1 , $114- •i LO 'i a k ry} r,.. 70.00 -PTW- �*Tws Is IM A FLOW NAZA10 ' ZONE t :� •+Yjtl1 . � �� -•pit ` 'e: WA is 24 d: j� .3 01V l� - w� r Il f}aSty�e�tt�. lYY B.K'/N70 E I' ULIS. �,,TMIS rsA FUM 7" DAMOL PAR& no LOyIEST Fum am SM FLOW MU D spNY.NOT LQCATED, NOTE' 1pf eke l of wom of Nuel 1 Aersey ill$ _,, _._..w..wA.. w.w diretJba, Surveyor a=go tm W*d Wh An EMDsyssd MegLAWTill* Room L It 2H alrorr+. 3. This i Glows A Slu11 0 w� SURVEY no...� SHEET I OF //( Mgj �� a a as N,ca,,psOrh►ps s tSt Q A. CIL m . 29.10' MS •r � 'p S ��3 0 2 PrS� 6.64 3 •i LO 'i a k t2•Q5 70.00 -PTW- �*Tws Is IM A FLOW NAZA10 ' ZONE `�. BATE OF EIIN!' H10tiFST A01 E: r Mus oaA mN}af fo.liN 1>Nf At.+oY�+�saa4� �: 4 �Ia�n ��aUo. Ep, iadss*s ars loon ossemed raerid e I by Prot i elaslHru an refsrrad N.GY_ �&.c 1y28 a load survey - above above 1:7400 SCALE PLAN F I �'.. . I gal—, AR CORE REVIEWER SIGNATURE ?fess$ FOR THE OVAL 0R r�-LnnC-A`s`r' I OF ANY TREE, A PEMMIT EVE -01 IS REQUIRED BY DER1,65. I IIIIII VIII VIII VIII VIII VIII I ull I ull VIII VIII � W VIII VIII VIII VIII VIII II� IIII Oerm Number: 2008-1105-1126-4837 Contact Name: MR VICTOR LEONI Contact Phone: (305)796-0096 Folio: 11-3206-013-0090 Project Name: ZEGRR RESIDENCE Date Received: 11/05/2008 Reviewer Name: MRRIR TUR Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-118246 Scheduled Inspection Date: December 18, 2014 Inspector: Rodriguez, Jorge Owner: ZEGAR, CHARLES AND MERRYL Job Address: 29 NE 91 Street Miami Shores, FL 33138 - Project: <NONE> Permit Number: DS -10-08-1862 Permit Type: Driveways/Sidewalks/Slabs Inspection Type: Final Work Classification: New Phone Number (212)397-9019 Parcel Number 1132060130090 Contractor: BUILDING CONCEPTS OF FLORIDA Phone: (305)796-0096 Building Department Comments REMOVE Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-98090. No plans and no permit on job. NB Failed ❑ 12/18/2014 - Please let inspector know permit is taped to back patio door near pool Correction ❑ Needed Re -inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. December 17, 2014 For Inspections please call: (305)762-4949 Page 1 of 29 Miami Shores village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fag: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 CCT 2 1 2008 By: -------------------- Permit No.vs%- I &o'� Master Permit N Permit Type (circle : Building Roofmg Owner's Name (Fee Simple er) c/� Phone # �� t �� Owner's Address D e i STe'1- City H tAl State Jjs. Zip Tenant/Ussee Name Phone # Job Address (where the work is being done) q i4c Qc <i City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name �y-LCJCt�� (- s� Phone # o (� P Contractor's Address �-1� 67 City I Al Stated Zip Qualifier Name _ Vkpe_ Lcb�l Phone # 7747L9 ® 65 State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ �'' 1 �� Square / Linear Footage Of Work:® C__� Type of Work: E]Addition ElAlteration [-]New [ Repair/Replace ❑ Demolition nAW.P1 h'. WAV -1r. Submittal Fee $ Permit Fee ad CCF $ C Notary $ Training/Education Fee Scanning $ Radon $ DPBR Bond $ 4�eStructural Review. $ N®V 2 1200 Technology Fee $ _ Zoning Double Fee Total Fee Now Due See Reverse side -+ 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 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 app ved and a reins ection fee will be charged Signature Signature `Owner 0 Agent ' ' Contractor The for o n instrument was a wl � ged bef a me this The fore of g 'nstrument was ac w g befor me this day o�G' ' 20 �by LA day of , 20 , . wh Is-bersonally known to me or who has produced Sign: Print: My Commission Expires: APPLICATION APPROVED BY: (Revised 07/10/07) My Commission Expires: Plans Examiner Engineer Zoning