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FW-14-1799Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-218064 Permit Number: FW -8-14-1799 Scheduled Inspection Date: January 29, 2015 Permit Type: Fence/Wall Inspector: Rodriguez, Jorge Inspection Type: Final Owner: COSENTINO, GABRIEL Job Address: 9300 BISCAYNE Boulevard Miami Shores, FL 33138 - Project: <NONE> Work Classification: Wood Fence Phone Number (305)962-1893 Parcel Number 1132060141640 Contractor: STABLE ROCK CONSTRUCTION CORP Phone: (786)877-2796 comments WOODEN FENCE REPLACE AROUND REAR OF""'" PROPERTY INSPECTOR COMMENTS False Passed Inspector Comments Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. January 28, 2015 For Inspections please call: (305)762-4949 Page 4 of 39 BUILDING PERMIT APPLICATION BUILDING ❑ ELECTRIC Miami Shores Villageii Alli 18 2014 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 FBC 200 Master Permit No. Sub Permit No. ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: -lJco $i5cAy►,�e Fq yiD City Miami Shores County Miami Dade Zip: 3 31-39 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder):LP56_ 1 ( N 0 Phone 6%S) Ci la -(C:bci Address: �'Mz 2(ScAa16je UL'D City: L'L( e+ ° I 5 Ry4LC-S Stater Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: !3`-� ✓� N` ��d��°1 �'� Phone#: `� i ��q Address: 3 1%O -71 City: iia i /$lam I 1'6V-�q State: IF -L- Zip: -!�, 3) 4 Qualifier Name:/oc-it A. Phone#: I; State Certification or Registration #: C CC 152-1 1 kA (4 Certificate of Competency #: _ DESIGNER: Architect/Engineer: Phone#: Address City: —State: Zip: Value of Work for this Permit: $ .7 0 C . Square/LinearFootage of Work: �� L i' Type of Work: ❑ Addition ❑ Alteration ❑ New E2 Repair/Replace ❑ Demolition Description of Work: Wcr pei ! FENc-G=-l�- _5A On _ Specify color of color thru tile: Submittal Fee $ c Permit Fee Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Radon Fee $ Training/Education Fee $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ �f 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 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 —41iii OWNER or GENT CONT CTOR The foregoing instrument was acknowledged before [mee this day of AUG u 5- 20 � l by who is personally known to !l me or who has produceJf'0'�! ��lte)tdCDC as identification and who did take an oath. NOTARY PUBLIC: Print: 'C Seal: / lim AMA WCMffM=6W=W WMAUG 21,2015 lot kwm= APPROVED BY (Revised02/24/2014) The foregoing instrument was acknowledged before me this day of G T , 20 ) q by 1(.>jZPwho is personally known to me or who has produced < Ah as identification and who d take an oath. NOTARY PUBLIC: Sign: pz7t Print: o Seal: Plans Examiner Structural Review I 1� 1. - � .� .- I I -�- : t= �, . , .1 , . /t Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT B. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. C. COPY OF LIABILITY INSURACE* D. COPY OF WORKERS COMPENSATION INSURANCE* *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: s4A-b w- zxjZ c z, ar ° BUSINESS ADDRESS: 3 , Caa ws Ayk- JL7 1 CITY tjt 5L I 136- A-Ust STATE IPL ZIP CODE 33) LI 0' BUSINESS PHONE: aft—). VOL 225 ( FAX NUMBER3(�S ) S�35- - 7 CELL PHONE (]!�L) 22M -2251k QUALIFIER'S NAME: A-bYIe,(- AMNI QUALIFIER'S LIC NUMBER: OkC 1 S 1119 q From: Javier Gututier�rez� Fax: +1 (306) 463-9431 To: Fax: +1 (306) 768-8972 Page 2 of 2 08115120141:27 CERTIFICATE OF LIABILITY INSURANCE-DATE(MM/DDIYY'Y) IILIR S A TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL (ABILITY 08/152014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOTAFFIRMA71VELY 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 ALL CITY INSURANCE INC - ACI CONTACT CARMEN RODRIGUEZ 275 FONTAINEBLEAU BLVD. SUITE 190 MIAMI FL 33172 PHONE (305) 463-9431 FAX .(305) 436-6797 WD E-MAIL CRODRIGUEZ@ALLCITYINS.COM INSURERS AFFORDING COVERAGE NAIC S INSURERA:MID-CONTINENT CASUALTY 00 23418 INSURED STABLE ROCK CONSTRUCTION, CORP 3200 COLLINS AVE # 71 PERSONAL&ADV INJURY 1,000,000 Miami Beach FL 33140 - INSURER D :. I URER E : RG •171 MY IY VIYIOGR: `` THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. IILIR S A TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL (ABILITY DDL SUBR NUMBERPOLICY 04GL893070 EFF fflhumm= 0/032013 POPOLICY LICY EXP (M 10/032014 LIMITS EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED 100,000 CLAIMS -MADE OCCUR MED EXP one rson EXCLUDED PERSONAL&ADV INJURY 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- LOC PRODUCTS - COMP/OP AGG $ 1,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT H ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ 1 $ UMBRELLA LIAB EXCESS LIAR HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ WORKED COMPENSATIONWC AND EMPLOYERS' UABILTfY ANY PROPRIETOR/PARTNEWEXECUTIVE Y I N OFRCERIMEMBER EXCLUDED? (Mandatoryes.crib NFq If es describe under N / A STATU OTH- E.L. EACH ACCIDENT E.L. DISEASE- EA EMPLOYEE DISEASE- POLICY LIMIT _1_7E.L. COIVTRADCTOO LIC#ERAT 15S I LOC TIONS I VENCLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) 744 CERTIF7CATC Writ neo / 1 Y.%(. V MIAMI SHORES VILLAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd AVE MIAMI SHORES FL 33138- AUTHORIZED REPRESENTATIVE v i nee ZU1 U AL;UKU CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CON uSEC. iasw TtE; NUNS t�vl C'CW 196 01 MR, "ALGCI 5 Al,h: Loeal"e5s Tau Reciinly *ad= It or ar tr cWon often der's oa% nongeji and tura The REG MO ahovest b displ4od on ag win PAYMENT ;"AX C4 vim any 'r r I STATE OF FLORIDA A. DEPARTMENT OF BLISI PROF- ' ON ESSAND f; CGC1521744 x:09115/2013 CERTIFIED NUNEZ, AB x a STABLE RO , n IS CERTIFIED under the provisions of Ch.489 FS. Exphation date : AUG 31, 2014 L1309160000633 r� Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore, you may be personally liable for.the worker compensation injuries of any person allowed to work under this permit Please check with your insurance carrier since most property insurance policies DO NOT cover this type of.liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Print Name Signature: Owner State of Florida ) County of Miami -Dade) Sworn to and subscribed before me this day of &ZI /5 20—/—V—. CA (SEAL) Type of Contractor Print Name: bi(,.1/ AUP L Signature: State of Florida ) County of Miami -Dade) Sworn to and subscribed before me this day of /�FAI ! , 20L By A/ of JEFF ATWATER 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: 9/26/2013 PERSON: NUNEZ FEIN: 201886079 BUSINESS NAME AND ADDRESS: STABLE ROCK CONSTRUCTION CORP 3200 COLLINS AVE. #7-1 EXPIRATION DATE: 9/26/2015 ABNER A MIAMI BEACH FL 33140 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL CONTRACTOR Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS? (850)413-1609 a LOT 7 LOT 5 BLOCK 65 BLOCK 65 i! f ASp/ULT PAYENLprI • J, O V J F.LP, r Z LOIN) 7� Z WANDER OF LOT JO V BLOCK 55 4.1 rrm. Na ,s.eo• •.,ao• : rip. r/2' 54CSW 83.94 Rel `IN, $ �p ..... . V 7r A=r-0E-wAY (0Y?LATJ O .. .... ♦ Q"� ZIYt ASPHALT PAmmr. N. E... 93rd • STREET ' . / V. 1K �117 J AUG, 18 2014 / e �y .. •�'�'•::•.•:•:: .. � : Q� .��• rid �Q r�� WALL IN POOR CONDITION. OWNERSHIP NOT DETERMINED. MAP OF BOUNDARY SURVEY Property Address: 9300 BISCAYNE BLVD MIAMI SHORES, FL 33138 n� lineLappnd S6fR9�E H�pOY9SONC. 7925 Coral Way Miami, FL 33155-6524 www.OnlineLandSurveyors.Com Survey Date:7/3/2014 Survey Code:0-12044 :URVEY IS A TRUE RECTION THIS / THE STATE OF T•S. FLORIDA /chi CIS•• �@F .�i� v 0 5259 STATE OF Q A:. FLORIDA c� SIGNED _ 1 �+ FOR THE FIRM FERNANDO V. t;jOlj I�UR' E� t ��`` P.S.M. No. 5259 STATE OF FLORIDA NOT VALID WITHOUT AN AUTHENTIC ELECTRONIC SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL, AND/OR THE SIGNATURE ANMDR THE ORIGINAL RAISED SEAL OF A LICENSED SURVEYOR AND MAPPER. THE SEAL APPEARING ON THIS DOCUMENT WAS AUTHORIZED BY FERNANDO V. GOMEZ, P B.M. NO. 5258 ON THE SURVEY DATE NOTED Page 1 of 2 Not valid without all pages. q1qu'X-t4-2-19 o Shadow Box o Vertical Picket V Board on Board May 2009 L.illkts ill c -L Miami shores Village Building Department WOOD FENCE DETAIL 4x4 Post Spacing Fences <= 5' high posts spaced at Ton center maximum Fences <= 4' high posts spaced at 6"on center maximum Fence must not exceed Yin height 4x4 pressure treated posts embedded Tinto concrete footing 10" diameter x 2'deep ALL wood must be pressure treated I All fasteners must be corrosion resistant L No less than two fasteners in any connection 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 1x pickets fastened with two corrosion resistant fasteners per connection 2x4 horizontal pressure treated wood members with two corrosion resistant fasteners per connection