RC-14-1705Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-217306 Permit Number: RC -8-14-1706
Scheduled Inspection Date: January 21, 2015 Permit Type: Residential Construction
Inspector: Rodriguez, Jorge
Inspection Type: Final
Owner: GONZALEZ, RICARDO Work Classification: Repair
Job Address: 150 NW 101 Street
Miami Shores, FL 33138 -
Phone Number
Parcel Number 1131010230210
Project: <NONE>
Contractor: BLANCO DESIGN INC Phone: (954)243-8197
i3miaing Department comments
POOL HOUSE RENOVATION
INSPECTOR COMMENTS False
January 20, 2015 For Inspections please call: (305)762-4949 Page 2 of 37
Inspector Comments
Passed cm,
Failed
Correction
Needed ❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
January 20, 2015 For Inspections please call: (305)762-4949 Page 2 of 37
T
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-222487
Scheduled Inspection Date: October 31, 2014
Inspector: Rodriguez, Jorge
Owner: GONZALEZ, RICARDO
Job Address: 150 NW 101 Street
Miami Shores, FL 33138 -
Project: <NONE>
Permit Number: RC -8-14-1705
Permit Type: Residential Construction
Inspection Type: Slab
Work Classification: Repair
Phone Number
Parcel Number 1131010230210
Contractor: BLANCO DESIGN INC Phone: (954)243-8197
comments
POOL HOUSE RENOVATION
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-221958. CREATED AS
REINSPECTION FOR INSP-221871. Qualifier must see building official
Slab missing vapor barrier and dowel
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
October 30, 2014 For Inspections please call: (305)762-4949 Page 13 of 24
Exterminators, Inc.
4035 S.W. 98 Avenue, Miami Florida 33165
P.O. Box 650213 / Miami Florida 33165-0213
Tel. (305)552-0141 / 1-800 782-9284
FAX (305) 227-1797
WEB PAGE: www.al-flex.com / E -Mail: al-flex@bellsouth.net
Partial Treatment Notice
ProjectNameZSjXJ/!VVI
Lot Block Model:
Service order by:: -P 'ao V� A4 &;NJ`'
04!x%) i e.OD4u79-7 Asr //0-a
Date: /®1�°7 /4L Time: /FF-#
Product Used: --00/7114,11017 =P14-
N� 7881
Property Address: 150
FL
Number of Gallons applied:
Area Treated: ,moo r Tamp: /,.j
Stage of Treatment: Horizontal/Interior Vertical
62u%
Permit #:
Applicator: A&444610
Chemical Used:?
(alive ingredient)
Percent Concentration: 40•4J"
Linear feet Treated :
407 444 7��"4/46T 0 A,? -,W RAW -1
/0.
This Is not valid without a company seal
1. The above noted structure has received the first of two or more required treatmets for the prevention of native
subterranean termites.
2. Upon completion of this treatment and payment of any balance due under this contract, AI -Flex will provide purchaser with
written confirmation that the treatment is completed and the associated limited warranty is in full force and effect.
The limited warranty shall not be considered to be in effect until all required payment has been made.
This form is for inspection or construction draw purposes only. The perimeter of the above strugmi*
accordance with pesticide label and Florida Statue. Warranty and treatment certification will be issd up
treatment.
This form should not be accepted as proof of complete treatment for Certificate of Occupi ncy 0�
NOTICE TO BUILDER: It is the responsibility of the builder to notify AL -Flex Exterminators should�atia%
driveways and entryways. AI -Flex Exterminators must be notified at final grade of structure so finalatrrl
warranty issued, and required paperwork for closing submitted.
THIS IS NOT A PROOF OF WARRANTY
wA\
z
at final grade
American Testing Materials Engineering, I.I.C.
Tasting laboratories - Engineering Inspection Services
Chemist- Drilling- Environmental Services
PROCTOR COMPACTION TEST RESULT
Date
10/27/2014 10rder Number 14-061
Client
Blanc_ o Design Inc.
Address
8932 NE 10th Ct. Miami, Florida
ProJed
S.F.R (Remodelation_ Pool House)
Address
150 NW 101 St. Miami shore, Florida
Sample Location._
Stockpile at jobsite
Soll Description
Tan allies sand
Sam led By
I EV Rs rted To
IABORATORY TESTING RESULTS
[Sample Number: I 1
The is mmg eompadton test was =ducted In a=rdera9 with ft standard mettmft for Mdsbv&V nslly relations of edl using a 101b Hamner
at 18" dm p A-ASHTO Destg wOm T-180.
% Moist. Dry Dan.
7.0
102.0
8.0
104.0
9.8
105.6
12.0
103.0
Optimum Moisture 9.8
100% Max Dry Don
105.6
98% Dry Densily
103.S
95%,Dry Density
100.3_
Gradation Test!
PASSING 314" Si ve 1
1000/6
Em led B V
rested B EV
Checked B WQ
d B CM
108
{
105
l
,
104
�o
1 103
102
101
PROCTOR
8 7 8 9 10 11 12 13
Moisture
Special
ENSs
t4dN,P.E.*1481
�t�or - r97�1®�uildie,
ns
s
clients, and
Should any subsoil conditions In the property (area) tested be found different from
on our Density Test, AMERICAN TESTING MATERIALS ENGINEERING. LLC. Is not ill
As a mutual protection to client, the public and ourselves, all reports are submitted as the
authorization for publication of statements, conclusions or extracts from our reports Is reserved.
reported
or
AMERICAN TESTING MATERIALS ENGINEERING, LLC.
Testing Laboratories - Engineering Inspection Services - Chemist - frilling - Environmental Services
(OTPI. 3876 West 30th Avenue, Hollywood, Florida 33312 - Phone: 954-587-2479 Fax: 954-791-6998
Field Density Test of C�cted Soils
ASTM D-5195
Client:
Blanco Designs Inc Order#: 1 14-0426
Address:
8932 NE 10th Ct. Miami, Florida 33138 Date: 10/27/2014
Project:
S.F.R (Remodeladon Pool House) Gauge SIN: 35637
Address:
150 NW 101 Street Miami Shore, Florida
Phone No:
Moisture Contents
[Attention:
9.7
Test Number LocaBon (s)
1 Bathroom for slab; NE area; (Pool house remodelation)
2 Bathroom for slab; SW area; (Pool house remodelation)
DescNpftan of Material: Tan Sliica Sand
Fill Backll►/ Subgrade Base Rock
Tested B
Test Number
1
2
Depth (in)
12"
12"
Field Density LBICu Ft (Dry Density)
103.9
103.7
Moisture Contents
9.5
9.7
Maximum Density in the Field (%)
98.4
98.2
Compaction Requirement by Specs (%)
98.0
98.0
1004* Maximum Density (Lab)-AASHTO T180
105.6
105.6
Optimum Moisture (%)
9.8
9.8
Status
PASS
PASS
Remarks:
TvmW BY: CM
As a mutual protection to client, the public and ourselves, all reports are submitted as the confidential property of clients, and authorization for publication of
statements, conclusions or extracts from our reports is reserved.
BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department AUG 0 tot
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 Bly
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20 t
Master Permit Ne m— 6'�UJ�
Sub Permit No.
OBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑MECHANICAL ❑PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 150 NW 101 STREET
City: Miami Shores County Miami Dade Zip:
Folio/Parcel#:11-3101-023-0210 Is the Building Historically Designated: Yes No X
Occupancy Type: Load: Construction Type: Flood Zone: - BFE:- FFE:
OWNER: Name (Fee Simple Titleholder): Ricardo Gonzalez Phone#: 786.715.0071
Address: 150 NW 101 STREET
City: Miami Shores State: Florida Zip: 33150
Tenant/Lessee Name: - Phone#:
Email: rgonzalez@basingen.com
Blanco Design, INC 954.243.8197
CONTRACTOR: Company Name: g � � Phone#:
Address: 8932 NE 10 court
City. Miami State: Florida Zip. 33138
Qualifier Name: Sebastian Olarte Phone#:
State Certification or Registration #. CBC1258709 Certificate of Competency#:
DESIGNER: Architect/Engineer: Jose Ruben Jimenez Phone#: 305.582.2836
Address: 7950 nw 53 Street, Suite 337 City: Miami state: FL Zip. 33166
Value of Work for this Permit: $ (0.000 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New N Repair/Replace ❑ Demolition
Description of Work: PoOC ((v u S E 00 A t 10 ,-N
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ ()() CCF $ � „ CO/CC $
Scanning Fee $ ` ) ® Radon Fee $ & ; "t DBPR $ Notary $
Technology Fee $ Training/Education Fee $ e Double Fee $
Structural Reviews $oo Bond $
TOTAL FEE NOW DUE $
(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
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement mzist be posted at the job site ..
for the first inspection which occurs seven (7) days after the building permit is issued In'Ihe Lis of such posted notice, the
inspection will not be appy ed and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instru ent was acknowledged before. a this The foregoing instrument was acknowledged before me this
day f 20 , by 'N5 day of 20 _ ��i':: . by
l� ,who is personally known to � ��-°
meor who h 'ssproduced as -= or who h roduced as
identific/a�io andid to e a oath. identification and; o did take an a
wtnTw.b SII i wt/1'rAnvn�� Irl.
Sign
Sign.
Print:
Print:
Seal:
�OURDES . CHMG
Seal:
LOURDES., CMN
1Y MANN N d FF094767
COhba �, ON # FF09476 _
EXPIRES: Jw&M 2018
EXP :J=09,2018
e�k�k�k4ffi$&�>
L
APPROVED BY
Plans Examiner
r oning
:
Structural Review
Clerk
(Revised02/24/2014)
SEP 0 ft, O%
PREPARED BY&iW o Cm z p, iNa A e& -VA
DECLARATION OF USE
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
KNOW ALL MEN BY THESE PRESENTS:
WHEREAS, the undersigned ' 1.1 i re the fee simple owner(s) of the following described property (°Property
situated and tieing in Miami Shores Village, Florida:
Lots) 12 44 64f OF ta5t l l Block of &W41CAI (Subdivision), according to the plat thereof, as recorded In the Plat Book .
�Page _ofthe Public Records ofMiami-Dade County, Floridada,(addness)150NIA) I01SLftQfl 96W& yi .3316b ark
WHEREAS, the undersigned owner(s) have sought certain development approval from Miami Shores and are providing this document in consideration thereof
and to induce the Village to grant same:
NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which is acknowledged; the undersigned doles) hereby declare and
agree:
1. That the Property will not be used in violation of any ordinance of Miami Shores Village or Miami -Dade County now in effect or hereinafter enacted.
2. That the property will be used for a single family residence only.
3. That he/stie will not convey or cause to be conveyed the title to the above property without. requiring the successor in title to abide by all terms and
conditions set forth herein.
FURTHER, the undersigned decldre(s) that this covenant is intended and shall constitute a restrictive covenant concerning the use, enjoyment and t tle to the
above Property and shall constitute a covenant running with the land and shall be binding upon the undersigned, his/her successors and signs and may only be released
by Miami Shores Vtllage, or its successors, in accordance with the codes, rules and regulations of said Village then in effect.
IN WITNESS WHEREOF, the undersigned hasihave caused
200 L
WITNESSES)
Signature
and Print�Q, 'I I L•
Signature
and Pdn
STATE OF FLORIDA j
COUNTY OF MIAMI-DADE
hand(s) and seal(s) to be aftnced hereto on this day of
I HEREBY CERTIFY that on this day, personally appeared: before ma who is persoriagy known to me or has produced
(type of identification) as identification and he/she acknowledgethat he/she executed the foregoing, freely and voluntarily, for
purposes therein expressed.
SWORN TO AND SUBSCRIBED before me on this day of
My commission expires:
LOMES.A. CHANG
MY COMMISSION # PF094767
&){FIRES: J ma09, 2018