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DGT-14-20910 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-220308 Permit Number: DGT-9-14-2091 Scheduled Inspection Date: February 23, 2015 Inspector: Rodriguez, Jorge Owner: BECERRA, EDUARDO Job Address: 839 NE 97 Street Miami Shores, FL 33138 - Project: <NONE> Permit Type: Decks/Gazebos/Trellises Inspection Type: Final Work Classification: Pergola Phone Number (786)390-3312 Parcel Number 1132060142610 Contractor: FLORIDA PERGOLA LLC Phone: (305)400-0200 tsullaing Department comments BUILD PERGOLA INSPECTOR COMMENTS False February 20, 2016 For Inspections please call: (305)762-4949 Page 7 of 28 Inspector Comments Passed P�t�/ Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid February 20, 2016 For Inspections please call: (305)762-4949 Page 7 of 28 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-227701 Scheduled Inspection Date: February 19, 2015 Inspector: Rodriguez, Jorge Owner: BECERRA, EDUARDO Job Address: 839 NE 97 Street Miami Shores, FL 33138 - Project: <NONE> Contractor: FLORIDA PERGOLA LLC comments V -1111111111191112:10061 W.1 Permit Number: DGT-9-14-2091 Permit Type: Decks/Gazebos/Trellises Inspection Type: Framing Work Classification: Pergola Phone Number (786)390-3312 Parcel Number 1132060142610 INSPECTOR,COMMENTS False Phone: (305)400-0200 Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-226625. CREATED AS REINSPECTION FOR INSP-225622. CREATED AS REINSPECTION FOR INSP-220309. Same comments as before on front of permit card on 12/11/14 Failed ❑ Provide ladder to inspect lag bolts Eng letter does not adress lag bolts per rafter 02/05/2015 Correction CANCELLED BY JOSE Needed ❑ ��✓��5j Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid February 18, 2015 For Inspections please call: (305)762-4949 Page 10 of 30 265 South Federal Highway Suite 109 Wavne M. Bennett Deerfield Beach FL 3344411 Monday, December 15, 2014 Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores, FL 33138 Re: Permit No.: DGT-9-14-2091 Name: Becerra Residence Address: 839 NE Oh Street, MS Contractor: Florida Pergola To Whom It May Concern, I was asked by the Contractor to write a clarification letter for the rafter connection detail for the above mentioned permit is to be: • 3/8" x 8" Galvanized Lag Screw, per Rafter into the Lintel • (4) 4" Stainless Steel Screws, per Rafter into the Ledger If there are any questionsMM4fligitact me. jk KNAM ii Sincerely,♦X 57 N216 o •;�3► • :*do .. .0 TATF OW of IR •• `♦ WaYn kham '•�..�...•••' �` N 10 - Professional Engineer • PE 57216 wmbennettpe@gmail.com (954) 818-3825 Miami Shorse ilia e 9 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 ff.- The f: 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 maybe personally liable for the worker compensation injuries of any person allowed to work under this permit. please check with your insurance carver 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. Owner Contractor � Print Name: W Print Name: ! 0, ,Q,y 'g.- � o. fl Signature: z ®_ .,._ .. 0N ignature: ,. State of Florida) a € State County of Miami -Dade Sworn to before 14Sworn „-- " of Florida) County of Miami -Dade) a and subscribed me this to and subscribed before me this �b day of�� _� 20 i �,••'"w••, X0,10, -day of N OtrGlc r� 20114 ..•�"�' ,• -�0 CA , I 0 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: 11/14/2014 EXPIRATION DATE: 11/1312016 PERSON: BOVELL MATTHEW FEIN: 461250984 BUSINESS NAME AND ADDRESS: FLORIDA PERGOLA INC 12255 SW 128 STREET, SUITE 406 MIAMI FL 33186 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL CARPENTRY NOC CONTRACTOR Pursuant to Chapter 440.0.5(14), F.S., an officer of a corporation who elects exemption from this chapter by fling a c erttficate 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 bade limed 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 c affi irate, Me person named on the notice or certificate no lonW meets the requirements of this section for issuance of a certificate. The department shelf revoke a DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (1350)413-1608 Miami Shores Village Building Department SEP 2 4 2014 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 f_ Tel: (305) 795.2204 Fax: (305) 756.8972' INSPECTION'S PHONE NUMBER: (305) 762.494 BUILDING PERMIT APPLICATION Permit Type: WELDING JOB ADDRESS: 839 NE 97 STREET FBC 20 Permit No. Master Permit No. ROOFING City: Miami Shores County: Miami Dade Zip. Folio/Parcel#: 11-3206-014-2610 Is the Building Historically Designated: Yes NO Flood Zone: 33138 OWNER: Name (Fee Simple Titleholder): EDUARDO BECERRA Phone#: 786.390.3312 Address: 839 NE 97 STREET City: MIAMI SHORES State: FL zip: 33138 Tenant/lessee Name: N/A Phone#: Email: CONTRACTOR: Company Name. FLORIDA PERGOLA INC Phone#: 305.400.0200 Address: 12255 SW 128 ST SUITE 406 City: MIAMI State: FL Zip: 33186 Qualifier Name: MATTHEW BOVELL Phone#: 305.400.0200 State Certification or Registration #: CGC1518817 Certificate of Competency #: Contact Phone#: 305.400.0200 Email Address: MBOVELL@FLORIDAPERGOLA.COM DESIGNER: Architect/Engineer: WAYNE BENNETT Phone#: 954.818.3825 Value of Work for this Permit: $ , quare/Linear Footage of Work: Type of Work: DAddition OAlteration w ORepair/Replace Description of Work• BUILD PERGOLA Color thru tile: 667 1/2 SQ FT ODemolition Submittal Fee $ Permit Fee $ CCF $ G o n( CO/CC $ Scanning Fee $ ^� f Radon Fee $ DBPR $ _ o Bond $ Notary $ Training/Education Fee $ �� Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ fit' 1-4 14 ; bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City s� All,# 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 the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Owner or Agent The foregoing instrument was acknowledged before me this 9 day of , 20 i who is rsonally known to me r who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign. Print: C1 ri My Commission Expires: APPROVED BY 11f3LI(a-o).4- /e4 Signature -�,,__ Contractor The foregoing instrument was acknowledged before me thisq�K, day of � 41t» �, 20 j4, by f ,► AA whois pers! kn me or who has produced ADRu*AKURA Palk . Rwe at Fwta Plans Examiner Structural Review (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) identification and who did take an oath. NOTARY PUBLIC: PO OtEE1i6199 (O 11,2016 ,uN Sem My Commission Expires: /0 Zoning Clerk E" ffibO Tex DBAIBUSINESS NAME: FLORIDA PERGOLA INC BUSINESS LOCATION: 12255 SW 128 ST 406 MIAMI, FL 33186 OWNER/CORP. FLORIDA PERGOLA INC C/O MATTHEW C BOVELL PRES PHONE # 305-400-0200 12255 SW 128 ST 406 MIAMI, FL 33186 NAICS CODE: 2389 MIAMI-DADE COUNTY - STATE OF FLORIDA N/A October 15, 2014 LOCAL BUSINESS TAX RENEWAL 2014 -2015 APPLICATION RECEIPT. 6979513 STATE # CGC1618817 BUS. COMMENCEMENT DATE: 10/01/2010 SEC TYPE OF BUSINESS BLDG1 GENERAL BUILDING CONTRACTOR 1 If no longer in business, please notify us in writing. Review and correct the information shown on this application. A 25% penalty will be assessed to anyone found operating without a paid local business tax, in addition to any other penalty provided by law or ordinance (Sec 8A-176(2)). A Certificate of Use and/or City Business Tax Receipt may also be required. APPLICATION DETAILS FEE AMOUNT Receipt Fee 30.00 UMSA Fee 30.00 Beacon Council Fee 15.00 Bingo Permit Fee 0.00 Nightclub Permit Fee 0.00 Multi -Municipal Contractor Fee 0.00 Restricted Contractor Fee 0.00 Library Fee 0.00 Transfer Fee 0.00 Doing Business without a License Penalty 0.00 Late Penalty 0.00 Collection Cost 0.00 NSF Fee 0:00 Prior Years Due 0.00 Amount Recently Paid TOTAL AMOUNT DUIE: 0.00 To pay online go to www.mlamidade.gov/taxcollector To pay by mail, make check payable to: Miami -Dade County Tax Collector Business Tax 200 NW 2nd Avenue Miami FL 33128 To pay in person go to: 200 NW 2nd Avenue (305) 270-4949, fax (305) 372-6368 A service fee of not less than $25.00 up to a minimum of 5% will be charged for all returned checks. + RETAIN FOR YOUR RECORDS + ................................................................................................................................................................................................................................................................................................................. MIAMI-DADE COUNTY - + DETACH HERE AND RETURN THIS PORTION WITH YOUR PAYMENT + N/A October 15, 2014 STATE OF FLORIDA LOCAL BUSINESS TAX RENEWAL III I I II I RECEIPT: 2014 - 2015 APPLICATION STATE #CGC1518817 7068943 BUSINESS LOCATION: 12255 SW 128 ST 406 MIAMI, FL 33186 BUS. COMMENCEMENT DATE: 10/01/2010 OWNERICORP. FLORIDA PERGOLA INC C/O MATTHEW C BOVELL PRES FLORIDA PERGOLA INC C/O MATTHEW C BOVELL PRES 12255 SW 128 ST 406 MIAMI, FL 33186 SEC TYPE OF BUSINESS BLDG1 GENERAL BUILDING CONTRACTOR APPLICATION IS HEREBY MADE FOR A LOCAL BUSINESS TAX RECEIPT OR PERMIT FOR THE BUSINESS PROFESSION OR OCCUPATION DESCRIBED HEREON. 1 HAVE BEEN INFORMED OF ALL ZONING RESTRICTIONS IMPOSED ON THIS RECEIPT. I SWEAR THAT THE INFORMATION IS TRUE AND CORRECT. SIGNATURE REQUIRED SEE INSTRUCTIONS ABOVE Please pay only one amount The amounts due after Sept 30th Include penalties per FS 205.053. lfReceived By Oct 31, 2014 Nov 30, 2014 Dec 31, 2014 Jan 31, 2015 Please Pay $0.00 $0.00 $0.00 $0.00 7000000000000000000000006979513201500000007500000000000007 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, f D 0 ` ji Do N , +1-1�,Iloes hereby attest that (Property owner) The attached survey, performed by A CF— (Name of surveyor's company) For address: A �'+ $ H o(2£ S r( 33,3e Performed on I z �� (date of survey) is an accurate representation of the existing conditions 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 building permit for the property without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or 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. Furkiar,,Affiant say a ght. . t Li -O a7z)o /11 . 36 2g,.q Property Owner Signature Property Owner Print Name SWORN TO AND SUBSCRIBED before me this day of 5j 4 Affiant is—A—Personallyknown to me, produced as identification. ° Nom Publk . State of Florida Revised• kV��SNa►21.20T on 5/2212009/ Revised on 6/12/09 'r.,r, c * R 072475 ••+i P •0.90• 9999•• • • • 9999•• 9999• 9999• 9999•• 9999•• • 0000•• BOUNDARY SURVEY LEGEND X - FOUND X CUT Q - FOUND 5/8' IRON ROD ® -FOUND 1/2- IRON PIPE ® -WATER METER ABBREVIATIONS: A/C -AIR CONDITIONER SLAB CL - CENTER LINE CB -CONCRETE BLOCK EM- ELECTRIC METER FIP -FOUND IRON ROD FIR -FOUND IRON ROD CONC. - CONCRETE P -PLAT M -MEASURED NO ID -NO IDENTIFICATION OHW - OVERHEAD WIRES RNV - RIGHT -OF --WAY UE -UTILITY EASEMENT • 9999 • 9999 • 9999 • 9999• • 30 0 00 00 30 •••i (IN FEET: • • 1 INCHES = 3Q FT. • :so* • 1h h1.ii/7�1 ASPHALT DRIVEWAY W TOTAL RAY (18.SASPHALT PAVENENI) ACEFLOOD 9 INSP,�ppEC T/ONS B� P LXX W, M LB#6002 THIRD PARTESMaYNOTSE TRANSFERRED ORASS141KW PROFESSIONAL DESCRFrat DATE BY. SURVEYORS REWRSM AND MAPPERS Rl yVEM 4801 HOLLYWOOD BLVD., SUflE C HOLLYWOOD, FLORIDA 33020 DATENFIaD: DWALRLE PHONE. 954-924-1808 FAX DRAWNBy EOC DATEMVW 071IM3 954-924-1809 CB/londendb vn 00.COm I CR830Br ,, S9374X13 SHEET OF 9999•• 9999•• 9999• 9999• 9999•• • • •••••• 9999•• 15' ALLEY RAN(8'ASPHALT PAVEMENT} S89 -59-46 -E 125'(P&NI) M 0.r c LOT 17 LOT 18 • • . • BLOCK 73 BLOCK 73 0 00 WEST 1,10E EAST W OF • • C CLE FEN• LOT 18 BLOCK 73 LOT 18 BLOCK 73 i so*: p NOT INCLUDED • • :9 $ v • 996600 ft� 40.57sees goes* � • • •••999 . 11.a +s • • • • • • � COVERED] 1aa • • • • • Lc",,? • las CONI. N yt m • abw4 We aos t., � 1 _. ••• •9:•• •r7 2 ONESTORYN A/C m � � • � • • • • � � � a RESIDENCE sm V ••• • • $ • 0 . 115' lie w CONC. LANA ' 16-W °R 1aA i.a 0 1h h1.ii/7�1 ASPHALT DRIVEWAY W TOTAL RAY (18.SASPHALT PAVENENI) ACEFLOOD 9 INSP,�ppEC T/ONS B� P LXX W, M LB#6002 THIRD PARTESMaYNOTSE TRANSFERRED ORASS141KW PROFESSIONAL DESCRFrat DATE BY. SURVEYORS REWRSM AND MAPPERS Rl yVEM 4801 HOLLYWOOD BLVD., SUflE C HOLLYWOOD, FLORIDA 33020 DATENFIaD: DWALRLE PHONE. 954-924-1808 FAX DRAWNBy EOC DATEMVW 071IM3 954-924-1809 CB/londendb vn 00.COm I CR830Br ,, S9374X13 SHEET OF 9999•• 9999•• 9999• 9999• 9999•• • • •••••• 9999••