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DS-14-1150Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-213490 Scheduled Inspection Date: February 20, 2015 Inspector: Rodriguez, Jorge Owner: YZQUIERDO, JOSE Job Address: 1351 NE 101 Street Miami Shores, FL 33138 - Project: <NONE> Permit Number: DS -6-14-1150 Permit Type: Driveways/Sidewalks/Slabs Inspection Type: Final Work Classification: Addition/Alteration Contractor: APOGEE CONSTRUCTION & DEVELOPMENT CORP Building Department Comments Phone Number Parcel Number 1132050230080 Phone: (954)529-4552 REMOVE EXISTING ASPHALT DRIVEWAY REPLACE Infractio Passed comments WITH PAVERS I INSPECTOR COMMENTS False February 19, 2015 For Inspections please call: (305)762-4949 Page 6 of 27 Inspector Comments Passed ' Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid February 19, 2015 For Inspections please call: (305)762-4949 Page 6 of 27 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fran: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 PERMIT APPLICATION Permit Type: BUILDING Permit No. JUN 0 3 2014 FBC 2016 Master Permit No. Of j /'-/—//. -b ROOFING JOB ADDRESS: 9 Z-51 1'�'%7=7 1c) C 4 City: Npiami Shores County: Miami Dade lap: �� > 3 °�• Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: OWNER Name (Fee Simple Titleh Address: )13 7 1 '` ll City: AA 10'" Tenant/L.essee Name: Email: 0 �105a y L�tie 3A - State: CONTRACTOR: Company N e: V co�" 'v Address: �C3 City: State: Qualifier Name: State Certification or Registration #: CQ (O& t C3 ® `4 Certificate of Competency #: Contact Phone#: DESIGNER: Architec t/Engincer: Address: 3�4 - �4zz cp as 1 IS& Value of Work for this Permit: $ 4500 00 — S"ardLinear Footage of Work: '4 S ® (-) ��: . Type of Work: ❑Addition _.-, ❑Alteration WNew epair/Repjace ❑Demolition Description of Work: Color thru We: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ ovyl \iC W CCF $ CO/CC $ DBPR $ Bond $ Technology Fee $ 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 City State zip Tip 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs sev") days after the building permit is issued In the absence o such posted notice, the inspection will not be approved and a rfi&-spe)Won fee will be charged O r Or Age:C�eAd The foregoing ins was ackn fore me this Zo f N- by��is personally known to me or hhp has produced As identification and who did take an oath. NOTARY PUBLIC: My �s�� Feliciano �N� My Commission FF 082753 ��ci" Expires01/12J2018 APPROVED BY The foregoing ' nt was ackno edged be me this day of U b Mk Z�v Plans Examiner Structural Review (Revised 3/12/2012)(Revised 07/10/(Y7)(Revised 06110/2009)(Revised 3/15/09) personally known to or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Nota Pum state of Ruide Il�ciano My CanmWWw FF 082753 Expires 01/12/2018 «a� 7Sa�Lc# �$a$agegega�s�a�tgs�$a�����a� �r�� Zoning Clerk LtKTIFICATE.OF LIABILITY D" °D"rY' INSURANCE 022/04/04/15 PRODUCER Excellence Insurance Agency THIS CERTIFICATE 1S ISSUED ASA MATTER OF INFORMATION 3801 SW 107 Avenue ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Mlaml, FL 33165 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE P LI E Ow. (305)226-3900 Fax (305)228-3997 INSURERS AFFORDING COVERAGE MAIC IF INSURED Apogee Construction and Development, Corp ►NSURF_ft A: WMISM World Insurance Company 13196 304 Indian Trace #503 .#QYRER B: Weston, Florida 33326 INSURER C: INSURER D. INSURER 8: COVERAGES INSURER R THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED 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 DESCRP311D HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR amp —ADD'. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATEORM _ PDLICYExPIRATION DATE LIMITS A❑❑ ❑ GENERAL LIABILITY ® COMMERCIAL GENERAL LIABILITY CLAIMS MADE 6111 -OCCUR ❑ ❑ --- NPP8213290 01/02/15 01/02/16 EACH OCCURRENCE 11000,000,00 DAMAGE TO RENTED PREMISES IR!-cuermu100,000.()0 MED EXP (Anyone person) 5,000.00 PERSONAL & ADV INJURY 1,0001000.00 GENERAL AGGREGATE 21000.000.00 GEN'I. AGGREGATE LIMIT APPLIES PER: © POLICY ❑ PROJECT ❑ LOC PRODUCTS -COMP/OPAGG 1,000,000.00 AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OWNED AUTOS COMBINED SINGLE LIMIT Ea apeo"t ❑ ❑ SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON OWNED -AUTOS ❑ BODILY INJURY (Per Demon BODILY INJURY (Per accident) PROPERTY DAMAGE Per eowent ❑ GARAGE LIABILITY © ANY AUTO ❑ . AUTO ONLY - EA ACCIDENT ~ OTHER THAN EA ACC AUTO ONLY: AGO ❑ EXCESSIUMBRELLA LIABILITY ❑ OCCUR ❑ CLAIMS MADE EACH OCCURRENCE v AGGREGATE ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER I MEMBER EXCLUDED? ❑ TU- ❑ OTH- , ER E.L. EACH ACCIDENT E.L. DISEASE • EA EMPLOYEE If you, dwribe under SPECIAL PROVISIONS below E,L DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT/ SPEC ROVI NS General Contractor , License #: CGC 061004 CERTIFICATE HOLDER VILLAGE OF MIAMI SHORE 10050 NE 2DA Ave Miami FL.33138 FAX:305-753-8972 )01/08) QF SHOULD AIV AB 9 119 ?RIBSD PSYLICIES BE CANCELLED BEFORE THE EXP A' 0 T E 9I8SUE 0`INSURER WILL ENDEAVOR TO MAIL THE 30 RE .N CET HE IFICA71: HOLDER NAMED TO IMPO OF ANY T AIL T SDO R �H AG_9NTS'ORNREPRESENTATIVESN OR LIABILITY 1.0011.00'd 0:1) 6VOL SLOZ1N= ......._..... ...... 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. Owner Print Name: Signature: State of Florida ) �---' County of Miami -Dade) Sworn to an subscribed before me this day of 'Q� , 29--_14 (SEAL) My c mft mn FK 962733 6x0rss 9111212916 Print N Signature: v,� State of Florida ) County of Miami -Dade ) Sworn to and subscribed before me this day of 20. EX*m 01/12/2018 JUN 0 3 2014 a D Uri -- — --___ _ 0 0 � LOT 6, BLOCK 2 LOT 2, BLOCK 2 OLR 9' WP. FJP VY ••..,e. LP 1l2° N 9s•9o•9a• E IIB ' NO CAP umm A. ° W.NI. ° U•P� LOT 3, BLOCK72 P. a� Y 700fY0 a8 oao � ro I ani C, LL, �i z T ` EXI9TINCi PLANTER i yt W EXIBTINfa A/C PAD TO BE REMOVED TO /�('� BE REMOVED I Q TO Be REMOVED INC y yr i q� 1 J �a v— W 1 -1 T 4, BLOCK 2 I EXISTING I° w z 81Nr_i v PAMILT NOME. TOIBE REMOVEDR I W W R�FJ€3 _ V /�n/ ♦ `) d I t .7t• _ 3C.8' I FJ.PlW p NO CAP 21 W EXISTNO PLANTER L TO BE REMOVED ry COPE OF VYORK I xil IMO P. R 1.NEW INTERIOR REMODELING. TO ISIS 2. NEW C UNIT REPLACING E%STING A/C UNIT J. NEW ELECTRICAL WORN 4. NEW IMPACT WINDOWS AANLLD EAMOR DWRS. — \ 5. NEW PLIAGINGROOF TO /I 6. ALL NEW ROOF TO REMAIN. 7. ALL NEW WORK WITHIN E%ISRNC WALLS. NO AOD(TION THIS PERMIT. E7Q8'f. T D i' PIP 12' . _.. P.C. R.79O0• PIP ® L•3969' � NO CAP T9n.79A3' 74• PWY A-ww•m9• 04.3849' ® 4 045.N49'197N>'E th _ TREET_ -� PERM T LEGAL DESCRIPTION — — I°t9. BMaR2Ot8AY PARWEBTAtEB,mom&ptetln Pbt ---�� R NRmbNnCeuA�t'P blW� iami res Mlle- �,.m PEOPERTPADDEERSr 188, ME.,QI all:^•:.,: _ eme. mma lwwwsh n�FL38,Tw APPR 13Y PEOPEMFVL/ONMBM ti 8131• b' 7. uavvAn „,2054231 ZONING DEPT '` - ., w srTE PIAN V"- -0 _ .8,76' ' B� FOR SPA BLDG DEPT _!AT';'.; IQs NORTH SUBJECT TO COMPLUaNCE WITF i ALL FEDERAL py✓ STATE ANT) CCUNSY RULES AND REGULATIONS JU9 24 2014 1 • . e ► t - . A99.13G 0 . REINF. # 5 2" SAND BED 6" CRUSHED C- LIME ROCK 95% DENSITY COMPACTED SUB BASE DRIVEWAY DECK DETAIL N.T.S. GIC-NI P'X-V.E.R. 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