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DGT-15-686Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-231091 Permit Number: DGT-3-15-686 Scheduled Inspection Date: May 04, 2015 Inspector: Rodriguez, Jorge Owner: RIVERA, FRANZ AND JASMIN Job Address: 10255 BISCAYNE Boulevard Miami Shores, FL 33138-2648 Project: <NONE> Permit Type: Decks/Gazebos/Trellises Inspection Type: Final Work Classification: Deck - Wood Phone Number (305)799-0935 Parcel Number 1132050190070 Contractor: ANATOLIA CONSTRUCTION Phone: (305)304-8556 comments paver and wood deck over concrete slab. INSPECTOR COMMENTS False Passed Inspector Comments Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. May 01, 2015 For Inspections please call: (305)762-4949 Page 7 of 41 P N Miami Shores Village RLCPrx� Building Department MAR 2�� 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 7S6-8972 [BY: INSPECTION LINE PHONE NUMBER: (305) 762-4949 FFBBC20[D BUILDING Master Permit No.l,�i - ` —Gcc PERMIT APPLICATION Sub Permit No. UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR f�I•]3:I7.7d�'�� DRAWINGS Folio/Parcel#: 11 - 320S_ - vt q — OC�UO Is the Building Historically Designated: Yes NO Occupancy Type: ejM Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): tjs i 2- R1 0e A- � JM�5uW 9.4\10 li- Phone#: Address: JQZ� '?.LAAO City: IA,IIiA nnwl 'e:'tg0ar'S State: Zip: 3312)R Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: All A- Li_C_ Phone#: Address: b53$ C�QL.I.IN_::> fi . '— W176 City: mmm \ `13 ems} State: 'FL Zip: 33(4 i Qualifier Name: EQ44E 1 U 2M Y)V� Phone#: 53Xs-9Z4?-2jp9-2� State Certification or Registration #: 6� GC,1SlS02y Certificate of Competency #: DESIGNER: Architect/Engineer: &H m FAD Phone#: Address: (o ;� 2,Q G'41i IN!, &L *j-76 City: \M,IVq,gA j)'c1V lil State: T� zip::12J4� Value of Work for this Permit: $ Square/Linear Footage of Work: -ZOng -%r - Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: f�:ftqVV_ 4 w®Ofl btCAt_ Q\yei(L_ cop4 ( 7r� .�&A-G, Specify color of color thru tile: Submittal Fee $ W Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Technology Fee Structural Reviews $ (Revised02/24/2014) Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ Z 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 BE -FORE 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 o such posted notice, the inspection will not be approved and a reinspection fee will be charged. // _ ,� Signature Signature 44"K OWNER or AGENT I NTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledgdd before me this a_,;, day of f"AaCAA 20 LS"' , by -QO day of MAP d 20 ItTJ by i-aAN'� rnuvti-ru.. , who is personally known to yv► Ls•a , who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Wry Public State of Florida ommiSslon FF OB1441W 01WI2018 as me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: A �•� Print: Nolary Putx State of Florida Seal: ? , Elsa ANare2 M Commissloe FF 081441 X ptl' Expires o1 12018 as APPROVED BY l Plans Examiner (/ J Zoning AA - <131 twctural Review Clerk (Revised02/24/2014) Miami Shores Village Building Department APR 13 2015 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 20 BUILDING Master Permit No. lb r,T-3 - t5 "68� PER IT APPLICATION Sub Permit No. UILDING ❑ ELECTRIC ❑ ROOFING E!fRREVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City Miami Shores County Miami Dade Zia: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): � n7 a!03 �Lwc-- A Phone#: Address: ''bCNQ City: KA(t,�M1 State: T�6(- zip: 33tr&g Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Airq'mm- G®N3TeLiC�9 UX Phone#: Address:1'��3d COL -Luo -n, i^ ':(-76 City: INU NA 1 't3"CH State: P�_ Zip: X5314 Qualifier Name: Irk &7M (,) LwnoN Phone#: '9 jCc^TO7^2.092 State Certification or Registration #: r_&C_0 S� Certificate of Competency #: DESIGNER: Architect/Engineer: IYWt(A 9_ l!tt^(V1UYD ELL—Cl ( Phone#: Address: (S3$ CAP LLtNo 1-U' `$W76 City: A, State: (Zip: 33141 Value of Work for this P rmit: $ `7oo Square/Linear Footage of Work: �dl_ 4162-S17- Type of Work: Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: ftdL A W2 S F PNil-C -_t>zk_ _6LJQ(TI ,J 1-0 bGT ',-IS 686 Specify color of color thru tile:. Submittal Fee Scanning Fee $ Permit Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ 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 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 commencem nt m70704 posted at the job site for the first inspection which occurs seven (7) days after the building permit is issuedILL In the bsenceh posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT TRACTOR The foregoing instrument was acknowledged before me this Vs day of �&4,�-.. . 20 if , by Bg�mg'- tiva , w ipersonally know to me or who has produced identification and who did take an oath. NOTARY PU RommNsim SYata of Florida My FF 081441 Sign: �1 01N712018 04, Print: L'Lb A. u Seal: The foregoing instrument was acknowledged before me this l3 day of "a4l • . 201s . by U 2 -11" . who is persor I{r-known to as me or who has produced identification and who did take an oath. NOTARY PUBLIC. •NoWy Public Shft of Flor7da AWarez FF 081441 Sig U0M18 Pry Air Seal: as N�&�k �kEe �k�k �k+l �k�b*4&ri Sd��k�R Be#�k&akakNd3�kbS�kE� +b N��k�R�6 �k4�k&�kaY�k�#�k�F �k8��k3i�k 4+k �k�leKeB�kA�&�Y&8�R&&8�k�k�ki�k �k�k&&B��kY�R+k�k�k�3�k&&S��k ioB�aB�Rge9ffio1e �k�k�k�k4 i APPROVED BY��- I` -Plans ExaminerZoning Structural Review Clerk (Revised02/24/2014) e, CERTIFICATE OF LIABILITY INSURANCED o , 08/2015 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. 1. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(pes) must be endorsed. if SUBROGATION IS WANED, 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 CONTACT GULFSTREAM INS AGCY INC NAME PHONE FAX 5833 JOHNSON ST No, _ No E-MAIL DAMAGE TO RENTED PREMISES accwrence S HOLLYWOOD FL 330219999 ADDRESS: 23XTF INSURERIS) AFFORDING COVERAGE MAIC* INsuRERA:FLORIDA W.C. JUA $ INSURED INSURER B: ANATOLIA CONSTRUCTION, LLC 392 E 10TH COURT INSURER C: INSURER D. HIALEAH FL 33010 INSURER E COMBINED SINGLE LIMIT aecderd S INSURER F: BODILY INJURY(Per aCctdenQ S COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 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 INSR SUBR WVD POLICY NUMBER POLICY EFF MMID POLICY EXP MMIDD LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1:1 OCCUR EACH OCCURRENCE S DAMAGE TO RENTED PREMISES accwrence S MED EXP one S PERSONAL 8 ADV INJURY S GENERAL AGGREGATE S GENL AGGREGATE LIMIT APPLIES PER POLICY PROJECT LOC PRODUCTS — COMPIOP AGG $ AUTOMOBILE LIABILITY ANY AUTO IMULED AUTO NON -OWNED AUTOS HIRED AUTOS COMBINED SINGLE LIMIT aecderd S BODILY INJURY S BODILY INJURY(Per aCctdenQ S PROPERTY DAMAGE et $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS ME EACH OCCURRENCE $ AGGREGATE S DED1 IRETENTION S A WORKERS COMPENSATIONWC AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? YIN (Mandatory in NH) Y It yes, describe under DESCRIPTION OF OPERATIONS balaw NIA (GFRI3UB-2851C99-8-14) 11-29-14 11-29-15 STAT U OTH- X TORY LIMITS ER E.L. EACH ACCIDENT S 1 .000.000 ELDISEASE—EA EMPLO S 1-000-000 EL DISEASE—POLICY LIMBS 1,000,000 DESCRIPTION OF OPERATIONSILOCATIONSIVENCLES (Allach ACORD 101, Additional Remarks Schedule, If more space is require!) Contract License# CGcIS15024 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVENUE MIAMI SHORES FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE T HEREFO, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 019811-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Fw nmft AN UtmEKd MM AS 101+. BE FWC.IUA P.O. BOX 3556 ORLANDO FL 32802-3556 MIAMI SHORES VILLAGE DEPARTMENT 10050 NE 2ND AVENUE MIAMI SHORES 017972 BUILDING FL 33138 ACORD CERTIFICATE OF INSURANCE (On Reverse) Project Address Parcel Number Applicant 10255 BISCAYNE Boulevard 1132050190070 FRANZ AND JASMIN RIVERA Miami Shores, FL 33138-2648 Block: Lot: Owner Information Address Phone Cell FRANZ AND JASMIN RIVERA 10255 BISCAYNE Boulevard (305)799-0935 MIAMI SHORES FL 33138-2648 10255 BISCAYNE Boulevard MIAMI SHORES FL 33138-2648 Contractor(s) Phone Cell Phone ANATOLIA CONSTRUCTION (305)3048556 In Review Approved:: In Review Denied: Const: Wood Deck ;ification: Residential ning: 1_ Fees Due Miami Shores Village 10050 N.E. 2nd Avenue CCF Miami Shores, FL 33138-0000 F spa Phone: (305)795-2204 Project Address Parcel Number Applicant 10255 BISCAYNE Boulevard 1132050190070 FRANZ AND JASMIN RIVERA Miami Shores, FL 33138-2648 Block: Lot: Owner Information Address Phone Cell FRANZ AND JASMIN RIVERA 10255 BISCAYNE Boulevard (305)799-0935 MIAMI SHORES FL 33138-2648 10255 BISCAYNE Boulevard MIAMI SHORES FL 33138-2648 Contractor(s) Phone Cell Phone ANATOLIA CONSTRUCTION (305)3048556 In Review Approved:: In Review Denied: Const: Wood Deck ;ification: Residential ning: 1_ Fees Due Amount CCF $5.40 DBPR Fee $8.63 DCA Fee $8.63 Education Surcharge $1.80 Permit Fee $575.00 Plan Review Fee (Engineer) $40.00 Scanning Fee $9.00 Technology Fee $7.20 Total: $655.66 Valuation: $ 8,500.00 Total Sq Feet: 2000 Additional Info: paver and wood deck over concrete s Scanning: 1 Pay Date Pay Type Amt Paid Amt Due Invoice # DGT-3-15-54951 04/09/2015 Check #: 2451 $ 605.66 $ 50.00 03/26/2015 Credit Card $ 50.00 $ 0.00 Available Inspection Type: Final In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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,-FutheMuwe, I authorize the above-named contractor to do the work stated. April 09, 2015 AutFiorizeld'Signature:Owner / Applicant / Contractor / Agent uate Building Department Copy April 09, 2015 1 F i .1 1�5 LOCATION SKETCH SCALE ' I � tdea• 6ubdiadwd i ' J i RM / t as" k •epi''' 1 xr G� �d % 7-5 P<V. 8 9 10 2' N.E. 1021d.7 4 t � _,�OCKJ `10 t ----- I1 it 12 13 I ' J SAT eel, 5L � S CK a ` --- A 17 C',' `(�� 8 , 'ig • BO�ek IG ,pp lY bdBi:$ :b` i 9 ,nf 10 11 12 13 IIF I6 pro --- a DESCR PTION:Lot 5,less the East 55 feet and all of lots 6 and 7,Block 175, gRMSED PLAT OF MITI SHORES SECTION S,according to the Plat thereof as recorded in Plat Book 43,Page 67 of the Public Records of Miami -Dade County,Florida.- GENERAL_ NOTES 1} OWNERSHIP IS SUBJECT TO OPINION OF TITLE. 2) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. 3) (2.22) DENOTES THOSE ELEVATIONS REFERRED TO Nlk DATUM 4) LOCATION AND IDENTIFICATION OF UTILITIES ON AND/OR ADJACENT TO THE PROPERTY WERE NOT SECURED AS SUCH INFORMATION WAS NOT REQUESTED. Updated:March 25_,2015 5) THIS PROPERTY IS WITHIN THE LIMITS OF THE FLOOD ZONE .AE 6) NO UNDERGROUND LOCATIONS WERE DONE BY THIS COMPANY. Revised on October 15 2013 CERTIFIED TO: Franz E. Rivera DATE: February 12,2013 APPLICABLE ZONING, UNDERGROUND, ZONING -AND BUILDING SET BACKS, MUST BE CHECKED BY OWNER, ARCHITECT OR BUILDER BEFORE DESIGN OR CONSTRUCTION BEGINS ON THIS PROPERTY. I HEREBY CERTIFY: That the attached Plan of Survey of the above described property is true and correct to the best of my knowledge, information and belief, as recently surveyed and platted under my direction, also that there are not above -ground encroachments other than those shown. UNITEC This survey meets the minimum technical standards set forth by the Florida Board of Land Surveyors pursuant to Chapter 61 G17-6, Florida Administrative Code, Section 472-027, Florida Statues. SURVEYING, INC L.B. NO. 3333 aro D. Alonso 6187 NW 167T" STREET, H5 Pr. sslonal Land Surveyor Certificate No. MIAMI, FLORIDA 33015 305/512-4940 State of Florida THIS IS A BOUNDARY SURVEY NOT VALID UNLESS SEALED WITH AN EMBOSSED SURVEYOR'S SEAL r t PLAN OF SURVEY SCALE Ott ® ' h� •••• "4 C* i ••• •••o•• 0000•• y • •'• • ddJ� • 1 � 000•• Z00*see •• to 0. a /14 0000 • to 0000• I ! j 00009 .••. .0:000 / 'V to •• • 0000•• I /°1 ✓ w�+ • • • • ••••i• 00 0 6I 161 ,ice P It C Ile jh �. b..n J � _ �Ca�ld�rU � P / c� j N tC a J tA, n P r �d er ct � . ' ( b bl 4- r raQ ° F ° ♦ ,' .•. ed„IdI Q' �tdl� S,�yvd�P _ y - I C #',S/IR ° 0 ;-� �� d�g��ss•��' 'vim �tUV `' s � P� p ` rr 0, iY� •p `ry1''/e r e ��—ei ....� t . '0.4�J pFr Z A....ARC DISTANCE A/C .AI CONDITION GI- CBS... CO CRETE BLOCK STRUCTURE O.U.L... OVERHEAD UTILITY UNE CL ... CLEAX CIL�.CENTER LINE O RAD...RADIAL ENC...ENCROACHMENT RML..RlGHT OF WAY... FIP...FOUND IRON PIPE. O.H... OVER HEAD W.M....WATER METER MH....CHORD V) DISTANCE PtL... PROPERTY UNE CONC... CONCRETE F.H. FIRE HYDRANT UP ... UTILITY POLE R ... RADIUS U.E... UTILITY EASEMENT W � d...CENTRAL ANGLE R ... RADIUS PL.....PLANTER T ..... TANGENT C.B..... CATCH BASIN MH.....MANHDLE CLF ... CHAIN LINK FENCE W.F:... WOOD FENCE