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RC-14-2156Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-231334 Permit Number: RC -10-14-2156 Scheduled Inspection Date: April 01, 2015 Permit Type: Residential Construction Inspector: Rodriguez, Jorge Inspection Type: Final Building Owner: , Work Classification: Alteration Job Address: 22 NW 103 Street Miami Shores, FL Project: <NONE> Contractor: DOME ENTERPRISES INC comments BATHROOM RENOVATION. Phone Number Parcel Number 1131010180010 INSPECTOR COMMENTS False March 31, 2015 For Inspections please call: (305)762-4949 Page 28 of 36 Inspector Comments Passed QX_ Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid March 31, 2015 For Inspections please call: (305)762-4949 Page 28 of 36 i ►���1 GO&Tp Miami Shores Village Building Department artment r»T 09 2014 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 ( 0 BUILDING (waster Permit NoTC— 1 q l 5(o PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING [] MECHANICAL PUBLIC WORKS CHANGE OF CANCELLATION SHOP CONTRACTOR DRAWINGS a , JOBADDRESS: 22 Al1a-3 -67- City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 7/7 � %,9.-.s X Phone#: Address:-- - 7f3 2-49 city r.�� s ` tea• e State: ;�-G— Zip• Tenan Email: t/Lessee Name: 11 Phone#: jL— jff — f-�'72Z_ T•i��a'�J �Q��}®P , liB�-e CONTRACTOR: Company Name: ® ,Phone#: 7 Address /��Lf f 272 City: /07 <009,*,4 State: �d Zip: 7xoy� Qualifier Name: Lois 7-9 �9 z2a07 p e � Phone#: 77��-'3rJ10'r S' r ;PIP, State Certification or Registration #: ��" 7z /� Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: State Zip: Value of Work for this Permit-T-,,--'-Square/Linear Footage of Work: T d Type of Work: ❑ Addition 0 Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: -® --, 99e� /169 P, %T' -/-i®^ Specify color of color thru tile: Submittal Fee $ Q� Permit Fee $ _ ' C-0 CCF $�_ CO/CC $ Scanning Fee $ 0 ' L Radon Fee $ DBPR $ 2— Notary $ Technology Fee $ C' Training/Education Fee $ 0 • Double Fee $ Structural Reviews $ (Reviseda2/24/2014) Bond $ TOTAL FEE NOW DUE $ ` 9-0 Bonding Company's Name ()f applicable) Bonding Company's Address City state Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zip e 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 QWNER or AGENT The foregoing instrument was acknowledged before me this day of e,- &PO/ .20 /4( . by w o is personally know n me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Print: o;/p5'IflG�- s Seal: ;••° ••••,, Jessica 1 3 ..eCOMMISON sw 2018 Signature pi CONTRACTOR The foregoing instrument was acknowledged before me this day of —5'r 20 by ho is personally know o me or who has produced as identification and who did take an oath. NOTARY PUBUQ Sign:, Print: or Seal: ,,,• Jessie Tamfty t7cP►RE& JUL 01, 20= APPROVED BY �11Y Plans Examiner Structural Review (Rev1wd02/24/2014) Zoning Clerk 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: ///moi % �/al Y 167,7 Signature: State of Florida ) County of Miami -Dade) Sworn to and subscribed before me this day of ay0 137965 p(p1_FS: JUL 01, 2018 BON `N4. OF .••'` 1st FLAEiIDA NOTAR'6 LLC (SEAL) '.wa• Tvve of Identification produced Contractor Print Name:/r7 SignarFlorida Sta County of Miami -Dade) Sworn to and subscribed before me this day of fclhh � B �',..• t' '.00MIMiS'SION # FF 137966 lat FLORIDANOTARI. LLC (SEAL) Type of Identification produced 1110412014 12:50 7865585747 DOME ENTERPRISES PAGE 01101 �- CERTIFICATE OF LIABILITY INSURANCE I PATE j6AIRIlI " iHlS C'!!ItTIFICATE IS ISSUED AS A 014 MATTER dF INFORMATIM ONLY AND C�• ONFERS Nd RIGHTS UPON THE CER7iFtCATE HOLDS RTHIS CERTIFICATE DOES NOTAt►FFIRMATNI:LY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFOIwEo HY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN'rHE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE Oft PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: R the CMTtcm holder is - ADDITIONAL INSURED, the pellty(les) must he en�ml, E 8UBROUATION IS WAIVED, Subject to the terma and aond)tlona of the policy, certain Poiicles msy require an endorsemaht Astatemeet oh this certificate eon not confer rights certificate holder to lieu of auoh onaarpMe�sl, to the PRODUCER riTACT Hemisphere Insurance Group PHONt 305) 5D7 2801 11401 SW 40 St Sia EArI (�) 553-8010 Miami, FL 33165 ADDRESSnem tsltheremrgrli�scl.otrm Fax INSURED Dome E;ntarp&es Inc 11341 SW 27 ST MIAMI, FL 33185 U6 HA CERTIFICATE TEQ. NOTW 11 HSTANDINO ANY REQUI TERM OR CONDITION OFA I' INDICcERnFlCATE MAY ISE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN � IR TYPE OP INSURANCE ADD 8 ACCIDENT INSURANCE COMPANY 3 I irk INSURED NAMED ABOVE FOR THE POUCY PERIOD T OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, BY PAID CLAIMS. GENERAL I.MBILJTY , W VY NUMBER NltUff LINT$ © COMMFRCInI, GENERAL LM UrY EAACH�OCCURRENCE S ❑ ❑ CLAIMSMppE Q O�uR A PR6MIS i:�t�+a $ GPP 0016621-00 10/06/2014 10/08/2015 MED EW (Any am pmmm s ❑ PERSONAL A ADV INJURY S QON'LAGGREGATE UMIYAppLIF.S PFR GENERAL AGGREGATE $ ❑ POLICY El PRO, ❑LOG PRADUQT5 -COMP/OP AGG $ AUTOMMIL$ I.IA61LRy S ❑ ANY AUTO IN®S=Lr= UNT ❑ NED ❑AC�HE LED eoD11,YIWURY(Pm Pte) S ElNIREDTOS ALrrOA ❑ qOU 00WN0 BODILYINJURY(Poraa�dent S ❑tOPER UMURM LA LLAH ❑ Occurl $ EXCESS LIAR ❑ CL41M8 MADE EACH OCCURRENCE S ED RsTEwnAGGREGATE aN S $ WDRKriRB COMPENSATMN $ AND EMPLOYERta LUWUTY ANY PROPRIETOWARTNEW&VEcLn IN w 8;A ❑ OTH O; EMEr EXCLUMO7 = NIA aasle,., I.. u.,. EL. EACH ACCIDENT t DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AttUb ACORD 101. AdOi oml Rmmarts-'d"41lo, if maw opmm to mqurraq GENERAL CONTRACTOR LICENSE COC 024710 MIAMI SHORES VILLAGE BLDG DEPT. 10050 NE 2nd Ave Mlaml Shore,, FL 33138 ACORD 25 (2010105) QF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELL W BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEIJVERED IN ACCORDANCE IMTN THE POUCV PItOVISION9. AUTHORIZED REPRE9FMATME ®148&2010 ACORD CORPORATION. A!1 rights r"erved. The ACORD name and logo are r8glstarad tactics of ACORD GENERAL NOTES THE CONSTRUCTION OF THIS STRUCTURE SHALL COMPLY WITH THE FLORIDA BUILDING CODE 2010 FLORIDA PLUMBING CODE 2010, FRC 2010 & EXISTING BUILDING CODE 2010 2.- ALL WORK SHALL CONFORM TO ALL LOCAL ZONING CODES ORDINANCES ®' AND ALL OTHER AGENCIES THAT HAVE JURISDICTION. HANDICAPPED REQUIREMENTS SHALL BE IN COMPLIANCE IMTH CHAPTER 553 OF THE FLORIDA STATUE (F.A.C. 1997) , FAIR HOUSING ACT 24 CFR 100.205 AND FBC SECT 11-11.1 & FBC CHAPTER 11 4.- CONTRACTOR TO PATCH AND REPAIR WALLS, CEILING AND FLOOR WITH MATERIALS AND FINISHES THAT MATCH WITH ADJACENT EXISTING MATERIALS AND FINISHES IN DEMOLITION AREAS. (APPUCABLE ON ADDITIONS OR ALTERATIONS ONLY). 5.- CONTRACTOR SHALL NOTIFY THE ARCHITECT OF ANY DISCREPANCIES BETWEEN THESE DRAWING AND ANY FIELD CONDITIONS. 9.- JOB SAFETY AND CONSTRUCTION PROCEDURES ARE RESPONSIBILITY OF THE CONTRACTOR IN COMPLIANCE WITH OSHA SAFETY AND HEALTH STANDARD.(29 CFR 1926).- 13. -CONTRACTOR, SUBCONTRACTOR$, MATERIAL SUPPLIERS, ETC. SHALL MAKE THEMSELVES FAMILIAR WITH THE CONTRACT DOCUMENTS AND SHALL VERIFY ALL DIMENSIONS, CONDITIONS AT JOB SITE, PLANS, SPECIFICATIONS, ETC. AS APPLICABLE AND REPORT ANY DISCREPAN= ERRORS OF COMMISSION, OMMISION SEEN IN THE DRAWING OR IN THE FIELD, TO THE ARCHITECT WITHIN SEVEN (7) CALENDAR DAYS, BUT PRIM TO ANY CONSTRUCTION, OTHERW[SE WE ASSUME NO RESPONSIBILITY FOR ANY ERRORS, AND THE CONTRACTOR SUBCONTRACTOR, MATERIAL SUPPLIERS, ETC. SHALL ASSUME FULL RESPONSIBILITY FOR ERRORS AND/OR DELAYS AND CORRECT THEM AT THEIR OWN EXPENSE. ANY CHANGES, REVISIONS, ALTERATIONS, ETC. REQUIRED TO THE PLANS, DRAWINGS, SPECIFICATIONS, ETC., NOT MADE BY THIS OFFICE IN WAITING ONLY, WILL FULLY, UNCONDITIONALLY AND TOTALLY RELEASE THE ARCHITECT, ITS EMPLOYEES, CONSULTANTS AND DESIGN PROFESSIONALS, FROM ANY AND ALL RESPONSIBILITY. 18 -ALL WALL COVERING SHALL COMPLY WITH FRC. CHAPTER 7 WAIL & CEILING FINISHES MALL BE ACCORDING TO TABLE 803.9 FOC -10 WALLS AND CEILINGS FINISHES SHALL HAVE A FLAME SPREAD CLASSIFICATION NOT GREATER THAN 200 (FRC R302.9.1) WALLS AND CEILINGS FINISHES SHALL HAVE A SMOKE -DEVELOPED INDEX NOT GREATER THAN 450 (FRC R302.9.2) 20 -ALL WALLBOARD BEHIND SINKS, LAVATORIES, BATHTUB, SHOWERS, WATERC LOSETS AND BIDETS TO BE WATER RESISTANT TYPE (MOT . MOISTURE RESISTANT GYPSUM BOARDS GREEN BOARDS CAN NOT BE USED IN TUBS AND SHOWERS PER MANUFACTURERS RECCMIENDAMOIS. 31- ALL CERAMIC TILE FLOORS SHALL BE 'NON -SUP' TYPE. 384VERY BATHROOM DOOR SHALL BE DESIGNED TO ALLOW O EMNG FROM THE OUTSIDE DURING AN EMERGENCY WHEN LOCKED 39 -SEPARATE PERMIT & PRODUCT CONTROL APPROVAL„ WHEN APPLICABLE, IS REQUIRED FOR THE FOLLOWING ITEMS: STRUCTURAL. GLAZING, RIDGE VENTILATION, PRECAST SYSTEMS, STORM SHUTTERS, DSS, ROOIING, AWNINGS, FENCES, RAILINGS, WOOD TRUSSES, MULLIONS, WINDOWS, HANDRAILS. THE DRAWING SUBMITTED ARE IN ACCORDANCE FBC 2010 EXIST. CHAPTER 3 AND FBC CHAPTER 1 I LOCAVM PLAN ewe ars Miami Shores Village APPROVED By ®ATE BLDG DEPT SUFUFCT TO COMPUANCE WITH ALL FEDMAL STATE AND COUNTY RULES AND REGLH ATIONS EXISTING PLAN SCALE: 1/8"=1'-0" SCOPE OF WORK: INTERIOR WORK :so:*: . . EXISTING HOUSE TO REMAIN REPLACE TILE AT BATHS REPLACE PLUMBING FIXTURES AT BATHS UPDATE ELECTRICAL AT BATH ALTERATION LEVEL 1 �rOji d6 u' OCT 2014 ARCHITECT: R REC, f AR 0010924 8106 IBIS Mw ! 109 im PL=A 33183 PHOM (M) 594 ow E—M, c= PM EOT TmE. BLACK HOUSE RENOVATION 22 NW 103 STREET MM SHORES R. CLIENT: JAMES BLACK sees DRA ANG TITLE; • • • • €XISTINq fle" LOCATION �PLAN **sees NOtES••' WN BY. R.C. 103Sr9 201 an a � I l � � MST me MM Mw gill MWMMNBM Al I ALL WORK SHALL BE DONE IN ACCORDANCE WITH FBC-10 CHAPTER 27, NFPA 70-08 AND SHALL COMPLY WITH ALL LOCAL RULES AND ORDINANCES. 8 CONNECT SMOKE DETECTORS M UNSWITCHED CIRCUIT ( BEDROOM) .-• INTERCONNECT SMOKE DETECTORS FOR SOUND ALARM SMOKE DETECTORS SHALL BE 3' AWAY FROM KITCHEN, BATHROOMS & A/C GRILLS (NFPA 72 -CHAPTER 2) IN ADDITIONS SMOKE DETECTORS SHALL COMPLY W/EXIST. B.C. SECT 904 AND EXIST. B.C. 1004 9 ALL OUTLETS LOCATED AT BATHRIOMS, GARAGES, OUTDOORS,COUNTER KITCHEN, ;;WET BAR SINKS & CRAWL SPACES SHALL BE (NEC 210.8(A) =& DUPLEX RECEPTACLE CARBON MONOXIDE SMOKE DETECTOR PROVIDE TONE MOWER VE SHALL COMPLY W/ FPC 4,' AND M P. 120 F(45 Ch 1'11 BATHROOM RECEPTACLL cera 26 UK I AND G.F1 PROTECTED ADD SMOKE/CARBON MONOXIDE DETECTORS ANY AND ALL CLOTH AND RUBBER 5 INSULATED CONDUCT( )OS TO BE REPLACED CIRCUIT BEDROOM FLOOR PLAN SCALE: 1/4"=1'-0" MIAMI DADE COUNTY ORDINANCEWoved ; PLW MAXIMUM FLOW RATE & CONSUMPTION r--� Dee / y FIXTURE PLUMBING FIXTURE OR TYPE FIXTURE FITTING CLOTHES WASHER RESIDENTIAL WATER FACTOR OF 8 OR LOWER BATHTUB SHOWER HEAD 1.5 GPM AT 80 PS (SHOWER HEAD KITCHEN SINK W/ D/W+DIS'. 1.5 GPM AT 60 PS - D/W 6.5 GAL PER CICLE OR LESS LAVATORY 1.5 GPM AT 60 PS SHOWER COMPARTIMENT 1.5 GPM AT 80 PS (SHOWER HEAD WATER CLOSET 1.28 GAL PER FLUSHING CICLE NEW 1/2' CEMENT BOAR 'DUROCK' — AT ALL SHOWER WALLS NEW CERAMIC TILE — GLUED M BOARD LINER NAILING 1' ABOVE FINISHED TRESHOLD MIN. FINISHED TRESHOLD -------- 1/412 MIN. I�F PVC SHOWER PAN LINER (OATEY 4160?/ COMPLY W/417.5.2.1 COMPLY WITH FPC 10, 417.52 COMPLETED LINER SHALL BE IN ACCORDANCE W/ SECTION IN SHOWER LINER DETAIL WALLS KEY 8' CMU EXIST. TO REMAIN 4' EXIST. PARTITION BATHS LAYOUT TO REMAIN SCOPE OF WORK: REFERENCED STANDARDS INTERIOR WORK ANS Z 124.3 EXISTING HOUSE TO REMAIN ASME A 112.19.1M-TRHU 4M REPLACE TILE AT BATHS CSA 5.1-TRHU 4 REPLACE PLUMBUNG FIXTURES AT BATHS UPDATE ELECTRICAL AT BATH • • •; • • ASME A 112.19.2M 9999.. ALTERATION LEVEL I •;;;;- ASS: 1016 ASME A 112.19.1 CSA 8125.1 SINKS PLUMBING FIXTURES 99...9 - COMPLIANCE CHART & 9M CSA 845.2-TRHU 4 s • • 00 0 FIXTURE REFERENCED STANDARDS LAVATORIES ANS Z 124.3 ASME A 112.19.1M-TRHU 4M CSA 5.1-TRHU 4 WATER CLOSETS ANS Z 124.4 ASME A 112.19.2M CSA 845.1-4-5 SHOWER VALVE ASS: 1016 ASME A 112.19.1 CSA 8125.1 SINKS NNS Z 124.6 ASME A 112.19.1M-TRHU 4M & 9M CSA 845.2-TRHU 4 PLUMBING NOTES: All PUpM WIM SNAIL BE PERFOIOIED IN MMMM " THE LATEST FAWN OF THE FTA RUN COM 2010. FPC 2010 LOCAL OvmANCES AND m W19�I.Im TI9TH THE ENERGY CONSERVATION CODE & FM CHAPTER 11. FAC COQ. PLUMBBIG SYS1W SNAIL BE TESTED AWNU TO FPC-(AIAPTER 3 48- SHOVU/BAMIJB COMPARTMENT MUST HAVE FLOOR & WALLS CONSTRUCTED OF SMOOTH, CORROSION IRESISTONT AND NONABSORBENT WATER-RESISTANT MATMALS TO A HEIGHT OF NOT LESS MAN 72 WO ABOVE THE COMPARTMENT FLOOR AT THE DRAIN. FBC R307 20 -ALL WALLBOARD BEHIND SINKS, LAVATORIES, BATHTUB, SHOWERS, WATERCLOSETS AND BIDETS TO BE WATER RESISTANT TYPE(CEMENT BOAR).FRC R702.4.2 MOISTURE RESISTANT GYPSUM BOARS (GREEN BOARS) CAN NOT BE USED IN TUBS AND SHOWERS PER MANUFACTURERS RECOMENDATIONS. ARCHITECT: JOSE R CONDE R.A REG. # AR 0010924 8306 No MK # 109 MWA FLORIDA 33183 PHONE: (305) 5% 0686 E-gAd PROJECT TITLE: BLACK HOUSE RENOVATION 22NW 103 STREET MIAMI SHORES R. CLIENT: JAMES BLACK 9999 DRAANO ' 9 Thi.... • 9999.. • FLOOR 15iAU .. 90000 see* PLU1dmw• 0 0 •••:•ELECft t- 0000 DRAWN W. R.1~ CAD NAME- 22 AME22 NW 103 Sr MM PROJECT No.: 2014-038 man l NOT Yu® MEN BMW SFA DRAWWO NUMBER A2 W. -