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FW-15-1059 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-238483 Permit Number: FW-5-15-1059 Scheduled Inspection Date: July 21, 2015 Permit Type: Fence/Wall Inspector: Rodriguez,Jorge Inspection Type: Final Owner: MORRIS,JOLYON Work Classification: Wood Fence Job Address:74 NE 97 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132060130750 Project: <NONE> Contractor: HOME OWNER Building Department Comments WOOD FENCE IN FRONT OF HOUSE AND CHAIN LINK Infractio Passed Comments ON EAST SIDE. INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-234031. Fence must be completed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. July 20, 2015 For Inspections please call: (305)762-4949 Page 17 of 39 Permit NO, FW-5-'15-1 059 Miami Shores Village Permit Type:Fence/Wall 10050 N.E.2nd Avenue NE Work Classification:Wood Fence Miami Shores,FL 33138-0000 Per it Permit Status:APPROVE© Phone: (305)795-2204 issue Date: 5/15/2015 [ Expiration: 11/11/2015 Project Address Parcel Number Applicant ........... 74 NE 97 Street 1132060130750 Miami Shores, FL 33138- Block: Lot: JOLYON M3RkiS Owner 1.ormation Address Phone Cell JOLYON MORRIS 1900 N BAYSHORE Drive MIAMI FL 33132- 1900 N BAYSHORE Drive MIAMI FL 33132- Contractor(s) Phone Cell PhoneValuation: 1,600.00 HOME OWNER Total So Feet: 11A Approved. v Available Irspections: Comments: IPSIDPOtion TVr)p, Date Approved: Final Date Denied: Foundation Type of Construction:Wood Fence Additional Info: Pevievi F'!a r i n c Classification: Residential Scanning:3 Review BU116ing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# FW-5-15-55431 DBPR Fee $2.00 DCA Fee $200 05/15/2015 Credit Card S 7 2C $ 50.00 Education Surcharge $0.40 05/05/2015 Credit Card S E3.ofl $0.00 Permit Fee-Wire&Wood $104.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $120.20 In consideration of the issuance to me of this pern-t, I agree to perform the work covered hereunder in comp] ince with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the prol 3r authorities of Miami Shores Village. In accepting this permit I assume responsibility for all � or.: i understand that separate permits are required for ELECTRICAL,PLUMBING, MECHANICA .WINDOWS,DOORS, ROOFIN(-,an,, S\/\/IMM!NG P001-w—-,. OWNERS AFFIPIAVIT: I certify th a he information is accurate and that all vvor< will be done in com diance with q1! applicable laws regulating construction an oning. Futhermabove-named contractor to do the work stated. Me 1 1 017 AuWorizecl Signature:Owne'r--k Applica:It / Contractor / Agent )ate Building Department Copy May 15, 2015 1 Miami Shores Village , RF;'CFTVFD Building Department MAY 205 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax: (305)756-8972 $Y' INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2010 BUILDING Master Permit No. 15 — 10519 PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑SHOP CONTRACTOR DRAWINGS JOB ADDRESS: /tel C 27 sk-ra f City: Miami Shores County: Miami Dade Zip: J I Folio/Parcel#: 1 1 -3 _Q Q 6 0 / 30 '7-FSU _Is the Building Historically Designated:Yes NO I " �mAZ-y Occupancy Type:ICS• Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): ._ b L--j or--) 1,& " M 0 0( 4- j Phone#: 5(:)5 Cw 5 L! j Y Address: � ' ff-oy E- City: n�oa l-borlk.S State: L. Zip: 3_� 1 -53 Tenant/Lessee Name: Phone#: Email: c=v\ eP_Nt C-z i'iJL L! Q C l(n (1 i L - CONTRACTOR:Company Name: L)CO C—. 1 -- Phone#:, OS- OG Address: I �( NC- Cf 4 , - E-- City: (Y_'�, r_N� � Qu Is State: Zip: Qualifier Name: Phone#: State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ S O(D uare/Linear Footage of Work: j (,F'P-Q'V t Type of Work: ❑ Addition ❑ Alteration FNew ❑ Repair/Re lace p El j Description of Work: L:iCJ F> Specify color of color thru tile: Submittal Fee$ Permit Fee$ q (--)C) CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ Tl 1 • 26 (Revised02/24/2014) Bonding Company's Name(if applicable) t ' Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City 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 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 approvq and a reinspection fee will be charged. Signature Signature NER or AGENT CONTRACTOR The f going i strum nt was acknowledged before me this The foregoing instrument was acknowledged before me this ^�—��day of M,�� 20 (� by day of 20 by `1OL—TOL (A f f4,S who is personally known to who is personally known to me or who has produced PL--,W-1T—e— 11`Q—,— s me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: Seal: �,► ' Notary Public State of Florida Seal: Sindia Alvarez My Commission FF 156750 Nor Expires 08/03/2018 APPROVED BY Plans Examiner / / f Zoning Structural Review Clerk (Revised02/24/2014) ,5 ORES Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 LORICDA Tel: (305)795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: �G C 1� DATE: ADDRESS: 4�� Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida,F.S 489.103(7).And I have read and understood the following disclosure statement,which entitles me to work as my own contractor;I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor.You have applied for a permit under an exception to the law.The exemption allows you,as the owner of your property,to act as your own contractor even though you do not have a license.You must supervise the construction yourself.You may build or improve a one-family or two-family residence.You may also build or improve a commercial building at a cost of$25,000.00 or less(The new form states 75,000).The building must be for your own use and occupancy.It may not be built for sale or lease.If you sell or lease a building you have built yourself within one year after the construction is complete,the law will presume that you built for sale or lease,which is a violation of this exemption.You may not hire an unlicensed person as a contractor.It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances.Any person working on your building who is not licensed must work under your supervision and must be employed by you,which means that you must deduct F.I.C.A and with-holdings tax and provide workers'compensation for that employee,all as prescribed by law.Your construction must comply with all applicable laws,ordinances,buildings codes and zoning regulations. Please read and initial each paragraph. 1. 1 understand that state law requires construction to be done by a licensed contractor and have applied for an owner-builder permit under an exemption from the law.The exemption specifies that I,as the owner of the property listed,may act as my own contractor with certain restrictions even though I do not have a license. Initial 2. 1 understand that building permits are not required to be signed by a property owner unless he she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. Initial � 3. 1 understand that,as an owner builder,I am the responsible party of record on a permit.I underst d that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name.I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits @Md contracts. InitiaPing. 4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilI may also build or improve a commercial building if the costs do not exceed$75,000.The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease.If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete,the law will presume that I built or substantially improved it for sale or leag violates the exemption. Initial 5. 1 understand that,as the owner-builder,I must provide direct,onsite supervision of the construction i Initial 6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise per o orking on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and tApty or municipal ordinance. Initial 7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner-builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I,as an owner-builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner-builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Initial 8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed conact who is not licenses to perform the work being done.Any person working on my building who is not licensed must work under my direct supervision and must be employed by me,which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act(FICA)and must provide workers compensation for the em;,I I understand that my failure to follow these may subject to serious financial risk. Initia 9. 1 agree that,as the party legally and financially responsible for this proposed Construction activill abide by all applicable laws and requirement that govern owner-builders as well as employers.I also understand that the Construction must comply with all applicable laws,ordinances,building codes, and zoning regulatio s Initial 10. 1 understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service,the United States Small Business Administration,and the Florida Department of Revenues.I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http://www.mvfloridalicense.com/dbr)r/pro/cilb/index.html ,7 Initial 11. 1 am aware of,and consent to;an owner-builder building permit applied for in my name and unders ands that I am the party legally and financially responsible for the proposed construction activity at the following address: 7 VC FI !! Initial 12. 1 agree to notify Miami Shores Village immediately of any additions,deletions,or changes to any o t inf mation that I have provided on this disclosure. Initial Licensed contractors are regulated by laws designed to protect the public.If you contract with a pers wh does not have a license,the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court.It is also important for you to understand that,if an unlicensed contractor or employee of an individual or firm is injured while working on your property,you may be held liable for damages.If you obtain an owner-builder permit and wish to hire a licensed contractor,you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued,this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit.A copy of the property owner's driver license,the notarized signature of the property owner,or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this O_C— day of &A_�t , 20 Is By JOLtW WMoulS who was personally known to me or who has � -ve�� uc�►s� Produced there License or I�O�Q— —�"��— as identification. =Expill rida E R NOTARY ?:j S0 .............I................. ............................................................ . .................... ............ . ............... . . ..... ........... . ............... .................................................... .. ..............20'.-ASPHALT.-PAVEMENT. ....................................... .......... ..... .... ............................................I...............I.......................... .................................................... ................ . ..................... .............. . .................... ............................................................... ............. .............. .............. .. ............ ............................ ..7777-777 ...........1,.,: R7W . ........ ............................................. ........... ..................... ...... . ........ . . ........................ .................... .. ....... cv, .... ......... ............. .......... MAY 0 Fences Good Side Out. The vertic:1,7*d,h7i7,7ntal GRASS PARK'Ay)porting members of a fence shall face th 7---F- M MAY interior of the plot on which the fence is locate BY and the finished side shall face the adjoinin wq� N89*12'24"E 75.00, C) COPYO LV00A Ln tj BRICK DECK P�4v- CANVAS ROOF Y 4.5'ht.CBS '5 WALL CD 13.40T Av UJI C to Fht.CLF I t J,,C* PP.) C-n 13.40' 12.75' X—X x ON PL CBS STORAGE C5 r ..FAVERg'. kK. *Mf2 .... Lot 3& W/12 Lot 2 10L Lot 4, Block 6 Block 6 0 : Bllow(,ra (Pb.10,Pg.70) 40 (Pb.10,Pg.70) 1,0 Or 0 (P9..1Q,`Pg*.70) *0*0:0 z 1� I � *CAR-P10000. PORT.:; CSSTOAGE 0000 0000 UNDER STAIR 5'ht*G[,Fo 1 5' ...... (TYPJ ... ..... 11 , -': * ...22,,7 ":", 6.70' 35.ft 0 * 0 06 • 6060:9 < • IL -1 0 00 . LL 0-, wLL 01, 0000.. < :0900: —J'5.601 vpp' 0 P L S89* -W ......... . ...... ................. .................... .......... .. ..... .......... ............. ........ 'PA ....... ASPHALT:P ENT..:.:."'. ....... .......... .. ......... . .......... ....... ................. VE L \,\C,E NSF 2 No.LS 6592 < q AT n SURVEYOR'S CERTIFICATE: I hereby certify:That this"Boundary and Topographic Surverr SLOWD�' and Report resulting thereform was performed under my direction and is true and correct to the /6 Ib •00• 0.4066 0000 • • 0 •00 • • •• •06.0• • •• ••060• • • • • •400•• •0•••• • • •00• 4400 0000• 0000 •6•• ••0•• •69 6 •06.0• •006•• • 4• •• •• • • • 46•6.0 0.9060 • • • • •6.06• • • 0 • • SNoR>Es �li1C.1932 Li Miami shores Village logo Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 0R11DA Tel: (305) 795.2204 Fax: (305) 756.8972 WOOD FENCE DETAIL o Shadow Box o Vertical Picket o Board on Board 4x4 Post Spacing Fences<=5' high posts spaced at Yon center maximum Fences<=4' high posts spaced at 6"on center maximum Fence must not exceed Yin height 1x pickets fastened with two corrosion resistant fasteners per connection 2x4 horizontal pressure treated 0. ••rIV4Ctmemb ers.. itq.vJ two con �**• ....••. ...... jP4stant fasteners . fer 6onnectior3.. .... .... ..... ...... . ... ..... .. .. .. . goes.. . . . . . .0000. . . .0000. 00 0 . 000 00 4x4 pressure treated posts embedded Tinto concrete footing 10" diameter x 2'deep ALL wood must be pressure treated All fasteners must be corrosion resistant No less than two fasteners in any connection May 2009 s ••.. • . • • ... . • •. • . . •••..• ..•. •..• • • • • • • • • . .•.•.. ...... . • • • • •...•• •.• . . •. • • ♦5N°RES Lr Miami shores Village ' sign„ Building Department 10050 N.E.2nd Avenue I�LOR'�p Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHAIN LINK FENCE DESIGN DETAIL (ACCORDING TO THE F.B.C. SECTION R4408.11) TABLE R4408.11 CHAIN LINK FENCE MINIMUM REQUEREMENTS Fence Terminal Post Line Post Dimensions Terminal Post Line Post Concrete Height (ft) Dimensions (in inches) Concrete Foundation Size (in inches) (o.d. X wall thickness) Foundation Size (diameter X depth) (o.d. X wall thickness) (diameter X depth) (in inches) (in inches) Upto4 23/8x0.042 15/8x0.047 10x24 8x24 Over 4 to 5 2 3/8 x 0.042 17/8 x 0.055 10 x 24 8 x 24 For SI: 1 inch=25.4 mm. NOTES: 1. This table is applicable only to fences with unrestricted airflow. 2. Fabric: 12'/2 gauge minimum. 3. Tension bands: Use one less than the height of the fence in feet evenly spaced. *040 4. Fabric Ties: Must minimum the same gauge of the fabric. • . . 4444 444490 5. Fabric Tie Spacing on the Top Rail: Five ties between posts evenly spaced. • • •» • 6 ••• • 6. Fabric Tie Spacing on Line Posts:One less than height of the fence in feet,evenly spaced...... •••• ••••;• 7. Either top rail or top tension wire shall be used. 6 06:00 • 8. Braces must be used at Terminal Posts if top tension wire is used instead of Top Rail. 000* ..6 4 ;••••; 9. Post Spacing: 10 foot(3m)on center maximum. 664660 •.•.,, 10. Post shall be embedded to within 6 inches(152 mm)from bottom of the foundation. 4444.. 6 4 4 4 64:0 4' 11. In order to follow the contour of the land, the bottom of the fence may clear the contour 44 ground byotplo% inch .44444 (127 mm)without increasing table values to the next higher limit. •••••• 0 4 . . :000%4 0 •414• • 4 NOTICE TO PROPERTIES WITH POOLS: . . : If the fence is to meet the criteria as a pool barrier,the fence shall not be climbable and all rails must be placklecing 6 6 the inside of the property.Pedestrian gates shall have self-closing and latching devices installed at the minimum of 54" above ground.For further details see Section R4401.7.1 of FBC. CONCURRED Created on 5/22/2009 MLDV A ••1:•• • •• 6:0.00 • • • 0000 0000 Y:r•• seer 000• er•0• •0: • :00:06 00 0 of r• •• 0 000010 • • • • •••rrt • f • 6 • • • • a •• vZ� Miami Shores Village i _..jVFD Building Department MAY 30 2014 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305)795-2204 Fax:(305)756-8972 ,U y; r INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No.[")S _801p PERMIT APPLICATION Sub Permit No. UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL [—]PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP (� �f G� CONTRACTOR DRAWINGS JOB ADDRESS: I S— -7 ` City: Miami Shores County: Miami Dade Zip: J 3 Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): �((MA Luba Phone#: -44-%77 Address: ,q/37-7 N - qt" \ld ` ' City:_Myol ot `WWI'f State: P Zip: .331 3k Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Phone#: lp�<U'66d7J Address: /0 :3 Z 1 E7 Rtoa fail. City: i State: 'Al Zip: 3/$�F Qualifier Name: v /kl� Phone#: 66� State Certification or Registration#: C-C3 C�JG��� Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$_ 2,00 U Square/Linear Footage of Work: !9 Dt!�) Type of Work: ❑ Addition ❑ Alteration E2-New /❑ Repair/Replace ❑ Demolition Description of Work: ,�,< ��S �l� %�l�c /✓ �.C' G(/d� u�t�, Specify color of color thru tile: �� Submittal Fee$ Permit Fee$ CQ • (Do CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ �� •2O (Revised02/24/2014) r Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City 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 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 ins ction which s seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will n be ov and a reinspection fee will be charged. Signatur Signature OWNER or AGENT CONTRACTOR The fooregoing instru t was acknowledged before me this The foregoing instrument was acknowledged before me this 2 _t- day of 120 by .30 day of MAI 20 f q by who is personally known to who EEEknown o me or who has produced Rt' VIS ��`e�x5 as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: 0 elL• ea Print: &aW r-eNGe Jk) OAPA Seal: '01r'"'1 OLGALLEYVA Seal: J01 �t Y MY COMMISSION Y FF 006656 �� Notary Public State of Florida EXPIRES:June 4,2017 Lawrence Nei Wentworth ; ,,•' Bonded Thru Notary Public underwriters My Commission D0981396 ora Expires 06/27/2014 ******************************** ** **** *** *************** ************** APPROVED BY �v Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-213296 Permit Number: DS-5-14-1108 Scheduled Inspection Date: June 23, 2015 Permit Type: Driveways/Sidewalks/Slabs Inspector: Rodriguez,Jorge Inspection Type: Final Owner: VALERIE HALPERN, RICHARD LIBUTTI Work Classification: New Job Address:9377 NE 9 Place Miami Shores, FL 33138- Phone Number Parcel Number 1132050070100 Project: <NONE> Contractor: JAY CONSTRUCTION COMPANY Phone: (305)610-6688 Building Department Comments INSTALL NEW CHICAGO BRICK PAVER DRIVEWAY AND Infractio Passed Comments WALKWAY AS PER PLANS INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. June 22, 2015 For Inspections please call: (305)762-4949 Page 1 of 38 r 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: 1/18/2015 EXPIRATION DATE: 1/17/2017 PERSON: MEISELMAN JAY FEIN: 650546435 BUSINESS NAME AND ADDRESS: JAY CONSTRUCTION COMPANY 10321 EAST BROADVIEW DRIVE BAY HARBOR FL 33154 SCOPES OF BUSINESS OR TRADE: LICENSED BUILDING CONTRACTOR Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate 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...appy only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S.,Notices of election to be exempt and cartificates of election to be exempt shag be subject to revocation if,at any time after the iffing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this sedan for issuance of a certificate.The department shag revoke a DFS-F2-DWC 252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)4131609 -..-�- y STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 MEISELMAN, JAY EDWARD JAY CONSTRUCTION COMPANY 10321 EAST BROADVIEW DRIVE BAY HARBOR FL 33154 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range .. STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, DA DEPARTMENT RIRI BUSINESS AND and they keep Florida's economy strong. PROFESSIONAL REGULATION Every day we work to improve the way we do business in order to CBC056965 ISSUED 06/29/2014 sere you better. For information about our services,please log onto www.myfloridalicense.com. There you can find more information CERTIFIED BUILDING CONTRA GTOR about our divisions and the regulations that impact you,subscribe MEISELMAN,JAY EDWARD to department newsletters and learn more about the Department's initiatives. JAY CONSTRUCTION COMPANY , Our mission at the Department is: License Efficiently,Regulate Fairly. We constantly strive to sere you better so that you can sere your customers. Thank you for doing business in FloridaIS CERTIFIED under the provisions of Ch.489 FS. , and congratulations on your new license! Expiation date AUG$1,2016 L1406290000980 DETACH ERE RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OFF ORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION �z CONSTRUCTION INDUSTRY LICENSING BOARD NOW== 011 CBC056965 ' The BUILDING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. � y Expiration date: AUG 31, 2016 MEISELMAN, JAY EDWARD i' JAY CONSTRUCTION COMPANY 10321 EAST BROADVIEW'DRIVE BAY HARBOR FL 33154 ■ ISSUED: 06/29/2014 DISPLAY AS REQU ED BY LAW SEQ# L1406290000980 uueaa5 _ Local Business Tax Receipt Miami-bade County, Mate `., of f iorida THIS I5 NOT A�:91LL — DO NOT PAY 3345683 BUSINESS NAMl/LOCATiON RE EIPT NO. EXPIRES JAY CONSTRUCTION COMPANY INC IU NIEWAL SEPTEMBER 30, 2015 30321 E BROADVIEW DR 3496206 Must be displayed at place of business BAY HARBOR ISLANDS FL 33154 Pursuant to County Code Chapter 8A—Art.9&10 OWNER SEC.TYPE O BUSINESS PAYMENT RECEIVED JAY CONSTRUCTION COMPANY INC 196 SUB-GE RAL BLDG CONTRACTOR BY TAX COLLECTOR L B Tj Worker(s) 1 CBC056965 $45.00 07j14J2014 CREDITCARD-14-026600 This Local Business Tax Receipt only confines payment ci he focal Business Tax The Receipt is not a license, parmiL or a certification of the holder's qualifications,to d business.Holder must comply with any governmental or nongovernmental regulatory laws and requirements wh ch apply to the business. The RECEIPT NO,above mast be displayed on all cc erclal vehicles—Miami—Bade Code Sac$a-276. For more information,visit COITD CERTIFICATE OF LIABILITY INSURANCE DATE A 02/02/2015 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Gulfstream Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 5833 Johnson Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hollood FL 33021- INSURERS AFFORDING COVERAGE INSURED INSURER A:Mid-Continent Casualty CO Jay Construction Company INSURERS 10321 E. Broadview Dr. INSURER C: INSURER D: Bay Harbor FL 33154- INSURER E: COVERAGES 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TI IIS 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS 7R DATE MMIDDIYY DATE MIDDIYY A GENERAL LIABILITY 04-GL-000914210 10/14/201.4 10/14/2015 EACH OCCURRENCE $ 1.000,000 X COMMERCIAL GENERAL LIABILITY FERE DAMAGE(Any one fire) $ 100000 CLAIMS MADE I „ I OCCUR / / / / MED EXP(Any one person) $ i PERSONAL SADV INJURY $ 11000,000 GENERAL AGGREGATE _$__ 21000,000 GEN'L AGGREGATE=LIMIT APPLIES PER: PRODUCTS-COMR10P AGG $ _ 2,000,000 X POI_!CY JECf LOC AUTOMOBILE LIABILITY - / / / / COMBINED SINGLE I_kM1T ANY AUTO (Ea accident) $ ALL OWNED AUTOS I / / / / BODILY INJURY SCHEDULEDAUTOS (Per person) $ __ HIRED AUTOS / / / / BODILY INJURY (per accident) $ NON-O W NED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY-EA ACCIDEN f $ ANY AUTO / / / / OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY / I I I EACH OCCURRENCE $ OCCUR r-1 CLAIMS MADE AGGREGATE $ DEDUCTIBLE / / / / $ RETENTION $ EMPLO ERSLIABILITY ION AND _ / / / / TWOCR Mfrs °ER E.L.EACH ACCIDENT $ E.L.DISEASE-EA EMPLOYEE$ E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS License # CSC 056965 CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT MIAMI SHORES VILLAGE FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE 10050 NE 2ND AVENUE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHOR REPR T TIVE MIAMI SHORES FL 33138-2382 { ACORD 25-5(7J97) ©ACORD CORPORATION 1988 (p� VQ ff1 INS025S(9910).01 ELECTRONIC LASER FORMS,INC..(800)321 45 Page 1 of 2 f ;;Up 'a*"',leedy Invoice Permit Expediters Inc. Date Invoice No. 17635 NE 8th Court, Miami, FL 33162 01/15/15 6578 Office: 305.527.6282- Fax: 305.653.5509 SpeedyPermits@aol.com Bill To: Jay Construction Jay Meiselman 10321 E Broadview Drive Bay Harbor, FL 33154 Terms Project Number Description Amount Permit expediting fees for Halpern Residence located at 9377 NE 9tth Place, Miami Shores 150.00 HRS#AP1170184 12/11 To Fedex Office to make copies of plans, paid fees 12/19 To Miami-Dade County Building Department.Attempted to submit plans but was missing paperwork 12/23 Jay dropped off necessary paperwork to Speedy Permits 12/24 Submitted plans to Miami-Dade County Building Department, paid fees 01/07 Checked plans in HRS, not reviewed yet 01/14 Picked up approved plans and letter from HRS in MDCBD Fees paid by Speedy to Fedex Office to print copies of plans 12/11 4.82 Fees paid by Speedy to HRS to submit plans 12/24 70.00 Total $224.82 Payments/Credits $0.00 Balance Due $224.82 MIAMI—DADE COUNTY r. t fi t i_ t�• fi `S DEPARTMENT :�F r•:�'';_�i�-:��R`; At�I� ._�r_.�.iGMT>_, RES MjKRA MIT CENTRA _ _ r _5 �� 26 G1 .Erry 11 SW 26TH ST RM 149 MIAMI, F't v��l 7=_._.247—i MIMII- fl. 11175 73c . ,.. 1 5 .j 0''•L^f'0Y Merchant B: 53B31gg5g ' _' Tera ID: A81tc 3831495 MISCELLANEOUS RE E I�i e Sale se93 i+�+..-•mss 7 XX1aXXXXbfXX0 P R__E__E . ._ _ VIm En&v Method: sow T l� 7(� EPEE r+y` EI MI `` total: 1 IO./y0! W 93: a PLACE 12/1414 MIMMI SHORES, . L _17� 18:84:03 _' Inv u: 969812 Co�: 141 kpm: Onlire 829 REVIEW FEE . 0_7 TYPE PE CODE DESCRIPTION UNITS cry 7Wiw(You! DDH 400E EXIETlNG YETE:•if i,l1 f`1i,7lftfi;�:n :`•f_ `y,^ i ......_.___.._....._......................._.... 70. GO y �,�cf rail 12!24!2014 10:04 NORAZAN 271412240031 TL:f^'M9,.9J CENTRAL 70. 00 N 47 Fed]2z0ffica, FedEx Office is your destination for printing and shipping, 2179 NE 163rd St North Miami Beach, FL 33162 Tel : (786) 274-1984 12/11/2014 1 :36:43 PM EST Team Member: Lora D. SALE BW 2436 Print 1 6 4.5000 T 002172 Reg, Price 4.50 Regular Total 4.50 Discounts 0.00 Total 4.50 Sub-Total 4.50 Tax 0.32 Deposit 0.00 Total 4.82 Visa (S) 4,82 Account: 9882 Auth: 171563 (A) Total Tender 4.82 Change Due 0.00 Total Discounts 0.00 I Say Csosm c II I IIII VIII I IIT II f VIII - H IIII IIII 17410021375 1.-�bU alper� C�Q� bavr(��Ctt Tell us how we're doing and receive 20% off your next $25 print order fedex•com/welisten or 1-800-398-0242 Offer Code:— Offer expires 06/30/15 ci3�� � L