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BPP-15-312 (5)
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-234495 Permit Number: BPP-2-15-312 Scheduled Inspection Date: May 13, 2015 Permit Type: Pools/Whirlpools/Hot Tubs Inspector: Rodriguez,Jorge Inspection Type: Miscellaneous Owner: ROY,WILLIAM Work Classification: Addition/Alteration Job Address: 1280 NE 101 Street Miami Shores, FL Phone Number Parcel Number 1132050210010 Project: <NONE> Contractor: WATERMARK CONSTRUCTION LLC Phone: (954)776-3338 Building Department Comments ADD SWIM OUT, BEACH STEPS AND FLOOR TO Infractio Passed Comments EXISTING POOL WITHIN ORIGINAL STRUCTURE. INSPECTOR COMMENTS False Inspector Comments Passed ` CREATED AS REINSPECTION FOR INSP-234453. INSPECTIONS FOR THE STEPS MISSING: Termite treatment Failed ❑ Steel at steps nose Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. May 12,2015 For Inspections please call: (305)762-4949 Page 22 of 30 ,FORTH MIAMI-RADE 658 N.W.gr Street �ugray ~ SPECIAL A L SERV I C E Miami,.Florida 33950 nhe ❑SOUTH MIAMI-RADE 12540 S.W.130 Street Floridian Miami,Florida 33186 AGREEMENT BROWARD COUNTY 6550 N.W.Florida33re 3 '�� Sunrise, ida 33133 PEST CUKRCL ❑PALM BEACH COUNTY 2115 Lake Worth Road 9188E Lake Worth,Florida 33461 NAME: `� �\ �::? PHONE: / "? -j DATE: ADDRESS: � / �y/` <<'i CITY: y/ J�IIIP CODE: The following SERVICE Isro osed for the sum of P P I i L SERVICE ADDRESS: l /A1 � CITY: STATE: ZIP CODE: SERVICES FOR: ❑ Pest Control ❑ Rodent Trapping ❑ Critter Trapping ❑ Rodent Proofing ❑ Bee Service ............................ _.. ,...................,..,. ..,........:...........,tea.::..,...:.a ...., ,..:,.:.:::: ,-::::::;:,;:.;;:.;:.;:.:::.>:::;:_:.;:...:.. ,......_.: Oth er� SCOPE OF SERVICE: 1 1 S 7 L _ ACCEPTED BY: REPRESENTATIVE ! PROPERTY OWNER Rev 10114 Permit NO. BPP-2-15 ,3 ;Y `SHOPES`�{ Miami Shores Village :Permit Type: P'.00ls/WhirlpoolsfHiiit Tunis: { � 10050 N.E.2nd Avenue NE � ,., Work Classification:AdditionfAlteratiort Miami Shores, FL 33138-0000 Perit Permit Status:APPROVED Phone: (305)795-2204 6hT 8 Hi f�ORtDP' Issue Date: 3/23/2015 Expiration: 0911912015 Project Address Parcel Number Applicant 1280 NE 101 Street 1132050210010 Miami Shores, FL Block: Lot: WILLIAM ROl Owner Information Address Phone Cell WILLIAM ROY 1280 NE 101 Street (305)793-5050 MIAMI SHORES FL 33138- 1280 NE 1u9 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone` Valuation: $ 5,000.00 WATERMARK CONSTRUCTION LLC (954)776-333£ ------ Total '-,q Feet: 800 Approved: In Review s Available Inspections: Comments: inspection Type Date Approved: : In Review Fence Date Denied: f=inal Type of Work:Swimming Pool Occupancy Private Poel Deck Additional Info:ADD SWIM OUT, BEACH STEPS.AND FLC Bond Return : Wail Steel Sc, Classification:Residential mina: ' Review Planning_ Review Electrical Review Building Review Building `Review Plumbing RFview Structural Review Structural Fees Due Amount Pay Grate Pay Tyne Amt Paid Amt Due Bond Type-Owners Bond $500.00 CCF $3Invoice;°t SSPf�-2-15-54475 .00 DBPR Fee $2.25 03/23/26 1 5 ':heck#:4730 S 971.50 $ 50.00 DCA Fee $2.25 02/12/2C15 Credit Card S 5c-00 $ 0.00 Education Surcharge $1.00 Bond i# 2646 Permit Fee $150.00 Plan Review Fee(Engineer) $120.00 Plan Review Fee(Engineer) $80.00 Scanning Fee y0-;; Miami Shores Village FC ' ' FEB 1 2015 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY, Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20[0 BUILDING Master Permit No WP 15"1�(2, PERMIT APPLICATION Sub Permit No. ,OUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: /a 8 0 4Sf '-6E7- City: Miami Shores County: Miami Dade Zip: '3313e Folio/Parcel#:_//-,3,205 •DZi • QD/0 Is the Building Historically Designated:Yes NO / Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): w l G2m / =Q:�j Phone#: Address: /a80 'E /D I S�- City: &-hi)e$ State: Zip: (3313ff Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: 1,) .nq azK Phone#: Gy sy 77 -333F Address: /j. F�'-1�ra/ I%J�4 City: "� k_QLtOt State: Zip:_ 3j?691 Qualifier Name: 8r-"n_--N P !?"�� C ailt�m Phone#: State Certification or Registration#:_CPC 14,15 7.2,31. Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: Statee::yam Zip: Value of Work for this Permit:$ S-000Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ /Re lace Re air 9 p p ❑ Demolition Description of Work: 7- / Specify color of color thru tile:V Submittal Fee$�� )• d Permit Fee$ /��' /�d CCF C) CO/CC$ Scanning Fee$ 9•d D Radon Fee$ 2 2 DBPR$ 2_r Notary$ Technology Fee$ 470� eo- Training/Education Fee$ /• d Double Fee$ Structural Reviews$/2C•®d Bond$ S'C0_ dQ TOTAL FEE NOW DUE$ T /�rl��G• (Revised02/24/2014) 3'oa- vD 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 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 Signat / OW or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 1S bya-"i day of �kG rle�`.. 20 I by L� I Ii.�M O�-1 who is personally known to r�,rL r� P. OylG_.CSllu��1 who is persona�llv_known to me or who has produced as me or who has produced as identification and who id take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign:`�� `�� Sign: Print: &gA flLkS Print: Seal: ` :;�rP�' BETH LEIGH SCHOTANUS Seal: 1 aQin , B H LEIGH SCHOT a US' Ai :r.MY COMMISSION#EE880532 MY COMMISSION#EE881 4�EXPIRES March 04,2017 '�;FoEXPIRES March 04,2017dF P rvica.com q07)398-0153 F!ontlallotaryServloa.com APPROVED BY '2 r� Plans Examiner Zoning I ISJ Structural Review Clerk (Revised02/24/2014) Miami shores a Villa9 •5'��R�s L Building Department loop 10050 N.E.2nd Avenue Miami Shores, Florida 33138 SIZE Tel: (305) 795.2204 A�Rit, Fax: (305) 756.8972 Permit No: g P P 11- 3 ) i Page 1 of 1 Structural Critique Sheet 4 /CSO G� ► � (.�.,r �,�, J STOPPED REVIEW Plan review is not complete,when all items above are corrected,we will do a complete plan review. If any sheets are voided,remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re-submittal drawings. Mehdi Asraf T ♦SgoRES Lrt Miami Shores Village some Building Department 10050 N.E.2nd Avenue �Nres�Ne� Miami Shores, Florida 33138 0R1Dp' Tel: (305) 795.2204 Fax: (305) 756.8972 SURVEY AFFIDAVIT STATE OF(FLORIDA) COUNTY OF(DADE) The undersigned Affiant, UY-1 12---1 does hereby attest that (Property owner) The attached survey, performed by --Vyyc r -S• V,4—k � (Name of surveyor's company) For address: I a1� �e lob cSt • 1M: -. ��o�f�S Performed on q1 L4l (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. Further,A iau ht. Property Owner Signature Property Owner Print Name SWORN TO AND SUBSCRIBED before me this qday of a r SIS Affiant is personally known to me, --produced identification. Notary Revised on 5/22/2009/Revised on 6/12/09 BETH LEIGH SCHOTANUS b MY COMMISSION#EE880532 EXPIRES March 04,2017 41)7•a98.pt53 F'ondaNGWYSorolce.com SHEET 2 OF 2 �"T SUKIVIJED FOUND °?J 2 •;�•' „�.• Mcg VAIL P.R.M. � 5.24 5.17 ° n' ... U E / &NC. DECK qL F I CL. r 3 ........ f i•r 1.20' POOL o'6.0`:N K :6:07 rn RI ON CL- lo i J N�•. i Cl 10. ` 0.20 40 CO' SLAB °� :n'• = S . L 0' 1 _ POOL - \o.a7 b: EQUIP - / "� A/C \� l 1 a 5.97 4' PLASTIC F. t,tns 58 .....•,PL i + 0 7•_"GEEK 6.45 ELEV.=PL 20 10 6. _ :'ic'crs o6 37 '` o L - of a 23.20' �` �.. / )r N o 20.50' ;' it 2.2 vi 6.361 3.6• .�2.2' -.a 6.22 ILL ri'103 ¢ C7 12.0 tZ C) 52. ,3' - m ,n !Ei ry < Ll ti 6.28 -€ 18.60 ONE-TWO STORY 'n - o/• 9.65 ^ FES No.1280 _ 25.20' L CL.O 67.00 5120 ' • ' 2a i 0.45' 5'C.B.- 6.36 CL. Fo, i7 ..../;... P.T. _ �- `+ 6.41 6.22 ...... WALL �� u> '"' `_ ^ � v: NAIL 22.60' o WALK E i.00' `=y°n 5.8� ASPH. DRIVEWAYI 0 ,r„ .. Po.1/2"'' 23.5' �_-�1� 180' ; c LP. ... . ..._. P.C. 4.5�`' 5.20 ^D. 6;: .'ii")'<\^,'t ; c FD. U P 3 iX PRI id 14.5 „IDEWALK i DRILL HOLE 014'ANCHOR �'-_....._.___:._....._c.- i_ _.e._.____.:..._._�............ ' 2' CURB/GUTTER ASPH. ASPH. i'Il 24.0' PARKWAY PAV. PAV. i'J _.._............._.__....._.._._..__.• _.._ 19.0' ASPH. PAV. ..._._..._........_..__.. ...... ..._....._...._....._. ..._. ... .................._ .... ....._w.,.._._....,........ 5.11 NE 101ST =36 STREET Y _.. _. ....................................... 100' TOTAL R/W NOTES OA C.B.S. WALL ENC. UP TO 3.7' INTO A 5• U.E. OA CONC. DECK ENC. UP TO M5' INTO A 5' U.E. ©AN IRON GATE ENC. INTO A 5' U.E. THOMAS J. KELLY , INC. 81:21 ';lyV 1210 ST,EE FINIEC ESt FLORIDA 331,55 (78,S,: 2-2....7r.� Int:>'. i/34,, 771C;_...32$8 SR"D SIO C•, Lti-L-`. I.?Hi:: .rn+.ti( . .._....................._............._.........."_ .. _! • SHEET 2 OF 2 NOT SUBDD!VIDiOD mIJ FOU (2) , �; o 'DI P.R.MD olU 6.20 �`(. ^U rVAL ...-_...__—_ .. { 5.24 U 5.17 s _. ..........5_U E..... ... CONC, o DECK - iC.3.S.lIA_L Cl. !_ CO 6 57 ..00 5.55 6 _....-_.----.,..-.. P o CL. ;ti i . ..; ;. ;• 1 ; o 3 o. 5.50 _ ..._-_,..-............_...._._.___., m i.n o. ..o f 4'I� '? POOL o6.0'jN ,: - ' :6:07 u�CLO m BRICK CO!.C.,•�' .a N;.. '. b u.a. 10.0'? 40 CO' '.. SLAB I�',• = S.,AEi .� I�..._;; �...-_ POOL I :N .. 0 87 5:52 ;ACL 0 EQUIP --= =" = ! \ A/C I5 97 4'•PLASTC F. 6.5at PL'i' 0 Z -W00D�., ELEV,=PL. t,., `,� ?4 7 f lz,cns 1 "".S CK 6.45 —�•�.. X2010 ,....< ' „37 �'. ° 23.20o�— \ ,)P 20.50 of NtO12.2 < U vi .36 t .6' 1 ..w2.2 63 ' TILEoC7 0; 622 �, w o _ b h 12.0 Li cd i +628 64 ,m. i1S:60 .-'fi q zi ^: ONE-TWO STORY 'nF } C� �l 9:65' n s RES:No.1280 ¢o _ 1�00 W /5� � �0 6` .6 _.,__. 67.00' 17,0' ) 5�5' 12.0' `Y 0.45' 5'CFD. 6.336 ` a 6-5� !CL. .D. I ;o P.T. oWALL 6.26 l....;;......... NAILWALK .ice 7 ASPH. ORIVEVIAYI `6.00 i.00' it G,,x. {c 5.85 '^f1 \ s c F0.1/2" ; 23.5' � 1, 18.0' I.P. G"........_ ...... 4.50 5.20 "pc D, ti:. ; ; fC NAI, 1a.5' SIDEWALK ORILL HOLE ix, P.R.M. \` i 14'ANC4OR ...........:.._.:....___..._...._....s........... I 2' CURB/GUTTER O _} ASPH. ASPH. c ' 24.0' PARKWAYPAV. PAV. 1i 19.0ASPH, PAV. NE 101ST —36 STREET .............. ................................................ .._..... -- 100' TOTAL R/W NOTES' OA C.B.S. WALL ENC. UP TO 3.7' INTO A 5' U.E. OA CONC. DECK ENC. UP TO 0.85' INTO A 5' U.E. OAN IRON GATE ENC. INTO A 5' U.E. THOMAS J. KELLY , INC. IR Va.YC,RS-_x:.,. lids"' -• tr..,:;) 242-'7Fr_ <, t?A;_.:._ tax:,•; i.,-_ 28S c?RSYi> 86; 242-649- DAD_E FAX (9,554J779 -3260 FAX ..-................._................................-.....-...... .... r y M. ' ' ' ' �0�NUK0N00UUN0UUUN00UN8NUKN UKNNU UUNNU A0UU UNNU . �UNNUU00NUUU00UUUN0UU0�N8y0VU0NUVUN0U80V0XN0U NOTICE OF COMMENCEMENT OR Bk 29455 Py 2176; (Ips) 'ARECORDED COPY MUST BEPOSTED ON THE JOB SITE ATTIME OFFIRST INSPECTION RECORDED 01/07/2015 12:17:54 HARVEY RUVIN, CLERK OF COURT, MIAMI-DADE COUNTY, FLORIDA PERMIT NO. TAX FOLIO ND LAST PAGE STATE OFFLORIDA: COUNTY OF MIAMI-OADE: THE UNDERSIGNED hereby gives notice that improvements will bamade tocertain real property, and in accordance with Chapter 713, Florida Statutes, the following information in provided in this Notice of Commencement. 1. Legal description of property and street/address: 2. Des ption of improvement: 3. Owner(s) Interest in property:nLQrw.r- Name and address of fee simple titleholder: 4. Contractor's name and address: . 5. Surety: (Payment bond required byowner from contractor, nany) Name and Address: Amount nfbond 6. address: 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Soction713.13(1)(m)7.. Florida Statutes. Name and Address: D. In addition to h/moe|f. Owners designates the following person(s)to receive acopy of the Lienor's /vuuue as p.""."e" inSection 713.13(1)(b). Florida Statutes. Name and Address: — Expiration' _ --_ - -_ Notice of Commencement: (the expiration ' ,SNORES MAR 2 3 2015 logo Miami Shores village Building Department A 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 and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances,Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: ""�� Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this day of (Y'�r-,47C44 20 IS. ByW%�-L l who is personally known to me or has produced uui as identification. Notary: d SEAL: = 0310612016 NOTARV PUBIIC • COITIMISSIon # MAR 2 3 2015 WATERMARK CONSTRUCTIt " Super Showroom 4460 N. Federal Highway, Ft. Lauderdale, FL 33308 Tel: (954)776-3338 Fay (954)492-8769 AFFIDAVIT Please note that on permit #15-312, the only person from Watermark Construction that will be working on the job is Bryan P. Mccallum , an officer of the company and is workers comp exempt. Thank you, Signature: Ci.� ,.v-cwt cue �^, t� L. -h•- S Z 3 v� F�,(o�,..fl. r,A3 acx•�,c�^' �,tC.JtQfL � rrGCAA--r^ S �•v„c,r� �� �w Pr2.T �S' i a7�crr Cr�.o.--c �► -40 X00 ..910?/90/EO tea'•a� dx?,.• :'