DS-15-308 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-239312 Permit Number: DS-2-15-308
Scheduled Inspection Date: July 22, 2015 Permit Type: Driveways/Sidewalks/Slabs
Inspector: Rodriguez,Jorge
Inspection Type: Final
Owner: KIEFER, RONALD AND KATTIA GARCIA Work Classification: Addition/Alteration
Job Address: 1290 NE 100 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132050090020
Project: <NONE>
Contractor: CHAMPION CONCRETE Phone: (305)252-8055
Building Department Comments
CONCRETE PADS DRIVEWAY Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-228092. Need complete permit
�'a package
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
July 21,2015 For Inspections please call: (305)762-4949 Page 27 of 34
Miami Shores Village `\
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000
Phone: (305)795-2204 J � ' y . EP.:..
Ex iration: 10125/2015
P
j � 201
Ȣ ;a
Project Address Parcel Number Applicant
1290 NE 100 Street 1132050090020
I RONALD AND KATTIA GARCIA I
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
I RONALD AND KATTIA GARCIA KIEFER 1290 NE 100 Street
MIAMI SHORES FL 33138-
1290 N E 100 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 6,940.00
CHAMPION CONCRETE (305)252-8055 (786)402-4802
Total Sq Feet: 950
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved: :In Review Final
Date Denied: Foundation
Type of Work:CONCRETE PADS DRIVEWAY Additional Info: Review Planning
Bond Return: Classification:Residential Review Planning
Scanning:3 Review Planning
Review Building
Review Building
Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Owners Bond $500.00
CCF Invoice# DS-2-15-54469
$4.20 04/28/2015 Credit Card $649.20 $0.00
DBPR Fee $2.00
DCA Fee $2.00 Bond#:2694
Education Surcharge $1.40
Permit Fee $125.00
Scanning Fee $9.00
Technology Fee $5.60
Total: $649.20
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify thatII the fo going information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Fut 7, or the above-named contractor to do the work stated.
April 28, 2015
Authorized Signature:O n r / Appli ant / Contractor / Agent Date
Building Depart ent Co y
April 28, 2015 1
Miami Shores Village
g
Building Department
205
'
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax: (305)756.8972
INSPECTION'S PHONE NUMBER: (305)762.4949
FBCC20
.)J 1
BUILDING Permit No5 3 C)s
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: 12-Qo Nom' 100 5j'"
City: Miami Shores County: Miami Dade Zip: 33 3 0y
Folio/Parcel#:
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name
�✓r�! K f(Fee Simple Titleholder): /!w/VE E��- Phone#:
Address: t 2.410
City: State: '31 Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: C ��1m�'� ( 0jV�17� Phone#: 325rz.SZ d�
Address: 1140 U/ Aw 13J
City: J1 la's State: Zip: I7 y
Qualifier Name: �_ ��� Phone#: �"
State Certification or Registration#: Certificate of ompetency#: f_L�
Contact Phone#: Email Address: jtj,
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑Addition ❑Alteration ❑New ❑Repair/Replace dDemolition
Description of Work:
Color thru tile:
Submittal Fee$ Permit Fee$ .65 CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
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 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 I
ivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must b posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the ab ence o uch posted notice, the
inspection will approv d d a reinspection fee will be charged.
Signature Signature
wner or Agent Contractor /
The foreVint iinnstrumen as acknowledged before me this // The foregoi in trument w cknowled,ged before mr e this/,/
day of t e'J 20by �`� � �� f� day of 20��,by�.//7!Iz'�'
who is personaltly_known
ntto me or who has produced who i��p�rsf aly known to me or who has produced
MFidennntifcation and who did take an oath. ri� as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
o�P P e� LUCIA ESTRELIA
Sig a y COMMISSION I1 EE 680165 otiaar P:B�
Sign:
I
* [XP * MY COMMISSION 0 EE 880165
Print. 6 ruBud Nogrysorvia� Print:
4'OF W� ^gTFOp F�OR��~ Band®d?htu Sudpet Nogry S4rvioee
My Commission Expires: My Commission Expires:
APPROVED BY Plans Examiner 1 Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
SNoREs
Miami shores Village
c
B... , Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
�t0RlpA Tel: (305) 795.2204
Fax: (305) 756.8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
Whereas, (owner) ko1 6F 00�F° hereinafter referred to as the owner of
the following described property(address): �C1(� AvG /00 S/^
Legal Description Lot Block Subdivision
Folio#
Requests permission to install (describe work):
Within the public right of way of(address) C � XZ— f oV 5;,�
IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows:
1. To maintain and repair, when necessary, the above-mentioned item(s) installed within the dedicated right of
way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said
items within public right of way including restoration of street by reason of the Owner's failure to do so,
such expense shall be paid by the Owner or shall constitute a lien against the above described property
until paid.
2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County harmless from any
and all liability,which may rise by virtue of permitting the installation of these items within the public right of way.
1
i
3. The Owner does hereby agree to remove or relocate their facilities at their own expense, within 60 days
notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s)
to be removed and a lien being placed on the property and/or assessed against the Owner for all costs
incurred in the removal and disposal of the item(s).
4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land
and shall remain in full force and effect and be binding on the undersigned, their heirs and assigns, until
such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County,
Florida by the Village Manager of Miami Shores Village (or his fully authorized representative).
SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this X// ay of e` ' 20S
(Owner's Signature)
SIGN L D DELIVERED in the presence of:
o�PaY.°pBi, LUCiAESTRELLA
r ' o MY COMMISSION#EE 880165
EXPIRES:July 2,2017
?�TEaFF�o�Oe
Bonded Thru Budget Notary service.
2
Rick Scott
Mission: Governor
To-protect,promote&improve the health ,
of all people in Florida through integrated
state,county&community efforts. John H.Armstrong, MD, FACS
HEALTHState Surgeon General&Secretary
Vision:To be the Heakhiest State in the Nation
March 24, 2015
�2vtr►a� + att�q K►e fear
actb t4F oo %iye?ef
rn t av►i I skoves,F L-6313,5
RE: Modification to a Single Family Residence - No Bedroom Addition
Application Document Number: AP1178012
Centrax Permit Number: 13-SC-1589883
1290 NE 100 Street
Miami, FL 33138
Lot: 2 Block: 1 Subdivision: Earleton Shores
Dear Applicant,
This will acknowledge receipt of a floor plan and site plan on 0.""/26/2015 for the use of the existing
onsite sewage treatment and disposal system located on the above referenced property. No
Objection. New Paved Driveway. Pavers over drainfield. Removal of pavers was inspected and
approved by Y'. Martin on 3/20/2015. Reviewed by N. Gumbs or, 3/24/2015.
This office has reviewed and verified the floor plan and site plain you submitted, for the proposed
remodeling addition or modification to your single-family home. Based on the information you provided,
the Health Department concludes that the proposed remodeling addition or modification is not adding a
bedroom and that it does not appear to cover any part of the existing system or encroach on the
required setback or unobstructed area. No existing system inspection or evaluation and assessment,
or modification, replacement, or upgrade authorization is required.
Because an inspection or evaluation of the existing septic system was not conducted, the Department
cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use.
You may request a voluntary inspection and assessment of yot.lr system from a licensed septic tank
contractor or plumber, or a person certified under section 381,0 1 01, Florida Statutes.
If you have any questions, please call our office at (305) 623-3~00.
Sin*..-,um
{ Nic ,
Engine::ring Specialist it
Department of Health in Dade County
Florida Department of Health www.floridahealth.gov
in Dade County- ,Florida TWITTER:HealthyFLA
PHONE: (305)623-35CO FACE BOOK:FLDepartmentofHealth
YOUTUBE:fldoh
PLRMT-- NO.7A'!
OP HEAL'I'll DATE PAIL):
!;EWAGE. TPEATMENT AND DISPOSAI, F-EE pi\jo.
RECE I PT 4
ATIP1,TC)"TION FOR CONSTRUCTION PERMIT
IX ) Existing System Holding Tank Innovative
Abandonment Temporary
klD
TELFPTiC)9F :
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FL
;:.Y AF)' , I C.NNT OR APPLICANT' S ACTliORIZED AGENT. SYSTEMS t-fUST 1W C0!4_'TRUKTF[)
Pl): S UANT TO 489.105 (3) (m) OR 489. 552, FLORI DA STATUTES. IT IS TIFF.
TO PROVIDE DOCUMENTATION OF THE DATE THE LOT WAS CRF:A71-:D OR
;.ATTK.:) ] F i,'!:QUFSTING CONSIDERATION OF STATUTORY GRANDFATHER pRo`.rjslcNS.
;'P,l');'FF"" 1N1'01Q-!ATION
1,0 BLOCK: SUBDIVISION: E PLhTTED
PROPERTY 11) 9 ZONING: I/M OR EQl.'rPlA1,ENT: I Y /(Dl
FiZOPEITy 317F : ....... hi::U�S WATER SUPPLY: PRIVATE �LI [ (Q<=2000GPD >2000GPI)
AS 117::R 381 .0065, FS? ( Y DISTANCE TO
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BUILDING INFORMATION RESIDENTIAL COMMERCIAL
Unit Type of No, of Building Commercial/Institutional Sy_-U,_m Design
No Establishment Bedrooms Area Sgft Table 1, Cha�t.r 641:-6, 1---AC
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ONE STORY — I.POIIALD E KIEFER AND KATTIA 10 GARCIA AIEFEF
a RESIDENCE
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`• I �{ y N N �' TO THE PLAT THEREOF ON FILE IN THE OFFICE
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54.8' 4� FOR 6f1AA41-DARE COUNTY.FLORIDA RECORDED
IN PLAT BOOK 43.PAGE 80.SAID LANDS SITUATE.
FOUND;'2' ^ rt_.._ ._.,z � �1_ _ FOUND?l2' T
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1 I HEREBY DERTJFY this survey meets Minimum Techn¢a+Slandards BLOCK 1 GU y1(,1'�-lam' fi'�r�`" BOUNDARY SURVEY
pursualrr to Section 472027 Pohrfa Sw e
2.The survey map and repos a ld he copse•hlieot a,e Trot valid A'thoul the
signature and the original raised seat file Florida I;erased surveyor and mapper. ,J \L' 1. �7 �� P '.r
3.Underground a obscured npro•ements v te)4Ioca!ed. _ +,r4T 1^ �1�'�(��(` -°•;I,&.to%rl f . r' P M SURVEYING
A.Dimensions IIIc record and field unless otherwise holed. /y�1/" C ` '�� ly
LICENSE[)°i,.">^.ESS No n'A3
S.Stated dimensions fake precedence over scaled drmenswrs. J U\ w;�i I
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6.This firm:Certificate otAulhonzahon Number is LS 678A. `
/RC1 ♦'� SIGN- . a DATE 05-22-14 )I 454. A5.9RIJ E STREET
7 Addrlia+s a deletions to survey maps a reµxfs by ofha h a 1 the-gnirq Y - \' q
A sTPA A+c"AHF y
party or parties is prohibited without,rnuen consent of the agog pally or parties. v``V/11 L
R PRd MAPPEP. / .r 4 84
B.Survey subject to reservations restrictions easements and rghls-of.r.ay ,( FAx
s.-478-11091
o//ecoid'This survey has been compleled in the absence of a Ime insurance policy). S\ FL ORIDA _ Ar t?
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SURVEYORS'NOTELOT 16 :L� � ��' �enC1 5
1.1 HEREBY CERTIFY this survey meets inimum Technical Standards BLOCK 1 ` � t J
pursuant to Section 472.027,Florida States. tf 41�
2.The survey map and report and the copies thereof are not valid without the �� 1--(1— (/ ,• I/rC �✓� —
signature and the original raised seal of a Florida licensed surveyor and mapper. 2
3.Underground or obscured improvements were not located. � � �� �
4.Dimensions are record and field unless otherwise noted. r"
5.Stated dimensions take precedence over scaled dimensions. 0LJj S+
6.This firm's Certificate of Authorization Number is LB 6788. t-r
7.Additions or deletions to survey maps or reports by other than the signing �I -�- (Ain SIGN s
party or parties is prohibited without written consent of the signing party or parties. lR
8.Survey subject to reservations,restrictions,easements and rights-0f--way pRp
of record.(This survey has been completed in the absence of a title insurance policy). �,V S � ���x��a� FLORA
9.Location map is gleaned from online mapping sites and and is only approximate. i