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DS-15-2007 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-241013 Permit Number: DS-8-15-2007 Scheduled Inspection Date: September 16, 2015 Permit Type: Driveways/Sidewalks/Slabs Inspector: Rodriguez,Jorge Inspection Type: Final Owner: SALYER, THOMAS Work Classification: Addition/Alteration Job Address:311 NE 94 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132060136100 Project: <NONE> Contractor: CHAMPION CONCRETE Phone: (305)252-8055 Building Department Comments REPLACE EXISTING DRIVEWAY WITH CONCRETE Infractio Passed Comments PAVERS INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 15, 2015 For Inspections please call: (305)762-4949 Page 11 of 16 Y ByrdD 6 ��sHO1�so, Miami Shores Village 10050 N.E.2nd Avenue NE r<14,00ffa6�n3c*bin/Aitatiorf '{ Miami Shores, FL 33138-0000 _._ r : ' Pelttai# ia� APPROVER.:.,; ti Fryy Phone: (305)795-2204 , FLORIDA Ry'Ej u/i 3 f ' Expiration: 02/21/2018 Project Address Parcel Number Applicant 311 NE 94 Street 1132060136100 Miami Shores, FL 33138- Block: Lot: THOMAS SALYER Owner Information Address Phone Cell THOMAS SALYER 311 NE 94 ST I MIAMI SHORES FL 33138-2831 Contractor(s) Phone Cell Phone Valuation: $ 6,500.00 CHAMPION CONCRETE (305)252-8055 (786)402-4802 Total Sq Feet: 1100 Approved: In Review Available Inspections: Comments: Inspection Type: Date Approved: : In Review Final Date Denied: Foundation Type of Work: REPLACE EXISTING DRIVEWAY WITH CC Additional Info: Review Planning Bond Return: Classification: Residential Review Building Scanning:3 Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Owners Bond $500.00 Invoice# DS-8-15-56661 CCF $4.20 08/10/2015 Check#: 1971 $50.00 $624.70 DBPR Fee $2.25 DCA Fee $2.25 08/25/2015 Credit Card $624.70 $0.00 Education Surcharge $1.40 Bond#:2817 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $5.60 Total: $674.70 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. Futhermore, thorize the above-named contractor to do the work stated. August 25, 2015 Authorize ignature:Owner / Apl ant / Contractor / Agent Date Building Department Copy August 25, 2015 1 Miami Shores Village g AUG z015 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949C, FBC 20 ( � BUILDING Master Permit No.� ( � PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP ^fCONTRACTOR DRAWINGS JOB ADDRESS: �� " `'L ' ITLt- S-r City: Miami Shores pp Countv: Miami Dade zip: 3!�r3 S Folio/Parcel#: SOTS lo��J p�G1� $ Is the Building Historically Designated:Yes NO_X' Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): _�� �� (/� >S o4.�-.YL=i2_ Phone#: Address01=r :q,� City: �'r'`tel 1' � .r� State: L__ Zip. Tenant/Lessee Name: Phone#: Email: (�✓� Tit-•�E R.. r C�►t� CONTRACTOR:Company Name: �i7�1 /"�Ej/v ��G �'[ Phone#: Address: i �� �VQ RA w City: tate: Zip. ./ �S`(� Qualifier Name: Phone#: -?(!rb`q0L `l +Z State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer:. Phone#: Address: / City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Z;/o D -57,x, Type of Work: ❑ Addition p❑, Alteration ❑ New �epair/Replace ❑ Demolition Description of Work: L�L�2 Ez-L� Specify color of color thru the Submittal Fee$ Permit Fee$ CCF$ CO/CC$ v Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ � t TOTAL FEE NOW DUE$ (RPvkPdn,)/')d/Jn1dl R s 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of ch posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT C NTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day ofyn� 201 by 10 day of �tJt6df� 20 by who is personalllyl known to I� �Ig+l�'1'1 6d51�� o who is personally known to me or who has produced r �. S��d 2�Z 1�F14s�U me or who has produced as identification and who did take an oath. lSS I®OOL�TUU identification and who did take an oath. NOTARY PUBLIC: 111 D�11 NOTARY PUBLIC: Sign: Sign: Print: Pu Print: RUTHLEDESMA I0"I FF tow ;*;' LM MY COMMISSION N FF 172019 Seal: *1 OOIIMII§*M MY,19,2O19 Seal: •.• ` EXPIRES:January 18,2019 Bonded Thru Notary Public Underwriters APPROVED BY Plans Examiner �� Zoning Structural Review Clerk ♦SH0Res Li �c Miami Shores Village Building Department 10050 N.E.2nd Avenue FNres„�8� Miami Shores, Florida 33138 �zORiDp' Tel: (305) 795.2204 Fax: (305) 756.8972 SURVEY AFFIDAVIT STATE OF(FLORIDA) . . .... ...... COUNTY OF(DADE) ' ...... .. . ...... The undersigned Affiant, 76mss &("ks"S+ereby attest that ••• • .... . ..... (Property owner) ' ...... .... ..... The attached survey, performed by " 9690 06•••• (Name of surveyor's company) • • • • •••••• For address: 3« n} .is . �� s-r ►h� ►� Sri ,. �•. ... 3$ .... •• • Performed on (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 Affiant say eth naught. Property Owner Signature Property Owner Print Name 1 SWORN TO AND SUBSCRIBED before me this J day of v W Affiant is personally known to me, produced Sd�o 3 G uUDIANA L RODRIGUEZ Notary Public,State of Fiorlda Ocmmlae W FF 209430 t� *1 01M -� daBl13�e1 , Notary Revised on 5/22/2009/Revised on 6/12/09 5ORs t . ' Miami Shores Village unit" Building Department 10050 N.E.2nd Avenue x�yd Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) TFb W40fQ W • s .`c l�`�--- hereinafter referred to as the owner of the following described property (address): I I T S S,yo29S/9L, Legal Description Lot A0—If Block vS Subdivision Folio # LA___f 0106k-- 104 Requests permission to insta (describe work): JJArk)8'✓ZQ-AUL Within the public right of way of (address) .3l/ --r- IN CONSIDERATION of the approval of this permit by the Village, the owner agreeA asf'bllows:.... 1. To maintain and repair, when necessary, the above-mentioned itern(69.}instaled*wlthin the-:. dedicated right of way. If it becomes necessary for Miami Shores "fitite or Dade Cou+�ty•: to make repairs or maintain said items within public right of way i6�jyding jestoration*.af.. street by reason of the Owner's failure to do so, such expense sha&lpepaid by." OwM4••9 or shall constitute a lien against the above described property until-patd. 00.0:0 2. The owner does hereby agree to indemnify and hold Miami Sl6W:Village99r DagjP.;:0 County harmless from any and all liability, which may rise by virtue. of pdrHfttng the installation of these items within the public right of way. •• ••• • 3. The Owner does hereby agree to remove or relocate their facilities at their owTf e*ense, 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). Signature W ' Owner or Agent �10 The foregoing instrument was acknowledged before me this day of �O , 20 , by JNW'(�U� j U U tj, who is personally known to me or who has produceAl� _ L1t a�L� �,_A t U�,(j as identification and who did take an oath. � � � � N UB Sign: EZ MOM Com kWo W FF XM 1A►ear►, Mu.t2,2ot9 O '� / •�, Cpl �(1 `V 1' 1 11 /r II I I (, 1 Ilr.jd: � r...,•� • • •i .�• (r .r,��"' mow:� •' i e+ � r �II �1 w)I 'h�M r''��; , j/' .� �1 ♦ ~ + �+i '• / s � � •i/li,'�i'� , 1 t• /r. 'o ''o~e� ..'x,l�i �1 � �� ,�+f � �,. 77 tj Iri'41 i �, • • r w�- fir;, �ry + + �4• M; r1.}; 10" ' � A,9' � .L \• •• ...• Jtgla�,li�b• I. g w! +'u,M r,` � 1•*Y+"� "� hO °:'�,, n'i tz j,Q�;,�t � I � ��,T W w ,1 '�ie.ra� ov•ai�, p p Of• • • :�..• ,a 00 vo a ye/\ �''ra,!� °`' \�41sr �P Legal Description �,�x'({�y _,✓ ' -''fir'` ° �'�„ �8 s 3 r.3�Or>E:;2HEr111� e� ��h �� �Q� �� �s• `�''�-'� L.tra , ��a Lots 10 and 11,Block 45, ofAN"EJ .o. )� °�' rs ' 2 �5 SHORES SECTION NO. 1,according b " )O. a* recorded in Plat Book 10, Page 70,of r Dade County,Florida. Date of field work: 3115194 Completion date: 3116194 Flood zone: X Panel: 0093 Survey number: G-3912 'f�1�✓� ' � ."!� 4 i�J� ' 'Cel ct�c�. �, t, CertiJled to: Thomas W Salyer and Kathleen M. Sal tvY-1/ I Q Services,Inc.;First American 17tle Ins Z BancBoston Mortgage Corporation, its Jam- y l� asz t,.v�a�( i assigns s� '� ' roperty address: ' b —� R :U I R E DI1 N.E. 94 Street -* =- a t ) e CountyMiand,FL 33138 ,, -�►. � ,.;&W II Program Application o. Date: oil oZfl1 l NOTESI First / R EITHER ASSUMED I 1) BEARI�Mqj !1 E CE fHb I BOUNDARY SURVEY MEETS THE MINIMUM TECHNICAL STAND DS AS SET z) LEGAL�281. loN PROVIDED BY OTHERS. Financial Ip RD OF PROFESSIONAL LAND SURVEYORS IN CHAPTER 21H FLORIDA 3) THE LAND BROWN HEREON WERE NOT ABSTRACTED FOR EASEMENT TIV" p, DANT TO SECTION 472.027,FLORIDA STATUTES. OR OTHER RECORDED ENCUMBRANCES NOT SHOWN ON THE PLAT. d) UNDERGROUND PORTIONS OF F40TINGS,FOUNDATIONS OR OTHER IMPROVEMENT WERE NOT LOCATTED. 5) ELEVATIONS ARE BASED ON NATIONAL GEODETIC DATUM. RALP: ERDL F 8) FENCE OWNERSHIP NOT DETERMINED. REGISTERED LAND SURVEYOR NO.3411 7) WALL TIES ARE TO THE FACE OF"rHE WALL. CTATr-nF R f)RinA 8) NOT VAUD UNLESS SEA).ED WITH AN EMBOSSED SURVEYORS SEAL. ,�� nwn .•-Vr-f% A 1t•