DS-15-261 Perm#quo. DS-1 0-15.2651
Miami Shores Village Permit Type'Driveways/81dewalkWSlabs
10050 N.E.2nd NE
2d A `W
ark C168 catfon. epair
Miami Shores,FL 33138-0000 fie'r
Permit Status.APPROVED Phone: (305)795-2204 _�,
RYOR'LDp'
Issue Date: 10/2912016 Expiration: 26/201
Project Address Parcel Number Applicant
186 NE 106 Street 1121360050010
Miami Shores, FL 33138- Block: Lot: CK PROPERTY SOLUTIONS, LLI
Owner Information Address Phone Cell
CK PROPERTY SOLUTIONS, LLC 209 NE 95 Street (305)758-3133
MIAMI SHORES FL 33138-
209 NE 95 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 1,200.00
CLEMDEL CONSTRUCTION CORP (305)856-4715
Total Sq Feet: 00
Approved:In Review Available Inspections:
Comments: LInspection Type:
Date Approved::In Review Date Denied: onType of Work:SIDEWALK REPAIR Additional Info: lanningBond Return: Classification:Residential uilding
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
DBPR Fee InVOICe# DS-10-15-57468
$2.00 10/29/2015 Credit Card $66.20 $50.00
DCA Fee $2.00
Education Surcharge $0.40 10/19/2015 Credit Card $50.00 $0.00
Permit Fee $100.00
Scanning Fee $9.00
Technology Fee $1.60
Total: $116.20
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 that all the foregoi g information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zaffing. Futhe ore,I authorize a above-named contractor to do the work stated.
f
October 29, 2015
Aarha
ed Sigr4ture:Owner / Applicant / Contractor / Agent Date
Build Department Copy
October 29,2015 1
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-245975 Permit Number: DS-10-15-2651
Scheduled Inspection Date: November 09, 2015 Permit Type: Driveways/Sidewalks/Slabs
Inspector: Rodriguez,Jorge Inspection Type: Final
Owner: SOLUTIONS, LLC, CK PROPERTY Work Classification: Repair
Job Address: 186 NE 106 Street
Miami Shores, FL 33138- Phone Number (305)758-3133
Parcel Number 1121360050010
Project: <NONE>
Contractor: CLEMDEL CONSTRUCTION CORP Phone: (305)856-4715
Building Department Comments
SIDEWALK REPAIR Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
November 06,2015 For Inspections please call: (305)762-4949 Page 21 of 42
7BY:
C E VED
Miami Shores Village T 19 2015Building Department -
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20/,5--
BUILDING Master Permit NOo/� /4---
PERMIT APPLICATION Sub Permit No.
F-IBUILDING ELECTRIC ROOFING REVISION EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL F-]PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
J fid/ fCONTRACTOR DRAWINGS
JOB ADDRESS: / �✓ L� /�= / s T
City Miami Shores County: Miami Dade Zip:
Folio/Parcel#: /l 7— v1 Gil? S U Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: C�Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): � 'x'76 1,25etZ Phone#: ZGS- 7S ' /
Address: 2 C�y
City: � �/ ®/i✓�c�ll.� c' State: l i� Zip:
Tenant/Lessee Name: � Phone#:
CONTRACTOR:Company Name: ��7 /- �� Phone#: 30S QG ��wl
Address:
City: Q State: Tl� Zip:
Qualifier Name: S • Phone#: 0�
State Certification or Registration#: G6G Dy�+ 3el3 Certificate of Competency M Lim 393
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ C Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work: (((
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$,�
TOTAL FEE NOW DUE$ C(,o o'�
(Revised02/24/2014)
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 ` Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument as acknowledged before me this The foregoing instrument
was acknowledged before me this
�dayofi•, 20 /y�'by /7 day of /l�/� 20 S/,by
T . ®G Gd>e�o .who is personally known to �lGi rL �qL�� lEf�_ who is personally known to
me or who has produced �� �i L� as me or who has produced F t— J as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
ZG
Sign: Sign:
Print: o Print: r UZ
iPay PLj6,,i� JIM U.
Seal: =2�+ �, . Notary Public-State of Florida Seal: =,=oWaY"` JIM D.PAMPLIN
My Comm.Expires Jan 13,2017 Notary Public-State of Florida
Commission#EE 864892c' My Comm.Expires Jan 13,2017
'''•0111��,
Commission#EE 864892
J2 �
APPROVED BY /� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
a e r
♦5�i�c.Ru s'
s••• ® ninM Miami Shores Village
° m 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 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:_ZO�
`: '��
Owner
State of Florida
County of Miami-Dade
The forego'ng was acknowledge before me this S day of ® G t' 20_LV.
BI who isersonally kno to me or has produced
Ll
as identification. ----•
__°`"`••`!��.NAOM.11�'1�c,GONCELOS
Notary: Q � l'F MY COMMISSION#FF0885
EXPIRES February 2,201a
SEAL: �~•"
(407)39&0163 F1orh&t:4,4a Servicex=
a
�LEMD� CONSTRUCTION CORPORATION
GENT CONTRACTOR/CONSTRUCTION MANAGEMENT
OCTOBER 17,2015
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
BEFORE ME THIS DAY PERSONALLY APPEARED CLEMENTE GONZALEZ WHO,BEING
DULY SWORN, DEPOSES AND SAYS
1 CLEMENTE GONZALEZ WILL BE THE ONLY PERSON FROM CLEMDEL CONSTRUCTION
CORP.WORKING ON THE PROJECT LOCATED AT:
186 N.E. 106 STREET
MIAMI SHORES VILLAGE, FLORIDA
CLEMENTE GONZALEZ
( SWORN TO(OR AFFIRMED SUBSCRIBED BEFORE ME THIS ` l DAY OF
D C+,O CAUGUST,2015,BY
C4 if -z—
w�. PERSONALLY KNOW
°�a NAOMI VASCONCELOS s
W�v Pp
MY COMMISSION#FF088554
tio► EXPIRES February 2,2018 OR PRODUCED IDENTIFICATION
(407)39&0163 FloridallotaryService.co
TYPE OF IDENTIFICATION PRODUCED—LL r L
11 SHORE DR.EAST MIAMI,FLORIDA 33133
305 656 47 15 OFFICE /305 731 2407
/ COC 047393 LICENSED AND INSURED
r-)FRIT �#: - 69).
APPROVED By DATE
ZONING tiN3 OCT 19 cis
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ALLSTATE SURVEYING,LLC PROPERTY LOCATION MAP PROUDLY SERVICING ALL OF FLORIDA
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DATE:08/12/2015 FILE NUMBER: MIA.SH.08-15 PROPERTY ADDRESS:186 NE 106TH STREET,MIAMI SH65Fe9!;*33138 • • •
• •
CERTIFICATIONS: LEGAL DESCRIPTION: COUNTY:MIAIWADC• • •
CK PROPERTY SOLUTION LOT 1,BLOCK 201,DUNNING'S MIAMI SHORES EXTENSION NO.1,ACCORDING TO THE PLAT THREOF,
AS RECORDED IN PLAT BOOK 41,PAGE 51,OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY,
FLORIDA.
FLOOD INFORMATION:
COMMUNITY NUMBER:120652
PANEL NUMBER: 12086CO302
DATE OF INDEX:09/11/2009 SUFFIX: L
FLOOD ZONE:X BASE FLOOD ELEV:WA V1%!
LEGEND & ABBREVIATIONS: GENERAL NOTES:
AIC............AIR CONDITIONER OVERHEAD CABLES(OH) THIS IS A COPYRIGHT DOCUMENT CONTAINING PROPRIETARY INFORMATION
BM.............BENCHMARK -CK- AND IS NOT WARRANTED BY ALLSTATE SURVEYING,LLC.OR THE SIGNING
(C)............',CALCULATED POLYVINYLCHLORIDE FENCE(PVCF) SURVEYOR WHEN COPIED BY OTHERS.
C.G............CURBCON &GU GUTTER ORVALLEYED GUTTER UNLESS OTHERWISE SHOWN HEREON,THE FOLLOWING NOTES APPLY:
C&G.........CURB&GUTTER WIRE OR CHAIN LINK FENCE(CLF)
CH..............CHORD X_X_ " RECORD AND MEASURED CALLS ARE IN SUBSTANTIAL AGREEMENT AND POINTS
C.M.E.........CANAL MAINTENANCE EASEMENT WOOD FENCE(WF) ARE WITHIN 0.10'POSITIONAL TOLERANCE.
CNA........„..CORNER NOT ACCESSIBLE METAL FENCE(MF) • THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENTS OR OTHER
DONC.........DELTACONCRETE
–0 MASONRY OR— RECORDED ENCUMBRANCES NOT SHOWN ON THE PLAT AND THE SAME,IF ANY
D.................DELTA(CENTRAL ANGLE) MASONRY OR CONCRETE BLOCK WALL MAY NOT BE SHOWN ON THIS SKETCH.
D.E..............DRAINAGE EASEMENT
EOP..„........EDGE OF PAVEMENT CONCRETE ' UNDERGROUND PORTIONS OF FOOTINGS,FOUNDATIONS OR OTHER IMPROVEMENTS
FC.......„..»..FENCE CORNER ; WERE NOT LOCATED.
FDH............FOUND DRILL HOLE ELEVATIONS ARE BASED ON NGVD 29 OR NAVD 88 AS NOTED ON SKETCH.
FE...............FI NCE ENDS OVERHANG(OIH)OR ROOF FLOOD ZONES:"B","C","D"&"X"ARE NOT IN DESIGNATED FLOOD HAZARD ZONE AREA.
F.F..............FOUND I FLOOR t�,�-
FIP/FTR......FOUND IRON PIPEIROD ® " FENCE TIES ARE TO THE CENTERLINE OF THE FENCE.FENCE OWNERSHIP NOT
FN...............FOUND NAIL COMMUNICATIONS BOX DETERMINED BY THIS OFFICE.
FN&D..........FOUND NAIL AND DISC CATCH BASIN WALL TIES ARE TO THE FACE OF THE WALL.
F.Pk.N.........FOUND PARKER KALON NAIL ” BASIS OF BEARINGS,IF ANY,ARE ASSUMED PER PLAT AND/OR LEGAL DESCRIPTION.
LD...............Sl1ATTAHO'S IDENTIFICATION SEWER MANHOLE
CHATTCHATTAHOOCHIE,EPDXYSTQNE •THIS SURVEY HAS BEEN PREPARED FOR THE EXCLUSIVE PURPOSE FOR USE AS AN
........
L..................LENGTH
C-Q_) UTILITY POLE(UP) AID IN OBTAINING TITLE INSURANCE ON THE HEREON DESCRIBED PROPERTY.
LA.E...........LIMITED ACCESS EASEMENT }y� LIGHT POLE(LP) NO ADDITIONAL WARRANTIES ARE HEREBY EXTENDED.
L.M.E.......».LAKE MAINTENANCE EASEMENT 1���77 'THIS SURVEY IS VALID IN ACCORDANCE WITH F.S.627.7842 FOR A PERIOD OF 90 DAYS
(M)..............MEASURE WATER METER(WM)
FROM THE DATE OF CERTIFICATION.
OB........»....OFFSET ,� UTILITY ANCHOR
P.0..............POINT OF CURVATURE....„........PLAT 1�--yt FIRE HYDRANT(FH) I HEREBY CERTIFY THAT THIS SKETCH OF SURVEY SURVEYOR'S SEAL
P.0 �i
P.C.C..........POINT OF COMPOUND CURVATURE CENTER LINE WAS MADE UNDER MY RESPONSIBLE CHARGE
PL................PLANTER AND TO THE BEST OF MY KNOWLEDGE AND BELIEF H. H Yq T
P.O.C.......»POINT OF COMMENCEMENT B POINT OF BEGINNING1�, PROPERTY LINE SAID SURVEY MEETS THE MINIMUM TECHNICAL �+,�� 1q,T✓�,
P.RC..........POINT OF REVERSE CURVATURE ® WATER VALUE I CLEANOUT STANDARDS SET FORTH BY THE FLORIDA BOARD AGE Mg
PP.RM.........POINT OF TANENT RGENCYNE MONUMENT ® CABLE BOX(CA.TV.) OF PROFESSIONAL LAND SURVEYORS IN CHAPTER 4636
R.................RADIUs ELEVAIRIC METER(EM) 5J-17 FLORIDA ADMINISTRATIVE CODE FURTHER,
(R)...............RECORD D THIS DOCUMENT IS ELECTRONICALLY SIGNED AND
4W.............RIGHT-OF-WAV ® ELECTRIC BOX(FPL) SEALED PURSUANT TO SECTION 472.027,OF THE
SIR.............SET 1f2'IRON ROD FLORIDA STATUTES AND CHAPTER 5J-17 OF THE
SND.....».....SET NAIL AND DISC HANDICAP PARKING(HCP) o•� •-
(TYP.)..........TYPICAL FLORIDA ADMINISTRATION CODE. C
U.E.............UTILITY EASEMENT ®PLANTER OR PLANTED (C)2015 P�.n STATE OF y4
W.E............WATERS EDGE
POINTS OF INTEREST O� F. FLORIDA ¢•
0 SPECIFIES POINT OF INTEREST BILL H.HYATT h ELEVATION MARKER U'
G SPECIFIES POINT OF INTEREST PROFESSIONAL LAND SURVYOR ✓O�g1,SURV"y O��
TREE (SIZE!TYPE) STATE OF FLORIDA LICENSE NUMBER: 4636
• a QR CODE FIELD DATE:08/11/15 SIGNED DATE:08/12/2015 REVISED DATE:
.`
SCAN TREE (SIZElTYPE)
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Corporate Hwd Guenem:4987 N UNIVERSITY DRIVE,LAUDERHILL,FLORIDA 33351
PAGE 1 of 2 FILE NUMBER: MIA.SH.08-15 PH:(888)569-0480 I www.AliStateSurveyors.com I FAX:(888)569-4590
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