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DS-15-2600 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-250544 PermitNumber: DS-10-15-2600 Scheduled Inspection Date: January 08, 2016 Permit Type: Driveways/Sidewalks/Slabs Inspector: Rodriguez,Jorge Inspection Type: Final Owner: BOLTON,JOHN AND JENNIFER Work Classification: Addition/Alteration Job Address:1202 NE 101 Street Miami Shores,FL Phone Number (305)754-2136 Parcel Number 1132050210030 Project: <NONE> Contractor: CHAMPION CONCRETE Phone: (305)252-8055 Building Department Comments DRIVEWAY CONCRETE Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-245645. LN Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. January 07,2016 For Inspections please call: (305)762-4949 Page 19 of 24 ... 7t larmit NO.DS-10-15-2600 Miami Shores Village Permit Type. DriVeways(SId£WBli efb"rla6 ' '� �S. 10050 N.E.2nd Avenue NE Wott*tClassification.Add0rsja"/'Ak Miami Shores,FL 33138-0000 Foy Phone: (305)795-2204ta�t �'"�Ita�{ED iss bate.10127120' Expiration: 2016 Project Address Parcel Number Applicant 1202 NE 101 Street 1132050210030 JOHN AND JENNIFER BOLTON Miami Shores, FL Block: Lot: Owner information Address Phone Cell JOHN AND JENNIFER BOLTON 1202 NE 101 ST (305)754-2136 MIAMI SHORES FL 33138 Contractor(s) Phone Cell Phone Valuation: $ 7,300.00 CHAMPION CONCRETE (305)252-8055 (786)402-4802 Total Sq Feet: 1250 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final Date Denied: Foundation Type of Work:DRIVEWAY CONCRETE Additional Info: Review Planning Bond Return: Classification:Residential Review Building Scanning:3 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Owners Bond $500.00 CCF Invoice# DS-10-15-57413 $4.80 10/27/2015 Check#:2033 $ 131.30 $550.00 DBPR Fee $2.25 DCA Fee $2.25 10/14/2015 Credit Card $50.00 $500.00 Education Surcharge $1.60 10/27/2015 Check#:885 $500.00 $0.00 Notary Fee $5.00 Bond#:2897 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $6.40 Total: $681.30 In consideration of the issuance to me of this permit, I agree to perforin the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS, OFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information i accurat Zd that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-name�Y rac to do the work stated. October 27, 2015 Authorized Signature:Owner / Applicant / C tractor / Agent Date Building Department Copy October 27,2015 1 Miami Shores Village "RFC-R,IVFD Building Department OCT 14 2015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 1 Tel:(305)795-2204 Fax:(305)756-8972 BY: G� INSPECTION LINE PHONE NUMBER:(305)762-4949 11/ FBC 20/41 J'- BUILDING '- BUILDING Master Permit No.D5 / 2ZC--)O PERMIT APPLICATION Sub Permit No. Ii-DING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: �1� t� f 2 4a� �� (�'/ City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: U— 32,05— 02)— 003 0 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder)i��/�' �� ' Phone#: Address: i l-07r City: ato �/ "�� State: — Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: d�21/ �� Phone#,�� Address �� City: /!/$�d State: Zip: ��✓> Qualifier Name:�/ / !�? %r Phone#:If 6 �� ' State Certification or Registration M Certificate of Competency#: b-PIT DESIGNER:Architect/Engineer: Phone#: Address: 7 City: State: Zip: &"Iue of Work for this Permit:$ quare/Linear Footage of Work: l.Z-05 Type of Work: ❑ Addition p' ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: ��11 Submittal Fee$ Permit Fee$ .I CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ = TOTAL FEE NOW DUE$ I ° 2-0 (Revised02/24/2014) 6,---;3,1 s 3;,Z) 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 deli ered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be sted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of su posted notice, the inspection will not be a roved and a reinspection fee will be charged. Signat re V Signature OWNER or AGENT CON RACTOR The foregoirIstrument was acknowledged before me this The foregoing instrument was acknowledged before me this Sr day of ®C�dQi ,20 Ir ,by /2, day of 20 �� , by ✓0oio /W- &IAW ,who is personally known to 135'2 cj Lg!22 ,who is personally known to Me or who has produced 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: Men 6 /ew-2a P 7-- Print: State 8f Rod a 1pRY P(, Seal: a°:"'•e`'O MIONICAGONZALEZ Seal: Joanna M Feliciano *A', * MY COMMISSION 9 EE 194445 �,� My CammisSiam FF 082753 EXPIRES:July 26,2016 a w� F,cp- s 0 111 212 01 8 F F� �P Bonded Thm Budget Not ry Services A APPROVED BY SIU/l 1rPlans Examiner ' Zoning Structural Review Clerk (Revised02/24/2014) Miami Shores Village Bm UK"" Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) C? - 6700V hereinafter referred to as the owner of the following described property (address): Legal Description Lot Block Subdivision Folio # Requests permission to install (describe work): Within the public right of way of(address) f 20- A !Y dHuunti PL 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. 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). Signature Owner or Agent The fore Ing 7zi ment was acknowledged before me this day of c!9,-7b�� , 20 /�, by why ®�I who is personally_ kn2wn to me or who has produced as identification and who did take an oath. NOTARY PUB Sign: Print: J�elrr®e-a My Commission Expires. µY �aP.•.,8.� NIOPIICAGaN7J1LEZ * MY COMMISSION#EE 194445 EXPIRES:July 26,2016 ��9°OF F��\oP EOnded I IUU BUd98t S81YlC8S YT�•�'fiYuJS�` 1. �` jV r •� SKETCH OF SURV —_ lu ,30' 7 r IJI�� c`lmi Sher`_,Village I � APPROVED BY DAZE ' zri!iNJG DEPT BLDr DEPT SUBJECT.Y O CONIPLIAPrICE WJT'ri FERAL St _C„ or _ 4 t _ Ai\ID OU TIO — • /o. O Lo 6 --- N X0.4 REBAR .97' • Ste-~ •• s PC. `' h \ 275 O.•�•.: ..ED.DR �, / .. r HOLT co CD o QpRG CV t0 z m / 3?-LOT ` ~~ ~ NN ON F > , 1E . 14,92 CID o 'd� O�G�. 5 c9.6 I Q PAVED DRIVE _ 5 UTIL. EASMT.-� IE 7j 4i5 LT. � . 18') S&9� 9' l5°E (90.00') 4 i SET TW ,\FD. IRI N.: J IRON PIPE 6990 PIPE BILK, 5 LOT 2 P. 8a 43 R80