Loading...
PL-14-2797 ,R Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-225734 Permit Number: PL-12-14-2797 Scheduled Inspection Date: May 28, 2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: DAIDONE, GLENN Work Classification: Addition/Alteration Job Address:54 NE 97 Street Miami Shores, FL Phone Number (305)788-2711 Parcel Number 1132060130770 Project: <NONE> Contractor: D& D PLUMBING CORP Phone: 305-379-0516 Building Department Comments PLUMBING CONNECTION ROUGH AND FINISH FOR Infractio Passed Comments TWO COMPLETE BATHROOM WATER HEATER AND INSPECTOR COMMENTS False INSULATION Inspector Comments Passed Eq, CSL` Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. May 27,2015 For Inspections please call: (305)762-4949 Page 4 of 32 Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 - FBC 2010 BUILDING Master Permit No-1z-1-J � PERMIT APPLICATION Sub Permit No.� r-1 BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORK5 ❑ CHANGE OF ❑CANCELLATION ❑ SHOP �j,� CONTRACTOR DRAWINGS JOB ADDRESS: °� � �� `�] City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:) l 226(0 —a G —C)r?-?®Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): (f,-; I ii Dl /l Address: E7 q -1, S City: H (. 1/L1/ 4>14CY-e5 state: t- Zip: 153/3 Tenant/Lessee Name: Phone#: Email: .,may CONTRACTOR:Company Name: P Phone#:� 2 -®��� Address: 3 I qt;- S' City: 'M I State: 1-1 Zip: 33 y Qualifier Name: 2 Phone#: State Certification or Registration#: (�r c"�Z�l �S Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 1 O L>3 Square/Linear Footage of Work: Type of Work: ❑ Addition r& Alteration n❑ New ❑ Repair/Replace ❑ Demolition 1 Description of Work: '01V 1, Specify color of color thru tile: Submittal Fee$ Permit Fee$ -2.�• � CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ �✓ (Revised02/24/2014) -, .� t , i - � � 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 brochu II be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commence must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. e.a, � a of such posted notice, the inspection will not be approved and a reins on fee will be charged. Signature Q@�` Signature f 0 NER or AGENT CONTRACTOR The f ,egoing in ent cknowledged before me this Th foregoing instrument was acknowledged before me this May of >�L,-- 20 by l 1" I day of I`C_. by �.. whs personally kno t0 ��� D� n 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 %2,�11 Print: Print: Seal: +;:W �MABELIS E FERNANDEZ Seal: �o�a MY COMMISSION#FF127992 '' fiR•° EXPIRES June 1, 2018 ****•�� 99qe> A**edf�Iq�fp9F��* **�****�x��a�*�*ax��.*********�.**�***�**�*�******�x*x�*�.*�*�****w*m*�.� APPROVED BYoA3-®y Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 003395 , e Local Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOTA BILL — DO NOT PAY \ILBTI) 5268586 ROSINESS NAME/LOCATION RECEIPT NO. EXPIRES D&D PLUMBING CORP RENEWAL SEPTEMBER 30, 2015 3145 SW 19 ST 5505483 Must be displayed at place of business MIAMI FL 33145 Pursuant to County Code Chapter 8A—Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED D&D PLUMBING CORP 196 PLUMBING CONTRACTOR BY TAX COLLECTOR Worker(s) 1 CFC1426173 $45.00 08/03/2014 CREDITCARD-14-031179 This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt is not a license, permit,or a certification of the holder's qualifications,to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles—Miami—Dade Code Sec Ba-276. For more information,visit www.miamidade.Q Ci collector RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CFC1426173 6' The PLUMBING CONTRACTOR f Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 DIAZ, DAVID .� D& D PLUMBING CORP 3145 SW 19TH STREET MIAMI FL 33145-1927 ISSUED: 08/11/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1408110001168 CERTIFICATE OF LIABILITY INSURANCE DATE(AEtAlOD/YYYY) 12/02/14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: N the certificate holder Is an ADDITIONAL INSURED,the poNcy(tas)must be endorsed.tf SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endorsemenL A statement on this certificate does not confer rights to the certificate holder In lieu of such emtorsament(s). PRODUCER Lucia EstreNB Accurate PHONE (305)226-8727I IAIC Ne. (305)226-8767 8300 West Flagler Suite 114 tudyaestratia@ elsouftLnet Miami,FL 33144 INSURER(Si AFFORDING COVERAGE NAIC ft Phone 305)226-8727 Fax (305)226-8767 INSURER A: United States Liability Insurance Comp INSURED INSURER 6: D S D Plumbing Corp ANSURER C: 3890 NW 2 Terrace INSURER D: Miami,FL 33126 (305)979-0516 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IPfTSRR A R POLY EFF POLICY EXP TYPE OF INSURANCE POLICY NUtABER IIID LJA9rrS GENERAL LIABILITY EACH OCCURREN E $ 1,000,000.00 OA T RENTED 5,000.00 © COMMERCIAL GENERAL LIABILITY PREMISES a e S A 0 ❑CLAIMS-MADE Q OCCUR Y Y CL-2633197A 11126/2014 11/26/2015 MED EXP( am ) $ 100,000.00 PERSONAL&ADV INJURY S 1,000.000.00 ❑ GENERAL AGGREGATE S 1,000,000.00 GEML AGGREGATE LIMIT APPLIES PER: I PRODUCTS-COMPIOPAGG $ 1,000,000.00 ❑POLICY ❑PRO• ❑ LOC $ AUTOMOBILE LIAR[L 1Y CEaM ED SINGLE LIMIT cet tunI ❑ ANY AUTO BODILY INJURY(Per perwn) S ALL OWNED❑ SCHEDULED BODILY INJURY(Paracddwd S AUTOS ❑ AUTOS ❑ HIRED AUTOS El SINNED PgPERTY DAMAGE $ ❑ ❑ 9 ❑ UMBRELLA UAB ❑OCCUR EACH OCCURRENCE $ ❑ EXCESS UAB ❑CLAIMS-MADE AGGREGATE S I El OED ❑ RETENTIONS S WORKERS COMPENSATION ❑WC STATU- ❑0TH- AND EMPLOYERS LIABILITY Y I N ER OFFICEOOPRIETER ExRTNEEERfIE ECUTNED E.L.EACH ACCIDENT $ (Mandatary In NH) E.L.DISEASE-EA EMPLOYE S I yyeess describe wow OF OPERATIONS below E.L.DISEASE-POLICY LuffS i LIESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Addlawal Remarks Sched.1%If more space is required) State Plumbing Contractor License CFC 1426173 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE OF-SCRIBED POLICIES BE CANCELLED BEFORE Shores Village BUidling Dept. THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Miami Miami h 2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores,FL.33138 AUTHORED REPR Lucia Estrella ACORD CORPORATION. All rights reserved. ACORD 25(2010105)QF ACORD name and logo are registered marks of ACORD JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION *"CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from.Florida Workers'Compensation law. EFFECTIVE DATE: 3/22/2014 EXPIRATION DATE: 3/21/2016 PERSON: DIAZ DAVID FEIN: 200604412 BUSINESS NAME AND ADDRESS: D&D PLUMBING CORP 3145 SW 19 STREET MIAMI FL 33145 SCOPES OF BUSINESS OR TRADE: LICENSED PLUMBING CONTRACTOR Pursuant to Chapter 440.05(14),F.S.,an officer of a aorlxsration who elects exemption from this chapter by Ming a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt..aPPiy on] within the scope of the business or trade listed on the notice of election to be exempt Pursuant to Chapter 440.05(13),F.S.,Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at arty time after the filing of the notice or the issuance of the certificate, Me person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS?(850)413-1609 5 013F.SD '£moveo,,, Miami Shores Village Building Department tORtIDA 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.In these circumstances,Miami Shores Village does not require verification of workers'compensation insurance coverage from the contractor's company. Therefore,you may be personally liable for the worker compensation injuries of any Rgrson allowed to work under this permit. Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. �ow C,' #ra for 1 / j Print Name: G'` ��� Print Name: Signatu : Signature: . State of Florida} State of Florida) County of Miami-Dade) County of Miami-Dade) Sworn t an d sub ribed before met is Sworn to subscribed before me this day o ,20^_/ day of �L ,20)� �QQy�\\(�P �p rkr"Del. D l rbc e� By ` By -A" 'GJ SIV ` Psi 10' \PG�O �b��J MABE EMRNANDEZ (S AL) `+p N#FF127a9P (SEAL) G �' T e of Id t rS lune- T e of Identification roduce (407)398.0153 FlorldallotarySerfte.00M . '�w N'i 1P`f 1 �7` 4• 4 t � q � ro� _tl��y,y„J� `}Il t i� 5 4. ' ��� ����,�I-•S'Fw� _,� �� � La's`4i y� � 1' l'� � �� } � � y'ya 1 4, r C, �n . . �- co c c 0 w m K . 4 o y cn —1 V N m O C s C < CL { GJ Q o OAD Q a < Z ° D Z A p Z p (n F ° z D p � C8 0 CD m p z y m CDx ' O �C�r � z Q� � -■ � CL R 1 r t #+r Q O N Ul ygn @ co� ww � d•�' s f0 Q_• N� CD ONK (j) t IDca U n El 0 CL O O a r .. t. n m m CD Q w Y:. 'sw - CD cn rt 0 > -10 1 p n c rn ._ CD CL a N m� w d O m rn tD a " CD arC .< Q 3 m 5 a N Wco s m .rt —n z O0 tU rF b � V/ N � N �•,r � a � F m c Z S Q m c w D d Z = /o** In r °o • w Q i Y w C13 Z w m C =rin F cn f r - r; * r, 0 ati2,+., �� W Z Z C 7i' kt t / 4 CD C9 MW WIA-11M �•� �+�- "' p d ��� "`iti "��8 �'�r `�'i tr � � ���,. � ;�' - n�, �;.Z r.y _, i��` F�._. _.. "1� __ Ems*__, _.. -•Y: _ •¢' ._. - ,__. i, _ -__ -�.. , .,. ....–... C. Q ~,i Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-227676 Permit Number: RC-9-14-2093 Scheduled Inspection Date: June 24, 2015 Permit Type: Residential Construction Inspector: Rodriguez,Jorge Inspection Type: Final Building Owner: DAIDONE, GLENN Work Classification: Garage Enclosure Job Address:54 NE 97 Street Miami Shores, FL Phone Number (305)788-2711 Parcel Number 1132060130770 Project: <NONE> Contractor: OZ CONSTRUCTION SERVICES GROUP, INC Phone: (786)467-7200 Building Department Comments GARAGE CONVERSION BATHROOM RENOVATION. Infractio Passed Comments CHANGE OF WINDOW AT FOYER REMODEL OF INSPECTOR COMMENTS False INTERIOR WALL AT LIVING Inspector Comments Passed Aa— Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. June 23,2015 For Inspections please call: (305)762-4949 Page 2 of 30 CESAR M. CAVO A.I.A. a r c h i t e c t 4906 Campo Sano Ct. Coral Gables,FL 33146 Phone(305) 740 7929 Fax (305)74.0 7929 Letter Monday,March 16,2015 To:Village of Miami Shores Building Department 10050 N.E.2nd Ave Miami Shores,FL 33138 Re:54 NE 97 ST Miami,FL 33138 Permit Number:RC 14-2093 Dear Sir. The existing 2x8 wood floor joists at the shower area are being cut 2"for a length of 5'-0"to recess the shower.The remaining 5'/2"are being reinforced with an additional 2x6 on the side with 3/8"diameter thru bolts with washer and nuts spaced at 24"o.c.and staggered.I found such reinforcing adequate and in compliance with the FBC 2010. Should you have any questions,or need additional information,please do not hesitate to contact me. Sincerely Cesar M.Cano Cesar M.Cano A.I.A. State of Florida Registration#4929 Page 1 of 1 a v ' Royer Ornamental Fencing & Welding 1842 NW 21 st Ter Miami FL 33125 786-970-3315 2/24/2015 Village of Miami Shores Building Department 10500 NE 2nd Ave Miami Shores FI 33138 To whom it may concern: This letter is to certify that the field welding work performed at the property of Mr. Glenn Daidone, 54 NE 97 St in Miami Shores has been performed by US. Sincerely, / Royer Ornamental Fencing & Welding CESAR M. CANO A.I.A. L a r c h i t e c t 4906 Campo Sano Ct. Coral Gables, FL 33146 Phone(305) 740 7929 Fax (305) 740 7929 Letter Thursday, February 05,2015 To:Miami Shores Building Department 10050 NE 2ND Ave Miami,FL 33175 Re:54 NE 97th ST Miami Shores,FL 33175 Permit Number:RC 14-2093 Dear Sir: This letter is to notify that I approve the use of 445 each way at the center of the footing F-1. Should you have any questions,or need additional information, please do not hesitate to contact me. Sincerely�� Cesar M.Cano Cesar M.Cano A.I.A. State of Florida Registration#4929 Page 1 of 1 t CESAR M. CAVO A.I.A. a r c h i t e c t 4906 Ca m po Sa no Ct. Coral Gables,FL 33146 Phone(305) 740 7929 Fax (305)740 7929 CHIP EXISTING FOOTING TO INSTALL NEW TIE COLUMN AND NEW FOOTING.DO NOT CUT EXISTING BAR.POUR MONOLITHIC. 4'-0' i STL.COL. I v I O V STL PLATE I 2' -0• EXIST. 10'x22' 4 �:�CO-INSCT CONC.WALL FTG. 'x20'ALL FTG. EXIST. WALL FOOTING ENLARGEMENT DTL. SCALE:3/4'=1'-0° Page 1 of 1 p Miami Shores Village - , 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 2010 _ BUILDING Master Permit No �- N_ DOO 5 PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: �� ImoEi — City: Miami Shores County: Miami Dade Zip: ooe Folio/Parcel#: I I "�7� —0•1-7 Q Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: GFFE: OWNER:Name(Fee Simple Titleholder): 1f1�9 ti �/4 IN F Phone#: �® —2 I Address: �Q- ��-715+- City: t(�LCL{o q1State: iEL— Zip: Tenant/Lessee Name: Phone#: Email: /_ CONTRACTOR:Company Name: C JZ 0 iV sly((_)A �e'S Phone#: -736-4L3 L3— Ido® Address: 7 il/ S Gu 14 5 l City: "!n lily State: Zip: Qualifier Name: State Certification or Registration#: t� � � �,�) Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: (4 Square/Linear Footage of Work: Type of Work: ❑ Adrz:z2) ' 'on Alteration 11 New F-1 Repair/Replace El Demolition Description of Work: 6120XI Specify color of color thru tile: Submittal Fee$ Permit Fee$ a CCF$ ( � CO/CC$ ' Scanning Fee$ 1 0 Radon Fee$ ' 2 DBPR$ 1 d ��� Notary$ Technology Fee$pC) •T l "), Training/Education Fee$ Double Fee$ 5y Structural Reviews$ o• Q jeal _f� l� Bond$ c CP TOTAL FEE NOW DUE$ (Revised02/24/2014) 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 Kt5ULT IN YUUK PAYING TWILL FUK IMPKUVEMENT5 TU YUUK PKUPLKTY. IF YUU INTLNU 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 ob f such posted notice, the inspection will not be approved and a reinspection fee will be charged. ' Signature - Signature A OWNER or AGENT �` CONTRACTOR The foregoing instrument was acknowledged before me this The foregoin stIment was acknowledged before me this da of bf.0 ew P 20 b �. da of _( y Y Y � Y(—���� �- ,ZO b l��e G1 VI doh� ,wno is personalty Known to � � >-t_ 11 uvt�,who is personally Known to z me or who has produced as me or who has producedTU VQ -(AU( as identification and o did take an oath. identification and who did take an oath. NOTARY PUBL NOTARY PUBLIC: ign: Sign: Pri Print: Notary Public State of Florida Seal: Sindia Alvarez Seal: .4'*'70, JEAN JOL My Commission FF 156750 (COEUR JR. �ij�Aott' Expires 09/03/2018 ?.�.. P1 MY COMMISSION#FF044329 -•'.FOFr,�,"..'' EXPIRES Au�tst 1 ** * �� *�**rx�r *sere*sx�x****ra* ,*• *s+►**e* **+*** rs� es�rree sws* ae��ss FloridallotaryService.com i APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) OZConstruction Services 305-461-6816 p.2 ... p,.. Miami shores Village Building Department �tORID�' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A$30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE(CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY. A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT} D. COPY OF WORKER COMP INSURANCE(EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33138 ■......s......r....■a■.u■....■a.a .....■........M. ...........�r.����■■..r�.�.........rai COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME:02 C�C�—�S�'VG �n ��2�,�► �E-s �+2 �c� s- e BUSINESS ADDRESS: CITY taM41 STATE `FL ZIP CODE BUSINESS PHONE: CL7 r )�Llv? — -7d--q0 FAX NUMBER CELL PHONE( . r2 216o --02?. ,2 QUALIFIER'S NAME: ,e QUALIFIER'S LIC NUMBER: c G 1 C5 2: 019-4 E-MAIL ADDRESS(IF APPLICABLE); 00-CeF M t/'f rM 10; Created an 3H%ID9 BY MLOV)RV 3!26/09 MLOV OZ Construction Services 305-461-6816 p.3 ` s ` STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 FERNANDEZ, OSBEL OZ CONSTRUCTION SERVICES GROUP, INC 3642 SW 14TH ST MIAMI FL 33145 Congratulationsl With this license you becomeone million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range �! '. STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSINESS AND and they keep Florida's economy strong. -REGULATION PROFESSIONAL Every day we work to improve the way we do business in order to CGC 1520184 -ISSUED: 08/31/2014 serve you better. For information about our services,please log onto www.rnyfloridalicense.com. There you can find more information CERTIFIED GENERAL CONTRACTOR about our divisions and the regulations that impact you,subscribe FERNANDEZ,OSBEL. to department newsletters and learn more about the Department's initiatives. OZ CONSTRUCTION SERVICES GROUP, IN Our mission at the Department is:License Efficiently,Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. [hank you for doing business in Florida, IS CERTIFIED under the provislons of Ch.489 FS. and congratulations on your new license! Expiration dale:AUG 31,=6 L1400310004577 DETACH HERE RICK SC01T, GOVERNOR KEN LAINSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION _ CONSTRUCTION INDUSTRY LICENSING BOARD sy . CGC1520184 The GENERAL CONTRACTOR Named below IS CERTIFIED ;to WE Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 FERNANDEZ, OSBEL At OZ CONSTRUCTIONSERVICES GROUP, INC 3642 SW 14TH ST MIAMI FL33145 ISSUED: 08131/20114 DISPLAYAS REQUIRED BY LAW SEQ# u4003100045n Q 010071 Local Business Tax Receipt 19 Miami=gads County, State of Plorlda -THIS 1S NOTA;BILL - DO NOT PAY to 7021074 LB Tj BUMNE00 NAME/LOCATION RECEIPT NO. EXPIRES OZ CONSTRUCTION SERVICES GROUP INC RENEWAL SEPTEMBER 30, 201S 3642 SW 14 ST 7297088 Must be displayed at place of business MIAMI rL 33145 Pursuant to County Cotte Chapter SA—Art 9&10 OWNER 820. 96 GENERAL BUILDING CONTRACTOR PAYMENT RECEIVED OZ CONSTRUCTION SERVICES GROUP BY TAX COLLECTOR Worker(s) 1 CGC162t)184 $45.00 07/16/2014 CHECK21-14-020774 This Local Rosiness Tax Recalpi only couRrma payment of the L ai Business Tax.The Reoeipt is nm a Rcmm% paradt,or a certification of the holder's qualifications.to do business.HoidarmustcompiywRh airy goveratneetel N or eongouernmental regulatory laws and requirements which apply to the husiaess. n TO RECEIPT NO.above must he displayed an all commercial vehicles—Miami—Dade Code Son W276. For mom bdorm lan,visit www.mlamldade aayAaiienijiigig� 0 U 7 L 0 U N 0 OZ Construction Services 305-461-6816 P.5 T ® DATE(MMIDDIYYYY) ACORN CERTIFICATE OF LIABILITY INSURANCE 12/3/20114 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE. CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES HOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: lithe certificate halder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions or the policy,certain policies may require an endorsement- A statement on thls certificate does not confer rights to the certificate holder In lleu of such endorsemerit(e). PRODUCERUUNIACT ANDYS ASSURANCE AGENCIES PHOSAx 1441 R Flagler St a F,d (305)642-8407 N :(305)643-5969 Miami , FII 33135 AODREss:loreta@and sa.ssurance. om ! 1`4911REMS) APPOIWINO COYEERJU3E NAIGO WSURERA:MAXUM INDEMNITY COMPANY INSURED OZ CONSTRUCTION SERVICES GROUP,INC, INSURER 0: 3642 SR 14 ST INSURER c: MIAMI , FL 33145 INSURER 0: L� INSURER E: j INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD j INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, E7CCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LLTTAR TYPE OF INSURANCE L suami MM Wo POLICY NUMBER MM1oor FF (AWT EXP I GENERAL LIABILrIY LIMBS EACH OCCURRENCE i 1 00,000 X =01NAERCIALGENERAL LIABILITY PREMISES IEs osamu rnenoe .$ 100,000 CLALIRS MADE 1 "IOCCUR MED EXP(Wry one parson) $ 1 0 o 0 j A EOG0074501-02 04/23/14 04/23/15 PERSONAL BADV INJURY s 1,000,000 GENERAL AGGREGATE is 2,000,000 ! GE!\L AGGREGATE LIMIT APPLIES PER i PRODUCTS-cop.&"AGG $ 2,000,000 ! X POLICY 11771 PROs LOC $ i AUTOMOBILE LLASRITY Ea aaciden is BODILY INJURY(Per pardon) 5 t ! ALL SCHEDULED AUTOS BODILY INJURY(peraaidaml S HIRED AUTOS `_ AUTO$$$ ER $ Pm'aoadent 5 — UMBRELLA UAS OCCUR EACH OCCURRENCE $ EXCESS UAB CL,yyqS4AADE AGGREGATE $ ` DED I RETENTION$ $ WORKERS COMPENSATION T R ATR$ ER i AND EMPLOYERS'LIASIUTY YIN + At" PRCM1=-T4*R/PAITTN1!R0KECUT1%,E oPFICER/ME � &L.EACH ACCIDENT $ I,BER EXCI, NIA LUGEaQ BraW In nae B deeenDa under E.L.DISEASE-EA EMPLOYE S DESCRIPTION OF OpERA7NNS bebw E.L DISEASE-P0JCY LIMIT $ I I OESCRIPTXOhf OF OPERATIONS I LOCATIONS I VEHICLES (Arad:ACORD 101,Additional Remarks Schadldo•If more spares requimd) GENERAL CONTRACTOR—REMODELING 1 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BLDG DEPT. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10050 NE 2 AVE. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MIAMI SHORES VILLAGE,FL. 33138 ACCORDANCE WITH THE POLICY PROVISIONS. I AUTHORIZED REPRESE ` ®f$88-2010 C RD CORPORA7(ON. Ali rights reserved. ACOR025(201D(05) The ACORID name and logo are registered marks ofACORD OZ Construction Services 305-461-6816 p.6 PLEASE CUT OUT CARD BELOW AND RETAIN FOR FUTURE REFERENCE I— - - -- -- - - - - - - - - - • I - - -• - - -- --- IMPORTANT STATE OF FLORIDA I Pursuant to Chapter 440.0504),F.S.,an off bar of a corporation DEPARTMENT OF FINANCIAL SERVICES who elects exemption from this chapter by filing a Certificate of election under this section may not recover or DIVISION OF WORKERS'COMPENSATION F CONSTRUCTION INDUSTRY EXEMPTION ' IO compensation under this chapter. CERTIFICATE OF ELevnoN TO BE EMMPTFROM FLORIDA I I.. Pursuant to Cnapter 44O.M12),F.S.,Certif=les of election to wORKERW COWPENSATrOk LAW D be exempt...apply only within the scope of the business or trade EFFEGTNE DATE; 811/2014 EXPERATION DATE 7/3112016 listed on the notice of election to be exempt. PERSON: FERNAN0..2 OSSEL I'I Pursuant lo Chapter 440.0503),F.S.,Notices of electbnto be FEN: 6626067e8 E exempt and certEicatas of election to be exempt shalt be BUSINESS NAME AND ADDRESS: R subject to revocation f,at any time after the tiling ofdle nclice OZ CONSTRUCTION SERVICES GROU E or the issuance of the certificate,the person named on the notice at certificate no longermsetsthe requirements of this section for issuance of a certificate.The department shall revoke 3642 SW 14 ST a certificate at any time for failure of the person named on the MIAMI FL 33145 I certificate to twat the requirements of this section. I SCOPES OF BUSINESS OR TRA LICENSED GENERAL L ONTRACTOR DFS-F2-OWWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 GIUESTIONS?(850)413-1609 S�uRs y n „„ Miami shores Village nn. Building Department tpR�pA 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. f1. 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.In these circumstances,Miami Shores Village does not require verification of workers'compensation insurance coverage from the contractor's company. Therefore, oy u may be personally liable for the worker compensation injuries of My person allowed to work under this permit. Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Owner Contr ctor am : Print Name: E�� /�l D +tea Print N r v ) Signature: Ci �– Signature: i State of Florida) State of Florida) County of Miami-Dade) County of Miami-Dade) Sworn to d subscribed before me this Az Sworn to and subscribed before me this day of ,20 day of — �( NoEPUblICe of Fbrida By By ILC �+� MY F 158750(SEAL) ;•j.. .� MY COMMISSION#FF127N2 (SEAL) e►t�►�'' EX8 Type of I 'n u Jun T of Identification roduced U.S.DEPARTMENT of HOMELAND sECUIM ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No.1660-0008 National Flood Insurance Program Important: Read the Instructions on pages 1-9. Expiration Date:July 31,2015 SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owners Name GLENN DAIDONE Policy Number. A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number 54 NE 971"STREET City MIAMI SHORES State FL ZIP Code 33138 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) LOT 6 AND THE WEST 112 OF LOT 5 MIAMI SHORES SECTION ONE P.B.10 PG.70 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessary,etc.)RESIDENTIAL A5. Latitude/Longitude:Lat.25*51'51'N Long.80*1147'W Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 8 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of=wlspace or enclosure(s) 1109 sq ft a) Square food of attached garage 200 sq ft b) Number of permanent flood openings in the crawispace b) Number of permanent flood openings in the attached garage or enclosure(s)within 1.0 foot above adjacent grade 6 within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b 1031 sq in c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name&Community Number 132.County Name B3.State VILLAGE OF MIAMI SHORES 120652 MIAMI-DADS FLORIDA B4.Map/Panel Number B5.Suffix 86.FIRM Index Date 87.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone 12086C/0302 L 9-11-2009 Etfedive/Re Date Zone(s) AO,use base flood depth) B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ OthedSource: B11. Indicate elevation datum used for BFE in Rem 139: ® NGVD 1929 ❑ NAVD 19M ❑ Oftw/Source: B12. Is the building ionated in a Coastal Barrier Resources System(CBRS)area or Otherwise Protech Area(OPA)? ❑ Yes ® No Designation Date:WA ❑ CBRS ❑ OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Constriction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations-Zones Al-A30,AE,AH,A(with BFE),VE,V1 V30,V(with BFE),AR,AR/A,AR1AE,AR/A1-kW,AR/AH,AR/AO.Complete items C2.a-h below according to the building diagram specified in Item AT In Puerto Rice only,enter meters. Benchmark Utilized:N-568 Vertical Datum: N.G.V.D.1929 Indicate elevation datum used for the elevations in items a)through h)below. ®NGVD 1929 ❑NAVD 1988 ®Ottw/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a)Top of bottom floor(including basement,crawlspace,or enclosure floor) 11.15 ®feet ❑meters b)Top of the next higher floor 13.80 ®feet ❑meters c)Bottom of the lowest horizontal structural member(V Zones only) NIA. ❑feet ❑meters d)Attached garage(top of slab) 11.40 ®feet ❑meters e)Lowest elevation of machinery or equipment servicing the building N/A. ❑feet ❑meters (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 15.0_,5 ®feet ❑meters g)Highest adjacent(finished)grade next to building(HAG) 11.M ®feet ❑meters h)Lowest adjacent grade at lowest elevation of deck or stairs,including structural support N/A. ❑feet ❑meters SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation informationl cerlfy that the information on this Ceriftate represents my best efforts to interpret the data avar7able. I understand that any false staterent may be punisshable by tine or imprisonment under 18 U.S.Code,Section 1001. ® Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ® Check here if attachments. licensed land surveyor? ® Yes ❑ No Certifiers Name MIGUEL ESPINOSA License Number 5101 Title P.S.M. Comparry Name MIGUEL ESPINOSA LAND SURVEYING,INC Address 10665 SW 190 ST.SUITE 3111 City CUTLER BAY State FL ZIP Code 33157 Signature Date 5-16-2014 Telephone 305-262-2992 FEMA Form 086-0-33(7/12) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE,page 2 IMPORTANT:In these spaces,copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE Building Street Address(Including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number. 54 NE 97TH STREET ` City MIAMI SHORES State FL ZIP Code 33138 Company NAIC Number. SECTION D—SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agentf ompany,and(3)building owner. Comments LATITUDER.ONGITUDE PER GOOGLE EARTH ATTACHMENTS=BUILDING PICTURES A/C UNIT ON ROOF Signature Date 5-16-2016 SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5.If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A.B, and C.For Items E1-E4,use natural grade,if available.Check the measurement used.in Puerto Rico only,enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or glow the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or Q below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams"with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below time HAG. E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment sevicng the building is ❑feet ❑meters ❑above or❑below the HAG. E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑ Unknown.The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A.B.and E for Zone A(without a FEMA-issued or community-Issued BFE) or Zone AO must sign here.The statements in Sections A,B,and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments. SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who Is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation Certificate.Complete the applicable items)and sign Flow.Check the measurement used in Items G8 G10.In Puerto Rico only,enter meters. G1.❑ The information in Section C was taken frau other documentation that has been signed and seated by a licensed surveyor,englneer,or architect who is authorized by law to certify elevation information. (Indicate the sauce and date of the elevation data in the Comments area below.) G2.❑ A community official completed Section E for a building located in Zone A(without a FEMA-Issued or community4ssued BFE)or Zone AO. G3.❑ The following information(Items G4-G10)is provided for community floodplain management purposes. G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of CompliencOOccupancy Issued G7. This permit has been issued for. ❑New Construction ❑Substantial Improvement G8. Elevation of as-built lowest fir(including basement)of the building: ❑feet ❑meters Datum G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑metes Datum G10.Community's design flood elevation: ❑feet ❑meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here 9 attachments. FEMA Form 086-0-33(7/12) Replaces all previous editions. ELEVATION CERTIFICATE,page 3 Building Photographs See Instructions for Item A6. IM PORTANT:In tftese spaces,copy tete corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number: 54 NE 97TH STREET City MIAMI SHORES State FL ZIP Code 33138 Company NAIC Number: If using the Elevation Certificate to obtain NFIP flood insurance,affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View and"Rear Meal; and,if required, "Right Side VieW and "Left Side View." When applicable, photographs must show the foundation with representative examples of the fwd openings or vents, as indicated in Section A8.If submitting more photographs than will fit on this page,use the Continuation Page. FRONT VIEW 5-16-2014 �yk 'Nil WN Yz ...--ren.:.:. ... .... REAR VIEW 5-16-2014 F « r- � tPrms FEMA Form 086-0-33(7/12) Replaces all previous editions. • EL.EVATM CERTIFICATE,page 4 Building Photographs Continuation Page IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Budding Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number: City MIAMI State FL ZIP Code 33 Company NAIC Number. If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, ff required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents,as indicated in Section A8. RIGHT VIEW LEFT VIEW F/F=1380 GARAG=11.40 HAG=11.15 LAG=1095 SWK(R)=10.68 SWK(L)=10.99 CR(L)=10.99 CR(R)=10.91 A/C-IN ROOF F/V 5=0.6 X 1.10 1=2X2 FEMA Form 086-0-33(7/12) Replaces all previous editions. Miami Shores Village �S,oRFsG Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 aio�b Tel: (305)795.2204 R' Fax: (305)756.8972 q13 C- 1, Permit No: Page 1 of 1 Structural Critique Sheet Af o,.—j 4 0 L:�L tr — -4rie CV'f'4 c.1'eo cep s 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 + STATE OF FLORIDA PERMIT NO. DEPARTMENT OF HEALTH DATE PAID. ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: SYSTEM RECEIPT @ APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: [ ] New System OG.] Existing System ( J Holding Tank ( J Innovative [ J Repair Q [ ] Abandonment /�J [ j Temporary - APPLICANT: (A- AGENT: - �C/'-_�•`-C ------ - - -- -- -- - --- AGENT: TELEPHONE: ---- -/O ko MAILING ADDRESS: TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST HE CONSTRUCTED BY A PERSON LICENSED PURSUANT TO 489.105(3) (m) OR 489.552, FLORIDA STATUTES. IT IS THE APPLICANT'S RESPONSIBILITY TO PROVIDE DOCUMENTATION OF THE DATE THE LOT WAS CREATED OR PLATTED (MM/DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS. PROPERTY INFORMATION LOT: 15 BLOCK: SUBDIVISION: PLATTED: 19 PROPERTY ID #: _l/ ����Q 7.�� ZONING: _ v"" IOM OR EQUIVALENT: [ Y PROPERTY SIZE: �l—� ACRES WATER SUPPLY: [ J PRIVATE PUBLIC K ]<=2000GPD [ 1>2000GPD IS SEWER AVAILABLE AS PER 381 .0065, FS? [ Y � J DISTANCE TO SEWER: FT PROPERTY ADDRESS: N _ .- -. —. -- ------ ----- __-._ DIRECTIONS TO PROPERTY: BUILDING INFORMATION [XI RESIDENTIAL [ ] CO1*9RCIAL Unit Type of No. of Building Commercial/Institutional System Design No Establishment Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC 2 -9-"Yoako� 4 ( ] Floor/Equipment ins [ Other (Specify) ---._.__-._---- ---------- -- S I GNATURE' - -- ----- c15' c.G.�Imo_.-_ DATE: 4015, 0 (Obsoletes previous editions which may not be used) Incnrpo ed 64E-6.001, FAC Page 1 of 4 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR CONSTRUCTION PERMIT I;.. ---sr r ,cd"&Vd /8f Py d 00'SL ---------- o ov •�• ------------ Scale: Each block re re 1 �svtN "CR ,0*"81qu 00,0 1 V O - � r .at-s +► .0081 nif 3ON301 ANO1S 3NO N o .00X1 m o ,O1YZl .os� V ,t7D'dt ,OB'Ol J v < 4i, Notes: ; /'�' tf;QQ�L : ' -" t - ci h1F Site Pian submitt /Z Plan o Not Approved Date By County Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015,08W(Obsotetes promw editions which may not be used) Incorporatted: 64E-6.001,FAC Page 2 of 4 (510a NUMW. 5744-002-4015$) PERMIT A. ,STATE OF FLORIDA ® DEPARTMNT OFHEALTH EM AND DISPOSAL SYST ON SEEPAGE TREATMNT SITE EVALUATION AND SYSTEM SPECIFICATIONS r AGENT APPLICANT: a LOT: BLOCK: SUBDIVISION: (section/Township/Parcel No. or Tax ID Number] PROPERTY ID #: TO BE COLLETED BY ENGINEER, HEALTH DEPARTMENT EL`lPLOYEE,OR OTHER QUALIFIED PERSON' ENGINEERS MUST PROVIDE REGISTRATION NUNIDER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: 3 I l NO NET USA A AVAILABLE: a S TOTAL ESTIMATED SEWAGE FLOW: GALLONS PER DAY [RESIDENCES- 1 �TABLEj] AUTHORIZED SEWAGE FLOW: GALLONS PER DAY [1500 GPD/ACRE UNOBSTRUCTED AREA AVAILABLE: sQFT UNOBSTRUCTED AREA REQUIRED: SQFT BENCHMARK/REFERENCE POINT LOCATION: g/FTl LAB ] BENCFV"/ INT ELEVATION OF PROPOSED SYSTEM SITE IS riTSFO THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES DITCHES/SWALES:�_FT NORMALLY WET? [ ] YES —�NO SURFACE WATER: �— WELLS: PUBLIC: FT LIMITED USE: '�— FT PRIVATE: FT NON-POTABLE:LI ES FT BUILDING FOUNDATIONS: ___05_FT PROPERTY LINES: ' _FT POTABLE WATER LINES: FT SITE SUBJECT TO FREQUENT FLOODING: [ ] YES A=NO 10 YEAR FLOODINGy YES 0 10 YEAR FLOOD ELEVATION FOR SITE: Fi MSL/NGVD SITE ELEVATION: !D• FT MSL/NGVD SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2 MUNSELL N/COLOR TEXTURE DEPTH MUNSELL $/COLOR TEXTURE DEPTH / "I TO NTO lloN TO 1f _ T n TO TO TOTO TO /. ! � TO 0�f7l � � TTGqA - TO TO TO TO USDA SOIL SERIES: Q e f S USDA SOIL SERIES: OBSERVED WATER TABLE: tMe INCHES [ABOVE BE W] EXISTING GRADE. TYPE: [PERCHED APPARENT ESTIMATED WET SEASON WATER TABLE ELEVATION• INCHES [ABOVE EXI HIGH WATER TABLE VEGETATION: [ ] YES MOTTLING: [ ] YES DEPTH: iiaCHE3 SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING. D H OF EXCAVATION: INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH BED ( ] O (SPECIFY) REMARKS/ADDITIONAL CRITERIA: .i SITE EVALUATED BY: DATE: Dai 4015, 0 (Ob *too prwrio ition® which may not by used) incorporated: 64E-6001.FAC Page 3 of 4 �l:x�l�"T� iia f'i• a,3 +.• r. .u: orf•;;3 •17� 'Y ','-�.+. t•-. -Y'1 V::3a;' .>11 r t r: = -+. • } •{• t -.V��• •,- •.... r?.C1' i'..t .N.;f •,1.i+� -�.'. :ir v.. -i :+.:,i:' • 'I si '-:1:.1' .V ib. •(. ':L - ).. .'+' .. :3 4.: Y_:+;V •' I:K .�.'�•+. f 11 .Ir i7 J;�1 t•MI S:i, .` • 1 .:'V:. . Y - .,�-_ter•.... �: L1 11.. " • ,Ii +.. . .,. �..• _ • J".,.t•.Y.i.:f :I#,' 1:��..!.::_...21. !._. - • • 'r c i:3r :Lt b.�.,.. } r^t� , 1,Yi» `.. �c a I� `e•.ir.:r.. r�.3,y .,;fy r! .<.i ''1l � 1 .a • :a' •r' :f. f v. - � n •3' carr . .•{ .3: . �'}' •.a 1 •: ra l •1' r ••::. :i:: :ti:.ir f.:.r_ ..+, rl' f 1•J:. •':� ,r _ I:�;,. :"•. • v:Sr. ti�� s. J-� act .i -•' fi•=-",.';.N,',S'I ..r..^ •':'. �:7"4f •ice ..1:.". .�::i_�.• '"!. Y.31 C. � �l ry• • •. 13 7� 't:.' i.C`. fe;i•'.r.}�1. .••Z- .I:H; •):�' -: 1.1- •..E1..r N. E. 97th STREET 21 ' ASPHALT PAVEMENT I1) •�Q•, � 1 i Ca j 23' PARKWAY i V� 150.0n'ei 7Y.00!(-PJ(M) �1:c�►r� �'A1x�• FI-P 1/2 � t 130' .9 W.. •��� FSP 1/2` F.LP.1/2' BLOCK CORNER 4 �+ ��• h ., 10.80' I • c13.40, tv T�• •a. °° ~ 17.00' .� iso• 22.40' c --N O Y 17.00' � � W � V4 ONE STORY O O p RESIDENCE #54 p i 'J J uj 19.00' I m +� B�• 3 15.40' .� W 4 0 10.80• ac O I °f 2' 18.40' �aoio'" gw PAV Parvo. w> v3 Ix t v3 0.40' .7 ^ 0.40' F_LP.1 2' `' _1.P.1 2` s.7•: 75.00 P M 3 8' PARAWAr 0 0 9' ASPHALT PAVEMENT f 1 _ Accepted By_ Property Address: 54 N.E.97 STREET NOTES. NO NOTES MIAMI SHORES, FL 33138 lJLlE.R 4CEKM THAT TH6R'BOUNQAM'SURVEY'IS A TRUE AND CODEC" FORMS FLORIDA BUILDING CODE,ENERGY CONSERVATION FORM 4022010 Reshlential 13uHdhV Thermal Envelope Approach ALL CLIMATE ZONES PSON011OLT .u's build titins not txamply witn this method or Alterttata form 402(t may stili tmrrtply under Section 405� fladda Be)tding Cade.Energy Cansarvatfon. PfIOXCT NAM- wamm PERNUTTING offm -- ._...__...._-_.f.......- ..... .............. OWNEW QLOehz� t2J6-Av0k3 ftT"W.: I JUMMIUM NO.: 2 9 ro 0 0 Gen"bmuocLtw 1.New construction which Incorporates any of the following features cannot comply udng the ma0tod: areas in excess M 20perent of cortdittoned door am,electric resistance 2.Fig In afi the ap*Able spaces of tare"To Be Instalted'column on Table 410 with IN Wonn*w remaw.Alt"To Be lmww Vetoes must be"W to or more efficlad than the rimed ice. 3.Complete page 1 based an the To Be installed"column information. 4.Read the requirements of Table 4028 and check each box to Indicate your Intent to comply with all applicable items. 5.Read,sign and date the`Prepared W certification statement at the bottom of pap 1.The owner or ownefs agent must also sign and date the form. Plea"Print CK 1. New consbuctim additlom or existing bulkling 1. -00 2. Single-family detached or madople4mily aftachecf 2. S-f-- V 3. If multiple4amily-ft.of units covered by Otis submission & 4. Is this a worst case?(yeato) 14.. to • CondM*nW Raw area(sq.%) • Imam type WW area: a.1.1-factor Ga. is SHGC 613. c.Glass area Go. sq.111. 7. PervenhW of glass to if=area 7. 0.11 % & Floor type,area or perimeter,and Insidatton: a.Slab-on-grade(R-value) &L R= - KnAL b.Wood,raised(R-value) 8b.R= 0 7-S:5 sq-fL c.Wood.Lwanion(11-value) ft.R= - Sq fL d.Concrete,raised(R-value) 8d.R= e,CbRevete.torimm(R-value) Be.R. -act.fL 9. Wall type,area and Insulation: a.Exterior, 1. Masonry(Insulation R-value) Wl. R= qq.fL 2. WOW flume(Insulation R-value) 9a-2 R= scl.% b.Adjacent: 1. Masonry rInsulation R-value) 9b-l. R= 2. Wood fturne(Insulation R-value) Ob-2. R=- -.-. smfL 10. C411ft type,was and inaulatim: a.Under attic(Insulation R-value) 10a.R- sq.fL b.Sin*assembly(Insulation R--.alue) 10b.R= -sq.fL 11. Air distritnifim system:Duct Insulation,location,On a.Duct location.insulation Ila. R= b.ARU location 11b. c.Qn.Test report attached(<0.03.yes1no) lle.Test report attached? Yes(FO.) 12. Cooling system: a.Type 12a.Type: M f Ao b.Efficiency 12b.SEERIEER: I& cleating system: 13a.Type. K4F-b,%- VO res a-Type 13b.HSPFICGPIAFUE:- 3-IL b.Eftiency 14. HVAC sizing caloulation:athwhed 14. Yes I& Hot crater system: a.Type Ise.Teo: b.Efficiency 15b.EF: I f0ft cu*that the DWS MW specilicatim Word by the catwahm are in campftnw with tire ftrda Havew owars mid swftaons cmni.d by rMoMm hithoda cwrowns%aftRoft EwW Cade. EWW CG&8ft8 00striften IS hated.ft bW**VAH be hMeftd far cunpFam in apow0w wfth Secfi(m PRE-PAM BY: CODE(�FIUTAL: i taea�p avfiry ttat tips ap Is in taopliarxe with the Ronda Energy Cate: �,�r®. OW"AGENT: DATE CA 2010 FLORIDA BUILDING CODE-ENERGY CONSERVATION FORMS TABLE 402A 13U1LO{NO COMPONENT— ___ rW7E W __ tNSTALLED YAt tff� ---- — — ---- --:U-Fadnr-c M66 We Note 2): SHM-0.38 4 SHt3C %oiCFAc=2D% %of CFA= U-factor c 0.76 I �_Doa�E> d00TU ------------IAEA-------__-_._.� �0��...__......_.-------------�-V-fa�°r=----. ._ • Floors. Stal"nVame No runt R Varus- Fla C Mces(s�P _ ._...._R13-.... ...... ....... . Waft-Ed.arid Ary_(am Nae 3): - Frame R-13 PV.,,0 Mass (see NOW 3) hrtedar 01 wa R•7.8 r .E>deriw of wad. .�. i R•Va�_ $�•�- - i Canes(see Notes 3&4) R=30 i R Vww= Tom mow 025 Air d0ftflon,system(sea Note 4) tero<ic&air itatxNng ung Tom? i tkwo Not d space owed 1 Dad R-value R-valw z 8 i R Vakre= ?A Yew Air tampon QR S 0.43 l�„a �. C,3 A"cora. PEEF+=. t _. _. Has"systan I pre Naas) Cooing SEER=134 SEER. ar Heattn9: HSPF-7.7 {+H8PF= . Gm bunaoe AFUE 78% }AFUE= On fiffneas AFUE 78% III AFUE- N Electric rte:Not armed(see Note 6) ------------- i 1 Water ficaft ftfstern(eros ti") c. 2 Elawo(We Note 8}: 40 gal:EF=082 Ga�rrs= i 60gal:EF=0.90 EF= �C Gf-L On fired(see Note 7): 40 gal:EF-0.59 Gas"= rs.h. Oiher(drecrilm): 50 gat EF-0.58 EF. • i � (1)Each txnmponentpresent ntheAsProposedhome must maetoretweedeach oftheapp#icahteperforrnancecriteriainordertocomplywithffdscodeusingthismethod; odterwtw Sept 405 iartce must be used (2)Wlndowsand doom qualifying as glazed tenestrationareas must comply w iti both the maximum U-Fac Wand#te naximumSHGC(solar Heat Gain C tt)criteria w4 hm it gwwrmun fatal window area equal to or less than 20%of the cond6orteci flow area(CFA);otherwise Section 405 must be used for compliance. Exception: Additions of 600 square teat(56 rnv or less may have a maximum glass to CFA of 50 percent. (3)R-Values we for insulation magi only as applies)in accordance with manufacturers'installation instructions.For mass wed.the"irderiorof wraif"requirement must be met except K at least 50%of the R-6 insulation required for the"eldedor of vwali°is installed exterior of,or integral to,the wall. (4)Ducts&AHU Installed tti*teak free per Section 40322.1.Test by Class 1 BERS rater required. Exception:Ducts Installed onto an existing air distribution system as part of an addition or renova lion;duct must be R-6 installed per Sec.5032.7.2. (5)For all conventional units with capacities greater than 30,000 Bkft. For other types of equipment,we Tablas&032.3(1-8)_ Exception:Tire proftibillon on electric resistance treat does not any to additions.renovations and raw treating systams install in e)ftMg buildings. (S)For athw electro stake volumes,minimum EF=0.97-(0.00132 x volume). (7)For outer natural gas storage volumes,minimum EF=0.67-(0.00119 x volume). ' -----.AAAA.----------__--_ _TABLE 4M MAMATM AIME.. _T- To _ i T t �To be carder gaskeled>weaterstripped or allmolso seated.Recassad 1100 IC-rated as toasting ASTM E I Air y 402.4 283.Vb dwxs and doors-OM clw 1ag.R.Tang or visual inspect1=20d gashed dWs& i ora¢ow cornWsHon aN. ceffir4a4um Waft 405.21 R•19 space peg. f� 1s thwatostet 403.1.1 Where foroed-alr tumsce 1.orta?y eye.P.X..01.them—tat Is recluked. 1 M ... 4032 ifs in attics or on roots tr�tated to R-8:other ducts .ducts tested to O=0,03 by a Cass 1 KERrater ater !/ 1 r - .MIME ..MIME. �_. _ _ R-8_._ _ _ .. Heat trap required for vertical pipe cissa.Complywith 11th in Tabto 4034.32.Provide sw fth or steady Water mere 403A �SCh breaker(ems)or slvAa(gas).Cheuleftwistern pipesirmulatedto-R-2+aooessUs mangier 'Spas and heated pools must have vapor-reMudaro covers or a Bgcdd cover or means proven to reduce hear swirmninp pawl&spas 4439 toss exwpt 8 74°6 d Fcea1 fionr *m>rill Olt 8+a�#r rimed d3ae heaters rrm�gon�srrrmt l �y � effe�y-78%(SM after 4118113).Heat p root heaters rutinose COP=4.0. Sb&O calculation perfowied&attached.Mk6mon affidencles per Tats 502.3.Equipment eftwvv vent on �equip"Venc 403.6 required.Special occasion woft or heating caPacAY requires separate syslotn or vadaote cap-4 system. i Ekxft hest AMW must be divided into two or nmrs stages. �i9►rting equiprrtant - 404.1 -At Wast 50%a pamww*installed OgWh B robs ahaa be t eflfcaY lanw. ---- 2MO FLORIDA BUILDING CODE—ENERGY CONSERVATION CA 0- k Miami Shores VillageLSEP CF—IVED �o g 2 0 2014 Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No. r-cl moi-- 20,12> PERMIT APPLICATION sub Permit No. BUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION []RENEWAL ❑PLUMBING F-J MECHANICAL PUBLIC WORKS M CHANGE OF 0 CANCELLATION F-1 SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 54 NE 97 ST City: Miami Shores County: Miami Dade Zig): Folio/Parcel#:11-3206-013-0770 Is the Building Historically Designated:yes NO X Occupancy Type: R-3 Load: Construction Type:V-B Flood Zone: X BFE: N•A- FFE: 12.09' OWNER:Name(Fee simple Titleholder):GLENN DAI DONE Phone#:305-788-2711 Address:54,SIE 97 ST City: MIAMI SHORES State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: ''A i CONTRACTOR:Company Name: ` ` \ „ Phone#: Address: City Stam' a _.,=' Zip Qualifier Name: Phone#: State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: CESAR M. CANO Phone#: 3055-740-7929 Address:4906 CAMPO SANO CT City. C. GABLES State: FL Zip: 33146 Value of Work for this Permit:$$25,000.00 Square/linear Footage of Work:400 S.F. Type of Work: ❑ Addition M Alteration El New Q Repair/Replace ❑ Demolition Description of work: GARAGE CONVERSION BATHROOM RENOVATION, CHANGE OF WINDOW AT FOYER REMOVAL OF INTERIOR WALL AT LIVING 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$ (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..... OVMEWS 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 A�pllcant: As a condition to the Issuance of a building permit with an estimated value exceeding$2500, the applicant must promise IR 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 (p) 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 - Gni Signature NER or AGENT CONTRACTOR The foregoing Instrument was acknowledged before me this The foregoing Instrument was acknowledged before me this day of t-5 - .20 by day of =� - ---.20 - - by %j who is pern l know to .who is personally known to ii me or who has produced a°°°°° °i SANcg,�Vz as me or who has produced - as Identification and who did take an h:rP 4o�M+ssi°" %• ���; identification and who did take an oath, NOTARY PUBLIC: a ®� NOTARY PUBLIC: ® #EES60600 a' • O� .. gooh t Sk SIA- . Sign' 9`• • • Q ��� Sign: Print: •aR"l iia+� Print: Seal: Seal: APPROVED BY / Pians Examiner - �v �' Zoning .Stritetiirai Ravipw CIPrk a M 1 � � � e y� n " a .. r � e FORMS l FLORIDA BUILDING CODE,ENERGY CONSERVATION FORM 402-2010 Residential Bullding Theme Envelope Approach ALL CLIMATE ZONES 'Complia;hfhtb Sectio402stories or lessnadditions toappiitable.To couildinmusform.If a buildinot comply wdh this method or Ntemate Form 402 h may stag compy under Setdion 405 of eda Building Gode,Energy Conservation. PROJECT NAME: tf4T**-V0V- • BUILDER: AND ADDRESS: fj+ PERMITTING --- %"t IAat+t I s/iIOW'�j OFFICE: OWNER: QL*_*,j►J t�tp %,V010 Ig: PERMIT NO.: JURISDICTION NO.: 2 2 re,O O General hmu m ens: 1.New construction which Incorporates any of the following features cannot comply using this method:glass areas in excess of 20 pevent of conditioned floor area,electric resistance heat and air handlers located in attics.Additiotm s 60 sq.11.,remvatimts and egaipm at ebangeouts may comitly by this method with etccepnotw ghum. 2.fill in all the applicable spaces of the'To Be Instaged"column on Table 402A with the Information requested.Ali"To Be Installed"values must be equal to or more efficient than the required levels. 3.Complete page 1 based on the"To Be Installed"column Information. 4.Read the requirements of Table 4028 and check each box to indicate your Intent to comply with all applicable items. 5.Read,sign and date the'Prepared By"certification statement at the bottom of page 1.The owner or owner's agent must also sign and date the form. Phme Print CK 1. Nov constructhm,addition,or existing building 1. -10P 2. Single-family detached or muttlple-termly attached 2 Z.'F. ✓ 3. If multiple-famity-No.of units covered by this submission 3• 4. Is this a worst can?(yes/no) 4, lu J 5. Conditioned boor area(sq.ft.) 5. 2 7j 51 �✓ - '� 6. Glass type and area: a U-fa6a. b. C O- c.Glass area 6e. 24 sq.It. 7. Percentage of glass to floor area 7. 0.(� % y S. Flow type,ani or perimeter,and Insulation: a.Slab-on-grade(R-value) Be.R= lin.ft _ b.Wood,raised(R-value) $b•R= O 7-!S!:5 sq ft c.Wood,common(R-value) 6C-R= sq.fL -- d.Concrete,raised(R-value) tad.R_ - sq.fL e.Concrete.common(R-value) Be.R -- 9. Wall type,area and Insulation: a.Exterior. L Masonry(Insulation R-value) 9a-1. R= 217 _ � sq.ft 2. Wood frame(Insulation R-value) ga-2 R- sq.% b.Adjacent: 1. Masonry(Insulation R-value) 9b-1. R= sq.ft 2. Wood frame(insulation R-value) 9b-2. R= sq ft 10. Caning type,area and insulation: a.Under attic(Insulation R-value) 10a.R=_ sq.% 2 Pl r7 b.Single assembly(Insulation R-value) 10b.R= -- sq.ie t/ 11. Air distribution system:Duct insulation,location,On a.Duct location,insulation 11a. R= A- b.AHU location 11b. Ob-e1 Ya . c.Qn.Test report attached(<0.03.yes/no) 11c.Test report attached? Yes No 12 Cooling system: 12a.Type; a.Type b.Efficiency 12b.SEER/EER: 13. Heating system: 13a.Type: 444r:-,t--t- a. -t4r:-,t--T a.T�rpc 13b.HSPF/COP/AFUE 3•-4- b.Efficiency 14. HVAC sbding calculation:attached 14. Yes ✓ 15. Hot water system: 15a.Type: fE�t�e�21 a.Type •r92 b.Efficiency 15b.EF: 1 hereby cenUy that the plans and specifications covered by Bre calculation are In cornpliance with the Ronda Review of plans and specifications covered by fhis catculabon indicates compliance with the Rodda Energy Coda. Energy Cote.Before construction Is compieffid,this buftog will be inspected for compliance in f accordance with Seclion 553.908.F.S. PREPARED BY: OATS CODE ttFFICiAL I hereby ratify that this is in compliance with the Florida Energy Code: DWNER AGENT: DATE: 'a-r"�I L4 DATE: C.4 2010 FLORIDA BUILDING CODE-ENERGY CONSERVATION FORMS TABLE 402A BUR DINQ COMPONENT PERI'ORMANCE CRITERIA' INSTALLED VALUES: ------ Windows(see Nate 2): SHGC=0.30 U-Factor= ©'tG %of CFA<=20% t''HGC= t)•��v 1.1-Factor<0.76 %of CFA Doors:Ehderkw door 1.1-Factor U-Factor<0.65 U-Factor= Roos. Slam-grade No requirement R-Va_ __ Ora sparree(sem Note 3 R-13 Wells-End.arnd Ad).(see Nate 3): Frams R-13 R-Vahm= Mass (see Pots 3) Interior of wall: R-7.8 R Value= Exterior of wall. R-6 R-Vahre= .� •_ CefOrlis(see Notes 3&4) — R=30 R.Value= Test report Attached? Reflectance 025 Reflectance= ®• �! ' YesNVo Air system(we Note 4) Ductwork urdt " (t ,p. ETea re spNotmowed d? Corte space Attested? Yes/NoDuctR-value R-value 6 R-Vakre= - ' 2N •s, - Airleakage Qn Qn 50.03 On= C .O 3 Air urea Note 5 SEER=13.0 SEER= Heatiry%V— Heat pumpsee( Note 5) Coo". SEER=130 SEER- �3 Healing: HSPF-7.7 HSPF= - Gas furnace AFUE 78% AFUE= Oil furnace AFUE 781/6 AFUE= N Electric resistance:Not allowed(see Note 5) Water Ireddnp systern(storm Electric(sae Note 8): 40 gal:EF=0.92 Gaflore- 50 ger:EF=0.90 EF= C"d-tom_6 Gas fired(see Pate 7): 40 gal:EF-0.69 Gallons= ph.b Other(describe): 50 gal:EF-0.68 EF= a,A (1)Each component present in the As Proposed home must meet orexceed each of tits apple perbirmatnce criteria in orderto comply with this code using lift mettod; othamilse Section 405 oomplka must be used. (2)VAndows aril doorsqualifying as glazed fenestration areas most c amply with both the mexffnum U-Facrorand the maximum SHGC(solar Heat Gain Coefficient)criteria and have a maximum total window area equal to or less than 200%of fire conditioned fioor area(CFA);otherwise Section 405 must be used for compliance. Exception: Additions of 600 square feet(56 in)or less may have a maximum glass to CFA of 50 percent (3)R-values are far insulation material only as applied in accordance with manufacturers'installation instructions.For mass walls,the interior of wall"requirement must be met except if at least 509/6 of the R-6 insulation required for the"exterior of wail"is installed exterior of,or integral to,the wall. (4)Ducts&AHU Installed substantially leak free per Section 403.22.1.Test by Class 1 KERS later required. Exception:Ducts installed onto an existing air distribution system as part of an admen or renovation;duct must be R-6 installed per Sec.5032.72. (5)For all conventional units with capacities greater than 30,000 Bttlfir. For other types of equipment,see Tables 5032.3(1-S). Exception:The prohibfion on electric resistance heat does not apply to additions,renovations and new hung systems installed in existing buildings. (6)For otter electric storage volumes,minimum EF=0.97-(0.00132 x volume). (7)For other natural gas storage volumes minimum EF=0.67-(0.0019 x volume). TABLE 4028 MANDATORY REQUWd3UNFS COMPONENTS SECTION REQUIREMENTS _- J --CHECK To be cauked,gasketed,weatheraripped or otherwise sealed Recessed Righting IC-rated as meeting ASTM E / Air leakage 402.4 293.Windows arhd doors=0.30 dnA q ft.Teeing or visual iron required Firms:gadcaed doors& Y _outdoor-combustion ak. -- — — CedngsAotee wags 4062.1 R-19 space pemdtting. Programmable thermostat ---403.1.1 Where forced-ah furnace is Primary system,programmable thermostat is required. — Air distribution systan 4032 Ducts in attics or on roots Insulated to R-8:other duds R-8.Ducts tested to O,-0.03 by a Class 1 BERS rata. !� Heat trap required for vertical pipe risers.Comply with eta In Table 4034.3.2.Provide switch or dearly / Water heaters 403A marked circuit breaker(electro)or shutotf(gas).Ckaufafkhg system pipes Insulated to=R-2+accessible manual OFF switch. Spas and heated pools must have vapor-retartarn covers or a liquid cover or other means proven to reduce heat Swimming pool&spas 403.9 loss except if 70%of beat from energy.OBAimer switch required.Gas Treaters minimum thermal (�. efficiency=78% 82%after 4/16/13.Heat pump pool Treaters mkhimum COP=41L Tables 5032.3. vertflication CodirngAheatiM equipment 403.8 required.Special occasion cooling a heating capacity r per system or variable�system. (/ Electric treat>1 MIN must be divided Ito two or more ughdng equipmem 404.1 1 At least 50%of permaner*irtstalled Righting fihmues shall be high efficacy!mire. 2010 FLORIDA BUILDING CODE—ENERGY CONSERVATION CA i�2Al� Miami Shores Village e� ge , : Buildin Department VAR0 2015 � g p 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 a`- INSPECTION LINE PHONE NUMBER:(305)762-4949 � FBC 20 BUILDING Master Permit No. t� ' <4- 2D5O PERMIT APPLICATION Sub Permit No. NBUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: T4 4 ST City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: cFFFcE:: OWNER:Name(Fee Simple Titleholder): ��N �t �� Phone#: X05_9u0 Z�I Address: *4' kw, I-,?� City: tA(J6.1.x t SPAO "AZC State: Zip: 0 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Phone#: � —q-&7— q- 7 - __Z)60 Address: 9/0 `t �p_ g LAI/ 14 �_Ir' City: I l at+rte( State: Zip: S I Qualifier Name: Phone#: State Certification or Registration#: (23C I GZC( Eq Certificate of Competency#: DESIGNER:Architect/Engineer:_� C.^46-50 Phone#: Address: 41®1 cAmpo S^x-)o Cr. City: 4Ae5C='3 StaterT_Zip: Value of Work for this Permit:$ 'too. ° Square/Linear Footage of Work: Type of Work: F-1Addition ® Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: OLCUll T!CM' TO vtAX 7*0� TO ®G�0 Ge.)OC4L 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$ 4 (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 a of such posted notice, the inspection will not be approved and a reinspection fee will be charged. ) 1 Signature -- --- - --f Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 20 by day of '20 S, by C-,L�((lJ D4\Q who is personally known to S is X11. s personally known to me or who has produced _LQJ�2 u�N%'is me or who has produced `C- L as identification and who did take an oath. identification and 4o did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign. Sign: �� Print: Print: ;4 Sindia Alvare Seaz `• "'Y l FF 158750 Seal: < My commission •,C•'a"�.�'' " � ,�� Expires 09103/2018 ��i�`, r, a APPROVED BY (� l� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami Shores Village Department ��El ��E����� Building p MAR 0 6 2015 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 0® BUILDING Master Permit NO2C4— PERMIT APPLICATION Sub Permit Nw -/ ❑BUILDING gELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: G4: City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: l Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type:�•� - Flood Zone: BFE: FFFE: 1 OWNER:Name(Fee Simple Titleholder): ` ] iJJ!U J//7 1 bD�E Phone#: L� -/ f� Address: !: LC= 7 City: IA;16!&k, State: Zip: Tenant/Lessee Name: Phone#: Email: // � �a / �/ ) q�1 CONTRACTOR:Company Name: CV -7 ,,. 4 (r1�(4A( "�t'���I�Phone#: ��& Address: 3 / Qi 4LS c 22 City: State: L Zip: 5J Qualifier Name: Phone#: State Certification or Registration#: ee'- lD'Q!tt46 -4/01,9t9 ificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ AdditioHn, '❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: (`-��? C 6 -� j c� fPC­1��� 7---J Speci coo of co or fifru fi �� Submittal Fee$ Permit Fee$ S°l i CCF$ CO/CC$ Scanning Fee$� lJy Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE (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. Si dc. Sig ure WNER or AGENT CONTRA The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _ day c 20 /95 ,by 15�- day of /lty,� 20 ,by r-71t.c'.v — who i ersonall know o ��5� !.-'lE�� who i ersonally know 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: P Sign: Print: Print: a4•.....,.»,.�� •. I fMY Seal: •P' •( �e MY COMMISSION#FF127992 Seal: .+� �•,,.r EXPIRES June 1,2018 I +`»••• y0' EXPIRES June 1,2018 (407) 153 FloridallotaryService.com .,���o!;••' 16 (407)399-0153 FlorldaftwrySemce.cam APPROVED BY 7/5/40712- Plans Examiner Zoning Structural Review Clerk (RevisedO2/24/2014) ,s _ . . _'.rl � . .._ ,_ ... .. .. ..