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RC-15-1694 (3) Miami Shores Village it ing Department NOV 3 2015 sl[: 1 0 R:E .E. nd Avenue,Miami Shores,Florida 33138 ��: G1` I: 305)795-2204 Fax:(305)756-8972 ' I 1 N LINE PHONE NUMBER:(305)762-4949 �/)/ FBC ZV BUILDING Master Permit No. f�C�-— ►5 — 1 C 9 y PERMIT APPLICATION Sub Permit No. (BUILDING F-1ELECTRICROOFING REVISION F-1EXTENSIONRENEWAL ``[]''PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: I "1 S-t - City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes—?(—NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): Phone#: Address: 31 D N ET qj q S4 City: J+jCjr,'7' 6 bo-P 3 State: F(- Zip: 3-3136 . Tenant/Lessee Name: Phone#: Email: �^ ll CONTRACTOR:Company Name: FaA 7h 7L 4* 6-A�e Y-10 Phone#: 786 9S)0340 Address: , h -71Od ileo! B Blvd . City: M 1cl - State: rG Zip: -3-2/36 _ Qualifier Name: ra bI'D C4 sf C rr>j'no Phone#: State Certification or Registration#: 6.C l-,S-U(o G 4-r Certificate of Competency#: DESIGNER:Architect/Engineer: F, Phone#: 3" 7,86 303fl- Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: :Dvz�w I �n CG VyeC+) 0Q- Qa�A �2 1y4-C -0 Io or -® �x v-C rnvvcA 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$ ' W Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) • 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." o h issuance a buildin ermit with an estimated value exceeding 2500 the applicant must Notice to Applicant: As a condition t t eo $ , PPf 9 P 9 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 ._<--f Z42 eT;; OWNER or AGEN CON CTOR The foregoing instrument was acknowledged before me this The foregoing Instrument was acknowledged before me this 1 day of ALc tleMber 20, 1577 by I day of lloyem6 er ,20 1!57 by f-)nn&1d nV oder► who is personally known to T:!S bicD C19*rain a ,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• LL Sign• Print: 0i'i P► l Qow, Print: Seal: JOHN UDBARDY Seal:' (NARY PUBLIC JOHN UDBARDY STATE OF FLORIDA NOTARY PUBLIC ComWO FF098337 STATE OF RMDA .� fires Wi2018 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Inspection Worksheet { Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-248898 Permit Number: RC-7-15-1694 Scheduled Inspection Date: December 08,2015 Permit Type: Residential Construction Inspector. Rodriguez,Jorge Inspection Type: Fill Cells Columns Owner. HAYDEN, DONALD J Work Classification: Addition/Alteration Job Address:310 NE 99 Street Miami Shores,FL 33138- Phone Number (305)799-5198 Parcel Number 1132060135580 Project <NONE> Contractor: FAB INTERIOR&EXTERIOR INC. Phone: (305)751.4447 Building Department Comments KITCHEN&BATHROOMS REMODELING INTERIOR Infractio Passed Comments STAIRCASE REMOVAL AND BATHROOM EXPANSION 1 INSPECTOR COMMENTS False DOOR EXTERIOR RELOCATION AND 2 WINDOWS RELOCATION Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-247971. CREATED AS REINSPECTION FOR INSP 238520. Need location for fill cells from Arch Remove part of block next to existing Rebars not set with epoxy Failed ❑ ONLY kitchen and master bath south opening Pending letter formaster bath west opening Correction T ® � , Needed a Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid December 07,2015 For Inspections please call: (305)762-4949 Page 39 of 44 * , . t Edgar Munoz, P.E. Florida Lic. #50051 6623 NW 173 Lane Miami FL 33015 Tel 786-303-7913 December 7, 2015 The Building Official Miami Beach Building Department PROJECT: 310 NE 99 Street, Miami Shores, FL 33138 Permit#RC7-15-1694 I, Edgar Munoz, P.E. as the engineer on record,certify that the window infill reinforcement has been done properly and it will be enough to resist 175 mph wind forces. The method used here comply with local codes and with FBC 2010. For further information please feel free to contact us at 786-303-7913 Sincerely, Ed ar MunP.E. 0051 I Zl 7( t'r f Miami Shores Village C�ivMD JUL 8.7 2015 Building Department BY: 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 205 BUILDING Master Permit NOA 15-- 7 PERMIT APPLICATION Sub Permit No. WBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL F-IPLUMBING MECHANICAL 7 P E OF CANCELLATION SHOP PUBLIC C W 0RKS CHANGE CONTRACTOR DRAWINGS JOB ADDRESS: 310 NG q �h s�e 64- City: City: Miami Shores County: Miami Dade zip: 3�3 Folio/Parcel#: 3 a-0 6 -0( "ifs f3itit*jij�iistorically a O D;s%nd:Yes,�NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): D onafc J - iQ n Phone#: Address: -310 Tl(✓7 q lq 5¢Y ee--f City: j o Yn i_s kn Y PJD State: zip: 33 13 �b Tenant/Lessee Name: Phone#: Email: j, //++ 1 CONTRACTOR:Company Name: �"a+ ZL44?_YrUr &( T eY/0Y Phone#: Address: `Itt9i uLtScq y wi 1,231Vd . tt^byf+e, `� ) I h City: �1t&WX i State: f—C— Zip: -3-31,;lU t Qualifier Name:_'F-461"a ��Te r111^'0 Phone#: 7 b 6 a s 1 V 3 qo State Certification or Registration#: (! 4 C. �d 6 C Certificate of Competency#: DESIGNER:Architect/Engineer: >kAn Y jjU 0 Z Phone#: Address: In�0�3 7 3 1"a�`� City: J J State: ot Zip: 81S Value df yl►brC iotitis P �.0 Square/Linear Footage of Work: 2 f Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work:__Kf4ci&L!n �+ ba4li-roo rnS gemo&e F iS 11nkF_rioy <+A.Rr,ca.) e wp. Y w oVaA 1W4arooYn PaC chyiS;o 4o a eYrw do cux fovn 4 ?_ wtno(Dw 3 retoCAf1&n . Specify color of color thru tile: //O� Submittal Fee$21��� �� Permit Fee$ i,®� : ' ` CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews, b` u$$ -r Bond$ s Cz � �1 a f f fptAl YgLAVW( TOTAL FEE NOW DUE$11,202. 5o (Revised02/24/20141 E 0 2 . Lam® 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 ai641Signature —<7/z- OWNER or AG CONTRACTOR The foregoing instrument was ackno ledged before me this The foregoing instrument was acknowledged before me this fday of 20 TS ,by 3y day of J V n f ,20 1 S ,by I�C.H AAAA ,who is personally known to �ab CO C(Sftrn 1^ 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. NOT UBUC: NOTARY PUBLIC: 1 Sign. Sign: / Print: j1 Print: 17 �l y�y Seal: NOTARY F�UBLIC I ctA +„� Seal: STATE OF FLORIDA •,o IilIJAN=ALYAMRAID IN COMMISSION Ii IT 06WC0Mm#FF088i37 * * EXPIRES:Oder 27,2017 Expires 54=18 x*s�*��u�**�e �w s r* *�«�**x�x������s•*axr**�s+rs**:s�*:s*+�*r��ra:*s���**x*sx�*aa�� APPROVED BY Plans Examiner Ok) 7/ Zoning (//)7-7Structural Review Clerk (Revised02/24/2014) DDIFYM ACONffCERTIFICATE OF LIABILITY INSURANCE i �'N =6 THIS CERTIFK:ATE!S ISSIkD AS A�IIATTER�tNFORMAT�N ONLY AND COAXERS NO tiKiHTS UPON THE CERTIFICATE FSR.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEOATNELY AMEND,.EXTEND OR ALTER THE C011ERAGE AFFORDED BY THE CIES , BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSIiM INSURERM AUTHORIZED ; REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. e subj • ilU1PWt'PAI�Ti•if tip cute!wider�an Ate• , polkSt(#es)moat be+arty. W SUBR+OciATWN i8 WANED,subject to the leattei and colons of the poft9,certain p may"Ire an ecdorsemmrt. A statement on this oleate does not confer domsto the cedrm"hoUWin ow of such ertdorssmult(S). __.-_...._ _ _.._..:._.._ ._..._ _..... .__.. _... ..... ..........__ ... _. ...__. .. Nora LataaAule PRS �_Nlkttln; ......_...._. ,. .... .. . . .... ... � 7-0224 Insurance,PNS,Inc. } ,.t0thk._{3 j38T'0?22....... ........ .. ... �. ,mak. .... .. ..... .. . 14335 SW 120 Strom Sufte 114 INSUR�tL AFFC�OMKi•COVERAGE t MartdFL 33188 Phame (305}367-d222_ _- —. Fax ( 38?-0224 d tasurtt A: �Urnlerrvritera At _. _....._...__ __ LION INSURANCE COMPANY ' IINSURED _..___._.._.... .._•-_-_._........_ . INSURER C;.... ....._ »....... _ ... .. fai?Ir►teelor And EAKM IIIc I'••-_. .-.. 1040 NE 93 Stmt �tsutR u ......._ :.......... ........ .f FL 33136- KamiShare _ ....._i.rwsu{u r:....... __. ......__. _.. REViSMNUMBER: { S CERTIFICATE NUI : Ti,� LS TO t RTPY THAT THE POLICES UdS7JRANCE LUTED BELOW RAVE_BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THEPOLICY PERI W ICATED. NOTWITHSTANDING ANY RENT,TERN OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERT14CAT'E MAY BEISSUED OR MAY PERTAIN,THE INSURANCE MPORDED BY THE POLICIES DESCRIBED FEREIN IS SUBJECT TO ALL THE TES, , EXCLUSIONS AND CONDITIONS OF SUCH POLICES.LISTS SHOWN MAY HAVE BEEN REDUCED UY PAID CLAW. _._...__..__._..._. ._. .. ...._......._LIMITS .M......_.. . . t TYPE OFPt>ldCY iNSURAKE s.4 _._ EACH COC(R2REM1UE _.... .1�O ,ODO.Od_- i® COAtRflERC1At C,EeIERALLIABRJTY } ! ' oRt g 'I00,0W,00 I ! ❑ MA -MADE ® OCMIR ' btiAAfiaEfi NS " moi..,. . _ _. .... ❑ � A Y SUB12 2212641 03!22/2015 '03d2�J2016 r I PERSONAL&ADV INJURY s 1,0OD,�.00 __._..........__. .. .... . .t ..._.:.._... ...... _... : GM AGGREGATE LIMIT APPLES PER: i r GENERAL AGCtRECiaTE S 2,OQ0,000.00 ; ❑POLICY ❑ 20r ❑ LOC i PR4DUCrS.COAAPWP AGG t S. 1.aQ0,000.�1 OTHER t•� ..__.---._.-.__.._ ._.._.___ $____.}...__._....._..___....__ _....__ _._.._,...__....__ .. . cor,�iNEDSIMGLELIMtI` j AUTOMOBILE LIABILITY F..._... t S ....... .... BODILY INJURY(Per POISM) S IJ �-' ANY AUTO I _......_... _..__ t B i 1❑ U ,IED�D ❑ D i BODILY M URY{Per ac.... S i PR(1 �.y pltRtiAf;E !C] HIRED AUTOS ❑ AW �FgE�R NED ; � ; (P�acc ^.A... g �_❑ t ULAUAB ❑SUR i t EACHG>R��U2RC►iCE $...... In ... _..._... f S •I wommm AM SMOV T�T!S':iLrF.%ECU7'IVF{r N i E.L.EACH AGK�DENT ANY N .NIA A f WCiT1849 011012016 101101/2017 - g i OFFICER R tOOCtxAJL ED? EL Otr5EA9E-e?A EwpLoYe: S 100,000.00 I Mmmo"III NH) _. 1 Rye%dewfteurAw E L DISEASE-POLICY L&IT 5 1 OO,Qt�.00 i OE8CRiPIMOFOPERATIONSgelaw .____. !-....__ _._.___.._._...._..__.._.._._ ._....__. »...__._....__.t_..__._.._._...__..._......... __..._._,....._. _ _..........._. .... . oSSCRWrM aF CPERATMS 1 LOCATIONS r vE1QMM(Aitaeh ACORD,e1,AetQe wW..._ sa:I ,e�,at more rs required) GENERAL CONTRACTOR,PAINT,CARPENTRY CERTIFICATE R CA+NCELLATON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE i CITY OF MIAMI SHORES THE EXPIRATION DATE Tldaz ,NOTIM WILL BEIN ACCORDANCE VM THE AGCY PROWISION& 10050 NE 2 AVE MIAMI SHORES,FL 33138 AUTHORIZED REPRESENTATIVE 1 _._. 01M411tA ACORD CORPORATION. M dgIdS MMI Med. ACORD 26(2914181)OF The ACORD now and bVo ase regMend tracks Of ACORD