RC-15-2610 I
• �-- - Miami Shores Village - - - -- - _-
Building Department OC T x 2015
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 i
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(30S)762-4949
FBC 2014
BUILDING Master Permit No. KC t i—2-jG d�
PERMIT APPLICATION Sub Permit No.
UILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
[]PLUMBING M MECHANICAL [PUBLIC WORKS M CHANGE OF ❑CANCELLATION ❑ SHOP
• CONTRACTOR DRAWINGS
13
10B ADDRESS: J
CiMiami ShoresCounty: Miami Dad Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: F/FE:
OWNER:Name(Fee Simple Titleholder):, da ke JAX Phone#: `30 �
Address:
City: I �AIO APc, State: Zip: 75132-
Tenant/Lessee Name: d q Phone#:
Email: a kr
r .rbe-(&Lith r y7e+
CONTRACTOR:Company Name: r oP?s&ZCJb1�14012D. Phone#: . (®SF)
Address: 97 Jk-
City:_ State: - zip:..
Qualifier Name: /el' J ) C Phone#: � .� �� ���
State Certification or Registration#: T43C—' 50 6) 6 21 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ ,5�/ �`� Square/Linear Footage of Work: =l ��
Type of Work: ❑ Addition ❑ Alteration ❑ New �R pair/Replace ❑ Demolition
Description of Work: NIL" !`'7 8T i2AoQk(- j: X C0 r �1 a,/ TJ �..-r<
Specify color of color thru tile:
Submittal Fee$ ,�Permit Fee$ 4(0 CCF$ CO/CI~$`
Senning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$('�C!
(Revtsed02/24/2014)
Bonding Company's Name(if applicable) hV
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 bt / Signat
OWNER or AGENT JNTR�CTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 1�5 by Is. day of ��/�` '20 I-S by
who p rsonally kno to who is personally known to
me or who has produced as me or who has produced A aN& �%&&as
Identification and who did take an oath. identification and who did take an oath.
NOTARY PWC: NOTARY PUBLIC:
S n Sign•07
�-
nt• Print
Seal:
E
BARIMAESIV
Seal: ��0 MEXP�ES:Murch 29,2018
LIM%4T:9Nd)(3
* ;.°' eo�aea rn�racer uncles
A� �,
�*�s+rs+s*.x*+►*rtr*�*e"s'�l �
APPROVED BY ILI I-A Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
- R aFP
n
Miami shores Village
Even
Building Department
1pR ► 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 and has acknowledge that he or she will not use
day labor,part-time employees or subcontractors for your.project.The contractor has provided an affidavit stating that he or she will
be the only person allowed to work on your project.In these circumstancks,Miami Shores Village does not require verification of
workers'compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Signature:
r
State of Florida
County of Miami-Dade
The for oing was ackn wledge before me this day of ,20
By &4 — who is personally known to me or has produced
C----------------
as
-as identification.
NoIr LEXYQVM
•"•.
ell- WCOWS"tEESM
SEAL: EXP RES•,Wt 10,2017
— r
Arco Construction Corporation
October 14,2015
State of Florida
County of Miami Dade
Before me this day personally appeared Lester Jensen who, being duly sworn,deposes and
says:
All work to be performed by Lester Jensen or licensed and insured subcontractors.
Sworn to (or affirmed)and subscribed before me this day ofQ G{WIV , 20 r�.by
L 6; Q
Personally kno
Or Produced Identification
Type of Identification Produced
Print,Type or Stamp Name of Notary
_��`' eaRenRnnESTEP
W COM MISSIC1#FF O7S75
" EXPIRES:March 29,2018
Bonded Tlw ND"Public Urdemvbm
General Contractors/CGO50516311665 N.E. 137 h TerraceW.Miam4 FL 33181
305.892-6507
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-254157 Permit Number: RC-10-15-2610
Scheduled Inspection Date: March 08,2016 Permit Type: Residential Construction
Inspector: Rodriguez,Jorge Inspection Type: Final
Owner: CLARKE,ALEXANDRA Work Classification: Alteration
Job Address:1320 NE 103 Street
Miami Shores, FL
Phone Number (305)756-0063
Parcel Number 1132050300030
Project <NONE>
Contractor. ARCO CONSTRUCTION Phone: 305-892-6507
Building Department Comments
NEW BATHROOM FIXTURES, NEW TILES Infractlo Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
March 07,2016 For Inspections please call: (305)762.4949 Page 44 of 44
i
Miami Shores Village
1NC.fp k
1
10050 N.E.2nd Avenue NE "• i "" "'
k
Miami Shores,FL 33138-0000 r
` Phone: (305)795-2204 �..
t
11 Expiration: 0413012016
Project Address Parcel Number Applicant
1320 NE 103 Street 1132050300030
Miami Shores, FL Block: Lot: ALEXANDRA CLARKE
Owner Information Address Phone Cell
ALEXANDRA CLARKE 1320 NE 103 ST (305)756-0063
MIAMI SHORES FL 33138-2624
Contractor(s) Phone Cell Phone Valuation: $ 5,500.00
ARCO CONSTRUCTION 305-892-6507
_. _ Total Sq Feet: 48
Approved:In Review Available Inspections:
Comments:
Inspection Type:
Date Approved::in Review
Fill Cells Columns
Date Denied: Final PE Certification
Type of Construction:NEW BATHROOM FIXTURES,NEW Occupancy: Window Door Attachment
Stories: Exterior: Framing
Front Setback: Rear Setback: Insulation
Left Setback: Right Setback: Drywall Screw
Bedrooms: Bathrooms: Window and Door Buck
Plans Submitted:Yes Certificate Status: Review Planning
Additional Info:
Certificate Date: Review StructuralReview Mechanical
Bond Ret um: Classification:Residential
Review Building
Fees Due Amount Pay Date Pay Type Amt Paid AmReview Buildingt Due Review Building
CCF $3.60
DBPR Fee $2.48 Invoice# RC-10-15-57424 Review Plumbing
DCA Fee $2.48 10/15/2015 Check#:4855 $50.00 $138.56 Review Plumbing
Education Surcharge $1.20 11/02/2015 Cash $ 138.56 $0.00 Review Electrical
Permit Fee $165.00 Review Electrical
Scanning Fee $9.00
Technology Fee $4.80
Total: $188.56
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I ce ' t all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Fut a ,I authorize the above-named contractor to do the work stated.
November 02,2015
l Authorized Signa r / plicant ntractor / Agent ate
Building Depa nt Copy
November 02,2015 1
i
LINEN �� , +_�
" I
71
tw
SET
Al
LTa
� t4 t sZ6� \v;�►.�W * c tic � ,
1 E c t OL. Jc/sT
Ic
4t-
moll
cV
—_._ __._. __ d•
.. .nr_L coy: .Cocom
1
t
....YY
•4r- VIP
Y • • Y
so
• • • • •
•
nil ••Y• • • •
-�- • • • •Y•YY•
•Y•YY•
qt,„ fir
s6
Scope of Work:
Replacement of existing fixtures with new ones as specified on Plumbing section.
BY DATE Tub surround to be constructed in W cement board and finished with ceramic
- --- tiles, full height to the ceiling.
Lul`i.fdti New tiles: floor and around the tub (full height).
All work to be performed in accordance with FBC 2014 5th edition. '�c
RJJTURAL 1, - --- _ --
Zz v !OCT 2 2 2015
Y
ELECTRICAL
, l�Y:
NG /d-Z ?_/5 C. 0
0
i oi P L i i
=4-
E,p
-" -
E,p
AWL-
FA0 $A .••• • r• • .••.•
l(��'j • • • • •
•••• • • ••
Z���(1 3( Dal • •
q(.., Z. ►(
lt�-e-Tel CAL
am ton N E%ou
BATHROOM RECEPTACLE ON 20 AMP CKi
AND G.F.i PROTECTED ADD SMOKE/CARBON MONOXIDE DETECTORS.
ANY AND ALL CLOTH AND RUBBER
INSULATED CONDUCTORS TO BE REPLACED.
No electrical work to be performed.
ELECTRICAL REVIEW
APPROVE � DATE
i
bi 5t�
9 -
9999..
f .._, •9999• ••
0 9996 0696 90600.
d- •
• 9.
S� • 9696 696696
666 99 9 . 9
9 9 6 6 •
696 • 96 99:•x•
9 6669 96 9 90•69
99 • 96 9996•
Z'-7 f ' o" 9999
•
af- 0 9
.....
9999..
0
. . 999..
99 6 6 699 9 6
6 9 6
99
Plumbing General Notes:
9999_. ��.
1. Scope of work: PLEIr,PLAI\Y9Approved
Replacement of existing fixtures with new ones: Bathtub, toilet, Mid*p►goDate���ved nate,
No shower compartment. i
New valves: Tub/shower combination and sink faucet.
2. All plumbing work shall be performed in accordance with the latest edition of
Florida Building Code (FBC 2014 5t" edition).
3. Occupancy classification: R-3.
4. Level 1 of Alterations per Existing Building Code Sections 403,404 and 405,
5. Type of Existing Construction as per FBC 601: III.
6. As per FBCR P2708.3 Shower control valves. Individual shower and
tub/shower combination valves shall be equipped with control valves of the
pressure-balance, thermostatic-mixing or combination pressure-
balance/thermostatic-mixing valve types with a high limit stop in accordance
with ASSE 1016 or CSA 8125. The high limit stop shall beset to limit water
temperature to a maximum of 120 F (49 C). In line thermostatic valves shall
not be used for compliance with this section.
t t®'�
(2-AN CWI-KC;
A 0( \<
tn 11�
9,D WG ( 0:3 rd, -1pT W;6:1- N6*4 "TK"Ott IFI
E- 7. 5 6
M E-1
cc
0
cc
IL
z
uo,
0-,j
LL
C—\
E- 0 <
�Ido
7 7-
-cc
Uwo
ci\
F110E
r
>
v'opy
V'
0 To
fam,
Aw
OCT 15
Village
:•: . ®ATE
I -
*APPROVED 13YJ
ZONING DEPT
000 6:4 0
0
•0 00 FILDG DEPT
000 ;w
I SUBJECT TO COMPLIANCE%TH ALL FEDERAL
*'-,TI-ATFF-AND COUNTY RULESQ REGULATIONS
Atilt
im.
— r
El
-314 3 O 24 i=+1• If.er,3
�j
<.' A 71014 6
1
'� � � • � _ .. � _.. - - - -. _.. - -_. _ - - - - - - ._..�._ .-_.�._l1--fir -- - - - - --- - - - '
_
l fPao 4c.# w• �'
5. ,
_ - c
Cz� t
, I
--
NOOK. 14••� 10. i�-- - +
I '
W __ _.. . . t a tE I •_ _ t
TCLHI^Nrc gra,- - U KUCSM (
-- - i
' r.eotrec Gert>•xltq%t4 Ty
f 1
�F
w . P��ta nc.s t c } ► P S l I N t TI#car.ws I
,\voe0 LT•
6/9�Atom
lr1
T,
_ >
I�ANIN EA ✓ReavfE is a A F
LIVING twm
'4 ICLOSET
c. ! is
—� .i.M� !• i ^ �' \ 4= -8 ¢' 4 S"ass 2L
h �' t-gyp, .. _. .. V v ac•i I f
.c6luxr..
F=OY!E R" vt..S7c' to , .s _ ,1 rfy
r L
, � t .1 YS..+-:. ,a ..7 U ;:•gyp _ , - - - -_- _ --- .- � --- - '
r . i ,•, �.«t-Utt. ... -tet �'_-�>
,
• ' .. — -- — - _ — '� -- C '
.�1 ;; ���` ♦ a°to - ' k w o
r tcnti l !, a T• r:, v. ; , io
E�fTR7 14 3 —.t.4_2 __._ --- I �/ .. b - —_ - b-.. -- -• ,r
AR flG ac Te1'd a.eo.\q [,.a2• - �_� I ii
._.. r .y •� f t. '7J6(O 'v..�.:- 1 •t.n. pV 1
�• ..J ._ f,/1 ► ;,JN i G...v. wv•. tr••, c�'uti4 ' IIi
r. 1 •-7 .O. e,k"I�Ist•?;•_! tttr. \v4/4 jCC7X>i•'c
11,,s ntCtr,vD TJ _nev.6R-
• ,�' , .'y .I ' ..... 4 qTA uSIG Hif.. ly Oq •1 K/
3. f !'* R w•tlt +L .�• `"r'L C? 1 L '�. — r — ei 'r f '
♦ r .�,e v.r,.v � a.•N All, 4 r 75 •tr 7f w,. r 11 �4'+ i 1 ...
ti - IZc«..' Sat,v Ht:
tie1,,40/100,
5rN Pon-
6w.
*^
�!1f1 tttr� a r..«.+a• �e� wK ` ✓ � a,.� ' -----_. -- `• _._ -----.------'s .--_ .. L 0
•
,
<a
w►a t l Ct.: a rlc"f p OL T r
♦ ♦ f e 8 a t ;
ItsM•OSGtr+,rrh:-
^
PLAN - i —2t51L7EkkgE
UC-QNSEY CO�ST:UC_.10".a _�0 At2Ch1t 7EGT
gcwtt t/�'� �'o• ? 1!t.oT--3 PjLOGK-s Rte A"_T"n.T `� i
I A\IAA\1 $HOI(:., Er A7 PALK. ESTATks .,VD._ A.re111.1
Fu } 9tNY _ titer
f/CfE• ALL t..7C.k Nt. OCl4i SMAtI flAvc` _.--`n\I fv,\\I _SbO�'E�� PLA• - - f�-
ANFoA1 TutLf,140•r+ I W"'??46R.STKIPS
,