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If Inspection Worksheet .4' Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-256619 Permit Number: RC-12-14-2673 Inspection Date:April 11,2016 Permit Type: Residential Construction Inspector: Dacquisto, David Inspection Type: Survey Final Owner: SALTZBURG, DONALD Work Classification: Addition Job Address:94 NE 100 Street Miami Shores, FL Phone Number Parcel Number 1132060131180 Project: <NONE> Contractor: P 2 -5666 Q S CONSTRUCTION INC hone (786) 28 Buliding Department Comments MOVE KITCHEN TO NEW ADDITION AND MAKE Infrectio Passed Comments EXISTING KITCHEN AND NOOK INTO NEW BATH INSPECTOR COMMENTS False CLOSET AND NEW UTILITY ROOM RELOCATE JACUZZI "THE APPLICATION DOES NOT CORRESPOND WITH THE PLANS. N.O.A'S ARE ATTACHED TO PLANS HOWEVER, NO WINDOW/DOOR SCHEDULE ON PLANS Hold menta GC and roof contractor nee tl t le Afe%J it�f �WrgloPhag ialperoocontractor roc ver the roof Is instructed by the Building Official not to rc of section. Failed lug Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid For Inspections please call: (305)762-4949 April 11,2016 Page 1 of 1 LOCATION SKETCH r NP_ SCALE: NTS �O'• 73'F�IT�WAY(8Y FKa.TI ^�� ��., 20't.ASPFIALT PAVEMENT NP_ 100th STREEr CE SCALE:1"=30' A-"ALT =5'PAWWAr I. 1 2016 I T: FM f . 1I�7W (Pdlll) 6151 * 5 4 Z 1 I $Y: •CONOS�EWALK ' . RLIZ f/2" 'l MAL err ` I 18 19 20 21 22J23 1 S FEET I ORYVFWAY I a, 0.1220' ►' �i 8 i 04.50 to k �O• •••• id LOT 4 I 3'CBS ALL oNe BTORr l 800 •••••• ••s• ••• BLOCK 9 I a2aa 0941 CM PLOP. _21.90 'a.is 'Q':` •••v•• • • I FFELEVQ�O18' 24JB' a a� •••••• t•••i• • �i • I 19.00' 8 �, I G T3 �.. WO'. ',:i , .,Miami Shores Village • :•.•:• ••• • f APPROVED Y DATE •• • •o•• • • too 0 ao'..".d / 1n ZONING DEPT PL � — 4'C.L. F. .a 7a. 't --- — (AV Lq.} B a'ASPyALT1ZQ7d' (Pdll� LDJ i% 1(-F WITH Al I FFDFRAL fs'ALLEY . LLOT (I LOT 23LOT21BS9 BLOCK 9 ecocK s BLOCK s I PROPERTY ADDRESS: 94 N.E. 100TH ST., MIAMI SHORES, FL. 33138. • LEGAL DESCRIPTION: LOTS 1, 2 & 3 LESS THE WEST 35 FEET BLOCK 9 ABBREVIATIONS: OF AMENDED PLAT OF MIAMI SHORES SECTION NO. 1 SUBDIVISION S4kC=StDEWIX,ACELSsCONCRETE BLOCK STRUCTURE.CLF=CHAW UNKFENCE.PL=PROPER7'f LWE,DUE-DRAINAGEU77LI-IyEgSEM EW.Ipa�ON PIPE, F=FOUND,AICsAIR CONDITIONER PAD,PIC-PROPERTY CORNER D/H=DRILLED HOLE,WIF.%OODEN FENCE,RES=RESIDENCE,CL-CLEAR.RB-REBAr., ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 10 AT PAGE 70 UE=UTILITY EASEMENT, CONIC-CONCRETE SLAB. RNWRIGHT OF MAY. DE=DRAINAGE EASEMENT, CfL=CENTER LINE. O=DIAMTER, TYP=TYPICAE, WMEASURED.R-RECORDED,ENCR=ENCROACHMENT;COMP-COMPUTERASHISPHALT,NID-NAIL&DISC.S-SET,FEE-FINISH FLOOR ELEVATION, OF THE PUBLIC RECORDSMIAMI–DADS COUNTY, FLORIDA OIS-OFFSET,PIP"POWER POLE,OHP-OVERHEAD POWERUNE,WA-WATER METER •VtOODFENCE- MAseNRv ELEVATION BASED ON LOC:-# -- - __. --------- CONCRETE= G: t..:.j••o.•:.•t..:••s..:••s.•:•.i.:..:.:. 3�00 '-- NOT VALID UNLESS EMBOSSED WITH MAINTENANCE&DRAINAGE EASEMENT-M&D.E. CBM# N--568 ELV. 9.65' SINCE 1987 TYPE OF SURVEY;BOUNDARY SURVEY SURVEYOR'S SEAL I HEREBY CERTIFY That the survey represented SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2)NOT VALID WITHOUT THE SIGNATURE theteon meets the minimum technical requirements BL.ANCO SURVE.'YORS ING. ry AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NO? adopted by the STATE OF FLORIDA Board of Land — •- COVERED BY PROFESSIONAL LABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. S. Sulveyors pursuant to Section 472.027 Florida Engineers•Land Surveyors•Planners-LB#0007059 UNDERGROUND ENCROACHMENTS'NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC statutas.VERTICAL DATUM OF 1929.. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL There are no encroachments, Overlaps,easements 655 NORTH SHORE DRIVE RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAYBE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9; appearing on the plat or visible easements other than. MIAMI BEACH,FL 33141 CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONiNC as shown hereon. 305 865-1200 Email:blanIAMI BEAC INFORMATION. 10)EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDEE ( } �Qyahoo.com Fax: (305)865-7810 REVISED: INSTRUMENTS,IFANY,AFFECTINGTHIS PROPERTY. FLOOD ZONE: g SUFFIX: L DATE: Additions or deletions to surveys or other the the s 9/11 09 BASE:N/A p . reports b3' signing party or parties is prohibited without written consent ADIS N.NUNEZ PANEL: 0302 COMMUNITY# 120652consentof the signing PAY or parties. • BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE-OF SAID P8' 10 70 REGISTERED LAND SURVEYOR [�,T F SCALE: DVVN.BY: JOB No v PAGE _ STATE OF FLORIDA#5924 3/l O/l6 11-= 30' F,pylanco 16-256 POST ON SITE INSPECTION E C O R D Pern3/tNO. RC-q 12-14-2673 Miaini Shores Vi lage --- ----- — >l�� y Permit Type: Residential Construction 10050 N E.2nd Avenue _+ Miami Snores,FL 33138-0000 Work Classification:Addition Phone: (305)795-2204 Fax: (305;750-8972 -- ---- - -- Issue Date: 5/27/2015 r0E 10P' _.� Expires: 11/23/21115 SPECT"ON REQUESTS: (305)762-4949 or Log on at https://bidg.miamishoresvillage.com/cap .EQUESTS ARE ACCEPTED DURING 8:30AM-3:30PM FOR THE FOLLOWING BUSINESS DAY. te;tuests must be received by 3 pm for following day inspections. Residential Construction Parcel #A 132060131190 Owners Name: DONALD SALT7_BUR w_________r._ __.._,. ........._.___..:_.___:...___.__....___._.___._.... _..... ...... . _.. .. _......__.._..._._._.___... G _ Owner's Phone: .Job Address: 94 NE 100 Street �� _ Total Square Feet: 300 Miami ShQr .5 FL — — Bond Number: Total Job Valuation: $ 158,000.00 WORK IS ALLOWED MONDAY THROUGH SATIJRDAY, 7:30AM-6:00PM. NO WORK IS ALLOWED ON Cntractor(s) _ Phone Primary Contractor SUNDAY OR HOLIDAYS. i «'S CONSTRUCI-ION INC (786)229-5666Yes BUILDING INSPECTIONS ARE DONE MONDAY THROUGH THURSDAY. ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY. NO BUILDING -- -- -- INSPECTIONS DONE ON FRIDAY. 014/12 •vcc,. w,/.c /v&v *�7w o Dom- ate.,s✓,�pey N s" " / i6 - Stie �-- cam- `'' 4IS AT 111' InMN ILIO iNSPECTION WILL BE MADE UNLESS ]"HE PERMIT CARD IS DISPLAYED AND HAS LEEN.APPROVED. PLANS ARE READLY AVAILABLE. IT IS TfIE PEFM11 ftPPLICANVS RESPONSIBILITY TO ENSURE THAT WORK IS ACC SS0LE:AND EXPOSED FOR 1NS'PECTION PURPOSES. NEITHER 7HE BU1DING OFFICIAL NOR THE CITY SHALL BE L.LABLE F OR EXPENSE ENTAILED IN THE REMOVAL OR RE-PLACEMENT OF AN"MATERIAL REQUIRED TO ALLOW fl SPECTION. WARNING TO OWNER: ' YOUR FAILURE TO RECORD A NOTICE OF ('OMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU 'NTE-ND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF , )!V MENCEMEN T. INSPECTION RECORD STRUCTURAL ZONING PLUMBING INSPECTION DATE (INSP INSPECTION JDATE INSP INSPECTION DATE INSP Foundation Zoning Final Sternwall ZONING COMMENTS Rough Slab Water Service Columns 1st Lift 2n Rough Columns 2nd Lift Top Out Tie Beam Fire S rinklers Truss/Rafters Septic Tank Roof Sheathing Sewer Hook-up Bucks Roof Drains Windows/Doors ELECTRICALGas C Q�. S Interior Framing �/ / INSPECTION DATE INSP LP Tank Insulation v j Tem orar Pole Well Ceiling Grid 30 Day Temporary Lawn Sprinklers Drywall Pool Bonding Main Drain Firewall — Pool Deck Bonding Pool Piping Wire Lath Pool Wet Niche Backflow Preventor _ Under round Interce for _ Pool Deck Footer Ground Catch Basins Final Pool Slab Condensate Drains _ Final Fence Wall Rough HRS Final Screen Enclosure Ceiling Ro Driveway Rough PLUMBI _ COMMENTS Driveway Base Tele h ne qough Tin Cap_ Telephone Final Roof in Progress TV Rough Mop in Progress TV Final - Final Roof LAtiachment Cable Rou hShutters Cable Final Final ShuIntercom Rough Rails and Guardrails Intercom Final MECHANICAL ADA com fiance Alarm Rough INSPECTION DATE INSP Alarm Final Underground Pipe DOCUMENTS Fire Alarm Rough Soil Bearing Cert Fire Alarm Final Rou h Soil Treatment Cert _ Service Work With Floor Elevation Survey / Ventilation Rough Reinf Unit Mas Cert _ ELECTRICAL COMMENTS Hood Rough Insulation_Certificate Pressure Test Spot Surve Final Hood Final SurveyFinal Ventilation Truss Certification—j– Final Pool Heater STRUCTURAL COMMENTS Final Vacuum 1 MECHANICAL COMMENTS INSPECTION JDATE INSP Final Sprinkler _ _ Final Alarm WINGERTER LABORATORIES, INC. Engineering Testing.Inspection Services 1820 NE 144th Street,North Miami,FL 33181 -TELEPHONE:305-944-3401 FACSIMILE.•305-949-8698 FIELD DENSITY TEST CLIENT: Q's Construction Inc. REPORT NO: 1 PAGE NO.: 1 of 1 PROJECT: Residence ORDER NO.: 15-1258 P.O.#: CONTRACTOR: TEST DATE: 7/10/2015 PERMIT#: PROJECT LOCATION:94 NE 100th Street,Miami Shores,FL TIME IN: 02:00 PM TIME OUT:03:00 PM INSPECTOR: Alberto Morales PROCTOR SUMMARY OF DENSITY TEST INFORMATION RESULTS Retest Dry Probe Optimum Max.Dry Percent Percent Lab Field Fill Field Test Location: of Moisture Density Depth Proctor Moisture Density Field Compaction Test No. Test# Lift Lab No % C Lab No. %) CF acti R ent Status Footing:Back end of House 1207 1 F West side of House 8.8 126.4 12 98.3 95.0 PASSED 1208 2 F East side of House 9.1 126.1 12 98.1 95.0 PASSED (Minimum 3 Per in Remarks: Proctor information provided by client. WINGERTER LABORATORIES,INC.offers no warrantee expressed or implied that material tested is representative of the proctor sample. Optimum Moisture-9.5 %and Max.Dry Density= 128.5 PCF. H. w b. `I . . �O HIZ, S,INC. Field density test was performed in accordance with ASTM D 2922. Cpm;•• �� This report is submitted as the confidential property of the client. The original of this report was signed and sealed by the herein referenced Registered @P,P.E.,P.G. Engineer in accordance with Rule 61 G 15-18.011 of Florida Administrative Code. No.34715 INSULATION CERTIFICATE Building Permit No: RC-12-14-2673 Project Name Donald&Wendy Saltzburg Residence Project Address: 94 NE 100 Street,Miami Shores,Florida STATEMENT OF COMPLIANCE We,the undersigned,hereby certify that the THERMAL INSULATION installed in the above referenced project is in compliance with the latest edition of the FLORIDA BUILDING CODE, the APPROVED ENERGY CALCULATIONS and Plans, and is in accordance with good construction practice. The insulation furnished and installed has the characteristics shown below:(Circle the applicable items). T1)Exterior CBS Walls Insulation: R- (Min.) Material: Thickness: inches) Density: Ib/ft Mfr: 12)Exterior Frame/Metal Stud Walls: R- (Min.) Material: Thickness: inch(es) Density: Ib/ft Mfr: 3)Exterior solid concrete walls: R- (Min.) Material: Thickness: Inch(es) Density: Ib/ft Mfr: 4)Interior walls separating A/C from non A/C spaces insulation: R- 13 (Min.) Material: Kraft Insulation Batt Thickness: 3.5 Inch(es) Density: Ib/ft Mfr: Owens Coming 5) MULTI-FAMILY RESIDENTIAL CONSTRUCTION ONLY.The COMMON (Party)walls to two separate conditioned tenancies shall be insulated to a minimum of R-11 for frame walls, and to R-3 on both sides of common masonry walls.See FLORIDA BUILDING CODE 2020—Energy Conservation,Section 402.2.12.These"minimum levels of insulation",are not included in the Energy Calculations,but shall be installed in the field. 6)Ceiling insulation: R- 30 (Min.); Material: Kraft Insulation Batt Thickness: 9.5 inch(es): Density: Ib/ft: Mfr: Owens Coming INote:Do not use this form for lightweight Insulating concrete. Installed by(select one): Insulation Contractor General Contractor/Builder Q's Construction, Inc. (company name) (CC number) (company name) (CC number) as Con nc. CGC1508464 (contractor's name) (license number) ( t me) (license number) 03124/2016 (contractor's signature) (date certified) ( ctoes signature) (date certified) SWORN AND SUBSCRIBED before me by Alfred 4uero ,being personally known to me( )or having produced as identificatibn Personally Known ,and who being fully sworn and cautioned, stat for oing is true and correct to the best of his/her knowledge and belief. Arlene Torres 03/24/2016 Signature Date ARI.E[rB EIIOSIN4 Notary Pu wMy Commission Expires: ownill"#1 Miami Shores Village Building Department 10050 NE a Ave. Miami Shores, FL 33138 305-785-2204 I.Fax 305-766-8972 NOTICE TO MIAMI SHORES BUILDING DEPARTMENT OF EMPLOYMENT AS SPECIAL INSPEC'T'OR UNDER THE FLORIDA BUILDING CODE. I(We)have been retained by HZ_jc:"/A9 to perform special inspector services under the Florida Building Code 2010 at the�da �) l �areg�tstered� project on the below listed structure as of architect/professional engineer licensed in the State of Florida, Process Number. Special Inspector for piling,FBC 1822.1.20(R4404.6.1.20) Special Inspector for Trusses>35 ft.long or 6 ft.high,FBC 2319.17,2.4.2(R4409.6.17,2A.2) Special inspector for Reinforced Masonry,FBC 2122.4(114407.5.4) �.Special inspector for Steel Framing,FBC 2218.2(84408.5.2) _. Special Inspector for Soil Compaction,FBC 1820.3.1 (R4404.4.3.1) Special Inspector for Precast Attachments,FBC 1927.12.2(R4405.9.12) —Special Inspector for Roofing Applications, Lt.Weight. Insul.Conc.FBC 1917.2(84405.12.2) x_Other Special inspector for roof truss repairs. Note:Only the msrked boxes apply. The following individual(s)employed by this firm or me is authorized representative to perform . inspection* 3. 4. *Special inspectors utilizing authorized representatives shall insure the authorized representative is qualified by t tor• *lu qualifications shalt include ticenaure as a duties assign Special nspoc q , . education or luxnsure to perform the 8n by P professional engineer or architect:graduation from an engineering education program in civil or structural engineering: graduation from an architectural education program;succmfal completion of the WIRES Fundamentals Fxamination: or registration ac building inspector or general contractor. I(we)will notify the Miami Shores .Building Department of any changes regarding authorized personnel performing inspection services. I(we),understand that a Special inspector inspection log for each building must be displayed in a convenient location on the site for reference by the Miami Shores Building Department Inspector. All mandatory inspections,as required by the Florida Building Code,must be performed by the Miami Shores Building Department.Inspections performed by the Special Inspector hired by the owner are in addition to the mandatory inspections performed by the department. Further,upon completion of work under each Building Permit,I will submit to the Building inspector at the time of the final inspection the completed inspection log form and a sealed statement indicating that,to the best of my knowledge,belief and professional judgment those portions the project outlined above meet the intent of the Florida Building Code and are in s n 'al i e with the approval plans. In ineerlNc itect Nam lint s� �� - �• Date: _ _ Address FATHI ARCHITECTS,INC. y \h AA 0003088 _ IB 0001031 ARCHITECTS INTERIORS PLANNERS 8828 BRIDLE PATH CDURT SUITE 208 DAME,FLORIDA 33M l' , TEL.(308)438-3348 at@fathiarchitects.c= ,. L(Cf moi+ Date: April 8,2016 To: Miami Shores Village Building Department 10050 N.E. 2nd Ave. Miami Shores,Fl. 33138 Re: 94 Nf.E. 100 Street: Miami Shores,Fl.33138 Permit#: RC 14-2673 Dear Building Official, I,Asghw J.Fathi with Fathi Architects,Inc.,having performed and approved the required inspections,hereby attest that to the best of my knowledge and belief,the above-described construction of all structural load-bearing components complies with the permitted documents. This document is being prepared in accordance with Section 105.13.4.1 of the Florida Building Code and is being submitted to the Miami Shores Village Building Department at the time of final inspection for the above referenced structure. Please feel five to contact me,if,there are any questions and concerns. e $ubmi By, hi c. :F ',JR.A: Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-256445 Permit Number: RC-12-14-2673 Scheduled Inspection Date:April 08,2016 Permit Type: Residential Construction Inspector: Rodriguez,Jorge Inspection Type: Final Owner: SALTZBURG,DONALD Work Classification: Addition Job Address:94 NE 100 Street Miami Shores,FL Phone Number Parcel Number 1132060131190 Project: <NONE> Contractor: Q'S CONSTRUCTION INC Phone: (786)229-5666 Building Department Comments MOVE KITCHEN TO NEW ADDITION AND MAKE Infractio Passed Comments EXISTING KITCHEN AND NOOK INTO NEW BATH INSPECTOR COMMENTS False CLOSET AND NEW UTILITY ROOM RELOCATE JACUZZI "THE APPLICATION DOES NOT CORRESPOND WITH THE PLANS. N.O.A'S ARE ATTACHED TO PLANS HOWEVER,NO WINDOW/DOOR SCHEDULE ON PLANS kJolei building official Inspector Comments The roofing contractor procee ver the roof sheathing v �ggfoval and after he ct by the Building Official not to cover the new r n. Failed Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid April 07,2016 For Inspections please call: (305)762-4949 Page 24 of 27 � � •.. �: ; Its _ � ) • z z ta'fS, b � 3 a E �E Miami Shores Village 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 Phone: (305)795-2204 E3 '° '•, €s3.,mn'. Expiratlon. 1`U 2015 Project Address Parcel Number Applicant 94 NE 100 Street 1132060131180 DONALD SALTZBURG Miami Shores, FL Block: Lot: Owner Information Address Phone Cell DONALD SALTZBURG 94 N.E.100 ST. Contractor(s) Phone Cell Phone Valuation: $ 158,000.00 as CONSTRUCTION INC _ (786)229-5666 Total Sq Feet: 300 Approved:•In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final PE Certification Date Denied: Tie Beam Bond Beam Type of Construction:MOVE KITCHEN TO NEW ADDITIO Occupancy:Single Family Window Door Attachment Stories: Exterior: Slab Front Setback: Rear Setback: Termite Letter Left Setback: Right Setback: Framing Bedrooms:3 Bathrooms:2 Insulation Plans Submitted:Yes Certificate Status: Drywall Screw Certificate Date: Additional Info:MOVE KITCHEN TO NEW ADDITION Trusses Plan Submittal Bond Return: Class cation:Residential Roof Sheathing Spot Survey Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Wall Sheathing Rake Beam CCF $94.80 Invoice# RC-12-1453838 C Fee $50.00 Footing CO/CC/CFee $71.10 05/27/2015 Check*101 $5,418.00 $200.00 Window and Door Buds DBPROCA Fee $71.10 12/08/2014 Check#:2556 $200.00 $0.00 Roof Trusses Education Surcharge $31.60 Density Permit Fee $4,740.00 Fill Cells Columns Plan Review Fee(Engineer) $40.00 Wire Lathe Plan Review Fee(Engineer) $160.00 Final Building Plan Review Fee(Engineer) $160.00 Declaration of Use Plan Review Fee(Engineer) $40.00 Review Structural Scanning Fee $33.00 Review Structural Technology Fee $126.40 Review Structural Total: $5,618.00 Review Planning Review Building Review Building Review Building Review Building Review Mechanical Review Electrical Review Electrical Review Electrical Review Plumbing Review Plumbing 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. May 27,2015 1 Miami Shores Village ; Mt ,, 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 Phone: (305)795-2204 a Expiration: 1123/201 Project Address Parcel Number Applicant 94 NE 100 Street 1132060131190 DONALD SALTZBURG Miami Shores, FL Block: Lot: Owner Information Address Phone Cell DONALD SALTZBURG 94 N. E.100 ST. Contractors) Phone Cell Phone Valuation: $ 158,000.00 as CONSTRUCTION INC _ (786)229-5666 _ Total Sq Feet: 300 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final PE Certification Date Denied: Tie Beam Bond Beam Type of Construction:MOVE KITCHEN TO NEW ADDITIO Occupancy:Single Family Window Door Attachment Stories: Exterior. Slab Front Setback: Rear Setback: Termite Letter Left Setback: Right Setback: Framing Bedrooms:3 Bathrooms:2 Insulation Plans Submitted:Yes Certificate Status: Drywall Screw Certificate Date: Additional Info:MOVE KITCHEN TO NEW ADDITION Trusses Plan Submittal Roof Sheathing lBond Retum: Classification:Residential Spot Survey Fees Due Amount Pay Date Pay Type Amt Paid AmWall Sheathingt Due Rake Beam CCF $94.80 Invoice# RC-12-14-53838 C Fee $50.00 Footing CO/CC O/CFee $71.10 05/27/1015 Check#:101 $5,418.00 $200.00 Window and Door Buck DBPRDCA Fee $71.10 12/082014 Check#:2556 $200.00 $0.00 Roof Trusses Education Surcharge $31.60 Density Permit Fee $4,740.00 Fill Cells Columns Plan Review Fee(Engineer) $40.00 Wire Lathe Plan Review Fee(Engineer) $160.00 Final Building Plan Review Fee(Engineer) $160.00 Declaration of Use Plan Review Fee(Engineer) $40.00 Review Structural Scanning Fee $33.00 Review Structural Technology Fee $126.40 Review Structural Total: $5,618.00 Review Planning Review Building Review Building Review Building Review Building Review Mechanical Review Electrical Review Electrical Review Electrical Review Plumbing Review Plumbing OWNERS 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. Futhermore,I authorize the above-named contractor to do the work stated. May 27,2015 2 •r Miami Shores Village ,;> �• 3W, x 10050 N.E.2nd Avenue NE � 3 { Miami Shores,FL 33138-0000 ` Phone: (305)795-2204 i iii;.}i,...., ,+ E 1-,...' t' •'.9a,,. mak, „ Expiration: 1112312015 Project Address Parcel Number Applicant 94 NE 100 Street 1132060131190 DONALD SALTZBURG Miami Shores, FL Block: Lot: Owner information Address Phone cell DONALD SALTZBURG 94 N.E.100 ST. Contractor(s) Phone Cell Phone Valuation: $ 158,000.00 Q'S CONSTRUCTION INC (786)229-5666 Total Sq Feet: 300 Approved:In Review Available Inspections-. Comments: Inspection Type: Date Approved::In Review Final PE Certification Date Denied: Tie Beam Bond Beam Type of Construction:MOVE KITCHEN TO NEW ADDITIO Occupancy:Single Family Window Door Attachment Stories: Exterior: Slab Front Setback: Rear Setback: Termite Letter Left Setback: Right Setback: Framing Bedrooms:3 Bathrooms:2 Insulation Plans Submitted:Yes Certificate Status: Drywall Screw Certificate Date: Additional Info:MOVE KITCHEN TO NEWADDITION Trusses Plan Submittal Bond Return: Classification:Residential Roof Sheathing Spot Survey Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Wall SheathingRake Beam CCF $94.80 Invoice# RC-1214-63838 C Fee $50.00 Footing CO/CC O/CFee $71.10 0527/2015 Check#:101 $5,418.00 $200.00 Window and Door Buck DBPRDCA Fee $71.10 12/082014 Check#:2556 $200.00 $0.00 Roof Trusses Education Surcharge $31.60 Density Permit Fee $4,740.00 Fill Cells Columns Plan Review Fee(Engineer) $40.00 Wire Lathe Plan Review Fee(Engineer) $160.00 Final Building Pian Review Fee(Engineer) $160.00 Declaration of Use Pian Review Fee(Engineer) $40.00 Review Structural Scanning Fee $33.00 Review Structural Technology Fee $126.40 Review Structural Total: $5,618.00 Review Planning Review Building Review Building Review Building Review Building Review Mechanical Review Electrical Review Electrical Review Electrical Review Plumbing L / Review Plumbing t._ __.-_`J- -a _t• l _ - � a4: .._Ct 1 _-...__ i_ ._-.2_...-_ iL_ ._.._J 4_-_...-J-_ C- __ Authorb g Owner / Applicant / Contractor / Agent Date Building Department Copy May 27,2015 3 Miami Shores Village :iF Building Department10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION UNE PHONE NUMBER:(305)762-4949 FBC 2010 BUILDING Master Permit No. � PERMIT APPLICATION Sub Permit No. QBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION E]RENEWAL ❑PLUMBING ECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 94 100 Street City Miami Shores County Miami Dade Zip: . Folio/Parcel#:11-3206-013-1190 Is the Building Historically Designated:Yes NO )(XOC Occupancy Type: Residential Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Na (F )mple Titleholder):Donald &Wendy Saltzburg Phone Address:94 100 Street City: Miami Shores State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Q's Construction, Inc. Phone#: 786-229-5666 Address: 7005 N Waterway Drive, Suite 304 City: Miami state: FL Zip: 33155 Qualifier Name: Alfred Quero Phone#: State Certification or Registration#: CGC1508464 Certificate of Competency#: DESIGNER:Architect/Engineer: ` Phone#: Address: rr Vila QJ �1 ��� �� amity:Mootage t SState: Zip: ?�Cd Z� Value of Work for tthiss Permit:$ o Square/U of Work: Type of Work: Li'l Addition Q Alteration El New ❑ Repair/Replace El Demolition Description of Work: Remodeling of kitchen and bathroom. Specify color of color thru tile: Submittal Fee$ Permit Fee$ Ll 1-7 Llo ` CCF$ • CO/CC$ Scanning Fee$32-00 Radon Fee$ I I • LO DBPR$ -1 (• (� Notary$ Technology Fee$_ 12(p •L4C:) Training/Education Fee$ 3 1 - �P® Double Fee$ Structural Reviews$ •�� (0 C:>• V00.®• O . ®0 Bond$ TOTAL FEE NOW DUE$ 54 1 • C3" (Revised02/24/2014) t Bonding Company's Name(if applicable) N/A Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) N/A Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature ��/OVNERWGENTNIT RACTOR The foregoing instrument was acknowledged before me this The foregoing i trum t s acknowledged before me this 21st day of May .20 2015 by 21 st day of May .20 15 .by ho is personally known to Alfred Quero ,who is personally known to me or w o has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: ` Sign: Print: Print: Arl Noteryr Public•Stete ol Flame .i �"0—% ARLENE TORRES ''"Seal a�� ' ppmry PubNc•State of Fide Seal %:F �� Conunissibn#►FF 108184 :,� car ru�a�� yf� My Comm.Expires Apt 18,2018 ••,� ;.•' Commissfon s FF 108184 ****************** ** * * *** ********************************************************************** APPROVED BY �O I Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (85 0)487-1395 .a 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 QUERO,ALFRED A Q'S CONSTRUCTION INC 7005 N.WATERWAY DRIVE SUITE 304 MIAMI FL 33155 Congratulations! With this license you become one of the nary :, on milli FI radians this the Department of Business and 8 on O by pa rofessionals and businesses range Professional Regulation. Our p g STATE OF FLORIDA from architects to brokers,from boxers to barbeque restaurants, Y� DEPARTMENT OF BUSINESS AND and they keep Florida's economy strong. PROFES.81 0 ,1�ALR GULATION E n fi ";TS'. v work to improve the way we da business in order to Every day we w P Y CGC1508484 -,.0812812014 you ou better. For information about our services,please log onto -' www m fiorldolicense.com. There you can find more information Y , , Y CERTIFIED Gt�i• _. •C��?Ni Chi t... 5......CauaY.: about our divisions and theulations that impact you,subscribe reg QUERO,ALF to department newsletters and loam more about the Department's Q'S CONSTR initiatives. ;. �.. Our mission at the Department is:License Efficiently,Regulate Fairly. We constanq strive to serveou better so that you can serve y our customers. Thank you for doing business in Floida, IS CERTIFIED under the provisions of Ch.489 FS. and congratulations on your new licensel ExpUatb dere:AUG 31,2016 L14082MXX12MS DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD WC 1s1 MS4 The GENERAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. , Expiration date: AUG 31,2018 »� ➢w,. 4 '+ ". ■ QUERO,ALFRED A Q'S CONSTRUCTION !11{ � w: Fn.r 7005 NORTH WATERWA, -, "::.: ip UNIT 304 .. : ti MIAMI FL 33155 _ •:�;;y'•. oma- . "^.•5w3r5'. . .....�.n-A.'�fiX+a.». �0 .-'0�era ... - � -'4.b......31A..:• 4 7..y`'":. .> ISSUED: 0er28=14 DISPLAY AS REQUIRED BY I AtAr -- Local Business Tax Receipt Miami-Dade County,. State. of Florida THIS IS NOTA BILL - 00 NOT PAY �LBT ) 4283651 BUSINESS N"IMMOCA 'ION a "NO• EXPIRES QSCONMUCT1oNINC RENEWAL SEPTEMBER 30, 201E 7005 N WATERWAY DR 304 4472365 Must be displayed at piece of business MIAMI FL 33155 Pursuant to County Code Chapter SA-Art 9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEnnW QS CONSTRUCTION INC 196 GENERAL BUILDING CONTRACTOR BY TAX COLLECTOR Workers) 10 CGC1508464 $82.50 10/06/2014 CREDITCARD-15. 0815 This Local Business Tax Receipt only confirtM payment of the Local Bashress Tax.The 800010 is not a 1109880, wait,ere cortI& 11,a of the hol squal ifioadms,to do business.Holdercaaet oomph writb any goventaxoNl or son&wermreatal regulatory laws and requiremeals whioh apply to the bum. The MCEIPT N&above sent badisplaysd on all sonvowlel vehicles-mad-ReiISCods Sao an-VIL, For msre baisrnuation,vW UA l t(lVlWUUlT T) AcoRD ' • • ' j CERTIFICATE OF LIABILITY INSURANCE iSept4,2014 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Florida Insurance Agency of Miami ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O.Box 441340 HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Miami,Fl.33144 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P;305-445-8100 INSURER AFFORDING COVERAGE NAICS# INSURED INSURER A. Essex Co Q,s Construction Inc INSURER B: 7006 N Waterway Dr INSURER C. Miami Fl 33156 INSURER D: INSURER E: INSURER F: coYem9es THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT- WITHSTANDING 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 TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADOL EFFECTIVE EXPIRATION LTR INSR TYPE OF INSURANCE POLICY NUMBER (MM1DDtYY) (MMIDDIYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE 1.000.000 D70=E 10 REM I ED COMMERCIAL GENERAL LIABILITY PREMISES(Es oCCUn'er=) $100100( CLAIMS MADEX�OCCUR MED EXP(anyone person) 58,00( A3df6277-01 6112/2094 619212015 PERSONAL&ADV INJURY 1.000.000 GENERAL AGGREGATE 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG 1.000.000 POLICY PROJEC LOC AUTOMOBILE LIABILITY (E BIN SINGLE LIMIT a accident} $ ANY AUTO (E ALL OWNED AUTOS ' (Per SCHEDUL ^ ED AUTOS Person) _ $ HIRED AUTOS �� _ NON-OWNED AUTOS (Per Accident) $ (Per Accident) ANY AUTO AUTO ONLY AGG ALL OWNED AUTOS EACH OCCURRENCE,F7 _ OCURR CLAIMS MADE AGGREGATE RDEDUCTIBLE RETENSION 5 $ EMPLOYERS LIABILITY TORY LIMITS ER ANY PROPIERTORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? ��+'�1Y- if yes describe under SPECIAL PROVISIONS below DESCRIPTION OF OPERATIONS 1 LOCATIONS1VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS: GC1508464 UC1224136 FC1427045 x ICERTIFICATE HOLDER I JADULINSURED___ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BFORE THE EXPIRATIC Mialni Shores VllhgeDATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHAT Budding DepaT(wnt IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURED,ITS AGENT OR 10050 NE 2nd AVenue AUTHORIZED REPRE ENTATIVE Miami Shores, FL 33138 Tony Zoghbi -Z ACORO z5(zoolros) Aco CORPORATION 1988 ACOI • ' 'CERTIFICATE OF LIABILITY INSURANCE °"'�`M °°"�""' 05/06/2015 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:If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER cONTAcT NAME Joel E.Sanchez Emmanuel insurance&Associates,Inc. PHONNE : (305)693-0003 No; (305)691-4381 2370E 8TH AVE A-DDDRESs: joel@emmanuelinsurance.com INSURERS)AFFORDING COVERAGE NAIC 0 HIALEAH FL 33013-4236 INSURER A: BusinessFirst Insurance Company 11697 INSUREDINSURER B Q'S CONSTRUCTION INC. INSURER C: ALFRED A.QUERO INSURER 0: 7005 N WATERWAY DR STE 304 INSURER E: MIAMI FL 33155-2834 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER MMIDO EYYY)FF MMN LIMITS GENERAL UABILITYEACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 11 CLAIMS-MADE 71 OCCUR MED EXP(Arty one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ POLICY PRO- Loc $ AUTOMOBILE LIABILITY COMBINED $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALOWNED SACOEDDULED BODILY INJURY(Per acxideru) $ AOSHIRED AUTOS NON-OWNED ED Per a E $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAS CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION STATU- O R- AND EMPLOYERS'LIABILITY T ANY PROPRIETORIPARTNER/EXECUTIVE YIN N E.L.EACH ACCIDENT $ 1,000,000.00 A OFFICERIMEMBER EXCLUDED? ❑Y N I A Y 0521-11041 01/242015 06/06/2015 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000.00 If yes,describe urs 1,000,000.00 DESCRIPTION OF OPERATIONS beer E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,I more space is required) Contractors. Licensed No CGC1508464 CUC1224136 CFC1427045 Any Changes or afterations Done to this document after being issued shall constitute it null and void. CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10050 NE 2nd Avenue I Miami Shores,FL 33138 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Email:sailybumstad@bumstadinteriors.com ACCORDANCE WITH THE POLICY PROVISIONS. Email:PBROWN@miamidade.gov AUTHORIZED REPRESENTATIVE ®1988-2010 ACORD CORPORATION.All:rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1 t � Miami Shores Village 71 cFTVRR ff DEC 0 S 2014 Building Department Bim• 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION UNE PHONE NUMBER:(305)7624949 FBC WO BUILDING Master Permit Nokc ILA • 26 -4 PERMIT APPLICATION Sub Permit No. BUILDING ❑ELECTRIC ❑ ROOFING REVISION ❑EXTENSION ❑RENEWAL ❑PLUMBING M MECHANICAL MPUBLICWORKS ❑ CHANGE OF [:]CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: T4• lU e !Do "�� ST_ City: Miami Shores County: Miami Dade zip: 3 3 t 3 a Folio/Parcel#: 1190 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): i^y4 C� \�7��4 j Phone#3p , Address:Nk® &vc�y1 _ City: 'l 5sl% i 15is 0518.5, State: Zip: Tenant/Lessee Name: Phon Email: CONTRACTOR:Company Name: St¢ "c- • � XVone# ���'4�3-52?Z Address: t ZZC> ,.�► City: v«r State 'Ft '"'r Zip• 3,3 23' Qualifier Name: A a Phone#: 4f4 .44A-&`'t%9 State Certification or Registration#:C C.e-Cc--,25&.3 Certificate of Competency#: DESIGNER:Architect/Engineer. I&SLAG ACZ.. J_A-rN i Phone#: 30b'- *3&I-33d Address: 1"I Of-<3 S� t 1 't"57 City: w►.R446 S State:Tom.. zip: 3 3d2dj Value of Waft for this Permit: Square/Linear Footage of Work: 3 2 Type of Work. L1 Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: W\kQU F K t•T4 0"-� '•rt' t�JE cu Arwot m-m%- '; iM i1�r" [G1Tcd}E� .o -bG3►1G- l+► o Specify cplor of color thru tile: Submittal Fee$jQQ•[Zd_Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Rewbedo2/24/2014) Bonding Compares Name(if apple") Bonding Company's Address City State Zip Mortgage Lenders Nance Pf applllcabie) Mortgage Lenders Address City , State ZIP. Application Is hereby made to obtain a permit to do the work and Installations as Indicated. I certify,tfM no work or Installation has 001nn"wed 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, SIGN, POOLS, FURNACES,BOILERS,HEATERS,TANKS,AIR CONDI IONEIM ETC.— OVJNEFeS AFRDRVR I certify drat all the foregoing kdamatfon Is accurate and drat all work will be done In corm with all applicable laws regulating construction and zoning. . "WARNING TO OWNER: YOUR FAIWP4E TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR YEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT YOU NDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEME Notice to Appffimwe As a n to the Issuance of a esdnxmd value exceeding$2M the applkant must promise in good faftii that a copy of the nye of room ffen low brochure wiff be deli er ed to the person whose propertyis=*,ct to attachment Also,a c+eVkd copy f mustbe posted at dwjob site for the fist hit which occurs seven(7)days after the Is In the absence of such posted notice, the inspection wX not be approved and a rekWecdon fee will be Suture Signature r! OWNER or AGENT CIOR TheInstrument was acknowledged before me this The forego instrument was acknowledged before me this fi�'1 day of 20 �by �day c C�LeU .20 -by 1 lt%�Y�IY 9 T4 �7_�U � ruin is!ersonal to A flkhn 91�.s11'aV .wtro it 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 PUB : sign Print: ' Pti PAULA NEIL J.RUSSILLO �' _ Carnmission#FF 146589 Seal: EXOMCanmbebn#FF 046232 Expires August 10,2018 DeanmtIer 15,2017 ftWW In TMY F&1=mwlOp3WM* Bp�tTAaTm►Fe1n Nae 1Q18 #+IM►+�+t+tYif+t+MiRiqR .ie�rf+tPPt+RMq#iMittlu,#f� APPROVED BY Plans Examine' �� 2ont wl.-e r.., 1, Structural Review Clerk L(RrA d=A4AM4) ke-� ;n n►,i rrl1%e.N C�9%S Ore.. akNo"h ��kh►e:�ule r m w:n6mb 1 ?co v%degA c*n.elaw oS �'ca�cct uo,ocoa �a-vex s for 4+10- r►�rxs��f . ncl•L^VVQ%J1.4,OCt Mr_1MRT STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD _ w CGC002863 The GENERAL CONTRACTOR ' Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 SIRAVO,ANTHONY SIRAVO&GUERRIERI INC ,.. 1220 DANBURYAVENUE e DAVIE FL 33325-1243 ISSUED: 08/14/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1408140001921 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2014 THROUGH SEPTEMBER 30,2015 DBA:SIRAVO & GUERRIERI INC Receipt Type- CONTRACTOR (GENERAL) Business Name: Business Type: Owner Name:ANTHONY s=RAvo Business Opened:07/16/1993 Business Location:13730 STATE RD 84 State/County/Cert/Reg:CGC002863 DAVIE Exemption Code: Business Phone: Rooms Seats Employees Machines Professionals ; 19 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF FeePenalty Prior Years Collection Cost Total Paid 54.00 0.00 0.00 0.00 0.00 0.00 54.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature.You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location.This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: ANTHONY SIRAVO Receipt #ICP-13-00013995 1220 DANBURY AVE Paid 08/28/2014 54.00 DAVIE, FL 33325 2014 - 2015 From:Andrea Creller FaxID: Page 2 of 2 Date:1Ill 112014 05:35 PM Page:2 of 2 , R t . • � OP ID:AC A�C'pRL7'" DATa(IdBOtDDlYYYY) �,...- CERTIFICATE OF LIABILITY INSURANCE 11J11r2014 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(ft AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollutes)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder M ileu of such endorsement s PRODUCER NAL1E:TAcT Joseph Plechura Gateway-Acentria, LLC PHOS54 73B.gEQp F :954-735-2852 2430 West Oakland Park Blvd. Ft Lauderdale,FL 33311 EIMAILADDRESS: CIBTOMERID w.SIRAN02 BISU AFFORDING COVERAGE NAS s INSURED Siravo S Guerrieri,Inc. INSURER A:Brill efield Employers Ins Co 10701 Attn: Mr.Daniel Guerrieri w=mER a:Evanston Insurance Company 1220 Danbury Avenue musuat c:Scottsdale Insurance Com parr Davie,FL 33325 ID:General Insurance Com pany 24732 w=nanE:SL Paul Travelers 00070 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. POUL WJM POLICY EFF POLICY EXP L TYPE OF INSURANCE POLICY MAMR LIME s GENERAL LIABILITY = OCCURRENCE $ 11000, C X COMMERCIAL GENERAL LIABILITY CPSISSS095 1213112013 1213112014 PREMISEs(E"..0 rence $ 100,04 CLAIMS-MADE ®OCCUR MED EXP(AnV one person) $ 51 PERSONAL&ADV INJURY $ tow'04 GENERAL AGGREGATE $ 2,000, ikid KEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 1,0K POLICYX JECT F-1 PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1'000jD X ANY AUTO 2CC31021710 12/3112013 12131120'14 (Ea ecUtleng BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (PER ACCIDENT) $ X NON OWNED AUTOS PIPwx UMBRELLA LIAB X OCCUR EACH OCCURRENCE X EXCESS " CLAIMS-MADE AGGREGATE $ 1,000, B OVA646213 1213112013 12/3112014 DEDUCTIBLE $ X RETENTION $ none $ WORKERS COMPENIRATIONX WC STATU- OTH- AND EMPLOYERS'LUU39 7Y ORY I IT ER A ANY PROPRIETORIPARTNERJEXECUTIVE Y 1 N 83022848 12/3112013 1213112014 E.L.EACH ACCIDENT OFFICERIMEMBER EXCLUDED? El N J A (Mandatory M NH) E.L.DISEASE-EA EMPLOYEE $ , Ityyes describe under �qulpmwfl E5 RIPTION OF OPERATIONS below_____" E.L.DISEASE-POLICY LIMIT $ 500, E entedAeased 708039846658 12131/2013 1213112014 Limit 110, deduct 1, DESCRVTICN OF OPERATIONB 1 LOCATIONS t VEMCLES(Afteh ACORD 101,AddlSwW RmuuM Schedule,irmere spate is r"Wred) GCO02863 CERTIFICATE HOLDER CANCELLATION MIASH01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE THE EXPIRATION DATE THEREOP, NOTICE wL.L BE DELIVERED IN ACCORDANCE WFrH THE POLICY PROVISIONS. BUILDING DEPT 10050 N.E.2 AVENUE AUnIDWZEDREPRESENRAWE MIAMI,FL 33138 9409*- 0 1986 2009 ACORD CORPORATION. AN rights reserved ACORD 25(2009/0 The ACORD name and logo are registered marks of ACORD Property Search Application - Miami-Dade County Pagel of 8 4 Address Owner Name Folio SEARCH: 94 NE 100 St. Suite Back to Search Results PROPERTY INFORMATION Folio: 11-3206-013-1190 Sub-Division: MIAMI SHORES SEC 1 AMD Property Address 94 NE 100 ST Miami Shores, FL 33138-2315 Owner DONALD SALTZBURG&W WENDY Mailing Address 94 NE 100 ST MIAMI SHORES, FL 33138-2315 Primary Zone 1000 SGL FAMILY-2101-2300 SQ Primary Land Use 0101 RESIDENTIAL-SINGLE FAMILY: 1 UNIT Beds/Baths/Half 3/2/0 Floors 1 Living Units 1 http://www.miamidade.gov/propertysearch/ 2/19/2016 Property Search Application - Miami-Dade County Page 2 of 8 Actual Area 2,680 Sq.Ft Living Area 1,632 Sq.Ft Adjusted Area 2,200 Sq.Ft Lot Size 13,886.25 Sq.Ft Year Built 1946 I ,Y a• �k 1 �� !l��� IsllllllP PSI t a} E e Aenal'OhOtography 60ft' Featured Online Tools Comparable Sales Glossary Non-Ad Valorem Assessments PA Additional Online Tools http://www.miamidade.gov/propertysearch/ 2/19/2016 Prpperty Search Application-Miami-Dade County Page 3 of 8 Property Record Cards Property Search Help Property Taxes Report Discrepancies Report Homestead Fraud Tax Comparison Tax Estimator TRIM Notice Value Adjustment Board ___. MMS. ........, ASSESSMENT INFORMATION Year 2015 2014 2013 ". Land Value $264,172 $264,172 $181,049 Building Value $153,120 $149,160 $149,160 , Extra Feature Value $1,940 $1,971 $2,001 °- Market Value $419,232 $415,303 $332,210 ' Assessed Value $291,143 $288,833 $284,565 _, , ,,.,,..., ..... ....... . ........... .. ,,. „.,.,. . ... TAXABLE VALUE INFORMATION 2015 2014 2013 __..__...__..._..... . .......... -.._............._........ .................._.._. ' n COUNTY Exemption Value $501000 $50,000 $50,000 .... ............ ............. .. Taxable Value $241,143 $238,833 $234,565 ,, I, SCHOOL130ARD Exemption Value $25,000 $25,000 $25,000 Taxable Value $266,143 $263,833 $259,565 ............ --.._...__....._................_._-_......._.................._..................................----------------_....................-.--._.-....................._.._..._.-......................................._-..............._....................._...__.................. CITY Exemption Value $50,000 $50,000 $50,000 Taxable Value $241,143 $238,833 $234,565 ....................................... .................................-. _.._......._....._.............................--....................................................._ .._................................. ..... ..... . ... ............................._ ............... REGIONAL Exemption Value $50,000 $50,000 $50,000 Taxable Value $241,143 $238,833 $234,565 BENEFITS INFORMATION Benefit Type 2015 2014 2013;. Save Our Homes Cap Assessment Reduction $128,089 $126,470 $47,645 u Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 E hq://www.miarnidade.gov/propertysearch/ 2/19/2016 Property Search Application-Miami-Dade County Page 4 of 8 + Note:Not all benefits are applicable to all Taxable Values(i.e.County,School Board,City,Regional). FULL LEGAL DESCRIPTION MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 12 3 LESS W35FT BLK 9 LOT SIZE IRREGULAR i OR 19858-4972 08 2001 1 SALES INFORMATION Previous Sale Price OR Book-Page Qual fication Description 08/01/2001 $235,000 19858-4972 Sales which are qualified 11/01/1989 $0 14348-2371 Sales which are disqualified as a result of examination of the deed 04/01/1989 $0 14059-2167 Sales which are disqualified as a result of examination of the deed For more information about the Department of Revenue's Sales Qualification Codes. ........... 2015 2015 : 2014 2013 LAND INFORMATION Land Use Muni Zone PA Zone Unit Type Units Calc Value GENERAL R-17.5,R-18.5 1000-SGL FAMILY-2101-2300 SQ Front Ft 81.00 $177,209 GENERAL R-17.5,R-18.5 1000-SGL FAMILY-2101-2300 SQ Front Ft. 39.75 $86,963 w: BUILDING INFORMATION Building Number Sub Area Year Built Actual Sq.Ft. Living Sq.Ft. Adj Sq.Ft. Calc Value 1 1 1946 2,357 1,632 1,985 $138,156 1 2 1959 323 0 215 $14,964 Building Sketches Availablei EXTRA FEATURES r Description Year Built Units Calc Value Chain-link Fence 4-5 ft high 1975 125 $630 Wall-CBS 4 to 8 in,reinforced 1975 297 $1,310 http://www.miamidade.gov/propertywArch/ 2/19/2016 Property Search Application-Miami-Dade County Page 5 of 8 _....._.—_.........._......... . ................._...----...... ......_.--_. ..............................................................__.................................._._.................................._ . .......... . . ..............................._._..__............... ....... ADDITIONAL INFORMATION The information listed below is not derived from the Property Appraiser's Office records.It is provided for convenience and is derived from other government agencies. � LAND USE AND RESTRICTIONS _._.....w__..___..�..„ .._........„.. ....w..��,___...,.__._,.,..,...._____..._. ._.__._._ ___� Community Development District: NONE Community Redevelopment Area: NONE 1 1 Empowerment Zone: NONE Enterprise Zone: NONE 1 Urban Development: INSIDE URBAN DEVELOPMENT BOUNDARY €j Zoning Code: R18.5- ! Existing Land Use: 10-SINGLE-FAMILY,MED.-DENSITY(2-5 DU/GROSS ACRE). 5 Government Agencies and Community Services .......... __..._..._............._.._ OTHER GOVERNMENTAL JURISDICTIONS y.__.._..___...........__.._._.._......................................................._.................................._«......................................._. .__...__._.._.._.__. _---...._._._._._-----------------------------------__._------------------_.._.._.-._..__.._..-...._......._.__.� - Business Incentives 1 Children Trust City of Miami Shores Environmental Considerations Florida Department Of Revenue Florida Inland Navigation District x Miami Dade County Bulletin Board Non Ad Valorem Assessments I School Board South Florida Water Mgmt District i Tax Collector _ ................ _ _ _ ..._....._.. .... .; The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at http://www.miamidade.govrnfo/disdaimer.asp For inquiries and suggestions email us at http://www.miamidade.gov/PAPortaVContectFomVContactFormMain.aspx. Version:2.0.3 EXEMPTIONS 8 BENEFITS hq://www.miamidade.gov/propertysearch/ 2/19/2016 Property Search Application-Miami-Dade County Page 6 of 8 Deployed Military Disability Exemptions Homestead Institutional Senior Citizens More> REAL ESTATE 40 Yr Building Re-Certification Appealing Your Assessment Defective Drywall Folio Numbers Mortgage Fraud I More> TANGIBLE PERSONAL PROPERTY Appealing your Assessment Assessment Information Search Exemptions Extension Requests Filing Returns http://www.miamidacle.gov/propertysearch/ 2/19/2016 Property Search Application-Miami-Dade County Page 7 of 8 More> PUBLIC RECORDS Address Blocking Change of Name Change of Address Change of Ownership&T'itle Declaration of Condominium More> ONLINE TOOLS Property Search Property Sales Tax Estimator Tax Comparison Homestead Exemption and Portability More> TAX ROLL ADMINISTRATION Appealing your Assessment Reports http://www.miamidade.gov/propertysearch/ 2/19/2016 A Property Search Application-Miami-Dade County Page 8 of 8 More> http://www.miamidade.gov/propertysearch/ 2/19/2016 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850)487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 QUERO,ALFRED A Q'S CONSTRUCTION INC 7005 N.WATERWAY DRIVE SUITE 304 MIAMI FL 33155 Congratulations! With this license you become one of the nearly one 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. , PROFES4I 4rREQULATION Every day we work to improve the way we do business in order to CUC122413$ PER.,,-.0812812014 serve you better. For information abut our services,please tog onto :``�° www.myfloridalicanse.com. There you can find more information CERT UNDER + Fr C l f R about our divisions and the regulations that impact you,subscribe QUERO,ALF >;: ` ``"•Y:. to department newsletters and learn more about the Department's Q'S CONSTR initiatives. Our mission at the Department is:License Efficiently,Regulate Fairly. ."'sem We constantly strive to serve you better so that you can serve your Customers. Thank you for doing business in Florida, s IS CERTIFIED under the"Ordifisions of Ch.489 FS. and congratulations on your new license! +M AUG 31,2016 L140828DOMM i I DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION i CONSTRUCTION INDUSTRY LICENSING BOARD i . i CUC1224136 The UNDERGROUND UTILITY&EXCAVATION CO.;-Y=:` - Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2018 QUERO,ALFRED A Q'S CONSTRUCTION I 7005 N.WATERWAY"© SUITE 304 MIAMI FL 33155imp 8 7. E ISSUED: 06/28!2014 DISPLAY AS REQUIRED BY LAW cF^" '"^,.^^^^----- I 001237 Local Business Tax Receipt Miami-Dade County, State of Florida THIS IS NOTA BILL — DO NOT PAY 5890448 \ILBT EBBS NA 1111.0"TION =013wr NO. EXPIRES Qs ams=cndN INC RENE'W'AL SEPTEMBER 30, 2015 7005 N WATERWAY DR 304 6144273 must be displayed at place of business MIAMI R 33155 Pursuant to County Code Chapter 9A-Art.9&10 OWNER Sloe.Typo OR BUBINEGG PAYMENT RECEIVED Q$CONSTRUCTION INC 196 SPECW.TY ENGINEERING CONTRACTBY TAX COLLECTOR Worket(s) 1 CUC1224136 $82,50 10/06/2014 CREDITCARD-15-000815 Thin Local Basioass Tex Recei confines papaest of the Local Business Tax.The Receipt Is act it Ifaanes. poreft o or a aerdRa�x of fire holdeYs aalffloadoas,to do bn .Holder a� wRh any govermadd q a vrbiatn to the business. � oto laves�1 re irenenats h +fq� �I q app The RECOff NO.above molbe displayed on aR cowwetcial vehicles— Cade Sac 8a-278. fatstare Wonsadon.visft