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DS-16-1113 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fan: (305)758-8972 Inspection Number: INSP-263287 Permit Number. DS4-16-1113 Scheduled Inspection Date:July 18,2016 Permit Type: Driveways/Sidewalks/Slabs Inspector Mesa,Michel Inspection Type: Final Owner. CEDENO,JOSE Work Classification:Addition/Alteration Job Address:157 NE 101 Street Miami Shores,FL Phone Number (857)998-0378 Parcel Number 1132060131951 Project: <NONE> Contractor: ALL DESIGN CONCRETE CORP Phone:(305)320-8484 Building Department Comments DRIVEWAY,SIDEWALK AND WALKWAY n o arse Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-257534.7-1416 need to finish landscaping. Failed Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled untll reinspection fee Is paid 3 July 15,2016 For inspections please call: (305)782-4949 Page 29 of 44 Miami Shores Village 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 � 3 Phone: (305)79-r-2204 ,E ��� �a %Rv � Expiration: 12103/20'i 6 <a, Project Address Parcel Number Applicant 157 NE 101 Street 1132060131951 JOSE CEDENO Miami Shores, FL Block: Lot: Owner Information Address Phone Cell JOSE CEDENO 157 NE 101 Street (857)998-0376 MIAMI SHORES FL 33138- 157 NE 101 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone $ 3,800.00 Valuation: ALL DESIGN CONCRETE CORP (305)320-8484 Total Sq Feet: p Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final Date Denied: Foundation Type of Work:DRIVEWAY,SIDEWALK AND WALKWAY Additional Info: Review Planning Bond Retum: Classification:Residential Review Building Scanning:3 Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Owners Bond $500.00 Invoice# DS-4-16-59532 CCF $2.40 04/26/2016 Cash $50.00 $569.40 DBPR Fee $2.00 DCA Fee $2.00 06/06/2016 Credit Card $569.40 $0.00 Education Surcharge $0.80 Bond#:3103 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $3.20 Total: $619.40 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 i at all t foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construct' nd zo rmore I thorize the above-napiQ conpilictor to do the work stated. June 06,2016 net ner / Applica / Co rector / Agent Date WWI apartment Copy June 06,2016 1 . % Miami Shores Village - _. 6'� Building Department APR ots g - p 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 By: P Tel:(305)795-2204 Fax:(305)756-8972 `0 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201`( BUILDING Master Permit No. DSl (0 _ 1 1 IS PE MIT APPLICATION Sub Permit No.- BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL ❑PLUMBING ❑ MECHANICAL PUBLIC WORKS [:] CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS:in y e, /o/ Com• Miami Shores County: Miami Dade Zip: 355/3 b Folio/Parcel#:p/ a'LO(-�- P13 l`?' cl Is the Building Historically Designated:Yes NO Occupancy Type:_ Load: Construction Type: Flood Zone: BFE: FFE: OWNER:,Name(Fee Simple Titleholder): `750,n; (Z. CA e z 305"- 310-126 Address: A j�Q I f City: /.�a�Q [ �, ?��°r, State: �'� Zip: ` Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name:( 51� �� &Phone#: �� �` �� Address: l- City: State: Zip: Qualifier Name: A 52a Phone#: a., State Certification or Registration#: Certificate of Competency#: 3 eqtkj DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: r Value of Work for this Permit:$ -S. 92010 /'SquaW--near footage.afwork:-S30 Pvd�, 100 S 1&Wd/& Type of Work: ❑ Addition ❑ Alteration ["New Repair/Replace ❑ Demolition Description of Work: Q Specify color of color thru tile: Submittal Fee$ � Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ ' w DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 1= (Revised02/24/2014) S 6q 9 C) . L 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. Signatur Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _day of rL 20 / p by [day of �i ,20 Z� .by Ce..., 4who is personally known to ,- f [�I_ i �1�I'7GC5 �vho is personally known to P 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 PUBLI Sign Sign: ` Print: A Print: ` r Sea[ %- Yagaalin Jackson Seal: � ?�� Exp: Mri 21, M5 =�c � COMMISSION#FF125221 ""'�. •��o�`' YVWW AM ONNTARVACON EXPIRE& May 21, 2018 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) ACQ AUDES141 WIXESON I.-2 ABILITY INSURANCE DADMDVfyMCERTIFICATE OF I6111 . 511812016 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 ALTIat THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSUMM A CONTRACT BETWEEN THE 13SUIN©INSURERS),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMP'ORTAN'T: 9 the cerMaats holder Is a"ADDITIONAL It WRED,ttra polky(Ies)must be endoged. If SUBROGATION IS WAIVED,subject to the tL>t m and eamU um ckf ft POft-Oubin Pdkks rnaY require an ettdorummt A staltemeM on this cumcaft does not oot&r.riabb to the o®rtl[loate[holder In Rau of s"Ch y� Anratfaan Insurance Agency,LLC &AnD Angle Dail 1855 West State Road 434 407}7$$3000 F Lin• 40 7$8-7933 Longwood,FL 32750 AnglaMal 'oatumcom AF URMG COVERAGE NAL_a munmA:Busenwa list Insurance Company 11597 Im B: All DmWn Concrete Corp. awe: 840 W Sat Plans u i Hialeah,FL 33012 INSURER E LNSuRr�F i • CQVSRq©E CERTIFICATE NUMBER: REVISION NUMBER: THIS 18 TO CERTIFY THAT THE POLICIES OF INSURANCELLSTE0 BELOW HAVE BEEN ISSUED TO THE INSURED NAM ED AL3Ot/E FOR THE POLICY PERIOD INDICATED. NOTWITHL3TANDINc3 ANY REQUIFiEAAENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT To WHICH THi3 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN)S SUBJECT TO ALL TL•1jS TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LI&M SHOWNMAy tqAVE BEEN REAUGM BY PAID CLAIMSNm sm . TR TMOFIN.RIr{lAR POUOY ppLlpy CIA6 GAT.uAH87rY Lmm EACH OCCURRENCE g CL.NMS.ArADE F-1 OCCUR ArISEs ocaurretoce $ MED Exp W7=0p") $ PERSONAL,&ADV INJURY 9 CiEMLAOGF'EGA'LT£L[MITAPPIJFA� C31=NFRAI.Ati012EC3ATE $ -.,,.. Fmicy❑sm El SOC PROOLK08-COUP10PAGG $ aurolyoD .e uaenJnr S eoddsrd INGL.E MIT ANYAUTb $ ALL OWNED SCHEDULEDAl�= AUTOS �i Y L1�gJRY(per perecn) g Ndk-OWNED BODIL,Y[NARY raeo dMU) g HIRL'D AUTOS AUTOS S UMBRI IA LAM $ bCCC1R X89 Lm EACH OCCURRENCE g • I DED I I RF:IENILowm AGGREOAV g COMIPE"voN' p�R $ AM S,UA1�Y STATUTE A ANYPROPRIE 0RPARTNE17jD=uTjW YIN 160dabuyl03JQ3/2816 a�LJo3rzo17 "EXCLUDI? NIA E.LFACIt•ACCIDENT g 1.000,00! Ifa EL DISEAK.EA EMpLOM $ 1,000,001 OF C*TAk7Rm ha— a9.I..DLsEq,9E-POLICY LIMIT $ U 00 a,001 4> AON I OPERAYMS I LWATIQNS I VEN10=IAODRD 101,Adm D Shmlmd If m,F.�pgee Is replmedl E130MIl CERTIFICATE HIXDER CANCELkATIoN SHOULD ANY OF THE ABOVE DESCI WED POLICIES 88 CANCELLED lir FORE THE IOMATION DATE THISIMP, NOTICB WILL BE nRUVBRED IN AcOOkUWNCB wrm THE POUCY'PRoVISLONS. Cky of Mlatni Shores Building Dept REPRESENTATIVE 10050 NE 2nd Ave. IMIAMI MO--M_,FL 33138 ACORD 25(201,4/01) The ACORD rrsrne and ®1988-2014;ACORD CORPORATION. Au rights reserved. Io90 are mglstored marks of ACORD ape Co,lc re-6e U&w z pads 2= f o� ural 3000 Ps= ncre�e w r�k 1�6er. 3, �qk = �`' ✓r,ri I M uki On Covw-4c 9'►ds rtr sidewa( 1 4q. rnU !o4l.Y_w 13'0- ra-.F c�� `: . A. v�ernev�}� � G ewa.� '�x '- 3O sox s-w� , ° ►:� NO REVIEW REQUIR 4 l ,.. ;s 0 Florida Health Miami-Dade Cou i O.S.T.D.S. 11 P m - i z k dation No.: - p L Da• 16.00' It vel 37.50' 8 �_ y �� �2ke ••• i � '. 54.83' . �. 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