DS-12-3086 Inspection Worksheet i
Miami Shores Village Cj
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-251573 Permit Number: DS-12-15-3086
Scheduled Inspection Date: July 06,2016 Permit Type: Driveways/Sidewalks/Slabs
Inspector: Mesa,Michel Inspection Type: Final
Owner: REY,GONZALO Work Classification: Addition/Alteration
Job Address:98 NE 103 Street
Miami Shores,FL 33138- Phone Number
Parcel Number 1132060131570
Project: <NONE>
Contractor: TRUE STAMP CONCRETE LLC Phone:(305)494-4465
Building Department Comments
PLAIN CONCRETE DRIVEWAY AND PATIO SLAB IN In ractio Passed Comments
SQUARE SHAPES OF 8'X 8'AND 8'X 6' INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-249301. Need to finish the
landscaping
Failed --to 4S�
Correction
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
July 05,2016 For Inspections please call:(305)762-4949 Page 4 of 21
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it., Concrete
3000 Fsi W/Fiberme h
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Pert No. D -12
446
Miami Shores Village � le/1Tt 7" WAi;EtdfAd,BItabS
10050 N.E.2nd Avenue NE C;l��#oi':AddRio 1/Alteration
Miami Shores,FL 33138 0000 Permit St€atu AP# �tVEt •,
wep e Phone: (305)795-2204
fitORNp
Issue Expiration: 26(2016
Project Address Parcel Number Applicant
98 NE 103 Street 1132060131570
GONZALO REY
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
FGON;ZAALO REY 98 NE 103 Street
MIAMI SHORES FL 33138-
98 NE 103 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation:µ $ 2,400.00
TRUE STAMP CONCRETE LLC (305)494-4465
Total Sq Feet: 2400
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied: Foundation
Type of Work:PLAIN CONCRETE DRIVEWAY AND PATIC Additional Info: Review Planning
Bond Return: Classification:Residential Review Planning
Scanning:3 Review Building
Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Contractors Bond $500.00 Invoice# DS-12-15-58039
CCF $1.80
DBPR Fee $3.00 12/29/2015 Credit Card $719.80 $0.00
DCA Fee $3.00 Bond#:2935
Education Surcharge $0.60
Permit Fee $200.00
Scanning Fee $9.00
Technology Fee $2.40
Total: $719.80
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 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 prize the above-named contractor to do the work stated.
December 29, 2015
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
December 29,2015 1
E
Miami Shores Village
Building Department DEC 5 0'5
�J
10050 N.E,?nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
r ,iWS"P!0N LINE PHONE NUMBER:(305)762-4949
FBC 2011
BUILDING Master Permit No. l J—
PERMIT APPLICATION Sub Permit No.
BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSI N ❑RENEWAL
[]PLUMBING ❑ MECHANICAL PUBLIC WORKS [ CHANGE OF ❑ CANCEL TION ❑ SHOP
C� Q CONTRACTOR DRAWINGS
JOB ADDRESS: ` U NC /03 6 � b
City: Miami Shores County: Miami Dade rzip:
Folio/Parcel#: 0/3 /S' 70 Is the Building Historically Designated.Yes NO C
Occupancy Type:�V �y( oad: ' Construction Type: Flood Zone: 8FE: FFE:
OWNER:Name(Fee Simple Titleholder): 6 Q ti ZZI C�'ry /t a ,� Phone#:.'.
Address — S
City: / / S`YD/l S State: Zip:—23 /.3 r
Tenant/Lessee Name: Phone :
Email:
CONTRACTOR:Company Name: Phone#:_L VV � k
Address: 1Z2-0 Gi w X 6 7`
D
City: 1��� State: zip. -3
Qualifier Name: 7;4-,c-L0 6•SL Phone#
State Certification or Registration#: dj�!"O X O,0 ,7 L/;F Certificate of Competency M
DESIGNER:Architect/Engineer: Phone#I�:
Address: City: State• Zip:
Value of Work for this Permit-$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ll ❑ New Repair/Replace ❑ Demolition
Description of Work: r r✓ C®A✓�/c�fC d�l vaklA�Z 19 N1 � 2�7 5 Lq S��/ 5�7v A IP Sy�oo ag
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ o CCF$- CO/CC$
Scanning Fee'$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee 1$ zlor-- �
Structural Reviews$ Bond$ I,1-I • du
Bonding Company's Name(if applicable)
Bonding Company's Address
City State T�p
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,E*C' :..
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 flrst inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
Inspection will not be approv section fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before-me this
day of 20 by 42- day of Oy C- ,20 by
l(i2 k/ ,who is personally known to who is personall_ nown to
me or who has produced;,L--,. P c.-g -ci Q 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: 44ff Sign:
Print: Print
MY COMMISSION#FF 913308 rr� ARAN
Seal: , o= FxpIpES:September 18,2019 Seal: �, 418C,pltt�yQ
sanded rtw ruhk und*.r s -�', COWSSION#FF 913308
September 18,2019
APPROVED BY �t Plans Examiner Z s / Zoning
Structural Review Clerk
y os
Noon M Miami Shores Village
aH�
Building Department
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:
I. 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.
i
i
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 circumstances,Miami Shores Village does not require verification of
workers'compensation-insurance coverage from the contractor's company for day labor,part-time a ployees or subcontractors.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Signature:
Owner
State of Florida
County of Miami-Dade
The foregoing was acknowledge before me this. /2— ,day of De C _,20/5 .
By L,9,0 ti 16 L Q l e K who is personally known to me or has produced
!� L lc,o,..�2-( as identification.
Notary' ss•a" +ybc ARANELISLJJ
MYCOMMISSISEAL: 0; EXPIRES:Septended rhtu Not"
True Stamped Concrete LLC.
Date: ff,(z-7Z� s
State of:-,,2 6 A-,(
County of, /11/14ft I
Before me this day personally appeared (,&i 66 r//—C-4i/0L who,being duly sworn,
deposes and says:
That he or she will be the only person working on the project located at: Mle, l0
Sworn to(or affirmed)and subscribe before me this 1-7 day of ADI/ .20-L�
by: GIlf�C�,�-�..�
Affiant Signature:
Personally Known:
Or Produced Identification:
Type of Identification Produced:
ARANEus
GON761 F7
W COMMfSSION#FF913m
EXPIRES:September 18,2019
Tbru rotary Pubrr UftdWw tM
Print,Type or Stamp Name of Notary
Miami Shores Village `S oREs
s�
Building Department logo.,
10050 N.E.2nd Avenue
Miami Shores, Florida 33138 r ��
Tel: (305) 795.2204 '��ORI
Fax: (305)756.8972
December 15, 2015
Permit No: DS15-3086
Planning Critique
FRONT CIRCULAR DRIVEWAY CAN NOT BE MORE THAN 12 FT IN WIDTH WITH
FLARES OF NOT MORE THAN 5 FT.
DRIVEWAY MUST BE LOCATED NOT LESS THAN 5 FT FROM RESIDENCE.
LANDSCAPE STRIP OF NOT LESS THAN 2 FT MUST BE PROVIDED BETWEEN
SIDEWALK AND DRIVEWAY.
REAR DRIVEWAY CAN NOT BE MORE THAN 20 FT WIDE.
ONLY GRASS IS PERMITTED BETWEEN DRIVEWAY PADS.
FRONT YARD MUST GRASS, APPROVED PLANTINGS OR DRIVEWAY, PAVING OF
YARD FOR PATIO NOT PERMITTED.
David Daquisto
305-762-4864
Plan review is not complete, when all items above are corrected, we will do a complete
plan review.
If any sheets are voided, remove them from the plans and replace with new revised
sheets and include one set of voided sheets in the re-submittal drawings.
MAP OF BOUNDA.
rvoyc?rs &mMappers
WW'JV 1APrOLLANDSURVE7®RS 00M 98 NE 10"STREET,MM
N.W.72�A� ;TE 3026 1 2e04 DEL R�O®r_VD sOUTs
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(308)262-01v_^-0 ^
:(305)262-04.09 20 0 10
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Mlb n: Rick Scott
r 000t,promote&improve the health Governor
ofall people in Florida through integrated
state,county&community effortsJohn H.Armstrong,MD,FACS
HEALTHState Surgeon General&Secretary
Vision:To be the Healthiest State in the Nation
December 07, 2015
True Stamped Concrete
98 NE 103 Street
Miami, FL 33138
RE: Modification to a Single Family Residence - No Bedroom Addition
Application Document Number: AP1213128
Centrax Permit Number: 13-SC-1643258
98 NE 103 Street
Miami, FL 33138
Lot: 1 2 Block: 12 Subdivision:
Dear Applicant,
This will acknowledge receipt of a floor plan and site plan on 11/18/2015 for the use of the existing
onsite sewage treatment and disposal system located on the above referenced property. Proposed
stamped concrete driveway, and rear stamped concrete slab.
No objection letter was issued by C. Icaza on 12/07/15
This office has reviewed and verified the floor plan and site plan you submitted, for the proposed
remodeling addition or modification to your single-family home. Based on the information you provided,
the Health Department concludes that the proposed remodeling addition or modification is not adding a
bedroom and that it does not appear to cover any part of the existing system. or encroach on the
required setback or unobstructed area. No existing system inspection or evaluation and assessment,
or modification, replacement, or upgrade authorization is required.
Because an inspection or evaluation of the existing septic system was not conducted, the Department
cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use.
You may request a voluntary inspection and assessment of your system from a licensed septic tank
contractor or plumber, or a person certified under section 381.0101, Florida Statutes.
If you have any questions, please call our office at (305) 623-3500.
Sincerely,
r
Carlos I
Engineer III
Department of Health in Dade County
i
Florida Department of Health www.floridahealth.gov
in Dade County• •,Florida TWITTER:HealthyFLA
PHONE: (305)623-3500 FACEBOOK:FLDepartmentofHealth
YOUTUBE:fldoh