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EL-15-2960 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-251757 Permit Number: EL-11-15-2960 Scheduled Inspection Date:January 28, 2016 Permit Type: Electrical- Residential Inspector: Devaney, Michael Inspection Type: Rgh Owner: RIVERA, FRANZ AND JASMIN Work Classification: Generator Job Address:10255 BISCAYNE Boulevard MIAMI SHORES, FL 33161- Phone Number (305)799-0935 Parcel Number 1132050190070 Project: <NONE> Contractor: ELECTRICAL SERVICES JC INC Phone: (305)244~8628 Building Department Comments GENERATOR RELOCATION Infractio Passed Comments INSPECTOR COMMENTS False ��✓�� - Inspector Comments PassedEz Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. January 27,2016 For Inspections please call: (305)762-4949 Page 20 of 23 permft pro. EL-11-15-2960 �yxoRns°ter Miami Shores Village ■ f' rr it Type:Electrical R ldentlal 10050 N.E.2nd Avenue i Wor>r+tcCleslSl+C 010'+Generatoe Miami Shores,FL 33138-0000 Phone: (305)7952204 Permit, t8tu n �.�iF�PI�C��© e eb : oRro� Expiration: 0 6/27/2016 Issue,I�ate::1213t}t2ti'� P� Project Address Parcel Number Applicant 10255 BISCAYNE Boulevard 1132050190070 MIAMI SHORES, FL 33161- Block: Lot: FRANZ AND JASMIN RIVERA Owner Information Address Phone Cell r1 FRANZ AND JASMIN RIVERA 10255 BISCAYNE Boulevard (305)799-0935 MIAMI SHORES FL 33138-2648 10255 BISCAYNE Boulevard MIAMI SHORES FL 33138-2648 Contractor(s) Phone Cell Phone Valua ion: $ 1,000.00 ELECTRICAL SERVICES JC INC (305)244-8628 Total Sq Feet: 10 Type of Work:GENERATOR RELOCATION Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning:1 Review Plumbing Review Planning Review Building Review Electrical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee Invoice# EL-11-15-57865 $2.25 11/24/2015 Check#:2500 $50.00 $115.10 DCA Fee $2.25 Education Surcharge $0.20 12/30/2015 Credit Card $ 115.10 $0.00 Permit Fee-Additions/Alterations $150.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $165.10 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, I authorize the above-named contractor to do the work stated. December 30, 2015 Authorized Signature:Owner / Applicant / Contractor / ate Building Department Copy December 30,2015 1 Miami Shores Village KA Building Department artment NL2 A 2015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 - INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC201 `¢ BUILDING Master Permit No PERMIT APPLICATION Sub Permit Nod._ F-1 BUILDING 16ECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL ❑PLUMBING ❑ MECHANICAL [—]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: Ua5- s SC�_ A5�s_mp City Miami Shores County: Miami Dade Zia: 3N 381, Folio/Parcel#: W32Q'�_—01'11-CO-1C) Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:: OWNER:Name(Fee Simple Titleholder): F-dA%1- d 3 rri Phone#: 06 Z 179 7�/ &0 Address: j ozs G City: VCU A-'v+1 State: i'--�- Zip: ?;w!9 Tenant/Lessee Name: Phon�: Email: ( � •� �y � CONTRACTOR:Company Name: �` ° Gl �� 9 ' Phon Address: Mu City: � �� State: Zip: 331(0 Qualifier Name: �® Phone#: State Certification or Registration#: C 1`)00 Certificate of Competency 1: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: / d 0 c� y Value of Work for this Permit:$ Square/Linear Footage of Work:' ,� Type of Work: ❑ Addition di Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 6e6"W(-AOS fLAslLKAS:j� Specify color thru tile: P fY color of Submittal Fee$ a Permit Fee$ 14®I40V CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ i Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ ° (Revised02/24/2014) i^— a � Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of-a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature `s O ER or AGENT CONTRKCTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this (2 day of ,,2a .20 by _Z> day of I�uW 0 20 by 9AN110 1i ,wh ' personally know to (�V(11 ` ^r i ( O ,who is personally kno n to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLI Sign: S / Print: Print: i - Of FWae =Ca Seal: nfoOl�. Elm Seal: , pera osef12 8081441 * #M'Ifl�t 21.>�18 APPROVED BY /� ��H�d�f� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) NOV-24-2015 23:37 From: To:3057S68972 Pa9e:1,'1 I I i � S 1 y Local gusiness Tax Hec6ipt MiaMi-DadeCounty.State of Ffa ida -7MISfS NOTA BILL-00 NO-e PAY I • I ga�sruas�ntaa�a�vse�c�ROni ag evrs�o. -EXPIRED r ELECTRICAL SERVICE-15 X INC RENEWAL SEP7F—MBER 30, MIS � } 4401 SW 102 AVE I �asrs g srktst be e$OaVVI at plactr of ons#s+� } I MIAMI, EL 33965 I Pursuant to Cony Coda `I I Chaptet At:_9 9c 10 f OWN g-GG-TYPE or-EtEssw as !?AYiNBAiT htGEMd .ELECTRICAL SERVICES JO INC i96 .ELEG�RiCAL EY TAX COL =Iait CON-CRACTOR 75.00 13TI03T2015 I "bricerjs) 1 Eci`30ii55sG =I-15,6747 Alr+s LpoW$nimxs'Tax Hr�iptovly car-"DaY9*=01 ttw Ldeat Radces3Sm Um[itcell is nLRs yC�. r niE or v ferocadca amara bvldar s qua ift0fand,to RPP bu4int.8.HOWet Oast emap11 wt�h W4 WVOTPmesui gisca�s�ermnogtslE roWsrtorp laws and rgquhca),.M Whivit sgplY is7he Is M= s Ttrs$£f13fTF>vfl_.773oy9 awl 1s tlrsyltnyed an M cQrAMt;fcW gebk1w-�saiami-Dade reae Ssc Bs WL �- r-�s-nt>,rc iRtW'>itati0f6yl,ft4v.+ryt�d,�s�darlamiulral'cailarS.v • j I f I ' i STATE OF FLORIDA ©ErMkTMEWT OF BUSINESS AND I PROFESSIONAL RECULKFION I .CC13005560 ISSUED: 06/11/2014 I i I CERTIFIED ELECTRICAL^CONTRACTOR i PORTILLO,JU;DN CARLOS I ,ELECTRi(,AL SERVICES JC INC 1 • s I • i IS CEP.-iFI-mi) srrae: thr; YrcL•Isipna e! Ch 469 FS G:' :ORE tt2.1it�i:t�;1S3 icar?:a::ian oat- �L• '� AIN i sco Ti I ZL I 1 I 11/24/2013 09:53 3056037603 PANDORA INSURANCE PAGE 0_1/01 CERTIFICATE OF LIABILITY INSURANCE �:VI(MMIDDlYYYy) THIS I R T LATE IS ISSUED qS A MATTER OF 1NFQRIUTATION ONawY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2016 HOLDER./THA$ CERTIFICATE DOES NOT AFFIR1fQAT1VELY OR NEGATIVELY AiIAEND,EXTEND pR ALTER THE COVERAGE AFFORDED$Y THE POLICIES f DELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED 11 'REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the ce1`01 ate holder Is en ADDITIONAL INSURED,the Policy{lea)mast be endorsed_ If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain Policies may require an endorsement.A sWement on this certificate holder In lieu of such endorsement(s). certificate does not confer rights to the PRODUCER Pandora Insurance NAM a Murka PHONE 13520 West 13th Ave Suite 155 e-MAIL%-ux l (305)231-9598 (305)675-8034 Hialeah,FL 33012 nlurkafpandorainsvrande.com Phone 305)231-9898 Fax (305)675-8034 INSURERS AFFORDING COVERAGE NAIc# INSURED INSURER A: Ascendant Commercial insurance ELECTRICAL SERVICES JC INSURER F3: Associated Industries Insurance Compan INSURER CI 4401 SW 102 AVE INSURER D MIAMI FL INSURER E! 33165 COVERAGES CERTIFICATE NU14iti INSURER F THIS IS TO CERTIFYTNAT THE POLICIES OP INSURANCE LISTED BELOW HAVE t3EEN IS$UEp TO TME INSIJRi D NAMEb BOREWS-IOVE FIOR�TBHE POLICY PE►�IOD 111 R, INDICATED. NOTWITMSiANDINGANY REQUIREMENT,TERMOR CONDITION pp ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO 1NFiICN THIS CERTIFICATE MAY BE DATION OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, !LEXCLU510NS AND CONDITIONS OF SUCH POLICtI S.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, TR 7YPEOFW$URANCE ADD 3U8R JPOLICY NUMBER PO ICY EFF POLICY E F I!i FOENEIAL L1AgILITY MMI DIYYYY Mmo LIMITS COMMERCIAL GENERAL LMILrrY EACH OCCURRENCE $ 1,000 000,00 A D ❑ CLAIMS-MADE ❑ OCCUR P E T RE NTED � $ 100,040.00 ❑ GL-48549.0 07/01/2015 07/01/2016 MED EXP Argoneperson I 5,000.00 f J PERSONAL&ADV INJURY $ 1,000,000.00 Ifl-ENLAGGREGATELIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000AO ❑POLICY D PRO.-[] L. I PROD UCIS-COMIlAGG $ 1,000,000,00 AUTOMOBILE LIABILITY $ JI ❑ rAUTO {II OMBINdES ED RUTQS DISINGLELIMIT ALLOWNED SCHEDULED I BODILYINJU ❑ AUTOS RY(Per person) $ p HIRED AUTOS D NON-OWNED BODILY INJURY{Per aWden $ AUTOS PRPERD $ ❑ UMBRELLA UAB :1 OCCUR S ❑ EXCESS Lab D CLAIMS-MADE EACH OCCURRENCE i $ DED REYENTION$ AGGREGATE g WORKERS COMPIENsATION AND EMPLOYERS'LIABq,iTY YEN ❑PE S ANY PROPRIETQFVPARTNER/EXECUTI F TH- l3 '.OFFICBoryinN4) EXCLUDED? I I NIA AWC1054878 E,LEACH ACCIDENT $ 1,000,000.00 1 Mandatory in NHl �J 10/30/2015 10/30/2016 Yom.describe under EL DISEASE-EA EMPLOYE $ 1,000,000.00 QESCRIPTION OF OPERATIONS below E,L.DFSEASE-POLICY LIMIT S 1,000,000.00 I OESCRIP7ION OF OPERATIONS I,,-flu-s/VEHICLES I (Attach ACQRp 101.AdetftlOnSi Raniarks Schedule,If mere sPACS IS required! I Licence#EC13005560 I •�—; I I CERTIFICATE HOLDER CANCELLATION Miami Shores Village SHOULD ANY OF THE ABOVE DESCRIBE POLICIES BE CAN, BEFORE THE EXPIRATION DATE THEREOF,NOTIC WILL BE DELIVERED IN !ami l 2nd Ave ACCORDANCE WITH THE POLICY PROVISIONS, Miami Shores,FL.33138 Phone:305-795-2207 AUTHORIZEOItEPRESENTATNE W.305-756-8972 i CORD 252014!01 1 ( )OF ®7988-2014 ACORD CO PORATION, All rights reserver!. The ACORD name and 1090 are registered marks of ACORD U.S.DEPARTMENT OF HOMELAND SECURITY L ATI N ® I FIS OMB No. 1660-0008 FEDERAL EMERGENCY MANAGEMENT AGENCY National Flood Insurance Program IMPORTANT:Follow the instructions on pages,1-9. Expiration Date:July 31,2015 SECTION A—PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name FRANZ E. RIVERA&JASMIN K. RIVERA 15-963 Policy Number: A2. Buildin Street Address includin Apt.,Unit,Suite,and/or Bldg.No.)or PO.Route and Bax No Company NAIL Number: 1255 BISCAYNE E OD. � City MIAMI SHORES state FL 1; =,� Code 33138 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) , LOT 5 LESS E 55 FT.&ALL OF LOTS 6&7,BLOCK 175 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) ritial A5. Latitude/Longitude:Lat. N25°52'11 7R" Long, 1�o zbal.D tt�r�: ❑NAD 1927 ❑x NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain d instc� 11 A7. Building Diagram Number 1 A A8. For a building with a crawlspace or enclosure(s): A9.Fo u}#i wit, n attache garage: a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft b) Number of permanent flood openings in the crawlspace N/A b) Number of permanent flood openings in the attached garage or enclosure(s)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade NIA c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b NSA sq in d) Engineered flood openings? ❑Yes ®No d) Engineered flood openings? ❑Yes ®No SECTION B—FLOOD INSURANCE RATE MAP(FIRM) INFORMATION B1. NFIP Community Name&Community Number B2.County Name B3.State MIAMI SHORES 120652 MIAMI-DADE COUNTY FLORIDA 84. Map/Panel Number B5.Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8.Flood Zone(s) B9.Base Flood Elevation(s)(Zone Revised Date A0,use base flood depth) 12086CO306 L 09/11/2009 09/11/2009 AE 8' BIO.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 89: ❑FIS Profile ®FIRM ❑Community Determined ❑Other/Source: B11.Indicate elevation datum used for BFE in Item 89: ®NGVD 1929 ❑NAVD 1988 ❑Other/Source: 3:12.1s the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? r]Yep ®N$*00:0 Designation Date: / / ❑CBRS El OPA SECTION C—BUILDING ELEVATION INFORMATION (SURVEY REQUI •' ' 000000 IM : • C1. Building elevations are based on: ❑Construction Drawings* ❑Building Under Construction* ®F"Ved Cons;WctiV ;•••• *A new Elevation Certificate will be required when construction of the building is complete. •••0•• • _• ••• • C2. Elevations—Zones Al—A30,AE,AH,A(with BFE),VE,V1—V30,V(with BFE),AR,AR/A,AR/AE,AR/A1—A30,AR/aH4 ARAA"Complete l&aw 69:906 C2.a—h below according to the building diagram specified in Item A7.In Puerto Rico only,enter meters. 900060 •• • ••• •• Benchmark Utilized: B-26-RA Vertical Datum: NGVD 1929 •• Indicate elevation datum used for the elevations in items a)through h)below. ®NGVD 1929 .❑NAVD 1988 Othe;Sourc we e 082.000 Datum used for building elevations must be the same as that used for the BFE. • • • • • Check the measurement used. •••••• a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 8 . 70' K feet' �❑meters • :�: • b) Top of the next higher floor N/A ®feet meters • • c) Bottom of the lowest horizontal structural member(V Zones only) N/A , K feet ❑meters d) Attached garage(top of slab) N/A , ®feet ❑meters e) Lowest elevation of machinery or equipment servicing the building 7 75' K feet ❑meters (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 6 , 90, ®feet ❑meters g) Highest adjacent(finished)grade next to building(HAG) 7 , 10' ®feet ❑meters h) Lowest adjacent grade at lowest elevation of deck or stairs,including N/A , K feet ❑meters structural support SECTION D—SURVEYOR,ENGINEER, OR ARCHITECT CERTIFICATION._ This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information.I certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by tine or imprisonment under 18 U.S.Code,Section 1001. ®Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ®Check here if attachments. licensed land surveyor? K Yes ❑No Certifier's NameISL AI,'--, - License Number ADIS N. NUNEZ 5924 Title Company Name i :,t f- REG LA D SURVEYOR BLANCO SURVEYORS, INC. Addr ss City State ZIP Code 555 N. HORE DR. MIAMI FL 33141 Sign u Date Telephone 11/10/2015 305 865-1200 A Form 086-0-33(Revised 7/12) See reverse side for continuation. Replaces all previous editions. t. ELEVATION CERTIFICATE,page 2 IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number: 10255 BISCAYNE BLVD. City State ZIP Code Company,NAICNumber: MIAMI SHORES FL 33138 SECTION D—SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments LATITUDE&LONGITUDE OBTAINED BY GOOGLE. C2.E)A/C ELEVATION=7.75' CROWN OF THE ROAD ELEVATION: 11.10 ON CENTERLINE ON CENTER OF THE ROAD BM#:B-26-RA LOCATOR#:3250 NE ELEVATION: 17.23' GENERATOR ELEVATION=8.01' Si re Date 11/10/2015 SECTION E—BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1—E5.If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B,and C. For Items E1—E4,use natural grade,if available.Check the measurement used.In Puerto Rico only,enter meters. E1.Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawispace,or enclosure)is ❑feet ❑meters ❑above or ❑below the HAG. b)Top of bottom floor(including basement,crawispace,or enclosure)is ❑feet ❑meters ❑above or ❑below the LAG. E2.For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions), the next higher floor(elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG. E3.Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG. E4.Top of platform of machinery and/or equipment servicing the building is []feet ❑meters ❑above or ❑below the HAG. E5.Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance?❑Yes ❑No ❑Unknown.The local official must certify this information in Section G. 0:***: ••••0 0 0 SECTION F—PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION property owner orbwner's Z N 5d zed representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE)or must sT6"Re.The rct**-*ants in Sections A,B,and E are correct to the best of my knowledge. .Property Owner owOwner's Aut4R MAft[•Representative's Name •0000• ys .. 0000 Ad re • • • • • • •g 0 � 0 0 0 0 0 0 City State ZIP Code 51gh�a�?e ••0• 0 • Date Telephone •0000• •00• •0 •• Coinments • •••••• 000.00 � • • 00000 • • • • • ..000• • • • • • •0• 0 El Check here if attachments. • '• SECTION G—COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation Certificate.Complete the applicable item(s)and sign below.Check the measurement used in Items G8—G10.In Puerto Rico only,enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information.(indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone A0. G3. ❑ The following information(Items G4—G10)is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6.Date Certificate Of Compliance/Occupancy Issued 07. This permit has been issued for: ❑New Construction ❑Substantial improvement G8. Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters Datum G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters Datum G10.Community's design flood elevation: ❑feet ❑meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑Check here if attachments. FEMA Form 086-0-33(Revised 7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box_No. Policy Number: 10255 BISCAYNE BLVD. 15-963 City State ZIP Code Company NAIL Number: MIAMI SHORES FLORIDA 33138 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page,use the Continuation Page. DATE TAKEN: 11/9/15 } •.• Hilq- :VIEW ...... .. • r t. ...... . ...... dh . ••0000 . • �` � - _ _ ,riTT � r.:. 0000•• • •..' 0000• f ***see *see 0000•• • • S r ,r. •• •• *go:••• !•Y•f• 0000•• • •• 90* 90 4 v' REAR VIEW t FEMA Form 086-0-33(7/12) Replaces all previous editions. SCALE 1 1� JOB :13_715 LOCATION SKETCH - 1: PLAN, 01= SURVEY SCALE V = k , r , r^ �✓ �.,; BL CK •••••• L 192 •..... Q iBs eo eo i K. Ib ti! { ' • ee P� /o� 5 OCK / A r J ` • 'Q or - 2 dt 10 1 / tZ s4. . /-.u/•.,F , �,_v O' s•••';•� •••• oo* •it •• vE < , F ,.. y. � • N. . 101s� ST. a k!g ° Jr ( �i a ••• ?, I •••••. ,r/i� i -e� 4 i O� .'v •• • ..,�i • • • • 4 3 - \'#', / • • 4 3 2 I r9 7 q na � i / z '-1 � �, � �• • ` 8CK ---- ) 1�7 T5 e3;16'e 16 u ry„i/ Iola}• � � !f i �� h�10 I1 2 13 f4 ' s I � � •I` `� ' �4�rte,, �-� r= � _ Block 175 6 and 7 LEGAL DESCRIPTION:Lot 5,less the East 55 feet and all of lots , , ICT o s t RE®ISED PLAT OF MIAMI SHORES SECTION 8,according to the Plat thereof as recorded in Plat Book 43,Page 67 of the Public Records of Miami–Dade County,Florida.– (s1i ! `191 f GENERAL NOTES ? 1) OWNERSHIP IS SUBJECT TO OPINION OF TITLE. 2) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS,IF ANY,AFFECTING THIS PROPERTY. 3) (2.22)DENOTES THOSE ELEVATIONS REFERRED TO N/A DATUM. p S m Q V 4) LOCATION AND IDENTIFICATION OF UTILITIES ON AND/OR ADJACENT TO THE PROPERTY WERE NOT SECURED AS SUCH INFORMATION WAS NOT REQUESTED. Updated:March 25,2®15 -' 5) THIS PROPERTY IS WITHIN THE LIMITS OF THE FLOOD ZONEAE ^ 6) NO UNDERGROUND LOCATIONS WERE DONE BY THIS COMPANY. Revised on October 15,2013 # '— CERTIFIEDTO: Franz E. Rivera DATE: February 12,2013 APPLICABLE ZONING,UNDERGROUND,ZONING AND BUILDING SET BACKS,MUST BE CHECKED BY OWNER, r ARCHITECT OR BUILDER BEFORE DESIGN OR CONSTRUCTION BEGINS ON THIS PROPERTY. i 6 . r!'' ��` y F g•`c r r } yrr tR I HEREBY CERTIFY: That the attached Plan of Survey of the above described property is true ` — r p r and correct to the best of my knowledge,information and belief,as recently surveyed and platted under my direction,also that there are not above-ground encroachments other than those shown. i o G P • 1 F UNITEC This survey meets the minimum technical standards set forth by the Florida Board of Land Surveyors - t Q I pursuant to Chapter 61G17-6, Florida Administrative Code,Section 472-027,Florida Statues. , ! w i ,� SURVEYING, INC / # , fr .z-.. t f Y qf\ a� f' _ �(t'"` ` ✓f ( f B. NO. 3333 / f r Ir ; r L. ` y:x`t aro D.Alonso + 6187 NW 167TH STREET, H5 Pro" ssionai Land Surveyor f �s ,; �' _.y _ , _ 6� e _. � _ ��. — �iFov Certificate No.3590 MIAMI, FLORIDA 33015 j State of Florida R 3051512-4940 jH)c IS A BOUNDARY SURVEY 0 A....ARCDISTANCE AC...AIRCONDITION G CBS...CONCRETEBLOCKSTRUCTURE O.UL...OVERHEADUTILITYLINE CL..CLEAR C!L .CENTERLINE _ _ — RAD...RADIAL ENC. ENCROACHMENT RNJ...RIGHT OF WAY... FIP...FOUND IRON PIPE O.H...OVER HEAD W.M.—WATER METER C.H....CHORD I"d A� EISGiB®vc�sEE2 �L.)E�V,E�C Li,.�'yc�, � C.ce N �I DISTANCE P/L...PROPERifLINE CONC...CONCRETE F.H.FIRE HYDRANT UP...UTILITYPOLE R...RADIUS U.E...UTILITY EASEME14T I�OT Va4Ll® UNLESS SE Le l� VITA � u A...CENTRAL ANGLE R...RADIUS PL.....PLANTER T.....TANGENT C.B.....CATCHBASIN MH.....MANHOLE CLF...CHAIN LINK FENCE W.F.....WOOD FENCE