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EL-16-1420 VIR k yy se ,� Miami Shores Village 10050 N.E.2nd Avenue NW �C M Miami Shores,FL 33138-0000 Phone: (305)7952204a ` �tf,; ''' ••,,; ,a .,.,3 Expiration: 1 122/2016 Project Address Parcel Number Applicant 9811 NW 1 Avenue 1131010330080 Miami Shores, FL 33150- Block: Lot: MARIO GONZALEZ Owner Information Address Phone Cell MARIO GONZALEZ 9811 NW 1 Avenue (786)236-0135 MIAMI SHORES FL 33150- 9811 NW 1 Avenue MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone Valuation: $ 1,500.00 FRAN BEA ELECTRICAL CONTRACT( (305)322-1462 _-��.,� .. .�sYn.__......._.�.... �._.......�... _.��....._._-�- Total Sq Feet: p Type of Work:ELECTRICAL FOR GARAGE CONVERSION. Available Inspections: Additional Info: Inspection Type: Classification:Residential Final Scanning:1 Meter Box Alteration Relocation Fire Alarm Service Change Review Electrical W.W. Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# EL-S-16-59897 DBPR Fee $2.25 DCA Fee $2.25 05/26/2016 Credit Card $160.70 $0.00 Education Surcharge $0.40 Permit Fee-Additions/Alterations $150.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $160.70 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 AFI 5ermore, y that all the foregoing information is accurate and that all work will be done in compliance with all applicable taws regulating construction a I authorize the above-named contractor to do the work stated. ' May 26,2016 Autho Si re:Owner / Applicant / Contractor / Agent Date Building Department Copy May 26,2016 1 Inspection Worksheet Miami Shores Village G 16-3-12- 10050 6_3-12- 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-259557 Permit Number: EL-5-16-1420 Scheduled Inspection Date: September 07,2016 Permit Type: Electrical- Residential Inspector: Devaney, Michael Inspection Type: Final Owner: GONZALEZ,MARIO Work Classification: Addition/Alteration Job Address:9811 NW 1 Avenue Miami Shores, FL 33150- Phone Number (786)236-0135 Parcel Number 1131010330080 Project: <NONE> Contractor: FRAN BEA ELECTRICAL CONTRACTORS INC Phone: (305)322-1462 Building Department Comments ELECTRICAL FOR GARAGE CONVERSION. Inftactio Passed Comments INSPECTOR COMMENTS False Inspector Common Passed Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid September 06.2016 For Inspections please call: (305)762-4949 Page 8 of 40 i Miami Shores Village RECD . Building Department MA Z 3 2016 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: Tel:(305)795-2204 Fax:(305)756-8972 b T,4INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 20 N BUILDING Master.Permit No. >��• — 7. 116 ' 372 PERMIT APPLICATION Sub Permit No. f ' ❑BUILDING ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP `' CONTRACTOR DRAWINGS ®@ A" JOB ADDRESS: !y� � Vj /Ave- City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: �Construction Type: Flood Zone: BFE�: ,, FFFFE: er)OWNER:Name(Fee Simple Titlehold (9�a Lode t. ' o"' I V� oO S h1 Aa -n.l 6kzy-•e S Z �J3 IS O Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: e—;iAA) &4 6JeAy tc- Phone#:�3?2 —/sed z Address: -705115 AW 13'> 4=+ City: log i of i State: 56L Zip: -3-3 123 Qualifier Name: A Phone#: State Certification or Registration#: 96 e 3 D.'t -4/ 2 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demollijon Specify color of co►or thru tile: Submittal Fee$ Permit Fee$ /iMOI O CCF$ Co/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ I G 6 •`1 (Revised02/24/2014) 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 whosse pi 1. subj2eaL to attachment.—Also, e recarded notice of COMM errcer►rent mu iL uepostear at thvlob—M---- -- for the first inspection which occurs seven (7) day after the building permit is issued. In the absence of such posted notice, the inspection will not be approved i be charged. ignature NER or A NT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this _Q?Q day of20 1(0 by day of •r 20�by who is personally known towho is 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 PUBLIC: Sign: Sign: ATOS Print - Print: C� �FF 240090 ' ENEIDkLOPEZ _ EXPIRES:JWY 26,201 Seal: *_ Ct>mr salon#FF 154 Seal: �u NWWPU* Expires Atgt 26,2M „ aaaarnmlr�oyFml �a,�aota ############################################################################################################ APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 5 YlitC.I93a y ..•. UNION AIW / Apt, Miami Shores Village L; okref, f- 33/a Building Department LORIDA �Q 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305)756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS F ORIDA STATE CERTIFIEDCONTRACTOR: COPY OF QUALIFIER'S STATE LICENCES COPY OF LOCAL BUSINESS TAX RECEIPT /CJ COPY OF LIABILITY INSURANCE COPY OF WORKERS COMPENSATION INSURANCE (Worke Compensation EXEMPTIPN- ust have NOTICE TO OWNER form and Contractor Affidavit) -7 A, IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY--- Y A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: BUSINESS ADDRESS: !2 b V O CITY/A!!i STATE ZIP BUSINESS PHONE: ,2o/a FAX NUMBER(d ub If CELL PHONE(aoS ) 3AZ ■/#1A.z QUALIFIER'S NAME: --�eje-2;o � QUALIFIER'S LIC NUMBER: e C 1.9e 02 3/4 RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY 1 -—T - �F fLORIDA - DEP RINI N �O 030ES A[VD PROFI=SSIGNAL,RE113t t N f.. ra E°[IiGt EN 'T �� }d0�� _; -�- fir.�-�„��_.c:-," - - - � '�V"' oa• `4t E E Tft�AL-G-0N YprQ safi�r�s ofbapte - N ", } �—Sgvl M'.' ISSUED: 06109/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1406090001186 001017 rI I j „udt ';f(' , 't3u:;�11�.d�Fltr t ,air 11tfZrrr .t, c ttd ' !13{'R.sill All lu ' Milli 1v I �� Sr t, + i 1r aullk j r ( !u I}11iti r ” G�1 tr' ,{�' *i li ill j iii Irl {in. att !If .,r„ i {y •. . va.iI!-�tst ,37',�.e tti'yf Lra>��75?���SSSr rt:, i+r�(s, )jr,,�si I �i/>rS�7����t���j�ti�iF 1n���111�1},an ^"r?�Jlq .-�}{� � alltl� ft"ti�x ?F i;4«,Ilf;�! a ;$1Vi ttNi r�Iull;t s � RE.,},i;!: �l�fi i tn411)t�lr�li�eps )�)}n�jtikliu. <ay � r 1 y YfS n��w:t+irk i ftt Irl; ' It t� � Slfr�r n�yij ( t',,rts �i?flf.�trNfll(l� Q�Sr¢stf\Sulrirtt`)fir t, S}k;47 t+f ' �l tl��,t �i� d:fi �4Aa�F,r a 1111 ", Klstli,rrhvif1lt�ltl+Isa« SRI; y,}F��+'��.•fllf�lt{I( ) t � if 1 �. '�dj.*i }Q(i'1:7 n a, r/ i I +�y, at. .r; rt�3r Irl ffIr A4�, ll, a a ;4 fly'. r � �nYrl3'�v>;•/ ,�'>��'�IqNA Fell ` u I}i rtl7ltp\.<�Sl�>+S TI�r a}17t1 7+. 1(liTs' !S �Z y$ >J OWNf�# SEC RE OF 8�f$IIa1, PAYME RECEII/ p " tr LECTRICAL CON CTORS 996 � RICALI �{� r 1 , jIj�Pv T of 1 Fgm R Ai +ents> 10 "EC13 2312 $75.00 Q7/O7/2015 y, frCHECK--15-156.980 Thr Busine � Etory cai o 1 } rms t Y Ym> +ol�liasp 1 Business Tax The Reaalpt is not a ItCpnse, r==' � cernfi3a�lm Ure hot �Ufi �} 'to dp��f' .Noll P�pl'# any govetjMnamammantgIayYa Jrequt +�riia tahi�� ;m the b �{st»4 t '-Tb�'WWOTNO.abi"inustbe i ►11ft ` on ercial'v li�les NI�� f" �a$�J 8a-276 {IIn7}i1�4llin ail ,�fia �� __ r F �ptnlatl d i„r I 1 v w A�® CERTIFICATE OF LIABILITY INSURANCE DATE(MMroD/YYYn 5/12/2016 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 COMENTA T Carlos Allen 3r. NA Pan Am Assurance Agency PHONE -1424 ac No:(305)270-8997 9100 Sunset Drive ADpi :carlos@panamassuranoe-com INSURER(S)AFFORDING COVERAGE NAIC S Miami rL 33173-3433 INSURERA WGSCO Insurance Company 25011 INSURED INSURER B:Pro ressive Express Ins Company 10193 Fran Bea Electrical Contractors Inc INSURER C Brid efield Employers Ins Company 10701 PO Box 561834 INSURERD: INSURER E: Miami FL 33256-1834 INSURER F: COVERAGES CERTIFICATE NUMBER-CL1651200513 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. ILTR TYPE OF INADDLSUBR SURANCE POLICY NUMBER MMMIDD EFF MMMMD CY FSP LIMrrS A X COMMERCIAL GENERAL LIABILITY WPP1430139 00 01/01/2016 01/01/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTEff— CLAIMS MADE 1X OCCUR PREMISE Ea oxurrenee $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY E PRO- —1 LOC PRODUCTS-COMPIOP AGG $ 2,000,000 JECT OTHER: B AUTOMOBILE LIABILITY 02695964-0 10/01/2015 10/01/2016 MBIN SINGLE LIMIT g 100,000 Ea acddent x ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOSAUTOS Per acddent Ie Amit $ UMBRELLA LU\B OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ C WORKERS COMPENSATION 830-14391 01/01/2016 01/01/2017 1 STrH- ATUTE I I ER AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE NIA E.LEACHACCIDEN7 $ 500 000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEN$ 500,000 Ifdescribe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT 1$ 500 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached N more space is required) Electrical Contractor. CERTIFICATE HOLDER CANCELLATION (305)756-8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 N.E. 2nd Ave Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE Carlos Allen Sr./DS ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS026 oni4n1i CSpace Architecture and Design Inc. AA-2602356 • 4530 N. Hiatus Rd Suite 101 Sunrise Florida 33351 •••• • . • 0000 0900 . •I .. Telephone 305 433 2210 '•.' : ,• Fax 305 677 3088 • ARO-UTECTURr: -+ ©�Sl�ii*j� , 099990 " chris@cspacearchitecture.com '••• . www.cspacearchitecture.com 9"". •, • 0000. 0900 9 90 9.09. 0000.'. • 9999. Memo 99'00 •••••• Village of Miami Shores Building Chiistc iter C o ••••:. Department . P 0 00090- 0000 0.00 0 CSpace Architecture+ Design Gbh2alez Residence street Prd� hUmbe File code Ado. 3 9811 NW lrt Avenue 1542 City,State,Zip Project location Miami Shores, Florida Telephone number Fax number Pages OL (305)433-2210 2 Date Email 04/20/2016 chris@cspacearchi tecture.com Subject Response to Building Department Comments Permit# 16-372 in,r-espow, io.pjqn mvjew che4,ist poow q fa.iepos)1)gck#o.� e s o e�: Correction Notice: Buildina Comment#1: Provide a Site Plan,reflect the location of all utilities servicing the building. Response: Site plan with utilities has been provided. Refer to sheet A 101. Comment#2: Provide a survey of the property.The survey should reflect the crown of road elevation and the highest back of sidewalk elevation. Response:The property survey with the elevations above has been provided. _ � Comment#3: Reflect the finish floor elevation in NGVD. Also reflect the change of elevations at stairs,doors,and floors. Response:Refer to Sheet A 10&finish floor elevations are now shown on the plans.Elevations and change of elevations are also shown In the sections In sheet A202. specifications to replace all sections of damaged sidewalk on the front and sides of the property. ` CSpace Architecture and Design Gonzalez Residence 04/20/2016 Page 2 " 0000 • 0000 0000.. •••••• •••• •••••• • •••• •• • •••••• • • •••• • •• ••••• •• • • •••••• •• • •••••• Response: 099960 • Refer to sheet A 101.The site plan shows the ardas'of repot for the damgird sidewalks and a Sidewalk Construction Detail has been pWWWId. 9 •• 0000 Comment#5: Provide cross section,foundation to roof secltons marked in red on sheet A102 of the office set of plans. Ate: Refer to sheet A202.Sections have been provided. Comment#6: Provide 3'-0" minimum clearance in front of the electrical panel in the laundry room. Response.Refer to sheet A 103.Minimum X-0"clear has been provided. Comment#t7:Specify at in*ri`or Wskes.Wim, Cefifts,and%ors. Response: Refer to sheet A 103. Finish Schedule has been provided. Comment#8: Provide New landing outside the side door of the new storage room. Response.Side door will be closed off from the Inside. ELECTRICAL Comment#1: Need 3'-0" clear space in front of Panel A. provided. Comment #2: Show location of smoke detectors on sheet A101. Hi-hats to be I.C. Rated. Response: Refer to sheet EiOI.Smoke detector Is being shown and all new recessed lights ae called out to be I.C. Rated. Comment#3: Arc fault breakers and panel schedule. Response:Refer to note on sheet E101. Comment#4:Tamper proof receptacles. Response:Refer to note on sheet E101. BUILDING PHOTOGRAPHS SOMB Control Number: 1660-0008 See instructions for Item A6 Expiration: 11/30/2018 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. 9811 N.W. 1 STAVE. Policy Number: City MIAMI SHORES State FLOE Zip Code Company NAIC �•...� 0 33150 Numb4r: �•. ••.. .����� If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below ac7c5rdirTg to the ipm?ections for+ Item A6. Identify all photographs with date taken; "Front view"and Rear view"; and, if required, 'Right Side%*%4 and"Lett~Sitie View."*YW44n applicable, photographs must show the foundation with representative examples of the flood openings or vents, aslndicated ill Section#A8. If• submitting more photographs than will fit on this page, use the Continuation Page. • . ;'. •, • • �x.S�'"� ` , �y rte_, • • • y x , n DEPARTMENT OF HOMELAND SECURITY r Federal Emergency Management Agency • ELEVATION CERTIFICATE IMPORTANT: FOLLOW THE INSTRUCTIONS ON PAGES 9-16 OMB Control Number.1680-0008 Expiration:11l30/2018 Copy all pages of this Elevation Certificate and all attachments for(1)community official,(2)insurance agentleompany,and(3)building owner. SECTION A-PROPERTY INFORMATION FORM INSURANCE COMPANY USE Al. Building Owner's Name Poli Number. MARIO GONZALEZ, III Policy A2. Building Street Address(including Apt, Unit,Suite,and/or Bldg.No.)or P.O.Route and : .'. •••• •... . Box No. Company NATO• . .... • 9811 N.W.1 STAVE. Number 0000•• •.:• .... . •00.00 . City MIAMI SHORES State FLORIDA .' 2UCode:VlSQ • A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) ••..•. . . • LOTS 12 AND 13,BLOCK 128,P.B.10,PAGE 39 •• •. :""' 0..000 , • A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etm)RESIDENTIAL ' : . •• ...... ..... A5. Latitude/Lon itude: Lal N25°51'56.37" Lon .W80°11'57. Horizontal Datum: ' • 9 9 C`NAD 1927 •• MAD 191,x,� �•••• A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 8 A8. For a building with a crawispace or enclosure(s): A9. For a building with an attached garage: a)Square footage of crawispace or endosure(s)1,841 sq ft a)Square footage of attached garage 200 sq ft b)Number of permanent flood openings in the 6 b)Number of permanent flood openings crawlspace or enclosure(s)within 1.0 foot in the attached garage within 1.0 foot WA above adjacent grade above adjacent grade c)Total net area of flood openings in A8.b 1,016 sq in c)Total net area of flood openings in A9.b NIA sq in d) Engineered flood openings? (7Yes ( No d) Engineered flood openings? (7 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 FLORIC B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel Effective/ B8. Flood Zone(s) B9.Base Flood Elevation(s) 12086CO302 L Revised Date X (Zone AO,use base flood Sep 11,2009 Sep 11,2009 N/A depth B10.Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item 139: ('FIS Profile ( FIRM (`Community Determined C`Other/Source: B11.Indicate elevation datum used for BFE In Item 139: (47v NGVD 1929 ( NAVD 1988 (7 Other/Source: B12.Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? (. .-Yes (o No Designation Date: N/A (`CBRS C',OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl.Building elevations are based on: C,Construction Drawings* C`'Building Under Construction* ( Finished Construction C2.Elevations -Zones A1-A30,AE,AH,A(with BFE),VE,V1 -V30,V(with BFE),AR,AR/A,ARAE,AR/A1 -A30,AR/AH,AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7.In Puerto Rico only,enter meters. A new Elevation Certificate will be required when construction of the building is complete. Benchmark Utilized: 3100 SW Vertical Datum: NGVD 1929 Indicate elevation datum used for the elevations In items a)through h)below. (•1 NGVD 1929 (7 NAVD 1988 (,Other/Source: 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) 11 - 01 ( :feet (':meters b) Top of the next higher floor 11 - 83 ( feet C meters c) Bottom of the lowest horizontal structural member(V Zones only) N/A - (.',feet ("`meters d) Attached garage(top of slab) 9 - 55 ( feet C meters e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) 10 _ 50 feet (':meters f) Lowest adjacent(finished)grade next to building(LAG) 9 - 50 ( ,feet (`meters g) Highest adjacent(finished)grade next to building(HAG) 9 - 75 C:feet (`meters h) Lowest adjacent grade at lowest elevation of deck or stairs,including structural support NIA - (`'feet C:meters FEMA Form 086-0-33(7/15) Replaces all previous editions. Page 3 of 15 ELEVATION CERTIFICATE OMB Control Number.1660-0008 Expiration:1113012018 9811 N.W. IST AVE. MIAMI SHORES FLORIDA 33150 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 cet* that the information on this Certificate represents my best etforts to interpret the data available.1 understand that any false statement may be punishable by fine orimpdsonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A00 • • + ® Check here if attachments. provided by a licensed land surveyor? •• • ++ (:,Yes CNo +++�.. ++:+ • Certifier's Name License Number ••+•• • • ADIS N.NUNEZ 5924 ++++ + •• • �•++• Title Company Name •• •• LAC • REG.LAND SURVEYOR BLANCO SURVEYORS INC. •• •• 'y •• • ERE + Add r City State Zip Code : + •• •• .+++++ +++++ 555 N S ORE DR. MIAMI BEACH FL 33141 • + • •+ • Sign r Date Telephone •• • • :*o 00 0 • Apr 18,2016 +1 (305)865-1200 Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments(including type of equipment and location,per C2(e),if applicable)" LATITUDE AND LONGITUDE OBTAINED BY GOOGLE.C2.e)A/C ELEVATION. CROWN OF THE ROAD ELEVATION:10.1&ON CENTERLINE ON CENTER OF ROAD. BM#N-444 LOCATOR:3100 SW ELEV:10.79' Signature Date Apr 18,2016 SEC 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,crawlspace, _ (.feet (`meters ❑ above or ❑ below the HAG. or enclosure)is b)Top of bottom floor(including basement,crawlspace, _ {-�feet (•,meters ❑ above or ❑ below the LAG. or enclosure)is 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 - C-feet C meters ❑ above or ❑ below the HAG. E3.Attached garage(top of slab)is Cleat Cmeters ❑ above or ❑ below the HAG. E4.Top of platform of machinery and/or equipment servicing the building is _ - C feet (7 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? (7 Yes (`-No C Unknown. The local official must certify this information in Section G. SECTION F -PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE)or Zone AO must sign here.The statements in Sections A,B,and E are coned to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name: Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33(7/15) Replaces all previous editions. Page 4 of 15 I .. O WoTi: �a LOCATION SKETCH°r: :Ne e 99th TREET ASCALE: NTS m n a J • 8 '1 W J 9ASP HAL T PA �r-dr1G1\1 , Y S • 1!i• rn • • .....R=25.00N.W._ 99th . . � •LL •••• •• z � q J.'-L=39.39. $ w - W • '•:Tan=25.12° :: •::v•.:.• 16 PARKWAY �+ a .,.:.. � � y��J•� q �••• F- N •••• ........'•'�Q .. '• ZZZZs 105 88' R 8 M F.I.P.1/2" ( ) 13 12 11 10 9 ,o ...: :�• (—N—O— '.�19-`•_ ;'i :: f�~.y. .� ri. s'�.. • .s �j • .o„ ,' •..' J:. .. ,:•..'�•• ,�,, I *GOO••••• uct ZoWz .5 •• FIP.1/2”f ' e•••(NO ID.) + I : (NO ID.) 151 •wezd�' .•••••• ••• ALLEY �� � .,.. :4;:.�'•�: I tF. 01^ ON PL •• • It m •••• CIO� QQ • F.I.P.1/2" + I POOL U oaa1 30.00' `a': (NO ID.) • x >. 5 W •./. = 40.50' ., •.• '• �• z p U •� •;; f; '_ ''-�.,,,a' `' GARAGE °° %.••.,dt...:�'.. •' p� a o z ,!• .•s=•,.� k` '.!, ••.•r, '.ASPHALT ELEV.=9.55= • i i '3 e •''�A.. V U V U J ,� M °"' _ '•:DR�VEWAl'• 13.00' A: •' ui •' = r. 16.73 ;:..•f•,,, :,., �• a9 g '•: PL ON �811111 ORY3 PORCH C.B.S. ENCE�1 : ;" OOD ROOF `- # 11 N n12*51Ym •; a 0. F.F.ELf V.=11.83' 13.00' ' i W z. �} $/_ zEOoa W o 39.00' .i�: STEPS � `° u 15.30' .7,' i 6 agn`w W LL 00 11 OwN ' Qtn ii 5 E MUM • 24'39.00' ti ',• 14.50' ••• � LOT 11 Property Address:9811 N.W. l a Ave.,Miami Shores, •' '" .w ' ; M• s.«; BLOCK 128 FL.33150. ^• ••i..••.!••Y, r '.� .,j ti . Ll i LOT 13 O;J ( '''•= y•• •'.•'• •�'`_•y„4 ••d'.9••�. ,, •, -? Y :; Certified To:Mario Gonzalez,III,a married man; Space Coast Credit Union ISA0A/AT1MA;Isis Valle, _•� :_, BLocK 128 !: ,,,• :�� : r�i, P.A.;First American Title Insurance Company. ^ ' p°�� 9 4'y 0 8.0= O PL F �5 I LOT 12 p F.I.P.1121= '9" y' � 'C.B S. WALL BLOCK 128 (No ID.) LEGAL DESCRIPTION: LOT12 & 13 �a : 30.00' FII S_ BLOC} 128 v .a.; F.LP.I/2" 105.91' (R 8° M ) OF MIAMI SHORES SECTION 6 SUBDIVISION . ,+ (No ID.) 15'ALLEY 39 "�•' ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 10 AT PAGE ~•• OF THE PUBLIC RECORDS MIAMI—DADE - - COUNTY, FLORIDA DOD F=MASONR NCE= ELEVATION BASED ON LOC.# CONCRETE=. = 31 0 � 'N* CONCRETE=. .:• t•.:• t••t •::s .:••t•.:••t .:•.: •:..t •:. NOT VALID UNLESS EMBOSSED WITH MAINTENANCE BDRAINAGEEASEMENT=MBD.E. CBM# N-444 =LV. 10.79�'YPE OF SURVEY:BOUNDARYSURVEY ;NR INCE 1987 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 thereon meets the minimum technical requirements BLAUR' VEYORS ING. I 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 - - C COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5; Surveyors pursuant to Section 472.027 Florida Engineers• yors•Planners•LB#0007059 Agffk UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC Statutes. TH SHORE DRIVE VERTICAL DATUM OF 1929.. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL There are no encroachments, overlaps, easements I° RESTRICTIONS NOT SHOWN ON THIS SURVEYTHAT MAYBE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 91 appearing on the plat or visible easements other than EACH,FL 33141 - CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONINC as shown hereon. (305j 865-1200 Email: eyorsinc@yahoo,com FaX: (305)$65-7810 INFORMATION. 10)EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDECREVISED: INSTRUMENTS,IFANY,AFFECTINGTHISPROPFJ3TY �` FLOOD ZONE: X : L DATE: 9/11/09Additions or deletions to survey maps or reports by other than the signing party or parties is prohibited 0302without written consent of the signing party or parties. ADIS N.NUNEZ PANEL. UNITY# 120652REGISTERED LAND SURVEYOR [7PTF' SCALE: Y: JOB No BEARINGS WHEN SHOWN ARE REFERRED TO Aid ASSUMED VALUEOF SAID P$" 10 PAGE 39 STATE OF FLORIDA#5924 4/.gO/1'6 :. 1•=20 - .16-352