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FW-14-1652 Miami Shores Village pFCFIV D Building Department JUL 3 20 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 L® BUILDING Master Permit No d Gs2- PERMIT APPLICATION Sub Permit No. UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP !!,^, Al / CONTRACTOR DRAWINGS JOB ADDRESS: IC9 W V E City: Miami Shores .�c� /� County: Miami Dade Zip: Folio/Parcel#: �- 2l 11&0 0 0q — D f�Q Is the Building Historically Designated:Yes NO 'r Occupancy Type: fe6o Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): Vaf')') 40�s s5y 966 Phone#:&0j-- MVn06t� Address: City: LSJ State: Zip: r? Tenant/Lessee Name: Phone#: Email: 1 IV`,C�S _-- CONTRACTOR:,Company Name: L r �_C.JQ.. Phone#: ads,qs-e-77AP Address " City: State: FL Zip: ✓�� Qualifier Name: LA Phone#:, eps-§>-0?yi? State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ CQ45` Square/Linear Footage of Work: ®(rJ Type of Work: ❑ Addition ❑ Alteration ��❑ New []Repair/Replace ❑ Demolition Description of Work: ' � �� C— Specify color of color thru tile: Submittal Fee$ Permit Fee$ n . CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) 777777"" Bonding Companfs 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 la brochure Will be delivered to the person d at the job site whose property is subject to attachment. Also,a certified copy of the recorded notice of co encement must be 0"S�ft for the first inspection which occurs seven (7) days after the building permit is issued. e absen of su po ted notice, the inspection will not be approved and a reinspection fee will be charged. 0 u lien e n c d la 0 a e brochure encement c cn em a b e abs e 0"suc, Signatureq, Signit6re. CO T OWNER or AGENT CONTRACTOR Th folego-Ing instrument was acknowledged before me this The foregoing instrurn nt wasackn'owlddged before me this Whdav o t7(t ( U 20 J by ��ay of _'20 by 't'Z�4AQ6 who is personally now 15 CCA o is personally known to 6_ e�Or who has produced as <&or who has produced as identification an A identification nd who did take an oath. NOTARY PUBLI NOTARY PU A VALE Nrmiy2IL20 2WMWW.W9GL 30 FA------- 114 -7— Si k I—AIIA Print: Print: Seal: Seal: APPROVED BY Plans Examiner .-Zoning Structural Review Clerk (Revised02/24/2014) JV_le County,�S�ta#, f Florid ` P MS15 NOT A'BILL-DO NOTMr t� c No 93esoos63 Rt tNglt NAIY ILO,"MON R�CE#I�i JI►Q e orae « . EXPIRES 25$3$tw i'4A1fE ��w;susr ss " S-EPTEMSER 30, 2014 atstae,d)eplaye ;arpiaosortwsl�aes:. Chapter8A'-Art.9&10 OWNER TYPE OF Blumm8s PAYMENT tl6LEIVED LEfiAASTER FBdCE C Si' I1S*811!lD�iG COPiiRAGR?i7 BY TAX-vo sure 175.00 .10/04/,013 0227-14=8W118 rbrmore�tetmatiae,rrleit �iemidede.p000tleetor: �tlamiadeCountYy Statelff-l`urrd�. i*s�NOTABNI r NOTi�Y1Y �03284�i' , susl�iEss»n"�trJ%ocA.rroN 440 - EX PARES t,G St��ECORP 0,04 wp�, LF MB R 3DB 20'14 25838 At 1,44 AVE 3-,, Mm Fl. 331332 Mu bbtllsplaye�la1pJaEeittbus Jess _ t1DatJtytTDde RIV&10 OWNER SEC.TYPE OF BUSJNE33 PAYBE€JT,RECbiVEO LC RNcE�` 198 -NBU�h�i; BYTAX Ct}LEtsi OR ODMRACfOR 82.50 10/04/2013 93EMOM3 02714-itpQ118 Thist,ocai T l3ec�tontYcat�tnsp d.afthetacatBu�nessTac.7ti��eceiptistwtalkem% �penrvk�igtae Fond" eh0ltfet'SgUaFtC ct ioODMdn=.MdertmJstEpfllpiyl�i6ta<gtgDlRrtrl armn sandrec�drersNsxtdcnawy thehoi's me;"PrNOab000m toed donalcarmrecialveWesoMto it aftco esec8 Farmo llft OR lsit Q bard U81NE85�iER7*tCAlt OF COMPMNCY L.c Y f .• r 1 S ARJR ' CERTIFICATE OF LIABILITY INSURANCE DATE iMMIODIYYYY) 07/28/2014 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 Ileu of such endorsement(s). PRODUCER CONTACT NAYS Berta Davalos Marys Insurance PHONE FAX No: 27132 S Dixie Hwy. E-MAIL Naranja,Florida 33032 INSURER(S)AFFORDING COVERAGE NAIL 0 (305)246-7700 INSURER A: Uoyds of London INSURED L C Master Fence INSURER B: U.S.F.&G. 25838 SW 134 Avenue INSURER c Homestead,Florida 33032 INSURER D (305)258-7748 INSURER E: 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. ILTRR ADDTYPE OF INSURANCE L R POLICY NUMBER MD EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 100 000.00 DAMAGE TO RE COMMERCIAL GENERAL LIABILI YPREMISES Me o-=menca $ 100,000.00 CLAIMS-MADE OCCUR 1711 17* MED EXP(Any one person) $ 5,000.00 A GCCCE 02/02/2014 02/02/2015 PERSONAL&ADV INJURY $ 100 000.00 GENERAL AGGREGATE $ 200,000.00 GEN%AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 100.0W.00 POLICY PRO- F] T LOC $ AUTOMOBILE LIABILITY17 BaBINED SINGLE UM 17* (EaANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PAUTOS �OP �DAMAGE $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ MB EXCESS LI .._........ CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATIONSTATU- OTH- AND EMPLOYERS'LIABILITY YIN TORLIMITS YS PROPRIETORIPARTNERIEXECUITVE ER B OFFICFJMEMBER EXCLUDED? NIA 3313026 99 3 02/02/2014 02/02/2015 E.L.EACH ACCIDENT $ 1()0,000,00 (Mandatory in NH) - E.L.DISEASE-EA EMPLOYE $ 500 000.00 tt underL.DISEASE-POLICY LIMIT $ 100,000.00 171_(-- E.. DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES(Attech ACORD 101,Addit onai Remarks Schedule,it more specs Is required) FENCE INSTALLATION CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building&Zoning Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 NE 2 Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores,Florida 33138 AUTHORIZED REPRESENTATIVE Berta Davalos ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD •j Miami shores Village Building Department �, 10050 N.E.2nd Avenue �OR1Dp' Miami Shores, Florida 33138 JUL 2014 Tel: (305) 795.2204 y. Fax: (305)756.8972 W00 FENCE DETAIL o Shadow Box o Vertical Picket CITY o Board on Board y OGG*:* %1 4x4 Post Spacing -.0 P.. •. Fences<=5' high posts spaced at 5'on center maximum 009:90 '• •0 0 0 0 0 Fences<=4'high posts spaced at 60 on center maximum 09000* 0 • • 0000.. Fence must not exceed 5'in height •090 1x 4sktwfastenv4•, ••:•.' ,,.. W114 twDtorrofrl 0 0• 0000:0 .000 reVjVpj fasteners per 0 cornectifn • 000000 0000.. . . 0000.. .. 0000 0000 2x4 horizontal pressure treated wood members 00000 with two corrosion 000 peir nngd O Z 'o z� � � Z � G) O o M 78 �' v i 4x4 pressure treated c posts embedded 2'inCD to -� concrete footing 10" diameterx2'deep ALL wood must be pressure treated All fasteners must be corrosion resistant o No less than two fasteners in any connection CJL....CHORDOWAUM SCR...60439M HAZARD ZONE P.Me..PLAT go= r...... OLE....DRADIAM EASIMUW sus...s8r�arwa FL..'"Wpamum CONC—COUCF&M FJL....PMHVDmowr VM.. PANEL NO.% 9347 COMMUNITY#: 12%52 up.t.Ufa"POLE M...."X= ..... ML....UFAMEAMBOW DATE OF FIRM: 07/1711995 CERTIFY TO: RASE FLOOD: WA FINISH 1FLOOM NIA James R. Stabs I 11, Jr And Caridad Stops LOWEST N/A Scott A. Marcus, P.A. AbX GRAbE Attorneys' Title In rance Fund, Inc. N. E. '109th. 8 T . Washington Mutual Bank F.A., Its Successors And-40-P .A-s-zi LEGAL DESCMMON: 99 Lot: 6 Block: 216 1T ASPHALT Subdivision: bunnings Miami Shares Extension No. 5 M PAVIM According to the Plat thereof as recorded in Plat Book: 48 Page: 21 Public Records of MIAMI-DADE County, "w#w"- ASPEIAVT- AbDRESS; 75.00' (R)M 126 N.E 109TH STREET MIAMI SHORES, FL 33138 % 51.CONC SV' Encroachments Noted: Wour- F.N.D. o F.N.D. LOCATION SKETCH PIPEPIPE 4, SCALE; Lj.'j:S a NO M NOIR Fences Good Side Out. The vertical and horizontal supporting members of a fence shall face the interior of the plot on which the fence is 10 000 0 and the finished side shall face t e ad*ginin 0 0 lot or 'G`216 orn 0 1911100 0 0 9:0 1J 0 0 > 0 •0: . . 75, 31 0 0 0 it: 5 4 1.49 N:::: 0 9� 0 0 0• 7 oo:**: •VA % •••••• •000 'MC • 0* 0 r- ONE STORY 0 e 00 cri 30 9 10 11 12 13 :999 0_1 RESIDENCE 04-W • 0*00 -216- 28 0A, 00 0 N PL- CV Zr) PORCH 4i V-0 LOCATION SKETCH 10 31.09 24.1V WnTs. I V U A) AD auftna mUor onawAmmu Ac" (A b.—ors f .. .man.. F�0.-fth* . , by Wmd m"w. L40 VAVUV*Of(4NM mot SCRFJWM LOT-7 POOL ao ow of Timm J.to.1K. 9 d 8 in 1 40P 104 a the ram. 0) Th-ft—d h.—d—mr fiply 0.ily CL. IWft r41W""4P9MVSad WVM Rabe fm 6 fl..dbw—dm y.aW d—a -ft MbOW i va as pwr at*6 rd"6 OW offtw or owpbpe 1.2L1'CL V26.0 far my damw*0 msubs fma reseee." .0 F.N.D. kibnostim. F.N.D. PIPE k* 1) 7k 106*ad hum am mewd Per the NOM UP X W FWY NO ID S.oW a�altaa of tttk an Reda a homed ii'ASPHALT d I h—Irf ft"ffy*0 the—or 75.W (R)(K PAV'N(1 = h,Chqw 61Qr-6A9==k THOMAS I. KELLY, INC. L.B. #6486 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 �[OR�pA Tel: (305) 795.2204 Fax: (305) 756.8972 SURVEY AFFIDAVIT STATE OF(FLORIDA) COUNTY OF(DADE) The undersigned Affiant,,. YY1'Q-cS ,does hereby attest that e e e e e• (Property owner) : •e• •••• see.:• The attached survey,performed by—r&wo" )a) �vt �—Y�C" • sees.. .. sees.. .sees. s (Name of surveyor's company) eseeee.s e sees. . For address: d..... seees sees.• e s e e 00 00 0000 sees.e 0 ?ll� �q s sees. Performed on (date of survey)is an accurate representation of the wdstir�cdhdiions and e e e so: 000000 locations of all structures on the property as of this date. e • . . e0 a .000 0 sees.. 0 The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for tlye�property without first providing a survey less than seven (7)years old old. The Affiant, as property owner,further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits. urther,Affiant say ,t naught. 3-6 Moes S+o bs rorty Owner Signature Property Owner Print Name SWORN TO AND SUBSCRIBED before me this day of I. Affiant is�rsonally known to me,_produced n. Revise on 5122120091 Revised on 6112109