The URL can be used to link to this page

DS-16-2700 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-268325 Permit Number: DS-10-16-2700 Scheduled Inspection Date: December 07,2016 Permit Type: Driveways/Sidewalks/Slabs Inspector: Naranjo, Ismael Inspection Type: Final Owner: STANFILL, LAWRENCE Work Classification: Addition/Alteration Job Address:9200 NE 6 Avenue Miami Shores, FL 33138- Phone Number (405)751-7919 Parcel Number 1132060150020 Project: <NONE> Contractor: EW REED INC Phone: 305-759-5271 Building Department Comments REPAIR SIDEWALKS Infractio Passed Comments INSPECTOR COMMENTS False ,tiaspector Comments P Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. December 06,2016 For Inspections please call: (305)762-4949 Page 8 of 29 s " Miami Shores Village 10050 N.E.2nd Avenue NE WOW, 1110 „r. Miami Shores,FL 33138-0000 " N ' ,:. Phone: (305)795-2204 Expiration: 10/2017 Project Address Parcel Number Applicant 9200 NE 6 Avenue 1132060150020 Miami Shores, FL 33138- Block: Lot: LAWRENCE STANFILL Owner Information Address Phone Cell LAWRENCE STANFILL 9200 NE 6 AVE (405)751-7919 MIAMI SHORES FL 33138-2835 Contractor(s) Phone Cell Phone Valuation: $ 1,923.78 EW REED INC 305-759-5271 Total Sq Feet: 90 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final Date Denied: Foundation Type of Work:REPAIR SIDEWALKS Additional Info:REPAIR SIDEWALKS Review Planning Bond Return: Classification:Commercial Review Building Scanning:3 Fees Due Amount Pay Data Pay Type Amt Paid Amt Due CCF $1.20 DBPR Fee InVO1C@# DS-10-16-61549 $2.00 10/12/2016 Check#:34192 $66.20 $50.00 DCA Fee $2.00 Education Surcharge $0.40 10/03/2016 Check#:34190 $50.00 $0.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $116.20 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 d the w rk ted. V10 A October 12,2016 Authorized Signature:Owner / Applicant / Contractor / A nt Date Building Department Copy October 12,2016 1 Miami Shores Village Building Department C 201b AA10050 N.E.2nd Avenue,Miami Shores, Florida 33138 B A = Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER: 305 762-4949 FBC 20N BUILDING Master Permit Nos (b PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP y� � CONTRACTOR DRAWINGS JOB ADDRESS: �000 1 Ik (Q hue tp - City: Miami Shores County: Miami Dade Zia• Folio/Parcel#:1 j --3a(P _0 t,5 (020 Is the Building Historically Designated:Yes NO '0 _ Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): 'CC^Ce_. t 1 Phone#: Address: c120Q the (c •At-e - ' ! j 33131t1- City: �A.v,n , ._�)�`P� State:�r 1 Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: ( it J --tviC • Phone#:15 O's Addresskx is ,%Ac,P. w City: ai-ky\��-- ((��c.��nll State: �• Zip:2$76 Qualifier Name: GCLIU-- -\ W • Phone#'..X.35 �� _O�t�,1• State Certification or Registration#: G CSC OC�00459`3 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 1903 ") 6 , Square/Linear Footage of Work: q O Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: kJ5 Z2Q=) k Specify color of color thru tile: Submittal Fee$ Permit Fee$ ( d V CCF$ CO/CC$ d� Scanning Fee$ Radon Fee$D- M DBPR$�� Notary$ Technology Fee$ �0 Training/Education Fee$ 6 ' QED Double Fee$ Structural Reviews$ Bond$ ��11- � TOTAL FEE NOW DUE$ cas- Zo (RPvi;Pdn7/74/7n141 6 Bonding Company's Name(if applilcable) 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 thatza 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 Signatur .- OWNER or AGE CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this Z� day of SQpk,mbt� .20 ,by day of 20 ,by 3444110 M. SAOwho is personally known to �cc�ly� h —]who is personally known to YU me or who has produced 11441c. Vfrs �d{�k as me or who has produced a ^ , I i _ as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: a 10 MARIA CAROLINA OOMEZ °.•"'•. Seal: Notary Public,State of Florida Seal: * * � ISSIOtI Commission#FF 209431 EXPIRES:August 27,2019 My Comm,exgres Mer.12,2019 .a,*6 B=WT1n&*dNoWyftr4u APPROVED BY Vr Plans Examiner Zoning Structural Review Clerk (0—i—A n')/7A/*)nl A 1 00142 LocaU Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOT ABILL—DO NOT PAY [LBT 392209f__j BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES REED E W INC RENEWAL SEPTEMBER 30, 2017 13400 NE 17 AVE 392209 Must be displayed at place of business NORTH MIAMI FL 33181 Pursuant to County Code Chapter 8A—ArL 9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED REED E W INC 196 GENERAL BUILDING CONTRACTOR BY TAX COLLECTOR Worker(s) 10 CGCDO4598 $45.00 08/17/2016 CHECK21-16-114030 This Local Business Tax Receipt only confirms payment of the Loral Business Tax.The Receipt is not a license,- permit or a certification of the holders qual fications,to do business.Holder must comply with any governmental or nongovernmentel regulatory laws and requirements which apply to the business. The RECEIPT NO.above must be displayed on all commercial vehicles—Miami—Dade Code Sec ga—U6. For mom information,visit vamyv miamidade gov/texcollector DATE(MM ACORQ® IDD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE 1/29/2016 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 CONTACT Josette Toussaint NAME: NSI Insurance Group PHONE (305)556-1488 FAX 8181 Northwest 154th Suite 230 ADDRESS:josettet@nsigroup.org INSURER(S)AFFORDING COVERAGE NAIC# _ Miami Lakes FL 33016 INSURERA:United Specialty Insurance Company 12537 INSURED INSURER B:Commerce & Industry Ins Co 19410 E.W. REED, INC INSURER C: 13400 N.E. 17th Avenue INSURERD: INSURER E: North Miami FL 33181 1 INSURER F: COVERAGES CERTIFICATE NUMBER:16-17 GL/WC 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. INSR TYPE OF INSURANCE A DL S B POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDD MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DA AGE ToRENTED A CLAIMS-MADE [ OCCUR PREM SES .occurrence $ 100,000 DCG0288400 4/13/2016 4/13/2017 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PR - X POLICY D JECT E LOC PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ _ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-0WNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Pr acddent UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N X STATUTE I I ER ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? NIA B (Mandatory in NH) VC 003-63-7014 1/11/2016 1/11/2017 E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Edwin W. Reed General Contractor GCG #004598 CERTIFICATE HOLDER CANCELLATION 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 NE 2nd Ave Miami, FL 33138 AUTHORIZED REPRESENTATIVE Oscar Seikaly/JOSETT ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025=14mi r ♦ ORES' Gr shoresMiami Village loss Building Department 10050 N.E.2nd Avenue A� Miami Shores, Florida 33138 ZOR1DA Tel: (305) 795.2204 Fax: (305) 756.8972 SURVEY AFFIDAVIT STATE OF(FLORIDA) COUNTY OF(DADE) The undersigned Affiant, L azwcyncg S4ow4i 11does hereby attest that (Property owner) The attached survey,performed by goyc�/ C• SG h we)oI(P. � � SrnG (Name of surveyor's company) ((''�� For address: 9900 NS Iv he I-A%C Y � ShO fs . • 1 Performed on 2.1 197 (date of survey)is an accurate representation of the existing conditions and locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the 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. Furt ,Affiant say eth naug t. J Property Owner Signature Y Property Owner Print Name SWORN TO AND SUBSCRIBED before me this ?S day of S!A ' 1? - Affiant is personally known tome, ✓ produced *41L Utn l tW as identification. :Not"M IA CAROLINA GOMEZ > r a Public,State of Florida �. mmissio er s MarFF o122 019 CAR®mm.expi NVQ►Public,Stetr ®omr(d alor#FF 7My w n,mores M Revised(6/25/12)Revised on 5/22!20091 Revised on 6/12/09 -