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RCRT-10-981BUILDING PERMIT APPLICATION FBC 20 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit NQ. IZCt 1 •5 - IO Master Permit No. Permit Type: BUILDING _ OOFIN G Owner's Name (Fee Simple Titleholde O 41l l ` YJ Q Phone # Owner's Address City State Zip Tenant/Lessee Name Phone # Email Job Address (where the work is being done) M 1 el V d City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # 1.132,0(0011 0 1 50 Is Building Historically Designated YES NO Flood Zone Contractor's Company Name Phone # Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Contact Phone E -mail Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Type of Work: ❑Addition Describe Work: ❑Alteration Square / Linear Footage Of Work: c, 405 ❑New ❑ Repair/Replace ❑ Demolition Submittal Fee $ .=,210 Notary $ Scanning $ Radon $ Double Fee $ Structural Review. $ Permit Fee $ Training/Education Fee $ DPBR $ Violation date: CCF $ CO /CC $ Total Fee Now Due $ Technology Fee $ Bond $ See Reverse side —> 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20 _, by , day of , 20 , by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: My Commission Expires: My Commission Expires: APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) Engineer Plans Examiner Zoning Clerk checked UNITED STATES POSTAL SERVICE • Complete items 1, 2, and 3. Also complete item 4 If Restricted Delivery Is desired. • Print your name and address on the reverse so that we can retum the card to you. • Attach this card to the back of the maliplece, or on the front if space permits. 1. Article Addressed to: JOHN MILITAtsfA ggp� 815C4YNE BLVD M1lIMi St/ORES.F 33/38 2. Article Number (Transfer from service label) • Sender. Please print your name, address, and ZIP +4 in this box • hiMbA SHORES VILLAGE NAN aceso M. E. 2nd AVEi SHORES. FLA. 33139 1 tr llftiIIu 'filial tlt SENDER: COMPLETE THIS SECTION COMPLETE MS SECTION ON DELIVERY . 12 " 410 AS X ❑ Agent Addressee 0 Mer PS Form 3811, February 2004 Domestic Return Receipt First -Class Mail Postage & Fees Paid LISPS Permit No. G -10 D. Is delivery different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type ❑ Certified Mail ❑ Express Mall ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mall ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 7009 1410 0000 7000 9897 102595-02-M-1540 For - delivery _..' o u,sit { website at www€ ap.,p x =,: Sent To J o IAN MIL.11AWi Ala $$o l BIS CAYNE $ LVD City, State, ZIP+4 Mi t S,!R FL 3 3f-3381 Certified Mail Provides: • A mailing receipt , • A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Servioe for two years Important Reminders: • Certified Mail may ONLY be combined with First -Class Mail® or Priority Math®. • Certified Mall is not available for any class of international mail. • NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. • For an additional fee, a Retum Receipt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Retum Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mallpiece Return Receipt Requested °. To receive a fee waiver for a duplicate return receipt, a USPS® postmark on your Certified Mail receipt is required. • For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent. Advise the clerk or mark the maiipiece with the endorsement 'Restricted Delivery°. If a postmark on the Certified Mail receipt is desired, please present the arti- cle at the post office for postmarking. If a postmark on the Certlfied Mail receipt is not needed, detach and affix label with postage and mail. IMPORTANT: Save this receipt and present' it when making an inquiry. PS Form 3800. August 2008 (Reverse) PSN 7530-02-000-9041 5/28/2010 MIAMI SHORES VILLAGE Building Department Certified Mail # 7009 1410 0000 7000 9897 Property located at: Address: 8801 BISCAYNE Boulevard Miami Shores, Florida, 33138 -3381 Permit Number: RCRT -5 -10 -981 Folio # Dear Owner: 10050 NE 2 Ave, Miami Shores Fl, 33138 Tel: 305-795-2204. Fax: 305- 756 -8972 Notice of Required Inspection/Certification The Village has been notified by Metro -Dade Building & Zoning Department that the above referenced property has a building or structure that is forty (40) years old or older. In accordance with Miami -Dade County Chapter 8 Section 8 -11, the subject property must be inspected by a Florida Registered Architect or Engineer and a report furnished to this office. A report and a fee of two- hundred fifty dollars must be submitted to this office within ninety (90) days of receiving this Notice of Required Inspection/Certification. If you would like a copy of Minimum Inspection Procedural Guidelines for Structural and Electrical Recertification, or if you have any questions, please call my office at 305- 795 -2204. Sincerely, Norman Bruhn, Building Official 305- 795 -2204 MINIMUM INSPECTION PROCEDURAL GUIDELINES FOR BUILDING'S STRUCTURAL RECERTIFICATION INSPECTION Cr E DATE: INSPECTION COMPUTED DATE MIAMI -DADE COUNTY, FLORIDA Folio Number of Building: .1V.040\ kl.r10-96 tus •'15� •CoCo�l, ��B�I 0 BUILDING DEPAR TJ d �i 201 1 INSPECTION MAD SIGNATURE t A�P PRINT NAM � I /+ 1' Building Code Oc� upan Classification: Present Use: General Descri ption, Type of Construction, Size, Number of Stories, and Special Features Additional Comment sitikr 3ESCRIPTIO . Name of Title: v- n�!% 111 iMISIZI. _ Street Address: ,wT rPIIIVir-lre T�NF", s/i ITIS ' Legal Description: „ / ."!'�r Owners Name: ;311 :' Owner's Mailing Address: .�.`� %— ' % R P 115 "1 :,"., r 3!_►1E" y 3 132 N MINIMUM INSPECTION PROCEDURAL GUIDELINES FOR BUILDING'S STRUCTURAL RECERTIFICATION Name of Title: Street Address Legal Description: Owner's Name l c�.'►q Owner's Mailing Address: General Description, Type Additions to original structure: Contra DESCRIPTION F`STRUCTURE Building Official Folio Number: . Building Code Occupan Classification: 7 7��� N rai rm i ni l-- - ire o js4 .1 r i to__ � of on ize Number of Stones, and Spe al Fea res nn�cc��srrtaatiiai :.C::hc?r c r= Surface conditions — describe general conditions of finishes, noting cracking, spelling, peeling, signs. of moisture penetration & stains. i . Cracks — note location in significant members. Identify crack size as HAIRLINE if barely issembie; FINE ifiess than 1 mm in width: MEDIUM if between 1 and 2 mm in width; WIDE if ver 2 mm. General extent of deterioration — cracking or spoiling of concrete or masonry; oxidation of metals; rot or borer attack in wood. MAW -- 14 0 N g. Nature of present loading indicate re s en a "commercial, ether estimate magnitude. . Previous patching or repairs 3:. INSPECTIONS General alignment not good, fair, poor, explain if significant 1. Bulging V.:, c2N 2. Settlement 0 3. Defections PsIent4 4. Expansion 5. Contraction b. Portion showing distress (Note, beams, columns, s ctural walls, floors, roofs, other) N MINIMUM INSPECTION PROCEDURAL GUIDELINES FOR BUILDING'S STRUCTURAL RECERTIFICATION Name of Title: Street Address Legal Description: Owner's Name l c�.'►q Owner's Mailing Address: General Description, Type Additions to original structure: Contra DESCRIPTION F`STRUCTURE Building Official Folio Number: . Building Code Occupan Classification: 7 7��� N rai rm i ni l-- - ire o js4 .1 r i to__ � of on ize Number of Stones, and Spe al Fea res nn�cc��srrtaatiiai :.C::hc?r c r= Surface conditions — describe general conditions of finishes, noting cracking, spelling, peeling, signs. of moisture penetration & stains. i . Cracks — note location in significant members. Identify crack size as HAIRLINE if barely issembie; FINE ifiess than 1 mm in width: MEDIUM if between 1 and 2 mm in width; WIDE if ver 2 mm. General extent of deterioration — cracking or spoiling of concrete or masonry; oxidation of metals; rot or borer attack in wood. MAW -- 14 0 N g. Nature of present loading indicate re s en a "commercial, ether estimate magnitude. . Previous patching or repairs 3:. INSPECTIONS a. Date of notice of required inspection `b. Date(s) of actual inspection ) j J ". L. L. 1010 c. Name and qualification of individual submitting inspection report: •. Description of any laborato or othe formal testin • , if required rather than ,• rocedures manual or visual Stru tural repair note appropriate line: one required 0. Required (describe and indicate acceptance la. Concrete masonry units .!►T; t. Clay tile or terra cots units /fie . Reinforced concrete tile columns ./! .. Reinforced concrete tile beams i ie. Lintel Other type bond beams ig. Masonry finishes - exterior 1. Stucco 2. Veneer 3. Paint only ° 4. Other(describe) Masonry finishes - interior . 1. Vapor barrier 2. Purring and plaster 3. Paneling 4. Paint only PrIIA,AZ _ K.4 5. Other ( describe) r�1aLli . Cracks: N Cif,, 1. Location - note beams, columns, other 2. Description ' Spelling: . 1. Location - note beams, columns, other (� I , Li C _. 2. Description c. Rebar corrosion -check appropriate line: 1. None visible 2. Minor - patching will suffice z\rf�l�E'!.7..�J 3. Significant -but patching will suffice /e4 4.. 'SUPPORTING ;.DATA. a. NIA* N b. ,�A� c. i :IIAA'SGNR 'M sheet written data photographs drawings or sketches: " lnak14e51oad lair,; anrvni;ippriipriaterlinest b. Exposed Steel - describe condition of paint & degree ot corrosion: N Li ur 1. Sampies chipped out for examination in spell areas: N epme, 1. No. 2. Yes - describe color texture, aggregate, general quality E FLOOR AND .ROOF SYSTEM Root . AA p 1. Describe (flat, slope, type roofing, pe roof deck, condition. A ' 2. Note water tanks, cooling tow -rs air cons itio ing equ ■ment, s • ns, other eavy equipment and condition of support il. , 4 01e ' hi • I 3. Note types of • ems and scupper a ' • Inditionooling towers, air condition: ot gnificant fb. Floor systems(s) 1. Describe (type of system framing, material, spans, condition) - ' , ^- 410 General condition S .:40i0r44:;11111avitIg-iatUa-'-‘ c. Inspection - note exposed areas available for inspection, and where it was found open ceilings, etc. for - nspection of typical framin• mem' -rs. necessary to MIUMMIRMALgallIllr la. Description b. Exposed Steel - describe condition of paint & degree ot corrosion: N Li ur . Concrete or other fireproofing - note any cracking or spelling, and note where any covering was removed for inspection II. 46, i jd.Elevator sheave beams & connections, and machine floor beams - note condition: 1\1 k . Full description of structural system -4E Pro31 ita; .. Cracki,, ot gnificant ocation and description of members affected and type cracking General condition . 4. Significant-structural repairs required • e a - . la. Type — fully describe if mill dOnstruciton, light construction, major spans, trusses; Note metal fitting i.e., angles, plates, bolts, split pintles, pintles, other, and note condition: . Joints — note if well fitted and still dosed: •. Drainage — note accumulations of moisture: ie. Ventilation —note any concealed spaes not ventilated: If. Note any concealed spaces opened for inspection: i 1. Non le . ocation and description of members affected and type cracking 3. Significant but patching will suffice 4. Significant - structural repairs required (describe) e. Sam. = ipped out in spall areas: No. . s, describe color, texture, aggregate. general quality: 9.: 'WINDOWS (Wood, steel, aluminum, jalousie, single hung, double hung, casement, awning, pivoted, r xed they) 11 nchorage — type & condition of fasteners and latches: Sealant — type of condition of perimeter sealant & at mull' s: �� L L - • Id. Interiors seals — type & condition at operable vents: N je. General condition 1 MIAMI -DADE COUNTY, FLORIDA MINIMUM INSPECTION PROCEDURAL GUIDELINES FOR BUILDING'S •ELECTRICAL RECERTIFICATION INSPECTION C M DATE: /�/" INSPECTION COMPLt 1 tD DATE cZho— INSPECTION MADE B SIGNATURE: PRINT NAME TITLE ADDRESS: BUILDING DEPARTMENT t1 AM . Name of Title: 1 .,K4,4, 1111■111111 . Folio Number of Building: 1 MIKEDIMILMERWIfir Street Address: Legal Description: LO Owners Name: Owners Mailing Address: Budding Code Occupancy Classification: Present Use: General Descrip on, T Additional Comment of Construction, Size, Number of Stones, and Special Features GUIDELINES AND INFORMATION FOR RECERTIFICATION OF ELECTRICAL SYSTEMS OF FORTY (40) YEAR STRUCTURES 1. :ELECTRI:CSERKiCE 1. Size: Amperage 2. Phase: T. - ' ase 3. Condition: 4. Comments 2. METER :AND'ELECTi1C RO 1. Clearances: Good ( . Comments: • :� Ilry Fit . Location: 2. Taps and Fill: Z. Comments: 13. Panel # ( Location: 4. Panel # ( ) Location: r FuseO ( ) Breakers ( Single Phase Fair ( ) Needs Repair Fair E Good Good Requires Correction Requires Repair Requires Repair Needs Re . air Needs Repair 77 Needs Repair ( ) ( 1 5. Panel # ( ) Location: 16. Comments: BRA461111* 1. Identified: 2. Conductors: 3. Comments: ood { Good ( Good ( ) Needs Repair ( Needs Repair ( ). .N..�.::: .:,'..�. �•. •:...::':ilia: Rmti:aw tivb� �i .. ............... ». Yes ( ) Must be identified Deteriorated ( ) Must be replaced ( ) 1 6. GROUNDING 2 1 . Condition: !Comments: 7. GROUNDING OFEQUPME Condition: !Comments: 8. •SERV10EiCP OPILIPIRAAPV.A. Condition: Comments: 9. SERVIdE Condition: Comments: t :EMER, Condition: Comments: Condition: omments: Orillato , 14. FiRgAlAwp. Condition: omments: 15. SMOKE` DETIBC:43RS ■•• APAIMMO.Ai 10.. TYMBP: TRICIG5 Condition: Conduit Raceways: Conduit PVC: NM Cable: BX Cable: PP "Ate=s etif Condition: Comments: Good Good M. •••,. • • ••••••,. ?: Good Good Good Good Good Good Good Good Repairs Required ( Repairs Required ( - 711-7;D: • ■••-• , F . , " :"••" '?"7 , 7i7•7" , . •;•"! Repairs Required ( ) Re airs Re uired (>< ( ) ( ) ( ) Repairs Required Repairs Required Repairs Required Repairs Required - go4 , 14. %.*71.ydr. Repairs Required Repairs Required ( ) t200d • • ' Re Reguired Repairs Required Condition: Comments: 1 16. EXITALI Condition: Comments: 1 16. WJFWJ Condition: Comments: Condition: omments: 17. EMERWW Condition: • lComments: *EC _ Condition: Comments: SD:rtc:rv:09/01/2000:40yrintranetsystem Tatfthligft70#4 7:47.A70.0017eW. Good ( ) 4 '• Condition: omments: 410041g , Attif . gratrrpi urrt4i; •NE • hIlgq....t■T • Good ( ) Repairs Required ( - - • • . Good Repairs Required RKING. SURFACE t, zpt • r .1.! UGHTNG Good Illumination Required Repairs Required ( ) Repairs Required Repairs Required Lt5= 1, .• - • Good ( Re airs Required r r,r4A161. 4 ..