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DS-13-464Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 186985 Permit Number: DS- 3- 13-464 Scheduled Inspection Date: April 29, 2014 Permit Type: Driveways /Sidewalks /Slabs Inspector: Rodriguez, Jorge Inspection Type: Final Owner: HART, NEIL Work Classification: New Job Address: 295 GRAND CONCOURSE Miami Shores, FL 33138- Phone Number (305)962 4547 Parcel Number 1132060133600 Project <NONE> Contractor: ROSS SERVICES Phone: (954)401 -2013 comments ADD 500SQ FT F MIAMI PAVERS TO MATCH EXISTING I AS PER PLANS INSPECTOR COMMENTS False April 28, 2014 For Inspections please call: (305)762.4949 Page 2 of 25 Inspector Comments Passed Failed Correction Needed ❑ Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 28, 2014 For Inspections please call: (305)762.4949 Page 2 of 25 U, 5, M iaml S hores V11age ,cl-717p- MAR 14 Building Department ;j'�' 10060 N-Und Avenue Miami ShOm, Florida 33138 TIC; (3o5) m,?W4 Foo (305) 75&w72 CHANGE OF CONTRACTOR / ARCHITECT PMM -2—�64 0"W8 WN (Fee fto rft To -r Prone t. 30 tqQqs, 4� OwWs Aftm: State: r-- C3— 0 Job Address (Of W1 work Is W4 d=) I- el Ckf*. Miami smros� State, (L QL CC% 4f &�o —Roft—� zip CW8. Cdr d0es Cry Nate: 40S.- Pht. Address: one c4r. 12� State:- Zip Code. 04 Quallffees Name C e: Nutter. C tic. Amhk%cV BOW of Record Address: M341 Describe VVb&- � kiz,-�L -- Phonet!D�C�-�S- 14 - 423, 8 I hereby certify that the work has been abandoned andfor the contractodwchited is unable or umWolng to complete the contract, I hold the Building Official and the Mlon! Shores harmless for all ISO lnvolvwnft D 4-� 0OW-OrApd The b99ft ant was BbWwW* betm n* The Vft 65 WOURY Mown to 118 Or Vft fm pmduoW as h*ff=ft. 61 Seat: wo WUHAWOW tie fro Rh �M by My COMMISSION #FF01 Miami Shores 'pillage Building Department 10050 N.E.2nd Avenue, Miami ShOM Floxida 3313$ Tel: (305) 795.2204 Fast. (305) 756.8972 INSPECTIONS PHONE NUMBER: (gam 762.4949 BUILDING PERMIT APPLICATION Permit Type: BUMDING JOB ADDREW.- C> t (._goC citr- 11+11emi SIx Comty: FOlio/Parcel#: b Me Building MAarlcaily Designated.. Yes OWNER; Name (Fee IVXVZ# Ai CONTRACTOR: FBC ZU PermkNo. Mier Permit No. ROOMG zow: state: - _' DESIGNER: ArcltiiteW aginew Value of Work for this Pertnit: $ a� Square/iinear Footage of Warkw T"e of Work: DAddi&m DAlter on ONe Description of Work: 1`l� . ll�L• =- �, n f.''7 color SabmhW Fee S Permit Fee $ CCF $ COICC $ Scanning Fee $ Radon Fee S . DBPR $ Bond $ NotalY $ Trai hWEdacatiion Fft $ TechuMogf Fee $ Double Fee $ Structural Revlew S ____ TOTAL FEE NOW DUE $_� Bending Company's Name (if applicable) Bonding Company's Address l C1 �!2✓ 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 alt laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUWM, SICsNS, WELLS, POOLS, FURNACES, BOII ERS, 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 applkwd 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 inspecdon will not be approved and a reinspecdon fee will be charged Signature ! ~ L Owner or Agent The faregoing instrument was acknowledged before me this day of -ftZO, by who is personally known to me or who has produced As identification and who did take an oath NOTARY PUBLIC: APPROVED BY signature Contra The foregoing instrument was aclmowledged befse me.tb _• day of 20 L 'by T"n 1/'/', o e "; who is pertly known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: (Revised 5PI1Z012)(Rv4i=d 3/121 112 ) = XRevissd otilll )( Reviwd 3n W9XRevisW 7110=7) zo Clerk ■ Complete Hems 1, 2, anti 3. A complete s ►e+� Nem 4N 1loteci De X Ltlol • Nnt your name and add on reverse Addressee so that we can return the lard to you. Attach Oft card to the back of the maltplece, g; by fp, ) —�� C. natg of Delivery or on the front N space permits. t. Artist® to: D. (s de6ve�y address r,9:"n Item 1? O Yes If YES, enter �� 0 No , �y " SZII %10 kV Service TAM O Pa&bmd ® Rdwn Pmelpt for Mwdmdm 0 Insured Mao 0 C.O.D. 4. Pm&ktad Delivery? (60a Fee) O Yes 2. Article Number R►msfar*o , wMw ts} 7013 2630 0000 3369 3431 PS Form 3811, February 2W4 Owestic Return Remot 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 BUILDING PERMIT APPLICATION C 20 Permit No. L 1 Master Permit No. %% -- Permit Type: ILDING ROOFING JOB ADDRESS:-925' DDRESS: 9 25' City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO _ Flood Zone: 011fe A OWNER: (Fee Address: • 9411 City: M/AlIkv, Tenant&zssee Name: Email: CONTRACTOR: Company Name: IL � � � ��C�J C'. �° Phone#: 30 5" 01%� — 3 74 2 Address: 16 Tl S W /3 0 V 9 City: h / Qualifier Name: L State Certification or Registration #: Contact Phone#:" G DESIGNER: Architect/Engineer: _ 2] `?' ?/ of Competency #: // POO Value of Work for this Permit: $ '(70o t a'° Square/Linear Footage of Work: . s1�7 Type of Work: OAddition hp" n n h Description o W, Submittal Fee $ Permit Fee $ ONee /w Scanning Fee $ Radon Fee $ Notary $ Trahung/Education Fee $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE �� .J . ' Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State zip 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 Con 4G The foregoing instrument was acknowledged before me this day of l t` , 20 a by who i ersonally known to me r who has produced As identi The foregoing instrument was acknowl ed before i e day of 20Lby, who is personally known to in or who h6s r_p oduced as identification and mhe adid take an oath. L4, Notary Pubuc State of Florida NOTARY PUBLIC: �e11 shorn NOTARY PUBL My Commission EE 18250a Expires 04/27/2016 Sign Sign: Print: VJ1 r 14 i� Print: d Nalsry Fuolic State of Florida Abet Jesus Vener+eo My Commission Expires: y.- r —024/ �/ My Commissio v My Commission EE036321 �aa� Expires 12128!2014 ak �k sk sk da sk sk ak �Ia ak sk H� � �k ak sk ds � ?k d � d� $a �k da ak��k His sk�sk �Ia �x �k �k �k sk �k �R d�da ak /k ak � d� ak da Ha nk ik �k � �k �k > K � N da sR da ds ak Kok sk Aa N APPROVED BY `! %��" / /� Plans Examiner _ Structural Review (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /102009)(Revised 3/15/09) Zoning Clerk 10/18/2012 17:09 3052656246 OBREGON INS PAGE 02/02 ' " '� CERTIFICATE OF LIABILITY INSURANCE OA7E(MRIIOnIWYY) �-� j 1 art E3r1 a THIS WRTIFIWE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS 90 RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMAWELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the ceilffir to holler IS an ADDITIONAL INSURED, the pollWlea) must he endorsed, If SUBROGATION IS WANED, subjed to the terms and oond)pons of the policy, eertaln policies may require an endDmment A statelnent On this Certificate does not CoMa► flghts to the certificate holder In lieu of such endorsemenge} PRODUCER 0W QA YOANA G13REGON Obre •- Y w n Insurance Nam — ._._.. 0p PA�.NeEle._�)• (805) 265.8226 Not ($05) 265 -f3248 1740 SW 57 Ave 'MAIL obre ®oninsurenc®yn�i400m .Op,RF,S3: Miami, FL 33155 1NSURERr81 AFFORDING COVERAOG NAIC 0 Phone (30$) 2656226 Fax (305) 265 -6246 INSURER A: • GRANADA INSURANCE COMPANY INSURED INSURER 13; RM DESIONS CONCRETE CORP INSURER 0: 10251 SW 130TH AVE 1NSURERD,,�_ MIAMI, FL 33186 INSURFJi E: ^_ _ COVERAGES CE INSURER F RTIFICATIS IULIMFIPP- QCtlle:l/1W til11AADDD• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE: FOR THE! POLICY PERIOD INDICATED. NOTVNTHSTANDINO ANY REQUIREMENT, TERMS OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUOIES. LIMITS SHOWN MAY HAVE BEEN REDUCCO BBppYppPAID C�LppAJM��S.. INS TYPEOF INSURANCE yip POLICY NUMBER "MMIUDrIlYYYY MIVIIDD/YYYY I LIMITS _ -- A OENERAI. LIABILITY [] COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMSMADS ❑ OCCUR ❑ ❑ GENLAGCRMATEUNT APPLIES PER; ❑ Poucy EI PRO' ❑ LOC 0165F L00039718 10/02!2012 10/02/2013 EACH COMENCE $ 500 000.00 RENTED R ISES [Ea tsccurrance] $ 100,000.00 MED W (Any one ICI an S 5,000.00 PERSONAL A ADV !•N�+URY S 5,000,000,00 GENGRALAGGREGATE s 5,00D,000.00 PRO DUCTS, COMPIOP A00 S O.OD C�OMESNED 31NLaLE LibaT AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ AULT09�� ❑ SC14®UL513 ❑ HIRED AUTOS ❑ A�UTNOgVYNEb BODILY INJURY (Pew pm-an) 9 $ $ BODILY INJURY (PeraadderM LgPGRTY AMAG r dcciaen EACH OCCURRENCE 5 ❑ UMBRELLA UAE ❑ OCCUR ❑ F.YCESS LIAR ❑ CLAIMS.MADE AGGREGATE $ ❑ OED ❑ RETENTION$ _ �• $ WOR11011SCOMPENBATION AND EMPLOYERS* LIABILITY YIN OFFIG�ERIMEMi ER OCCIUD UTiV (Mandatory In NH) DRIFT ON dP�AnoNe Imt� NIA — ~^ ❑ OTOT R LAIpTAIxS �. E.L. EACH ACCIDENT $ ....-- E.L. DISEASE - EA EMPLOYS $ _ R.L. DISEASE - POUCY LIMIT _ S — P— L --i DESCRIPTION OF OPERATIONS 1 LOCATIONS f VENICE RS (AlQoA ACORD 707, Additionef Remern Schedule, M mare mpae:e ha n qulMd) CERTIFICATE HOLDER CITY OP MIAMI SHORES 10060 NE 2 AVENUE MIAMI, FL 33138 ACORD 25 (20101115) QF CANCELLATION SHOULD ANY OP THE ABOVE DESCRIBED POLICIES THE EXPIRATION DATE THEREOF. NOTICE WILL BE ACCORDANCE WITH THE POLICY PROVISIONS. BEFORE; 01988 2010 ACORD CORPORATM All rights reserved. The ACORR name and logo are registered marks of ACORD �,.. w w � -- - -ice - I �I ' I. I'�. Miami Shores Village 10050 N.E. 2nd Avenue Miami Shcres, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756-8972 Permit NO. DS -3 -1 3— jP4 1 Issue Date: 3/21/2013 Expires: 09/17/2013 INSPECTION REQUESTS: (305)762 -4949 or Log on at https : /Ibldg.miamishoresvillage.com /cap REQUESTS ARE ACCEPTED DURING 8:30AM - 3.30PM FOR THE FOLLOWING BUSINESS DAY. Requests must be received by 3 pm for following day inspections. Driveways /Sidewalks /Slabs Parcel #:1132060133600 Owner's Name: NEIL HART Owner's Phone: (305)962 -4547 Job Address: 295 GRAND CONCOURSE Total Square Feet: Bond Number: Miami Shc,res FL 33138 - Total Job Valuation: 500 $ 4,700.00 WORK IS ALLOWED MONDAY THROUGH SATURDAY, 7:30AM - 6:0013M. NO WORK IS ALLOWED ON SUNDAY Contractor(s) Phone Primary Contractor OR HOLIDAYS. R &M DESIGN CONCRETE CORP Yes BUILDING INSPECTIONS ARE DONE MONDAY THROUGH THURSDAY. ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY. NO BUILDING INSPECTIONS DONE ON FRIDAY. NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED. PLANS ARE READLY AVAILABLE. IT IS THE PERMIT APPLICANT'S RESPONSIBILITY TO ENSURE THAT WORK IS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO - OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.