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BPP-12-3340 Permit NO. BPP-12-16-3340 Miami Shores Village t Permit Type:Pooistwhliripools(Hot Tubs M10050 N.E.2nd Avenue NE ON Q Work Classification:Addition/Alteration Miami Shores,FL 33138-0000 PumrlllPermit Status:APPROVED Phone: (305)795-2204 s FLORIDA Issue Date: 1/5/2017 Expiration: 07/04/2017 Project Address Parcel Number Applicant 1130 NE 91 Terrace 1132050010410 Miami Shores, FL Block: Lot: BARBARA TER HORST Owner Information Address Phone Cell BARBARA TER HORST 1130 NE 91 Terrace (305)432-1775 MIAMI SHORES FL 33138- 1130 NE 91 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 3,800.00 NATIONAL POOL DESIGN LLC (305)559-1020 .. v.� �e..... Total Sq Feet: 450 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved: : In Review Fence Date Denied: Final Type of Work:Swimming Pool Occupancy:Private Pool Deck Additional Info:REPLACEMENT OF POOL WATER LINE Bond Return: Wall Steel Classification:Residential Scanning:3 Review Planning Review Electrical Review Building Review Plumbing Fees Due AmountPay Date Pay Type Amt Paid Amt Due CCF $2.40 DBPR Fee Invoice# BPP-12-16-62315 $1.71 01/05/2017 Credit Card $82.82 $50.00 DCA Fee $1.71 Education Surcharge $0.80 12/12/2016 Check#: 1072 $50.00 $0.00 Permit Fee $114.00 Scanning Fee $9.00 Technology Fee $3.20 Total: $132.82 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. OWNER AFFIDAVIT: I c ity t tall the going information is accurate and that all work will be done in compliance with all applicable laws regulating constr adz Hing. F ter re, I a orize the above-named contractor to do the work stated. January 05, 2017 Authorized Signatur wner / Applicant / Contractor / Agent Date Building Department Copy January 05, 2017 1 ' C _'VED Miami Shores Village o .2 Zoos Building Department Y:_ 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 20145+h BUILDING Master Permit No. bpp 16 – `i O PERMIT APPLICATION Sub Permit No. .BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [--]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: II 3 0 A/TG)I �� r►� City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: SEP_ Load: Construction Type: 900Flood Zone: BFE: FFE: L• OWNER: Name(Fee Simple Titleholder): I la✓b&li r a ?r r Aai- i- Phone#: 77j, Address: /l 2 0 NF 91 7-er✓ City: CA02 i �h o rc I State: r—L- Zip:_ 3�l 3f Tenant/Lessee Name: A.l/!4 ` Phone#:_T Email: Qrf 6 �0 577 0 J / i G U JZ CONTRACTOR:Company Name: _ (0/ P#d / el J-6 4 L LC__ Phone#: 9 o r S5-!/d a-O Address: 9U-3 JW /(47 OVL !/Y)►� a �-- -78 b— Z.6-1` 55q 5 0-F4-0 City: 11-4'Li ►')'1 ► State: FL Zip: %j 1®■'(- Qualifier Name: r1 Z Phone#: State Certification or Registration#: O—PC /L�,- 7k-L}.- Certificate of Competency#: DESIGNER:Architect/Engineer: y>, {,,�✓ fZcG✓Q-I Phone#: Address: I3 r 3 a So 75-/. S j City: /A 1 Arn State: AL Zip:33 / 77 Value of Work for this Permit:$T 9 ADD. 06 Square/Linear Footage of Work: 4,1 �0 c� Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: n.; �6D / G AHI'Afv.t 2614) oil Specify color of color thru tile: Q Submittal Fee$ Permit Fee$ �'—_!_ CCF$ 2~'��1d CO/CC$ Scanning Fee$ Radon Fee$ —1 ' DBPR$ ' T Notary$ `— Technology Fee$ Training/Education Fee$ 030 Double Fee$ Structural Reviews$ Bond$ gyp, TOTAL FEE NOW DUE$ �• �1 (Revised02/24/2014) Bonding Company's Name(if applicable) {V 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 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. I Signature i Signature OWNER or AGENT CONTRACTO The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 1�C e s,4 ase✓ ,20 I by day of L %7)�wlr 20 16 by �! A/b A✓�' V JS who is personally known to �I�`• y� who is personally known to '�- r Y '� `1 r Y me or who has produced as me or who has produced I/AJ as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: �• p ,, r Piy'' MARIA THERESA PINO Sign: ..�' �e a, MARIA THERE7FIorida Sign: Notary Public tMy Public-StatePrint: 12 Ion# Print: �c Commission#FF 15368 My Comm.Expires May 7,2017 -%,,os�n•.: y comm.Expires ay , Seal: Seal: RP W co APPROVED BY u�- v Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 5�1OR10c. Es G, s� �� Miamishores Village ••-s~ Pill ""'�' Building Department 7181 10050 N.E.2nd Avenue �LORIDp' Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 NOTICE OF REQUIREMENTS RESIDENTIAL SWIMMING POOL,SPA AND HOT TUB SAFETY ACT I (We) acknowledge that a new swimming pool, spa or hot tub will be at 1(ba Ay87 0 ( .T t?#)CG ? N�:?g Miami Shores, FL, and hereby affirm that one of the following methods wi be used to meet the requirements of Chapter 515, Florida Statues and the Florida Building Code R4101.17. Please initial the method(s)to be used: The pool will be equipped with an approved safety pool cover that complies with ASTM F1346-91. (Submit Manufacturer's Specifications). A continuous,one-piece(child) barrier meeting the requirements of Florida Building Code R4101.17.1.15 will protect the pool perimeter. The plans shall show the fence location and method of attachment, including one end that shall not be removable without the aid of tools. (Submit Manufacturer's Specifications). _ V _A combination of non-dwelling walls and fences(screen enclosure,child fence, masonry fence walls,chain,link or wood fence,etc.)will protect the pool perimeter. The plans must specify the type and location of all non dwelling walls. Florida Building Code, R4101.17.1 ✓ Any combination of protection which incorporates dwelling walls with openings directly into the pool perimeter and all windows and doors will be equipped with exit alarms complying with Florida Building Code, R4101.17.1.9(Submit Manufacturer's Specifications). Any combination of protection which incorporates dwelling walls with openings directly into the pool perimeter and all doors will be equipped with a self-latching device with positive mechanical latching/locking installed a min. 54"above the threshold. If this option is selected,submit plans showing all types and location of all perimeter protection. The plans must also show the location and type of all openings,and the hardware type for each location. (Submit Manufacturer's Specifications). In accordance with the Code,the pool may not be filled with water without compliance with the Private Swimming Pool Safety Requirements,and upon expiration of the permit,the pool shall be presumed to be unsafe. I understand that not having one of the above installed will constitute a violation of Chapter 515, F.S.,an d will be considered as committing a misdemeanor of the second degree, punishable as provided in Section 775.082 or Section 775.083 F.S.This form must be signed by the owner/agent and the 'me contractor. ,priC2 2 . 201 CONTMCT&SIGN URE AND DATE WNER'S SI NA E AND DATE lfr4dal Udr ./ee- /ffa hor r ;ot�a MARIA THERESA PINO CONTRACTOR'S NAME( E PRINT) OWNER'S NAME(PLEASE PRINT) = Notary Public-state of Florida PL AS Commission#FF 15368 My Comm.Expires May 7,2017 NOTARY PUBLIC NOTARY PUBLIC ORES h t,,, ,,,Nrm Miami Shores Village Building Department �LOiR1Dp' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RESTRICTIVE COVENANT PROTECTIVE POOL ENCLOSURE KNOW ALL MEN BY THESE PRESENTS: WHEREAS,the undersigned 266PA9 —T?;?Z 16�r &Qis/are the fee simple owner(s)of the following described property situated and being in Miami Shores Village, Florida: Address: (130 A)-G- Q I • 7W-P-Iq-c , Whereas,the undersigned owner(s) desire to utilize said Lot(s)as a single building site, and the undersigned owner(s)do(es)hereby declare and agree as follows: I. That the property will not be used in violation of any ordinances of Miami Shores Village or Miami-Dade County now in effect or hereinafter enacted. II. That the purpose of the covenant is to induce Miami Shores Village to issue a permit for a pool where the required enclosure is not on the subject property where the pool is located. III. That if any of our adjoining neighbors remove any portion of their fence or wall,or if our/my property shall fail to meet code requirements for pool barriers,we, as owners will immediately installs a protective enclosure to meet code requirements and will obtain a permit for such fence. IV. That, I/we,as owner(s)hold Miami Shores Village harmless for any negligence or injury that results from not having the enclosure. V. If enclosure belongs to said property, I agree to maintain &or replace said enclosure in the event that is damaged or removed by any case. NOW,THEREOF,for good and valuable consideration,the undersigned do(es)hereby declare that he/she will not convey or cause to be conveyed the title to the above property without requiring the successor in title to abide by all terms and conditions set forth herein. FURTHER,the undersigned declare(s)that this covenant is intended and shall constitute a restrictive covenant concerning the use,enjoyment and title to the above property and shall constitute a covenant running with the land and shall be binding upon the undersigned,his/her successors and assigns and may only be released by Miami Shores Village,or its successors, in accordance of said Village then in effect. OWNER SIGN &PRINT OWNEft SIGN WIRNT I Hereby Certify that on this day personally appeared before me and has produced ID# as identification and he/she acknowledge that he/she executed the foregoing,freely and voluntarily,for purposes there in expressed. SWORN TO ANDS y of 20_6, MARIA THERESA PINO Notary Public-State of Florida Commission#FF 15366 �FF;�;: My Comm.Expires May 7,2017 OTARY PUBLIC STATE OF FLORIDA (Revised 05/2209 StIORPS G� logo n...� Miami Shores Village Building Department �L�iRIDA 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 SWIMMING POOL OWNER'S CERTIFICATION Date b e ce.•h n ✓ oZ, 2-0) 6 Miami Shores Village Building &Zoning Department Attention: Building Official I certify that I am the legal owner of the property described as 13ar,b r-A 12K6d,-fit" , located at 1 l � AJV q i T%2404}CS UbhymL GrTea-E55. 0. 3 g In accordance with Section 33-12(o, Code of Metropolitan Dade County, I certify that I understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until separate permit has been obtained for an approved safety barrier, and such barrier erected, inspected and approved. I further understand that this certification, however, does not eliminate the need for obtaining a permit and erecting and approved barrier prior to final inspection and use of the pool. Legal Owner—1)� Note:This certification is to be submitted with a swimming pool permit application in duplicate.