BPP-17-2541?pr ?„.Sk-11
C'f eg'
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO. BPP -10-17-2541
■ Permit Type: Pools/Whirlpools/Hot Tubs
ermiWork Classification: AdditioniAlteration
Permit Status: APPROVED
Issue Date: 11/712017
Expiration: 05/06/2018
Parcel Number
Applicant
1200 NE 105 Street
Miami Shores, FL 33138-
1122320910001
Block: Lot:
VILLAGE DEL MAR
Owner Information
Address
Phone
Cell
Village Del Mar do Regatt Management 1200 NE 105 Street
MIAMI SHORES FL 33138
Contractor(s)
L A POOL SERVICE INC
Phone
(305)216-2492
Cell Phone
Valuation:
Total Sq Feet:
$ 3,600.00
900
Approved: In Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Work: Swimming Pool
Additional Info: REPLACE TILE DIAMOND BRITE TO THE
Classification: Residential
Occupancy: Private
Bond Return :
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$2.40
$2.25
$2.00
$0.80
$150.00
$9.00
$3.20
$169.65
Pay Date Pay Type Amt Paid Amt Due
Invoice # BPP -10-17-65456
10/25/2017 Credit Card $ 50.00 $ 119.65
11/07/2017 Credit Card $ 119.65 $ 0.00
Available Inspections:
Inspection Type:
Fence
Final
Pool Deck
Wall Steel
Review Planning
Review Building
Review Building
Review Plumbing
Review Electrical
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 re, I authorize the above-named contractor to do the work stated.
November 07, 2017
Authorized : Owner / Applicant / Contractor / Agent
Building Department Copy
Date
November 07, 2017
1
(0(
2L(972
Miami Shores Village RECEIVED
1- _3 ,.�` Building Department CT 25 2017
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
�� Tel: (305) 795-2204 Fax: (305) 756-8972 11
INSPECTION LINE PHONE NUMBER: (305) 762-4949 5fi
\/\ FBC 20IU ( I
BUILDING Master Permit No.f p� t\ —ZSu I
PERMIT APPLICATION Sub Permit No.
❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City:
/a S'
Miami Shores
County:
Miami Dade Zip: 33 /36
Folio/Parcel#: / /— 2.2 3 -2 0 4) -000 ( Is the Building Historically Designated: Yes NO i{
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): �)0 /,5',Z /ISS
Address: /2_ Oa ,VW R /n $ Sf .
City: ,(..r / Sia 2-.0 State: �L
Tenant/Lessee Name:
Email:
Phone#: 30E- 69ZU
Phone#:
Zip:
3 /36
CONTRACTOR: Company Name: 2 4 pro L 5e-'40 ire, 1,0 C
Address: 7 y 9s rvzo S>< 5716/5—
City:
714" 5City: A.,/ 4 /C 1 / .State: �C Zip: 'b 3 / Z p
Qualifier Name: .� Vj( l.( 416-05-744.
WDf Phone#: 30 (- aJ�6_) J 2
State Certification or Registration #: (RP -- S S 55-01- )-Certificate of Competency #: p000 y/4
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work: dv
Phone#: 3.0 r---2/4.
0
Type of Work: ❑ Addition ❑ Alteration [1] New Repair/Replace ❑ Demolition
Description of Work: ej p ��, C:.� "�/'e dig 4(10/() (Q fj vi /.-e An f c�.e ,Po Z
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ I i 6S
(Revised02/24/2014)
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 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.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
4-1)+17
day of °C-'7°C-'77)671--�, 20 / / , by
4 ` 14. Ei , who is personally known to
me or who has produced as
identification and w . did take an oath.
NOTARY PUBL
Sign:
Print:
Seal:
APPROVED BY
(Revised02/24/2014)
CONTRACTOR
The foregoing instrument was acknowledged before me this
v day of f 20 /' , by
r 14- , who is personally known to
me or who has produced
nriL
identification and who did t
NOTARY PUBLIC:
Sign:
Print:
Seal:
e an oath.
as
Notary Pubiic. State of Florida
Commiseion# FF 163909
My comm. expires Sept. 28. 201 8
********************************************************
Plans Examiner
Structural Review
Zoning
Clerk
, ,,r6ANC3-0
7
LUIS ALFREDO VIGANEGO
-•••�
Notary Public, State of Florida
Commission# FF 189946
1 ;ire : :
My comm. expires Jan. 14, 2019
***************************L***.***************
APPROVED BY
(Revised02/24/2014)
CONTRACTOR
The foregoing instrument was acknowledged before me this
v day of f 20 /' , by
r 14- , who is personally known to
me or who has produced
nriL
identification and who did t
NOTARY PUBLIC:
Sign:
Print:
Seal:
e an oath.
as
Notary Pubiic. State of Florida
Commiseion# FF 163909
My comm. expires Sept. 28. 201 8
********************************************************
Plans Examiner
Structural Review
Zoning
Clerk
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
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 constructed or installed at
U LI_14-6e1- 11-11. /2-00 PI /04`5/Miami Shores, FL, and hereby
affirm that one of the following methods will 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).
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. .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 prime contractor.
_ /o/re/r )-
CONTRACTOR'S SIGNATURE AND DATE
44654, •
C Q�RA� OR 'S NAME ((P)jEAJ P�
L.Wit:r!%<At
iFfilr,7174 !0.Z.
'- !.
BiAry Public. tate of Florida
,,A'1,
Commission# FF 163909
'I."
My comm. expires Sept. 28, 2018
#X7
E AND DATE
u; 6gc, .130)
E PRINT)
4ireot
LUIS ALFREDO VIGANEGO
Notary Public, State of Florida
Commission# FF 189946
My comm. expires Jan. 14, 2019
Miami Shores Viiiage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
SWIMMING POOL OWNER'S CERTIFICATION
Date 10/11H
Miami Shores Village
Building & Zoning Department
Attention: Building Official
Icertify that I am the legal owner of the property described as \ I ��J1 � Q\ M oI r , located at fa )1/4)��
In accordance with Section 33-12(9, Code of Metropolitan Dade County, l 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
Legal Owner
ij\\\Q �� Ow g5%c.-
Note: This certification is to be submitted with a swimming pool permit application in duplicate.
Miami Shores Vitiage
Building Department
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: UkttcAuPAn_^WHEREAS, the undersigned Ad(A14 Q17 RCP
� .
is/are the fee
simple owner(s)ofthe following described property situated and be in Miami Shores Village, Florida:
Address: 9.00 �� d f (n,r�l��J ITv� t♦ �J�3
Whereas, the undersigned owner(s) NC.(j *I\ Q� �s V k\\D I f'
rs o(
desire to utilize said Lot(s) as a single building site, and the undersigned ownees) here y declare
and agree as follows:
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.
. r,
;� � u� -�► r ��°IIS , kf viw
SIGN & PRINT
OWN GN & PRINT
I Hereby Certify that on ttO stay pers n lj appea ed before me 4i)4 -r7
and has produced ID # o! j Y26 0 as identification and he/she acknowledge that he/she
executed the foregoing, freely and voluntarily, for purposes there in expressed.
SWORN TO AND SUBSCRIBED before me on this 0 day of a 'eV
4.0777z -
(Revised 05/2209
messiismiumsamoniansirmsompo
LUIS ALFREDO VIGANEGO
Notary Public, State of Florida
Commission# FF 189946
My comm. expires Jan. 14, 2019
20 f
9 (/6v0 /k/LI
TATE OF FLORIDA
VILLAGE DEL MAR CONDOMINIUM ASSOCIATION
We approve L.A. Pool Service Company as the
official contractor to do the repair work at the
community pool.
Village Del Mar Condo Association
President — Adam Roth
1200 NE 105 ST Miami Shores, FI 33138
2017 FLORIDA NOT FOR PROFIT CORPORATION AMENDED ANNUAL
REPORT
DOCUMENT# N03000002434
Entity Name: VILLAGE DEL MAR CONDOMINIUM ASSOCIATION, INC.
Current Principal Place of Business:
1200 NW 105 ST.
MIAMI SHORES, FL 33138
Current Mailing Address:
1430 NW 15 AVE
MIAMI, FL 33125 US
FEI Number: 11-3717545
Name and Address of Current Registered Agent:
PAUL A. MCKENNA & ASSOCIATES, P.A.
1360 S DIXIE HWY
# 100
MIAMI, FL 33146 US
FILED
Jun 12, 2017
Secretary of State
CC0576161146
Certificate of Status Desired: No
The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida.
SIGNATURE:
Electronic Signature of Registered Agent Date
Officer/Director Detail :
Title P/T Title DIRECTOR
Name ROTH, ADAM Name ROGHI, FRANCOIS
Address 1430 NW 15 AVENUE Address 1430 NW 15 AVE
City -State -Zip: MIAMI FL 33125 City -State -Zip: MIAMI FL 33125
I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under
oath; that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 617, Flonda Statutes and that my name appears
above, or on an attachment with all other like empowered.
SIGNATURE: ADAM ROTH
PRESIDENT 06/12/2017
Electronic Signature of Signing Officer/Director Detail Date
LA,
POOISEAI7CE
7495 NW 7 ST STE # 5
MIAMI,FL33126
305 216-2492 FAX 305
269-1998
T .FX(alT .A PfN1T .SPR VTCFTNf
Name / Address
VILLAGE DEL MAR CONDO
PO BOX 4579 DEPT 150
Houston, TX 77210-4579
Estimate
Date
Estimate #
10/20/2016
977
Project
Customer Signature
Project
Description
Qty
Cost
Total
EMPTY THE POOL OUR SUBMERSIBLE PUMP
1
0.00
0.00
REMOVE ALL MATERIAL THAT IS BAD (balloon and small
cracks )
1
0.00
0.00
INSTALLING THE MUDCAPS IN THE STEPS OF THE
1
0.00
0.00
LADDER
PREPARE AND INSTALL THE PLASTER ( COOL BLUE)
1
3,900.00
3.900.00
REPLACE THE MD COVER AND JET
1
0.00
0.00
FILL UP THE POOL AND BALANCING
1
0.00
0.00
DISCOUNT
1
-300.00
-300.00
WE BEAT ANY PRICE IN THE MARKET
1
0.00
0.00
5 YEAR WARRANTY
0.00
0.00
Thank you for your business.
Total
Customer Signature
1
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ERMIT- :
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04-47/
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APPROVED
DATE
ZONING DEPT
BLDG DEPT
tr—
RECEIVED
OCT 25 2017
SUBJECT 10 CCA, PLIFNCE WfVH AL FED IQp)%9"I,
STATE ANL) CC -UN, ( riULLS AND R• GULAji N 4
Folio: 11-2232-0117-0001 (Reference)
Sub -Division:
VILLAGE DEL MAR TOWNHOMES A CONDO,
VILLAGE DEL MAR TOWNHOMES A CONDO
ANCO SUB PB 53-54
PORT OF LOT 1-A & LOTS 2A & 3-A
AS DESC IN DEC OR 22094-1876
LOT SIZE 24219 SO FT
FAL/ 112232-027-0020-0030-0040
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01/25/2017
Miami -Dade Property Appraiser
Property Address:
Date Printed: 10/18/2017
•
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01/2512017
Miami -Dade Property Appraiser
Property Address:
Date Printed: 10/18/2017