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BPP-17-233 Inspection Worksheet MiamiShores Village 100511 N.E. 2nd Avenue Miami Shores,FL Phone:(305)795-2204 Fax (305)7584972 Inspection Number: INSP-300668 PermitNumber: BPP'-1-17-233 Scheduled Inspection Date:April 03,2018 Permit Type: Pools/Whirlpools/'Hot Tubs Inspector:Naranjo,Ismael Inspection Type: Final 3 Owner: F,LORES,,SYLVIA Work Classification: Addition/Alteration Job Address:650 NE 97 Street Miami Shores,FL 33138- Phone Number i Project: < ONE> Parcel Number 1132060171640' Contractor: MASTER CRAFTSMAN POOLS INC Phone:(305)746-2849 Bu ldi"Department Comments ADD NEW SPA TO EXISTING POOL RE PIPE POOL ►nfractlo Pissed Comments' REMODEL SHAPE ON POOL INSPECTOR COMMENTS False t IInspector Comt ents PaSSEdTED ASREINSPECTION FOR IN 275572. (MAKE SU E'SUR EY -FINAL IS AT THE JOS SITE) failed Correcftn - Needed P i For,Inspections please call: (3115)762-4949 Page 34 of 35 r ` Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 nspectionNumber: INSP-300092 Permit Number: BPP-1-17-233 Inspection Date: March 23, 2018 Permit Type: Pools/Whirlpools/Hot Tubs Inspector: Kendall,Travis Inspection Type: Survey Final Owner: FLORES, SYLVIA Work Classification: Addition/Alteration Job Address:650 NE 97 Street Miami Shores, FL 33138- Phone Number Project: <NONE> Parcel Number 1132060171640 Contractor: MASTER CRAFTSMAN POOLS INC Phone: (305)746-2849 Building Department Comments ADD NEW SPA TO EXISTING POOL RE PIPE POOL Infractio Passed Comments REMODEL SHAPE ON POOL INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed t Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. r For Inspections please call: (305)762-4949 March 23, 2018 Page 1 of 1 D 'AVILA l Associates Services, Inc. ofessional Land Surveyors,Mappers&Engineers rtificate of Authorization NO.29o56&NO.LB'753A, " Main Line:(305)953-2600 I Fax:(305)953-26o•S " WWW.DAVILAASSOCIATESSERVICES.COM. J ENT:ERNESTJONES BOUNDARY SURVEY 17 DDRESS:650 NE 97 STREET MIAMI SHORES FL 33138 6a n s atP O SCALE =1:20 LOCATION SKETCH WTTH�,W O b��Oi 4 8W ALL LOT 5, BLOCK 100,MIAMI SHORES SECTION 4 AMENDED,ACCORDING TO THE PLAT THEREOF AS SCALE =N.T.S. f �b1N P X`.B Sb}�1 KOAGE 14,OF THE PUBLIC RECORDS OF MIAMI DADE COUNTY,FLORIDA. NE 97th STREET �/14ILlldflsl. M1E ON r 'r 9E � V QNSWERE MEASURED USING SURVEY-GRADE GLOBAL POSITION SYSTEM EQUIPMENT,THAT UTILIZES THE F.D.O.T. w A'w'. �{2 R(rNCE NETWORK AS ITS HIGH ACCURACY REFERENCE NETWORK(H.A.R.N) z o AAkbl.bAI 9 F,�GOID,INSURANCE RATE MAP OF THE FEDERAL EMERGENCY MANAGEMENT AGENCY DATED OR REVISED ON > tl9 f3.i�2d�9 E 1 I ETN.DESCRIBED PROPERTY IS SITUATED WITHIN ZONE X BASE FLOOD ELEVATION N/A COMMUNITY 120635 LU o o a� PANEL NUM13EP 008 SUFFIX L EFFECTIVE PANEL DATE 09-11-2009 Fri ¢� z Qom. 01 ;.�. ............. ... .... ..... ... .... . ... �. �`. .. T OTA L:.... ... W... ,:1 g`.:� .. S H...P.. WMT' ...............................-...... _....: .::. ... ... ................. ��. NE 97th STREET.. �.. I ­ ' .111.'i /.... ....... ..:::.: ........ ..... -. �..................... ...... .... ........ -�-I -�29.70' -�-I-- 's � 11-1�111�1�111�1�111�1�111T �-�-�-I-I-I-I-I-I-I-I-I ----I--�-I- o I I I-I ISI-I-I I-I Ln r` 1111111TILE.�1111111 23.4' PARKWAY ' •"' � I-I-I-I- I-I-I-I r; ., � • 11�ITI�IIITl�lll�l�l � 11111111111111111111 pECE@VED 11T1T1T1T1T1T1T1T1T1 R O 111111120�30'�111111 1 5'�'COt C' SnWK. 75 00'(R&MF) a a d° MAR 2 3 1.1118 y, 10. I-I-I 120.30-1 _I 25u0rrF:I.PY2 I�Iilill_lil�l 9�; F.LPY" 1 111 LOT 5 NO ID - NO ID o`O 111 �' PORTION OF �� 1111 BLOCK 100-1--1 LOT (JJ _ C:) 1-1 1�1i. q�rLi lel l I BLOCKI 0 m 111111111--� IIIIIIII o N 1111111!T,11111111I1 � Q r � 1111111TILEL11111111 I � I I I I-I-I-I-I-I-I I-I-I-I-I-I- � I- -------- I I I 11111111111111 oLj 10.00'I t o �4j �A.) 10.00' a2.ao' i�—— i1i1i1= 1�� / W -- I�I�I�I�I z ON PL 20.80 p 11111111 PL r 10.00' R ,5.00 GARAGE 6 v o 5.00 ,� FF=9.05' 9.30' O M zo O ON ONE STORY 'off R RES.#650 M x�� o FF=10.60' i 05 ; . o co LOT 6 x ° 0 I REMAINDER OF BLOCK 100 C:) co 39.00' 10.00 p LOT 4 16 o BLOCK 100 Cf)x o TE--RAS 00 6 �► o�• m C6 0 r 111----I--I-I-I-- --I-I-I-ILII POOL UL. x p� 11j----- 29.40 -- - 1111 PUMP U p I_I-ti Miami Shores Village v 1p•11 O POOL �p 1 i 1 1T 1 i 1 APPROVED BY DAT. 10.50' 10.60' �I� LL 1i1i-1 -P�_ SPd 1 1 ZONING DEPT '3/;L4 1 .00 8.90' — —I-1— — i-- LID 1 1-TILE-1111111 1111111- 1 ----I-I- o 7.20' !i1i1i11j1i1i1i1i1i1i 1111- BLDG DEPT KO s.70'I 0 d° SUBJECT TO COMPLIANCE_WITH ALL FEDERAL Ci �_ o -- 8.00 0� �� STATE AND COl l l`r i3lJt;ES`ANS]E�EGUL,4T v� I 0.10' �i� ��, �N It �t o � F.LP'Y" g �� e C.L.F.4' �� N ............................... a �.. w'.75.00 (R&MF) ............... I 10' ASPH. PVMT. LEGEND&ABBREVIATIONS A-ARC DISTANCE C.U.P.-CONCRETEURUTYPOLE LM.E.-W(E MAINTENANCE PONT-POINT OF TANGENCY STY.-STORY O1 =OVERHEAD UTILITY LINES D,A V I L A A/C-AIR CONDITIONER PAD CP.-CONCRETEPORCH ' EASEMENT' PO.C.-POINTOF SWK-SIDEWALK =CONCRETE BLOCK WALL(CB.S) AE.-ANCHOR EASEMENT CS-CONO2ETESLAB MINUTES COMMENCEMENT SIP-SETIRONPIFE K—x=,�— =CHAIN LINK FENCE(CLF) &Associates SBAV%CBS, Inc AR.-ALUMINUMROOF CW-CONCRETEWALK (M)-MEASURED DISTANCE POB.-POINTOFS.I.R.-SETIRONROO AS.-ALUMINUM SHED DE.-DRAINAGE EASEMENT (MF)-MEASUREDRELD P.R.C.-POINT OF REVERSE SP-SCREENEDPOROL =IRON FENCE(LF.) Land Surveyors&Engineers AS -ASPHALT DME-DRAINAGE MAINTENANCE M.E.-MAINTEWWCE CURVATURE S.V-SEWER YALVf � -WOOD FENCE(W.F.J CERTIFICATE OF AUTHORIZATION N0.29056 B.C.-BLOCKCORNER EASEMENT EASEMENT PWY-PARKWAY SECONDS 0199, � -ELEVATIONS CERTIFICATE OF AUTHORIZATION N0.7538 BLDG-BUILDING DRWY-DRIVEWAY. M.H.-MANHOLE PR.M.-PERMANENTREFERENCE T-TANGENT 14750 NW 77 CT SUITE 204 BM.-SENOIMARK •-DEGREES NAP-NOTAPARTOF MONUMENT TWP-TOWNSHIP MIAMI LAKES,FL TEE BOB.-BASISOFBEARING ELEV-ELEVA77W NOVI)-NATIONAL GEODETIC ALS.-PROFESSIONALLAND unL.-UnuTv -CONTACT YOUR PROCESSOR MI LAKES,FIL 3 0 (C)-CALCULATED ENCR.-ENCROACHMENT VERnCALDATUM SURVEYOR U.E.-UTIUTYEASEMENT CB.-GTCHBASIN FH.-RREHYDRANT N.T.S.-NOT TO SCALE PP-POWERPOLE UP.-UTWTYPOLE CBS-CONCRETE BLOC( FLP.-FOUND IRONPIPE #wNO.-NUMBER P.U.E.-PUBLIC UTILITY WM.-WATERMETER SIR RE F1R.-FOUND IRONROD O/S-OFFSET EASEMENT WF-WOOOFENCE �• O C.B.W-CONCRETE BLOCKWALL F.F.E.-FINISHED FLOOR O.H.-OVERHEAD WP-WOODPORCH CH.-CHORD ELEVA77ON O.RL-OVERHEAD U7TLRYUNES .(R)-RECORD DISTANCE WR.-WOOD ROOF CH.a-CHORD BEARING F.N.D.-FOUND NAIL&DISI( ORB-OFFICIAL RECORDS BOOK R.R.-RAILROAD WV-WATER VALVE CHL.-CHORDLENGTH FT.-FEET O.V.H.-OVERHANG RES-RESIDENCE M-MONUMENTUNE CL.-OEARI FNIP.-FEDERAL NATIONAL PJMT-PAVEMENT R/W-RIGHT-0FWAY (- / CENTER UNE CO._CLEANOUT INSURANCE PROGRAM PL-PLANTER RAD.-RADIUSORRADIAL d-DELTA BY • CLF-CHAINLINKFENCE FN-FOUNDNA(L PL PROPERTY RGE.-RANGE l-PROPERTYLINE D FRANCISCOA UIRREAE.,P•L.S•(03 -2018) CME CANAL MAINTENANCE INAEG.-INGRESSANDEGRESS ACC-POINTOFOOMTWND ROE-ROOFOVERHANG • • EASEMEM EASEMENT CURVATURE EASEMENT CONC-CONCRETE LP-UGHTPOLE P.C.-POINT OF CURVATURE SEC-SECITON • • t1 • • • • LFE.-LOWEST FLOOR ELEVATION LEGAL NOTES TO ACCOMPANY SK TCH OF aT-: PROFESSIQ�'ja■Lt AND SURV�'OR�O.: 354 S1•TE�O�IOA• •THERE MAY BE EASEMENTS RECORDED IN THE PUBLIC RECORDS NOT SHOWN ON THIS SURVEY. (VALID COPIES•OF THA!il•'EY WI ARE E�OS9iD SrL OF ATTESTING •EXAMINATIONS OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TOLIETERMINE RECORDED/NSTRUMEMS,IFANY, LANG SURVEYOR). �� Y• • DRAWN BY: MEB AFFECTING THE PROPERTY • • •• •THIS SURVEYIS SUBJECT TO DEDICATIONS.LIMITATIONS.RESTRICTIONS,RESERVATIONS OR EASEMENTS OF RECORD. SURVEYORS CERTIFICATION: •LEGAL DESCRIPTIONS PROVIDED BY CLIENT OR ATTESTING TIRE COMPANY. •BOUNDARY SURVEY MEANS A DRAWING ANWOR A GRAPHIC REPRESENTATION OF THE SURVEY WORK PERFORMED IN THE IVMEBYC RTIFY TO: FIELD,COULD BE DRAWN AT A SHOWN SCALE ANGOR NOT TO SCALE. •EASTHEEMENTS AS SHOWN ARE PER PLA T BOOK,UNLESS DEPICTED OTHERLMSE. AiA�THE�ATTACHc'D.9OnRY-SUFWEY Q� THE ABOVE DESCRIBED TERM ARCHITECTS SHALL VERIYZMEANSEGULEg NS.BOVEREST GNOUNS,ENCROACHMENTS. PRQPERTY,IS JRUE AND CORRECTTO RHD BUT OF MY KNOWLEDGE CHECKED BY: R.A.-S ARCHITECTS SHALL VER/FY ZONING REGULATIONS.RESTRICTIONS,THORZKSAND WILLBEROPER AIBLE FORS UBMITTING •PLOT PLANS WITH CORRECT INFORMA TION FOR FOR AUTHOR/ZATION•TO THE PROPER AUTHORITIES IN �'BELIEfi, A Vt ENItY SURVE%D AND PLOTTED UNDER MY CONSTRUCTION. RESPONSIBLE DIq�TI SCALE: 1"_20• UNLESS OTHERWISE NOTED,THIS FIRM HAS NOT ATTEMPTED TO LOCA TE FOOTING AF ORFOUNDATIONS. y.�0A,AND THAT TH RE•ARE NO ABOVEGROUND •FENCE OWNERSHIP NOT DETERMINED ENCROACHMENTS UNLESS SHOWN4MF•REIDpI.1 FURTHER CERTIFY THIS •THIS PLAN OF SURVEY,HAS BEEN PREPARED FOR THE EXCLUSIVE USE OF THE ENTITIES NA MED HEREON THE CER TIFICAre SURVEY MEETS THE STAN DARDS-OF-PRACTICE FOR BOUNDARY-SURVEYS, •DOES NOT EXTEND TO ANY UNNAMED PARTY. FIELD DATE: 03-02-2018 •ELEVA710NDATUM USED NOVO 1929 PUgFL1P NT TO SECTION 472.027, FLORIDA STATUTES, AND ADOPTED IN SURVEVOft•S NOTES: WICHA4TER gJ-17.090,F4.OI;IDA•ADMINISTRATIVE CODE.EFFECTIVE DATE /.CERTIFICATE OF AUTHORIZATION LS 07538.NOT VALID THOUT AN AUTHENTICATED ELECTRONIC SIGNATURE AND JOB NO: 18-0361412 AUTHENTICATEDELECTRONICSEAL. JANAARY J1, 201¢' AS AMEN Et F:BRUAIkY`23,2005. ' 2CKAEL uI ON9.E RESPoNSIBLEFORANYgSTAACEAAGLEORELLV 1-TAKEFROMIHISppAWI 1-ANYPIAiPIJSEOFCESIGNOR : • " • :•: • ••• • •• • • r • • SHEET.' 1 OF 1 1 . • ••„ ;• 0: • Miami Shores Village 7BY CBuilding Department N 3 ® 20,7 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 }`- __—_ / Tel:(305)795-2204 Fax:(305)756-8972 (� INSPECTION LINE PHONE NUMBER:(305)762-4949 .S'--, FBC 201'4 BUILDING Master Permit No. 6 9 �P 1-4 -2-33 PERMIT APPLICATION sub Permit No. ©BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP q CONTRACTOR DRAWINGS JOB ADDRESS: (050 / 7 City Miami Shores County: JF Miami Dade zip:• Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): —ZrW S Phone#: Address: �� ,(-56 N� 9 7 S City: PAirt /%&( T Itz Aa� State: Zip: ' Tenant/Lessee Name: Phone#: Email: 00Pk0ne#: (),hC0S736C-1 CONTRACTOR:Company Name: l�V, Address: 2-5 � 0 4- - 365 7" a—�g City: State: Zip: :3�;'( V�. Qualifier Name: ' cPhone#: State Certification or Registration#: e PC 6 J 7 �e1Z Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ r0i 660 Square/Linear Footage of Work: 460 Type of Work: ❑ Addition [y <Altteration ❑ New ❑ Repair/Replace F-1Demolition r' Description of Work: a" AV ��.t � swS lvQ �5/ fae e!Lo\-el �0-6 I "&M-00-0 S 4q/! PIl cool. Specify color �of.�color thru tile: / �, Submittal Fee$ J�J ��� Permit Fee$ � CCF$ LS/ CO/CC$ 5 Scanning Fee$ S Radon Fee$ 1 • s� DBPR$ G'• S� Notary$ Technology Fee$ S Training/Education Fee$ 2- Double Fee$ Structural Reviews$ O Bond$ TOTAL FEE NOW DUE$ U Z O• (Revised02/24/2014) pD� • i 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 Signature N�f�gr,AGENTV CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrumentass acknowledged before me this r2l S day f NES;% .201 by 31-:10day of `� 'e'!20 by V l "t who is personally known to -J0 Pq(,.,. g who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: f Sign: (��►►- _ e Print:' Print: �J Y cM t11 •�.•t y"••,,, M MICHAEL RQTH Seal: ADASeal: •saa of pogo. -'s• . C ' t"•• ARDEN A.PAREDES OEMMY COMMISSION A FF"6780 my c'mm•how on i6,20m" o. EXPIRES:J*17.2020 ************* ********************s *~ , lR * 04d �Rlli�lA4A M ***** APPROVED BY Plans Examiner (l / Zoning / Structural Review Clerk (Revised02/24/2014) r 009692 �- local Business Tax Receipt I Miami-Dade County, State of Florida [LOT —THIS IS NOT A BILL—DO NOT PAY R 1 6095715 ' BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES MASTER CRAFTSMAN POOLS INC RENEWAL SEPTEMBER 30, 2017 12925 SW 110 TERR 6358303 Must be displayed at place of business MIAMI FL 33186 Pursuant to County Code ? Chapter BA—Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYM IeNT RECEIVED MASTER CRAFTSMAN POOLS INC { .196 SPECIALTY PLUMBING CONTRACTOR BY TAX COLLECTOR It C/O JOSE PAREDES QUALIFIER. CPC057304 $75.00 07/14/2016 i Worker(s) 1 CHECK21-16-088606 t This Local Business Tax Receipt only confirms payment of the Local Business Tax,The Receipt is not a license, I permit,or a certification of the holders qualifications,to do business.Holder must comply with any governmental ? or nongovernmental regulatory laws and requirements which apply to the business. l e The RECEIPT N0.above must be displayed on ell commercial vehicles—Miami—Dade Code Sec Ba-276., For more information,visit www miamidade oovMaxcoliector. — RICK Si;OTT,GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA ;; A 4• � - DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION bE CONSTRUCTIONINDUSTRY.LICENSING BOARDS , ,. 1 CPCO57304 The COMMERCIAL POOL/SPA CONTRACTOR. Named below IS CERTIFIED'' Under the prcMsigns of-Chapter.480-F& l Expiration date 7AUG 31'2018 i a x DE3*JOSE ^�°-�'R'`"`.�-•����.�"'"-''R-i� "`}�'*-� a++� � � ,'� �1 ,,, a # ti + a ♦ ti r 9 Ii vj p MASTER GRAFTSMANPQOLSINC.- `" :,.�`''4:` .. ` 12925 SW VI OTR TERRACE—_` ° '- .�'...'� �. �• �-, + ,� , . MIAMI- --"', FL33186 •� y7` 'i� -` .4, � "�_' ,6 -ti •,-,;�y ,.., z t f d- , , k- -. '- ` ;„• '+ '`�_^+f'�..++""�.,v.,.r 3�` ,,,tar` �..!.4''* �,, � ?. „� ,,y• ,•''��"" �' �•`P*,1' mt�`''�'ttti`I: �*�y�y i�•_ '� �...:S.rr ..w'L"»!'e"` ...t -s. .� � 'dY,+. ` ♦ '�4-F l .�� ..?.:wR...�.�`,x'.�. ..'�, .T� �"��i F�fy "'Y � '..�'3�.,S.{ t f ISSUED: 07/17/2016 DISPLAY AS REQUIRED BY LAW SECT# L1607170001838 I r CERTIFICATE OF LIABILITY INSURANCE DATE 2 --- 12/28/128/1/YYYYj 6 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 :F BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED I REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. l IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(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 CONT CT Jorge L.Gonzalez Florida Bankers Insurance PHONE FAx (305)225-1243 Alc No (305)225-5053 961-963 SW 122 Ave MAIL jorgeluis@floHdabankersinsurance.com j Miami, FL 33184 INSURERS AFFORDING COVERAGE NAIL it + i. Phone (305)2251243 Fax (305)225-5053 INSURER A: SENECASPECIALTY INSURED INSURER B: Master Craftsman Pools Inc,Jose Paredes INSURER C: 1 12925 SW 110 Terrace INSURER D: Miami, FL 33186- (305)746-2849 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ADDLSUBR I LTR POLICY EFF POLICY EXP TYPE OF INSURANCE VD POLICY NUMBER MM/DDlYYW MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000.000.00 © COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED ❑ F1CLAIMS-MADEOCCUR PREMISES Ea occurrence 1$ 00,000.00 ANVBA478784 MED EXP(Any one person -S 5,000.00 —� ❑ N 08!2012016 08/20/2017 PERSONAL&ADV INJURY $ 1,000,000.00 ' ❑ GENERAL AGGREGATE s 2,000,000.00 { GEN'L AGGREGATE'LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s '2,000,000.00 ❑� POLICY ❑ PR0- ❑ LOC $ AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT i Ea accident $ ❑ ANY AUTO j ALL OWNED SCHEDULED BODILY INJURY(Per person) $ ❑ AUTOS ❑ AUTOS BODILY INJURY(Per accident S NON-OWNED. PROPERTY AMAGE O HIRED AUTOS AUTOS Per acad.nl S f ! a-�❑ UMBRELLA LIAB ❑OCCUR: _ EACH OCCURRENCE S ❑ ❑CLAIM EXCESS LIAB S-MADE AGGREGATE $ 1:1DED ❑ RETENTION$ $ WORKERS EMPLOY RS'COMPENSATION ILII - 14E.L. C STATMjTS ❑OTH- AND EMPLOYERS'LIABILITY Y/NER ANY PROPRIETOR/PARTNER/EXECUTIVE CH ACCIDENT S OFFICER/MEMBER EXCLUDED? ❑ NIA i (Mandatory in.NH) - If yes,describe under SEASE-EA EMPLOYE $ DESCRIPTION OF OPERATIONS below SEASE-POLICY LIMIT $ i ! 3 j 1 DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (Attach ACORD 101,Additional Remarks Schedule,..if more space is required) Pools repair and construction. ;License#:CPCO57304 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1 VILLAGE OF MIAMI SHORES THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 10050 NE 2 AVE ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES, FL-33138 AUTHORIZED REPRESENTATIVE 3 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05)QF The ACORD name and logo are registered marks of ACORD I I AC O® � CERTIFICATE�OF LIABILITYnINSURANCE °A, 2 o1"s THIS CERTIFICATE IS ISSUED ASA 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. this certificate does not confer,rights to the certificate holder in lieu of such endorsem d policies may„require,°an endorsement A statem IMPORTANT: `if ttie”certificats holder is an ADDITIONAL' INSURED the li les must have ADDITIONAL INSURED"'"ovlaick%or tie endorsed. If SUBROGATION IS WAIVED subject,to the terms and conditions of the int on PRODUCER CORICHARD'J_BOGANI NAM •'- `BOGAN!-CHRISTIANO'LLC PHONE (561)433-2215' FAX M 9100 BELVEDERE RD STE 207 A S RICK@CONNECTMYINSURANCE.COM INgU _,i AFFdRIMG COVERAGE' NAIC a ROYAL PALM BEACH FL 33411 INSURER A: FWCJUA INSURED _. INSURER B MASTER CRAFTSMAN POOLS INC' - ER C - 860 WELLINGTON TRACE 438-128 INSURINSURER D: WELLINGTON FL 33414 INSURER E: FEIN:260573954 INSURER F: COVERAGESCERTIFICATE'NUMBER:: 1612280017 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,TERMOR 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 DESCRIBEDHEREIN IS'SUBJECT TO ALL THE TERMS; I EXCLUSIONS AND CONDITIONS OF SUCH POLICIES:LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADOL SUB R POLICY EFF., POLICY EXP LTR TYPE OF INSURANCEPOLICY NUMBER MIDDIYYYY) (MMMONYYYI LIMITS: 'COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ UAMAGEIFDRENIEIT- CLNMS-MADE "OCCURmxummra) $ 1 MED EXP Om one $ I PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ POLICY 0 CT. L]LOC PRODUCTS'-CDMPJOP AGG j OTHER S j AUTOMOBILE LIABILITY SINMTTMffr $ ANYAUTO BODILY INJURY(Per K"w) $ OWNS ONLY 1k D BODILY INJURY(Per arxiderd) $ FUREDALIT� Y AUTOS m PR�ERTY GE $ 5 UMBRELLA UAB OCCUR EACH OCCURRENCE S EXCESSLIAB CLAMS-MADE AGGREGATE S DED I I RETENTION SS WORKERS COMPENSATION � OTH- AND EMPLOYERS'LIABILnY X STATUTE ER ANY PROPRIETOR/PARTNERJEXECUTIVE —N] ._ E.LEACH ACC IENT S. 500,000.00' A OFFICERfMEMBEREXCLUDED? ❑N NIA 5745BOO12 10/4!2016 10/412017 (MartMory In NH) E.LpSEASE-EAEMPLOYEE i 504,000.00 flfl�m aesaibeunder. 500,000:00 DESCRIPTION OF OPERATIONS bdow E.L.DISEASE-POLICY LIMIT S I DESCRIPTION Of OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remuks'SGredule,may be aUached if in r space is required) CERTIFICATE HOLDER CANCELLATION Village of Miami Shores SHOULD'ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10050 NE 2 Ave THE EXPIRATION DATE THEREOF, NOTICE WILL 'BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Mar1'1i Sh6ir@S FL 33186. AUTHORIZED REPRESENTATIVE $ Phan Number (305)795-2207 l ®1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD } FW JUA FLORIDA WORKERS COMPENSATION JOINT UNDERWRITING ASSOCIATION.INC WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY EXTENSION OF INFO PAGE-SCHEDULE WC 00 00 01 ( A) POLICY NUMBER: (GFR1 3UB-5745BOO-2-1 6) INSURER : FLORIDA W.C. iJUA PREMIUM BASIS 4 ESTIMATED RATES ESTIMATED TOTAL ANNUAL PER $100 OF ANNUAL CLASSIFICATION CODE REMUNERATION REMUNERATION PREMIUM LOCATION 001 01 FEIN 260573954 ENTITY CD 001 MASTER CRAFTSMAN POOLS, INC . 8401 LAKE WORTH RD STE 111 LAKE WORTH, FL 33467 SIC CODE : 1799 NAICS : 238990 SWIMMING POOL - CONSTRUCTION - NOT IRON OR STEEL & DRIVERS 5223 87600 6 :63 5808 CLERICAL OFFICE EMPLOYEES NOC. 8810 20800 .23 48 ------------------------------------------------------------------------------------ 1 .10% EMPL . LIAB . INCREASED LIMITS(9807) $ 64 ADD FOR INCREASED LIMITS MINIMUM (9848) 11 EXPERIENCE MODIFICATION: NONE MODIFIED PREMIUM NONE TOTAL ESTIMATED ANNUAL STANDARD PREMIUM 5931 EXPENSE CONSTANT(0900) 200 0.0200 TERRORISM (9740) 22 TIER 2 SURCHARGE 1231 FWCJUA FLAT FEE(9601 ) 475 TOTAL ESTIMATED PREMIUM 7859 DEPOSIT AMOUNT DUE 7859 i DATE OF ISSUE: 01 -11 -17 KF ST ASSIGN: FL Page 1 of 1 ` Miami Shores Village 1oo*omE.2nd Avenue ws t Penniffype:PoolstWhirlpoots/Hot Tubs Miami Shores,FL no1o8-0000 'eroll&I I h&I ftit Work Classification:Addition/Alteration PermfiStatus:APPROVED Phone: (305)795-2204 11D 0 Issue Date:313012017 Expiration: 09/26/2017 Projectpplicant' 650 NE 97 Street 1132060171640 Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell SYLVIA FLORES 650 NE 97 Street MIAMI SHORES FL 33138 650 NE 97 Street MIAMI SHORES FL33138- Contractor(s) Phone Cell Phone Valuation: $ 110,000.00 MASTER CRAFTSMAN POOLS INC (305)746-2849 Total Sq Feet: 400 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved:: In Review Fence Date Denied: Final Type of Work:Swimming Pool Occupancy:Private PoolDeck Additional Info:ADD NEW SPA TO EXISTING POOL RE p Bond Return Wall Stee11'___'_' Classification:Residential Scanning:5 Review Electrical Review Planning Review Building R view Plumbing Review Siructurai Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Contractors Bond $500.00 Invoice# BPP-1-17-62763 CCF $6.00 01/30/2017 Credit Card $50.00 $92000 CO/CC Fee $50.00 DCA Fee $4.50 Bond 3357 Education Surcharge $2.00 Permit Fee $300.00 Plan Review Fee(Engineer) $80.00 Scanning Fee $15.00 Technology Fee $8.00 Total: $970.00 / In oonomemnvn of the issuance to mo of this pennn. | agree to perform the work oovwmu hereunder in compn.moe with all ordinances and regulations pertaining thereto and mstrict conformity with the plans,drawings, statements or specifications submitted to the prol-ar authorities of Miami Shores Villag6. In accepting this permit | assume responsibility for all work done byeither myself, my ogent, xemoctz. or :mp!oyea | understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL worx. OWNERS AFFIDAVIT: | certify that all the foregoing information is ocounom and that an work will be ucne in oom/oonoewim on applicable |owo regulating construction and zoning. Futhermore,I authorize the above-named contractor to do the work stated. / ch30, 3017 Authorized Signature:04fer / Applicant / Contractor / Agent Date Building Department* �� o���n�U�� �*���n «����^ ,����� = "- x—� SPIKEBU OP ID:YG ,d►�o• CERTIFICATE OF LIABILITY INSURANCE DOW06ATE /2017 Y) 03/06/2017 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 SLATON INSURANCE NAME: Yvonne Goode P.O.Box 220537 a/c°No E:t:561-683-8383 ac No):561-684-5995 West Palm Beach,FL 33422 AEDORless:ygoode@slatonriskservices.com J.Cal Boynton,CIC,,President INSURERS AFFORDING COVERAGE NAIC# ti INSURER A:Scottsdale Ins Co 41297 INSURED Spikebusters,Inc. INSURER B:AmTrust North America Matthew Nieves INSURERC: 30 NW 130th Avenue Miami,-FL 33182 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. ILCY EXP TR TYPE OF INSURANCE NR ADD UBR POLICY NUMBER MM DDfYYYY MPOLICY EFF M DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CPS2605821 12/12/2017 12/12/2018 PREMISES RENToccuED $ 100,000 CLAIMS-MADE 7 OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 X GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY F PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ I AUTOS PER ACCIDENT UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ I WORKERS COMPENSATION T WC STATU- OTH- AND EMPLOYERS'LIABILITY R M R B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N AWC1055773 12/10/2016 12/10/2017 E.L.EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? F-1 N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Electrical Wiring—within Buildings S Drivers Clerical Office Employees i 1 CERTIFICATE HOLDER CANCELLATION MIASHOR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. Building Dept AUTHORIZED REPRESENTATIVE 10050 NE 2nd Ave Miami Shores, FL 33138 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD C r K ' SHEET 2 OF 2 i F 1 20 0' ASPH. PAV 15'ALLEY✓ LA V FD. o� . 75.00'(R/M) N o�o1W FD. 0:30' 4'CH.L. �9C`qC CL i CL. u METAL S-i�D 'o CL. o NO, ON CONC. t2. o, WEST Y2 LOT 5 BLK: 100 LZ LOT 4- J X N 19.65' 7.1 POOL 2.00' u SCREENED AREA: PUMP ?• CL. v '8,9 1-2.00'. NCU 'POOL 4 6.0' 'n 30.00' r 4' s ! T O 4 0.CLtC as 3 Qo 10.00 .�+' lJ/ '3890 O m O �ONE'STORY 2.00' '? o ENC o o%; f M.No.850 ( 1 r O >, I • • O 9.2G •r. Q 2.00 • • • ••• • •• 10:00 1 25.00'. o r r .. r T C •••••• FL a ALE n4. PL. �T0;t0' ••••• •••• •••••• DRIVEWAY v •••••• • 20.2' �'• • • • •. • • 23.0' PK%VY 0 rq 19.0' ASPH. SAV - � - NE 97TH ST n NOTES' 01i A I!ETAL F. & CH.L.F. ENC_ 2' IS TO THE ADJACENT PROPERTY 2 .A WALK ENG 1,0' INTO Tt-E ALLEY THOMAS J. KELLY , INC. LB # 6486 SURVEYORS-MAPPERS-LAND PLANNERS 8125 SW 120 STREET PINECREST, FLORIDA 33156 (786) 242-7692 DADE (954)1779-3288 BRWD (786) 242-6494 DADE FAX (954)779-3260 BRWD FAX DATE FlELO WORK SCALE SURVEY NO. 04/23/2010 ]'=20' 10-0542 i { i t f • LEGEND OF SURVEY ABBREVIATIONS Sheet 1 'of 2 A A.....MC DMTANCE AJC....AIR CONwrIOMNO Cu...CONCEEre DLOCK STRUCTURE NOVO...NATIONAL GEODETIC VERTICAL DATUM T C....CAACOLATIC CO... .CATCNIUJUN OAU_..OVERKIJOUTM7VUNE PRC...POINT OF REVERS[CURVATURE FLOOD ZONE: X CL....CLEAR CA...'CarrEA UNE ►,CL...POINT OF COMPOUND cum RAD. RADIAL ,THIS IS A FLOOD CMC...EMCROACNMIW PL. .POINT OF CURVATURE PDX PONTO►COMMENCEMENT •w.-Juan Of MAI /HAZARD ZONE N no... FOUNDu.OPIPE POR INO.POINTorstowNat"..wuJ ka OEC..,SECTION ,THIS IS NOT A FLOOD Ox...OVER Nu+D INAL...wAYSR METER C.K....CHORD DUTANCE OCR...SCREENED HAZARD ZONE Pi...PATROOK M.....WAEURFD DA....OKMALAOE EAMMENT S.LP....Be am PIPE PANEL NO.% 306/L P&..PROPSATY UNE CONC..CONUETE PM.....n"NIORANT SM..AIDa.ALA COMMUNITY0. 120652 UP..Urtrr"CLA fn....FOUWD R.....RAAPA UE.....UT1Uw EAeEMENt DATE OF FIRM: 09/1112009 DNIP....CHUN LINK"'NOR BASE FLOOD: NIA CERTIFY TO: FTNISH FLOOR: NIA Chad Berkshire And SiMa Flores LOWEST NIA Joanne R. Urauiola, P.A. ADJ GRADE First American Title Insurance Co. Embrase Home Loans, Inc., Its Successor And/Or Assigns. A.T.I.M.A. LEGAL DESCRIPTION: Lot: THE WEST 1/2 OF LOT 4 AND ALL OF LOT 5 Block: 100 Subdivision: Amended Plot Of Miami Shores Secton 4 According to the Plot thereof as recorded in Plat Book: 15 Page: 14 Public Records of MIAMI-DADE County, Florida. ADDRESS: 650 NE 97 STREET MIAMI SHORES, FL 33138 Encroachments Noted: 21 LOCATION SKE'T'CH SCALE: W"� tN7 NE 97TH ST ACCAXY L LLQ OF A8ftVMTiON6 250.0'(M) A/C._.-.._;......A,R CONDITIONER I (.J . Ages PAJ.,.:ASPHALT PAVEUENT • CHLF .CNAw 14K FENCE ff ( W • • C/5.. .._CDNQLEIE SL.M I _� I ••S••• •• •• TE 4� � ::000* • c AosL�r Q 10 9-7 6 5! ` ! 4 3 ••••• •••••• • raurJp 35' ) • ,P_ d.PIPE • j �)� • • P.C. g�Fr OSRVATURE L�� • OA- A�•• �i — ALLEY 9:06606 ••••• •••• P/L...._.....:.PIfQPfAtY lNE 1p) .00:: ,�C.P„..... M 1•CONrROL POINT ••••• •••• P.RM..........�Sm;trNDE vCHLIU NT • • (R):.....:............RECORD LJ ••••• •• •• (R/U}..;.„,.:RFICW%VO MEASURED ZI • • •E� „_�wAY 11 12-14 15 16 17 18 • • /« •••••• SW SIOewux • • • IT 0*41,.'CNCI •••••• L................ .LEA!N •CY,..:..__.....l..�j1yEDb•iANCE I Moral: A) AN G-eAr J.A/r A.r+AArN.LAA- Y-PI M M A7•rrA A.ai.. FA-9--RT4• ti.LW IRM. LAEY LA-a-A•AI IRAOAA w MtArW.1. n TY ArMY b bAA-AS k++wE,1 i ND.IAe1 ILgr- aAIF A.LSdMI f RM ILY r 9f.►Ar w N b A...tfL.E.TLb-PI17'N r w M MNd!rw U-ILw.YR. 9AI.V•.IR1.de•iL r AM alar MM.ILNAV..e.n1. v..Af Thar.T TAb.W. C)CASA--a-Aad INN rANA An r nhaAld -*A-P IY. D)TLA HAAS MNwI.Aw d.nl.Lama.AMA-..wv TIM,NM nNeAAAe w.PA/tr.M r.0 r IN{.- 1 het Aw1M9 r 6~r•Ara An r.Aw IMM Y -LAA Pr.A NN R.•.Ary afPJMA Af AAJIMJ-NMnA. k APr AM.w NM.. h,f—wIN.P.w AALS , MwIeMILr, E)TNa loot Ei•N.Y AAJI-.AIN wn.rRA 9r w I %Vd d..*A.A w-.Mt- Aa-TAfF d NNA Aw AM.-001w. F)V."V_”6—ch--w.if-f.r IwM1 t LrIYF QV%*y NM.TNA INN.IN..ACINAR wJA.IAM..A.- 'h 0OW 4'r'""I`A.W.-C THOMAS J. KELLY, INC. 57.17 OW N 17.002 NA. CW p..... A Ot7 PN MAew-. L.B. #6496 1 SURVEYORS-MAPPERS-LAND PLANNERS JTO493LAWFIVOINJI'S A,PS.6 M.2CA858 8125 SW 120 STREET PINECREST, FLORIDA 33156 ORIDA SISE ID1VITMAN sF.L (786)242-7692 DARE (954)779-3288 BRW�D PAOr1U4 L. v SPAWN.EEAIUM ARE TO AM ASwNI® (786)242-6494 DADE FAX (954)779-3260 BAWD FAX LLRSDEAM(IN PIAT). r. v w•KnL G.&ATIOMs AM R@BIRED M.c V to 2929 DATE FIELD WORK SCALE SURVEY NO. 2 TWO u A aaRCARV M.RVn. 04/23/2010 l"_ 10-0542 « I w r THOMAS J. KELLY, INC., P.S. & M. r 8125 SW 120 STREET PINECREST, FLORIDA 33156 DADE TEL: (786) 242-7692 BRWD TEL: (954) 779-3288 DADE FAX: (786)242-6494 BRWD FAX: (954) 779-3260 Company: Joanne R. Urquiola, P.A. 708 SOUTH DIXIE HIGHWAY #100 'CORAL SABLES, FLORIDA 33146 Attention: LUCY Survey No. 10-0542 Name: Chad Berkshire And Silvia Flores Address: 650 NE 97 STREET MIAMI SHORES, FL 33138 , Lot: THE WEST 1/2 OF LOT Block: 100 •• .y Sub: Amended Plot Of Miami Shor . . ... .. ...... •fldt�ook.'15 , Page: 14 ...... .... as .. .••:•• •sftte Order+te 6-04/21/2010 •sage :0090 •••• • Date 0one.•••!04/23/2010 sass.. •.... Certify to::... • ...e.. • sass.. sass . . . Survey: 300.00 sew• website:www.TJ Ksurvev.com Other: Amount Due: 300,00 ` PLEA5E REMIT WITH PAYMENT THANK YOU.WE APPRECIATE YOUR BUSINESS I I I