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BPP-18-2064, • Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address i3ermi Parcel Number Issue Dat Permit NO. BPP-1-18-2�i Permit Type: Pools/Whirlpools/Hot Tubs Work Classification: Repair Permit Status: APPROVED 7110/2018 Expiration: 01/06/2019 Applicant 1263 NE 92 Street Miami Shores, FL 33138- 1132050270270 Block: Lot: MARTA J PACHECO BOBONIS Owner Information Address Phone Cell MARTA J PACHECO BOBONIS 1263 NE 92 Street MIAMI SHORES FL 33138- (786)531-9479 1263 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) ORINOCO BUILDING LLC Phone CeII Phone (786)531-9479 Valuation: Total Sq Feet: $ 3,000.00 510 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Work: Swimming Pool Additional Info: Classification: Residential Occupancy: Private Bond Return : Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Plan Review Fee (Engineer) Scanning Fee Technology Fee Total: Amount $1.80 $2.25 $2.00 $0.60 $150.00 $45.00 $9.00 $2.40 $213.05 Pay Date Pay Type Invoice # BPP-1-18-66245 01/26/2018 Credit Card 07/10/2018 Check #: 315740 Amt Paid Amt Due $ 50.00 $ 163.05 $ 163.05 $ 0.00 Available Inspections: Inspection Type: Final Review Building Review Building Review Building Review Building Review Structural Review Planning 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 and zoning. Futhermore, I authorize the abovetractor to do the work stated. July 10, 2018 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy July 10, 2018 1 Keening Custamers Waxy For Over 45 Ye, HUGE SHOWROOM 11720 Biscayne Boulevard -: North Miami, Ronda 33181 Dade; (305) 893.4036 Brnwar4; (954) 746-8133 Fax. (305) 895-4557 • POOL SERVICE • REPAIRS ! REMODELING • HOT TUBS • SUPPLIES s • CHLORINE GENERATORS • HEATERS Neal Baumwoll Renovations Specialist Cell: 305-338-8561 Nealtallfloridapoo I.com www.allfloridapool.com •Miami Shores Village BUILDING PERMIT APPLICATION I�BUILDING ELECTRIC PLUMBING 0 MECHANICAL JOB ADDRESS: Building Department 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 20 Master Permit No. b i' P l 9)—20 b Sub Permit No. ROOFING 0 REVISION 0 EXTENSION 0 RENEWAL PUBLIC WORKS ri CHANGE OF I 1 CANCELLATION IZbs N. E a Z s- City: Miami Shores County: Folio/Parcel#: t\' S .07 — 95ai# CONTRACTOR Miami Dade Zip: Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: Flood Zone: /► OWNER: Name (Fee Simple Titleholder): I -PAC-Meta 6563 Address: 1h3 N - SO-Ak City: ,vVO N,koreA Nth SHOP DRAWINGS NO BFE: FFE: Phone#: 780 — Z33 -- 3b0 b State: Zip: 3�I Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Aar Address: 1. S'10 (tD•C.. b`vo City: MAAvut State: "I. Zip: 35) I Qualifier Name: DPh'1O 40..v Phone#: 0 State Certification or Registration #: Pc_ A.a ,tS + Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: State: Zip: Address: City: Value of Work for this Permit: $ IQt'%o Square/Linear Footage of Work: Type of Work: I I Addition n Alteration New Description of Work: NI-S u r bgec, LAJ4•IJ Lt•.n NAIL • e o D t 11 ✓Repair/Replace 30s-$413-4oi6 n Demolition Specify color of color thru tile: ^� Submittal Fee $ Permit Fee $ �� • w CCF $ CO/CC $ Scanning Fee $ Radon Fee $ a• DBPR $ o2-. '1 5 Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE$ ((03. OS (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 d and a reinspection fee will be charged. Signature OWNER or AGENT Signature CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this a• day of MAi , 20 IF , by 9 day of MS. (� Iet0 h. ,,5 , who is ersonall known o �(��.. r �' y � �✓'��D C.o�}c,✓ , who i personally known me or who has produced as me or who has produced as ,201% ,by identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Sea identification and who did take an oath. *********************************************************************************************************** APPROVED BY 1 ` Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 Tel: 305-795-2204 Fax: 305-756-8972 Inspection Number: INSP-001157-2018 Permit Number: BPP-1-18-206 Scheduled inspection Date: October 31, 2018 inspector: Naranjo, Ismael Owner: MARTA J PACHECO BOBONIS Address: 1263 NE 92 ST Project: Miami Shores, FL. 33138 Contractor. ORINOCO BUILDING LLC ELOY PAREDES Permit Type: Pools/Whirlpools/Hot Tubs Inspection Type: Building Final Work Classification: Repair Phone Number: 7865319479 Parcel Number: 1132050270270 Phone Number: 7865319479 Building Department Comments POOL RESURFACING Checklist Item General Comments Passed Passed False Failed Correction Needed Re -Inspection Fee No Additional inspections can be scheduled until re -inspection fee is paid. Comments 10/25/2018 > DEMOED WOOD, DECK AND INSTALLED PAVERS DRIVEWAY ALSO DONE IN PAVERS . Inspector Comments DEMOED WOOD DECK AND INSTALLED PAVERS . DRIVEWAY ALSO DONE IN PAVERS . THAT WORK WAS DONE IN PERMIT DS 18-2151 October 30, 2018 For Inspections please call: 305-762-4949 Page 16 of 25 r JUNCTION BOXES (G) • WATER CIRCULATING EOUIPMEN1 ELECTRICAL PANEL DMNG BOARDS DECK FORMING - DRAMS SHELLS . POOL & DECK ? REINFORCING/ LADDERS STEEL FENCE METAL DOOR FRAMES. ETC, <5FT POOL GROUND WATER FD EC MOUTOR META: H BAR HEATER (0) <. 5 FT EQUIPOTENTIAL BONDING GRID DETAIL (NEC 680,26) NTS DEG( RONOINO RRQUIRDIDdT*N (NEC 88028(BX2)PERIMETER SURFACES) PERIMETER SURFACE SHALL BE ATTACHED TO THE POCI REINFORCING 8TEEL OR COPPER CONDUCTOR GRID AT A MINIMUM OF (4) POINT UNIFORMLY SPACED ARDIUNO THE PERIMETER OF THE POOL • IF STRUCTURAL REINFORCING STEEL IS NOT AVAILABLE, A COFFER CONDUCTOR (8) SHALL BE JTII I7FD WHERE THE FOLLOIMNO REQUIREMENTS ARE MET (NEC 88028(BX2)(b) ALTERNATE MEAN” • AT LEAST ONE MINIMUM 08 AWO SOUO COPPER CONDUCTOR SHALL BE PROVIDED. • THE CONDUCTORS SHALL FOLLOW THE CONTOUR OF THE PERIMETER SURFACE. • ONLY LISTED SPLICES SHALL BE PERMITTED. • THE REQUIRED CONDUCTOR SHALL BE 1r TO 21' FROM THE INSIDE WALLS OF THE POOL • THE REQUIRED CONDUCTOR SNAU. BE SECURED WITHIN OR UNDER THE PERIMETER BURFAcE 4' TO 8' BELOW THE SUBGRADE 1 'It M A P LOT-9 BLOCK-2 0 P 1/2' NO IL LOT-17 BLOCK-2 \\I POOL EQMT A/C 4'xir 1 -25 9 .917 .• s•• oI CC 0 I Oj c'JLO I I L50H1 RP 1/2' NO ILI Or3: ARKWAY EDGE OF PAVEMENT : • 4 t: ' s s •: • • 9•Ws. "o 0 o .ur EP A Et "Sr LOT-10 BLOCK-2 g I 75. 001(R8,m) is' CHAIN LINK FEN E eg- • fet—‘, ib 38.8' s • lc? It) 13.S 26.1' // 7=e* / LOT-16 BLOCK-2 2 STORY RES. No. 1263 F.F.E. =6.65' 13.2' •-.10 • .7 • :%.2 4.• • 1: S.• . 011.fivt• •s V' " • .,S • "; :4••• . • • . • . • . . • . . • • • . • . • . . • . • . • . • . • . . • . • . . • . . • • . • • • . . • . . • . • . . • . • . • . • . . • . . • . . • . 17• 15.5' rSHED 23.005 ...... .......................... ..... . ... . •royr..ow. ... • . • . • • • • • • • • ......................... ..... ........................................... .. . . . . . . .. ... . . . . ........ .... ' •••••••••." ........ ' " ...... " " • " • " ..... 512.• TOTAL...RION . . . . . . . . . . . . . . . .•••;;;;;;.".'40t. . . . . . . • . . . . . . . . . . . . . . . . ................. • • " " " " " ' • " • • " • ' • " " ' " • " " ' • *.•;.*. ............................. ............. ....... .................. • . . . . . . . . . . . . . 1/2' NO LEA so—•=s• ON PL 1 25.00'(R&M) LOT-1 BLOCK- LOT-11 BLOCK - ON PL FP V2' NO LI2 200.001(R, .11.111.111.1.1.0111••••10 4 WV El ) -__NA,Jc csrs,i)- c 4cott, (_,, A3 t1'6RksR4r.„ , 7 l.0-- pie ; L,IG.P1-r ,- BLOC4V CORNER FP Vr NO ID. LEGA 01: P • —•••0 • — ..... - '412 ND. • • • • • TRFET LOCATION MAP AL (NOT TO SCALE) Graphic Scale d' = zd I ys — • • • ' 0 • .. • • IA I .... • 0 I. ..... • • • • • • • • QED 1018 DESCRIPTION: /RA Block 2, "BAY LURE", according to the Plat the : f, as recorded ok 44, at Page 63, of the Public Records of Miami Dade County, ONE WITHIN ZONE: AE ELEVATION: 9.0' COMMUNITY: 120652 PANEL No.: 0306 SUFFIX: DATE: 09/11/2009 ORDER NO.: PA-10554 FIELD BOOK TILE' DATE SEPTEMBER EL 2015 UPDATE UPDATE t OgI pC171Xm n w w ® ors-003AI e • • • . :▪ 144. E 41/ Afc.int-EL-,ggir irw ligin“,agn A§ mCuR iNig,134,10.1 11 II la 11 II .1 II II II II II Cd ‘i °,1 Sddzito.f.: PROPERTY ADRESS: 1263 N.E. 92nd Street Miami Shores, FL. 33138 FOR: CHRISTOS TZAVARAS AND MARTA J. PACHECO BOBONIS I HEREBY CERTIFY: THAT THIS DRAWING REPRESENTS THE RESULT CF A SLRVEY OF THE WITHIN DESCRIBED PROPERTY AND THIS DRAWING AND SAID SURVEY WERE PREPARED ME OR UNDER MY DIRECTION. THERE ARE NO ENCROACHMENTS UNLESS SHOWN THEREON. NOTES: • THIS SURVEY DOES NOT REFLECT OR DETERMINE OWNERSHIP. • EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THE PROPERTY THIS SURVEY IS SUBJECT TO DEDICATIONS, LIMITATIONS, RESTRICTIONS, RESERVATIONS OR EASEMENTS OF RECORDS. • LEGAL. DESCRIPTIONS PROVIDED BY CLIENT OR ATTESTING TITLE COMPANY. • UNLESS OTHERWISE NOTED, THIS FIRM HAS NOT AN ATTEMPTED TO LOCATE FOOTINGS AND/OR FOUNDATIONS. • NOT VISIBLE ENCROACHMENTS WERE FOUND ON THE PROPERTY, UNLESS SHOWN. • IF SHOWN ELEVATIONS ARE REFERRED TO N.G.V.D. 1929 • BENCH MARK USED NO. B-62, LOCATOR 3250S, WITH ELEVATION: 8.67' THIS SURVEY IS I ' ••T VALID WITHOUT THE " SIGNATURE AND NAL RAISED SEAL OF A FLORIDA LICE N ` ' b - EYOR AND MAPPER NARCISO J. RAMIRQ PROFESSIONAL LAND SURVEYOR & No. 2779 STATE OF FLORIDA 8341 SUNSET DRIVE MIAMI, FL 33143 TEL: (305) 596-0888 & (305) 5913-0990 E-MAIL: a8anocserv400t0belloou5h.not • • • Signature Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT BPP-1-18-206 Permit N. Owner's Name (Fee Simple Title Holder): P'larta Pacnaco Owner's Address: 1263 NE 92 St City: Miami Shores Phone #: (706) 233-3306 Job Address (Of where work is being done): 1263 NE 92 St City: Miami Shores Contractor's Company Name: Orinoco Building LLC Address: 9350 E Bay Harbor Dr, #2 State : FL State: Florida Phone #: Zip Code: 33138 Zip Code: 33138 (786) 531-9479 City: Bay Harbor Islands Qualifier's Name : Eloy Paredes State: FL Zip Code: 33154 Lic. Number: CGC 152 3919 Architect/ Engineer of Record Name: Phone #: Address: City: State: Zip Code: Describe Work: Pool renovation hereby certify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. I hold the Building Official and the Miami Shores harmless of all legal involvement. Signature Owner or Agent The foregoing instrument was aknowledged before me this \ day of ‘-\c J ,20eby rY►A zits I At yx.o Who is personally known to me or who has produced P ZZ L�— 550 S 9 S ci 3- O as indentification. Notary Sign: Seal: blic: c QS/nan.ct rn 0 rt0\ "ki Notary Public State of Florida Osmara Zamora ` My Commission FF 905588 r net Expires 09/11/2019 C6ntractor or Architect The foregoing!!��instrument was aknowledged before me this or day of i 161 , 20/8 by �^ 101 w ois personally known to me or who has produced Gv1S 'prnv-Cv's tCAr\ as indentification. "Pep 3a- ?• 3 , c7 • O t1111U/l//�, NotaryP i , 1i, i Sign` JC" .ors ")85r•� k E Clo,,,,, Seal: • & ® d _ :z, 0• e = • 1ap3�6 ' • o i *4� S - * ••. d.;*d thitut ; • .<<, $�` '/s'`,1/h:1, Y PUB1 C'AA N `� ( uw)c) rt (AM t: jQ ca,‘3,9\(?) BUILDING PERMIT APPLICATION BUILDING ❑ ELECTRIC PLUMBING ❑ MECHANICAL Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 Master Permit No. Sub Permit No. ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 11 6'3 N 1 2 S City: Miami Shores County: Miami Dade Zip: 331 �d Folio/Parcel#: Is the Building Historically Designated: Yes NO >( Occupancy Type: Load: Construction Type: OWNER: Name (Fee Simple Titleholder): !"�C4 1 `'i PG1 �+ Address: CZ- 3 ti-C ¶2 City: NU � % t44 C 7("1 r}v c. State: Tenant/Lessee Name: Phone#: Email: Flood Zone: BFE: Phone#: FFE: 0-'141 Zip: '� 1 3 CONTRACTOR: Company Name: ()VT `'lo Cc3' R,_} t rI `t Address: co $c City: ci^j v 7 Qualifier Name: (,)Uv 0 V ate:�— GAG State Certification or Registrationt#: C �C 157-3 Phone#: ` 40 C) I 9'11R-5 Phone#: Certificate of Competency #: Zip: (116) S3\9'il' DESIGNER: Architect/Engineer: Phone#: Address: City:. Value of Work for this Permit: $ 3 0 (T CD Type of Work: ❑ Addition ❑ Alteration ❑ Description of Work: PO v C. S v 1r G State: Zip: Square/Linear Footage of Work: 5 (O S T ❑ Repair/Replace ❑ Demolition Specify color of color thru tile: Submittal Fee $ 6), Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ t . ` ) Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) tr,ftq'l":43$1 Bonding Company's Name (if applicable) Bonding Company's Address-,1 >l':�i City State Zip Mortgage Lender's Name (if applicable)' Mortgage Lender's Address City 2—t.• •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 permitmust 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 $2560, 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 a ved and a reinspection fee will be charged. Signatu NER or AGENT The foregoing instrument was acknowledged before me this Signature CONTRACTOR The foregoing instrument was acknowledged before "me this 2 e, day of V 20 Le , by 2 Co `day of ,o20 (e by A jSf1(\v, �3VNlS7_41.V4 �W�' � 5 who is personally known to , who is personally known to me or who has produced r11� 1kki (—k-C:515ats 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: OrAji, Print: StNt)(A W ---Q, Seal: } 4JtYPk! Notary Public State of Florida }., . Sindia Alvarez s •-,p" My Commission FF 156750 'o, ..` Expires 09/03/2*018 o-' APPROVED BY Plans Examiner Sign: Print: (Revised02/24/2014) eal: c �pRY OV • io Notary Public State of Florida • , Sindia Alvarez 4 ° of ' My Commission FF 156750 yxcF0, Expires 09/03/2018 ********************•* Zoning Structural Review Clerk )11154 Local Business Tax Receipt Miami —Dade County, State of Florida —THIS IS NOT A BILL — DO NOT PAY 7198034 BUSINESS NAME/LOCATION ORINOCO BUILDING LLC 9620 NE 2 AVE 207 MIAMI SHORES FL 33138 OWNER ORINOCO BUILDING LLC C/O ELOY PAREDES MGR Workers) 1 RECEIPT NO. RENEWAL 7480439 EXPIRES SEPTEMBER 30, 2018 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 SEC. TYPE OF BUSINESS 196. GENERAL BUILDING.CONTRACTOR PAYMENT RECEIVED BY TAX COLLECTOR - CGC1S2391-9- -, .. - S45.00'" 07/10/2017-• -• ; CREDITCARD-17-045698 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permk or a certification of the holders qualifications, to do business. Holder must comply with any governmental or nongovemmental regulatory laws and -requirements which apply to the business. The RECEIPT',3bove must sp;'ayed on allcommercial vehicles — Miami —Dade Code Sec 8a-276. For %>4;,, 'Ion, visit www.miamidade.gov/taxcollector Orinoco Building Co CGC # 152 3919 State of Florida County of Miami -Dade Before me this day personally appeared Eloy Paredes who, being duly sworn, deposes and says: That he will be the only -son working on the project located at i'26) Sworn to (or affirli.p_c_n and subscribed before me this 2018, by.sny ham` day of , Personally know OR Produced Identification Type of Identification Produced 04.54 1e Notary Public State of Florida d ? ' Sindia Alvarez �%�, My Commission FF 156750 4 o►ct0 Expires09/03/2018 Sc ND Print, Type or Stamp of Notary 9620 NE 2nd Ave, Suite 207, Miami Shores, FL 33138 Ph (786) 531-9479 Notice to Owner — Workers' Com p Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: State of Florida County of Miami -Dade The foregoing was acknowledge before me this 2. day of1.--1s.013j Y , 20 (a. -gpL30 N! S Z 1,AVA.Tags By M4:214 JOS'E'fTNp-p_P- cyz, who is personally known to me or has produced PA as identification. Notary SEAL: 491 vts. Notary Public State of Florida it)e' ` ; Sindia Alvarez ' Commission FF 156750 ', , of f�a'4 Expires 09l0312018 IVUI IUJJ I IV p OP —caT-0 -2 T 1/2' BOUNDARY LOT-10 I LOT-0 BLOCKY a ®LOCK-2 75. OO (R&M) `6' CFHAN ELIN 6 I RP NO lQ 7 lE� Ir1r—•= ON PL .• •2U LOT-10 BLOCK-2 2 STORY RES. No. 1263 06 CC . 0 0 7.5 rSHED ON PL 2100 LOT-15 BLOCK-2 4.3. • PIP 1/2' NO La k . 200.00'(R) BLOCK PP 1/2' NO{Q LOCATION MAP (NOT TO SCALE) Graphic Scale d W 8d 1'=od LEGAL DESCRIPTION: Lot 16, in Block 2, "BAY LURE', according to the Plat thereof, as recorded in Plat Book 44, at Page 63, of the Public Records of Miami Dade County, Florida. Pd QX A-4't,t 0i'0®'ti®® 1III lL0* 0 w o me? cD J'm3 �ie� FLOOD ZONE: WITHIN ZONE: AE ELEVATION: 9 0' COMMUNITY: 120652 PANEL NO.: 0306 SUFFIX: L DATE: 09/11/2009 ORDER NO.: FIELD BOOK DATE UPDATE: UPDATE M•10554 TILE. SEPTEMBER B. 2015 PROPERTY ADRESS: 1263 N.E. 92nd Street Miami Shores. FL. 33138 FOR: CHRISTOS TZAVARAS AND MARTA J. PACHECO BOBONIS I HEREBY CERTIFY.,T TI�GI.R�VINGUIREPFTS WITHIN DESCRIBED PROPERTY AN,IHIS.RAIA1 NTS 'PPE RESILT O* SURVE•C•THE •D sib SI/•EY WERE PEPARED BY ME 0R UNDER M•DIRECTION. • • • • • • • • THERE ME NO EN.OACHMEN* •LE•SNO*! THEECN• • • • • • • • • • • • • • NOTES: • • ••• •• • • • •• • THIS SURVEY DOES NOT REFLECT 0R DETERMINE OWNERSHIP. • EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRIHENTS, IF ANY, AFFECNG THE PROPERTY THIS SAVEY IS SUBJECT TO DEDICATIONS, LIMITATIONS. RESTRICTIONS, RESERVATIONS OR EASEMENTS OF RECORDS. • LEGAL DES•NPTION6 1.4IDED BY CLIE.T OR A 1 TITLE COMP Y. S AN • ANDIOR CROACSIENTS 1WEPE •OHIINSONT TR MPTEO L FOOTI • NOT VI ��- • • IF SHOWN 1EVATICNANE D T•PE.V.O.929 • • • • • BENCH •.RH QED NO.B•2, LOCATOR 325E, WI• ELF•ATION: B.61' • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • THIS SURVEY IS NOT VALID WITHOUT THE SIGNATURE AND ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER NARCISO J. RAMIREZ PROFESSIONAL LAND SURVEYOR & MAPPER 9 S041E STATE OF FLORIDA 8341 SUNSET DRIVE MIAMI, FL. 33143 TEL: (305) 596-088851305) S95-0993 E-MAIL: aeenlIcsa)M••bel5bwn.nel JCA ENGINEERS LLC STRUCTURAL CONSULTANTS CA No. 30943 JAVIER CANIZARES, P.E. FL 63883 14449 SW 17 STREET MIAMI, FLORIDA 33175 PHONE: 305-979-6507 jcanizares.eng@gmail.com EXISTING POOL REPAIR Project: 1 263 NE 92 ST. MIAMI SHORES, FL 33138 Project No: 1 406By: JAVIER c. Page: 1 OF 1 Date: 09-06-1 6 NEW CONC. TIE BEAM W/ 2-'4 T 4 5, AND "3 TIES 19 24' O.C. WATER LINE CHIP OUT CONCRETE FROM EXIST. WALL AS NEEDED. PRESERVE EXISTING WALL REINF. EXISTING CONC. WALL EXISTING BOTT. SLAB STRLTC. T u;AL REVIL, APPROVED / / 15' 11_111=if -1 11=1 I I-i 11=1 I 11=111=11=11 i I 1-111l-- 1 1111111- 1 ! I=1.11 -111-I I I=1 -III=III-I III=III=III= -III-III-I / //1 11111111111111 �% %11111I111 - / -III-111- /;I 11=111=11 / /I—i i i 11=III= / //%111111111 /�// Ii1111� IIiIII: _ _ _ I-11 I-11-11 1 111 11111 111, 1111 111=! 11=111__ _111=111=111=III=111- � i i1 I - 11=1 I I=1 I I=111E111E111=I I E111=' i��- . .... . . .... . . .. .. . . . . . EXISTII • •; COMPACTED FILL WALL REPAIR TYP. SECTION SCALE 3/4' = 1'-0' INTERLOCKING PAVERS ON COMPACTED SAND • . • . .. . . .• . • . • . • •.• . . . .. . . • . . .. . . . • .. . RECEIVED FEB 15 2018 . • . •• • • • •