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PL-17-983 (3)Miami Shores Village j+* Building Department OCT 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: - Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 ) 4 sty BUILDING Master Permit No. DPP 11- 9e)z- PERMIT APPLICATION Sub Permit No. C �Io- 83 ❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL 51APLUMBING ❑ MECHANICAL ❑PUBLIC WORKS A CHANGE OF ❑ CANCELLATION ❑ SHOP ONTRACTOR DRAWINGS JOB ADDRESS: .5-1��) 1 " `V L S� City: Miami Shores County: Miami Dade zip: 5 !S �%t Folio/Parcel#: �1 — �2V�(�1�}'—�UV U Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fees Simple Titleholder): ,1 ll '(e,-��1�? ei& Phone#: (9-yh) 32(0— Address: L S} City: �" State: � i'�'�Zip: Tenant/Lessee Name: Phone#: Email: (� CONTRACTOR: Company Name: () ffaS MA Mumj: (GY1 S1�) U-( Phone#: lJlJu — I So - 7119 Address: 117, -� a1 'y V\-) (p U Ave Ni k 4 16 2. \-IcytLA I City: I" , (A Qualifier Name: zip: 33 OY�t hone#: _(1U' (01 C14-) )L U State Certification or Registration M C 1?C I S 5 S Q Y. Certificate of Competency #: PL DESIGNER: Architect/Engineer: Phone#: Address: Value of Work for this Permit: $ Type of Work: ❑ Addition Alteration City: State: Zip: Square/Linear Footage of Work: ❑ New ❑ Repair/Replace ❑ Demolition Specify color of color*thru tile: - Submittal Fee $ Permit Fee $ ?cam' CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Structural Reviews $ Training/Education Fee $ Double'Fee $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) I 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 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 on 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 nat be approved and a reinspection fee will be charged. Signature V I X Signature C- F OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this pp i day of L) bW , 20 r �- by who ,,isspersonally known to me or who has produced�� ��'110.6-'1 as identification and who did take an oath. NOTARY PUBLIC: Sign: Print:�VTWLIE BASS Seal: ,SiON 0 FF 166797 :' ••iober7,2018 °4'FOF f�oa • : one t:. • Notary Services The foregoing instrument was acknowledged before me this day of 0 20 1,1 - , by r who is personally known to me or w[ has produced 52C(2(oUJ4201() as identification and who did take an oath. NOTARY PUBLIC: 1)22� Sign: 5 (�,� CC Print: N ckbw I -e- & S!] Oxy P&A, Seal: aP;•••.•k NATHAUE BASS * * MY COMMISSION A FF 166797 EXPIRES: October 7, 2018 or''Fa FICA' Bonded Thru 04efttary Services APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 jj CHANGE OF CONTRACTOR / ARCHITECT Permit N. �' `'1 ' - V 2- Owner's Name (Fee Simple Title Holder):QoI1 �Q I PAC, Phone #1�_l �` p -fij Owner's Address: 1 Q 2 S 4 arty: GI'r\.1h_(; re State : 1. Zip code _ & 8 Job Address (Of where work is being done):_ S :t City Miami Shores c State: _Florida Zip Coder -% ► a Contractor's Company Name: IACAS Phone ?+{rldress: _ ' 7l SZ�1 KI ern( e t l A ro ,A.We, City: i Qualfier's Name: Architect/ Engineer of Record Name: Address: City- _ Describe Woric State: l= L State: Zip Code: Uc. Number. C_l: C� 1459I1og. Phone #: Zip Code: 1 herebycertify been'abandoned rtify that the work has been abandoned and/or the contractor/architect is unable or unwilling to complete the contract. 1 hold the Building Official and the Shores harmless of all le volvement. Signatu Signat7he ;nMniamii Contractor or Ardiaxt The foregoing instrument was aknowledged before me jfrrging.,nstrument was aknowledged before me this Aaday of K,20I"} by AI i Ck M jtk this day of (i( r , 201-4byWho is personally known to me or who has produced who is personally known to me or who has produce Notar1Cub as indentification. SZC�.I�ia(1 �-� y�q —(� as indentification. Notaryublir. No7701��, Sign: Sign: Seal: Seal: NATHAUE BASS # * MY COMMISSION i FF 1WW r ru fit' ...�� # Y COMMISSION f F�F 166797 'EXPIRES:r 7,2DIS EXPIRES: October7,2O18 �, a Bonded ThruS6udgel�NoetarySetriCet '� of 1 Bonded ThN Budget Nobry swim Morros and Munoz Contruction LLC October 25, 2017 State of Florida County of Miami Dade Before me this day personally appeared Percy Munoz who, being duly sworn deposes and says: That he will be the only person working on the project located at: 573 NE 102 St Miami shores, FL 33138 Sworn to (or affirmed) and subscribed before me this day of 0lAur 20� by Personally know OR Produced Identification Type of Identification Produced D�40�(O bb!b —Y Zvi o NAiWWE BASS * * MY COMMISSION i FF 166197 EXPIRES: October 7, 2018 Bonded Thru Budget Notary Se AM Print, Type or Stamp Name of Notary Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Comaensation Insurance Exemation 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: aw caner State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of , 20. By �0-i TAR V06 who is personally known to me or has produced T ka) q W—A-).10-1"i U as identification. am, . a Iwo I SEAL: NATWE BARB MY COMMISSION # FF 166797 EXPIRES: October 7, 2018 I''Fov F5doe Bonded Thru Budget Notary Servka �rara¢ ml air or � �M 1�MN� t F - of t. 4 STATE OF FLORIDA z DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CGC 1519479 ISSUED: 08/28/2016 CERTIFIED GENERAL CONTRACTOR MUNOZ, PERCY MASTER DIAMOND POOL SERVICE CORP IS CERTIFIED under the provisions of Ch 489 FS Expiration date AUG 31, 2018 LlGO8280003559 STATE OF FLORIDA j DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CPC1458168 ,:--ISSUED: 08/28/2016 CERT POOUSP SERVICE CONTRACTOR MUNOZ,PERC MASTER DIAMO POOL SEVICE CORP IS CERTIFIED under the provisions of Ch.489 FS. Expmalion dale AUG 31. 2018 L1508280003998 004078 Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL -DO NOT PAY 6901632 LBT BUSINESS NAMIAMOCATION RECEIPT NO. EXPIRES MASTER DIAMOND POOL SERVICE CORP RENEWAL SEPTEMBER 30, 2017 1711 SW 137 CT 7177330 Must be displayed at piece of business MIAMI FL 33175 Pursuant to County Code Chapter BA - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED POOL SERVICE CORP196 SPECIALTY BUILDING CONTRACTOR ey TAx couecTOA MASTER DIAMOND C/O MUNOZ PERCY CPC1458168 $75.00 08/16/2016 Worker(s) I CREDITCARD-16-047734 This local Business Tax Receipt only confirms payment of the local Business Tax. The Receipt is not a license, permit or a certification of the holder's qualifications, to do business. Holder must Comply with any governmental or songovemmemai regulatory laws and requirements which apply to the business. The RECEIPT NO. above must he displayed on all commercial vehicles -Miami -Dade Code Sac ea-ZX For more inlermation, visit 'n"dtll miamidade eoyhaxeollec/of 004026 Local Business Tax Receipt Miami —Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 6861927 BUSINESS NAME/LOCATION RECEIPT NO. MASTER DIAMOND POOL SERVICE CORP RENEWAL 1711 SW 137 CT 7136591 MIAMI FL 33175 LBT EXPIRES SEPTEMBER 30, 2017 Must be displayed at place of business Pursuant to County Code Chapter RA - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS MASTER DIAMOND POOL SERVICE CORP196 GENERAL BUILDING CONTRACTOR PAYMENT RECEIVED C/O MUNOZ PERCY CGC1519479 BY TAX COLLEcroR Worker(s) 1 $75.00 08/16/2016 CREDITCARD-16-047734 This Local Business Tax Receipt only confirms paymm t of the local Busiaess Tax. The Receipt is not a license. Pernh, of a c"ficatlen of the holder's yvalificatiorrs, to de business. Holder most comply with any "vernmental or noagovemmerdal regulatory laws and requiremenns which apply to the business. The RECEIPT NO- above must be displayed on all commercial vehicles - Miami-oada Cade Sec ga-276. For more inimmetioa, visit ACORU® CERTIFICATE OF LIABILITY INSURANCE �ft� DATE(MM/DD/YYYY) 1 04/07/2017 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(ies) 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 NAME: Susan Camacho Just Insurance Brokers - Doral PNONE (305) 418�701 F� No): (305) 418 4706 EMAIL scamacho ibinc.net ADDRESS: CAI 1200 NW 78 Avenue INSURER(S) AFFORDING COVERAGE NAIC # Suite 105 INSURER A: NAUTILUS INS. CO. 17370 Miami FL 33126 INSURED INSURER B : INSURER C : Master Diamond Pool Service Corp, INSURER D : DBA Ram Construction Inc. INSURER E : 1711 SW 137 CT INSURER F : Miami FL 33175 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. INSR LTR TYPE OF INSURANCE ADDL INSD S 8 WVD POLICY NUMBER POLICY EFF MWDD POLICY EXP MWDD LIMBS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 500,000 CLAIMS -MADE 1XI OCCUR DAMAGE TO RENTEU_ PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 500,000 A NN602539-1 10/16/2016 10/16/2017 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 PRO JECT- X POLICY ❑ PRO ❑ LOC PRODUCTS - COMP/OP AGG $ 500,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS(er PPROPERd nDAMAGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ N / A E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE --POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) General Contractor License* CGC1519479 LICENSE CPC #1458168 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village. Building Dpt. ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave AUTHORIZED REPRESENTATIVE Miami Shores FL 33138 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD Master Diamond Pool Servj�� Q3S7Fontainebleau Blvd #10180 Miami, FL33172 Licensed &Insured State of C1 y Lc, County of Before methis day personally appeared who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: Sworn tu(or affirmed) and subscribed before methis rA j day of '20_JL-T—_' = Personally dentificatiom Type of Identification Produced Notary Print Name Miami shores'nViiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 ......... ....'feL305)_795.2204 - - - Fax: (306) 756.8972 Notice to Owner --Workers' Compensation Insurance Exemption 77 .r Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 4- 00 03 allows corporate officers in the construction industry to exempt themselves from fnis requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of W orlcers' 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 Nvorkers' compensation coverage. Corporate officers or members of a limited liability company CLLQ 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 Departrnent of State., Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Deparunent 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 �, lid for a period of two years or until a voluntary revocation is fted or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has aolmowledge that he or she will not use day labor, part-time employees or subcontractors for vour 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, IVEa,-ni Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part -ire employees or sub contractors. BY SIGNING BELOW YOU ACIUNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERS!'r->ND Ii S CONTENTS. Signature: _ State of Florida _ County of Miami -Dade The foregoing was acknowledge before me. this �� � day of Q- 1 > 0 � By l who is personally known to me or has produced -;0 A2( -! `�-as identiEca:don. Notary: 1 � / It t I VL J - -" `` SEAL: +`YP''' z NAMIE MR MY COMMISSION! t FF 1W97 r_ _ EXPIRES: October 7, 2DIS 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 l-lift, I D Z a f • 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). V/ 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, R4101.17.1.9 (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 provid in Section 775.082 or Section 775.083 .S . This form must be signed by the owner/agent and t ime contractor. 11�1 x Gos+oyj vwYc_1 CONTRACTOR'S SI NATURE AND DATE OWNER N ND DATE cr_Cc I Hul r�nZ CONTRAC OR'S NA PLE PRINT) OWNER'S NOTAR,Xa C N\ AtdUE BASS *? ' MY COMMISSION # FF 166797 v EXPIRES: October 7, 2018 Bonded Thru Budget Notary Services JUI1�j-Gl ��� PRINT) * MTKYNMSION # FF 166797 EXHRES: Ocieber r, ;?{;18 Bonded Thru Budget Notary Seivires Miami Shores Village 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 /41—+ Miami Shores Village Building & Zoning Department Attention: Building Official I certify that I am the legal owner of the property described as %cated �3 lbly-G3 P9 1S-14Plial Sh r lot 22 `� W'/z at 2s H IGrn i shQVT-S, t'-L- In accordance with Section 33-12(f), 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 X UUU Note: This certification is to be submitted with a swimming pool permit application in duplicate. Miami Shores Village 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: WHEREAS, the undersigned (,G+S V r K-e- jL4 I I f is t is/are the fee simple owner(s) of the following described property situated and being in Miami Shores Village, Florida: Address: 10-1 14 m; S hoer S, iZ 33IM Whereas, the undersigned owner(s) GC+SJOr',N V Sly i L+QT-cPe9 desire to utilize said Lot(s) as a single building site, and the undersig ed 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 onl released by Miami Shores Village, or its successors, i accord ce of said Village then in effect. X 0 ER N & PRINT OWNEWMW& PRINT I Hereby C ify that on this ay rsonally ap eared before me , q and hasp duced ID �� identification and he/she acknowle a that he/she execute he foregoing, freely and voluntarily, for purposes there in expressed. SWORN TO AND SUBSCRIBED before me on this day of , 20� ?o,"`:;•'uB�% NATHAUE BASS MY COMMISSION # klfVMQSW2D19F FLORIDA (Revised 05/2209 '',,OFF%.V Bonded ThroBudget Notary Softes f V Miami Shores Village 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 11 IZ(P/ t3 Miami Shores Village Building & Zoning Department Attention: Building Official certify that I am the legal owner of the property described as btk 93 P beg 15-14 Miomi show sec, 4 10122+ 14Yz 101- 23 , located at 573 NE ►02 s'treF-4 Mtorni Shareo, PL 33)36 In accordance with Section 33-12(f), Code of Metropolitan Dade County, I certify that 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. 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 a of the pool. Legal Owner, Note: This certification is to be submitted with a swimming pool kbrmit application in duplicate. Miami Shores Village 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: WHEREAS, the undersigned (I GLO"t p-n V t I"y'E4 is/are the fee simple owner(s) of the following described property situated and being in Miami Shores Village, Florida: Address: 615 NE 101 &1, M tQIM i sh"eo , a, 33 t 3 g Whereas, the undersigned owner(s) (A�Iael V t (11�_ e'4 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 install a protective enclosure to meet code requirements and will obtain a permit for such fence. IV. That, Itwe, 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 undersi d, his/her sucgessors and assigns and may only be released y iami Shores Village, or its successors, in accords e o I hen in effect. OWNER SIGN & PRINT OWNER qNG & PRINT I Hereby Certify that on this day personally appeared before me I I and has # as identification and he/she acknowledge that s exec ed the fo oing, freely for purposes there in expressed. SWORN TO AND SUBSCRIBED before me on this day of , 20 13 n NOT (Revised 0512209 GABRI E. GUARDIA MY COMMI SIGN N FF 030887 EXPIRES: July 4, 2017 Bonded Thru Notary Public Underwriters