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BPP-18-1380
�` ygort£s t, y -fie FLORtOQ' Project Address Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit NO. tSJOV-5-1 t3-13t$U Permit Type: PoolsANhirlpooWHot Tubs r` Work Classification: New Permit Status: APPROVED Parcel Number tssueoate:6126/2018 I Expiration: 12/23/2018 Applicant 142 NW 101 Street 1131010220180 Miami Shores, FL 33150- Block: Lot: SEKOU RASHAD CALDWELL SEKOU RASHAD CALDWELL 142 NW 101 Street MIAMI SHORES FL 33150- 142 NW 101 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone ONE STOP POOLS & CONSTRUCTION (305)297-5120 roved: In Review Approved:: In Review Denied: of Work: Swimming Pool ional Info: ification: Residential Fees Due Amount Bond Type - Contractors Bond $500.00 CCF $10.20 DBPR Fee $7.65 DCA Fee $5.10 Education Surcharge $3.40 P&Z Review Fee $35.00 P&Z Review Fee $35.00 Permit Fee $510.00 Plan Review Fee (Engineer) $45.00 Scanning Fee $12.00 Technology Fee $13.60 Total: $1,176.95 Occupancy: Private Bond Return Scanning: 4 Cell (206)512-4708 Valuation: $ 17,000.00 Total Sq Feet: 188 Pay Date Pay Type Amt Paid Amt Due Invoice # BPP -5-18-67632 06/26/2018 Credit Card $ 976.95 $ 200.00 05/21/2018 Credit Card $ 200.00 $ 0.00 Bond #: 3807 Avauame Inspection Type: Fence Final Pool Deck Wall Steel Review Electrical Review Building Review Structural Review Plumbing 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 construction and zoning. Futhermore, I authorize the above-named contractor to do Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy t all work ill be done in compliance with all applicable laws regulating works ed. O ? June 26, 2018 June 26, 2018 1 V�A ov �o G , V BUILDING PERMIT APPLICATION 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 /BUILDING ❑ ELECTRIC ❑ ROOFING 2 X 2018 FBC 20 (_� Master Permit No. � Ao'eb Sub Permit No. ❑ REVISION ❑ EXTENSION RENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS [-]CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: NZ /V 0 IVI 51 Folio/Parcel#: LI -3101^ 02Z -0/90 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: ,. /Flood Zone:: BFE: QFFE: OWNER: Name (Fee Simple Titleholder): SQ�0y k,4�Ad OW'd ��CE Phone#: 0 Z6 / Address:: /W 67" - City: ��--•l� City: 0 /odw " ( State: /"L Zip: 3,3 1,26 Tenant/Lesssseee� Name: Phone#: Email:%� `-J1Z,f%� Q -Se f -)4"wS CONTRACTOR: C'o'mpany Name: Okc; / r�� CZW_' 44 k � Phone#: SG Address: 122 43 1 q'? 46A City: d4A4A i State: Zip:321ek Qualifier Name: !2a& 4w•6U 6?, Phone#: S - S" 20 State Certification or Registration #: GPG 1gs12 SI Certificate of Competency #: DESIGNER: Architect/Engineer: e#: Address: City: State: Zip: Value of Work for this Permit: $ 1000 . 00 quare/Linear Footage of Work: LZL r Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Description of Work: /U6iCO t -U) j HY1A)re W Specify color of color thru tile: Submittal Fee $ 2 c5o • c5p Permit Fee $ Sl 0 ' 00 CCF $ CO/CC $ Scanning Fee $ 2 ` dU Radon Fee $ `�• t DBPR $ .Notary $ Technology Fee Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ 'F q�� . :Ej?, ��- X Z = :90 TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) I _ _ ._ _ A s.:x I Bonding Company's Address City State Mortgage Lender's Name (if applicable) _ Mortgage Lender's Address City State d 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 an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien low 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 //Aal OWNER or AGENT CONTRACT The foregoing instrument was acknowledged before me this -le day of A�� 1 20 J by 5(,- at) �to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Print: / U 6/SZZ"ekA L Seal: MICHELLE ESPINOSA-CLARK MY COMMISSION #FF126847 EXPIRES: MAY 28, 2018 °i Bonded through 1st State Insurance APPROVED BY� (RevisecIO2/24/2014) as The foregoing instrumtrit was ackndwledged before me this day of 20by who i ersonally know me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Print: KJ (,&f l/UD.SI - Seal: MICHELLE ESPINOSA-CLARK o�YP mo MY COMMISSION #FF126847 EXPIRES: MAY 28, 2018 Bonded through 1st State Insurance Plans ExaminerZoning Structural Review 'Clerk 5/18/2018 Property Search Application - Miami -Dade County .,....,.,'OFFICE OF THE PROPEUITY APPRAISER Detailed Report Property Information Folio: 11-3101-022-0180 Property Address: 142 NW 101 ST Miami Shores, FL 33150-1214 Owner SEKOU RASHAD CALDWELL Mailing Address 142 NW 101 ST MIAMI SHORES, FL 33150 USA PA Primary Zone 0800 SGL FAMILY - 1701-1900 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY: 1 UNIT Beds / Baths / Half 2/1/0 Floors 1 Living Units 1 Actual Area 1,332 Sq.Ft Living Area 1,080 Sq.Ft Adjusted Area 1,203 Sq.Ft Lot Size 8,100 Sq.Ft Year Built 1948 Assessment Information 2017 2016 2015 Year 2017T2016 $0 $0 2015 Land Value $178,398 ,398 $131,771 Building Value $83,729 ,729 $83,729 XF Value $787 $797 $605 Market Value $262,914 $262,924 $216,105 Assessed Value j $261,486 $237,715 $216,105 Benefits Information Benefit Type 2017 2016 2015 Non -Homestead Cap Assessment Reduction 1 $1,4281 $25,209 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Generated On: 5/18/2018 Taxable Value Information 2017 2016 2015 County Exemption Value $0 $0 $0 Taxable Value $261,4861 $237,7151 $216,105 School Board Exemption Value $0 $0 $0 Taxable Value 1 $262,9141 $262,9241 $216,105 City Exemption Value $0 $0 $0 Taxable Value 1 $261,4861 $237,7151 $216,105 Regional Exemption Value $0 $0 $0 Taxable Value 1 $261,4861 $237,7151 $216,105 The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at httpJ/www.miamidade.gov/info/disdaimer.asp Version_ 5/118/2018 Property Search Application - Miami -Dade County r<r�OFFICE OF TSI Generated On: 5/18/2018 Property Information Folio: 11-3101-022-0180 Property Address: 142 NW 101 ST Roll Year 2017 Land, Building and Extra -Feature Details Land Information Land Use Muni Zone PA Zone Unit Type Units Calc Value GENERAL R-14.25, R-15 0800 Front Ft. 75.00 $178,398 Building Information Building Number Sub Area Year Built Actual Sq.Ft Living Sq.Ft Adj Sq.Ft. Calc Value 1 1 1948 1,332 1,080 1,203 $83,729 Extra Features Description Year Built Units Calc Value Wood Fence - 1996 60 $787 The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at httpl/www.miamkiade.govfinfo/disdaimer.asp Version: 5/18//2?0118j , Property Search Application - Miami -Dade County OFFICE OF THE PROPERTY APPRAISER cL 1 ,• Generated On: 5/18/2018 Property Information Folio: 11-3101-022-0180 Property Address: 142 NW 101 ST Roll Year 2016 Land, Building and Extra -Feature Details Land Information Land Use Muni Zone PA Zone Unit Type Units Calc Value GENERAL R-14.25, R-15 0800 Front Ft. 75.00 $178,398 Building Information Building Number Sub Area Year Built Actual Sq.Ft. Living Sq.Ft. Adj Sq.Ft Calc Value 1 1 1948 1,332 1,0801 1,2031 $83,729 Extra Features Description Year Built Units Calc Value Wood Fence 1996 60 $797 The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http://www.miamidade.govrnfoldisclaimer.asp Version: 5/18/201.�8'Ld, Propertv Search Application - Miami-Dade County OFFICE OF THRIE PROPERTY APPRAISEH tirtic Generated On: 5/18/2018 Property Information Folio: 11-3101-022-0180 Property Address: 142 NW 101 ST Miami Shores, FL 33150-1214 Roll Year -2015 Land, Building and Extra -Feature Details Land Information Land Use Muni Zone PA Zone Unit Type Units Calc Value GENERAL R-14.25, R-15 0800 Front Ft. 75.001 $131,771 Building Information Building Number Sub Area Year Built Actual Sq.Ft Living Sq.Ft I Adj Sq.Ft. I Calc Value 1 1 1948 1,3321 1,0801 1,2031 $83,729 Extra Features Description Year Built Units Calc Value Wood Fence 1996 160 $605 The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http:/Avww.miamidade.govrinfo/disdaimer.asp Version: 5/18/2018 Propertv Search Application - Miami -Dade County OFFICE OF THE PROPERTY APPRAISEn Generated On: 5/18/2018 Property Information Folio: 11-3101-022-0180 Property Address: 142 NW 101 ST Full Legal Description GOLD CREST PB 21-56 LOT 1 W1/2 OF LOT 2 BLK 3 LOT SIZE 75.000 X 108 OR 17279-3628 0796 1 Sales Information Previous Sale Price OR Book -Page Qualification Description 03/23/2017 $385,000 30469-4274 Qual by exam of deed 08/26/2014 $300,000 29291-1516 Qual by exam of deed 07/01/1996 $80,000 17279-3628 Sales which are qualified 10/01/1992 $67,000 15684-0207 Sales which are qualified 09/01/1983 $48,000 11927-2290 Sales which are qualified 12/01/1976 $1 00000-00000 Sales which are disqualified as a result of examination of the deed The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http://www.miamidade.govriinfo/disclaimer.asp Version: https://www.miamidade.gov/propertysearch/#/reporYdetails 5/5 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 -- Ili Z Al W (O( S� 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 R41O1.17. 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 S , 0 • 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 toa unsafe. I understand that not having one of the above installed will constitute a violation of a )ter 515, F.S ., an d will be considered as committing a misdemeanor of the second degree, pu shable provided in Section 775.082 or Sectio 5.083 F.S . Th' form must be signed by the ow r e t d the prime contractor. CONTRA TOR'S SI NATURE AN DATE OWN 'S SIGMA URE AND D 'rheo IoU�Z x fJI' Ca{�buJ�li� C 07, T T R'S A (PI EASE PRI' S AI�I1%E) MY COMMISSION #FF128847N�RW EXPIRES: MAY 28, 2018 r�rUlG�� PUBLI _Insurance STATE OF (FLORIDA) COUNTY OF (DADE) Miami Shores Village Building Department SURVEY AFFIDAVIT 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 The undersigned Affiant, 66 KW k6Nb Qqh&does hereby attest that (Property owner) The attached survey, performed by&XAC,-tA (CJD SU/AIA (Name of surveyor's company) For address: 19Z AJ W ID 15r , Performed on Z' 12-9 Z (date of survey) is an accurate representation of the existing conditions and locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits. Further, a say ait. SE lCOL) 4r ,� eUU� Property Owner Signature Property Owner Print Name SWORN TO� AA SUBSCRIBED before me this � Q_day of Affiant isy personally known to me, _produced as identification. MICHELLE ESPINOSA-CLARK 5�?.Y ILB MY COMMISSION #FF126 f EXPIRES: MAY 28, 2018 Nota O 0. Bonded through 1st State Insurance Notary Revised on 5122/20091 Revised on 6112109 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 SP K0Q aS4b 0t',dW6UL, is/are the fee simple owner(s) of the' following described property situated --and being in Miami Shores Village, Florida: Address: _i q Z Aj W t d l -c4- �t�l )LL' ilk yu Al, Whereas, the undersigned owner(s) t; KOt) O-skb CAt6UJ6ZL desire to utilize said Lot(s) as a single building site, and the undersigned owner(s) doles) 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 doles) 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 a released by Miami Shores Village, or its successors, in accordance of said Village then in effect. X OWNER SIGN 8e, PR OWNER SIGN & PRINT I Hereby Certify that on this day personalty appeared before me 5s K L) S �g.L�t� and has produced ID # as identification and he/she acknowledge that he/she executed the foregoing, freely and voluntarily, for purposes there in expressed. SWORN TO AND SUBSCRIBED before me on this _I g day of 201 5� P� MICHELLE ESPINOSA-CLARK MY COMMISSION #FF126847 k1ffJW/(i EXPIRES: MAY 28, 2018 NOTA PUBLIC STATE (Revised 05/2209`„" Bonded through 1 $t State Insurance 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 r I? 2018 Miami Shores Village Building & Zoning Department Attention: Building Official I certify that I am the legal owner of the property described as 606h P15 d.\ -Sb Ca -1" 1 , located at t q 2 xju) l01 st In accordance with Section 33-12(o, 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 ins ection and use of the pool. MICHELLE ESPINOSA-CLARK i� Legal Ownpr 0.Y P�B4n MY COMMISSION #FF126847 EXPIRES: MAY 28, 2018 �de inrougp 1st State Insurance Note: hi aft itted with a swimming pool permit application in duplicate. ' � CERTIFICATE OF LIABILITY INSURANCE DATE05/09D/YYYY) Ilk. �"�^'f 05/09/18 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 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 CONMTA NAE: Lucia Estrella --{ Accurate 8300 West Flagler Suite 114 PA.MAto Eat);__(305)226-8727 FAX �__ (305)226-8767 a_ D_RI_E_s_s_: accurate.certificates@gmail.com INSURER(S)AFFORDINGCOVERAGE � NA Miami, FL 33144 Phone (305) 226-8727 Fax (305) 226-8767 INSURERA: Covington Specialty Insurance Company $ 1,000,000.00 INSURED INSURER B: INSURER C : _ One Stop Pools & Construction, Inc 12243 SW 144 Terr INSURER D: aBciciNd DlSINGLE LIMIT $ Miami, FL- 33186- INSURER E BODILY INJURY Per accident INSURER F PROPERTY DAMAGE Per accident $ 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 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 A TYPE OF INSURANCE GENERAL LIABILITY Q COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE ❑Q OCCUR ❑ ADD INS Y SUER I WVQ Y POLICY NUMBER VBA61444300 POLICY EFF (MM/DD/VYYY) 04/17/2018 ; POLICY EXP MM/DD/YYYY 04/17/2019 LIMITS EACH OCCURRENCE $ 1,000,000.00 DAMAGE TO RENTED PREMISES (Ea occurrence S 100,000.00 MED EXP (Any one person) $ 5,000.00 PERSONAL 8 ADV INJURY I $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- W POLICY El .1111 ❑ LOC PRODUCTS - COMP/OP AG_G $ 1,000,000.00 Deductible $ 500.00 AUTOMOBILE LIABILITYEO ❑ ANY AUTO ALL OWNED SCHEDULED ❑ AUTOS AUTOS ❑ NON -OWNED ❑ HIRED AUTOS ❑ AUTOS ❑❑ aBciciNd DlSINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ 1 $ ❑ UMBRELLA UAB OCCUR ❑ EXCESS LIAB ❑CLAIMS -MADE I_� EACH OCCURRENCE (, S I AGGREGATE $ ❑ DED ❑ RETENTION$ $ j WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTNE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) El IF as, describe under DESCRIPTION OF OPERATIONS below I / NA i I WC STATU- OTH- ❑ TOSY IJMITS ❑❑❑❑❑❑❑J E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE -POLICY LIMIT! $ —J i DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) License number # CPC1458519 I CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 Ne 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE RbLICY PROVISIONS. AUTHORIZED Lucia Estrella 988-2010 ACORD CORPORATION_ All rinhtc ri cPrvpr1 ACORD 25 (2010105) OF The ACORD name and logo are registered marks of ACORD %4CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYY) 01/08/2018 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 have ADDITIONAL INSURED provisions or 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 FrankCrum Insurance Agency, Inc. 100 South Missouri Avenue Clearwater, FL 33756 CONTACT NAME: PHONE A/C, No, Ext): 800 277-1620 X 4800 FAX A/C, No): 727 797-0704 E-MAILADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: Frank Winston Crum Insurance Company 11600 INSURED FrankCrum UC/F One Stop Pools & Construction, Inc. 100 South Missouri Avenue Clearwater FL 33756 INSURER B: INSURER Q INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 468203 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 INSRD SUBR W VD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occu _. $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL B ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY O PROJECT OLOC PRODUCTS-COMP/OPAGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Per arson $ OWNEDAUTOS SCHEDULED ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED AUTOS NON -OWNED ONLY AUTOS ONLY UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCURRENCE $ AGGREGATE $ EXCESS LIAR DED I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 0 N/A WC201800000 01/01/2018 01/01/2018 X PER STATUTE oTH- ER E.L. EACH ACCIDENT $1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE -EA EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1.000.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Effective 01/11/2016, coverage is for 100% of the employees of FrankCrum leased to One Stop Pools & Construction, Inc. (Client) for whom the client is reporting hours to FrankCrum. Coverage is not extended to statutory employees. CERTIFICATE HOLDER CANCELLATION ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores Village Building Department 2nd Ave. AUTHORIZED REP ESENTATIVE ."s Miami Miami Shores, FL 33138 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ANTONIO CANELAS, P.E. LIC. No. 74099 7815 SW 24 ST SUITE 111 MIAMI FL, 33155 305 261 0321 Miami Shores Village Building and Zoning Department Miami Shores, Florida. Reference: Soil Statement Residential Swimming Pool Property of: Sekuo Caldwell 142 NW 101 ST. Miami Shores, FL 33150 To Whom It May Concern: Soil Statement: Date 7-05-18 A- 'S A field visual inspection was conducted on 7-05-18 of the swimming pool excavations for the above -referenced property. The existing site has been observed and evaluated, and we conclude that the conditions are similar to those upon which the design was based (allowable bearing capacity equal to 2000 psf . In addition, we conclude that the soil is adequate to support the Required Bearing Pressure of 650 PSF imposed by the new swimming pool. If you should have any questions regarding this matter, please do not hesitate to contact us. Sincerely, Q C ft q Q . No. 7 4099 • = ;7lap* _ 9:•• STATE OP •; �� to O "dill SI O N A`1011111 it, ```�.�. 7-05-18 Antonio Canelas, P.E. Lic #: 74099 Attached: Photographs of Excavation Amvwm-h -7A I Wig -M�lv Amvwm-h -7A