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BPP-17-1271O1S yetMiami Shores Village CCF 10050 N.E. 2nd Avenue NE CO/CC Fee Miami Shores, FL 33138-0000 DBPR Fee Phone: (305)795-2204 fi�ORLt1A $5.40 Permit No. BPP -5-17-1271 Pe Permit Type: Pools/Whirlpools/Hot Tubs r' Work Classification: Addition/Alteration Permit Status: APPROVED issue nate: 1/912018 1 Expiration: 07/08/2018 Project Address Parcel Number Applicant 1460 NE 103 Street 1132050310060 CHRISTOPHER SAVITS Miami Shores, FL Block: Lot: MONICA SAVITS 1360 N. E. 103 ST. Contractor(s) Phone Cell Phone POOLS BY G.E. CORP (786)732-0614 (786)355-3382 roved: In Review iments: Approved:: In Review Denied: of Work: Swimming Pool itional Info: Isification: Residential Fees Due Amount CCF $10.80 CO/CC Fee $50.00 DBPR Fee $8.10 DCA Fee $5.40 Education Surcharge $3.60 Permit Fee $540.00 Plan Review Fee (Engineer) $80.00 Scanning Fee $9.00 Technology Fee $14.40 Total: $721.30 Occupancy: Private Bond Return Scanning: 3 Phone Valuation:=�30 Total Sq Fee Pay Date Pay Type Amt Paid Amt Due Invoice # BPP -5-17-63960 05/09/2017 Check #: 1499 $ 50.00 $ 671.30 01/09/2018 Check#: 105 $ 671.30 $ 0.00 Availahle Insnections: Inspection Type: Fence Final Pool Deck Wall Steel Review Electrical Review Electrical Review Planning Review Building Review Structural Review Plumbing 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, PµUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: ify�th t all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning hedmbbre, I authorize the above-named contractor to do the work stated. January 09, 2018 Owner / Applicant / Contractor / Agent Buildhfg 00epartment Copy January 09, 2018 1 Miami Shores Village RECEIVED Building Department JAN 09 2017 J 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 �p�k FBC 20 P4 BUILDING Master Permit No. -8 PP91+ " r PERMIT APPLICATION Sub Permit No. 14B UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP / CONTRACTOR DRAWINGS JOB ADDRESS: t:A 6 o O'E— City: Miami Shores County: Miami Dade zip: '; 3) 9 9 Folio/Parcel#: '�'� 3�b " D 0 Is the Building Historically Designated: Yes NO I \ Occupancy Type: Load: Construction Type: Flood Zone: aF, BFE: FFE: a OWNER: Name (Fee Simple Titleholder): r i shc„o kQ_" Phone#: ?30t;--g� Address: 1 4 �0 City: lc S State: zip: 33/ 3� Tenant/Lesse Name: Phone#: Email: CONTRACTOR: Company Name: ro©( 5- i r p Phone#: S— Address: j '� 3 i '-' S 33 City: VO1 State: �Z^ Zip: ?��a I Qualifier Name: �s�' [ua4 �r Phone#:�8r; State Certification or Registration #: GPC ) F ,I I . DESIGNER: Architect/Engineer: Add Certificate of Competency #: City: ne#: Zip: Value of Work for this Permit: 9, ©00 Square/Linear Footage of Work: �OO Type of Work: , Addition ❑ Alteration ❑ New ] Repair/Replace ❑ Demolition Description of Work: -4ci ., I1Q T spo_ 4,,4d ✓14 1. - Specify color'of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $_ Structural Reviews $, (Revised02/24/2014) Permit Fee $ Radon Fee $ Training/Education Fee $ CCF DBPR $ CO/CC $ Notary $ Double Fee ^$ Bond SP --1(0 `A450-3 TOTAL FEE NOW DUE $ V l I.30 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: 1 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 apprd a reinspection fee will be charged. Sign or AGENT The foregoing instrume t was acknowledged before me this day of d� 20J by ,LYNN tl Su.u._4 who personally kno to me or who has produced as Signature a/1 1z, . / , 4TRACTOR"/ The foregoing instrument was acknowledged before me this day of �ti 2018 by iE30Jk:F—L 6513u'wois personally known to me or who has produced R--rDo1-�Jff2 as identification an who did take an oath. identification an who did take an oath. NOTARY PUBLIC: Notary Public - State of Florida Seal: ; • ; . Commission # FF 228649 My Comm. Expires May 10, 2019 Bonded through Naticpal Notary Assn. I , w -, I APPROVED BY (Revised02/24/2014) NOTARY PUBLIC: Sign: Print: Seal: Plans Examiner Structural Review Zoning Clerk �'j 111 Miami Shores Village �c . g qBY: 0 9, 2017 ��,�� Building Department- s 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 L � FB�7�C210 BUILDING Master Permit No.�r C l:4 PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF ❑ CANCELLATION SHOP i1 CONTRACTOR DRAWINGS JOB ADDRESS: I "( (PO N E 10351- City: Miami Shores County: Miami Dade Zip: a)3 138. Folio/Parcel#: 11-320,5-03) - y%) (49 () Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): �.ff"o Address: I `t(D O Nt"- I0 SY City: 1l i nmi SkOr•e s State: Pt- Zip: q 31j ty /G^ Tenant/Lessee Name: Phone#: ?oS- -70/ Ya Email: CONTRACTOR: Company Name: V Phone#: ?6069-- 355- 33, 2 Address: fZ'J 15 5(' ) I;k, rt- City: 'til l I n� State: Zip: 3 g6 Qualifier Name: ( // 351 tlen-tn s Iy e C J r. Phone#: _55-932Z. State Certification or Registration #' - Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ ' i)�� Square/Linear Footage of Work: 00 Type of Work: XAddition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Specify color of color thru tile: t.J Submittal Fee $ Permit Fee $ 5 + O ' CCF $ ` E1 CO/CC $� ' Scanning Fee $ ' Radon Fee $ U t 0 DBPR $ 'e, 10 Notary $ Technology Fee $ 1 44 tot Training/Education Fee $ 60 Double Fee $ /"— Structural Reviews $ �� Bond $ Y�--�( (; TOTAL FEE NOW DUE $ I 4 . 00 1 (Revised02/24/2014) 6-71-30 r jl `1 Bonding Company's Name (if applicable) 1 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: 1 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. I t t t , ., , "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." ; f 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 propeity 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 occursj&'en (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be annroved and,6 reinspection fee will be charged. or AGENT The foregoing instrument was acknowledged before me this .2 day of 00,LA 120 L , by C who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: h Si Pr' * * MY COMMISSION t FF 165563 Seal: of+""OFVIQ�� Bonded Thru Budget Notary Servim Signature i C T CTOR 1 The foregoing instrument was acknowledged before me this eye day of 20 t- by 4.11,01(v-tQ FSQUI V45r, who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: SignAIDA ROM: Print: rA.••��4c MY COMMISSION #fFF165583 EXPIRES: October 5, 2018 Seal: ° 11-17 o1.1O1 Bonded Thru Budget Notary Ser ices el -7 7 r i. --a` *s*******ssssss********ssss*s****ssssssss********ssssss******sss*ssssssssss*sssss****s*****s*******s****ss*s Q t t APPROVED BY `1 ` .Plans Examiner ( . + Zoning Structural Review Clerk (Revised02/24/2014) a A� U® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDWYYYY) 3/23/2017 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 Eastern Insurance Group, Inc. 9570 SW 107 Avenue Suite 104 Miami FL 33176 `NAAME: CT Amanda Nogues PHONE (305)595-3323 No:(305)595-7135 MAIL ADDRESS: amanda@easterninsurance.net INSURERS AFFORDING COVERAGE NAIC t INSURER A Scottsdale Insurance Co. INSURED Pools by G.E. Corp 12315 SW 133 COurt Miami FL 33186 INSURER B ausinessFlrst Insurance Co. INSURER C : INSURER D: INSURER E: INSURER F t_nyFnerF=C CERTIFICATE NUMBER:Master 17/13 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 10050 NE 2nd Avenue POLICY NUMBER MADDLSUBRPMOIIDCY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMSMADE a OCCUR PREMISDAMAGESE a occurrence)$ 100,000 MED EXP (Any one person) $ 5,000 CPS2646532 3/16/2017 3/16/2018 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OPAGG $ 1,000,000 x POLICY 1:1 PRO- F LOC $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE $ Peracadent UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y PER I TH % STATUTE ER E.L. EACH ACCIDENT $ 100,000 B OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 68119 00 3/16/2017 3/16/2018 E.L. DISEASE - EA EMPLOYEE $ 100,000 E -L. DISEASE - POLICY LIMIT $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Swimming Pool Service and Construction ncorrcrnwrc unr ncn [_Arron 1 AnnN ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INSD25 /?ment i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue AUTHORIZED REPRESENTATIVE Miami Shores, FL 33138 David Lopez/DAVID ---� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INSD25 /?ment i 010372 Local Business Tax Receipt Miami—Dade County, State of Florida —THIS 1S NOT A BILL — DO NOT PAY 7171037 FL B T BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES POOLS BY GE CORP RENEWAL SEPTEMBER 30, 2017 12315 SW 133 CT 7449887 MIAMI FL 33186 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS POOLS BY GE CORP 213 SERVICE BUSINESS PAYMENT RECEIVED C/O GUILLERMO ESQUIVEL BY TAX COLLECTOR Employee(s) 1 $75.00 07/28/2016 FPPU06-16--020645 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is niot,a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply,lpr""; ermmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0. above must be displayed on all commercial vehicles — Miami w. 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