BPP-19-7 (3)Location Address
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Permit No.: BPP -01-19-7
Permit Type: Pools/Whirlpools/Hot `i"ubs
fu Work Classification: New
ftffr—uu�� ug
Permit Status, Approved
Issue Date: 02/14/2019 1 Expiration: 11/25/2019
Parcel Number
550 NE 102ND ST, Miami Shores, FL 33138 1132060171041
Contacts
IRENE HEGEDUS Owner NATIONAL POOL DESIGN LLC Contractor
550 NE 102 ST, MIAMI SHORES, FL 331382455 ALFREDO RODRIGUEZ
Other: 3057250672 2423 SW 147 AVE SUITE 212, MIAMI, FL 33185
Business: 3055591020
Mobile: 7862675595
Description: NEW SWIMMING POOL AND DECK Valuation: $ 35,000.Inspection Requests,
00 130S-762-4949
Total Sq Feet: 160.00
Fees
Amount
$75 Inspection Fee
$75.00
Application Fee - Other
$50.00
CCF
$21.00
Certificte of Completion for Single Fam
$50.00
and Duplex
$50.00
DBPR Fee
$15.75
DCA Fee
$10.50
Education Surcharge
$7.00
Permit Fee
$1,000.00
Planning and Zoning Review Fee
$35.00
Scanning Fee
$9.00
Structural Review ($45)
$45.00
Technology Fee
$26.25
Total
$1,344.50
Building Department Copy
Payments
Date Paid
Amt Paid
Total Fees
$1,344.50
Credit Card
02/14/2019
$1,219.50
Check # 1537
01/02/2019
$50.00
Credit Card
03/12/2019
$75.00
Amount Due:
$0.00
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 above named contractor to do the work stated./
Authorized Signature: Owner / Applicant / Contractor /
May 28, 2019
Date
Page 2 of 2
Miami Shores Village pt�c EI
�\ `� FEB 6 19
y� Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 BY'
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
BUILDING Master Permit No. SPP- ,q _7
PERMIT APPLICATION Sub Permit No. MQ 2--fQ 430
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING /MECHANICAL E] PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: !�S0 Z s
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): -:X7aVN-"6 VS Phone#:. ' L175 - 6ct
Address:�St�� r1 ,�� 67 /d ?_S T
City: N i A-" � S r1 � a "� � State: IAV Zip: 33)'s-
Tenant/Lessee
3) 3
Tenant/Lessee N• ame:� C3, Phone#:
Email: —I: �C1"Cj H 1 �0 I Q)-441 L, Cof-i
CONTRACTOR: Company Name: N, `Tl oL �� L' �) L Phone#: J'
Address: 2'�Z'S -sL j i q 7 lq Z l Z
City: "/✓-Y,4 1 State: Zip: 3 ��
Qualifier Name: u F:-Q u tJi o
�i d 0 i Z E Phone#: 1 SZ
$9- /62
,
State Certification or Registration #: t1'1 S7 9 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑New ❑ Repair/Replace ❑ Demolition
Description of Work:
/NS-r4L- . / eiL-
Specify color of color hru tile:
Submittal Fee $ i/1' Permit Fee $ >r� CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $
(Revised02/24/2014)
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 an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signatu
OWNER or AGENT
The foregoing instrument was acknowledged beforemethis
! Z�� day of 20 l by
�—� ��G�✓S who is personally known to
me or who has produced
�PLI
identification and who did take an oath.
NOTARY PUBLIC:�.�—
CRISTINA RODRIGUE2
Notary Public - State of Florida
��
F :^ = Commission a GG 105164
oe:' My Comm, Expires May t 6, 2021
Sign:4 `',' d�� deditu r.rau&Atotur`6
Print:
Seal: Cp1S-r1+vA
as
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of % Lam, 20, by
1h• eCA0 1? who is pe a ly know to
me or who has produced _ as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
i ��. e •:
• `
q"_" o?
CRISTI
A-State UEZ
Notary Public - State of Florida
Notary
Commission # GG 105164
My Comm. Expires May 16, 2021
Print:
Seal: CeusT i AjA Pode\q V£' Z
APPROVED BY ` tans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
---- Uri V
Date:
State of 1 p n a- a
County of j A a Mti 0'a
Before me this day personally appeared 11zrn6r1L KvY3Z who, being duly sworn, deposes
and says:
That he or she will be the only person working on the project located at:
S 6 N�.. l a
Contractor Signature
Signature
Sworn to (or affirmed) and subscribed before me this day of FZ�vv rx int 20n, by
4AKO.1 (/0A04
Personally know.
OR Produced Identification Cl--'
Type of Identification Produced
1
L
—• rint, Type or Stamp Name of Notary b
'iPH °� '•., CRISTINA RODRIGUEZ
NotaryPublic- StateofFlorida
Commission =GG 105164
My Comm. Expires May 16, 2021
^, Boded throu§F. Naticnal Nctary Assn.
Notice to Owner - Workers' Com
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
nsation 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 staring 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.
Signatur
State of
County of Miami -Dade
The foregoing was acknowlege before me this 0S day of C b _� , 20
By P'1Q- ky(60 ho is personally known to me or has produced
L
Notary:
as identification.
;•s; P� •.,
CRISTINA RODRIGUEZ
SEAL:
= 2°�`�� c'.
Notary Public - State of Florida
• ;
Commission g GG 105164
37,
My Comm. Expires May 16, 2021
•9 °cF��,•
Bonded through Nahcnal Notary Assn.
as identification.
7210 SW 126th Court, Aniano J. Garcia, PLSM Ph(305)856-4566 Boundary Survey
Miami, Florida 33183 Land Surveyor & Planner agarcia297@aol.com
Scale 1 "= 20'
Property Address: 550 NE 102nd Street, Miami Shores, Florida 33138
Legal Description: Lot 6 and the East 2 of Lot 7, Block 94, of "AMENDED PLAT OF
MIAMI SHORES SECTION No 4", according to the Plat thereof, as recorded in Plat
Book 15, at Page 14, of the Public Records of Miami -Dade County, Florida.
Folio No. 11-3206-017-1041
— — — — — — — — — — — — — — — — — —
10.82'
10.82' 15' Wide 'Alley
0.9'
cl I
0.3'
Encr
O
O
L6
Lot 5,
Block 94 r,
O
O
O
Z
10.07'
S89034'58'1E '76.
Nu Line
7 10.31' C;
t10. S 4' - 10.09'
/-9.75' /-9.97''t
9.96'-f
50'
10.24' 10.21 ' ;.
N
Conc
B9) ------
10.07' 32.7'
0.4'
_ncr
__" Lot 6, Residence
Block 94 # 550
N
M
FFE=10.81 '
10.38'
X
.>00 P %\
10' Asphalt
Pavement `-10.40'
FIP
0.3
CI
mss-
O�
Co
o,
(N
1/_9.50'1R
9.92'
9.73'-� Septic'
Ta k
9.93' Y
Property ;a NX/
0N 3 /.'nlField, X�,
vNAX&��P�I/p�'rt/y t
Line
FDH
5' Sidewalk \-9.15 S89034'58"E 75.00' \-8.99' 9.08'
9.44'
a fc� Conc 21' Parkway
n
M
Edg of Pavement
\-9.62' \\-9.51' 9.52'-/
9.88' NE_ 102nd _Street lPavement pt
9.83'J (75' Total R/W) �� �%
X971" 9.71"
Trec
Legend:
Oak
Palm
Gumbo Limbo
Edge of Pavement
Reference Bench Marks:
County BM No. N-802, Elev=8.98 feet
in:) D-159, r--Iev,=10..32 „feet NGVD 1.929
Flood Plain Information:
Flood Zone: X; Panel No. 12086C0306L;
Community Name/No.: Village of Miami
Shores/120652
9.24'
_Property
Line
FIP
01"
This survey is certified only to the entities listed
and only for this particular transaction. Any use or
reproduction of this survey without the express
written permission of the surveyor is prohibited.
Use of this survey in any subsequent transactions
is expressly prohibited and is not authorized.
The surveyor expressly disclaims any certification
to any parties in future transactions. No entity
other than those listed should rely upon this survey.
0
UJ
N
cn
Q
I�
I�
Q)
ala
ole,
mIZ
°10
J �
SIJ
IW
_S89'34'58"E _ _ _
275.00' TBOB — — — - FIP
.,
BC
There may be easements and/or other
instruments affecting this property,
recorded in the Public Records not
shown on this survey
Note:
Identification of Septic Tank and Drain Field on the site
was done by client
Date Field Work 12-11-20 5
LEGAL NOTES Rev' ed 03-23-2016 For:
This Survey does not reflect or determine ownership; Examination of the Abstract of Title will vised 11-08-2018
have to be made to determine Recorded Instruments, if any, affecting the property; This Irene S. Hegedus
Survey is subject to dedications, limitations, restrictions, reservations or easements of recor ; , Aniano J. G I _69 105
Legal Description provided by client; The Liability of this Survey is limited to the cost of e
Survey; Underground Encroachments, if any, are not shown; This firm has not attempted o. Not vn, KithA �1 'signature
locate footing and/or foundations and/or underground improvements of any nature; If sh wn, cnd `the • ori'ginaI ra ed seal
Bearings are referred to an Assumed Meridian; If shown, Elevations are referred to Notiona of a Florida Iicense�surveygr. + . +g
Geodetic Vertical Datum of 1929 (NGVD 1929) ..,rl maTr nEF� 0 ; •. Did EJ" Np 15-0471
A = Arc Length; AC = Air Conditioner; AE = Anchor Easement; BC = Block Corner; BM = Bench Mark; B69 = osis •Of• Bean nis• `Oj = Calculated Dimension; CB
= Catch Basin; CBS = Concrete Block Structure; CFW Concrete Fence Wall; CH = Chord Length; CHB " CHbf8 Be'aNng! CI'= Clear; CML = City Monument Line;
CME = Canal Maintenance Easement; Conc = Concrete; DE = •Drainage Easement; DME = Drainage & Maintenance Easement; Dr = Drive; E = East; Elev =
0 Z Elevation; ENCR = Encroached; ETP = Electric Transformer;, FDH = Found Drill Hole; FIR = Found Iron Rod; FIFE = Finished Floor Elevation; FH =Fire Hydrant; FIP
Z O = Found Iron Pipe; FN = Found Nail; FT = Feet; LME = Lake Maintenance Easement;' LB = Licensed 8Lg'ingV,, LFE' _ LP'4st Floor Freuation; LP = Light Pole; (M)
Q = Measured Dimension; ME = Maintenance Easement; MON = Monument; N = North; NGVD 1929 = Nm*nal Geodet a Vejticbl Dat:m pf:1929; NTS = Not To Scale;
0 Q OE = Overhead Cables; OH = Over Hang; ORB = Official Record Book; 0/S = Off Set; Pb = Plat Book;•PC: F Point +of•Csrvoture! PEC•= Point Of Compound
Z > Curvature; PCOR = Property Corner; PCP = Permanent Control Point; Pg = Page; PL = Planter or Property Line; PLS ='Professional Land Surveyor; PLSM =
W W Professional Land Surveyor and Mapper; POB = Point Of Beginning; POC = Point Of Commencement; PRC = Point Of Reverse Curve; PRM = Permanent Reference
WCo Monument; PT = Point Of Tangency; R = Radius; (R) = Recorded Dimension; RLS = Registered Land Surveyor and Mapper; RJR = Rpil Road; R/W = Right Of
-J CO Way; Sec = Section; T = Tangent; S = South; SIP = Set Iron Pipe With Cap Stamped PLS 5105; UE='tttflitQ Eas"mQn1 CA =:Utility Pole; UTY = Utility;
Q W = West; WF = Wood Fence; WM = Water Meter; WV = Water Valve; = Centerline; —x— = Chain Link•Fence °- nc t all; = Degrees; A = Central
Angle; 0 = Diameter; = Existing Elevation; = Minutes; = Seconds; = Wood Fence+�•� 9
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
5,50 NJ�—' /0 2 5 Ir 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 comp lies 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 t he pool perimeter. The plans must specify t he type
and loc on 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 provided in Section 775.082 or S ction 715-08 F.S . This form must be signed
by the owner/ gent and the prim contractor. • . • • • •
CONTRACTOR'SOIGNATUQ AND DATE WNE11t S11VATlJ1!ZE ND D TY
Cp�TRACTOR'S N E (PLEASE PRINT) OWI�q'S roAW{� P IIT)
/ I 1 i1. 40_
NO CRISTINA RODRiGUET a� po '••, STINA RO ate of c2
NOTARY PU h N r Fublic -State of Florida
. ,av PuQ • • • • • • . .`� �4 a ha Cy
Public
. o : Notary Public - State of Florida • • • • Eemmission # GG 105164
` • _ Commission GG 105164 • • • • �y
• . - • • . . . s;s�. •Nly:omm. Expires May 16, 2021
';�' 0�5 My Comm. Expires May 16, 2021 • • • • • • •.,,9i F °y •
.,', or-��c?;;` • • • • • • � �� t"rcurt7 katiccal MttryA<sn,
"•.,...,,,, BordedthrucCKaticrzlP.ctzryAss". ",
1'
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: a ,�,,
&
WHEREAS, the undersigned 19E JE -MME F{EZ_1EpU5 is/are the fee
simple owner(s) of the following described property situated and being in Miami Shores Village, Florida: Q
Address: ` Gy NE tot -;1 I /iJ��iJM I sHO�1 F1 33R3a
Whereas, the undersigned owner(s)
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
meet code requirements and will obtain a permit for such fence.
immediately install a protective enclosure to
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 only be released by Miami Shores Village, or its
successors, in accordance of said Village then in effect.
O NER SIGN & PRINT OWNER SING & PRINT
I Here Certify that on this day personally appeared before me sy v ~ —and has produced ID
#L' as identification and he/she acknowledge th•Lhejspg ejecVted the foregoing, freely and voluntarily,
for purposes there in expressed.
10 • r, • .
SWORN TO AND SUBSCRIBED before me on this day of • • • • • . '
d
* • 64CTARYPQBUC $TAT?F FLORIDA
(Revised 05/2209 :0. : . :' ; :. I
• 011�11p' ;"P' , CRISTIN+tRODRIGUEZ
• • . • ;: ���;�, Notary Public - State of Florida
• Commission # GG 105164
• • a Poi' My Comm.d xpires May 16, 2021
• • •`�°' • .
Bended [hrogh National Notary Assn.
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
SWIMMING POOL OWNER'S CERTIFICATION
Date�2,"ZA —I$'
Miami Shores Village
Building & Zoning Department
Attention: Building Official
certify that I am the legal owner of the property described as
, located at 5-50 N 67 10-2 S T
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 a d use of the
pool. •
Legal Owner • •
.. ... .. . ....
Note: This certification is to be submitted with a swimgr b peol peTHta�plicdWnin,duplicate.
• • • • . • • • : • •
• • • 000 49e Y • . •
. ..... . ...