Untitled (2)W
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 is/are the fee
simple owner(s) of the following described property situ ed and being in iam Shores Village, Florida:
Address: ? -7� 4/ Ib 3 si(ec+
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
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 covena concerning the use, enjoyment and title to the above property and shall constitute a
covenant ru i e land and shall be binding upon the undersigned, his/her successors and assigns
and ma my be relea by Miami Shores Village, or its su c dance of said Village then in
effec JJ
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OWNER SIGN & PRIN p PR/I/N
I Hereby Certify that on this day personally appeared before me Revs, VS 0 (tot l (`f ', 614 -66
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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 17 day of lk j ok 1 , 20 1-1
(Revised 05/2209
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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 (WeackoNe that a new swi�ming pool, spa or hot tub will be constructed or installed at
tot S-br 4 ` 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).
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 considere mmitting a misdemeanor of the second
degree ishab e s provided in Section 77 or This form must be signed
by e o !ag nd the prime contr r.
�QNTRACTOR'S IG�TURE AND DATE N SIGNA AND DATE
CONTRACTOR'S NAME (PLEAS
NOTARY
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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
Datell 15 1
Miami Shores Village
Building & Zoning Department
Attention: Building Official
I certify that I am the legal owner of the property described as
located at � �
('l1(ccttql ��ort 5
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.
further understand that this certification, however, does not eliminate the need for
obtaining a permit and erecting and approved barrier prior to fin f i spection and use of the
pool.
Legal Own
Note: This certification is to be submitted with a swimming pool permit application in duplicate.
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