BPP-03-19-674, 1275 NE 103rd St (2)Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Parcel Number
1275 NE 103RD ST, Miami Shores, FL 33138 1132050200080
;ontacts
Jacques Nijankin Owner AQUATIC ENVIRONMENTS Contractor
1275 103 LUIS ESPINOSA
11767 S DIXIE 203, PINECREST, FL 33156
Business: 7863909029 aquadesignl@bellsouth.net
m_.._.._........_......, _ __ _......... ..
I Description. POOL REMODELING & PAVER DECK OVER SAND H Valuation:
$ 27,145.00
Ins ection Requests
S 76?*
Total Sq Feet:
1,450.00,E
„>
Fees
Amount
Application Fee - Other
$50.00
CCF
$16.80
Certificte of Completion for Single Fam
$50.00
and Duplex
DBPR Fee
$12.22
DCA Fee
$8.14
Education Surcharge
$5.60
Permit Fee
$764.35
Planning and Zoning Review Fee
$35.00
Scanning Fee
$12.00
Structural Review ($45)
$45.00
Technology Fee
$20.36
Total:
$1,019.47
Payments
Date Paid Amt Paid
Total Fees
$1,019.47
Check # 4678
06/05/2019 $969.47
Check# 4540
03/29/2019 $50.00
Amount Due:
$0.00
Building Department Copy
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 / AgentA4—/',-�' Date
v
June 05, 2019 Page 2 of 2
tXtMILUVI TV GA1b"TI-Iy
Miami Shores Village Per "e"Oa-'�-
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
FBC 20
BUILDING
PERMIT APPLICATION
[]BUILDING ❑ ELECTRIC ❑ ROOFING
PLUMBING ❑ MECHANICAL [:]PUBLICWORKS
JOB ADDRESS: 1275 NE 103rd Street
Master Permit No. 6 P P - 0 �) - 19 - Ul'i
Sub Permit No.
❑ REVISION ❑■ EXTEN ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores
County:
Miami Dade zio•
3S 12, $,
Folio/Parcel#: i I — �) 2 0G —
02 0 — 0O 9 O
Is the Building Historically Designated: Yes
NO
Occupancy Type: S F Vt Load:
Construction Type:
Flood Zone: BFE:
FFE:
OWNER: Name (Fee Simple Titleholder):_ A C Q U IrS N I J A N k 1 N Phone#:
Address: i --1 S NE i 0 S ST
city: M I A r-i l s R O IZ CC.- state: FL 04 t 0 A zip: SS 13 $
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name: A QU w I G 6 N U l a oN M e Ni S, L L C. Phone#: SO rO ' LAP 5- 0 8 9 G
'J22)Address: Il CP 7IX (5tW
city: State: F L-0 LZ I n P zip: 33 l l0
Qualifier Name: L- U I S GS I IJOS A , J i2 . Phone#: 7 & to 3)) 0 - 9 0-ICA
State Certification or Registration #: CPC C) 5 l 2 F<2 Certificate of Competency #: _
DESIGNER: Architect/Engineer: L -,-Co ��9 ► N121 N�3 Phone#: _
Address: 781 S GW '1.2 n d S+ . City: M Kern I State
Value of Work for this Permit: $ 0 Square/Linear Footage of Work: _
F L- zip: 3 3 t GS
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: S 14 i M (Yl I n
Specify color of color thru the:
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $ _
(Revised02/24/2014)
_* przs;?_4� � -I
CCF $ CO/CC $
DBPR $ Notary
Double Fee $
Bond $
TOTAL FEE NOW DUE $ _
Co')►C)19 _-4k
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. thence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged. /
Signature nmw. kL.L
OW ER or A ENT
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
I"v' dayof JUNC 20 20 by day of JUNC 20 -LO by
J R G(k U F-G N i J A N V I N. who is personally known to L-U i S E r—p i o O S A , who is personally known to
me or who has produced I'� 2G2 q 10 -11 1 —t LP O as mn.or who has produced
identification and who did take an oath. identification and who did take an oath.
fTj
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: C �'� Sign:
Prin . �L L Print:
Seal: ;Y;j; MILLED. Seal: N" MIWlp.pfiMCHET
i 4
WCOMMISSION IT OO M 6a i, MY COMMISSIOM S 00 21if U
c •a s�o` EMIM:AW 14, ' : =y S EXPM.Apf114.2023PIM
1Ms
*******#� s ********************* n.• BpiAedlM� PuOk ************
APPROVED BY Plans Examiner
Structural Review
(Revised02/24/2014)
Zoning
Clerk
Permit # BPP-03-19-674
To whom it may concern,
AQUATIC ENVIRONMENTS
Residential & commercial swimming pool contractor
11767 SOUTH DIXIE HWY. #203
PINECREST, Florida 33156
Tel: 786-390-9029
June 9 ,2020
As the contractor for the project located at 1275 NE 103 St, Miami shores Fl, I would like to
request an extension on behalf of the owner Jacques Nijankin. The permit is set to expire on the
161" of this June and we would alike an extension in order to be able to call final inspections in the
coming weeks.
Regards,
Luis Espinosa
President
BUILDING
Miami Shores Village
Building Department MAR2g1019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBCC 2\ 0 I-n1
Master Permit
PE MIT APPLICATION
BUILDING ❑ ELECTRIC ❑ ROOFING
Sub Permit No.
❑ REVISION ❑ EXTENSION [:]RENEWAL
❑PLUMBING ❑ MECHANICAL [—]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: IZ� N ) 03 StYeefi
City: Miami Shores County: Miami Dade Zip: :�':3I 35
Folio/Parcel#: 11'32Qri-0a0-i'0E0 Is the Building Historically Designated: Yes NO
Occupancy Type: G1 R— Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): -Y AC (3?'AI5S q [_Vt M IL1 7'4 Phone#: '?)Os
Address: L 2--5 06 1 b3 St'Yf_c
City: (N am, gnores State: T--i Zip:
Tenant/Lessee Name:
Email:
Phone#:
CONTRACTOR: Company Name: ACC l.l(��l C; (:� D U l (_0 n M eVAK Phone#: A-R(Cr- �,90"(l 1
Address: ^7-�� `di-4 64 S-1_GL7`(XL'E- !" SW �
l,/ �
City: / e--Cil'�2 �` State: P_ Zip: '5.6 C�
Qualifier Name: (Ai � {�[ �'j SSA Phone#:
o �7
State Certification or Registration #: � PC �-T Z S Z_ Certificate of Competency #:
DESIGNER: Architect/_Engineer: ' C, l�`l`� &IIr���� n9 Phone#: �C7S a(01 d3�
Address: 4'5 o s S U) aq -7� w1c o City: 00'tc yl% i State: ".Zip:�31 SC
Value of Work for this Permit: $ 2 /1 1 '4S. Square/Linear Footage of Work: lIk4SCI-)
Type of Work: ❑ Addition LQ Alteration ❑ New Repair/Replace ❑''DlIemolition
Description of Work: I�G u � e m C7 D Cam• t n G 17G ✓'e^ Deck do Sa►m D
Specify color of color thru tile:
Submittal Fee $ 4::::) Permit Fee $
Scanning Fee $ J Radon Fee $
Technology Fee
Structural Reviews $
Training/Education Fee $
CCF $_
DBPR $
CO/CC $
Notary $
Double Fee $
Bond 9 &03 • 0�
TOTAL FEE NOW DUE $ R 10 9 • q
(Revised02/24/2014) I j , f 6 q +
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
Zip
sm
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 co mence t must be posted at the job site
for the first inspection ch occur seven (7) days after the building permit is issue 1 the ab ence of such posted notice, the
inspection will not be prov d k1cq reinspection fee will be charged. , _
Signature
NER or AGENT
The foregoing instrument was acknowledged before me this
'�/
day of ` ' (GV 20 �, by
—l4cc�Alles Qk3 Ak, t Who is personally known to
T
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal
Signature I I I V/
CONT ACTOR
The foregoing instrument was acknowledged before me this
day of , 20 , by
►iV is e--S / ^ JD5A who is personally known to
------------------
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Commission # FF 924M
My Comm. Expires Dec 13, 2019 Seal:
Bonded through National Notary Assn.
-f�ocida
Commission # FF 924095
My Comm. Expires Dec 13, 2019
Bonded through National Notary Assn.
J / f
APPROVED BY 3` Plans Examiner > Zoning
ip_� — Structural Review Clerk
(Revised02/24/2014)
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
2601 BLAIR STONE ROAD
TALLAHASSEE FL 32399-0783
(850) 487-1395
Congratulations! With this license you become one of the nearly one million Floridians licensed by the
Department of Business and Professional Regulation. Our professionals and businesses range from architects to
yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong.
Every day we work to improve the way we do business in order to serve you better. For information about our
services, please log onto www.myfloridalicense.com. There you can find more information about our divisions
and the regulations that impact you, subscribe to department newsletters and learn more about the
Department's initiatives.
Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better
so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new
license!
dblOr
STATE OF FLORIDA DEPARTMENT
OF BUSINESS AND PROFESSIONAL
REGULATION
CPC057282 ISSUED:09/01/2018
COMMERCIAL POOL/SPA CONTRACTOR
ESPINOSA, LUIS
AQUATIC E O ME
- igrature
LICENSED UNDER CHAPTER 489, FLORIDA STATUTES
EXPIRATION DATE: AUGUST 31, 2020
SM 110bal �
6616711
BUSINESS 14AM FILOCATiGh RECEIPT K9, EX NRES
AQUATIC EN1l!RONMENTS RENEVML SEPTEMBER 30, 20'i9
11767 S DIXiE I WY 203 1
PINECREST, FL 33156 3ldcst be raY®Pursuant o county placea€ tsusiness
Chapter 84 - Art 9 & 10
OWNER StC. TYPE OF BUSINESS FAYME'AI .RECE9VED
AQUATIC EWPr—*'iUEEIM a SPECIALTY VW44"BifiiG 61 i A s
W ESPft OSA WIS CCKTPACTOR 45.W 09R7MS
VVorke*.? 1, CPCO57282 022448-GMIS
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ACOR 1 0
CERTIFICATE OF LIABILITY INSURANCE
�...�
DATE IMM/DU/YYVY)
04/18/2018
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 policylies) 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
JM Private Insurance
8700 West Flagler Street
Suite 401
Miami FL 33174
CONTACT Mary O'Keefe
NAME
PHONE (305)221 2400 FAX (305)552-5360
grMAIL mary@jmprivate com
INSURERS) AFFORDING COVERAGE
NAIC B
INsuReRA RSUIIndemnilyCompany
22314
INSURED
I Espinosa. Inc dba Aquatic Env -ion -relit
11767 S Dixie Highway #203
Pinecrest FI 33156
INSUP.ER D
INSURER C.
INSURER n
INSURER E
INSURER F
COVFRAGES CERTIFICATE NUMBER- CI..1841801224 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO 1HE INSURFiD NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT. "f ERN1 OR CONDI I1ON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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
INSD
VYVD
- -
POLICY NUMBER
POLICY-EFF
(MM/DDIVYYY)
POLICY XP
(MM/DDIYYYY)
LIMITS
X
COMMERCIAL GENERAL LIABILITY
_
EACH OCCURRENCE
$ 1,000,000
�
A ET RE
PREMISES Ea occurrence
S 100,000
CLAIMS MADE OCCUR
MED EXP (Any one person)
$ 5,000
P,,SONAL S ADV INJURY
$ 1.D00,000
A
Y
Y
VBA538801
04/18/2018
04/18/2019
GEN'LAGGRFGATE LIMIT APPLIES PER.
GENERALAGGREGATE
S 2,000,000
X POLICY ❑ PRG
JECT LOC
PRODUCES-COMPIOPAGG
5 2,000,000
_
Employee Benefits
$ 0
OTHER
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
1Ea accldenh
$
BODILY INJURY (Per person)
S
ANYAUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODItY INJURY (Per accrtlentl
FROPERTY DAMAGE
fPer—dent_
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
UMBRELLA LIAR OCCUR
EACH OCCURRENCE
$
EXCESS LIAI CI_.41MS-M IDF
.AGGREGATE
S
DEC) I I RETENTION $
$
WORKERS COMPENSATION
PFR CTH-
AND EMPLOYERS' LIABILITY YIN
AN V PROPRIETORIPARTNUOFXECUTIVE
OFFICER(MEMBER FXCL.UDEDY C l N IA
:TA: rUrE ER
EL EACH ACCIDENT
$- --
(Mandatoryin NIT Imo_
E I OISEASL - EA EMPLOYEE
S
Ityes. describe under
DESCRIPTION OF OPFRATIONS below
EL DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space's required)
Certificate Holdler is an additional insured with respects to General Liandlty when required by written contract
LICENSE # CPC-057282
rCQTICIr ATC Ynl nCQ rAurri t ATtnld
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Village of Miami Shares. Bldg Department
ACCORDANCE WITH THE POLICY PROVISIONS.
10050 N E 2nd Avenue
AUTHORIZED REPRESENTATIVE
Miami Shores Ft. 33138'L.l
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
ACORL,]®
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDfYYYY1
��
09/12/2D18
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 endomement(s).
PRODUCER
CONTACT Jessica Marquez
NAME:
Optisure Risk Partners
I Pt) CONr o Ert : (954)251-3673 (A X, No) : (954)251-3675
F- AIL Jessica. Marquez@optisure.com
ADDRESS:
18501 Pines Blvd
INSURER(S) AFFORDING COVERAGE
NAIC #
Suite 105
INSURER A: National Liability & Fire Insurance Company
20052
Pembroke Pines Ft- 33029
INSURED
INSURER B :
INSURER C :
L. Espinosa, Inc dba Aquatic Environments
INSURER 0:
11767 S Dixie Hwy
INSURER F :
# 203
_
INSURER F :
Pinecrest FL 331564438
COVERAGES CERTIFICATE NUMBER: CL179100361 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
AUUL5UbH1
INSD
WVD
POLICY NUMBER
POLICY EFF
MMIDD/YYYY)
POLICY EXP
(MM/DDlYYYY)
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
-1371TA
CLAIMS MADE DOCCUR
PREMISES Ea occurrence
$
MED EXP (Any one person)
.
S
PERSONAL &ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER.
GENERAL AGGREGATE
$
POLICY ❑PRO ❑
JEGT- LOG
PRODUCTS - COMPIOP AGG
S
$
OTHER
AUTOMOBILE
LIABILITY
J _
COMBINED SINGLE LIMIT
Ea- idenn
$
BODILY INJURY(Per person)
$
ANYAUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LAB
CLAIMS -MADE
DED RETENTION $
$____
AOFFICER/MEMBER
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETORIPAR fNER/FXFCUTIVE
EXCLUDED? ❑
INandatory in NH)
NIA
_
V9WC892502
09/1212018
09/M1 2/2019
X STT UTE I ERH
EL EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L DISEASE - POLICY LIMIT
$ 1,OOD,000
DESCRIPTION OF OPERATIONS J LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Code:
5223 - Swimming Pool Contr - NOT Iron/Steel
8010 - Clerical Office Employees NOC
STATE LICENSE: CPC-057282
CERTIFICATE HOLDER CANCELLATION
MIAMI SHORES VILLAGE BLDG DEPT.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
10050 NE 2nd AVE.
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
MIAMI SHORES„ FL. 33138
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
AQUATIC ENVIRONMENTS
By L. Espinosa, Inc.
Residential & commercial SWmming pool -contractor
1 1767 SOUTH DIXIE HWY. #203
PIN ECREST, FLORIDA 33156
TEL 78&390.9029
SWIMMING POOL CONTRACT
CPC:057282
This agreement between AQUATIC ENVIRONMENTS / L. ESPINOSA, INC. referred to as Contractor @ 11767 S. DIXIE
HWY. PINECREST, FL. And JACQUES NINJANKIN owner(s) or agent of the real property located at: 1275 NE 103 ST.
MIAMII SHORES, FL. (PROPERTY) . Dated: FEB, 22, 2019 for the renovation of a swimming pool & deck by AQUATIC
ENVIRONMENTS at above Property in accordance to the following specifications:
Renovations to be done on a 14 X 28' Swimming pool at the above address.
1. Engineering Plans for pool renovation / ( NO PERMIT FEES)
2. Install a Pentair IC-40 Salt Sanitizing System —for pool
3. Reroute all Pool pipes to NEW location & install new equip on a 3X3' Slab w/ new pvc valves
4. Construct a new set of steps at shallow end / Square off pool corners & Install an 18" deep end bench -
5. Construct a beach area 8" deep : 8' X 8' w/ a GlowBrite LED Color Light
6. Install a Pentair CC- 200 Cartridge Filter
7. Instal a Pentair 2-hp. SuperFlo VS —Variable Speed pool pump
8. Install 2- Pentair GlowBrite LED Color Lights —in pool
9. Electrical installation for all new equipment location & new pool bonding
10. Install new Travertine 12"x 24" Stone for coping straight edge on pool —Gray Color
11. Install a 6" Glass Waterline tile border-& 1" edge trim on steps & swimouts
12. Remove Existing deck- Install 1,000 sq. ft. of Gray / Silver Travertine
12" x 24" size stone over limerock sand base (a) $ 6.00 sq. ft.
13. Acidwash Interior pool surface & apply a new Diamond Coating ( Sky Blue -Light Colors)
Apply A Bond Kote Bonding system, Includes new drain cover & chemical start up.
TOTAL------ $ 27,145.00
Payments: AQUATIC ENVIRONMENTS shall receive payment in the amount of $ 27,145.00 with payments to be made within 2 business days of'
the following events in the amounts noted. or all work will cease until payments are brought up to date. Any change orders to this contract will be
paid in full upon acceptance of costs involved. Cancellation of contract after 3 days of execution forfeits deposit /deposit covers sales commission
and admin.Costs.. Any & final releases of liens will be issued upon final payment of this contract.
Payment Schedule: 10% DEPOSIT FOR PLANS / 20% AT DEMOLITION / 20% AT POOL SHELL POUR
20% AT EQUIPMENT INSTALL / 20% AT DECK STONE INSTALLATION / 10% AT DIAM. BRITE & FILLING
Notwithstanding the above stated payment schedule, in the event that there is a delay of thirty (30) days to the construction of the work included in
this contract By Owner, at no fault of contractor, then contractor. shall be entitled to payment for all fully completed performance under this
contract. Completed performance will be computed as Cost of work plus 30% profit, not calculated based on schedule of payments.
Any increase in material equipment or sub contractors cost due to this delay will be absorbed by Owner.
Contractor reserves the right to stop work until any past due payment is made. Owner agrees to pay interest to contractor. in the amount of 2 % per
month for any past due payment. In the event that any dispute arises out of this contract between AQUATIC ENVIRONMENTS and the Owner, or
Owners agent such dispute will be submitted and settled in accordance with the rules of the American Arbitration Association in the State Of FL,
and the decision of the arbitrator shall be final. Any delays by owner, causing permit to expire shall bear costs of reinstatement of permit... Any
checks returned with insufficient funds or non payment will place account on a cash payment basis only and payment is required before phase is
commenced. This contract constitutes the entire agreement between the parties and is not binding upon AQUATIC ENVIRONMENTS unless is
accepted by a duly authorized officer or agent of the corporation All changes to this contract shall be in writing, include the cost of the change, and
be signed by the parties before the changes are constructed. Contractor shall not be bound by any oral or written statements or representations not
included in this contract which have been or may be made by any person purporting to act or on behalf of AQUATIC ENVIRONMENTS Surplus
Materials & Equipment delivered to jobsite remain property of AQUATIC ENVIRONMENTS and will be removed by completetion. NOTE: Any
engineering tests requested, soil tests, City Bonds or termite inspections by owner or inspectors not listed in this contract are the responsibility of
the homeowner who shall bear such costs. Related costs to any additional engineering or design plans requested by inspectors or owner for
additioA ins p ions (i.e. such as pilings or electrical load calculations, variances on zoning issues shall be paid by the owner. Any Sidewalk
repai . )ver
ep ent will be at Owners expense for access to pool construction. NOTE: Pool barrier requirement options, such as door alarms,
fe s, by Owner as well as their installation costs. Any portable sanitation stations required will be at Owners expense.
AFA 220r
DATE
Miami shores Village
Building Department
1O05DN.E.2ndAvenue
Miami Shores, Florida 33138
Tel: (308795.2204
Fax: C305\756.8972
RESTRICTIVE COVENANT PROTECTIVE POOL ENCLOSURE
KNOW ALL MEN 8YTHESE PRESENTS.
WHEREAS, the undemined____�� `�y+u-Que5 w/' '' mlare the fee
simple m*ner(n)of the following described property situated and being in Miami Shores Village, Florida�
\" L�4-- to \() -7 �
,
Whereas, the undersigned a -T
desire toutilize said LoKo}asasingle buUdingsite, and the undersigned nwner(o)Uo(eo) hereby declare
and agree aohnUomm�
i That the property will not be used mviolation of any ordinances of Miami Shores Village
nrMiami-Dade County now ineffect orhereinafter enacted.
|i 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.
Ui 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 aprotective enclosure to meet code requirements and will obtain a
permit for such hanoe
|V, That, I/we, as owner(s) hold Miami Shores Village harmless for any negligence or injury
that results from not having the enclosure,
V. |fenclosure belongs \osaid property. | agree tomaintain &orreplace said enclosure in
the event that imdamaged o/removed byany case,
NOW, THEREOF, for good and valuable consideration. the undersigneddo(es)hereby declare that
he/she will not convey or cause to be conveyed the title to the above property withoutrequiring the
sucoessor in title ;o ;bide by all hanna and -conditions set forth herein.
FURTHER, the undersigned declare(s) that this covenant is intended and shall constitute a
restrictive covenant concerning the use,enjoynient and title to the above property aria' shall constitute a
coveim v� land andshaUbebmdiogupon d)eundem�ned.ha�orsuocenuumand assigns
~r*=,—.4J
~—p°-
OWNER SIGN & PRINT
/Hereby Certify th , before 'Sl^- S t"�TA-f3Lu�
q
and has produced |D3�s�/��N�_k����em identification and he/she acknowledge that he/she
executed the foregoing, freely and voluntarily, for purposes there inexpressed.
SWORN TOAND SUBSCRIBED before meonthis dayof 1M .20
VERN
(Revised wmmmmvv#,,x^yvv;
` � My Comm. Ex;|moDec 13.XO1V�
� "»V�X�p8mmoommoVx�m��wmmgmsn��
Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Date—WOL,(Otl 724
I certify that I am the legal owner of the property described as
fukko k\ - 3zo5-r—o-ocso located at S-1YU-f
M in-Cni SVI-bve�9, r---L 135
In accordance with Section 33-12ft Code of Metropolitan Dade County, I certify that I
W115 WMORKI 11pill I � I I � �
be used or filled with water until separate permit has been obtained for an approved safety
I further understand that this certification, however, does not eliminate the need for
obtaining a permit and erecting and approved barrier prior
M*1
Note: This certification is to be submitted with a swimming pool permit application in duplicate.
ELENA A SADLER
Notary Public - State of Florida
Commission # FF 924095
My Comm. Expires Dec 13, 2019
OF f,
Assn. Bonded through National Notary
Miami shores Village
Building Department
1U05ON.E2ndAvenue
Miami Shores, Florida 33138
Tel: (3OB7952204
Fax: (3K05)756.8072
NOTICE OF REQUIREMENTS
RESIDENTIAL SWIMMING POOL, SPA AND HOT TUB SAFETY ACT
��mn�"^'���
| orhot tub will be4«ffetnneted or installed at
KNiami Bhnmyn, FL' and hereby
affirm that one of the following methods will be used to mnvd the requirements of Chapter 515.
Florida Statues and the Florida Building Code R41O1A7.
Please initial the method(s) to be used:
___- The pool will baequipped with am approved safety pool cover that with ASTM
Fil 346-91, (Submit Manufacturer's Specifications).
Acontinuous, one-piece bhi|dlbarrier meeting 'the requirements OfFlorida Building "ode
R410117,1 15 will protect the pool perimeter. The plans shall show the fence location and method o(
attachment, including one end that shall not be removable without the aid of tools. (Submit Manufacturer's
Specifications),
combination of non -dwelling walls and fences 'eomen onoloxum, child fenoe, masonry
fence walls, chain link orwuodfence, at(,,)will protect the pool perimeter The plans must specify the typo
and location ufall nor, dwelling walls. Florida Building Code, R41O1]71
Any combination of protedion which incorporates dwelling wails with openings directly into the
pool perimeter and all windows and doors will De equipped with exit alarms complying with Florida Building
Code, R4101,17.1.9 (Submit Manufacturer's Specifications),
ycombination ufprotection 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
latch ino/lockinAinstalled amin. 54''above the threshold. |fthis option ieselected, submit plans showing all
types and |ooaUnonfuUpohm*terpm�cUnn.The plans must a|soshow the location and type ofall
openings, and the hardware type for each location. (Submit Manufacturer's Specifications).
In accordance with the Code, the pool may not bnfilled with water without compliance with the
Private Swim Pool Safety Requirements, and upon expiration of the permit, the pool shall be
ed
presu ed o nsafe. I understand that not having one of the above installed will constitute a
� viola on o C a er 515, F.S , an d will be consider as sdemeanor of the second
p or S co lit�FlFmi. This form must be signed
e, p n i(h le as provided in Section 775,082 ion 7
b Wte o n e #t and the prime contractor,
C_
p'
��N7���TORY�SIGNATURE AND DATE OVVN�R'�EUG�4TU�EAMDDATE
CONTRACTOR'S NAME (PI'LEASE PRINIT)
State of Florida
ec Notary Public
my C
... I.,1,XOP Bonded through National Notary Assn.
0VVNEFYSNAME (PLEASE PRINT) °
ELFNAA8ADLER �—
mvmrypumm'VmmmFmna
wrp�,�,V
:vmmion/vn # FFV2*o95
MY Comm. Expires Dec 1o.018
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 Jacques Nijankin.
1275 NE 103 ST
Miami Shores, FL 33138
To Whom It May Concern:
Soil Statement:
Date 06-28-19
A field visual inspection was conducted on 06-28-19 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,
,`j%%J1111ii"ni
` ��ON\o Cq�y�C,
;� •..��GENS�.•-yN
N0. 74099
STATE
OP
oar . •• 2
.° -N
N AL
06-28-10
Antonio Canelas, P.E.
Lic #: 74099
Attached: Photographs of Excavation
Picture # 1
Picture #2
1275 NE 103 ST
INTRODUCTION
Congratulations on your purchase of the TEGHKO Safe
Pool model S187D safety alarm. The Safe Pool can be
used to provide a high volume alarm alert when children
have entered a pool or spa area. The S187D can be used
outdoors on wood or metal gates, or indoors on doors and
window leading directly to potentially dangerous areas.
OPERATION
The Safe Pool is designed to sound a loud alert when
children enter through a Safe Pool protected door/gate.
When properly installed, the Safe Pool will allow adults to
pass through the protected door/gate and immediately shut
off the sounding alarm.
When powered. the Safe Pool is always in protection mode.
The alarm will activate the instant when the deer/gaie opens
by more than 1/2 inch (when the magnetic sensors are apart
by more than 1/2 inch). Once the alarm activates, it will sound
continuously until the BYPASS button is pressed.
When passing through the door/gate press the BYPASS
button, then open the door/gate, pass through and close
the door/gate within 8-12 seconds and the alarm will not
activate.
' FEATURES
• Easy installation for gate, door or window protection
` Water / weather resistant
• 9 Volt battery power (sold separately)
` High output 110-115 dB alarm siren
* Low Battery / signal LED Indicator
` Optional additional BYPASS button for delayed entry from
other side of door or fence
` Optional additional magnetic sensor for screen door
exittentry
PARTS LIST s7870 U YPAss
ZIP TIE
.. ✓ Fig. 1
scrs�w
SENSOR � O
IMPORTANT SAFETY TIPS
Alarm siren is VERY lard; NEVER place the unit close to
ears -
Install the unit high enough to be out of reach of children
54" or hiqher is recommended.
Keep this manual for future reference.
The Safe Pool can provide valuable protection when
used correctly. However, it cannot guarantee complete
protection against accidents or injuries. Therefore.
Techko cannot be held responsible for any loss. damage,
or injury that may occur.
INSTALLATION
WARNING: Read all installation and operation
instructions thoroughly before proceeding with
installation. Note: Not all parts included are needed for
installation. Please read the different mounting
instructions to see what is needed for your specific
application.
INSTALLING THE BATTERY.•
1. When testing, before installing the battery. use a rubber
band to temporarily secure the two magnetic sensors
together with the arrows pointing toward each other to
avoid setting off the alarm unintentionally- During the
actual installation of the alarm. it's best to install the
battery after it's mounted to avoid the alarm going off
unintentionally.
2. Remove the battery cover of the unit and install a new 9
Volt battery. Replace cover. (See Fig. 2)
3. If you are sensitive to loud sound. please near ear
protection against the loud alarm siren before testing
the alarm.
4. Once the battery is connected. the o
unit is now ON and working. To test
the alarm siren, make sure you
have ear protection before testing.
After ear protection is in place.
separate the magnetic sensors
apart by more than Xz inch. The
alarm should sound immediately after the sensors arc
separated. Press the BYPASS button and immediately
secure the two magnet sensors together again to avoid
the alarm sounding off unintentionally.
LED LIGHT WARNINGS
1. When the battery becomes low in charge or the volume
becomes weak, the LED light will illuminate. The 9 volt
battery must be replaced.
2. Upon battery installation, the unit will beep once and the
LED light will flash 10 times as it prepares to become
armed.
3. When a bypass button is pushed, the LED light
illuminates to indicate acknowledgement to PASS through.
4- After the bypass button is pushed in and released. the
LED light will flash 10 times to allow pass through and to
prepare the unit to become armed again.
MOUNTING:
WARNING: The alarm should be positioned close to
the door high enough to be out of the reach of children
As each mounting application varies, Techko suggests
testing the unit's installation location and effectiveness
before permanently mounting the S187D.
MOUNTING INDOORS
Using the provided mounting template printed in this
manual, mark the position of the screw holes on the
desired mounting surface.
* The Additiona
delay button In
be mounted on
other side of th
entrance. Whe
pressed. it will
delay the alarm
8-12 seconds
before alarm is
triggered, allow'
time to secure
door/gate.
Fig. 3
* The Additional magnetic sensors allow the unit to be
used on sliding door with screens.
* Alarm will sound only when BOTH sets of magnetic
sensors are apart, there for allowing the slider to be open
while still providing protection at the screen door.
MOUNTING INDOORS USING DOUBLE -SIDED TAPE
Make sure that the mounting surfaces for the double -sided
tapes are completely clean. Attach the double -sided tapes
onto the rear of the unit, and then secure the unit onto the
desired mountinc surface,
MOUNTING INDOORS USING SCREWS
Using the provided mounting template printed in this
manual, mark the position of the screw holes on the
desired mounting surface. Drill the screws in to the
mounting surface with
approximately 1/8 inch of thread
remaining. Slide the unit over the
screws and secure the unit by a
pushing it downward, as shown in
Fig. 4. You may need to adjust the
screws towards or away from the
mounting surface to provide a more R9.4
secure frt.
r
•
c r
„•
•
MOUNTING THE SENSORS
Make sure that the arrows of each sensor are pointed towards
each other. Using either the double -sided tape or the screws
provided, mount the sensors so that they are less than %z inch
away from each other. Sensors must be mounted flush in
height and depth, so with some doors or windows. special
custom fitting may be necessary. Please make sure that the
wired portion of the magnetic sensor is mounted on the
non-moving portion of the mounting surface and the
standalone sensor is mounted on the doorgate. (See Fig.
51Fig. 6)
MOUNTING OUTDOORS ON WOODEN GATES
using the provicec ,rru :riling
template prnted in tnis yppgilh"G vTJGORS
manual_ mark the position or DN WDCDEN a=
the screw holes on the
desired mounting surface.
Drill the screws onto the
moun .rg surface with
_ ..
ethe
--•=.:5 and Fig. 5
secure the unit by pushing
it downward as shown in Fig. 5. You may need to adjust the screws
towards or away from the mounting surface to provide a more secure
ft. Make sure that the arrows of each sensor are pointed in the same
direction. Note- Wooden gates do not require the sensor housings.
MOUNTING OUTDOORS ON METAL GATES
Using the provided zip ties, MWNnNGDaTDooxS-
attach the alarm body to the MYTAAL cares
metal gate frame. (See Fig. 6) ��
Using a small flat head �>
screwdriver. gently pry opener a
the recessed sensor spacer
of the senso- mg + F:g.6} * �-
i:fake sure thatt the arro:vs of
each sensor are pointed in the
same direcuon as the sensor
housing before placing the magnetic sensors inside the sensor
housing. Note: f.letal gates may interfere with the magnetic sensor
function. Use spacers provided to ensure sensors operate properly.
Secure the sensors using the zip ties onto the gate frame. Make
sure that the sensors' avows are pointed towards each other and
that the sensors are less than %, inch apart.
MAINTENANCE
When the alarm volume becomes low, or the unit does not
produce normal alarm sound. the red light will illuminate,
you must replace the 9-volt battery.
The Safe Pool's plastic parts resists ultraviolet rays from
direct sunlight exposure. However, slight discoloration
over time is normal.
WARNING!
THE SAFE POOL ALARM IS EXTREMELY LOUD WHEN
ACTIVATED. FOR YOUR SAFETY. NEVER PLACE THE Safe Pool TM
UNIT CLOSE TO YOUR EARS. TO TEST THE ALARM,
ALWAYS USE EAR THE
AWAY BEFORE TES TNG ACTtIOVATING TANDHE EEALARM. CT UNIT Model S 18 7 D
IT IS PROHIBITED BY LAW TO REMOVE THE INSTALLED
ALARM AFTER IT HAS PASSED INSPECTION I
Important Warranty Information:
A dated proof of purchase is required for warranty service
('rr +nmar efVlCe
1-888-8TECHKO (1-888-883-2456)
Website: www.techkokobot.com
Mfg. By Techko Kobot
11 Marconi street
Suite A
Irvine,CA 92618
MADE IN CHINA CC
1 LS
Intertek
5010645
CONFORMS TO
UL STD. 2017
SSA Patent: No. 5,473,310
No. 6,727,819
NOTICE
THIS PRODUCT IS PROTECTED UNDER FEDERAL
PATENT, TRADEMARK AND COPYRIGHT LAWS AND
I LAWS PREVENTING UNFAIR COMPETITION. NO
DUPLICATION OR SIMULATION OF THIS PRODUCT
IS PERMITTED EXCEPT BY WRITTEN AUTHORIZATION
OF TECHKO, INC.
TECHKO AND THE CONFIGURATION OF THIS PRODUCT
ARE TRADEMARKS OF TECHKO INC.
COPYRIGHT 1994 TECHKO, INC.
ALL RIGHTS RESERVED
MADE IN CHINA
Area Entry Alarm
OPERATION MANUAL