BPP-10-19-2301, 249 NW 92nd StMiami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address Parcel Number
249 NW 92ND ST, Miami Shores, FL 33150 1131010331170
:ontacts
Fernando Gutierrez Owner DREAM DESIGN POOLS INC Contractor
24992 RAFAEL PELLERANO
133771 N GARDEN COVE CIR, DAVIE, FL 33325
Business: 9549165337
Other:7864022253
Inspection Requests:
Description: new swimming pool M Valuation: $ 20,000.00
Total Sq Feet: 338.00
Fees
Amount
Application Fee - Other
$200.00
CCF
$12.00
Certificte of Completion for Single Fam
$50.00
and Duplex
DBPR Fee
$9.00
DCA Fee
$6.00
Education Surcharge
$4.00
Permit Fee
$400.00
Planning and Zoning Review Fee
$35.00
Scanning Fee
$9.00
Structural Review ($45)
$45.00
Technology Fee
$15.00
Total: i�
$785.00
Payments
Date Paid Amt Paid
Total Fees
$785.00
Credit Card
11/15/2019 $585.00
Credit Card
10/01/2019 $200.00
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 at all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I authorize the above named contra o do the work stated.
Authorized Signature: Owner / Applicant / Contractor ! Agent
November 15, 2019 Page 2 of 2
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
PERMIT APPLICATION
QBUILDING ❑ ELECTRIC ❑ ROOFING
FBC 20 1-+ L^
Master Permit No. -No -
Sub Permit No.
❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 249 NW 92 St.
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-3101-033-1170 Is the Building Historically Designated: Yes NO XX
Occupancy Type: SFR Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Fernando Gutierrez Phone#:
Address:249 NW 92 St.
City. Miami Shores State: FL Zip: 33150
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Dream Design Pools Inc. Phone#: 786-402-2256
Address: 13771 N Garden Cove Cir. .
City. Davie, State: FL Zip: 33325
Qualifier Name: Rafael Pellerano Phone#: 786-402-2253
State Certification or Registration #: CPC057031 Certificate of Competency #:
DESIGNER: Architect/Engineer: Ken Pfeiffer Phone#: 786-235.2435
Address:8754 NW 206 Ln City. Cutler Bay State: FL Zip: 33186
Value of Work for this Permit: $ 9-44 <14 aS Square/Linear Footage of Work:
Type of Work: ❑ Addition El Alteration ME New ❑ Repair/Replace ❑ Demolition
Description of Work: New Swimming Pool
Specify color of color thru tile:
Submittal Fee $ Permit Fee $CCF $ CO/CC $�
Scanning Fee $
Technology Fee
Structural Reviews $
Radon Fee $
Training/Education Fee $
DBPR $ Notary $_ —
Double Fee $
Bond $ "
TOTAL FEE NOW DUE $
(Rev1sed02/24/2014)
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: 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 approved and a reinspection fee will be charged.
J�
Signature
OWNER or ENT CONTRACTOR
The
oregoing instrument was ack�Wledged befo e e this The foregoing instrument was, cknowledged before a his
day of�,c , - .20 by day of 20 L by
who is personally known to �( d� qT (I rl\ who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath, identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: —,� Sign. -
Print: v �� t Print: V I 1 e
Seal: Seal: �y Public rya of Florida
OWN Notary Public State of Fbrlda A Luis Arkl Duaft
yy c� B` My Commission FF 969561 Luis Arlel Duarte *w �� My i iE9S81
APPROVED BY
**
Plans Examiner
t' �, y%► Structural Review
(Revised02/24/2014)
Q.2 t'/ 1-Z %( Zoning
Clerk
Mhmon:
To protect, promote & improve the health
of all people in Florida through integrated
state, county & community efforts.
Vlslon : To be the Healthiest State in the Nation
Miriam Pellerano
249 NW 92 Street
Miami, FL 33150
RE: Contingency Letter
Application Document No: AP1436120
Centrax Permit Number: 13-SC-1994574
OSTDS Number:
249 NW 92 St
Miami, FL 33150
Lot: Block:
Dear Applicant:
October 22, 2019
Subdivision:
Ron DeSantis
Governor
Scott A. Rivkees, MD
State Surgeon General
This will acknowledge receipt of an application dated 10/01/2019 for a permit to use an existing
onsite sewage treatment and disposal system located on the above referenced property.
Reviewed on 10/22/2019. No objection for pool construction as per your site plan. Property will
remain with two bedroom. NO BEDROOM ADDITION. NO FLOW INCREASE.
From a review of your completed application, it has been determined that your existing system
appears to meet the minimum standards of F.A.C. 64E-6 for the proposed use. It is approved for
use with the plans submitted to this office. If this system should fail, causing an unsanitary
condition to exist, steps must be taken to bring the system into compliance immediately.
Department approval of the system does not guarantee satisfactory performance for any specific
period of time. Any change in material facts which served as a basis for issuance of this approval
requires the applicant to modify the permit application. Such modification may result in this
approval being made null and void. Issuance of this approval does not exempt the applicant from
compliance with other Federal, State, or Local Permitting required for development of this
property.
If you have any questions on this matter, please call our office at (305) 623-3500.
Sincerely, 4
Gerard Philizaire, Environmental Manager
Florida Department of Health www.FloridaHealth.gov
in DADE COUNTY TWITTER:HealthyFLA
1725 NW 167 St, Opa Locka, FL 33056 FACEBOOK:FLDepartmentofHealth
PHONE: (305) 623-3500 FAX: (305) 623-3645 1 YOUTUBE: fldoh
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 NW 9wlegge that a new swimming pool, spa or hot tub will be constructed or installed at
2 y f 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 considered as committing a misdemeanor of the second
degree, punishable as provided in Section 775.082 or Section 775.083 F.S . This form must be signed
by the owner/age t and the prime contractor.
CONTRACTOR'S SIGNATURE AND DATE OWNER' StGNATl1RE ND DATE
RAF#cL PaaurcQs,JV
CONTRACTOR'S NAME (PLEASE PRINT)
NOTARY PUBLI
�r Notary Public State of Florida
$ Luis Ariel Duarte
My Commission FF 969561
h 20
Expires 03126I20AA�
OWNER'S NAME (PLEASE PRINT)
NOTARY PUBLIC
M
Notary Pudic State of FloridaLuis Ariel Duarte My Commission FF 969561Expires 03126/2020
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
Miami Shores Village
Building & Zoning Department
Attention: Building Official
I certify that I am the legal owner of the property described as
Miami Shores Sec. 6 P610-39 E 1/2 Lot 17 & lot 18 BLK135 located at 249 NW 92 St
In accordance with Section 33-12(o, 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.
I further understand that this certification, however, does not eliminate the need for
obtaining a permit and erecting and approved barrier prior to final inspection and use of the
M1
Legal Owner_
Note: This certification is to be submitted with a swimming pool permit application in duplicate.
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
1243 NW 92eg?e that a new swimming pool, spa or hot tub will be constructed or installed at
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 considered as committing a misdemeanor of the second
degree, punishable as provided in Section 775.082 or Section 775.083 F.S . This form must be signed
by the owner/age t and the prime contractor.
CONTRACTOR'S SIGNATURE AND DATE 0WNER`SIGNATURE AND DATE
R � r # c t..
CONTRACTOR'S NAME (PLEASE PRINT) OWNER'S NAME (PLEASE PRINT)
NOTARY PUBLI ''^�"„" T - -
�r Notary Public State of Florida
Luis Ariel Duane
My Commission FF 969561
�itpw Expires03f26ly020
Ax
NOTARY PUBLIC
y y�'�v��ii�
"
�;
E
/ Notary Public State of Florida
Luis Ariel Duarte�; My Commission FF g69561
Expires o312612020
�o
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 Fernando Gutierrez is/are the fee
simple owner(s) of the following described property situated and being in Miami Shores Village, Florida:
Address: 249 NW 92 St Miami Shores, FL 33150
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 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.
OWNER SIGN & IN ) OWNER SIG & PRINT
I Hereby Certify that on this day personally appeared before me +-Zd-'Aa�1, b (Z- I
and has produced-104. G 3 ru L— ( 696sidentification and he/she acknowledge that he/she
executed -the foregoing, freely and voluntarily, for purposes there in expressed.
-� _ t
SWORN TO AND SUBSCRIBED before me on this day of, 20
� Notary P
�� Luis Ad* WWOTARY PU IC STATE OF FLORIDA
(Revised 05/2209 � �Commission Fzn 98sss+
LOCATION MAP `� 't v 2 - ZZ!5�
Scale: 1 " = 100'
12 11 10 9 8 7 6 5
50.00' 50.00' 501.00' 50.00' 50.00' 50.00' 50.00' 50.00'
15.0' ALLEY
Block
135
75.00
00
/
00
m 13
14
15
16
N
7 18
19
20
50.00'
S0.00'
50.00'
50.00'
25,0- / 50.00'
50.00,
50.00'
1T50
v
- --f`d.Rf. 92nd-3TREET- -
- -
LEGAL DESCRIPTION:
CERTIFIED TO:
FOLIO: 11-3101-033-1170
FERNANDO
GUTIERREZ
LOT 18 AND THE EAST 1 /2 OF LOT 17, LESS THE SOUTH 1 & 1 /2 FEET FOR SIDEWALK, IN BLOCK
135, 'MIAMI SHORES SECTION NO.6', ACCORDING TO THE PLAT THEREOF, AS RECORDED IN
PLAT BOOK 10, AT PAGE 39, OF THE PUBLIC RECORDS, OF MIAMI-DATE COUNTY, FLORIDA.
PROPERTY ADDRESS:
ABBREVIATIONS AND LEGEND:
249 NW 92 ST, MIAMI SHORES, FLORIDA 33150-2230
FLOOD ZONE: 'X' COMMUNITY:120652 PANEL: 0302
A/C
=DENOTES AIR CONDITIONING UNIT
CONC.
=DENOTES CONCRETE
DATE OF FIRM: 9-11-2009 SUFFIX: L ELEVATION: N/A
(Meas)
=DENOTES MEASURE
(Rec)
=DENOTES RECORD
GENERAL NOTES:
(CaIC)
=DENOTES CALCULATED
1) LEGAL DESCRIPTION PROVIDED BY OTHERS.
R/W
=DENOTES RIGHT - OF- WAY
2) EXAMINATION OF THE ABSTRACT OF THE TITLE WILL HAVE TO BE MADE TO DETERMINE
CL
=DENOTES CENTERLINE
RECORDED INSTRUMENTS, IF ANY, AFFECT THIS PROPERTY.
U.E.
=DENOTES UTILITY EASEMENT
3) THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENT OR OTHER
P.B.
=DENOTES PLAT BOOK
RECORDED ENCUMBRANCES NOT SHOWN ON THE PLAT.
PG.
=DENOTES PAGE
4) UNDERGROUND PORTION OF FOOTING, FOUNDATIONS OR OTHER IMPROVEMENTS
Cl.
=DENOTES CLEAR
WERE NOT LOCATED.
N.
=DENOTES NORTH
5) ONLY VISIBLE ON ABOVE GROUND ENCROACHMENTS LOCATED.
S.
=DENOTES SOUTH
6) WALL TIES ARE THE FACE OF THE WALL.
E.
=DENOTES EAST
W.
=DENOTES WEST
7) FENCE OWNERSHIP NOT DETERMINED.
D
=DENOTES DELTA
8) BEARINGS REFERENCED TO LINE NOTED AS B.R.
R
=DENOTES RADIUS
9) BOUNDARY SURVEY MEANS A DRAWING AND/OR GRAPHIC REPRESENTATION OF
L
=DENOTES ARC LENGTH
THE SURVEY WORK PERFORMED IN THE FIELD, COULD BE DRAWN AT A SHOWN SCALE
CH
=DENOTES CHORD LENGTH
AND/OR NOT TO SCALE.
O/S
=DENOTES OFFSET
10) NO IDENTIFICATION FOUND ON PROPERTY CORNERS UNLESS NOTED.
ID.
=DENOTES IDENTIFICATION
11) NOT VALID UNLESS SEALED WITH THE SIGNINGS SURVEYORS EMBOSSED SEAL.
❑0
=DENOTES WATER METER
12) DIMENSIONS SHOWN ARE PLAT AND MEASURED UNLESS OTHERWISE SHOWN.
C-Q)
=DENOTES WOOD POWER POLE
13) ELEVATIONS IF SHOWN ARE BASED UPON N.G.V.D. 1929 UNLESS OTHERWISE NOTED.
--- 0--
=DENOTES WOOD FENCE
14) THIS IS A BOUNDARY SURVEY UNLESS OTHERWISE NOTED.
=DENOTES CHAIN LINK FENCE
15) THIS BOUNDARY SURVEY HAS BEEN PREPARE FOR THE EXCLUSIVE USE OF THE ENTITIES
--0
=DENOTES IRON FENCE
NAME HEREON. THE CERTIFICATIONS DO NOT EXTEND TO ANY UNNAMED PARTIES.
—OH—
=DENOTES OVERHEAD WIRES
QQ
=DENOTES FOUND IRON PIPE (NO ID.)
CERTIFICATION:
SURVEYOR'S CERTIFICATION: I HEREBY CERTIFY THAT THIS "BOUNDARY
SURVEY" IS A TRUE AND COR ECT REPRESENTATION OF A SU EY PREPARED
UNDER MY DIRECTION. TH COMPLIES WITH THE MINIMU CHNICAL
STANDARDS, AS SET FOR BY THE STATE OF FLORIDA BO D OF
PROFESSIONAL SUFEY S AND MAPPi R IN 96APTER-17.051, FLORIDA
ADMINISTRA IV COPI PURSUANT TO SF_ 472.0 , FLORIDA STATUTES.
SIGNEQ " !/ (/ / / /// l / / FOR THE FIRM
MIy�G{1 JdEL ESPINVALID O A I'.S.M. o. 1-STATE OF FLORIDA
NTIC
NIC
RE AND
ELHCTRONIC SEAL AND/O IS MAP S NOTOVAL DIWN OUT THE SIGNATURE AND
THE ORIGINAL RAISED S OF A LICENSE SURVEYO ND MAPPER.
ALL BEARINGS AND DISTANCES SHOWN HEREON ARE
RECORD AND MEASURE UNLESS OTHERWISE NOTED.
MIGUEL ESPINOSA LAND SURVEYING INC.
PROFESSIONAL SURVEYOR AND MAPPER
7700 NORTH KENDALL DRIVE, SUITE 306, MIAMI, FLORIDA 33156
PHONE: (305) 262-2992 L.B. No. 6463
BOUNDARY SURVEY
Original Date: I Fi Id d te: Revision Date: Drawn by: Job No.
09/02/2019 0�/02/�019 09/02/2019 A.S. S-13369
10/29/2020 10/29/2020
d
�
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OR
t
9-
I
280.00'
(Basis of Bearin
I (per P.B. 10-Pg.
MAP OF SURVEY
Scale: 1" = 20'
15.0' Alley
8,00 Asphdlt-Pouem6n ^'
Found l /2' A .. .... . 1 ��t rn . Faun .1/2' ..... .
lro.n"Pipe q 7.5,00'.. .O> ... Iron.P.ipe..........
'
o _ o
Fi — — — Elev.7=771
— — —
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ON
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No Id.
A. d •
0
00
8:
vl
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Pool
7.35' c
27,70'
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1-STORY-BUILDING
6.92'
Residence No. 249
Cnn
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