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BPP-09-1467Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 134037 Permit Number: BPP -9 -09 -1467 Scheduled Inspection Date: March 22, 2010 Inspector: Bruhn, Norman Owner: AGRAS, ALONSO Job Address: 1182 NE 92 Street Project: <NONE> Miami Shores, FL Contractor: BLUE GEM POOL INC Building Department Comments March 19, 2010 For Inspections please call: (305)762 -4949 Permit Type: Pools/Whirlpools/Hot Tubs Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132050270450 Phone: (786)953 -5153 INSTALL NEW CONCRETE SWIMMING POOL AND PAVERS DECK OVER EXISTING VINYL POOL Passe Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 123531. Provide final survey NB Page 3 of 26 INSTALL NEW CONCRETE SWIMMING POOL AND PAVERS DECK OVER EXISTING VINYL POOL /(r/ o Pa se 9/tld Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until nspection Number: I NS P- 137594 Permit Number: BPP -9 -09 -1467 Inspection Date: March 10, 2010 Inspector: Dacquisto, David Owner: AGRAS, ALONSO Job Address: 1182 NE 92 Street Miami Shores, FL Project: <NONE> Contractor: BLUE GEM POOL INC Building Department Comments March 10, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Type: Pools/Whirlpools /Hot Tubs Inspection Type: Survey Final Work Classification: Addition/Alteration Phone Number Parcel Number 1132050270450 Phone: (786)953 -5153 Page 1 of 1 LEGEND OF SURVEY ABBREVIATIONS A ARC DISTANCE NC .... AIR CONDITIONING C CALCULATED C.B CATCH BASIN CL.... CLEAR cIL....CENTER LINE ENC ... ENCROACHMENT P.0 POINT OF CURVATURE FIP .... FOUND IRON PIPE P.O.B POINT OF BEGINNING O.H.... OVER HANG W.M WATER METER P.B.... PLAT BOOK M MEASURED P!L ...PROPERTY LINE CONC CONCRETE UP ... UTILITY POLE F.D FOUND CERTIFY TO: Alfonso And Leyda Agras LEGAL DESCRIPTION: Lot: 7 Block: 3 Subdivision: Bay Lure According to the Plat thereof as recorded in Plat Book: 44 Page: 63 Public Records of MIAMI -DADE ADDRESS: 1182 NE 92 STREET MIAMI SHORES, FL 33138 Encroachments Noted: (NONE) LOCATION SKETCH SCALE: NIT 5 XI/ N.E. 92 WATF_ERSEDGE (9 -141). NOTES: A) AB Clearances and/or encroachments sham hereon are of apparent nature. Pence ownershlp by visual mean. Legal ownership of fences not determined. B) This survey Is Intended for mortgage or refinance purposes only exclusively for this use by those to whom It Is certified. This survey is not to be used for constriction. permitting, design, or any other use without mitten con- sent of Thomas J. Kelly, Inc. C) Cade restriction and title search are net reflected on this eurwy. D) The flood Information shown hereon does not Imply that the referenced property will or will not be free from flooding or damage and does not create liability on the part of the firm, any officer or employee thereof, for any damage that results from reliance on said information. 0) The lands depicted hereon were surveyed per the legal description and no claims as to ownership or matters of title are made or Implied. P) Underground Encroachments, If any, not located. I h fy that the survey represented hereon ;� L the minim:,: technical sten- the Board of Land Sumsyors Florida Adminletnfive CCaadde .027 Pia. Statutes. EA, &M.#4858 S;a FLORIDA UNLESS IMPRINTED WITH AN EM SSED SURVEYORS'S SEAL NOTES: 1. IF SHOWN. BEARING ARE TO AN ASSUMED MERIDIAN (BY PLAT). 2. IP SHOWN, ELEVATIONS ARE REFERRED N.G.V.D 1929. 3. THIS IS A BOUNDARY SURVEY. CBS ... CONCRETE BLOCK STRUCTURE O.U.L OVERHEAD UTILITY LINE P.C.C POINT OF COMPOUND CURVE P.O.C POINT OF COMMENCEMENT BLDG BUILDING C.H CHORD DISTANCE D.E DRAINAGE EASEMENT F.H FIRE HYDRANT R RADIUS N County, Florid FD.1/2 t.P• �� 0 I J �° LP. UP F CL. 025 NOVD ... NATIONAL GEODETIC VERTICAL DATUM PRC ... POINT OF REVERSE CURVATURE RAD ... RADIAL RN/ ...RIGHT OF WAY SEC... SECTION SCR... SCREENED S.I.P.....SET IRON PIPE 8WK ...SIDEWALK U.E...:. UTILITY EASEMENT CHLF CHAIN LINK FENCE A5PN RETURN 11.5' 0- D a 7.5' l�x �s p /� . DRiVE`� • 17.10 50 TOTAL RIW. 1 - 16' PKWY 75.06 (RIM) 10 PL PORCH ONE STORY RES:N°H82 3 25.90 92 ND 18 PH. ROAD 22.10 ' 5'cH.L.t=. - FLOOD ZONE: AE ✓THIS I5 A FLOOD HAZARD ZONE THIS I5 NOT A FLOOD HAZARD ZONE PANEL NO.:. 306/L COMMUNITY #: 120652 DATE OF FIRM: 09/11/2009 BASE FLOOD: 8.00 FINISH FLOOR: N/A LOWEST N/A ADO GRADE 19.60' O 4 BRICK DECK r - rn 28.0' POOL . Q 33 ASPH- RETURN. 0 CV N 12.20 0 0 (V Sheet 1 of 1 21.0 F D. NOD d - t5 — a 8• 01'; O 9.95' a'N 75.00 (RIM) . WATEP5EDcE (9 -141) THOMAS J. KELLY, INC. L.B. #6486 SURVEYORS- MAPPERS -LAND PLANNERS 8125 SW 120 STREET PINECREST, FLORIDA 33156 (786) 242 -7692 DADE (954) 779 -3288 BRWD (786) 242 -6494 DADE FAX (954) 779 -3260 BRWD FAX 0.75 CL r u. U PD. NAIL . DATE FIELD WORK SCALE (SURVEY NO. 03/02/2010 1" = 20 10 -0244 O J SUBJECT O CCI'v1PLIANCE WITH ALL FEDERAL STATE AND CL, UN Y c-ft.II_ES AND PFGULATIONS nspection Number: INSP- 133511 Permit Number: EL -11 -09 -1909 J Inspection Date: January 14, 2010 Inspector: Devaney, Michael Owner: AGRAS, ALONSO Job Address: 1182 NE 92 Street Project: <NONE> Contractor: January 14, 2010 Miami Shores, FL Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 fR9 Oct (. Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Repair Phone Number Parcel Number 1132050270450 Page 1 of 1 Passed Inspector Comments j P10 „- / - - - - - /14/ }/9 g Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until nspection Number: INSP- 133511 Permit Number: EL -11 -09 -1909 J Inspection Date: January 14, 2010 Inspector: Devaney, Michael Owner: AGRAS, ALONSO Job Address: 1182 NE 92 Street Project: <NONE> Contractor: January 14, 2010 Miami Shores, FL Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 fR9 Oct (. Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Repair Phone Number Parcel Number 1132050270450 Page 1 of 1 Project Address 1182 92 Street Miami Shores, FL Owner Information ALONSO AGRAS Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $1.20 $0.40 $160.00 $3.00 $4.00 $168.60 Address Parcel Number 1132050270450 Block: Lot: Valuation: $ 1,675.00 Total Sq Feet: 0 1182 NE 92 ST MIAMI SHORES FL 33138 -2935 Contractor(s) RAY & REY INC Phone CeII Phone 305- 819 -9793 Type of Work: Additional Info: Classification: Residential 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. November 20, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy 909.. _. al . Re sidential Expiration: 05/18/2010 Phone Invoice # EL -11 -09 -36445 Check #: 4584 Total Amt Paid Amt Due $ 168.60 $ 168.60 $ 0.00 Applicant ALONSO AGRAS Date CeII For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Final November 20, 2009 1 Elecxec1 � ilikkA, \lila log BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) At z re AJ 70 4 & Phone # ek5 7QsS - Owner's Address 1/ 6 /I/ E q Z Cit /� If /f / ��jOI State Zip Tenant/Lessee Name Phone # Job Address (where the work is being done) City Nfiami Shores Village Is Building Historically Designated YES Contractor's Company Name A: 4i 2 7 / e p r Contractor's Address 7/2 f , -7 /wC , City // /nH /' Z � State 1-=., Zip SOOi9 Qualifier d E 6=-7/A/ /; Z• State Certificate or Registration No. EC / 300 /f/9 a Architect/Engineer's Name (if applicable) A�7 $ Value of Work For this Permit /6 /• Type of Work: ❑Addition Describe Work: Submittal Fee Notary $ AT Scanning $ 3 0 b Code Enforcement $ Total Fee Now Due $ . (Q b (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: 305) 795.2204 Fax: (305) 756.8972 Electrica ECEIIVED /' 93 ,li I z- County Miami -Dade Zip , /tS NO ['Alteration ❑New A3 Permit No. Master Permit No. Plumbing Mechanical Phone # 9E V .PS0,/ Certificate of Competency No. Phone # Square Footage Of Work: [ Repair/Replace * *** * * * * */* * *** *** * * * * * ** Fees *, , * * * * * * ** **** *** * * * * ** * * **** CL7 I I -0 g---1q09 Roofing ❑ Demolition Permit Fee $ /c7 CCF $ t • . 0 CO /CC Training/Education Fee $ • Li v Technology Fee $ � • 0. 0 Radon $ Zoning Bond $ Structural Plan Review. $ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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. Cho 05/13/03 Signature Signally Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 7/k) day of , 20 _, by day of ' V Q V • , 2( , by Pei nedG% 6 p. 4Q 2, who personally known to me or who has produced As identification and who did take an oath. who is personally known to me or who has produced Fc /p C as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBL C: Sign: Sign: Print: Print: My Commission Expires: My Commission °' S` P 4 0 0 04 047 749 4:0 4 *********************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * ** * * ** ate APPLICATION APPROVED BY: �, �. .-f l `l'��!/G/ Plans Examiner Engineer Zoning ITEM BATH TUB UNIT • FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE I REFRIGERATION GREASE TRAP -- APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE. TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS AVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL _ MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES- ' A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER- REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4" TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL _ AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL Scheduled Inspection Date: January 20, 2010 Inspector: Devaney, Michael Owner: AGRAS, ALONSO Job Address: 1182 NE 92 Street Miami Shores, FL Project: <NONE> Contractor: RAY & REY INC Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 I ? .q•da• 14 (.1 G Inspection Number: INSP - 123538 Permit Number: EL -9 -09 -1468 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Pool - Private Phone Number Parcel Number 1132050270450 Phone: 305 -819 -9793 ELECTRICAL WORK FOR NEW POOL Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments January 19, 2010 For Inspections please call: (305)762 - 4949 Page 8 of 30 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADOY, JNARO TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTIVE DATE {MMIDDIYYYYt POLICY EXPIRATION DATE ;MRMOD /YYYYI LIMITS A GENERAL LABILITY COMMERCIAL GENERAL LIABILITY TBA 10/142009 10/14/2010 EACH OCCURRENCE $ 1,000,000 Y DAMAGE TO RENTED PREMISES {Ea gCdurenCe) $ 50, 000 1 CLAIMS MADE 1 1 OCCUR MED EXP (Any one person) $ 5 PERSONAL 8 ADV INJURY $ 1, 0,000 GENERAL AGGREGATE $ 2,000•000 GEN'L AGGREGATE LIMIT APPUES PER: POLICY n jERT n LOC PRODUCTS - COMPIOP AGG $ 1,000,000 n AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ — BODILY INJURY (Per per.) — BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per aoad nt) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESS / UMBRELLA UABIUTY EACH OCCURRENCE $ OCCUR I j CLAIMS MADE DEDUCTIBLE RETENTION $ AGGREGATE $ _ $ $ $ B WORKERS AND EMPLOYERS' ANY PROPRIETORIPARTNER#EXECUi1VE OFFICER/MEMBER (Mandatory describe SPECIAL PROVISIONS COMPENSATION LIABILITY TWC3212519 1 0/312009 101312010 1 WC STATU- 1 10TH - TORY LIMITS ER E.L. EACH ACCIDENT $ 100,000 EXCLUDED? E.L DISEASE - EA EMPLOYEE $ 100 In NH) under b&aw EL OISEASE - POLICY U IT $ S 7000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY E7NDORSEMENT / SPECIAL PROVISIONS AC4 I INSURED Ray & Rey, Inc 14370 LAKE CANDLEWOOD CT Miami Lakes CERTIFICATE OF LIABILITY INSURANCE PRODUCER Ben Trust AIB, LLC 701 Waterford Way, Suite 300 Miami FL 33126 FL 33014 INSURERS AFFORDING COVERAGE INSURER Uoyd's of London INSURER B: Technology Insurance Co. INSURER C: INSURER 0: INSURER E COVERAGES CERTIFICATE HOLDER City of Miami Shores 10050 NE 2nd Ave Miami Shores, FL. 33138 -2304 ACORD 25 (2009101) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. CANCELLATION NAIC # SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABIUTY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. DATE (MMJOD1YYYY) 10!292009 AUTHORIZED REPRESENTATIVE Michael Alvarez © 1988.2009 ACORD CORPORATION. AN rights reserved. +t, Inspection Number: INSP - 127407 Permit Number: PL -9 -09 -1469 Scheduled Inspection Date: October 20, 2009 Inspector: Levrock, James Owner: AGRAS, ALONSO Job Address: 1182 NE 92 Street Project: <NONE> Contractor: BLUE GEM POOL INC Building Department Comments PLUMBING WORK FORN EW POOL Passed V Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector, Comments October 19, 2009 Miami Shores, FL Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 OF1 —14(01 Permit Type: Plumbing - Residential Inspection Type: Piping Work Classification: Pool - Private Phone Number Parcel Number 1132050270450 Phone: (786)953 -5153 Page 11 of 12 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Expiration: 03/2212010 Owner Information Address ALONSO AGRAS 1182 NE 92 ST MIAMI SHORES FL 33138 -2935 Valuation: Total Sq Feet: $ 15,000.00 400 Contractor(s) BLUE GEM POOL INC Phone Cell Phone (786)953 -5153 (786)355 -3387 Phone Approved: Yes Comments: SEE NOTE ON FENCE Date Approved: 9/1/2009 : Yes Date Denied: Type of Work: Swimming Pool Occupancy: Private Additional Info: EXISTING VIVYL POOL TO BE CONCRET Bond Retum : Classification: Residential Fees Due Bond Type - Contractors Bond CCF CO /CC Fee Education Surcharge Permit Fee Plan Review Fee (Engineer) Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $300.00 $9.00 $150.00 $3.00 $450.00 $60.00 $18.00 $150.00 ($150.00) $11.25 $1,001.25 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Invoice # BPP -9 -09 -35780 BPP -9-09 -35780 Total Amt Paid Amt Due $ 1,001.25 $ 851.25 $ 1,001.25 $ 1,001.25 $ 0.00 Bond #: 1891 Inspection Type: Fence Final Pool Deck Wall Steel 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. September 25, 2009 Date CeII For Inspections please call: (305)762 -4949 Available Inspections: September 25, 2009 1 BUILDING PERMIT APPLICATION FBC 20 Job Address (where the work is being done) Is Building Historically Designated YES Value of Work For this Permit $ 5/ 00 Type of Work: ['Addition ['Alteration • Describe Work: S M 5 Oo 2s Miami Shores Village Building D epartment 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit Type: BUILDING ROOFING /� Owner's Name (Fee Simple Titleholder) Al&50 A5, ' s Owner's Address 1 g Z N€ 9 2. � City In 1Afil Shoos State FL Tenant/Lessee Name Email 113°2_ 92 City Miami Shores Village County Miami -Dade FOLIO / PARCEL # (1 -" 3205 — 02 ( 7 -* 01450 Contractor's Company £ Name Lu C Pellet Po d L. p Contractor's Address cis a (..) 0 City oo t am % State E Qualifier Name ��! i (I.� t°M 0 E'q t,) State Certificate or Registration No. Contact Phone 9 gto 355 - 3 Y2 , NO Notary $ I/5.00 Training/Education Fee $ 3 Scanning $ Radon $ DPBR $ Double Fee $ b • Violation date: Structural Review. $ 66,4i Master Permit No. Phone # 1 U • V • 33N Zip 3313$ Phone # Phone # S ware / Linear Footage Of Work: Skew El Repair/Replace (OG Us-- * **x *** * ** *** *** * ** ** * * * * * * ** * *** ** F ees ** * * * * * * ** * *x ** ** * * * * * * *** ** ��,, y L /S 2 �Pbm�itta�Fe� $ l Permit Fee $ "= Permit No. j a C9 -kW Zip 3313$ CCF $ 9' Total Fee Now Due $ r iEffE.:7\WTE3 SEP 0 1 2009 jg BY: l F ti zo 3361 akifvtg9 r 7 ci53 --51 Zip 33 Y g'(. Phone Certificate of Competency No. 0 t GS O v g 9 4. E -mail 3 L u e 6e M Pool. s yrt 4 Architect/Engineer's Name (if applicable) Phone # 1 °D ❑ Demolition * * * * * * * * * * * * ** l DD . rij Technology Fee $ Bored $ i OQ. (70 1 C /C C $ See Reverse side -+ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lenderls Narne (if applicable) Mortgage Lender's Address City State 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 ence of such posted notice, the inspection will not be approved and a reinspection fee will be charged.. The foregoing instrument was acknowledged before me this W? day of , 20 _n by AtNsUt' who is ersona mowii to me or who has produced As identification and who did take an oath. I uT ARY PUBLIC -STATE OF FLORIDA °•" "" ,,. Guillermo Esquivel; Commission A .0 ;'D ^ 6614; , ,,,, ,./ Expires: A `3 . 10 2011 BOND1 A TRRU ATLANTIC BONDING CO., INC. NOTARY PUB Sign: Print:. My Commission Expires: (Revised 07 /10 /07)(Revised 06/10/2009) G k'P 4ctl £s k a ■I9 �•► Engineer Signature ontractor The foregoing instrument was acknowledged before me this 22 day of , 20 01, byGjui urVe who is personally known to one or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission EVELYN HERNANDEZ Notary Public - State of Florida . • mmin,Cion #nn s7R791 K� ;i My Commission Expires July 23.2010 Bonded Thru Pichard Insurance APPROVED BY 9I 9 / /09.•Srr "GrprlansExaminer / 7/: Zoning Clerk checked Inspection Number: INSP - 123539 Scheduled Inspection Date: November 23, 2009 Inspector: Levrock, James Owner: AGRAS, ALONSO Job Address: 1182 NE 92 Street Miami Shores, FL Phone Number Parcel Number 1132050270450 Project <NONE> Contractor: BLUE GEM POOL INC Building Department Comments PLUMBING WORK FORN EW POOL Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. November 20, 2009 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Sho Phone: (305)795 -2204 Fax: (305)75 r o ments For Inspections please call: (305)762 -4949 Permit Number: PL -9 -09 -1469 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Pool - Private Phone: (786)953 -5153 Page 8 of 26 Inspection Number: INSP- 126760 Scheduled Inspection Date: October 09, 2009 Inspector: Levrock, James Owner: AGRAS, ALONSO Job Address: 1182 NE 92 Street Miami Shores, FL Project: <NONE> Contractor: BLUE GEM POOL INC Building Department Comments October 08, 2009 Inspection Worksheet Miami Shores Vii!age 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 P q-00/-1 `k, 7 For Inspections please call: (305)762-4949 Permit Number: PL -9 -09 -1469 Permit Type: Plumbing - Residential Inspection Type: Main Drain Work Classification: Pool - Private Phone Number Parcel Number 1132050270450 Phone: (786)953 -5153 PLUMBING WORK FORN EW POOL Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comm its Page 11 of 11 Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 1182 92 Street Miami Shores, FL 1132050270450 Block: Lot: ALONSO AGRAS ALONSO AGRAS 1182 NE 92 ST MIAMI SHORES FL 33138 -2935 Contractor(s) BLUE GEM POOL INC Phone Cell Phone (786)953 -5153 (786)355 -3387 Type of Work: PLUMBING Type of Piping: POOL Additional Info: Bond Return : Classification: Residential Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $9.00 $3.00 $190.00 $3.00 $50.00 ($50.00) $6.30 $211.30 Address 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 / Agent Building Department Copy RO Expiration: 03/17/2010 Phone Invoice # PL -9-09 -35782 PL -9-09 -35782 Total Amt Paid Amt Due $ 211.30 $ 161.30 $ 211.30 $ 211.30 $ 0.00 Valuation: Total Sq Feet: September 25, 2009 Date Cell $ 15,000.00 400 For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Final 1 September 25, 2009 1 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Plumbing Owner's Name (Fee Simple Titleholder) A t.N VO A rIq S Phone # Q • 55.37) Owner's Address :),.) $O Pr3rer $ 11$x„ oJ£ 4 2 City V R f mt SienOt State FL Zip 33 1a 7 Tenant/Lessee Name Phone # E -MAIL: Job Address (where the work is being done) City Miami Shores Vill. a County Miami -Dade Zip 3 3 j al Miami Shores Villag e � ri � 1 T,T4-nr/m Village SEP 01 2009 � ' Building Department Y: 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. PI M 146P Master Permit No. FOLIO / PARCEL # 1 t 3205 -O2 ? 6450 Is Building Historically Designated YES NO Contractor's Company Name l ue Genf) PooL Phone # 9g0-355:- 3 3i2. G. Contractor's Address c1.5 20 S) 144 c F. City cif) 1� .State R. Zip 3 Qualifier Name 61,1 ((-PYMc) �$ Qi) IV'PC ,j�( Phone # 7 4.- qs" 3 -- 67 53 State Certificate.or Re istration No. (Z? 252554i g // Certificate of Competency No. Oil es oo it? V E -MAIL: B Lve &em Po6 LS 6 U A 1460 . GOt~'1 . Architect/Engineer's Name (if applicable) 4J Phone # Value of Work For this Permit $ (c oO Square / Linear Footage Of Work: Type of Work: ['Addition ['Alteration Xlew 1=1 Repair /Replact. 11 Demolition Describe Work: PQO r L. pip1h.)5 xxx * xxxxxxxxx :**.*ic*xxicxx *x4exxxxxx F x'° x xxxx' BXxxi:, xxxxxxv cicxxxxxxxxxx'o'rxxie*wve EP 01 PAID _ , Submittal Fee $ e Permit Fee $ CCF $ 9 TJ CO /CC Notary $ Training /Education Fee $ 3.03 Technology Fee $ 4•" Scanning $ 3 Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ I(.01 .30 See Reverse side -+ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Si ature r,/ Owner r Agent 1,/ IF i Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 22 VQ4 Sign: Print: My Commission Expires: X XX APPLICATION APPROVED (Revised 02/08/06) day of 0. 4001 , by.. Ai-FohKo AG n95 who is kn own to me or who has produced As identification and who did take an oath. NOTARY PUBL . NOTARY PUBLIC -STATE OF FLOR " "%., Guillermo Esquivol ' ' Commission # PDAR472 ., APE. 10, 2011 soaIDaH my mum soxuDro eft, rtfc: SU;11•er0ry £$ L XXXX%%XXX %X day of who isyersonnally known as id NOTARY PUB Sign: Print: ,2001 ,by trig;pr;;who I Utk NANDEZ _° 0 = of Public, - 5 to of Florid h' f�i9r t 60 gtiGPgh. Mp !' ssion Expires July 23, 2010 ' �ru ;'!chard Insurance t I �rN,saPz. My Commission Expires: Y' XU & xxx xx • X xxxxx XXx,'G x,kXxxx%x * xx x ****** xxxxxx x xxxx x r. t S , Plans Examiner Engineer Zoning Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 1182 92 Street Miami Shores, FL 1132050270450 Block: Lot: Type of Work: ELECTRICAL Additional Info: POOL Classification: Residential Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $9.00 $3.00 $225.00 $3.00 $50.00 ($50.00) $5.82 $245.62 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Invoice # Total Amt Paid Amt Due EL -9-09 -35781 $ 245.62 $ 50.00 it $ EL -9-09 -35781 $ 245.62 $ 245.62 $ 0.00 ALONSO AGRAS September 25, 2009 Date ALONSO AGRAS 1182 NE 92 ST MIAMI SHORES FL 33138 -2935 Valuation: Total Sq Feet: $ 15,000.00 For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Final Light Niche Alarms Bonding 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. September 25, 2009 1 s•- Inspection Number: INSP- 127525 Scheduled Inspection Date: October 22, 2009 Inspector: Devaney, Michael Owner: AGRAS, ALONSO Job Address: 1182 NE 92 Street Miami Shores, FL Project: <NONE> Contractor: RAY & REY INC Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 ELECTRICAL WORK FOR NEW POOL Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments pool deck bonding P/2-d/ / e E 11-'.0. / "11- �h d c /Pace- r 6r4- a/'` e October 21, 2009 For Inspections please call: (305)762 -4949 Permit Number: EL -9 -09 -1468 Permit Type: Electrical - Residential Inspection Type: Bonding Work Classification: Pool - Private Phone Number Parcel Number 1132050270450 Phone: 305 -819 -9793 Page 30 of 34 Owner's Address I L 1 2 NE_ I2 $t City � i A tin i State FL Tenant/Lessee Name /~ Email City (Nyi f}mi kes State FL Qualifier Name Re IN) Ft LA o 'bin, Z Miami Shores Village Building Department BUILDING PERMIT APPLICATION Master Permit No FBC 20 Permit Type; ELECTRICAL 2 Owner's Name (Fee Simple Titleholder) r t t3SO t- {� iq (A 5 Phone # PRQ U∎ ' 5 Zip Job Address (where the work is being done) 11 g 2 Ne. 9 2 $ City Miami Shores Village County Miami -Dade FOLIO / PARCEL # h " 3205- 02 -0 46 Is Building Historically Designated YES NO 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No. 4 1 14(d Contractor's Company Name "R d K ( *et . .1 C . Phone # Contractor's Address 1431 O CAnt 41 e O ®d 11 c Training/Education Fee $ 3'oO 33!38 Phone # PEP a 1 PP *** *: ******* * *** * * * ** * ** * * *** * * ** ** ** * * * * * * * * *** ** * * ** ** ** * * **: * ** 00 Submittal Fee $ $O W Permit Fee $ Z rS d CCF $ Zip . 33L3 k 3 as - 2504 Zip 3 3 O l Li. Notary $ Scanning Radon $ DPBR $ Double Fee $ Violation date: / c Structural Review. $ Total Fee Now Due $ ( IJ 4.D O /� . Bond $ See Reverse side --> SFP 0 2009 B �o;me.a....m Flood Zone Phone # State Certificate or Registration No. E C 1 3 vO 1 4 9 0 . Certificate of Competency No. Contact Phone 305 " q b (0 - 2504 E -mail Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ ROO. cap Square / Linear Footage Of Work: Type of Work: ['Addition ['Alteration New ❑ Repair/Replace ❑ Demolition Describe Work: * * * * * * * * * * * * * * * * ** C O /C $ Technology Fee $ SIDON Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City 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 FT.P.CTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, BEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S A14 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Sta Own or Agent The foregoing instrument was acknowledged before me this day of 2.q 0 0i , by ALFOnaSo A l who is personally known to me or who has produced As identification and who did take an oath. Sign: Print: My Commission Expires: APPROVED BY (Revised 07 /10 /07XRevised 06/10/2009) NOTARY PUBLIC$TATE OF FLORIDA " Guillermo Esquivel, Jr. Commission #DD661472 ,,,.$ Expires: APR. 10, 2011 BONDED THOU ATLANTIC BONDING CO., INC. * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 414 ritio CSQUIC $' t''of Plans Examiner Engineer Contractor The foregoing instrument was acknowledged before In this Z�' day of 200_, by Rfi dD l 1 , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign- Print: All CommvssIOr 67 m my Commission E t:l,as July 23,2911) Bonded Tina Pia':Ierz'I tIo ®olran� My Commissio Zoning Clerk checked FROM :RAY & REY INC. if IMO ACOBp CERTIFICATE OF LIABILITY INSURANCE 05/19/2009 RO 04 (30S)445-3535 FAX (305)447-9476 -9478 THIS : ERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION Fortun XnSurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 365 Palermo Avenue 11011 ER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR pL1•E !THE COVERAGE AFFORDED BY THE POUCIES BELLOW. Coral Gables, 'FL '33134 -6607 Peter Garcia INSURI RS AFFORDING COVERAGE NAIC # INSURER u Granada insurance Co V G WsDRED Ray & Rey •Inc. 14370 Lake Candlewood Court Miami Lakes, FL 33014 THE POLICIES OF INSURANCE USTFA BELOW HAVE BEEN ISSUED TO THE INSURED NA tED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT I JITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SL 3JECT TO ALL THE TERMS. EXCLUSIONS AND CONDfl1ONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. N$R ADEN_ TFt 6 OTHER TYPE OP INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 1 CLAMS WADE Q OCCUR GEN'L AGGREGATE UMIT APPLIES PER: --� Poucen FA- n Loo AUTOmaBtLE LWBILflY ANY AUTO ALL OWNED AUTOS _ - =4EDui..ED AUTOS HIZeD AUTOS NON-GINNED AUTOS GARAGE LIAe4 xiv ANY AUTO E CESSS,DABRELLA UABIUTY , OCCUR CLAIMS MADE R DEPUCTIMLE RETENTION s WORKERS cOMPENSATION AND EMPLOYERS' ANY PROPRIETOR/PARTNERIEXECU?IVE OFFICERrMEMBER EXOLUOED? SJ'SOIAL P IO bOttrff DESCRIPTION OF OPERATIONS 1 LOCATIQNS i VEHICLES f EXCLUSIONS ADDED BY ENDORSEmEWT /SPEC1t _ ELECTRICAL WORK WITH BUILDING CERTIFICATE HOLDER ( MIAMI SHORES 77 AVEST611 MIAMI SHORES: FI, 33115 •.. • ACORD 25 (2004108) • FAX NO. :305 -685 -4090 POLICY NUMB> R POW? N ItYYI 0185FL00009418 05/20/2009 7W03176666 10/31/ 008• Sep. 23 2009 03:36PM P1 INSURER a Associated Industries Ins Sery INSURER INSURBR ): INSURE* AUTNOI• ZED REPRESENTATIVE 1ectn:r Fortitn/I2 POLICY ,+ l mn 05/20/2010 • .10/31/2009 MITTS EACH OCCURRENCE DAMAGE TO RENTED PPFM,gp_S (Fl nrn .�+`A} MED EXP (Any one ttel'. n) PERSONAL & ADV INJURY PROPERTY DAMAGE (Pelf ac dent) GENERAL AGGREGATE . PRODUCTS • COMPIOP ASO memo 8(NGLE LfMIT (Ea acoklent) (Pm' BODILY ) BODILY INJURY • (Pe aeodent) ALFTO' OILY - EA ACCIDENT OTHER THAN AUTO ONLY: EA ACC AGO EACH OCCURRENCE. AGGREGATE E.L. OISCA$S - EA EMPLOYEE EL. DISEASE - POUCY LIMIT 1,000,000 s 50,000 s 1,000 $ • 1,000,000 $ 2,000,000 s 2,000.000 $ S $ S 6 S s $ 100,000 ITow IIser l I R E.L. EACH ACCIDENT $ 300.000 s 500,000 WTION 5RI0 ILO ANY OP THE ABOVE D POLICIES BE CANCELLED BEPORE THR EXP RATION DATE THEREOF. THE ISSUING INSURER WILL ENDERIADR To MAIL 31 1 DAYS WRITTEN NOTICE TO THE GER iWICATE HOLDER NAMED To THE LEFT, SU7 FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF i NY KIND UPON /HE INSURER. ITS AGENTS OR REPROSENTATIVES. OACORD CORPORATION 1988 f; '.. • - y. ` '4■:' i E ft ',.,,,.,„spi, A 0 . BATCH NUMUER k . ,- ' i•,;',.'4 latV °ISA it Tir A ; •: - F*•1, , 7- h - , p , ' ..4. i CI 7. / , I 0 0 : a r1.- 'co . .... .7.." • • ,. • ...; 4..; "F., SON 'et 'AD u-ttst- 4 74 ••(•.::".... • ••, !"1 : 1 , ‘...• ,f1 eGe • a , .A. ';;;: vt."M 4; ...N.'` DO NOT FORWARD RAY & REY INC REYNALDO DIAZ 14370 LAKE CANDLEWOOD CT MIAMI LAKES FL 33014 lit I litt iitli$11 ".; 11692144111g Permit No: 09- / Job Name: , 2009 Aif Norman Bruhn CBO 305 - 795 -2204 Building Critique Sheet a) L CA Zie 124G44.40 1 c T Feed L. ‘41. AA Iti Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. RECEIPT PERMIT #: 1'(( 140`) DATE: _0_ ) n 1 o I, rl C ontractor ❑ Owner ❑ Architect (other figS ,mill q9s Picked up 2 sets of plans and (o Address: J1 From the building department on this date in order to have corrections done to plans And/or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to , e permitting process. Acknowledged by: � :�,., 1, PERMIT CLERK INITIAL: RESUBMITTED DATE: ad PERMIT CLERK INITIAL: M iarni Shores Viiiage . Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 APPLICATION FOR: [ ] New System [ ] Repair APPLICANT: Alfonso Agras AGENT: Guillermo Esquivel MAILING ADDRESS: 1182 NE 92 St Miami, FL 33138 TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST BE CONSTRUCTED BY A PERSON LICENSED PURSUANT TO 489.105(3)(m) OR 489.552, FLORIDA STATUTES. IT IS THE APPLICANT'S REPONSIBILITY TO PROVIDE DOCUMENTATION OF THE DATE THE LOT WAS CREATED OR PLATTED (MM /DD /YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS. LOT: 7 SUBDIVISION: Bay Lure PROPERTY ID #: 11- 3205 -027 -0450 PROPERTY SIZE: 0.20 IS SEWER AVAILABLE AS PER 381.0065, FS? PROPERTY ADDRESS: 1182 NE 92 St Miami, FL 33138 DIRECTIONS TO PROPERTY: [X] Existing System [ ] Abandonment 195 exit 95 St Nw to end 96 St go until 10 Ave Ne right to end St left STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM BUILDING INFORMATION: [X] RESIDENTIAL Type of Establishment [ ] Floor /Equipment Drains SIGNATURE: DH 4015, 09/2006 (Previous Editions May Be Used) v 1.0.0 BLOCK: 3 PLATTED: ZONING: ACRES WATER SUPPLY: [ ]PRIVATE [ Y TN No. of Bedrooms 2 [ ] Other (Specify) AP936214 [ ] Holding Tank [ ] Temporary PERMIT #:, [ ] COMMERCIAL EID1002614 APP DOC #:AP936214 PERMIT #:13 -SC- 1002614 DATE PAID:09/16/2009 FEE PAID: RECEIPT #:13 -PID- 118313 [ ] Innovative TELEPHONE: 1(786)355-3382 I/M OR EQUIVALENT: [ Y /' N p ' PPROVED MIAMI -DADE COUNTY HEALTH DEPARTMear [X] <= 2000GPD [ ] >2000GPD DISTANCE TO SEWER: FT Building # Persons Total Design Flow Area Ft Served For This Unit 1883 4 300 DATE: 09/16/2009 Page 1 of 4 Additional Notes and Comments: County Notes Fields: County Process #: County Permit #: Storage Box #: General Comments: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM T • ' ermit is granted for a ne , 'pool only. Does not have any impact on the existing OSTDS. r• Ospina Engineer II v 1.0.0 AP936214 EID1002614 APP DOC #: PERMIT NO. DATE PAID: FEE PAID: RECEIPT #: OV u .. kIIAMWA Cowin( r HEAk TFI 00,41gT1NEkl7 OKRMIf AP936214 13 -SC- 1002614 09/16/2009 70.00 13- PID- 1183134 APPLICATION FOR: ( ] New System I ] Repair APPLICANT: - ro 0 e 1 I FL AGENT: MAILING ADDRESS: TO BE - COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT.. SYSTEMS MUST BE, CONSTRUCTED BY A-PERSON LICENSED PURSUANT TO 489.105(3)(m)zOR 489.552, FLORIDA STATUTES. PROPERTY INFORMATION LOT: PROPERTY ID #: PROPERTY SIZE: IS SEWER AVAILABLE AS PER 381.0065, FS? DISTANCE TO SEWER: FT PROPERTY ADDRESS: c ia Ur s F) DIRECTIONS TO PROPERTY: i v4 ?7"-- /4: .0(-44 PC BUILDING INFORMATION Unit Type of No Establishment 1 IRPB■ 4.4) HO 2 3 4 I ] Floor/Equipment Drains ( ] Other (Specify) SIGNATURE: »f DH 4015, 10/97 - Page 1 01 editions may be used) • Stock Number 5744-001-4015-1 STATE OF FLORIDA DEPARTMENT OF HEALTH ON-SITE SEWAGE DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT VA Existing System Abandonment - SUBDIVISION: BAL Lo r BLOCK: .3 )to 7J ? TAO' c (>0 RESIDENTIAL ,a) Fr) / N] PERMIT 140.1, g'//,,,;„(/7 DATE PAID: FEE PAID: RECEIPT": h/7 r 1 Holding Tank_ ] Innovative Temporary kAr.;,, p TELEPHONE: 1 7%3 55 g z nnt ; ckrvps F7 3 R.L ZONING: I/N OR EQUIVALENT: ( Y / N) ACRES WATER SUPPLY: [ PRIVATE PUBLIC (S<]<ft2000GPD 1 ]>2000GPD i C c oj 7,2), I ] COMMERCIAL DATE: PLATTED: -- 6 No. of Building Commerbial/Institutional System Design Bedrooms Area Sqlit Table 1, Chapter 64E-6, FAC I I - Page 1 of ,3 APPLICATION FOR: APPLICANT: AGENT: TELEPHONE: MAILING ADDRESS: LOT, BLOCK, SUBDIVISION: DATE OF SUBDIVISION: PROPERTY ID#: ZONING: PROPERTY SIZE: WATER SUPPLY: SEWER AVAILABILITY PROPERTY ADDRESS: DIRECTIONS: BUILDING INFORMATION: TYPE ESTABLISHMENT: NO. BEDROOMS: BUILDING AREA: BUSINESS ACTIVITY: FIXTURES: SIGNATURE / DATE: Check type of permit, if "Other specify type in blank. Property owners full name. Property owner's legally authorized representative. Telephone number for applicant or agent. P.O. box or street, city, state and zip code mailing address for applicant or agent. Lot, block, and subdivision for lot (recorded or unrecorded subdivision). If lot is not in a recorded subdivision, a copy of the lot legal description or deed must be attached. Official date of subdivision recorded in county plat books (month/day/year) or date lot originally recorded. Dividing an approved lot into two or more parcels for the purpose of conveying ownership shall be considered a subdivision of the lot. 27 character number for property. CHD may require property appraiser ID # or section/township/range/parcel number. Specify zoning and whether or not property Is In UM zoning or equivalent usage. Net usable area of property in acres (square footage divided by 43,560 square feet) exclusive of all paved areas and prepared road beds within public rights -of way or easements and exclusive of streams, lakes, normally wet drainage ditches, marshes, or other such bodies of water. Contiguous unpaved and non - compacted road rights -of -way and easements with no subsurface obstructions may be induded in calculating lot area. Check private or public <= 2000 gallons per day or public > 2000 gallons per day. Is sewer available as per 381.0065, Florida Statutes, and distance to sewer in feet. Street address for property. For lots without an assigned street address, indicate street or road and locale in county. Provide detailed instructions to lot or attach an area map showing lot location. Check residential or commercial. List type of establishment from Table II, Chapter 10D-6, FAC. Examples: single family, single wide mobile home, restaurant, doctors office. Count all rooms designed primarily for sleeping and those areas expected to routinely provide sleeping accommodations for occupants. Total square footage of enclosed habitable area of dwelling unit, exduding garage, carport, exterior storage shed, or open or fully screened patios or decks. Based on outside measurements for each story of structure. For commercial/institutional applications only. List number of employees, shifts, and hours of operation, or other information required by Table II, Chapter 10D-6, FAC. Mark Floor/Equipment Drains or Others and specify item or NA" if not applicable. Signature of applicant or agent. Date application submitted to the CHD with appropriate fees and attachments. ATTACHMENTS: A site plan drawn to scale, showing boundaries with dimensions, locations of residences or buildings, swimming pools, recorded easements, onsite sewage disposal system components and location, slope of property, any existing or proposed wells, drainage features, filled areas, obstructed areas, and surface water. Location of wells, onsite sewage disposal systems, surface waters, and other pertinent facilities or features on adjacent property, if the features are with 75 feet of the applicant lot. Location of any public well within 200 feet of lot. For residences, a floor plan (residences) showing number of bedrooms and building area of each unit. For nonresidential establishments, a floor plan showing the square footage of the establishment, all plumbing drains and fodure types, and other features necessary to determine composition and quantity of wastewater. Owner's Name: ALONSO AGRAS Job Address: 1182 92 Street Total Square Feet: 400 Miami Shores, FL Total Job Valuation: $ 15,000.00 Contractor(s) Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Phone Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 9/1/2009 : Yes Comments: SEE NOTE ON FENCE Issue Date: Not Issued Permit NO. BPP -9 -09 -1467 k&s' $F �.. Folio Number:1132050270450 Expires: Not issued Owner's Phone: Primary Contractor 15/1 87:29 9547416951 afpoddaicIEttablished 1967 thathalegithevareraligt Ndt 15, 2007' Baby Gard, l & 5299 Ind Sunnite, Fl. 33351 Attn: Mill Schatzbetg Re: Vey Test & Iran Dear Mr. Schaterg: Baby Guest Inc. retained to verify AS Standard 2286.0514► seat The Baby Guard Prods t line The tit speoknens cow of Been ("t8) foot section of representative safety *mains. The sadon 'mod immured forty-eight (48) inches high. They were Installed with horizontal apadr of thirtrabc (36) inches. The reperentadve samples Were instilled as per the ABTA Standard P -226.05 .fin 4. We have completed the performance test for vertical load and Wald te$thg hi our flOSItY based on the noted ASTM Standard a well as reviewing test results from Q-Lab and Divershied Testing lab. "on Based on otw testing and the Intimation provided to us for review that the produce were found to meet or exceed all n,Inknum req " ntS put forth by ASTM E-2285-05 Sincerely NtifTING ENGINEERS OF FLORIDA 1NC i e Director of Operations • • • • MMMO• Sward (954) 041.8100 • Port St. Lucie .. • . .. . • • • • • � .. • • . • . . I. • . . . . . . . . . • • • . I . • . . . . . . . . . .. . . • (581) 7284100 - Fax (581) 78,41r/5 408.1 • l r 624 PAGE 01/01 mem throughout ins toga vtR ,I a tratarmingeropearacam dbftr c ne at m Bev GUM INC • 0. SEP 1.8 2009 41npr ac 4utia "J25411M MP LRSERJET 3330 Ma4ufacture Spec's 4r X -PULE • • • :;! • • Load test Results HEX SCREW • The sample below was testa¢ by pull testing horizontally 36" from base with accu-force 250 force gauge, s/n 62988075 X -pole 64,4 with .063 aluminum extrusidn pole. Baby Guard mesh tested to ile strength ASTM D GRAB METHOD ® 157LBS. BU JNG STRENGTH MULLEN TESTER ASTM D 3786 c® LBS. Completed pool fence asserar ly x -pole space on 30" centers with Baby Guard mesh tensioned ;between x- poles, comprising of 5 poles per 10 foot section. Poles inserted with plastic composite sleeves into pool decking {ie; Set Pavers. concrete, wood} and sections connected with safety tonne' tors, The product completely assembled and installed will 'withstand 321.4 lbs burst. All mesh have a minimum of90% i sparency Testing results provided by: American test Labs Of. Sou Florida . testing and consulting services. Testing report -AT report# 0808.03 -03 in conjunction with Baby Guard Inc. **In compliance with Building code #424.2.17 pool barrier 2001 **Minimum um fence height is L8 ", * *Fence will be installed a minimum of 20" off pool's edge. * *Fence will be permanently attached in one area (a tool must be used to remove fence). ***sr attached exhibit 1 • •w1pt vow 'robe • listened ALUMINUM ANGLE To be fastened to dock DECK FASTENER DRILLED INTO POOL DECK 1 1 •• • ••• ••• •I• • Baby Guard Inc: ad,, nrige. .133 -5C Tel: 954- 741.615E Fax: 954- 7414951 • • • • • • • • • -I • • • ••• • • • • ••• • • a • • • • • • I • • • • ••• • • • • • • • • p.1 03/15/00 09:14 1E9305 670 1840 I.00PO OF 51~ ASSINWOMO mciparamele cc apereow) ILegeMallat c cict:40c0 o.U.4....0cleseakftUre • —OM* tik...4711111KIAlt cco...POlierts coMellp WPC ous cpucsoliglor _mg purpmplis c04...04Pacelp poi fOologo• Pee Coa....01/1.11611spesi ..epar0c1 O -macaw) Ice....sacINWRIII rat ....CIKMOCerscaE ▪ Walden • ..... NI•watet es.....tellaralle gm/Wm pc. Jig MartUNI COM .. 41coNInc up mop cum •D ADM 1 ^ 1 1 . CERTZPV TO: r Alfons & Loris Ayes rkwnet & Ziworatt. P.A. Attarowys' Titta lawman Fwd. Zee_ P F 6 Loots Inc. IN Eseassors And/ Or Amigo LEGAL DESCRE Block: 3 Subdtvisiwk: By Lave morass is 914 Plat thersof rseorgied 19 Plet Beek: 44 PAW 63 Public Records of Dime county. PiwNs• ADDRESS: 1162 NE 92 STREET ALUMS smoRes FLOR1334 33136 Enerawhmests NFFOO: 1.4FATUFF SCFLE I n iF , S0.0 2 51 V.) &tsp./A.941e ( 0- 1 4 % ) *Ma • as eaaelesearme.Posimilmono• loom rielap••••wiliva. Wpm amaa/ge 1••■•••••.6 %Apo ..casolso a I ilivamdol 00.4whol. .1 /IS IOW Mew wog Iv elf Wel MAIM 00 Wm% to• offes pome.greo0 riorkoo ram *•••••••••1. isselb• 1•Ireml WOWS ••••••••1111011011•Mos•• may*. wavereeraw. 4:1 ••• motaogimposud. alma anal IMMO mace 6i) Tie Isa ••014•0 11,31001 MM. &IMMO .10/ &mixt 08•••=14 ~poll woofs.* pm Soo awoke to 1•111106••• Ow +Owens *Mb mo1fOrs 1••••• ••••••••••••••••• ems,1116•••••••W•••■••••■•• eel gAISION33.. • 1374•010M113~1.•111* 41~11134313 WWI 111311.3163* NMI PO IMMO 31. f433.83113tP1.10 OW WIWI& 41.3...d131339100 4111111:11111a Iambi ....•■•••■••••••••••••■1• Swo•y••••••••••• Milal••••■•••• • .• • WM* 0091 13r0/ •••••••• ant 1171‘1. 1. vim.. Repo Mlle aid AMMO scatelad c IF IDIOM. 0411an0 cil RICONID DULV.T. SM. 3, MIS 24I 011110 033313. LAWYERS MP 0 ...011114111.4WireVelMALSO Noilidafftella Ir 2.t' Pew* 4fitattl._ Aft. --- .1t. • • NE. k _ 92STR ••■■■ •••••■■■■• 4'1 L. . LaJrt&&1 .; radiaietlf eir...101.ereputp* 8011119•• 11.0......••••• 11111...614•2•• w.E.....~11•4110ff 0 06 $how 1 a a NE; 4 71 f$ A PICKM HAZARD ZONE THIS ZS NOT A R100D HAZARD ZONE PANEL NO.:- cOMMUNITY 1106$2 DATE OF P33/0.: 07/1711963 944 FLOOD $-W F914 PLOot ELEv LOWEST CERT 401 Same fAl-r• 0E) C") t,t, 1.1b..1-6.12.6a.be, Cs, THOMAS Z. KELLY. ZNC. LI. $64116 SURVEYORS-MAPPERS-LAND PLANNERS 323 PP4401180 AVENvE CORAL auks. on.maDA 33134 (0) 444-7693 OADE (193 719-11296 IIRWO (605) 4414494 DADE FAX PM 719-3200 *WD FAX "a rp. 9 P10.41:. 03/15/00 09:14 $305 670 1840 LAWYERS FEDERAL EMERGENCY MANAGEMENT AGEkGY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Int Kant: Read I : tructIons DI s ! - 7. DO -07 S0 SECTION A - PROPERTY OWN INFORMATION Q.M.B. No. 3087 -0077 Expires July 31, 2002 007 BUILDING S NAME ALFONSO LEYDA AGRAS OR P.O. ROUTE AND BOX BUILDING STREET ADDRESS UncludNng Apt, Unit. Suite, andlor 8t ig No.) ST J3T� MI AMI SHORES B BT. (e4. a- PROP 0 RI P ON (Lot and Block tuanbvrs. Taus CK 3 BA NOMSa a at. A d I . gym ate. use - , eta) PAGE 6 3 r .' rr R +I, - G TUDE (OPTION-) ( „!! - . tte.>ler sr es a s') sin if naoeasary- ONTAL DA SOURCE: ), } GPS (TYa)= Otltsr L I MAO 1927 IJ ma IMO J u5sei Quad web SECTION B - FLOOD INSURANCE RATE MAP FIRM) INFORMATION B3. STATE FLORIDA NAME A COMMON N 120652 02. coU DADE EFFE FiRNI PAN CTIII /REVISED DATE . FLOOD ZONE ZON818) MOMS) Qum AO, usa dgytn n d ) ti s • • •3. 64. MAP Nt AND *NEL 8S 'n . Be z N4 93 J 7-11 95 610. Indicate the source cattle Sane Rood Elevation (BFE) data Or base tad oepih entered in E9. Li FIRM 1_1 Community DeMrminsd L,I Other (Describe): �): PS he e e 481 NAVD 1988 1....i Other 911. Indicate the elevation datum used for the BFE in 89: 1.X1 NGVD 11920 m A Ott Protected Ante (ppA)T 1.x1 Yob 1__1 No 812. to the building located in a Coastal Bafeier Reaouroes SyStem De619naden Date: g URy� REQUIRED) SECTION C - BUtlDING ELEVATION INFORMATION ( n Flnlshad Construction �' LJ8�ing Under Condo • C1. Building elevations are based on: uCatstruetba+ on of the puUd++zB is complete is being ��' see new Elevation NUmb ate w>i3 be elec tre d when most similar n Me building for w this e C2. Building Diagram Ntunbar 1 (Select the building diagram a skK� � W+�t'aDhJ pages l3 and 7. tf 110 diagram accurately represents the buffrimg. provide of Sec AR. ARIA. ARIAS. AR/A1 -A30. AR/AH. ARJAO C3. Elevations.. tones A1-A30. AE. AK A (with EWE). VE. V14130. V (with WE). the d atum used. 0 If A LAH. A Is di}iarrent ken+ Complete Items 038 below accardtnq to the blinding dlagfam specified in item C2. State i I' 1 d oo�NOn a nts te Section D or Section G. as appropriate. to moment the datum conversion. the datum used � ib1-E vtded � B. corivei1 t � an� datum to that used for the BFE. Show bald m catwlatlon. Use s pace FIRM L-1 Yea LJ ►!� Elwin Co�vetalOrt/Coe its Does the elevation reference mark used apP on the Elevation reference mark used 4—.11-011) O a) Top of bottom Boor (Including basement or enclosure) T�� + R(m) floor -+ 11 I �.E-(m) If O b) Top oz , •�, I rrtsm>�r (V Zestas anti) • c) Bottom o1 1Owest horizontal a�rctura O 4) MUM garage (top of slab) • e) Lowest elevation of machinery andIor ectuipment servicing the building U f) Lowest adjacent 6rede (LAO) CI grade (NAG) o g) o Penrument epenings Mood vents) wide 1 IL above aelaoent grade .....s an) O 1) Total WWI of all pennenefd Openings (fled vents) In 03h L(m) SECTION 0 • SURVEYOR, ENGINEER, OR ARCINITE b a Nevadan information. a land surveyor. engineer. or architect a data adan f This ceri t Ms is to be amens p � C on Mid Celli rspmserf$ my bed e1/ons to Interpret P+ ! Cerfih'thBt the M/onrredOrr ,., .. - _ . - order 18 t�S Colo • � 1001. i undaratanO That an false stalament Ma be , shale. b fins or SEE itEV6RSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS 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 /1$ 2- 2 S Miami Shores, FL, and hereby affirm that one of the following methods will be used to meet the requirements of Chapter 515, Florida Statues. Please initial the method(s) to be used: ) I l'er (. QUI \ie t. CONTRACTOR'S NAME (PLEASE PRINT) Mame SinesVilletfe e4 Defristmege 10050 NE 2nd Ave Miami Shores, Fl 33138 Phone 305-795-2204; Fax 305-756-8972 www.miamishoresvillage.com The pool will be isolated from access from the home by an enclosure that meets the pool barrier requirements of Florida Statute 515.29; The pool will be equipped with an approved safety cover that complies with ASTM F1346 -91; All doors and windows providing direct access from the home to the pool will be equipped with an exit alarm that has a minimum sound pressure rating of 85 decibels at 10 feet; All doors providing direct access from the home to the pool will be equipped with self - closing, self - latching devices with release mechanisms placed no lower than 54" above the floor or deck; I understand that not having one of the above installed at the time of final inspection, or when pool is completed for contract purposes, will constitute a violation of Chapter 515, F.S. and will be considered as committing a misdemeanor of the second degree, punishable by fines up to $500 and/or up to 60 days in jail as established in Chapter 775, F.S. EVELYN HERNANDEZ Commission #DD 576723 • e, My Commission Expires July 23, 2010 F°F' " Bonded Thru Pichard Insurance OWNER'S NAME (PLEASE PRINT) NOTARY PUBLIC -STATE OF FLORIDA " Guillermo Esquivel, Jr. Commission #DD661472 BLS Pees: ' ' .10, 2011 TIMI ATLANTIC anan11 G akin. SWIMMING POOL OWNER'S CERTIFICATION Date 23 A va 1 2oO' Miami Shores Village Building and Zoning Department Attention: Building Official I certify that I am the legal owner of the property described as BA Loa P8 4V - 3Lor9Yu(a , located at 1182 NE 12 .S+ C \IAmi Stloies 33!3' . 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 a 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 an approved barrier prior to final inspection and use of the pool. Legal Owner Note: This certification is to be submitted with a swimming pool permit application in duplicate. SWIMMING POOL OWNER'S CERTIFICATION Date 23 N v ,200 Miami Shores Village Building and Zoning Department Attention: Building Official I certify that I am the legal owner of the property described as BA Lore P8 1 1 1 1-63 Lot'? $'U< 3 , located at rn `t Ami S P wes j i 3313g . In accordance with Section 33 -12(0, 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 a 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 an approved barrier prior to final inspection and use of the pool. Legal Owner 1( g2 NE 92 .s-I' Note: This certification is to be submitted with a swimming pool permit application in duplicate.