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BPP-10-926Inspection Number: INSP - 151501 Scheduled Inspection Date: November 29, 2010 Inspector: Bruhn, Norman Owner: LONGMAN, THOMAS Job Address: 1200 NE 95 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MARS POOLS Building Department Comments INGROUND SWIMMING POOL, PAVER DECK, POOL NET. Passed9Z 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- 150592. CREATED AS REINSPECTION FOR INSP- 144200. Sidewalk is broken fence must be complete. Sod must be replaced. NB SAME COMMENTS November 24, 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 Number: BPP -5 -10 -926 Permit Type: Pools/Whirlpools /Hot Tubs Inspection Type: Final Work Classification: New Phone Number (305)892 -8598 Parcel Number 1132060144110 Phone: (954)214 -2844 Page 8 of 21 Scheduled Inspection Date: August 05, 2010 Inspector: Devaney, Michael Owner: LONGMAN, THOMAS Job Address: 1200 NE 95 Street Miami Shores, FL 33138- Project: <NONE> Contractor: JACQUES ELECTRIC Building Department Comments August 04, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 144205 Permit Number: EL -5 -10 -928 For Inspections please call: (305)762 -4949 to -* Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Pool - Private Phone Number (305)892 -8598 Parcel Number 1132060144110 Phone: (954)214 -8711 POOL ELECTRIC (SUPPLY & INSTALL) Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 4 of 21 INGROUND SWIMMING POOL, PAVER DECK, POOL NET. 0 4f,e Inspector Comments Pool equipment appears to be within 10' side yard setback. DD , - Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until nspection Number: INSP - 150110 Permit Number: BP P -5 -10 -926 1 Inspection Date: January 01, 2999 Inspector: Dacquisto, David Owner: LONGMAN, THOMAS Job Address: 1200 NE 95 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MARS POOLS Building Department Comments August 24, 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: New Phone Number (305)892 -8598 Parcel Number 1132060144110 Phone: (954)214 -2844 Page 1 of 1 NOT VALID UNLESS EMBOSSED WITH SURVEYOR'S SEAL i HEREBY CERTIFY That the survey represented thereon meets the minimum technical requirements adopted by the STATE OF FLORIDA Board of Land Surveyors pursuant to Section 472.027 Florida Statutes. There are no encroachments, overlaps, easements appearing on the plat or visible easements other than as shown hereon. ADIS N. NUNEZ REGISTERED LAND SURVEYOR STATE OF FLORIDA #5924 SINCE 1987 BLANCO SURVEYORS INC. Engineers • Land Surveyors • Planners • LB # 0007059 555 NORTH SHORE DRIVE MIAMI BEACH, FL 33141 (305) 865 -1200 Email: blancosurveyorsinc @ yahoo.co Fax: (305) 865 -7810 SUFFIX: L , DATE9 /11/09 BASE: 8' - COMMUNITY# 120652 10 -593 DATE: 8/6j10 DAN. BY: F. Blanco REVISED: 5' Co / :5'/ 4 L) AUG 2. 4 21f1 SCALE: 1 " =20' F.I.P. 1/2" (NO I.D.) W.P.P• ONC. WALK 5.00 2.80' 0 0 0 •F.I.P. 1/2" (NO /.D.) ". GARAGE 23.25' 31.00' LO • Lri rn 10610' (R &M) 21' PARKWAY 0 N N.E. 95th STREET 27'± ASPHALT PAVEMENT 80' RIGHT -OF -WAY (BY PLAT) ; 22.20' co 7.30 o TILE PORCH CBS ONE STORY RESIDENCE '�/ 6c1• # 12010 21.70' ' WOOD F. N u1 LOT 1 0) 3250 0 2.50' 2.50' 10.0' 10.00' F.I.P. 1/2" c 0 V 10.18' ON PL POOL EQUIP. 13.05' • O CO 0 —J F.i.P. 1/2" z o (NO I.D.) r LOT 2 ELEVATION BASED ON LOC. # CBM# B -62 ELV. 8.74' TYPE OF SURVEY: BOUNDARY SURVEY SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIG1ATURE AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3,Y THE SURVEY DEPICTED HERE IS NOT COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5) ' UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON. NATIONAL GEODETIC VERTICAL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL. RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY 9) CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING INFORMATION., 10) EXAMINATION O THE ABSTRACT OF TITLE WILL HAVE TO BE'�MADETO DETERMINE RECORDED INSTRUMENTS, IF ANY AFFECTING THIS PROPERTY. BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB • PAGE LOCATION SKETCH SCALE: NTS N.E. 95th STREET 16 15 14 3 13 ABBREVIATIONS; SIAK =SIDEWALK, CBS=CONCRET.E BLOCK STRUCTURE. CLF =CHAR) UNKFENCE, PL =PROPERTY UNE, DUE=DRAINAGE UTILITY EASEM ENT, IP=IRON PIPE, F= FOUND, NC=AIR CONOmONER PAD, P/C= PROPERTY CORNER, DIH= HOLE, W F =WOODEN FENCE, RES= RESIDENCE, CL-CLEAR, RB= R UE= UTILnY EASEMENT. CONC=CONCRETE SLAB, R/WRIGHT OF WAY, DE =DRAINAGE EASEMENT, C/L=CENTER LINE, O= DIAMTER, TYP=TYPICAL, M =MEASURED, R= RECORDED, ENCR = ENCROACHMENT, COMP= COMPUTER; ASH=ASPHALT, N/D=NAIL & DISC, S=SET, FEE =FINISH FLOOR ELEVATION, O /S= OFFSET, R/P =POWER POLE, OHP=OVERHEAD POwERUNE, WM =VW TER METER WOOD FENCE= MASONRYWA LL= I.:•: c s:• :.•i;.v'•c'r:••c;. :•.t:•:.•t:•• 1 R, MAINTENANCE & DRAINAGE EASEMENT= M & D.E SURVEY FOR: TOM LONGMAN, 1200 N.E. 95TH ST., MIAMI SHORES, FLORIDA 33138. LEGAL DESCRIPTION: 17 OF MIAMI SHORES BEACH VIEW ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 10 OF THE PUBLIC RECORDS MTAMI-DADE COUNTY, FLORIDA BLOCK 85 SUBDIVISION AT PAGE 37 INGROUND SWIMMING POOL, PAVER DECK, POOL NET. Inspector Comments Passed ; 614(6'' o is f, i; `f '� �s0 .e j Failed l ' "T r Correction Needed t rt Re- InspectLQp • Fela • • •.• • •• • •• ••. • • :: •• 1 ., ••• No Additional Inspections can be scheduled until " a re- inspectiorlfee is paid. • • ••` • ••• ,' t S �+` • • • : • • • : ! • • _ • r a nspection Number: INSP - 150110 Permit Number: BPP -5 -10 -926 Inspection Date: January 01, 2999 Inspector: Dacquisto, David Owner: LONGMAN, THOMAS Job Address: 1200 NE 95 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MARS POOLS Building Department Comments August 13, 2010 •• • • • • • - • • • ••• • • • • • • • Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 ••• • • • • • ••• • • • • • • 0 • • • • • • • • • • • •: • • • f or Inspections please call: (305)762 -4949 AUG i Permit Type: Pools/Whirlpools/Hot Tubs Inspection Type: Survey Final Work Classification: New Phone Number (305)892 -8598 Parcel Number 1132060144110 Phone: (954)214 -2844 Page 1 of 1 1 i HEREBY CERTIFY That the survey represented thereon meets the minimum technical requirements adopted by the STATE OF FLORIDA Board of Land Surveyors pursuant to Section 472.027 Florida Statutes. There are no encroachments, overlaps, easements appearing on the plat or visible easements other than as shown hereon. ADIS N. NUNEZ REGISTERED LAND SURVEYOR STATE OF FLORIDA #5924 DATE: 8/6/10 REVISED: CONr` S IDWWN: i N.E. 95th STREET 27± ASPHALT PAVEMENT 80' RIGHT —OF —WAY (BY PLAT) 21' PARKWAY F.I.P. 1/2" 2 (NO I.D.) 1 LOT2 ELEVATION BASED ON LOC. # CBM# B -62 ELV. 8.7 TYPE OF SURVEY: BOUNDARY SURVEY SURVEYORS NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGIi'ATURE AkID R4ISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT M/ERBD BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5) E NC:NOUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC • 1eR7?GRL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL. RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9) CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING INFORMATION. 10) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. BEARINGS WHEN SHOWN ARE REFE LOT 16 BLOCK 85 LOCATION SKETCH SCALE: NTS N.E. 95th STREET ABBREVIATIONS; SWK=SIDE1AALK, CBS=CONCRETE BLOCK STRUCTURE. CLF=CHAeI UNKFENCE, PL =PROPERTY UNE, DUE =DRAINAGE UTILITY EASEM ENT, IP=IRON PIPE, F= FOUND, AIC=AIR CONDmONER PAD, P/C= PROPERTY CORNER DIH= DRILLED HOLE, VOF =WOODEN FENCE, RES =RESIDENCE, CL- CLEAR, RB=REBAR, UE= UT1LETY EASEMENT, CONC=CONCRETE SLAB. R/V OF MY, DE =DRAINAGE EASEMENT, C/L=CENTER LINE, O =DIAMTER, TYP =TYPICAL, M= MEASURED, R= RECORDED, ENCR = ENCROACHMENT, COMP =COMPUTER, ASH =ASPHALT, N/D =NAIL & DISC, S=SET, FEE = FINISH FLOOR ELEVATION, O/S= OFFSET, P/P =POWER POLE, OHP=OVERHEAD POWERLINE, WM =MATER METER WOOD FENCE= MASONRYIMLL= I I 1 I I I 1 I I CONCRETE= kV.: �;r.°•:;:: • i;+: •Iw••1:•:•1 +. MAINTENANCE & DRAINAGE EASEMENT= M & D.E SURVEY FOR: TOM LONGMAN, 1200 N.E. 95TH ST., MIAMI SHORES, FLORIDA 33138. LEGAL DESCRIPTION: LOT 17 " BLOCK 85 OF MIAMI SHORES BEACH VIEW SUBDIVISION ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 10 AT PAGE 37 OF THE PUBLIC RECORDS MIAMI-DADE COUNTY, FLORIDA SINCE, .8 • : • • • • • BLANCO SURVE'YdRS INC. Engineers • Land Surveyors • Planners • L #Q00705e • • • • 555 NORTI,ANOFT6DRIVP. • : • • • • • MIAMI BEA, F!.•33.141 : • • • • • • •• OH (305) 865 -1200 Email: blancosurveyorslnc@yahoo.2om fax: (305) 865 -7810 FLOOD ZONE: AE PANEL: 03 SCALE: 1 ° = 20' DWN. BY: • • F. Blanco • SUFFIX: L DATEi911 /01 LANE: 80 • COMMUNI . # : • :"2(56.2• • • B No • • • • ••• • • ••• • 10 -593 j J 1 j NOT VAUD UNLESS EMBOSSED WITH SURVEYOR'S SEAL 21.70' 2.70' / ��•e SCALE: 2t± ASPHALT PAVEMENT 80' RIGHT —OF —WAY (BY PLAT) 106.10' (R &M) LOT 1 21' PARKWAY ' WOOD F. 0 (V ui ;14 1 LOT2 3250 S '(NO' Q) , F.L.P. 1/2" (NO LD.) ELEVATION BASED ON LOC. # CBM# B -62 ELV. 8.74' TYPE OF SURVEY: BOUNDARY SLRVEY • SIl� R' NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATURE AI D TVISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT CQV5RE'D BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5) UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL. RE TRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. 9) COYAgf.THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING I11F A.. ON. 10) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BEIVIADE TO DETERMINE RECORDED I14S1i2t v1 TS, IF ANY, AFFECTING THIS PROPERTY. BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB PAGE LOT 16 BLOCK 85 ABBREVIATIONS; SWK= SIDEWALK CBS = CONCRETE BLOCK STRUCTURE, CLF=CHAIN UNKFENCE, PL= PROPERTY UNE, DUE=DRAINAGE UTILI'IYEASEM ENT, IP=IRON PIPE, F= FOUND, A!C =AIR CONDmONER PAD, PIC= PROPERTY CORNER. DM=DRILLED HOLE, VPF =WOODEN FENCE, RES =RESIDENCE, CL- CLEAR, RB=REBAR, UE =UTILITY EASEMENT, CONC=CONCRETE SLAB. RA WRIGHT OF MY, DE =DRAINAGE EASEMENT C/L=CENTER LINE, O=DIAMTER, TYP =TYPICAL, M= MEASURED, R =RECORDED, ENCR = ENCROACHMENT, COMP =COMPUTER ASH = ASPHALT, N/D=NAIL & DISC, S=SET, FEE =FINISH FLOOR ELEVATION, O /S= OFFSET, P/P =POWER POLE, OHP= OVERHEAD POINERLI NE, WN =VWTERMETER WOOD FENCE= MASONRYNALL= CONCRETE= I••';s.. :•:sees;•:: t;•:•'•s;• ••s:••••s; ••s:�•I MAINTENANCE & DRAINAGE EASEMENT= M & D.E. I I 11 1 I 1 1 I SURVEY FOR: TOM LONGMAN, 1200 N.E. 95TH ST., MIAMI SHORES, FLORIDA 33138. LOCATION SKETCH SCALE: NTS LEGAL DESCRIPTION: LOT OF MIAMI SHORES BEACH VIEW ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 10 OF THE PUBLIC RECORDS MIAMI —DARE COUNTY, FLORIDA N.E. 95th STREET BLOCK SUBDIVISION AT PAGE 37 i HEREBY CERTIFY That the survey represented thereon meets the minimum technical requirements adopted by the STATE OF FLORIDA Board of Land Surveyors pursuant to Section 472.027 Florida Statutes. There are no encroachments, overlaps, easements appearing on the plat or visible easements other than as shown hereon. ADIS N. NUNEZ REGISTERED LAND SURVEYOR STATE OF FLORIDA #5924 SINCE 1987 BLANCO SURVEYORS Tp••• •• •• • • • • • • • Engineers • Land Surveyors„ Illa •Lri4 001g059 • 555 NORTH•DHOIe�EORW .•• ••• • MIAMI BEACH, FL 33141 (305) 865 -1200 Email: blancosurveyorsInc @yahoo.com Fax: -7810 FLOOD ZONE: AE PANEL: 0306 DATE: 6 J10 SCALE: 1 " =20' DWN. BY: F. Blanco ••• • • • • • • • • ••• • • • •. • • • • • ••• • - — • • •' • • • • • • ••• • • • • • • • •— i ∎u • INGROUND SWIMMING POOL, PAVER DECK, POOL NET Inspector Comments � ��f . • • • • 1• ` f ' y r G ` -4 10 VA LJ JL l a� 5 a J y / - ., ., a Passed Failed M 7741(0 Correction Needed Re- Inspection Fee No Additional Inspec iMs d*Csclie fidlgd Int: re- inspection fee is paid. • • • • • • • • •• ••• •• • • • 1 1::‘ ani nspection Number: INSP- 150110 Permit Number: BPP -5 -10 -926 Inspection Date: January 01, 2999 Inspector: Dacquisto, David Owner: LONGMAN, THOMAS Job Address: 1200 NE 95 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MARS POOLS Building Department Comments August 13, 2010 • • • • •• • • • • • • • • • • • • • • • • • • • • • • • •• • •• • • ••• • • • • • • • • • • • • • • • • • • • _ 0 • • • • 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 ••• • • • �P� AUG 1 2010 Permit Type: Pools/Whirlpools /Hot Tubs Inspection Type: Survey Final Work Classification: New Phone Number (305)892 -8598 Parcel Number 1132060144110 Phone: (954)214 -2844 Page 1 of 1 BUILDING PERMIT APPLICATION FBC 2004 Tenant/Lessee Name Job Address (where the work is being done) Value of Work For this Permit $ V S Q `1 S / OD Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 WO" Permit No. 9ZCp Master Permit No. Permit Type (circle) Building Roofing Owner's Name (Fee Simple Titleholder) � - rpm LO ins (Y)9n Phone # Owner's / Address 1 O L b ,IJ ( `Z 5 111 _15 J City i f 11�111 1 61 1 S State rL- aoO err= 95 5L City Miami Sho Vill . County Miami -Dade Zip ( 3 3 )3S FOLIO / PARCEL # - , a 06- 0/ 1 f 1( 0 Is Building Historically Designated YES NO Contractor's Company Name fY) POD I - Inc Phone # q91 a tka 8 f Contractor's Address 9y05 IJL() 109 1 tI( d 35 ( City (' 1 '-€._ tate Zip 335 1 Qualifier Name �' R C' SW Phone # /t/ '"q�$7 State Certificate or Registration No. S PC 1457 9 p1 2 Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Square / Linear Footage Of Work: 500 Zip 33/ 38 Phone # 305- 776 5 Type of Work: ❑Addition Alteration �1V ew f epair/Rep, e l ❑ emolition Describe Work: .11) f 1)1)1(1 {1 611) 1 t1� I lii (-1 D (� i (Aver V i< V oo I JJe Submittal Fee $ 150.00 Permit Fee $ ,tarp CCF $ 1(I' l oQ Notary $ p Tr ning/Education Fee $ 1 aO Technology Fee $ at Scanning $ ,_ J / 1 Radon $ DPBR $ Zoning $ Bond $ to f l Code Enforcement $ Double Fee $ Structural Review. $6 44 Total Fee Now Due $ 1 , 4 la' ( 1,F See Reverse side - C C /r6 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/4s promise in good f, whose property for the first i inspection will i Signature ` / Signature % Owner 4 1,;y The foregoing in I t \ ar t w: r cknowledged before me this day of 20 - T®m LooginR0 , r t As identification and who did take an oath. who is personally known to me or who has produced ii NOTARY PUBLIC: th that subject to ection whic t be approve G' & STEW DAV C01144118310N k bugbi EXP1R2S: April 19, 2014 Y 0 . Notary Uj¢cmm Auoc. Co *** **fesY4tir*9t &4e4ettY &4e4t4 *** — — APPLICATION APPROVED BY: (Revised 07/10/07) , •ndition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must i \copy of the notice of commencement and construction lien law brochure will be delivered to the person nt. Also, a certified copy of the recorded notice of commencement must be posted at the job site seven (7) days after the building permit is issued In the absence of such posted notice, the reinspection fee will be charged Contractor The forego instrument was acknowl 1 _ ed �be m e day of � ..� 20JO by li 1C �lAe, who is personally a own to me or who has produced as identification and who did take an oath. _ e- My Commission Expires: = ��`� ` r " 5/ .Sf P' 6 /. Plans Examiner Engineer 2 /6 Zoning S-R,,NT4 SUBMITTAL DATE: ADDRESS: I 114 II 7_ r is :.'d NAME:T W1 RESUBMITAL DATES: PROJECT TYPE: 0 BL f. w ZONING STRUCTURAL PLUMBING S IV:i(i 0 FIRE IMPACT FEES ELECTRICAL 70g'Y" HRS/DERM v b MECHANICAL NOC Lf..L_?/ Date 05 SWIMMING POOL OWNER'S CERTIFICATION a1/4010 Miami Shores Village Building & Zoning Department Attention: Building Official • • I certify that I am the legal owner of the property described as $� g (e 16/ i 1 q Res ten 4- `s ( , located at 1200 Af& Q6 1.4 5 f 11(1`4mi Stoves 1 F 3113g. In accordance with Section 33- 12(f), Code of Metropolitan Dade County, I certify that I understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until separate permit has been obtained for an approved safety barrier, and such barrier erected, inspected and approved. 1 further understand that this certification, howev obtaining a permit and erecting and approved barrier pool. Legal Owne P11 iami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 r, does not e rior to final ins nate the need for ction a use of the Note: This certification is to be submitted with a swimming pool permit application in duplicate. NOTICE OF REQUIREMENTS RESIDENTIAL SWIMMING POOL, SPA AND HOT TUB SAFETY ACT I (We) acknowledge tht a new swimming pool, spa or hot tub will be constructed or installed at I Zoo it! ( 4 5"1 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: /. �he pool will be equipped with an approved safety pool cover that comp lies with ASTM • F1346 -91. (Submit Manufacturer's Specifications). A continuous, one -piece (child) barrier meeting the requirements of Florida Building Code R4101.17.1.15 will protect the pool perimeter. The plans shall show the fence location and method of attachment, including one end that shall not be removable without the aid of tools. (Submit Manufacturer's Specifications). A combination of non - dwelling walls and fences (screen enclosure, child fence, masonry fence walls, chain link or wood fence, etc.) will protect t he pool perimeter. The plans must specify t he type and 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 iraion o the permit, the pool shall be presumed to be unsafe . I understand that not having ' � e of th abo e installed will constitute a violation of Chapter 515, F.S ., an d will be considere . as com ittin � a misdemeanor of the second degree, punishable as provided in Section 775.082 o Section 5.0 F.S . This form must be signed by the owner /agent and the prime contractor. A CONTRACTOR'S SIGNATURE AND DATE i t ae /Q 54 CONTRACTOR'S NAME (PLEASE PRINT) NOTARY PUBLIC 0 M iami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 A (PL . E INT) �UBU AND DATE OWNER'S NA :1 'a NOT �; 45' vs nWLNDOLYN 0, STEWART L 6 4 0 Mit COMMISSION 4 DD961985 c' sT E5tP1N,ES: April 19, 2014 ov 1•YOfbYNOTARY FE Navy Discount Assoc. Co. OWNER SIGN & PRINT (Revised 05/2209 M iami Shores Viiiage 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 7'M' LOI7 Rein is /are the fee simple owner(s) of the following des .96-'475/ ribed property situated and being in Miami Shores Village, Florida: Address: 1200,t t� Whereas, the undersigned owner(s) 2OFI C desire to utilize said Lot(s) as a single building site, and the undersigned owner(s) do(es) hereby declare and agree as follows: 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 install 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 s, r in title to abide by all terms and conditions set forth herein. FURTHER, the undersigned declares) that this covenant is intend concerning the use, enjoyment and title to the above property and shall cons binding upon the undersigned, his/her successors and assigns and may only successors, in accordance of said Village then in effect. I Hereby Certify that on this day personally appeared before me L O . g� � / and has produced ID as identification and he/she acknowledge that he /she exxtuted the foregoing, freely and voluntarily, for purposes there in expressed. / /� SWORN TO AND SUBSCRIBED before me on this ,1?/ day of 1 20 1. e a restrictive covenant ing with the land and shall be i Shores Village, or its TE OF F ORIDA OTARY PUB ..9"" GWENDOLYN B. STEWART My EXPIRES: ri119, 2014 �aA Fl . Wolery Dist Awe. Co I,app9- NOTARY Primary Zone: 1400 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL- SINGLE FAMILY Beds/Baths: 4/2 Floors: 1 Living Units: 1 Adj Sq Footage: 2,352 Lot Size: 9,206 SQ FT Year Built: 1946 Legal Description: MIAMI SHORES SEC 3 PB 10-37 LOT 17 BLK 85 LOT SIZE IRREGULAR OR 17223 -0247 0596 1 OR 17223 -0247 0596 00 Year: 2009 2008 Taxing Authority: Applied Exemption/ Taxable Value: Applied Exemption/ Taxable Value: Regional: $50,000/$186,500 $50,000/$186,264 County: $50,000/$186,500 $50,000/$186,264 City: $50,000/$186,500 $50,000/$186,264 School Board: $25,000/$211,500 $25,000/$211,264 Folio No.: 11- 3206 - 014 -4110 Property: 1200 NE 95 ST Mailing Address: THOMAS J LONGMAN 1200 NE 95 ST MIAMI SHORES FL 33138 -2550 Year 2009 2008 Land Value: $161,576 $231,854 Building Value: $226,853 $276,269 Market Value: $388,429 $508,123 Assessed Value: $236,500 $236,264 Sale Date: 5/1996 Sale Amount: $210,000 Sale O/R: 17223 -0247 Sales Qualification Description: Sales which are qualified View Additional Sales Year. 2009 2008 Homestead: $25,000 $25,000 2nd Homestead: YES YES Property Information Report Page 1 of 1 miiami. ade.go 'Close window' My Home Property Information Report Summary Details: Property Information: Assessment Information: Exemption Information: Taxable Value Information: Sale Information: 'Click here to Print' This report was created on 5/22/2010 7:18:20 PM for reference purposes only. Web Site © 2002 Miami -Dade County. All rights reserved. MIAMIDADE httn:// uisims2 _miamidade_uov /mvhnme /nrnntext nrint.asn ?fnlin= 111 ,0601 441 1 0&cmd= 5/77/2010 Charlie Crist Governor Michael R Stewart 1200 NE 95 St Miami, FL 33138 May 18, 2010 RE: Contingency Letter Application Document No: AP965666 Centrax Permit Number: 13 -SC- 1143910 OSTDS Number: 1200 NE 95 St Miami, FL 33138 Lot: 17 Block: 85 Subdivision: Miami Shores Dear Applicant: This will acknowledge receipt of an application dated 05/17/2010 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. 1. -There is no increase in sewage flow, change in characteristics compromising the integrity or function of the system installation. 2. -This project entails : "Installation of a NEW SWIMMING POOL " From a review of your completed application, it has been determined that your existing system is adequate for the proposed use : " APPROVED ". G/P If you have any questions on this matter, please call our office at (305) 623- Enclosures cc: Miami -Dade County Health Department 1725 NW 167 St, Opa Locka, FL 33056 Phone: (305) 623 -3500 Fax: (305) 623 -3645 Ana M. Viamonte Ros, M.D., M.P.H. State Surgeon General vcgy s APPLICATION FOR: [ ] New System [ ] Repair STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT its / 1)( Existing System [ ] Abandonment Abandonment AGENT: ' e / e 1 S4 ec- )C ( 4 APPLICANT: MAILING ADDRESS: / 2 00/( /g < "1 55 s s � )oreS ft_. 93/38 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 APPLICANTS RESPONSIBILITY TO PROVIDE DOCUMENTATION OF THE DATE THE LOT WAS CREATED OR PLATTED (MM /DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS. PROPERTY INFORMATION LOT: ' ) BLOCK: SUBDIVISION: i Div + 9)06' 5 5F (! -, O,1 PLATTED: / 9 9k PROPERTY ID #: r 0 ' 3,20(-)--(1 L /J/ 0 ZONING: I/M OR EQUIVALENT: [ Y / N ] 2 3 4 PROPERTY SIZE: , ? ) ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC [ = 2000GPD [ ] >2000GPD DISTANCE TO SEWER: FT htY : ,fit '3/ pla () L) A q c " House Cif re), -lea IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y / PROPERTY ADDRESS: /200 ,4f6 St DIRECTIONS TO PROPERTY: BUILt,JING INFORMATION Unit Type of No. of No Establishment Bedrooms [ ] Floor /Equipment Drains SIGNATURE: RESIDENTIAL [ ] Other (Specify) DH 4015, 10/97 — Page 1 (Previous Editions May Be Used) Stock Number: 5744 - 001 - 4015 -1 X /' 7 [ ] Holding Tank [ ] Temporary [ ] COMMERCIAL ' [ ] Innovative [ ] Building Commercial /Institutional ystem Design Area Saft Table 1, Chapter 64E -6, PAC PERMIT NO. rG��c," `' 0' DATE PAID: 0 4 1 ENO FEE PAID: 4i iOO ) RECEIPT A: 0 ,. of TELEPHONE: 9 t/ 2 IV-2 [b 1 V t DATE: ' ,,/ / / 2U s`' Page 1 or 4 APPLICATION FOR: APPLICANT: AGENT: TELEPHONE: MAILING ADDRESS: LOT, BLOCK, 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 . ' - . 4, Property owner's full name. Property owner's legally authorized Telephone number for applicant or agen P.O. box or street, city, state and zip code mailing address for applicant or agent. Lot, biock, 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. 27 characte number for property. CHD may require propertya ID # or section/township/range/parcel number. Specify zoning and whether or not property is in I/M zoning or equivalent usage. Official date of subdivision recorded in county plat books ay/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. Net usable area of property in acres divided by 43,560 square feet) exclusive of all paved areas and prepared road beds within public 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 included in calculating lot area. Check private or public ^=2DOO 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 Iots 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 11, Chapter 64E-6, FAC. Examples: single family, single wide mobile home, restaurant, doctor's office. Count all rooms designed primarily for sleeping and those those areas expected to routinely provide sleeping accommodations for occupants. Total square footage of enclosed habitable area of dwelling unit, excluding garage, exterior shed, or open or fully screened omt�mcv decks. � Based onouto�e � measurements for each ntomofm���um� story For number of employees, shifts, and hours of operation, or other information required by Table 11, Chapter 64E-6, FAC. Mark Floor/Equipment Drains or Others and specify item or "NA" if not applicable. Signature of applicant or agen Date application submitted to the CHD with appropriate fees and attachments. ATTACHMENTS: A site plan drawn to scale, nhmv 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 y 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 fixture types, and other features necessary to determine composition and quantity of Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)758 -8972 Owner's Name: THOMAS LONGMAN Job Address: 1200 95 Street Miami Shores, FL 33138- DRIVEWAY IS NOT PART OF APPROVAL FOR THIS PERMIT Folio Number:1132060144110 Owner's Phone: (305)892 -8598 Total Square Feet: 500 Total Job Valuation: $ 35,045.00 Contractor(s) Phone MARS POOLS (954)214 -2844 Primary Contractor Yes 1 Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 5/25/2010 : Yes Comments: POOL EFQUIPMENT MUST BE LOCATED NOT LESS THAN 10 FEET FROM SIDE LOT LINE J111111U111111li1 $11ii1111 . NOTICE OF COMMENCEMENT CFN. 20.10R0371; 45 r OR Bk 27306 flit 03021 tips) RECORDED 061.03 /2010 12:28 1.33 HARVEY MIN..CLERK OF COURT MIAMI -DARE COUNTY. FLORIDA Permit # LAST PAGE 1.,x-'3 a6 /� 2 Folio # The undersigned hereby gives notice that improvement will be made to certain real property and In accordance with Chapter 713, Florida Statutes, the following information Is provided in this Notice of Commencement 1. Legal Description of Property: Street Address if available: 2. General description of Improvement 3. a. Owner name and address: b. Interest in property: c, Name and address of fee simple titleholder (if other than Owner): 4. a. Contractor name,and address: b. Contractor's phone number: 5. a. Surety name and address: b. Surety's phone number: c. Amount of bond: 6. a. Lender name and address: b. Lender's phone number: WARNING TO OWN COMMENCEMENT FLORIDA STATU NOTICE OF C INSPECTION. COMMENCING RE CON S, AND C MENCEME YOU INTEN WORK OR R + wner(s) or 4 SIgnature(s) of By Pe„..101 Name tr Via/ Title /Office ,Lt// f 1D/ a V RIFICA TATUTES Under pe r altles of perju fare that I have read the foregoing and that the f -'cts stated ink : to the best of my knowledge and belief. Signatur By Asa 01d ri this space reserved for recorder Lot / 7 Block g Unit # ' Bldg # ❑L'engthy legal attached Subdivision / Condominium: 4 e',Pred . 'n✓. 12C0 _Al. ; . icrl i» 0.411 s" . l t ak , i be (lag $ tar ivioine#29s- it 7. a. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes: Name: Address: b. Phone number: 8. a. In addition to himself or herself, the Owner designates I "'c' 9e7 g .. E `l to receive a copy of Liennor otice per Section 71313(1)(b), Florida • b, Phone number of person or entity designated by owner ! r Z/ • 40 V v 9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a.different date is specified) PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF I DERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A MUST BE RECORDED AND PASTED ON. THE JOB SITE BEFORE THE FIRST OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE DING Y66 UR NOTICE OF COMMENCEMENT, razed Officer /Director /Partner/Manager By Prin Name Title/Office STATE OF FLORIDA COUNTY OF i3REIWARB , vik© The.forejojpg Instrument was acknowledged before me this 2/ day of 1 By '1001 COW 9f9igi'I ❑ Individually, or ❑ as for ❑ Personally known, or produced the following type of identification: Signature of. Notary Public: Print Name: (SEAL) ner( )' Authorized Officer /Director /Partner/Manager who signed above: By TE OP FLORIDA, COtitITY OF I HEREBY CERTIFY Mat 1113 is .01L. copy of ? • orlgInel filed n. ln.• ig ,ce on cd ,' of MB if, ' AD20 IMTNI ►r r n f nc Of t1 yea` 1. HAtiVL' F, &Mat ani Caw fifer gVormstnoc.= notice of commencement revised 7.3.07.doc BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Electrical Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 1 Lo,,5'ft3'/7 Permit No. Master Permit No. Owner's Name (Fee Singe e1 Titleholder) Owne4 ' Address / vU City i S ' v / es State r& Zip 33/F2 Tenant/Lessee Name Phone # 305- 715- 9/66 Phone # E -MAIL: 4) /00 5/n a, 4r /0/1/0/1914/q41 Cen Job Address (where the work is being done) ) pl 00 X f ( QS i' t City Miami Shores Village County Miami -Dade Zip 3 3/ 9 j FOLIO / PARCEL # 1 C& O/V — ¥ / /() Is Building Historically Designated YES NO X Contractor's Company Name , l cC a ) e3 C,'lec-tetic Phone # Contractors Address GO I_ U 4 L. S+ City t 1 L woo 6 S tate f lam. Qualifier Name 3 h 4 (Yl 1..Q C101.4) State Certificate or R; ► r j g 7 E -MAIL: J Or g. nu.) ao aim Architect/Engineer's Name (if applicable) Value of Work For this Permit $ *®D`0° Type of Work: ❑Ad ition �/ El on Describe Wprk: o K L t+ t P0061 F•1 1 Zip 33007 Phone # Certificate of Competency No. 0000 1 1 a 3a Phone # 6 1t/- Iii- Square / Linear Footage Of Work: ********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees ************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ - 50'00 Permit Fee $ /0e //�� ' CCF $ I • n ^� Notary $ Training/Education Fee $ (• .oO Technology Fee $ 9 4 (3 Scanning $5 OD Radon $ DPBR $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ a • CO /CC Zoning $ See Reverse side -* ❑ Demolition 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 Applic promise in goo whose prope for the first i inspection will n /V .A / ' if er o gent The foreg9ipg instrument was acknowledged yefore me this a > 20 j by `vr LM 914 , who is rsonally known to me or who has produced /L Signature day of faith t is subjec ection not be ap NOTARY PUBLIC: (.1`WC °NI)1OLYN B. STEWART m EXPittES: April 19, 2014 140 3. OTARY R. Nom Dlawunt ASSOC. Co Sign Print: My Commission Expires it***it* *****,k*** APPLICATION APPROVED B (Revised 02/08/06) a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must a cm py of the notice of commencement and construction lien law brochure will be delivered to the person achment. Also, a certified copy of the recorded notice of commencement must be posted at the job site occurs seven (7) days after the building permit is issued In the absence of such posted notice, the and a reinspection fee will be charged. As identification and who did take an oath. The foregoin day of who ,t,kd: * * ** **** ******* ik **** ******* * **** * Contractor instrument was acknowledged before me this 0 , by 1 144 Mt 1' personally kno NOTARY PUBLIC: Sign: Print My Commission me or who has produced as identification and who did take an oath. ' COMMISSION k DD961586 E<P1RCS: April 19, 2014 1400.9- NOTARY R. No =: • l;' GV /ENDOL'r Plans Examiner Engineer Zoning ` ° _ CERTIFICATE OF LIABILITY INSURANCE M DATt 5/112//100 PRODUCER Accredited Insurance 6099 Hollywood Blvd Hollywood, FL 33024 Phone (954)964-5444 INSURED JOHN M. LADOW JACQUES ELECTRIC, INC 7450 FARRAGUT STREET HOLLYWOOD, FL 33024 COVERAGES THE POUCIES OF INSURANCE LISTED 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 POUCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POUV EFFECTIVE :INSR, ADD. LTRi TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS MADE 0 OCCUR A ❑ '❑ ❑ — - — GEN'L AGGREGATE LIMIT APPLIES PER • POLICY ❑ PROJECT ❑ LOC AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS ❑ NON OWNED AUTOS ❑ — - ' GARAGE LIABILITY ❑ ❑ ANY AUTO EXCESS/UMBRELLA LIABILITY ❑ OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? If yes, desk under SPECIAL PROVISIONS below ❑ ❑ OTHER MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVENUE MIAMI SHORES, FL 33138 Fax (954)964 -0772 POLICY NUMBER 300721 RPG 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 TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURER A: NATIONAL GROUP INSURANCE INSURER It INSURER C: INSURER D: INSURER E: INSURER F: 05/18/10 POLICY EXPIRATION! DATE (MID DIYY) LMIITS EACH OCCURRENCE DAMAGE TO RENTED 05/18/11 PREMISES (Ea occurenc e) MED EXP (My one person) DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ELECTRICAL WORK W/IN BUILDINGS 30 DAYS THE LEFT, BUT F OF ANY KIND UPON AUTHORED REP ATIVE PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP /OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) PROPERTY DAMAGE (Per accident) 4 BODILY INJURY (Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG EACH OCCURRENCE _ AGGREGATE L ❑ QRY TA ❑ ER ! E.L EACH ACCIDENT E.L DISEASE - EA EMPLOYEE; E.L DISEASE - POLICY LIMIT 1 ,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000 r 1 — — o _CERTiFICATE HER — ` CANCELLATION / _ — — i SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE 1 EXPIRATION DATE OF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL NOTICE TO THE CERTIFICATE HOLDER NAMED TO Tq..DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY INSURER, ITS AGENTS OR REPRESENTATIVES. ACORD 25 (2001108) OF RD CORPORATION 1988 v THE POLICIES OF INSURANCE USTEDDELOW HAVE BEEN ISSUED TO THE MAD NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTVYRHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ,..... -..... - e..,. ...,. <.nxt, -z <.- 7 ,-,1 7 ems - - 7--r en v s"=r ^Q'r_,+- .to.%, ....... re. • �1, • .' - •n•• — .�. •r ..� .i . C "- '.3T POLICIES-AGGREGATE O ED LIMITS SHOWN MAY HAVE BEEN REDUCED BYPAID CLAIMS. •••M• • •• pp��� • y " •, •• WM UR I.2a = TYPE OF MISURRNCE POLICY NUMBER DATE (Di@:NDD DATE mi 42TD.'YY1 LRAITS GENERAL !!nBUTY COM RC!PL e 1 .RAL t' P, !TV EACH OCCURRENCE $ -- t NtN l t11.1 U A (Ea isx:.) PR . m ce: .:II PE=ISONAL g !LNIN:.S' Y $ GEL.°_AL AGGREGATE $ GEM . AGGREGU TE UMUT APPLIES PER. PRODUCTS - COLW OP AGO $ J POLICY ■ .EEC El LOC LE UABILiri ANrAUru ALLOWNEO AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS COMBINED SINGLE LIMIT $ ALIT _ BODILY INJURY (Par perm) $ BOD&Y INAIRY (Per au:4a* $ PROPERTY DAMAGE (Per amide* $ GARAGE LIABILITY ANYAUTO AUTO ONLY - EAACCMJ T $ OTHMS THAN EAACC $ AUTO ONLY: AGCi $ EXRELIA LIABHJ7Y OCCUR ❑ CLAW/MADE EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRETORPARTNERWE OFRCERIMEISER OCCLUDED? DPE SPECIALP%mSIONS below 10637108 04/01/10 04/01/11 WC STAI X TORY LIMITS I ER E- HA $ 1 00, 000 El DISEASE- EAEMPLOYES $ 10 0 , 0 I 0 El DISEASE- POLItwLm $ , 5 0 0 0 0 0 OTHER DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BYEN IT / SPECIAL PROVISIONS AtORDTR CERTIFICATE OF L!AEIL!TY !lac! eat ®e!CE IMPACT INSURANCE SERVICES LLC PO Box 278347 Miramar, FL 33027 (954) RR5 -1RR4 JACQUE'S ELECTRIC INC. 7450 FARRAGUT STREET HOLLYWOOD, FL 33024 5 4 -96 CERTIFICATE HOLDER ACORD25 42001/08) :IAN v sT':T r.rtfo 1:SPC :$3'S ;:lc_•TS ...1R.1144 3Z3 : Ffe�'7 3Te3°�T LR T .- igTr .∎•• i ...�1. Aw. Zi 'T'! C � .M i�e. ^ i r asa is e. ._a.. v.e..ac _+ u a-a. iNie i 6_.saw s - RL i G it; i f i6. S ::6 ••• • i. ii�LI as • • r.i •• ,- .1..bS • MSL RTER C INSURER 0: .Ii iLncn CANCELLATION FCBI : National union Fire Ins DATE (IfYYYI 4/13/2010 i 131259 1 i / MIAMI SHORES VILLAGE BUILDING DEPT. 10050 NE 2ND AVENUE MIAMI SHORES, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CA LEO BEFORE THE EXPIRATION 0717E THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS VOSTrEN NOTICE TO THECERruF1CATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION ORR�P)LIABILITY OF ANY l D UPON THE INSURER. /TS AGENTS OR urN� REP RESEN7yfJyE44. 6711,0.%.0. ACORD CORPORATION 1988 Kwkp aaut.0 10 W. f ►O WsR_ ST. ► �. f130 TAX :: /23!20 0001011000 1 4 000075:00 "' LADCW TCAL CONTRACTOR bZ08£ 14 80OMA110H is lnaaaIVJ 05'L 3I813313 s3nb3vr aHVMIiOI ION Oa woo'. LOg t USIN MIAMI•DA OOU IR 0 MUST BE PISPL,A D AT pL PURSUANT TO COUNTY CODE CHA P' WORKER /S 1 DO NOT FORWARD JACQUES ELECTRIC 7450 FARRADUT ST HOLLYW00D FL 33024 1„ 1, ��1f, 11 � tit �f�f�1��h ��l� t isal tilt tiltlAltilV2ll •THIS IS NOT A SILL -- DO NOT PAY . 172$97 2 >, qq AA . �T I RENEWAL 'J E TIC CG #�c0100017232 1728972 DOING BUS IN BADE CO FIRST+CLA88 U.S.ipOSTAGE PERM NO.231 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Mechanical Owner's Name (Fee Simple Titleholder) Own ' Address ) 1 City I 1 re State Tenant/Lessee Name E -MAIL: [ 0 Is Building Historically Designated Contractor's Address Value of Work For this Permit $ 3 — Type of Work: ❑A i ❑Al �;°� Describe Work: 10 Cn 1 1-1 z F') r)-� Notary $ Scanning $ 3 0 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. A ► '' ) V Master Permit No. 8tp 1 ( 2'^ 92 Imo 2 Tool L on m94 Job Address (where the work is being done) 1900 L�L qcfil City Mi • ill.. County Mi •-D e Zip FOLIO / PARCEL # • a. ° � NO Contractor's Company Name MCI (S POD IS II'C Phone # S L(O NO o fi PE" �s Zip Phone # YES State Certificate or R on o. E -MAIL: �cr I Architect/Engineer's Name (if applicable) Phone # F ;- Submittal Fee $ - Permit Fee $ CCF $ 1 •tO CO /CC Training/Education Fee $ ,no Technology Fee $ - 40 Zoning $ Radon $ DPBR $ ❑ Repair/Replace pi) /V' En5A r M X79 24 MO 13Y :.. . .. OW-ail -82y y Certificate of Competency No. Square / Linear Footage Of Work: f ❑ Demolition Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 51.0 See Reverse side -5 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 Ali 14I)AVIT: 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: promise in g ood whose prope rty for the first 1 inspection wil 11 -% %arm / \ ic or . t / Contractor The foreg • g inst t was acknowledged before me this al The foreg u g instrument was acknowledged before me thi day of '/ 20 1, by V n2 4 , day o � 2010, by hd VC o is , onally known to me or who has producC who is personal' known to me or who has produced as identification and who did take an oath. Signature th t ' subjec pection not be app to att ich oved NOTARY PUBLIC: Sign: Print: My Commiss * * * * ** * * * ** / / 0 69 MY COMMISSION 4 GD4413114 EXPIRES: April 19, 2014 (Revised 02/08/06) itkft APPLICATION APPROVED BY: a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must t a co of the notice of commencement and construction lien law brochure will be delivered to the person hment. Also, a certified copy of the recorded notice of commencement must be posted at the job site curs seven (7) days after the building permit is issued In the absence of such posted notice, the a reinspection fee will be charged As identification and who did take an oath. NOTARY PUBLIC: Sign: Print Engineer Zoning My Commission Expires: S:a, e N 0011 9 1 1. ° Plans Examiner Inspection Number: INSP - 144206 Scheduled Inspection Date: August 05, 2010 Inspector: Perez, JanPierre Owner: LONGMAN, THOMAS Job Address: 1200 NE 95 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MARS POOLS Building Department Comments August 04, 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 pr f- 5- to- 9 Lto Permit Number: MC -5 -10 -929 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Pool Heater Phone Number (305)892 -8598 Parcel Number 1132060144110 Phone: (954)214 -2844 POOL HEAT PUMP ( SUPPLY & INSTALL) I Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 5 of 21 08-05-'10 06:16 FROM- nspection Number: INSP - 144201 Permit Number: PL -5- 10-927 Inspection Date: August 04, 2010 Inspector: Hernandez, Rafael Owner: LONGMAN, THOMAS Job Address: 1200 NE 95 Street Miami Shores, FL 33138- Project <NONE> Contractor: MARS POOLS Building Department Comments POOL PIPING AND EQUIPMENT INSTALLATION FOR NEW POOL Passed Re- Inspection Fee Failed Correction Needed No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments &MI/3MA* AWL- c Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone; (305)795 -2204 Fax: (305)755 -8972 For Inspections please call: (305)762 -4949 T -049 P003/006 F -580 5Foo- Grzo Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Pool - Private Phone Number (305)892 -8598 Parcel Number 1132060144110 Phone: (954)214 -2844 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Plumbing Owner's Name (Fee Simple Titleholder) 0111 L 60) g 01 (4 0 Owner' Address a City 1 ` I i �✓VI i UPS State C� Tenant/Lessee Name Phone # E - M A I L : L o r 9 1') me '•-■ tom I� (Y 1 C0 Job Address (where the work is being done) 1, ©0 G ciS 5/tee 71 City Miami hores 71.,! L County Mi ami - FOLIO / PARCEL # I1 D V , . t4 t Is Building Historically Designated YES NO Contractor's Company Name ni ( I "Inc Contractor's Address S DS Ai. a Cit 500 in I' State FL-- Qualifier Name State Certificate or Registration No. � C , q S 7 E -MAIL: Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ F6OO t O V Type of Work: A ddition ❑Alterati [ Tew ❑ Repair/Re A Demolition Describe Work: T 00 ( m l ( � I ✓' S (� i Y)O7 Pr T OD 1 f t i I Submittal Fee $ Notary $ Scanning S • 0 0 Bond $ Structural Review. $ Permit Fee $ 02, CCF CCF $ ! • cc 0/ n/ Technology Fee $ a 4 U Training/Education Fee $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Zip Permit No. Master Permit No. Phone # 3 O ST 7 7 5q( 6, 33i Zip 3 32 Phone # "l - q~' ? / ` -d 2 `f Zip 3 3 51 Phone # J Radon $ DPBR $ Zoning $ Code Enforcement $ Double Fee $ Total Fee Now Due $ See Reverse side - 1 3©""/ A`1 ZZ 4 Mg Certificate of Competency No. Square / Linear Footage Of Work: 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: promise in goo whose property for the first ins inspection will Signature The fore day of d fa that subject to ection whi of be appr who is is known to me or who has produced NOTARY PUBLIC: Sign: Print. My Commis * * * * * * * * * ** APPLICATION APPROVED BY: (Revised 02/08/06) A , ondition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must copy of the notice of commencement and construction lien law brochure will be delivered to the person attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site oc rs seven (7) days after the building permit is issued In the absence of such posted notice, the %j # a rei -ction fee will be charged \ t t as ackno ledged before me this g/ 20/0, by OM JJ LNDOLYN li STE lull u)rDJSSION H DD961986 ires April 19, 2014 Notary Discount Assoc. Ft As identification and who did take an oath. Signature 1A /�� Contractor The forego' g instrument w acknowledged before me thi4' day of 20 by who is personally ,. own to t e or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: �• { . e4*, !arty � L My Commission Expires: 50. b ra • - .�l',�l'f - , 1 � an e�r,,,,� S Examiner Engineer Zoning The foltowing pages were originally attached to plans with the following permit T)PP -JO- 9c=a/40 84. Map /Panel Number 1202500093 B5. Suffix J 66. FIRM index Date 7/17/95 B7. FIRM Panel Effective/Revised Date 3/2/94 - 88. Rood Zones) 89. Base Flood Elevation(s) (Zone • AO use base flood depth) 13.00T U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE IFICATE e era a aitirgement Agency National Flood Insurance Program Important: Read the instructions on pages 1 - 8. A1. IlLi Name A2. Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1200.N.E. 95TH ST. mai A . P o rty Description (Lot and Block Numbers Tax Parcel Number, Legal Description, etc.) LOT ( J , BLOCK. 85, PB l'0 :iTAT W AGE 37 Conversion/Comments N/A a) b) c) d) e) 1) g) Top of bottom floor (including basem ent, crawl space, or enclosure floor) Top of the next higher floor Bottom of the lowest horizontal structural member (V Zones only) Attached garage (top of slab) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment in Comments) Lowest adjacent (finished) grade (LAG) Highest adjacent (finished) grade (HAG) SECTION A- PROPERTY INFORMATION ')o.`Irisurance Company Use: 09 -417 State ZIP Code SHORES FLORIDA 33138' A4. Building Use (e.g., Reside ttla tlo -it sident1q , Addition, Accessory etc.) RESIDENTIAL t A5. Latitude/Longitude: Lat. 51 x +5.60 Long. W80 10 r z,' . / ii " Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A6. Attach at least 2 photographs of the building lithe Certificate Is being used to obtain flood insurance. A7. Building Diagram Number 8 _ A8. For a building with a crawl space or enclosure(s), provide: A9. For a building with an attached garage, provide; a) Square footage of crawl space or enclosures) 2, 352 sq ft a) Square footage of attached garage 320 sq.ft b) No of permanent flood openings in the crawl space or 1 b) No. of permanent flood openings in the attacbp garage enclosure(s) walls within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b 1, 0U8 sq in c) Total net area of flood openings in A9.b N /A '• sq in SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION . B1. NFIP Community Name & Community Number VIL �G • ° I I 4. :OR. 120652 B2. County Name MIAMI - DADE B3. State FLORIDA 310. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. - ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe) B11. Indicate elevation datum used for BFE In Item B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes © No Designation Date ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. . C2. Elevations -Zones A1-A30, AE, AH, A (with BFE), VE, V1 V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 A30, AR/AH, AR/AO. Comp lete Items C2.a -g below according to the builcgn %lagram specified in item A7. Benchmark Utilized Vertical Datum NGVD 10.90 feet • • M feet NlA ® feet -9"° 5 n feet 9 60A feet 9.34 ® feet 9.50 feet Check the measurement used. SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by taw to certify elevation information. r certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under /8 U.S. Code, Section 1001. ® Check here if comments are provided on back of form. Certifier's Name ADIS N. NUNEZ Title • • REGIS RED LAND SURVEYOR Address 555 No SHORE DRI FEMA Form 81 -31 Fahniary 9nf1R Company Name • BLANCO SURVEYORS, INC. CA CI State ZIP Code BEACH FL 33141 License Number Telephone (305) 865 -1200 • Coo rovorco chip fnr cnntini infirm OMB No. 1660 -0008 Expires February 28, 2009 ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) i Raniaroc all nravir,i is crlitianc :forinsurance Company Use: Policy Number Company NAIL Number a IMPORTANT In these spaces, copy the corresponding infonnation from Section A. Building Street Address (Including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 1200 N.E. 95TH ST. City MIAMI SHORES Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments CROWN OF ROAD ELEVATION: 10.09' ON CENTERLINE ON CENTER OF ROAD A/C ELEVATION : 10.15' ON SOUTH_ SIDE OF RESIDENCE. S ION E - BUILDING ELEVATION INFORM ATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR -F request, co mplete Sections A, B, and C. For Items E1 -E4, use natural grade, if available. €heck the measurement used. In Puerto Rico only, enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawl space, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawl space, or enclosure) is _ ❑ feet ❑ meters 0 above or ❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Sectio A Items 8 and /or 9 (see ggge 8 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is . ❑ feet meters [] above or LI below the HAG. E3. Attached garage (top of slab) is 0 feet.[] meters ❑ above or 0 below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is 0 feet 0 meters 0 above or ❑ below the HAG. E5. Zone AO only If no flood depth number is available, is the top of the bottom floor elevated In accordance with the community's floodplain management ordinance? ❑Yes 0 No ❑ Unknown. The local official must certify this information in Section G. • Signs The property owner or owner's authorized representative who completes Sections A,13, and E for Zone A (without a FEMA issued or- community-issued BFE) or Zone AO must sign here. The statements In Sections A, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address Signature Comments Local Official's Name Community Name Signature Comments - FEMA Form 81 -31, February 2006 State FLORIDA SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) TOR ELEVATION: 9.60' ON SOUTH SIDE OF RESIDENCE. Date . 7 24/09- SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION City Date Telephone SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance-to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8. and G9. GI. 0 The information ih Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA issued or community- issued BFE) or Zone AO. G3. ❑ The following Information (Items G4. -G9.) Is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance /Occupancy Issued G7. This permit has been issued for. ❑ New Construction 0 Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum Title Telephone Date 33138 ZIP Code State ZIP Code ❑ Check here if attachments ❑ 'Check here if attachments ❑ Check here if attachments Replaces all previous editions Main Net Mesh Size: Braid: Net Braid Tension Lines Nylon Pulleys Net Strength: Expected life: Installation Fittings Surface Mount Plates Flush Mount Anchor Hook Alternate Anchors KY SQfe Pool Nets. Product Specifications 3.5 Inches (Required to meet ASTM 1346 -91 Standards) 100% Polyethylene with UV inhibitors built in, for prolonged lifespan %4 Inch 3/8 Inch 2 % Inch Body Length Pulley Wheel, 1 Inch diameter, 5/16 Inch width Tested up to 4851bs for ASTM 1346 -91 standard Between 7 to 10 years 3.5 inch plate with two anchor positions and two screw holes Glass filled nylon for increased resistance to sun and chemicals Available in Grey, Terra Cotta and Beige (cream) 3 /4 inch diameter barrel with flanges 1.5 inch depth Brass or Glass filled nylon for increased resistance to sun and chemicals Available in Grey, Terra Cotta, Beige (cream) and Brass 4mm Stainless Steel wire hook '/4 inch x 2 inch Stainless Steel eye bolts '/4 inch Stainless Steel drop anchors Stainless Steel S- hooks (Gate hook), min .141 x 1.5 inch 3101 SW 3RD AVENUE • FORT LAUDERDALE, FL 33315 -3317 • TOLL FREE1- 866. 463 -5700 • FAX: 954-760 -9973 WESSrrE: www.kidsafepoolnets.com MEMBER MUM 11AV -21 - 2002 12:41 PM APPLIED April 11, 2001 Mr. Kim Nothard President Kid Safe Pool Nets 215SW14Way Fort Lauderdale, FL 33312 RE: L/N 30137 Dear Mr. Nothard: This letter is regarding the safety testing of your Pool Safety Net. As you know, this test program has been successfully completed. The safety net was tested to assure compliance with ASTM F-1346-91, Standard Performance Specifieation for Safety Covers and Labeling Requirements for All Covers for Swimming Pools, Spas and Hot Tubs" and the work was performed under the above referenced ARL file number. The model that was tested and found to comply with the standard is trade -named "Kid Safe." This letter will serve as confirmation that these units are Listed by ARL effective March 20, 2001 and you are authorized to label your products with the ARL Listing Mark. Your Certification Report and Follow-up Service Procedure are in the process of being finalized and will be forwarded to you upon completion. If you have any questions, please do not hesitate to contact ARL. Cordially, Alan B. S Director of Engineering ABS /tn KIDSRFE RESEARCH LABORATORIES 5371 N.W. 131st STREET • MIAMI, FLORIDA 33014-8223 Website: www.atl test.aom • EmelI: arltest4ael.com PH. (305) 824.4800 • FAX: (305) 624.3652 TESTING FOR CONSUMER SAFETY 954 5234159 P.02 FAX: (954) 52341W:: :;J Safe WARNING fR l = - RIS 1 .866.463.5700 www.kids = ooinets.com Pool Nets. THIS MANUAL SAFETY COVER COMPLIES WITH ALL S MAR • SPECIFIED BY ASTM DESIGNATION F134541 • REMOVE COVER COMPLETELY BEFORE ENTRY OF BATHERS ENTRAPMENT POSSIBLE • NON- SECURED OR IMPROPERLY SECURED COVERS ARE A HAZARD • FAILURE TO FOLLOW ALL INSTRUCTIONS MAY RESULT IN DROWNING OR INJURY KEEP WATER LEVEL 5" BELOW NET PLEASE INSPECTTHIS SAFETY NET MONTHLY FOR PREMATURE WEAR AND TEAR OR DETERIORATION. Performance Reliability 7echuologi AE3000 H EAT PUMPS Ecological & Efficient Air Energy Heat Pumps Keep your heating expenses down and your pool warm all year with Jandy Air Energy heat pumps. Heat pumps simply take the heat from the air and transfer it to the water — making the heating process clean, efficient, and most of all, cost effective. Jandy's advanced controls make operating the AE -Ti heat pumps easier than ever. Enjoy your pool more often, knowing you've chosen the cleanest and most efficient heating method on the market. *Requires remote mounting kit R3009600 **Available on AE2500 and AE3000 models ADVANCED CONTROLS PATENTED FEATURES EFFICIENT DESIGN AUTOMATION READY The control panel features can be accessed at the heat pump or moved* to your home, cabana or patio. Add additional panels to control your heat pump from wherever you find most convenient. Our patented Maintain Temperature feature keeps water at set point temperature automatically, 24 hours a day, by overriding the pool time dock. Keep your pool comfortably warm 24/7 with this convenient feature. Air defrost allows the heat pump to operate at lower air temperatures. The optional hot gas defrost/chiller feature allows AE -Ti to to heat your pool when temperatures drop as low as 38,° and cool your pool during the hottest summer months.** The optional AUTOHP Kit provides complete pool to spa automation with the touch of a button from your conveniently located control system. Jandy Air Energy heat pumps are the most efficient, trouble - free swimming pool heat pumps in the industry. Heat pumps simply take the heat from the air and transfer it to the water — making the heating process clean, efficient, ecologically safe and most of all, cost effective. UPGRADED ENHANCED' Advanced Digital Controls Our advanced controls are designed to precisely and conveniently check temperatures and adjust settings. Titanium Heat Exchanger Has a lifetime warranty against corrosion and delivers superior hydraulic flow. Automation Ready Allows easy connection to Jandy Controls and other pool /spa automation systems, automatic valve systems, and remotes, or utilize the automation features with the AUTOHP Kit, which includes two JVAs and a remote mounting panel. Commercial Grade Compressor Our improved scroll compressor provides higher heating capacities and is the quietest and most efficient on the market. Air Defrost Allows the heat pump to operate at lower air temperatures. Extra -Large Evaporator Coil Our special lanced -fin design collects more heat as the outside temperature starts to drop. Durable Polymer Cabinet Rust and corrosion free for life. Utilize Air Energy to Heat Your Pool AE -Ti HEAT PUMPS AE3000 SPECI'FC.A BTU/hr* Output C.O.P. Voltage Supply Circuit Compressor Heat Exchanger Flow Rate G.P.M. Dimensions (in.) Weight (Ibs.) 135k 5.92 208V-230V/1/60 50 AMPS Scroll Titanium** 30 -125 Optimum 33" W/ 42" H/ 41" D 410 * Tested and Certified according to the 80 -80-80 standard ** Corrison -Free Technology not affected by chemical imbalances and/ or chlorine generators Impressive Warranty All Jandy heat pumps are backed by a highly trained technical support department, and by some of the strongest and most inclusive warranties in the industry. See our written warranty for complete details. CERTIFICATIONS oC. , Our Heat Pumps are ETL tested to us UL specifications Pumps • Filters • Heaters • Heat Pumps Controls • Lights • Water Purification Systems • Valves Water Features • Cleaners • Accessories 1.707.776.8200 • vwvw.iandy.com • info @jandy.com • ©2007 Jandy Pool Products, Inc. ALL JANDY PRODUCTS WORK SEAMLESSLY TOGETHER Jandy Control Systei Tis manage our complete line of technologically advanced products. \PSP NOT VALID UNLESS EMBOSSED WITH SURVEYOR'S SEAL 1 , ++- ✓,. *r te i HEREBY CERTIFY That the survey represented thereon meets the minimum technical requirements adopted by the STATE OF FLORIDA Board of Land Surveyors pursuant to Section 472.027 Florida Statutes. There are no encroachments, overlaps, easements appearing on the plat or visible easements other than as shown hereon. ADIS N. NUNEZ REGISTERED LAND SURVEYOR STATE OF FLORIDA #5924 DATE: 7/24/09 SINCE 1987 BLANGO SURVEYORS INC. Engineers • Land Surveyors • Planners • LB # 0007059 555 NORTH SHORE DRIVE MIAMI BEACH, FL 33141 (305) 865 -1200 Email: blancosurveyorsinc@yahoo.com Fax: (305) 865 -7810 FLOOD ZONE: AE • PANEL: 0093 SCALE: 1 ° =20' DWN. BY: F. Blanco SUFFIX: j COMMUNITY # DATE: /17/95 BASE: 8 ' 120652 // erN SCALE: 1 "= L =3363' R= 25.00' 1 F.I.P. 1/2" (NO l.©.) 23.25' F.I.P. 1/2" (NO 1.D.) LLLLLLLLLL_LLLLLLLL LLLLLLLLLLLLLLLLL LLLLLLLL ' LLLLLLLL LLLLLLLLLLLLLLL LLLLLLLLLLLLLLLL I_LLL_ LLLLLLLLL L_ LLLLLLLLL�L'I PLANTER 31.00' 21' PARKWAY N LK G WA 13.60' 22.25' 1' CBS WALL WOOD F. �~ F.I.P. 1/2" (NO I.D.) LOT 16 BLOCK 85 ELEVATION BASED ON LOC. # 3250 S CBM# B -62 ELV. 8.74' TYPE OF SURVEY: BOUNDARY SURVEY SURVEYOR'S NOTES: 1) OWNERSHIP SUBJECT TO OPINION OF TITLE. 2) NOT VALID WITHOUT THE SIGNATUF'E AND RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 3) THE SURVEY DEPICTED HERE IS NOT COVERED BY PROFESSIONAL LIABILITY INSURANCE. 4) LEGAL DESCRIPTION PROVIDED BY CLIENT. 5) UNDERGROUND ENCROACHMENTS NOT LOCATED. 6) ELEVATIONS ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM OF 1929. 7) OWNERSHIP OF FENCES ARE UNKNOWN. 8) THERE MAY BE ADDITIONAL RESTRICTIONS NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. c,) CONTACT THE APPROPRIATE AUTHORITY PRIOR TO ANY DESIGN WORK FOR BUILDING AND ZONING INFORMATION. 10) EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THIS PROPERTY. BEARINGS WHEN SHOWN ARE REFERRED TO AN ASSUMED VALUE OF SAID PB PAGE LOCATION SKETCH SCALE: NTS LEGAL DESCRIPTION: LOT 17 OF MIAMI SHORES BEACH VIEW ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK OF THE PUBLIC RECORDS MIAMI —DADE COUNTY, FLORIDA N.E. 95th STREET 151413 ABBREVIATIONS; SWK= SIDEWALK, CBS = CONCRETE BLOCK STRUCTURE. CLF=CHAIN LINK FENCE, PL =PROPERTY LINE, DUE =DRAINAGE UTILITY EASEMENT, IP "lRON PIPE, F =FOUND, A/C =AIR CONOmONER PAD, P/C =PROPERTY CORNER, D/H=DRILLED HOLE, W/F= WOODEN FENCE. RES =RESIDENCE, CL- CLEAR. RB= REBAR, UE= UT,UTY EASEMENT CONC=CONCRETE SLAB. RA/WRIGHT OF MY, DE= DRAINAGE EASEMENT C/L= CENTER LINE, 0 =DIAMTER TYP =TYPICAL, M= MEASURED, R =RECORDED. ENCR =ENCROACHMENT, COMP =COMPUTER, ASH =ASPHALT, N/D =NAIL & DISC, S =SET, FEE =FINISH FLOOR ELEVATION, O /S= OFFSET, P/P =POWER POLE. OHP=OVERHEAD POWERLINE. WM =W4 TER METER WOOD FENCE= MASONRY NWLL = CONCRETE= MAINTENANCE & DRAINAGE EASEMENT= M & D.E SURVEY FOR: TOM LONGMAN, 1200 N.E. 95TH ST., MIAMI SHORES, FLORIDA 33138. BLOCK 85 SUBDIVISION AT PAGE 37