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BPP-10-128Inspector: Bruhn, Norman Project: <NONE> Contractor: CAIBAI CONSTRUCTION LLC Building Department Comments June 15, 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- 146132 Permit Number: BPP -1 -10 -128 Scheduled Inspection Date: June 16, 2010 Permit Type: Pools/Whirlpools /Hot Tubs Inspection Type: Final Building Owner: MORRIS, BRADLEY Work Classification: New Job Address: 76 NW 97 Street Miami Shores, FL 33150- For Inspections please call: (305)762 -4949 Phone Number Parcel Number 1131010330360 Phone: (786)229 -2770 installation of new pool and pavers deck Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 16 of 20 installation of new pool and pavers deck t24.,) 66 ((o Inspgct �i ) m m r (rU, l , ! ;� A • ,I, ,„ , ._ , Passed Failed Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspection Date: January 01, 2999 Inspector: Dacquisto, David Owner: MORRIS, BRADLEY Job Address: 76 NW 97 Street Miami Shores, FL 33150- Project: <NONE> Contractor: CAIBAI CONSTRUCTION LLC Building Department Comments June 08, 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 - 145659 Permit Number: BPP -1 -10 -128 I For Inspections please call: (305)762 -4949 Permit Type: Pools/Whirlpools /Hot Tubs Inspection Type: Survey Final Work Classification: New Phone Number Parcel Number 1131010330360 Phone: (786)229 -2770 Page 1 of 1 LEGEND. FRO - FOUND CM - CONCRETE NONWENT IR - IRON R00 IP - IRON PIPE R/1 - RIGHT OF WAY PDS - POINT OF BEGINNING POC - POINT OF COMMENCEMENT PC - POINT OF CURVE POC - POINT ON A CURVE - CHAIN LINK FENCE / -- WOOD FENCE PS- PLAT BOOK P- PAGE M - MEASURED 0 - DEED R - RADIUS A - ARC 0 • CENTRAL ANGLE C • CHORD X.XX ELEVATION --I---1- NON- VEH1QLAR ACCESS LINE - CONCRE co —S) rn -U- • OVERHEAD LINE 0 • MAMOLE 2f: t3 - CATCH BASIN - TREE LEGAL DESCRIPTION LOT 13 EiLitv , emmzmnl mzEmll Eram 19,0' .. Ya ,.� POOL .. . r • t. 7.0' R .. I IM i 6' iii Y ii i to .. Y M.. WIN ∎M ∎iiiii •■ 1 ` a t i.I ii .. i■ ii! .. i 1 t� .. IIIIII Y w- .. .. ii .. .a 1 .. Mil .. =i s t 6. .. MIN ON—ii■ iiiiii —iii .li iii iiii ii (i ■ ii ii • WOMB ii i tii iiiiiiii i i TM IMMMIIMMIM 1,=111111i11111. 12.7' 2 STORY RES■ 76 CBS 24.6' 16.45' 18.5' SPECIAL PURPOSE BOUNDARY SURVEY PND 1/2' IP ammal Fa 1/2' IP • 7.0' PAVEMENT 50.0' 5.0' SWY SKETCH OF SURVEY SCALE' 1° - 20' GENERAL NOTES 1) BASIS OF MARINO. AS PER PLAT 2) ELEVATIONS SHOWN HEREON ARE RELATIVE TO NATIONAL GEODETIC VERTICAL OATUMIN.G.V.0.) 3) LOCATION 00 IDENTIFICATION OF UTILITIES 01 AND/OR ADJACENT TO THE PRGPERTY WERE NOT SECURE AS SUCH INFORMATION WAS NOT REQUESTED. 4) NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND ' 5) THIS SURVEY IS NOT INTENDED FOR CONSTRICTION PURPOSES 8) ENCENTS AND VIOLATIONS ON SURVEYtIF ANY). LOT 12 IN BLOCK 130 OF MIAMI SHORES SECTION 6, ACCORDING TO THE PLAT THEROF AS RECORDED IN PLAT BOOK 10. AT PAGE 39 OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY FLORIDA. 15.0' ALLEY 110 1/2' IP FAD 1/2' IP -C NW 97 STREET--------- - - - - -- 20.0' PAVEMENT THE PURPOSE OF THIS SURVEY IS TO SHOW SETBACKS OF NEW POOL JULIO S. PITA. P.L.S. PROFESSIONAL LAND SURVEYOR LICENSE NO. PSM 5789 STATE OF FLORIDA LOT 11 ELK 130 CERTIFICATION OF BOUNORY SURVEY. I HEREBY CERTIFY TN RESPONSIBLE CHARGE AND BELIEF =T STANDARD SE' FO LAND �' C CODE HIS HIS SURVEY WAS MADE UNDER MY 0 THE BEST OP MY KNOWLEDGE MEETS THE M I NI MUM TECHNICAL BY THE BOARD OF PROFESSIONAL T-- 61017-6 FLORIDA ADMINISTRATIVE T 472.027. FLORIDA STATUTES. J.S.P. SURVEYORS, INC. LAND SURVEYORS LB ■ 6971 7605 CORAL WAY. SUITE 116A MIAMI. FLORIDA 33155 PHONE. 1786) 236 8344 SECTION: 27-55-41 I COUNTY: DADE CERTIFIED TO BRADLEY MORR I S 76 NW 97 STREET. MIAMI SHORES. FL 33150 DATA 3/9/10 I REF: 10 - 03 - 06 LiP�( :OL 10926 ,,S Gi I j928 dun 617/2010 'I 3 :16 :54 AM installation of new pool and pavers deck ra) 6(?/; 0 Passed Inspector Comments f Y � t . ,, �� ` a = "`� - - = �' I Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until inspection Number: INSP - 145659 Permit Number: BPP -1 -10 -128 J Inspection Date: January 01, 2999 Inspector: Dacquisto, David Owner: MORRIS, BRADLEY Job Address: 76 NW 97 Street Miami Shores, FL 33150- Project: <NONE> Contractor: CAIBAI CONSTRUCTION LLC Building Department Comments June 08, 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 Parcel Number 1131010330360 Phone: (786)229 -2770 Page 1 of 1 C27 Co LEGEND' FND - FOUND CM - CONCRETE MONUMENT IR - IRON ROO IP - IRON PIPE R/W - RIGHT OF WAY POB - POINT OF BEGINNING POC - POINT OF COMMENCEMENT PC - POINT OF CURVE POC - POINT ON A CURVE — — CHAIN LINK FENCE — 1--- MOOD FENCE PS - PLAT BOOK P - PAGE M - MEASURED 0 - DEED R • RADIUS A • ARC A • CENTRAL ANGLE C - CHORD X.XX ELEVATION NON- VEHICULAR ACCESS LINE - CRETE -U- • OVERHEAD L1NE 0 E Z TREE O;- CATCH BASIN LWJ — 1 -1— LEGAL DESCRIPTION LOT 13 BLK 130 FAO 1/2' IP itIL— FAG SPECIAL PURPOSE BOUNDARY SURVEY 1 (•) 7.0' PAVEMENT 50.0' SKETCH OF SURVEY SCALES 1° • 20' GENERAL NOTES" 1) BASIS OF BEARING. AS PER PLAT 2) ELEVATIONS SHOWN HEREON ARE RELATIVE TO NATIONAL GEODETIC VERTICAL DATUM(N.G.V.D.) 3) LOCATION AND IDENTIFICATION OF UTILITIES ON AND/OR ADJACENT TO TFE PROPERTY WERE NOT SECURE AS SUCH INFORtATION WAS NOT REOESTED. 4) NOT VALID WITFAIUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 51 THIS SURVEY IS NOT INTENDED FOR CONSTRUCTION PURPOSES B) ENCROACHMENTS AND VIOLATIONS ON SURVE Y(IF ANY H i 112- IP 10.05' I III MI 14.0' :. L--/ A. . PM: MI 1111 is P001. .. 16.45' A. M i. • �� " 18.5' A. ° . 7.0' v .r. m 6' �. I' ice r. m! SV . PDOL ♦j t� G� INIM EfHJI: ��� �� v :. 12.3' ,�.I� �C o :. 1D — Ns = := Ai AI e� =i IIIIIIIMIIIIMMIM NW= MR MIMEO == l__ M ... 10.0' 2 STORY RES • 76 CBS 37.0' SWY 14.5' 15.0' ALLEY -C NW 97 STREET -- 20.0' PAVEMENT LOT 12 IN BLOCK 130 OF MIAMI SHORES SECTION 6. ACCORDING TO THE PLAT THEROF AS RECORDED IN PLAT BOOK 10. AT PAGE 39 OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY FLORIDA. cs FND 1/2• IP FAD 1/2 1P THE PURPOSE OF THIS SURVEY IS TO SHOW SETBACKS OF NEV POOL. CERTIFICATION OF 1 HEREBY CERTIFY RESPONSIBLE AND BELI ST LAND CODE • JULIO S. PITA. P.L.S. PROFESSIONAL LAND SURVEYOR LICENSE NO. PSM 5789 STATE OF FLORIDA liwwwwwwww■wmonwewsi SECTIOra: 27-55-41 COUNTY' DADS CERTIFIED To: BRADLEY MORRIS LOT 11 BLK 130 J. S.P. SURVEYORS. INC. LAND SURVEYORS LB ■ 6971 7805 CORAL WAY. SUITE 116A MIAMI. FLORIDA 33155 PHONE, (786) 236 8344 BOUNORY SURVEY. T THIS SURVEY WAS MADE UNDER MY TO THE BEST OF MY KNOWLEDGE Y MEETS THE MINIMUM TECHNICAL H BY THE BOARD OF PROFESSIONAL • 'N M ' 61017 -6 FLORIDA ADMINISTRATIVE C 472.027. FLORIDA STATUTES. 76 NW 97 STREET. MIAMI SHORES. FL 33150 DATE' 319/10 I REF: 10 -03 -06 p DvG:GL 10928 SG L 2010'11:16 :5 AM Inspection Number: INSP- 134289 Permit Number: BPP -1 -10 -128 Scheduled Inspection Date: March 22, 2010 Inspector: Bruhn, Norman Owner: MORRIS, BRADLEY Job Address: 76 NW 97 Street Project: <NONE> Contractor: CAIBAI CONSTRUCTION LLC Building Department Comments installation of new pool and pavers deck Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Videctox ilLAciver March 19, 2010 Miami Shores, FL 33150- 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: Wall Steel Work Classification: New Phone Number Parcel Number 1131010330360 Phone: (786)229 -2770 Page 4 of 26 LEGEND FND • FOUND CM - CONCRETE MONUMENT IR - IRON ROD IP - IRON PIPE R/W - RIGHT OF WAY POB - POINT OF BEGINNING POC - POINT OF C01!)ENCEMENT PC - POINT Of CURVE POC - POINT ON A CURVE -z -- CHAIN LINK FENCE - - MOOD FENCE PB - PLAT BOOK P - PAGE M - MEASURED 0 - DEED R - RADIUS A - ARC 9 - CENTRAL ANGLE C - CHORD K.XX ELEVATION -I -1- MY-VEHICULAR ACCESS LIME -U- • DVERREAD LINE 0 - MANHOLE CB - CATCH BASIN j../ TREE C'';Diawi F`s - CONCRETE LEGAL DESCRIPTION LOT 11 111.K 139 . F71 f IP)ND I0) Isar :20 3:28:47 P€°A SPECIAL PURPOSE SURVEY 12.3' 7.0' Asp 15' ALLEY _1 20.1' ' _ • . •. 59.8' r X -.-� X C.L.F. 2 STORY REST 76 CBS 37.0• 24.9' 5.0' SWY SKETCH OF SURVEY SCALE. 1° • 20' GENERAL NOTES. I) BASIS OF BEARING. AS PER PLAT 2) ELEVATIONS SHOWN HEREON ARE RELATIVE TO NATIONAL GEODETIC VERTICAL OATUNRN.G.V.0.) 3) LOCATION AND IDENTIFICATION OF UTILITIES ON AND/OR ADJACENT TO THE PROPERTY WERE NOT SECURE AS SIGH INFORMATION WAS NOT REQUESTED. 4) NOT VALIO WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER. 5) THIS SURVEY I5 HOT INTENDED FOR CONSTRUCTION PURPOSES S) EN ROACHWENTS AND VIOLATIONS ON SUAvEYRIF ANY/. LOT 12 IN BLOCK 130 OF MIAMI SHORES SECTION 6, ACCORDING TO THE PLAT THEROF AS RECORDED IN PLAT BOOK 10. AT PAGE 39 OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY FLORIDA. 8.5 9 FND I/2 IPLNO ID) FND I/2- IP)NO ID) N11 97 STREET t 28.8' PAVEtENT I - — - — - — - — THE PURPOSE OF THIS SURVEY IS TO REFLECT THE SETBACKS OF PROPOSED POOL DA's: 3/9/ 10 LOT 13 8LK 138 CERTIFICATION OF BOUNORY,SURVEYI I HEREBY CERTIFY THAT TH15 SURVEY WAS MADE UNDER MY RESPONSIBLE CHARGE AND TO BEST OF MY KIRINLEO&E AND BELIEF, THIS SURVEY STANDARDS AS SET ORTH LANG SURVEY CODE PURSUAN JULIO S. PIT PROFESSIONAL L M SURVEYOR LICENSE NO. PSM 5789 STATE OF FLORIDA SECTION: 27-55-41 CERTIFIED To: BRADL MORRIS REF: 10 - 03-06 • THE MINIMUM TECHNICAL BOARD OF PROFESSIONAL G17 -6 FLORIDA ADMINISTRATIVE 2 27. FLORIDA STATUTES. J.S.P. SURVEYORS. INC. LAND SURVEYORS LB • 6971 7805 CORAL WAY. SUITE 116A MIAMI. FLORIDA 33155 PHONE. (766) 236 8344 I COUNTY: DADE 76 NV 97 STREET. MIAMI SHORES FL 33150 p DWG =GL 10928 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) 1�J -f4 ® L _ t Owner's n Address r - 7 /0 W ` T" Cit �P . S k o R State Fc— Tenant/Lessee Name p Job Address (where the work is being done) - ( / C - S t City Miami Shores Village County Miami -Dade Zip ?) °.) 1 SO Is Building Historically Designated YES NO Contractor's Company Name ex/ e4/ 6,A/sr-Rye-I) ®f-) Phone # 67J6) 221 277C- Contractor's Address c 7 341.r City y //✓f / ,� State Qualifier N� L' Se- State Certificate or Registration No. e® 5'g S Architect/Engineer's Name (if applicable) Miami Shores Village r 4coyiE Building Department JA 2 ? xoi o 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 ` -.Wf 756.8972 Permit No. OPPO 1 2 lJ Master Permit No. Type of Work: DAddition Describe Work: $ Value of Work For this Permit 4 Z ( , S Q 0 — DAlteration .� °U CCF $ il �ao CO /e /23 Notary $ T F $ 4 _� Technology a n,(oi l Scanning $ Ilc-00 Radon $ Zoning Bond OS" OD I t ) 531 Code Enforcement $ Structural Plan Review'. $ ( -00 Total Fee Now Due $___lips . (Continued on opposite side) Submittal Fee S \ SO 00 Permit Fee $ WINew Zip - 3 3 1 S?) Phone # Phone # Square Footage Of Work: ( c ( ( -- S ❑ Repair/Replace ❑ 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 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 c mmencement must be posted at the job site for the first s ection which occurs seven (7) days after the building permit is issued , In the absenc' . such posted notice, the inspect' will be approved and a reinspection fee will be charged AtticrAijr" Owner or Agent III ontractor X 16 " J',di The foregoin instrument was acknowledged before me this` The foregoin instrument w acknowledged before me this ---7)---- day of `" ► ,201 by I J( M�� V g'1 day of 20 ° b ■ Y , who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. Chc 05/13/03 Signature NOTARY P Sign: ;ice. �ii? Print: � °' . i1' MY COMMIS .I. N I DD G228e j C 1 NokaN PIIbIlO Uad ®ryVdlOre My Co 1 _ � My Commission Expires: APPLICATION APPROVED BY: ��,,,/ / O 2)/4. Plans Examiner / Engineer "3/0/(d �v Zoning PERMIT # t-) MECHANICAL PLUMBING CONTRACTOR: PROJECT TYPE: STRUCTURAL FIRE IMPACT FEES HRS /DERM 10 - 12_4!) 126 OP 0/-q» BLDG =Au4-7-3-7 3 23 • • , e.:4.1. .1. • STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD ow 487-1395 1940 NORTH MONROE STREET TAMAN:A WEE FL 32399-0783 L ,0 SA JOSE A JR CAIBJlI CONSTRUCT/ON LLC 10876 SW 24TH TER MIAMI FL 33165 A JR vw .,SaliTRUCTION MUM'. " TIE 'TER _g1 • * r ` r. .. , OR -- -C ongatulatIonstifilth - lhislioaseconwrorterof the near:Ironer milUonr • - Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from archftects to yacht brokers, from boxers to barbaque restaurants. and they keep Florida's economy strong. Every day we work to improve the way we do business In order to serve you better. For information about our services, please log onto www.mytkondalicense-com. There you can find more Infomtation about our divisions and the regulations that impact you, subscribe to deparimard newsletters and learn more about the Department's irdtlatives. Our mission at the Department is: license Efficiently, Regulate Fakty. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license .11/30/2009.090142517 CGCO58065-. • thW orifigintRi% CONTRACTOR Namect4eigti*I5 CERTIFIED P 'ThIdee:ttiiil,rovisions of chapter. 489 ExpiratI.On date r AUG 31, 2010 DETACH HERE - I FS. 41 • t • CRtarnaRD =MAL COE1TRAMOR 1 4, LOBA, JOSE A JR • '- • CONSTRUCI11 70-LLC • ' - • • : • r Fa, ;ME AS REQUIRED LAW"' CGCO58065 - • 11/3.0/09 090142517 18 CERTIFIED under the provisione of Ch.48.9 ag oat,. AUG 31, 2010 L09113001439 • i STATE OF AMNESIA ACP 4 7 3 7 3 2 OF 33USINESS AND _ PROFESSIONAL REGULATION _STATE O_E_ELOSIDA,. : - DEPARTMENT OF BUSINESS BUS AND PROFESSIONAL. REGIMAT/ON CONST4.17CTION INDUSTRY LICENSING BOARD '14 EQ# L09113001439 z I. R CHARLIE' :LIEIT'S • • SECRETARY,..: .-€4.tC' Grp PRODUCER Raman Assurance In 12655 B.W. 42nd Street Naomi FL 33175 Phone (305)207-1332 IP4URED Ceiba' Cormhuclion LLC 10878 SW 24 Ter Miami, FL 33165 COVERAGES THE POLICIES OF INSURANCE LISTED WIVES EN ISSUED TO THE sauna WALLED AUOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUITEMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VNt1CH DIM CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. IHE INSURANCE AFFORDED BY THE POLLEES DESCRIBED HEREIN 18 SUa1ECT TO ALL THE TORSO. E70CWSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE MITTS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAMS. DLI TYPE LIABILITY JIcE POLICY RW DATE FEGTNE GENERAL 0 CoseetEacia. GENERAL HAuairY 00 calms MADE ❑ Dcc ui 0 0 CEI LAGGREGATELIVWRAPPLIESPET': ❑ POLICY fl PROJECT (1 LOG AUTQviome tummy E ANY AUTO . AU. OWNED Au TOS p ❑ scHEDLAED AUTOS ❑ HIREO AUTOS ❑ NON OWNED AUTOS ❑ r GARAG - E LIABILITY ❑ 0 ANY Auio 0 U OTHER EsCESSIAtaRELLA UABIJTY OCCUR 0 CLAUS MADE ❑ DffiUGTiaLz El RETENTION : EMPLOYERS' lJASI ITN ANY PROPRIETOR 1 PARTNER I EXECUTIVE OFFICER / MEMBER EXCLUDED/ Ives, describe under JSPt: eROVtSlONS Lia L CERTIFICATE MOLDER MIAMI SHORES VILLAGE BLDG. DEPARTMENT 10050 NE 2 Ave Miami Shores, FL 33138 ACORD 25 (2Obtlle)ar CERTIFICATE OF LIABILITY INSURANCE j DATE D/YY' age Fax POSAM -1343 SCP0702850 THIS CERTIFICATE IS OWED AS A NATTER OP INFORMATION ONLY ANO COQ NO RIGHTS UPON THE CERTIFICATE HER. TICS CERTIFICATE DOES NOT /UMW EXTEND OR AL. THEE INSURERS COVERN3E INsting A Western Heritage IN Et INSURER C: URER D: INSURER E INSURER F CANCELLATION T — SHOULD ALLY OF THE ABOVE ExPLIRATIOII DATE THEREOF, j 10 DAYS %TOTTEN , :,. VI-LE c..Yr. NUT FAILURE YO OF my IWZD up g$4 THE ,N AUTHORIZED intro OESR 1PnON OF OFERATIDus I LOCATIONS I vL LIES mammas PODIA) BY ESID RSC s TI swam. PROVISIONS MEO EXP (Any Ina peon) PERSONAL & ALV INJURY GENERAL AGGREGATE PRODUCl1 • CoaIPIOP ACID cCL IRWED SINGLE LSAT Es eo BODILY -INJURY person) BODILY INJURY (PereccdeM1 PROPERTY DAMAGE (Por AUTO ONLY- EAACCIDENT OTHER THIN EA ACC A EACH OCCUR AGGREGATE AUTO ONLY: E-L. EACH ACCIDENT El_ DISEASE - EA EMPLOYEE EL DISEASE - POLICY UNIT UNITS EACH OCCURRENCE 1,000,000 — 50 ,00)0 ' 5,000 1,000,000 2,000,000 1,000,000 m LID POLICIES DE cANc LLmD BEFORE - re INSURER LULL SAVOR TO MAIL CERTW1CATB HOLDER NAMED TO =Po= NO OBLIGATION OR LIABILITY MEWS OR RISIDSZeNTATrYee. Ii ACORD CORPORATION 1938 ALEX SINK STATE OF FLORIDA CHIEF FtNANCIAf_ OFR= DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CB1TIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSADON LAW ,1F CONSTRUCTION INDUSTRY EXEUPTION This certifies that the Individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE 12/09/2009 PERSON LOSA FEIN 800429597 BUSINESS NAME AND ADDRESS: CUBA' CONSTRUCTION LLC 10870 SW 24TH STREET MIAMI FL 33188 SCOPES OF BUSINESS OR TRADE 1- CERTIFIED GENERAL, CONTRACTOR IMPORTANT: Parmaat to Chapter 440. 064141, F.S., u officer of a corporation who elects exemption from this chapter by filing ■ certificate of election inter this seertoa may not recover huafirs sr campamatioa meter this eaaptar. Persoaat to Chapter 440.064121. F.L. Corti lianas of election to be exempt„ apply only within the scope of the business or trade hued earths Notice of election to be exempt Pursuant to Chapter 440.05(131, F.S., Notices of alectlaa to be snag and certificates of aledloa to be swamp shall he sabject to revocation if, at any time attar the klieg of the notice or the Issuance of the certificate, dye person lamed on Ike ounce or certificate ao leaver MOWS die ragalreaeats of this section for issuance of a certificate. The department shall revoke a eerta ate at any Una tar fathers of the parses named an the certificate to met the ragoi a meats of this suttee. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 QUESTIONS? (850) 413 -1509 EXPIRATION DATE: 12/09/2011 JOSE A JR 12 -09 -2009 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE * STATE OF FLORIDA DEPARTMENT OF FINANCIAL sERVIGEs DIVISION OF WORK COMPENSATION CONSTRUCTION IIduSTRY CERTIFICATE OF ELBCOOpt TO BE EXEMPT FROM FLORLOA WORKERS' COMPENSATioN LAW EFFECTIVE 12/09/2009 EXPIRATIONN PATE: 12/09/2011 PERSON: JOSE A LOSA dR FEIN: 800425597 BUSINESS NAME AND ADDRESS: CAWM CONSTRUCTION Lt: 10876 SW 24Trt STREET IIIAYI A. 33165 SCOPE OF BUSINESS OR TRADE 1- CERTIFIED OPRERAL CONTRACTOR j= IMPORTANT O Pursuant to Chapter 440.05(14), F.S. an officer of a corporation who elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or won under this D chapter. H Pursuant to Chapter 440.05(173, FS., Certificates of election to be R exempt_ apply only within the scope of Via business or trade listed on the notice of election to be exempt E Pursuant to Ctlapter 440.05(13), F.S, Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named an the notice or certificate no loser meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413 -1609 DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 CUT HERE • Carry bottom portion on the job, keep upper portion for your records. 1 t o COUNTY T ' TA W. � 1st FLOOR FLAMER ST. MIAMI, FL 33130 L ACALTAX COLRNf1I - STATE OF•FLORIDA EXP IRES SEPT x..2010 �TSE .AVEtLATP>ACE-OF P TOCOUNTyCODEPIAWMI8A ART. 9 & 10 6 54374 -9 THIS IS NOT A SILL — UO. NQT. PAY TRANSFER su 2 TERR ON LLC STAT�j�8Q65 484112 -9 33165 UNIN DADE COUNTY- mum. wilBAI CONSTRUCTION LLC „ nusnaiss e �_EWM BUILDING CONTRACTOR IS ONLY A DO ROT PERM' PERM' HOLDER TO VIOtsin ANY zotatta Laws Dv 1HE COUNTY an calm now IT EXEMPT TEIE non ROLM PST OR OTHER naturaavo BY LAW THIS IS NOT A CERTIFICATION OF THE maws OUALIFICA. _PAYMENT TAX 12 /11/2009 022 40002001 0 00007.50 SEE OTHER ECM WORKER /S 1 00 NOT FORWAIN, CAIBAI CONSTRUCTION LLC JOSE LOSA A JR 10876 SW 24 TERR NIANI FL 33165 6. A... 11„.. 11. 11... 1. 1... 11 1 .1.. .. ,1 .I..1i...1.11,..;t.1t FIRST -CLASS U.S. POSTAGE ! PAID MIAMI, FL - PERROT NO. 231 PERMIT #: ' 69P !O RECEIPT L-ddni (2.11/4 ontractor j2oc1/416A, ❑ •wner ❑ Architect ►v. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: QN (4 S O' PERMIT CLERK INITIAL: 'CA- M iami Shores Village Building Department DATE: 8 9-0t0 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Picked up 2 sets of plans and (other) (oi-T Address: N C 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 D men to continue permitting process. ning an Zoning Criteria 2/17/10 NEW PLAN OK Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Owner's Name: BRADLEY MORRIS Job Address: 76 97 Street Miami Shores, FL 33150- Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 1/27/2010 : Yes Comments: THE SIDE YARD APPEARS TO BE 5 FEET IN WIDTH Issue Date: Not Issued THE MINIMUM SETBACK BETWEEN THE SIDE LOT LINE AND POOL EQUIPMENT IS 10 FEET. Permit NO. BPP -1 -10 -128 � I d HotTubs WQ �tft €?dt Nevi Expires:Not Issued Folio Number:1131010330360 Owner's Phone: Total Square Feet: 445 Total Job Valuation: $ 22,000.00 Flamm a d nhig Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Owner's Name: BRADLEY MORRIS Job Address: 76 97 Street Miami Shores, FL 33150- Planning and Zoning Criteria and Comments Approved: No Comments: THE SIDE YARD APPEARS TO BE 5 FEET IN WIDTH THE MINIMUM SETBACK BETWEEN THE SIDE LOT LINE AND POOL EQUIPMENT IS 10 FEET. Permit NO. BPP -1 -10 -128 sued Expires:N ®t Issued Folio Number:1131010330360 Owner's Phone: Total Square Feet: 445 Total Job Valuation: $ 22,000.00 Date Denied: Permit No: 10 -128 Job Name: February 4, 2010 M iami Shores Vivage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Building Critique Sheet 1) Plans must be approved by HRS for the septic system. 2) Corrections for plumbing and zoning must be completed. 3) Provide a pool safety act acknowledgement form. 4) The pool design and notes are shown as 2004 FBC. The 2007 FBC is the required code in effect. 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. Norman Bruhn CBO 305 - 795 -2204 aa sm C3I 02/05/2010 17:35 FAX 1 800 685 7530 TRANSMISSION OK * * * * * * * * * * * * * * * * * * * ** * ** TX REPORT *** * * *$ * * * * * * * * * * * * * * * ** TX /RX NO 4604 RECIPIENT ADDRESS 93052256315 DESTINATION ID ST. TIME 02/05 17:35 TIME USE 00'41 PAGES SENT 1 RESULT OK Permit No: 10 -128 Job Name: February 4, 2010 Building Critique Sheet 1) Plans must be approved by HRS for the septic system. 2) Corrections for plumbing and zoning must be completed. 3) Provide a pool safety act acknowledgement form. 4) The pool design and notes are shown as 2004 FBC. The 2007 FBC is the required code in effect. 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. Norman Bruhn CBO 305 -795 -2204 DATA SCAN FIELD SERVICES Q001 M iami 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 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 76 97 Street Miami Shores, FL 33150- 1131010330360 Block: Lot: BRADLEY MORRIS Owner Information Contractors) Phone CeII Phone CAIBAI CONSTRUCTION LLC (786)229 -2770 (786)470 -4207 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 $13.20 $150.00 $4.40 $645.00 $60.00 $18.00 $150.00 ($150.00) $17.60 $1,208.20 Building Department Copy March 03, 2010 Address Parcel Number Phone Expiration: 08/28/2010 Applicant CeII Approved: Yes Comments: THE SIDE YARD APPEARS TO BE 5 FEET IN WIDTH Date Approved: 1/27/2010 : Yes Date Denied: Type of Work: Swimming Pool Additional Info: Classification: Residential Occupancy: Private Bond Retum : Invoice # Invoice Total Amt Paid Amt Due BPP -1 -10 -36907 Bond #: 1931 $1,208.20 $1,208.20 $0.00 Valuation: Total Sq Feet: For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Fence Final Pool Deck Wall Steel 2 A RECORDED COPY MIDST BE POSTED ON THE JOB STTE AT TIMg OF FIRST INSPECTUON PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA COUNTY OF DADE THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice f Commencement: 1. 2. Description 1(241_01Q c;( Le ® i21�.-, S ` >L) � ct - t S r l 3 QeS Interest in property: . Y1 e Name and address of fee simple title ' der. L)l 4. Contractor's name and address: t . * 11) j a • 5 2 CT( Q� - 7 t O I (L' 3. Owner (s) name and address: RV County r cts r c�ti RU Ji'�, LEA' , o� i ' tc9 eoun�o �N- Et IfKirlIMIIMPlompsour 5. Surety: (Payment bond required by owner from contractor, if anJ)h!EREEIY CERTIFY that tht6 is original lla, in "Iis ti /=trri Name and address: Amount of bond: $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom n ces or other d (1) (a) 7., Florida Statutes: Name and address: 8.in addition to himself, Owner designates the following person (s) to receive a copy of the Lienor's Notice as provided in Section 713. 13 (1) (b) 7., Florida Statutes: Name and address: Lion date of this Notice of Commencement (the expiration date is I year from the date of recording unless a different date is specified) Signature of Owner Print Owner's Name Sworn to and su Notary Public Print Notary's N My Commissio NOTICE OF COMMENCEMENT iption of pro rty and tt d s: • 1p-3 (P —7 (c , t�( � ° I� 7 of improvement: F2° 1 1 11 1 1 1111 1 1 1 11 1 1111111 1 111 1 1 1 11 CFN 2010R014-1 OR Bk 27200 Fs 15430 (1us) RECORDED 03/03i2410 09x07 =35 HARVEY RUVINr CLERK OF COURT MIAMI— DADE .COUNTYr FLORIDA LAST PAGE CA ( S1 Prepared by: is may be served as provided by Section 713.13 Address: 1 C A 1 R,3310s ram 1 04 KNOW ALL MEN BY THESE PRESENTS, that I, DAVID BLACK of DOLPHIN POOLS & SPAS INC at 1435 GRANT Street HOLLYWOOD FL 33020 - in consideration of the issuance to me by Miami Shores Village, Florida, of a permit or permits to construct or repair a building or buildings at the following address: 841 98 Street Miami Shores FL do hereby deposit with Miami Shores Village, Florida, the sum of: $300.00 and I agree with Miami Shores Village that, when such construction has been completed by me, within the meaning of the ordinances of Miami Shores Village, I will clear all premises and repair any Village property damaged by me, used for the deposit of material or equipment in the construction or repair and that, if I do not so clear and repair such premises immediately upon the completion of such construction within the meaning of such ordinances, the Village may clear and repair the same and pay the cost of such clearance and repairs out of the aforesaid Builder's Bond, and return the remainder to me; and that, if I shall clear and repair said property immediately, as aforesaid, then said Builder's Bond shall be returned to me. WITNESS MY HAND and Seal at Miami Shores Village, Florida this date: 03/01/2010 Signature INSTRUCTIONS TO BUILDER: When the above mentioned construction is completed and the premises are cleared and repaired, take this bond to the Village Building Inspector and obtain his approval, after which Miami Shores Village will refund your money in accordance with the above agreement. VILLAGE BUILDING INSPECTOR'S APPROVAL I hereby certify that the construction contemplated under this Bond, has been completed and that the builder thereof has caused the surrounding premises to be cleared and repaired in as good condition as they were before commencing said construction. WHEN CLEARED AND REPAIRED BY THE VILLAGE: Miami Shores Village, Florida BUILDER'S BOND Amount of Bond: $ Cost of clearing and repairs done by Village: $ Balance due Builder: $ Cancelled: By: Bond refund payable to applicant only. ($10.00 CHARGE IF BOND IS LOST OR DAMAGED) Issued: 02/26/2010 Amount: $ 300.00 Bond #: 1930 Permit #: BPP -1 -10-40 Village Building Inspector, Miami Shores Date Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 aft afraa 76 97 Street Miami Shores, FL 33150- 1131010330360 Block: Lot: BRADLEY MORRIS Owner Information Address Contractor(s) Phone Cell Phone ON CALL ELECTRICAL CONTRACTOF (786)388 - 5880 Phone BRADLEY MORRIS 76 97 Street MIAMI SHORES FL 33150 786/367 -9554 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 $0.80 $0.20 $300.00 $3.00 $50.00 ($50.00) $0.80 $304.60 Valuation: Total Sq Feet: $ 1,000.00 445 Available Inspections: 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 Pay Date Pay Type Amt Paid Amt Due Invoice # EL -1 -10 -36908 02/08/2010 Cash $ 50.00 $ 254.60 03/12/2010 Check #: 1548 $ 254.60 $ 0.00 Alarms Inspection Type: Final Light Niche Bonding March 12, 2010 Date can March 12, 2010 1 0 03 : 100Namplawft . =AWE Cr ELOMA. • as' ONNMEN (1F MOM ire Et -Maw NSW Etinsigi WORM elitntmlums * eeitties Oat Ss %Valid Wed taker has bb urn eilla Rift SIMMS NAME AM) Alinegga CPS CALL Efammegg. Mamma INC PS Mr law* MAW FL 881118 MORO OF 011inon OR Team a .�dr.ar��ee.�ie.rt,ael,f�, Os i.. + ; mod do Coe =Ms* AM tom ems no Stleitionals tit ° � IMO ffit 0 Ns OBlr .. Ai 0100001 e at am's* at MB OM 21 fklian � aa p mks 1 Congtatutafionsi With this ROME& you become one of the nearly one nation Floridians licensed by the Department of Business and Professionat Regulation. Our professionals and businesses range from architects to yacht brokers. *um boxers th berbeque restaurants. and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you batter. For infomatton about our services . please log onto awnsunyfbrldaficeese.com. There you can find more information about our divisons and the regulafions that impact you. subscribe to department reewslefters and learn more about the Department's initiatives. Our mission at the Department is: License Eficiantly, Regulate Fairly. We constantly strive to serve you better so that you can serve your custamers. Thank you for doing business in Florida. and congiatulations on your new Icensel -..s a (-4 ; AC# t...• 4. • S IA I t fit 1-LIJIGUA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRIC.AL COSTrRACTORS LICENSING BOARD (850) 487-1395 2940 NORTE MONROE STREET TALLAMSSCER FL 32399-0783 GILLIS, KEVIN ON CALL ELECTRICAL CONTRACTORS INC 13893 SW 1021D LANE MTAMI FL 33186 CBARLIE GRIST GOVERNOR DETACH HERE STATE OF FLORIDA 0E-:BfirsTrartigit . PRosmssi ..r "11 • • RS. mows The ELECTRICAL CONTRACTOR ; - ‘ - ..: ' Named below IS CERTIFIED - •:-..-:.-,:.. --•....._ . : Under the provisions of ;Cluipter;.:489; FS. - • Expiration date: ADC 33.; 2010' , •z--- -,'.:-- - `.7•-•:- "•- :•:-.3;... .....:::-:.*: - -- . :{- 4 -. -*-.. -.. GILLIS, KEVIN , ftft~ ; :-:- -•-• - ...,-__ ON CALL ELECTRICAL 1)y. •''', =ORR. -. ;:..-alw-. PO BOX 161494 •.3. --....--- ..?-4."- - • :--.• • ... MANI ''''''` FL n 3.0r .... ... . • • -- • 3'6198'efs IMPARTMENT OF BUSINESS Ank PROFESSIONAL REGULATION.-;- EC0000947 08/07/08 088010140 CERTIFIED ELECTRICAL CONTRACTOR. GCCLIIIS Kw= osr caw. ELECTRICAL CONTRACTORS, I XS CIESIZEFIED under theitaXIITAIltb212B C1C C11.489 PS Zleadaalt1411 eats. AVO 31., 2010 S08080702177 . • . LICENSE'"EBR-Cf- •'r -• 08/07/2008 088010140 E00000947-: . •• REGULATION • '...• G BOARD • Sga#L080800 ..• cHaituss- W DRAGO- - .::!SECItETARY PISPLef'AS-.REQUIRED LAW • . . THIS IS' NOT A BILL - DO NOT PAY. 53A8$5 -3 RENEWAL aa� LOCATION. RECUT N. . , .205161 =3 ON CALL E LECTRICAL`CONTRRACTORS 'STATES= EE0000947 INC 7593 NW 8 ST 7 33126 . UNIN DADE COUNTY INNER - ON CALL ELECTRICAL CONTR;:INC Etc-Ti of eem�sB • 11ELLCTRICAL.CONTRACTOR THIS IS ONLY. A•'LOGIL ' . BUSINEWTJUTRECHUT. R DOES.°.'NOT row • 1113 HOLDER: TO VIOLATE ANY EIIST31GFEGUWATORY.OR Z1313IG'• LAWS OF 'THE cowuy: Da IgTUM NOR DOM . fl MOM THE HOLOERIRONI ANY OTHER PBIroRr- - - - ow MEN= N1 .6Y.IAYA IB NOT A CERUF cA111 OP THE HOLOPR'S O1WLA- PATU232 REOOYEO. 20947 SW 122 PL NUNNONONIXAINFT C Tax MIAMI FL 33177 - 09/30/2009 . _09010878001. • 1 11 11 111 It 2 1 1 1 1 1 f ft S 11 11 f. 1 DO NOT FORWARD ON CALL ELECTRICAL CONTRACTORS INC KEVIN F GILLIS PRES 4CC CERTIFICATE OF LIABILITY INSURANCE DA 01 08 io PRODUCER _JVS, Insurance Agency THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 9600 SW 8th St, Suite 27 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Miami, FL 33174 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone (305)552 -5250 Fax (305)552 -5292 INSURERS AFFORDING 'COVERAGE NAIC # INSURER A: NOVA CASUALTY INSURANCE INSURER B: INSURER C: _ INSURER D: INSURER E: COVERAGES . INSURER F INSURED ON CALL ELECTRICAL CONTRACTORS, INC. 7640 NW 25th Street # 105 Miami, FL 33122- THE POLICIES 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 POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ; LTR tNSR ADD'L i !POLICY EFFECTIVE : POLICY EXPIRATION' ,I JNSRD I TYPE OF INSURANCE ! POLICY NUMBER DATE (MM /DDmr) , DATE !MM /DD/YY) I LIMITS I GENERAL LIABILITY !Vi COMMERCIAL GENERAL LIABILITY 09AL069921 01/10/10 01/10/11 , CLAIMS MADE ';V, OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: ! , POLICY j. PROJECT [1 LOC 1 AUTOMOBILE LIABILITY ANY AUTO I ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS 1. NON OWNED AUTOS GARAGE LIABILITY ._i ANY AUTO I EXCESS /UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE j RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY • ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? If yes, describe under LSPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS CERTIFICATE HOLDER ACORD 25 (2001/08) QF MIAMI SHORES VILLAGE BLDG. DEPARTMENT 10050NE2Ave Miami Shores, FL 33138 EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurence) MED EXP (Any one person) PERSONAL & ADV INJURY I GENERAL AGGREGATE PRODUCTS - COMP /OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per persdn) BODILY INJURY (Per accident) • PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT EA ACC AGG 'EACH OCCURRENCE AGGREGATE OTHER THAN AUTO ONLY: 1)VC STATU- • ! OTH- TORY LIMITS 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 INCLUDED CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE T9 THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE DO /SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE / NSUFj f IT$ ApENTS OR REPRESENTATIVES. AUTHORIZED REPRES SANDRA PEREZ © ACORD CORPORATION 1988 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Electrical Owner's Name (Fee Simple Titleholder) 2_1 Le L o 2 Phone # Owner's Address — 1 CO K q -1 ST- City M 1 a M t ShDrzeS State R-- zip X3 SO Phone # Tenant/Lessee Name E -MAIL: Job Address (where the work is being done) City Miami Shores Villa e FOLIO / PARCEL # Is Building Historically Designated YES E 1 eCT2-IC Phone # 78 (o -- 5 741 State F L_ Zip s 1 -- r - 7 e5 Phone # State Certificate or Registration No. Certificate of Competency No. e C crpO r / 7 E -MAIL: Contractor's Company Nam Contractor's Address - 2_0q Cit nn I ( -� (Y) Qualifier Name V•2_. Q 1 G, t I Architect/Engineer's Name (if applicable) Value of Work For this Permit $ 1 D 0 Type of Wbrk: ['Addition Describe Work: Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33 138 Tel: (305) 795.2204 Fax: (305) 756.8972 DAlteration e C - R 7C9 lbw cI1 S T County Miami -Dade Zip '351 SO NO Permit No. Master Permit No. Phone # Square / Linear Footage Of Work: S ❑ Repair /Replace ****** *** ********x** **** ************* *F ********** ****x**w, x xxx ************** **x Permit Fee $ 3 ' "m® / ' CCF $ CO /CC Submittal Fee $ — SO Training /Education Fee $ 0-20 Technology Fee $ Notary $ Scanning $ 5'OO Radon $ Bond $ Code Enforcement $ Structural Review. $ Total Fee Now Due $ 2.S4 DPBR $ Zoning $ Double Fee $ See Reverse side -4 REet JAN 2 7 2010 ❑ Demolition 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. 1 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: 1 certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COM MENCEMENT." 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 properly 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 Ow ier or Agent The foregoing instrument was acknowledged before me this 2_0 day of ,Y , - -Dt-`j 0 2t`A 6 who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: / 1 .^ • Re Ae11``1 rti.tt:er- a e "Mita • /•:•••- oep Banded Thru Notary Public Underwriters Sign: Print: My Co APPLICATION APPROVED BY (Revised 02/08/06) Signature ****** xxxxx* xx* xxxxx** xxxxxx* x* *xxxxxx * *xxxxxxxxx * **x* * * * * * *** Contractor The foregoing instrument was acknowledged before me this[) day of , 20 t Q by 1'.e v i ►J GIMP S who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Co xxx *xxxxxxx *x *xxxxxxxxxxx xxxxxxxx Z f`J`f .1.//0 Plans Examiner Engineer Zoning CERTIFICATE OF LIABILITY INSURANCE PRODUCER JVS Insurance Agency INSURED ON CALL ELECTRICAL CONTRACTORS, INC. Po Box 161494 Miami, FL 33122- COVERAGES INSURER F THE POLICIES 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 POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ;INSR ADD'L iPOUCY EFFECTIVE ; POLICY EXPIRATIONI LTRINSRD TYPE OF INSURANCE POLICY NUMBER __- _- I DATE (MM /DD/YY) , DATE (MM /DD/YY) : LIMITS GENERAL LIABILITY EACH OCCURRENCE DAMAGE ; COMMERCIAL GENERAL LIABILITY 1 09AL069921 01/10/10 01/10/11 PREMISES O RENTED (Ea occurence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE 1 PRODUCTS - COMP /OP AGG 9600 SW 8th St, Suite 27 Miami, FL 33174 Phone (305)552 -5250 G G _EN'L AGGREGATE LIMIT APPLIES PER: _ POLICY I ] PROJECT i 1 LOC i AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS CLAIMS MADE Iv' OCCUR GARAGE LIABILITY ANY AUTO I DEDUCTIBLE 1 i _i RETENTION $ CERTIFICATE HOLDER ACORD 25 (2001/08) QF EXCESS/UMBRELLA LIABILITY I OCCUR CLAIMS MADE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? If yes, describe under ;SPECIAL PROVISIONS below OTHER MIAMI SHORES VILLAGE BLDG. DEPARTMENT 10050NE2Ave Miami Shores, FL 33138 Fax (305)552 -5292 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. INSURERS AFFORDING COVERAGE NAIC # INSURER A: NOVA CASUALTY INSURANCE INSURER B: INSURER C: INSURER D: INSURER E: DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS CANCELLATION AUTHORIZED REPRESEt4TAT SANDRA PEREZ COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT EA ACC AGG 'EACH OCCURRENCE AGGREGATE OTHER THAN AUTO ONLY: DATE (MM/DD/YY) 01/08/10 WC STATU- ' OTH- TORY LIMITS ER E.L. EACH ACCIDENT ' E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT 1,000,000 100,000 5,0001 1,000,000 2,000,000! INCLUDED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TR THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE 7b� DO /SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE /INSUl , fTp AGENTS OR REPRESENTATIVES. 1 1 0 ACORD CORPORATION 1988 obi ALFY SNIK STATE OF PLOIUDA CHIEF NNAiie+lAi.! OP FINANCIAL SERVICES DIVISION OP WORKERS' CONWENSATION catimmis Engtein is I -CONSTRUCTION INIIUSTRV. plEMINTI This ee tifies the iad'ividUal listed held has Anted to bs exempt fauns Rafit a ! ipensetiorl lain. EFFECTIVE DATE: PERSON: FEIN: 252 BUSING NAME AND ADDRESS: ON CALL ELECTRICAL CONTRACTORS INC PO ®Wt 161404 MANN FL 33110 UCOPES OF BUSINESS OR TRADE: 1- ELECTRICAL CONTRACTOR crava Tl tre nom,: to Sew 410 . Uan F.,S is dhoti ®1 a eeipo who Nuts monowthia ram Vas Ay May a minim el etetateo seder rata _cries teat' w uodar Pten i er Cototoonotino tatei ttio *Rtgr. P'maaaa to Simdetr *WARM frootitikatts et etea to od eueeryt,.. epfy esly notate tae soma et NIe to siaoso ar made time ma tike maims ei +sitetenie l4a =Int. Peter et motet at 0A6S:f E$. lk2ker el err a la ms email 42 4 crag at erection to too onions stmt satieet es mamba IL et say ens site: ttar Snag d oe HaftbM et the !mass al too eefUkatp. tbs Ptisait saw nit An MOM Ur cattitlrm as helper swots i8o teeolretaeots of this eetise far isseseee at a centfle tta, t9s thottinet NM coos a ceh4hade at any tee s5t loots et t$* pewit amid ne tfe cattittesta At WM tit rettetreneaes of Or. sac n, GUESTIONS? (NCO 41 3 OWC -252 Z EIRF CA'1E OP ELECTION in OE Man aw&M 03-116 9J19IV2Us IDUIRATION DATE 021871,2an KEVIN 02-04 -2098 530885 -3 RENEWAL SIMMIMSMWMULOWNWN MWMWr NO. 205161 ON CALL ELECTRICAL CONTRACTORS STATE* EC0000947 INC 7593 NW 8 33126 UNIN ST COUNTY 7 OWNER ON CALL ELECTRICAL CONTR INC � 1 96 ELECTRICAL CONTRACTOR WoRKE2 THIS IS ONLY A LOCAL BUIENESSTAX RECOMMIT 00ES VIOIATE� MUMS OR REGW.AYORY OR ZOOMS LAWS OFIRE COUNTY OR CITES. NOR 00 NOT FORWARD DOES HOi T F ANY ON CALL ELECTRICAL-CONTRACTORS PERMIT OR RECEIPT REWARD BY LA MOMS INC TER T a KEVIN F GILLIS PRES MO 20947 SW 122 PL PAYMB4TRECEIVED MIAMI FL 33177 ammo= COUNITIAX COLLECIOTh 10/07/2008 n997 nnnitnni U.S POSTAGE PAID IRAK FL PERMIT NO. 231 P� - - 1.0 128 Inspection Number: INSP - 134295 Permit Number: EL -1 -10 -129 Scheduled Inspection Date: May 26, 2010 Inspector: Devaney, Michael Owner: MORRIS, BRAD' EY Job Address: 76 NW 97 Street Project: <NONE> Miami Shores, FL 33150- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Contractor: ON CALL ELECTRICAL CONTRACTORS INC Building Department Comments May 25, 2010 For Inspections please call: (305)762 -4949 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Pool - Private Phone Number C L Parcel Number 1131010330360 Phone: (786)388 -5880 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 Page 1 of 21 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 76 97 Street Miami Shores, FL 33150- Owner Information BRADLEY MORRIS 76 97 Street MIAMI SHORES FL 33150 Valuation: Total Sq Feet: 786/367 -9554 $ 2,000.00 445 Contractor(s) NOVO & SONS, INC Phone Cell Phone (305)444-7177 (305)303 -1811 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 $1.20 $0.40 $225.00 $3.00 $50.00 ($50.00) $1.60 $231.20 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, 1 authorize the above -named contractor to do the work stated Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Expiration: 08/28/2010 Parcel Number 1131010330360 Block: Lot: Phone Pay Date Pay Type Amt Paid Amt Due Invoice # PL -1 -10 -36910 01/27/2010 Cash $ 50.00 $ 181.20 03/15/2010 Cash $ 181.20 $ 0.00 Applicant BRADLEY MORRIS Date Cell Available Inspections: Inspection Type: Final March 15, 2010 March 15, 2010 1 BUILDING PERMIT APPLICATION FBC 2004 Value of Work For this Permit $ 1 1 Notary $ a Training /Education Fee $ Scanning $ V • OO Radon $ Bond $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 31-h5 ick s Code Enforcement $ Double Fee $ Permit No. _ 10-- 15 Master Permit No Permit Type: Plumbing Owner's Name (Fee Simple Titleholder) 31 Imo 7'l t O 2P4S Phone # Owner's Address — 7 1k) U ' ,G C( � 1 ST City kk YA O CL e5 State Ft-- - ;) 1 �Q Tenant/Lessee Name N rioN. Phone # E -MAIL: Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip 3 3 1 SO FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name ,13/ e t7 f 144A- Phone # ...1 D,r 4 /'/ Contractor's Address ve77. p S ' a . cr City / State /4 6,/2//74 Zip 35 f 3 Qualifier Name O/j .400///7 Phone# 3,e,j - L / / /,`y /fix State Certificate or Registration No. C pc / 417 a 3 3I. Certificate of Competency No. (900e7 // /‘.3 E -MAIL: Architect/Engineer's Name (if applicable) Phone # Square / Linear Footage Of Work: ***** 4 e*********x tie ********* **Fees******wwwww**** ** *xnYdc************* ***** ** Type of Work: ['Addition ['Alteration Jew ❑ Repair/Replace ❑ Demolition Describe Work: Submittal Fee $ ' � Permit Fee $ � � ll CCF $ I • °�O CO /CC o -' Technology Fee $ I • Le0 DPBR $ Zoning $ Structural Review. $ Total Fee Now Due $ See Reverse side - Bonding Company's Name (if applicable) t 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 wil , approved and a reinspection fee will be charged Ar lir —v Signature warseiric Signature � � 4 Co � y/ Owner or Agent Contractor The foregoing strument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20 0 , by JIZ 1, A -D ,e 1/ 0 re.-12.1 P day of — 20/D by who is personally known to me or who has produced who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: eYx ********* ****at********aY *deeFa:***** *** 4xrb*************oh _ „. ... g • -• `x xdedeet****xx APPLICATION APPROVED BY: (Revised 02/08/06) Sign: Print: My C Plans Examiner Engineer Zoning 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 FT.ECTRICAL 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 appro , , - - inspection fee "II be charged. Signature1. 11�J1 !1;/ /�i -I • "a er or Agent Contractor The foregoing instrument was acknowledged before me thisgl The fore: s instrument was acknowledged before me this27 day of S 4,tAeX , 200 by 5eavywAs b® (, � , day of 1 20d„ by \l 0 !/00 who r - is rsonall a or who has produced ` . who is f rsonally known to me or who has produced / As identification and who did take an oath. as identification and who did take an oath. Cho 05/13/03 NOTAR PUBLIC: Sign: Print My Commission Expires: IL, 4 01/ 1 9,14 -II ∎ one pqV rfMMISSION # 00129398 EXPIRES August 25, 2006 BONDED THRU TROY FAIN INSURANCE INC APPLICATION APPROVED BYr7 *** *** * * ** *** ***** * *** * ** *** * * *** ** ** *** NOTARY PUBL Sign: Print: My Commission rat * *a ** *** * ** ** air, ** * * * ** *** * * *** * * ***** t****** * * * **** ************** ** * *** **try MARY PAT aRJGGI % Notary Public - State of Florida 1 MYCanrnbsicn Expos Way11,2008 6, Sainerlaabsoltivecill fl+ibrr Bonded By National Notary Assn. **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * 3 J —A Plans Examiner Engineer Zoning ( tE itd# 0 d ig Miami Shores Village Building Department hermit No e` Job Name PLUMBING CRITIQUE SHEET 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Scheduled Inspection Date: May 26, 2010 Inspector: Hernandez, Rafael Owner: MORRIS, BRADLEY Job Address: 76 NW 97 Street Miami Shores, FL 33150- Project: <NONE> Contractor: NOVO & SONS, INC Building Department Comments May 25, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 I3PP- I- to -12? Inspection Number: INSP - 134304 Permit Number: PL -1 -10 -131 For Inspections please call: (305)762 -4949 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Pool - Private Phone Number Parcel Number 1131010330360 Phone: (305)444 -7177 PLUMBIN WORK FOR NEW POOL Passed Failed n Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments No Orbl Page 2 of 21 NOT E FEB ti MO io 'S SIGNATURE AND DATE se i-0 52 r - u -f S Tip iami hores illage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 NOTICE OF REQUIREMENTS RESIDENTIAL SWIMMING POOL, SPA AND HOT TUB SAFETY ACT e) acknowledge th a new,swimming pool, spa or hot tub will be constructed or installed at UJ ( Miami Shores, FL, and hereby affirm that one of the following methods will be used to meet the requirements of Chapter 515, Florida ues and the Florida Building Code R4101.17. Please nitial the method(s) to be used: The 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 expiration of the permit, the pool shall be presumed to be unsafe . I understand that not having one of the above installed will constitute a viol - i • n of Chapter 15, F.S ., an d will be considered as committing a misdemeanor of the second gree, nishabl provided in Section 775.082 or Section j 5.083 F.S . This form must be signed / by th - • er age the prime contractor. TURE AND DATE Mar 28 2003 10:18RM Kid Safe Pool Mete, Inc. 954-760 9973 p.2 -2-22 12:4l PM KIDSAFE M. RE: The for the The to 11, 2001 FAX: (954)523M$9 Nothard Kid I sfe Pool Nets 215 Vl 14 Way F. JLauderdale, FL 33312 L/N 30137 Mr. Nothatd: letter is regarding the safety testing of your Pool Safety Net As you know, this test prom= has been y completed. net wastested to emus compliance with ASTMF-1345-91, Standard Performance Specification ety Covers and Labeling Requirements tbr All Covers fix Swimming Pools, Spas and Hot Tubs" and rk was performed under the above referenced ARL file number. odel that was tested and fcamdto comply with the standard Is trade-nanied "KM Safe." This leiter:WS as confirmation that these units ate Listed by ARL effective March 20, 2001 and you are authorized l your produota with the ARL Listing Mark. Certification Report and Follow-up Service Procedure are in the process of being finalized and will to yon upon completion. If you have any questions. please do not heekate to =tact ARL. o Engineering RESEARCH LABORATORIES 5371 N.W. 1E1 et STREET * MIAMI, FLORIDA 330144223 WskeIhn twnearRestAxsti • Ernst erlteateasteern Fit (205)024-4500•FAX: (305) 624-3552 'rum= FOR CONSUMER SAFETY 954 5234189 P.02 m n. CPTE OF Lis ate has been found eligible for ARL's Listing, Labeling and Follow -up Inspection program under laboratory number(s) L/N 30137 Signed this day of _ April APPLIED RESEARCH LABORATORIES certifies that oot etc 3int. A t e ..4"4"/ Director of ngineering, APPLIED RESEARCH LABORATORIES Miami, Florida ITEM BATH TUB UNIT • FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE EATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING BISHWASHER RECEPTACLES A/C (WI DISPOSAL SERVICE TEMPORARY WC (CEO -) DRINKING FOUNTAIN SERVICE SIZE I AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPL I AIDE CURETS PROCESS AND PRESS P IP l NG INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 If STEAM BOILERS SHOWER MOTORS OVER 1- 3 If HOT WATER BOILERS SINK, POT/3 COMP. MOTORS OVER 3- 5 If MECHANICAL VENTILATION S INK, RESIDENCE MOTORS OVER 5- 8 If TRANSPORTING ASSEMBLIES S1NK, SLOP MVTCRS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 If FIRE SPRINKLER SYSTEMS UR1NAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES- A/C WINDOW RE INSPECTION 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 SW HAWING POOL OUTLETS. COMMERCIAL WATER SERV ICE _ SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER _ SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAW IELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPT IC TANK RE INSPECT ION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL &3'% mil? AREA DRAI ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER' NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL a . APPLIED RE LAB ABORATORIES certifies that ate ooLetL Jltt. has been found eligible for ARL's Listing, Labeling and Follow -up Inspection program under laboratory number(s) LIN 30137 Signed this 1.L —day of April Apr 21 2004 10:30AM LISTED GE:INSPECTION n:RVICE . 012345 .A PPLIED It1;Si:,llt1 :ii L.V>(hlt LS. I \C. YOUR PRODUCT LISTING HERE YOUR COMPANY NAME FIERE I ECh nC PSG .UJ R EiPP J.J.,ED IaaSOTP,n t OIflX INC. Kid Safe Pool Nets, Inc. Ft. Lauderdale, FL 33312 L/N 30137 Pool Safety Net, Model trade -name "Kid Safe" (File 30137) RESEARCH LABORATORIES 5371 Iti.W,161st Street. Miami, Florida 33014 Phone (3093 624 -4800 u F®t •2,4 - $52 • Email ARLTEST ® ed .d�, Kid Safe Pool Nets, Inc. PRODUCTS LISTED LISTING MARK (LABEL) NOTE Only products which bear the ARL Listing Mark (Label) are considered Listed by ARL. Issued'0411 Asa muNalprotection to dents. the public and ourselves. the cottiantsdtttls reportand Rs associated dacume ds them: le properly of A Of statements, eondudans or erttraas from or regardlnp this repot. Is reserved partd jr a written approvaL This report applies only lnspellons nrada. Unless otherwise sped /led, the test and/or inspection results are not Indicative or represerdative or the qualities d the ` o shntar products or materials. 954 -760 9973 1/01 Page C -6 p.1 I Er r . act Research Labaretanea, km. Authorization forsudKation Dm standards IdentB'ed on b !ha sanipie(s) iestad andlor lot from wretch the sample was taken or of epparerniyidentiml r . k7; Sc Pool Nets. THIS MANUAL SAFETY COVER COMPLIES WITH ALL STANDARDS AS SPECIFIED BY ASTM DESIGNATION F1346 -91 APPLIED Ri :SEARC1C LISTED REtNSPECT1O.1 SEF1 / CE (954) 463.5700 www.kidsafepoolnets.com AVOID DROWNING RISK • 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 DROWING OR INJURY • KEEP WATER LEVEL 5" BELOW NET PLEASE INSPECTTHIS SAFETY NET MONTHLY FOR Date: PREMATURE WEAR AND TEAR OR DETERIORATION. Mar 28 2003 10:18AM Kid Safe Pool Nets, Inc. 954-760 9973 Awed/aft,- c . UN: 30137 Anchor Plata Anchor Hook Anchor Plug Eye Boit Drop Anchor S- Hook DATE 04/11101 na Po° lIntr Pa*/ Various Various Various Various PAGE #1 003 . . 003 004 004 005 012 013 018 MODEL Kid Sate Pool Net 50 50 100 Vary Vary Vary K nelt round Stainless Steel anchor i Steel, 3/8 inch body, =1 (O n x 2 Inch Stainless Steel '4 Inch drop anchor. Stainless Steel Min .141 x 1.5 Inch Stainless Steal P•3 Mar 28 2003 10:22RM Kid Safe Pool Nets, Inc. 954 -760 9973 p.6 made by means of an indirect coaaeeaaa. - 4241.103 Derladen:. Plana and specifications for any deviation from the above manner of installation shall first be approved by the adMinierative authority before any portion *fatty suck system is installed When waste water disposal is to seepage pit installation, it shall be installed in accordance with the approval granted by the administrative authority. 424.2.115eparatlon tank. A separation tank of an approved type May be used in lien of the aforementioned . . means of waste water disposal whoa connected as a reclamation system. • 424.112 Testa • 424.2.12.1 Pressure test. All pool piping shall be inspa ed and approved before being covered or concealed. It . shall be tested and proved tight to the boa ofthe iaislrat ive authority under a stale waterer air pressure test of not lest than 35 psi for 13 minutes. Circulating pumps need•not be tested as required in this section. 4242122 Drain and waste piping. All drain and waste piping shall be tented by filling with water to the polat of overflow and all joints shall be tight. 424.2.13 Drain PIOUS . 424.2.13.1 Slope to.disdterge. Drain piping serving gravity overflow gutter limbs and deck drains shall be installed to provide minimums grade to paint of dim. 4142.13.2 Joints and connections. Joints and connections shat be made as required by the Florida Bidlding Code. Phrasbing. 424.2.14 Water R eatbng Egtdpmeet 424.2.14.1 Labia. Swimming pool water heating equipmnem shall conform to the design, construction and installation requirements in accordance with accepted tangimeaing psaedc s and shall bear the label of a reCognized testing agency, and shall include a consideration of combustion air, vetting and gas supply requirements for water Imatera. ' . 424.2.14.2 Water f'etention. If a heateris not equipped or designed for an approved petmaneat by -pass or anti-sip" bon device, as approved permanent by -pans or Mai-siphon device shall be installed to provide a Positive means of retaining water in the heater when the pump is not in operation. • 424.2.143 -Put Drainage. When the heater is installed in a pit. the pit shall be provided with approved drainage facilities.. - 1.424.2.14.4 Contaecttuns. Aliwater heating equipment shall be installed with flanges or anion connection adjacent to the heater. • 4242,14.5 Relief valve. When Water heating equipment which is laandied in a dosed system has a valve • between the sppliauae and the pool, a press= relief valve shall be installed on the discharge side of the water hearing equipment. For units-up to and including 200,000 Btu/hour input. the relief valve shall be • rated by the American Gas Associ • 424.2.15 Gat Piphsg..Gas piping shall comply with the .Flarlda Building Code, Fuel Gan.' 424.2.16 Electrical. Electrical wiring aand'egnipmeat shall comply with ChastcritollimillaisklitalingraiS the • • 424.2.17 Resdeatlal item >:hrgrsa#ifasdtnewe Residunial swintmdagpools shall fly with 4242.17.1 tlttnngli 424.2.17.3. • Euepdon: . A swimming pool with a poweranamiut safety pggl tovevorraptrwitirwsaferreova complying with .4 °t± Mar 28 2003 10:24RM Kid Safe Pool Nets, Inc. 854 -760 8873 ASTM F 1346.91. 424.2.17.1 Outdoor Swimming Pools. Outdoor swimming pools shall be provided with a barrier complying with 424.2.17.1.1 through 424.2.17.1.101 4. • 4242.17.1.1 The top of the ballet adall be at least 48 inches above grade measured on the side of ' the barrier which hems away from the swing pool. The maximum vertical clearance between • grade and the bottom of the barrier shall be 2 inches measured on the side of the banrierr which faces away from the swimming pool. Where the top of the pool structure is above grade the barrier may be at ground level or mounted on top of the pool structure. Where the barrier is mounted on top of time pool animate, the ma rdnuun vertical clearance between the top of the pool structure and the bottom. of the barrier shall he inches. ' • 424.2.17.1.2 t• - •.• 111.1. • . :... •1114•n it • .J1 .- 011N1 <i 1)• tj :!V ti•.'Ir 1' ._ I •I •)1 -11 i . . ^ : 1 .1'. II), .72 1 •1 1j !i•1. !� 1 L-1L'i`11' . 1 J1. tit 1 .. .1 . •1 • WW1, Openings in the barrier shall not allow passage of a 4-inch diameter sphere. 424.2.17.13 Solid barriers which do not have openings shall not clonfain indentations or protusions except fbr nonnal construction tolerances and tooled masonry joints. 424.2.12.1.4 Where the battier is composed of horizontal and vertical members and the distance • between the tap's of the horizontal numbers is lase than 45 inches, the horizontal members shall be located on the swimming pool side of the fence. Spacing between vertical members shall not exceed 144 inch in width. Where there are decorative cutouts within vertical members, sparing within the cutouts shall not mtc eed 1 }le inches in width. - 424.2.17.15 Where the barrier. is composed of horizontal and vertical members and the distance between the tops of the horizontal mender is 45 indhea or more, spacing between vertical members. shall not exceed 4 inches. Where there me decorative cutouts within•vertical members, spacing within the cutouts shall not exceed 1y, inches in width. 424.2.17.1.6 Maximum mesh sine for stain link fences shall be a 2'/4 inch square unless the fence is provided with slats fastened at the top or bottom which reduce the openings to no more than P'14 inches. 424.2.17.17 Where the barrier is composed of diagonal members, the maximum opening formed by the diagonal members shall be no mate than 144 inches. • 424.2.17.1.8 Access gates. when nmvlded . shall comply with the requirements of424.2.17.1.1 through 424.2.17.1.7 and shall be with a self- latchin a lockkeg device • 31' .� • •S.R!S 11.11, 11 1 1 . 11 .1 1 tilt 1 u It, . ,1..; 1 -, ] :. :: �l r: 1. �.• •.1 .. •1 1 1 11 1 1 4: 1 :II _ • :Y -- [ 1 1 .-1, i .`!1. . a] 11111 .., 11 leitstubsiauSiLatemenine.ounm.Periemburrattallatosuide accesaio the awhnminQ nool Zatelt shall um open outward away front the pool: eerie w The amps tstrarkh eganr, rent the gate and barrier have no opening greater than* ineh within 18 inches of the release mechanism. 424.2.17.1.9 Where a Wall of a dwelling serves as part attic barrier, one of the following shall apply: 1. All doors and wiedoara moulding wieirdirect access fuggjakan to the peal thronghtbar welt .11141 be equipped with an sit Blown complying with IJI. 20 17 chat has a miniutum smmd otessrae The exit alarm shall and which producer an Lgoetineno audible warning when the door and tts screen are opened. The alarm shall sound iuumdately after the door is opened and be capable ofbeirtg heard throughout the house during normal household activities. VItralarnrsludt P111+ •• 411.1, 11 1 111= . 11 111, p.7 Mar 28 2003 10:2611M Kid Safe Pool Nets, Inc. APPLIED TEST RECORD The test results have been found to be in accordance with ARL equirements and pertinent sections of the applicable standards for safety. Test results are maintained in the product file at ARL and are not reproduced in this report. .. CONCLUSION • Representative samples of the products covered in this report have been found to comply with the requirements for this category, and the products are judged eligible for Listing, Labeling and Follow -Up Service. The manufacturer is authorized to use the registered ARL Listing Mark (Label) on only such products that are manufacturing replicas of the products tested, and continue to be manufactured and tested in accordance with the Procedure. The Procedure will be updated as requirements change. Only those products Which properly bear the registered ARL Listing Mark are considered Listed by Applied Research Laboratories, Inc. LIN 30137 Kid Safe Pool Nets, Inc. Issued 04 /11/01 Page C-7 Act odiliddleigiddirditscindreAaliaddidend niOf d iia Nera.lhaMie % Otvfrgaatana l{ dOCraerel Mesole l dolled 1 Laboratories, Mo. ties, I.I On 'ru' ' � regarding dad report is reserved p.rdnp ar written apgm'si. 1% s report °op only to lee aenderds Wee..d end to to drripiet) tense index tnapeegeremade. Wen ad+e. ,Wegg.d.eretatardrortnspader amnetindieedis «, e,e Mire att the enamor the lot*orn wag Wen ordappere lfWedded ` r: almM prows or crenate • � RESEARCH LABORATORIES 5371 N.W. 161st Streets Miami, Florida 33014 Fbo . 524- 4WD at Fa 00*824- 3052 *Email NMraSiea m 954 -760 9973 Reviewed b B. Suk Director of Engineering in ietw 4 P. Mar 28 2003 10:30AM Kid Safe Pool Nets, Inc. 954-760 9973 L/N 30137 APPLIED 44-Mi?7,147.41:44refiritire RESEARCH LABORATORIE 5371 N.W. 161st Street *Nang, Florida 3301 Phone (3W) 524 - 4800 is Atit OS) d24 -3652 • Mean AFIL Kid Safe Pool Nets, Inc. onforontscomAluttmlansumyour ft!A . , hada* WO hi thil ZYP 0 ant wee Ws,: made ottamisithhas Innis WO: not isota atjahrthantAtat, tip* .thkensithr orfrop, — pante Pre T at tweak* them vol all. =OM • • . 040 p.10 ual0411/01 Aa a mutual prolecilon to (dards. the pubar.end °undue*, etoccuttentsof thit moorland Its essociatad documents ere the este °MOW Research Labareladas,faia. Autturfashon ftw publication or statesmen*. conclusions or extracts from or regarding ads report t maned perusing our unarm approusi, This report only to the standards Identified end t� dle Minaldga) Mated elnWor InsPecanne Made. Unless Ofherarite attedied, the lestandfcr limped= resulIs are not Indicative or representative of !bewail at theltd from which the sample was lekenor at apparently Identical \zr sinater products or matstais. ■ Page P-24 • • Mar 28 2003 10:35RM Kid Safe Pool Nets, Inc. 954-760 9973 APPLIED RESEARCH LABORATORIES! 5371 N.VV.161qtAreet 'Miami, Florida 3301 Phone pas) 324 - 4603 SAX (2004 424 -3852 Entail ARJ.tj I.cota JMO*RWMARMT, p.11 L/N 30137 Kid Safe Pool Nets, Inc. Is» ed 04111/01 Page P-25 As a mutat protodion to clams. etepubacana *unmans. the contents ottharsoort and Itsessodated do:tyrants are Mamas propeityolAppiled Research Laboratories, Inc. Authatellon tar pubacatkm staterents. CenduSions or anima; keel or regarding thls report l reserved pentane cue widen approval. rds regard applied onty to the standees identified end 10 100 semple(s) tested andfor Inspectels made. Unless otherwise spedned. the lost andfor lespeedert roman am nal [mamba or represerdseve of the enlitteaca Mahe (nun which the murals westeken of Ipairefet Identical street products or rnatedats. 4tWMIVIIPNWWMW4qMWOMORM elsts.0114 deal tat ig. • • r" 're Pe erg er mar ier •fter er. ree Os PO la im sqsArlINC1 W'Age ' IR Wel It ti ot ow) pi Ws ots suie ace so. so too w. ;'440br; )11`4111 PO MOM 1141 ROW k tme dit Lld nos . toe • WAINIIIIIIIVAISNIVANINIII REF Mar 28 2003 10:41AM Kid Safe Pool Mete, Inc. 954-760 9973 — APPLIED LIN 30137 Kid Safe Pool Nets, Inc. Is ued 04/11101 Page P-26 AB ornduelprotedion todents. publeandownetwes, titsCOOtardeedUll deport/Ind Its sasodated documerdsare teepee propededAppaed Research Laboratories. trim Authored= for Putahatien or deterrent". aardoraorni or °Waal kam or regarding this ,1odl reserved pending our ■vraten oppnencl. This raw= ady to the standards tdendled and to Me sanda(s) tested andkx 11151311CdOOS made. Med demise speeded. the lest ender inspection fads menet tratiostiee armaments,* ad me ad the lot from whit* the maniple vies Wegner of apparently mantles! K r diger products or matertats. . • • . • Tiro RESEARCH LABORATORIE 5371 N.W.101st 4treet Nang, Florida 330 Phone (31/g) 624 411 001 1 Fdi 6 6 4 et• -3e52 • ENO' AFL kfMtaiMIWAIWN0 p.12