1310 NE 101 St (5)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
t 3/
Date / a Job Address /US 10\ Tax Polio I c =4r
Legal Description
/ Lessee / Tenant (CO. f d o 1p■OX' Master Permit 41:3.3 A
Owner's Address L.,JV tua Ld 0
Contracting Cogt4/ l'ed &VI CD T-4 a(S M d Address
Qualifier �J n�
00a2e13 C7 SS# Phone 5 �
State it 4' Po ae � v
Municipal # Competen #C- ��Z(S 'Ins.Co.
' P-.
Architect /Engineer
Bonding Company Address
Mortgagor Address
Permit Type(circle one . BUILDING ELECTRICA► I MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Square Ft. imated Cost (value)
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
SO 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).
Application is hereby made to obtain a permit to do work and installation as indicated above, and
on the attached addendum (if applicable). I certify that all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
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 constru io a • zoning. Furthermore, I
authflrize the above -named contractor to do the work stated.
owner - _and/or Condo President
otary 3s to Owner "and/ r Condo President
My Commission Expires: .titTARY PUBLIC STATE OF FLORIDA
MY COMMISSION EXP. JULY 4,1995
BONDED THRU GENERAL INS. UND.
't \ ryN 2 POn
** * * � *t� '°13 * * * * * *
"/
FEES: PERMIT / , RADON C.C.P.
APPROVED: Fire
Zoning Buildin
Mechanical Plumbing
Address ' SLt /48
f Con ra
Signature
Dade:
r
" I.' ,
otary a to Contractor o I er- Duifder
My Commission Expires:
ROTA PUBLIC STATE -OF FLORIDA
AMY COMMISSION EXP. JULT 4,1995
BONDED THRU GENERAL INS. UND.
* * * * **
Q'Q ,5
NOTARY TOTAL DU
Phone
or or Owner- Builder
Other
Electrical
Engineering
E l 5T45PC2232
PERMIT NO. TAX FOLIO NO.
STATE OF Florida
COUNTY OF Dade
NOTICE OF COMMENCEMENT
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 of Commencement.
tO Legal description of pro erty and stye t addre s:
t Nt:_i tfc hotaicu ae i A- (b- Sc, 3 , Doe le,
T t 1 I o► -- r. mIaM 9 - a-I3f:3
2. Description of Improvement: Swimming Pool
3O Owner (s) name and addr ss : e ik;cQ,rdO Orr 1c
302- •uc (s S ,miQrn sh 81- 33(3e)
interest in property: 100%
Name and address of fee simple titleholder:
4. Contractor's name and address: Certified Gunite Co.,Inc.,
D,B /A Custom Pools 12165 S. Dixie Hig w ay, Mia mi, F .
5. Surety:(Payment bond required by owner from contractor, If any)
Name and address:
Lender's name and address:
Amount of bond $
7. 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 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), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the'explratIon
date Is 1 year from the date of recording unless a different
date is specified)
RECORDED IN OFFICIAL RECORDS o
OF DUDE COU,.Tr, FLORIDA
RECORD vERiF'E:I
CAA Ot CirCAlit & COW*
COUrts
xti
S l gnat u r.
a cb•� `,
me
Sworn to rjd'$ub r d. before • i s - , a
—
t
Nota y Pub 14c ,,,., ; .;
My Comm I ss I On Exp i RY' -PE;R cTAT r.—OF FLORIDA
- EdY - COMMISSION EXP. JULY 4,1995
IRVING CHAZEN BONDED THRU GENERAL INS. UND.
i/1 049 e.
Date ________ Job Address 1 a1D tO I ST Tax Folio
Legal Description k _ C : i + \ I O U - k k I U tlOr(11 910(P a ( P 8 . 5 2 5 - -
/ Lessee / Tenant ■ca ( /\ qr 1 *bn
L:30a u E 100 3 Phone cSS - S 31 cO
Contracting Co. kj d GU(1i l(l C0 easiro �'1 kISAddress I � t( S Di A4 MAXI_
Qualifier 11 GddS Phone 6X:=7-) - �31
State # Municipal # Competency 4P CC ( ?OD Ins.Co.
Architect /Engineer 1 ' PTA 1 1e
Bonding Company k Address
Mortgagor Address
Permit Type(circle one ELECTRICA MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Owner's Address
Square Pt. v Estimated Cost(value) $ 40D• 462
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
SO 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).
Application is hereby made to obtain a permit to do work and installation as indicated above, and
on the attached addendum (if applicable). I certify that all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
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 toning. Furthermore, I
authorize. -e above -named contractor to do the work stated.
I
otary s Q - (hier President
`
My CommisSion Expires.
Nei /: +' PUBLIC STATE OF FLORIDA
MY COMMISSION EXP. JULY 4,1995
BONDED THRU GENERAL INS. UND.
APPROVED:
** * * * * * * * * * * * *
FEES: PERMIT , 6 C 427 RADON C.C.F. NOTARY TOTAL DUE "
Zoning
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
r and /or Condo President
0�
Master Permit #
Address 3 Svc Y 4'B L .
ature of ►on ractor or Owner - Builder
:'Notary =s to Contractor or er - builder
My Commission ExpireAVOTARY . BLIC •OFFLORIDA
MY COMMISSION EXP ;,,DULY 4,1995
BONDED THRU GENERAL INS. UND.
* * * **
Fire Other
Buildin_ Electrical
V gineering Mechanical Plumbin:�'
CUSTOM POOLS
Nati
Project Name
Tree Review
CERTIFIED GUNITE COMPANY, INC • INCORPORATED IN FLORIDA AUGUST. 1964
TREE S JRVEY
k
Address 1 >1D NE LC) (
a There are no trees on the subjects
property that conflicts with the
construction of the swimming pool and
deck.
❑ There are conflicts between the
construction of the swimming pool and /or
deck. However, all trees that conflict
with the construction are less than
eighteen (18) inches in diameter.
❑ There are trees greater than eighteen
(18) inches in diameter that conflict
with the construction of the swimming
pool. However, this /these treets) is /are
of the following species that do not
require permit for removal:
Dated r(A3(R8
O Ficus
O Fruit tree
O Australian Pine
O Brazilian Pepper
O Malaleuca
O Bi schof i a
O Ear l eaf Acacia
O Norfolk Island Pine
O Schefelera
This review was accomplished by
1216E SOUTH? DIXIE HIGHWAY • MIAMI FLORIDA 33156 • (3051255-5315
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 3/ Job Address /3/c7 /t/ /O/ •o Tax Folio!). a�
�� 6PIQ
Legal Description 1 g Pk
/ Lessee / Tenant Master Permit # _ 3
Owner's Address ' /3'O yF l0 /`57--
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
Phone
e, e ; c." ;e6e ve
Contracting Co. 6 ? _ Address foi l
Qualifier (/J...O/70
�,l�
State # Municipal # Competency # / /9fr/ ns.Co. JZ47E 1t�
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 4e/' 4 -
SS# Phone 9Y' 97a 7
Square Ft. Estimated Cost(value) J?-P .._
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
SO 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).
Application is hereby made to obtain a permit to do work and installation as indicated above, and
on the attached addendum (if applicable). I certify that all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
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. Furthermore, I
authorize the above -named contractor to do the work stated.
Signatu
Date a
Contractor or
Owner- Builder
N ta as to Contractor or Owner - Builder
My Commission Expires:
** * * * * * * * * * aPP * * * * * * **
FEES: PERMIT T / " 0 D RADON C.C.F. NOTARY TOTAL DUE
APPROVED: Fire Other
Zoning Building Electrical q *, ,ipl
Mechanical Plumbing; Engineering
Date
Building and Zoning Department
Legal Owner
OWNER WILL BE CITED WITH A ZONING VIOLATION.
SWIMMING POOL OWNER'S CERIFICATION
Attention: Building Official
I certify that I am the legal owner of the property described
s kelt I i r Aarii Sh0(ZQ 4uA Pe). Pc ZS 3
(42f
Al c
located at R O I3E KJ STafist± , lO
In accordance with Section 33- 12(e)(f), Code of Metropolitan Dade
County, I certify that I understand and agree that the swimming pool
to be constructed at the above address cannot be used or filled with
water until a separate permit has been obtained for and approved SAFETY
BARRIER, including A SPRING LOCK - SELF - CLOSING GATE, (double gates do
not meet this requirement) equipped with A SAFE LOCK (no pad locks
permitted) and utilized when pool is not in use, and such barrier erected,
inspected and approved.
I futher understand that this cerification, however, does not
eliminate the need for obtaining a permit and erecting an approved barrier
prior to final inspection and use of the pool.
I have read and understand the reverse side of this form.
SEE REVERSE
Note: IF AT TIME OF FINAL, THE ABOVE REQUIREMENT HAS NOT BEEN MET THE
SEC 33-12 FENCE AND SAFETY BARRIERS FOR SWIMMING POOLS
(A) REQUIRED FOR FINAL INSPECTION OF POOL. NO FINAL INOECTIZIN AND APPROVAL FOR A SWIMMING POOL SHALL BE GIVEN BY THE
BUILDING AND ZONING DEPARTMENT. UNLESS THERE HAS BEEN ERECTED A SAFETY BARRIER AS HEREINAFTER PROVIDED. NO POOL SHALL BE
FILLED WITH WATER UNLESS A FINAL INSPECTION HAS BEEN MADE AND APPROVED. EXCEPT FOR TESTING PURPOSES MAY BE APPROVED BY
THE BUILDING AND ZONING DEPARTMENT.
(B) TYPES PERMITTED. THE SAFETY BARRIER SHALL TAKE THE FORM OF A SCREENED-IN PATIO. A WOODEN FENCE. A WIRE FENCE. A
ROCK WALL. A CONCRETE BLOCK WALL OR OTHER MATERIALS. SO AS TO ENABLE THE OWNER TO BLEND THE SAME WITH THE
STYLE OF ARCHITECTURE PLANNED OR IN EXISTENCE ON THE PROPERTY.
(C) HEIGHT. THE MINIMUM HEIGHT OF THE SAFETY BARRIER SHALL BE NO LESS THAN FOUR FEET.
(D) LOCATION OF BARRIER. THE SAFETY BARRIER SHALL BE ERECTED EITHER AROUND THE SWIMMING POOL OR AROUND THE PREMISES OR
A PORTION THEREOF ON WHICH THE SWIMMING POOL IS ERECTED. IN EITHER EVENT. IT SHALL ENCLOSE THE AREA ENTIRE PROHIBITING
UNRESTRAINED ADMITTANCE TO THE ENCLOSED AREA. POOLS LOCATED IN ENCLOSED STRUCTURES OR ON THE ROOFS OF BUILDINGS SHALL
NOT REQUIRED THE INSTALLATION OF BARRIERS AS REQUIRED HEREIN.
IE) GATES. GATES SHALL BE OF THE SPRING LOCK TYPE. SO THAT THEY SHALL AUTOMATICALLY BE IN A CLOSED AND FASTENED
POSITION AT ALL TIMES. GATES SHALL ALSO BE EQUIPPED WITH A SAFE LOCK AND SHALL BE LOCKED WHEN THE SWIMMING POOL IS NOT
IN USE.
(F) PERMITS. BEFORE ANY WORK IS COMMENCED. PERMITS SHALL BE SECURED FOR ALL SWIMMING POOLS AND FOR THE SAFETY
BARRIERS. PLANS SHALL CONTAIN ALL DETAILS NECESSARY TO SHOW COMPLIANCE WITH THE TERMS. AND CONDITIONS OF THIS CHAPTER. NO
SWIMMING POOL PERMIT SHALL BE ISSUED UNLESS SIMULTANEOUSLY THEREWITH A PERMIT IS SECURED FOR THE ERECTION OF THE
REQUIRED SAFETY BARRIER, PROVIDED HOWEVER. THAT IN LIEU OF THE PERMIT FOR A SAFETY BARRIER. A WRITTEN STATEMENT FROM THE
OWNER CERTIFYING THAT HE UNDERSTANDS AND AGREES THAT THE POOL CANNOT BE USED OR FILLED WITH WATER UNTIL A PERMIT HAS
BEEN OBTAINED FOR AN APPROVED SAFETY BARRIER AND SUCH BARRIER ERECTED. INSPECTED AND APPROVED WILL BE ACCEPTABLE. THIS
CERTIFICATION, HOWEVER. WILL NOT ELIMINATE THE NEED FOR OBTAINING A PERMIT AND ERECTING AN APPROVED BARRIER PRIOR TO
FINAL INSPECTION AND US OF THE POOL. IF THE PREMISES ARE ALREADY ENCLOSED. AS HEREIN BEFORE PROVIDED, PERMIT FOR THE
SAFETY BARRIER SHALL NOT BE REQUIRED. IF. UPON INSPECTION OF THE PREMISES. THE EXISTING BARRIER AND GATES ARE PROVEN TO
BE SATISFACTORY.
IG) WOODEN FENCES. IN THE WOODEN TYPE FENCE. THE BOARDS. PICKETS. LOUVERS, OR OTHER SUCH MEMBERS. SHALL BE SPACED.
CONSTRUCTED. AND ERECTED. SO AS TO MAKE THE FENCE NONCLIMBABLE AND IMPENETRABLE.
(H) WALLS. WALLS. WHETHER OF THE ROCK OR BLOCK TYPE. SHALL BE SO ERECTED TO MAKE THEM NONCLIMBABLE.
(I) WIRE FENCES. WIRE FENCES SHALL BE THE TWO INCH CHAIN LINK OR DIAMOND WEAVE NONCLIMBABLE TYPE. OR OF AN APPROVED
EQUAL. WITH TOP RAIL. THEY SHALL BE OF A HEAVY. GALVANISED MATERIAL.
IJ) REFUSAL OF PERMIT. IT SHALL BE WITHIN THE DISCRETION OF THE DIRECTOR TO REFUSE APPROVAL OF ANY BARRIER WHICH. IN
HIS OPINION. DOES NOT FURNISH THE SAFETY REQUIREMENTS OF THIS SECTION. I.E.. THAT IS HIGH ENOUGH AND SO CONSTRUCTED TO
KEEP THE CHILDREN OF PRESCHOOL AGE FROM GETTING OVER OR THROUGH IT.
IK) MAINTENANCE. IT SHALL BE THE RESPONSIBILITY OF THE OWNER AND /OR OCCUPANT OF THE PREMISES UPON WHICH THE SWIMMING
POOL IS HEREAFTER ERECTED TO MAINTAIN AND KEEP IN PROPER AND SAFE CONDITION THE SAFETY BARRIER REQUIRED AND ERECTED IN
ACCORDANCE WITH THIS CHAPTER. I ORD. NO. 57-19 + 5. (CC). 10- 22-57. ORD. NO. 64 -53. + 1, 10-23-64. ORD. NO. 74 -33 + 1,
2. 5-7 -74).
Date:
CERTIFICATION OF POOL OWNER'S ASSUMPTION OF RESPONSIBILITY
To:
Building. and Zoning Department
Attention: Building Official
I certify that I am the legal owner of the property described as:
k l 11C t 1 (1. ('o rn 1 gp AVdc 1 1 2 6.4 A 3
located at: ) 310 OF 101
In accordance with Section 5003.1 (d), Code of Metropolitan Dade
County, I certify and agree that the swimming pool to be
constructed at the above address cannot be used or filled with
water until a separate permit has been obtained for an approved
surrounding area walkway, and such walkway installed, inspected
and approved.
I further understand that this certification, however, does not
eliminate the need for obtaining a permit and installing the
required surrounding area walkway prior to final inspection and
use of the pool.
I agree to hold e'/ Arn ° CLOYJJ harmless
in all matters relate hereto.
Legal Owner: 'V• oryloi-
Note: This certification is to be submitted with a swimming
V pool permit application, in duplicate.
Section 5003.1 (d), Code of Metropolitan Dade County, states
the following:
(d) Surrounding areas and /or walkways shall be constructed
so as not to drain into the pool or spa or other adjacent
structures. An 18" minimum width of walkway around the pools and
spas, as measured from the pool water edge, shall be constructed
for at least 80 percent of the pool and spa perimeter. A raised
coping shall not be a part of the 18" minimum width.