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1189 NE 102 St (10)BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date i 0 Time Type Insp'n Permit NoB 0 Name Address Company Phone # For Inspector: Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE 4123 lq mss_ as ' ` of 611 Name & Date MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 1; l l a Time Type Insp'n L i 6 v Permit No. L, 2 . O ok - �� Name Approved Correction Re- Insp'n Fee Address IlFcr)iir 1 )\-P-_)-- Compan TC �v V Phone # 3 D ,3. For Inspector: t ViZ/D Date Type Insp'n Permit No. Name A Address Company Phone MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Time For Inspector: Name &Date Approvedi( ❑ Correction ❑ Re- Insp'n Fee ❑ Date Type Insp'n `� Permit No. - 2_00 -- �Q Name Address Company Phone # LI For Inspect�: L l Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buil s ing Inspection Requ 3os- U — YIN 1 Name & Date JP-0\x- MIAMI SHORES VILLAGE .1 BUILDING DEPARTMENT f , ,)i 5r^ 305- 795 -2204 Building Inspection Request Dat Type Insp'n Permit No. Name JJ ..J Address 1 l F 0 Time • zt r, Fee ' 7. bC)_,--Tr-c- Type Insp'n Permit No. 1 1 1/1 1 Company T C eit)—w Phone # 3 QS - 5 i -- (1 6 L 1 For Inspector: 11 J ) ` ` to Name Address MIAMI SHORES VILLAGE BUILDING DEPARTMEN 305- 795 -2204 Building Inspection Reque Date 1I/ )7/03 Approved Correction Re Insp'n Fee ime PERMIT APPLICATION FOR MIAMI SHORES VILLAGE � 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138.305- 795 -2204 Date T " d2— Job Address ``O (L ' S+ Tax Folio L egal Description Historically Designated: Yes No , O w � r � j ' r / L e s s e e / T e n e t r � G (ia o Master Permit # Owner's � � Address h 9)9 �- jC � J �'� � /� " W� Phone 3 Z, ffi tD Contracting Co. t e 772//- id/< Address n6c5 e Ckt/r /6" 677 Qualifier State # Municipal # 1.0 Competency # Ins. Co. L THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING OR ANOTHER INSPECTION. Permit Type (circle one): BUILDIN ELECTRICAL PLUMBING MECHANICAL ROOFING WORK DESCRIPTION: teW Square Ft. Estimated Cost (value) /,i 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 ANY 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 all disciplines. 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. Furthermore, I authorize the above named contractor to do the work stated. .A ,ice!_/ fraLa Signature of owner and/or Condo P Notary as to Owner an d/or Condo President My Commission Expires 9-1.O5 i t Maria Jahn •p• My Commission 0003113% N „dr Expires September 09 200e FEES: PERMIT 5� "" RADON C.C.F Date Signature of Contractor or Owner Builder Date N M SS# Phone Ct I . f�renim�I en.M •IVPrwi Diary astoC 9 � ; .' # DD 140861 y Commissi '' = EXPIRES: December 9, 2006 zk Bonded Thal Notary Public Underwriters OTARY APPROVED: TOTAL DUE Zoning Building Electrica 1��`d'2 Mechanical Plumbing Structural Engineer Date P-7- Go Date BOND ITEM BATH TUB ." UNIT .. FEE ITEM SWITCH OUTLETS' • UNIT FEE ITEM .. SPACE HEATERS' . UNIT FEE. BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR4€TER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UI'ERGROUND TANKS .. LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 0014 MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 If TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTCRS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 IP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION HATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL / OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES EWER CONNECTIONS SIGN TRANSFORMERS fTILITY-SEWER SIGN TIME CLOCK TILITY -WATER FIXTURES EPT IC TANK ANTENNA ELAY TELEVISION CUTLETS RAINFIELD, 4' TILE/RES. VIOLATION UMP & ABANDON SEPTIC TANK RE INSPECTION OAKAGE PIT CU. FT. ATCH BASIN ISCHARGE WELL ]MESTIC WELL TEA DRAIN )OF INLET )LAR WATER HEATER IRE STANDPIPE )CL PIPING WIN SPRINKLER SYSTEM LS RANGE :TER SET (GAS) S PIPING (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 11/21/2002 Applicant: ALICE Owner: GLADDING JOB ADDRESS: 1189 NE 102 Contractor ALL DADE ELECTRIC CO INC Contractor's Address: 8965 SW 157 ST Local Phone: (305)235 -8994 Parcel # 1132050190100 1 ),-- ti , ALA't a . 0 la ,o Total Fees: - MO- Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 5/17/2003 Construction Value: $1,000.00 Work: NEW POOL If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid inadvance_befnrp eatti fn._2ne .1..—•:-.. - - - - - This Permit is granted k ordinances pertaining there and approved by the prope authorization. A further col ordinances and regulations by his agents, servants or e Signed * In consideration of the is with the plans, drawings, st myself, my agent, sent Signe ..:^ w ,f11 LJ $ 1 va-L 099 /LCOI -C9 Electrical Permit Permit Number: EL2002 -382 GLADDING ALICE ST Legal Description: MIAMI SHORES SEC 8 REV PB 43-67 LOT 10 - ---- O Q'og )- ei 1 ° 6L MCC ld'II'WM 4668 S£Z '1S H1LSl 'M'S 5968 NI "00 011113313 30v0 0.691/10 ,j BLK 175 LOT SIZE 991[80 BPIJoI3 IUarTV'Samq$IH °MYMCI gi TOOEI aaWp sued agiIsaiaauid kClltWO1 J iO HNU9J 1UI)UIDWWO) 001 E09 9002, :IL LE01 0990:1 .l1E1 El t 0.11 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ,r� Time Type Insp'n / 0 v t S2zh Permit No. L ' v a 3E'0.2 , Name / Q�j ry � Q°2 S � Address j( O / Company � Phone # `; f �' - "/ 0 7SD For Inspector: 31 t,3 Name & Date Approved L �e Correction ❑ /t/��' p-3 Re- Insp'n Fee ❑ gi) Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10 /25/2002 Applicant: ALICE GLADDING ( Owner: GLADDING ALICE 0 JOB ADDRESS: 1189 NE 102 ST 0 t Contractor T C R POOLS INC Contractor's Address: 9615 SW 187 ST Local Phone: Parcel # 1132050190100 Fees: Description FEE2002 -5989 Building Fee FEE2002 -5990 CCF FEE2002 -5991 Radon FEE2002 -5992 Notary Fee FEE2002 -6073 Buildier's Bond Total Fees: Permit Status: APPROVED Permit Expiration: 4/21/2003 Signed: Signed: Building Permit Permit Number: BP2002 -1823 Page 1 of 2 Legal Description: MIAMI SHORES SEC 8 REV PB 43 -67 LOT 10 BLK 175 LOT SIZE Amount $280.00 $10.80 $17.60 $5.00 $300.00 $613.40 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. Construction Value: Total Fees: $613.40 Total Receipts: $0.00 This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. (INSPECTOR) BY: 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 responisibility for all work done by either myself, my agent, servants gr employes. REG CO1 102802 1323 11C401 • 002322 CHARGE $613.110 (Contractor or Builder) BY:' If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection M fee is $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Work: POOL, PATIO Signed: 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 responisibility for all work done by either myself, my agent, servants or -mployes. Signed: (INSPECTOR) BY: (Contractor or Builder) BY: ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE. Outlet, Appliance Q'I'1". TYI'I': Service Repair QTY. A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Dbmolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE. Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE. Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C WaWWin. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING TYPE A/C Condensate QTY 'TYPE Drains, Roof QTY TYPE Miscellaneous Fixture QTY" TYPE Soakage Pit Q'T1' Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY MIEM--7-4MMIMII7i16 11P2Z- 1111=0/11.1 D • TE -!•-• Zonin: Electrical Mechanical Plumbing IMMIIMMIril=7, — 17 Fire Public Works Structural Building Official 4419 Page 4 OFFICE USE ONLY CHECKLIST LI OWNER - BUILDER FORM (Attach) 0 FIRE DEPARTMENT APPROVAL (Commercial / multi-family) LI CONCURRENCY (New Construction) LI OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review Notary --fc0, 0 LI PROOF OF OWNERSHIP (Attach) LI HRS / DERM APPROVAL . (Septic / Sewer) 0 IMPACT FEE (New Construction) LI OTHER (Specify & Attach) PERMIT FEES $ (0.005/sq.ft.) $ [ b $ $ SO ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: 2-- (sq.ft. = x/1000 x 0.60) (0.01/sq.ft.) PERMIT APPLICATION LI CONDO ASSOCIATION APPROVAL (Attach) LI BPR APPROVAL (Restaurants) 0 CONTRACTOR REGISTRATION (On File) TOTAL $ 1,3, CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2 ND AVE., MIAMI SHORES, FL • (305) 795-2207 • FAX (305) 756-8972 • http://www.miamishoresvillage.com Page 2 PERMIT APPLICATION IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Othitr construction may have which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STA I OF FLORID Y OF MIAMI -DADE ✓ i a ature of 0 int Name .30 Irr Sworn to and subscribed before me this .30 day of . ai L i ' , • Signature of Notary blic - State of Florida e sc/ N Maria Jahn My Commission DD039313 ‘ Expires September 09 2005 Personally known '/ OR, Produced Identification SEAL: Type of Identification Produced: STATE • ORIDA, CO / 0. IAMI-DADE fi L/ i� '//_4 7 ignature of Contractor Qualifier P 11 , As C. CN - AT G 4..1 to of Florida Sw int Name SEAL: o and subscribed before me this Public - O;;1CIAl tiA P(J , ANGELA n9 _ 43: O r rr 0 c1 • .:o. 0 X3097 �t day C I li o , , Personally known r^ Q)g Produced Identification Type of Identification Produced: LLD L 3 0S b PROPERTY OWNER ('5ilt9,0 Address t i 02_ S.. i l: .4.1-t.2 S(o^es , Pt- 3Sc3g Home Telephone 3 CAS , 7 — 0— I J Business Telephone Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior License No. `�4 ‘ 7 Repair Alteration Interior Demolish Telephone30 6 r`r' Fax Relocation of Structure / Shell Only / Foundation Only Add'1 Attachment Other Add'l Detachment Other CONTRACTOR Name „re ^ , , l ( .3 S License No. `�4 ‘ 7 Address er A rs- 41 fa7 /-0 Telephone30 6 r`r' Fax / Qualifier Name /� / INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Job Address: Folio Number Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other \\ f rU c ( 3 -. Address Ant. Lot Block Subdivision Current Use of Property Proposed Use of Property Tenant Information PB PG Zoning Square Feet '7 ' 7 Units Floors Value of Work. \ $t 03O Bldg Value Tax Assessed/ApprSai'sedNalue Flood Zone PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No. w►; 44+1: 5kr.rto s r�L City State Description of Work ` a' ` 4r; o PERMIT APPLICATION 35/3 5 Zip Linear Feet Base Floor Elev. ENGINEER Name License No. Address Telephone Fax STATE OF FLORIDA) COUNTY OF DADE) The undersigned Affiant, • Miami /iumi Shori AFFIDAVIT ,f � « 4 AJ` n. , does hereby attest that the O(property owner) J attached survey, performed by L c. rq nC, v4- performed on 9') 7 - o l , is an accurate representation of the existing conditions and (date of survey) locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than six (6) months old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits.. Further, Affiant sayeth naught. itness(sign and print,/ J (name of surveyor's company) • SWORN T AND SUBSCRIBED before me this 30 day of Qpva. Affiant is personally known to me, produced as identification. fr � Maria Jahn .N4 My Commission D0039313 tif September 09 2001 Date - 3o -aZ Miami Shores Village Building and Zoning Department Attention: Building Official SWIMMING POOL OWNER'S CERTIFICATION I certify that I am the legal owner of the property described as , located at 1\c"°1 NE. Ic2..S In accordance with Section 33- 12(f), Code of Metropolitan Dade County, I certify that I understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until a separate permit has been obtained for an approved safety barrier, and such barrier erected, inspected and approved. I further understand that this certification, however, does not eliminate the need for obtaining a permit and erecting an approved barrier prior to final inspection and use of the pool. Note: This certification is to be submitted with a swimming pool permit application in duplicate. This property described as: Lot 10, Block 175 REVISED PLAT OF TRACTS 175A, 175B, 175C, 176A, 176B, 176C, 177A, 177B and 178A, OF THE REVISED PLAT OF MIAMI SHORES, SECTION 8, according to the Plat thereof, as recorded in Plat Book 43, Page 67 of the Public Records of Dade County, Florida. !_L. r•. // -67 -- bIJOrEs Lor-JEST ht' TA•l3 L. 5 I%L4(7 _ V4 r I o►� iri VAri ot-1 . io141 -1 1�it rEP-, TO I-I Wd .I,Z, loi-ll✓Sr Ai JAc 4 r 4 teA1 = 8�� -/a -99 1 9 -- ,PE' Lo - Ai2Ati El,rva -riot - 8 ' PROPERTY OF: Gladding, George, ►mo o I ncur me =taw A BOUNDARY MID INC ORA7ML AWSta OM OF SAE/ MAMA L 71NND SUR C MID I HOW WIIIIFY THAT M DORM' ArtPRE NM MUM 1EET3 THE WINU TEC14MC . =moan XI PxTH WV INC BOARD di (MI SAWM IS N CHAPTER eici7 -e "LIMA MWOSM TIK CODE FLIM NT IO SELTU 472.cT7. M STAflJ- TES. MOW ARE NO MCICAQIYIMS. mows MIMIC O GI NC RAT CIDER XVII AS / Fiz77ys. Da fIOfJDA Pifer. =[Tat AIO WPPEN _ 9 = / G T 4/° 14.Z.NO. O /D .__ ' r nap DUE 9 -17 - 01 Page 1 of 2 1189 N.E. 102nd Street Miami Shore LANNES AND GARCIA, INCFlprida LB #2098 - • SURVEYORS— MAPPERS —LAND PLANNERS 3EALE 5M ITH *6 5238 OFFXZ WORM ZVI ALCAVM IMMIX, , CORAL MIL= RLANOA 33134 CIO) e..- O164) SCALE CRAM BY 47A CONTRACTOR'S SIGNATURE do DATE CONTRACTOR'S NAME (PLEASE PRINT) . NOTARY PUBLIC hote4Tilla BUILDING DEPARTMENT 10050 N.E. SECOND AVENUE MIAMI SHORES. FLORIOA 33138.2382 TELEPHONE (305) 795-2204 FAX (305) - 756 -8972 NOTICE OF REQUIREMENTS RESIDENTIAL SWIMMING POOL, SPA AND HOT TUB SAFTY ACT I (We) acknowledge that a new swimming pool, spa or hot tub will be constructed or installed at A Wk -S'v' Miami Shores,. Fl., and hereby affirm that one of the following methods will be used to meet the requirements of Chapter 515, Florida Statutes. (please initial the method(s) to be used) The pool will be isolated from access from the home by an enclosure that meets the pool barrier requirments of Florida Statute' 515.29; The pool will be equipped with an approved safty cover that complies with ASTM F1346 -91; All doors and windows providing direct access from the home to the pool will be equiped with an exit alarm that has a minimum sound pressure rating of 85 decibels at 10 feet; All doors providing direct access from the home to the pool will be equipped with self - closing, self - latching devices with 'release mechanisms placed no lower than 54" above the floor or deck; I understand that not having one of the above installed at the time of final inspection, or when pool is completed for contract purposes, will constitute a violation of Chapter 515, F.S. and will be considered as committing a misdemeanor of the second degree, punishable by fines up to $500 and /or up to 60 days in jail as established in Chapter 775, F.S. OWNE SIG ATURE do DA GLee wi `y4 . ION # DD 73672 EXPIRES NOV.20, 2005 %OF BONDED TROUGH FS ADVANTAGE NOTARY • AME ( PLEASE P 2_