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BPP-10-379Inspection Number: INSP - 137550 Permit Number: BPP -3 -10 -379 Scheduled I -w lion Linn D te: April 22, 2010 Inspector: �j Owner: GRANT, KENNETH Job Address: 77 NE 107 Street Project: <NONE> Miami Shores, FL Contractor: ESSIG POOLS INC Building Department Comments April 21, 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: Final Work Classification: Addition /Alteration Phone Number (305)757 -2142 Parcel Number 1121360070390 Phone: 305 - 949 -0000 Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 7 of 25 /us 111app ]1 SPECZA _ fr 111,415‘ cNLY Al 4bOAI MNES TAX RECEIPT. IT Ct• NOT 1PEHMJ THE WEIR R9t:'YICITATI :AN YOR SEE OTHER SIDE $1' 11 PINS co z�€ tS IS T• 6•BIL - DO NOT PAY . nc a crrvwu, DO NOT FORWARD ESSIG POOLS INC 1800 NE 151 ST NORTH MIAMI FL 33181 126 +P1RS CI.A55S DIMAR.OS7�;AGE 1 FJ fRt M N O 2311 a• THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS (ISUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR NSRO TYPE OF INSURANCE POLICY NUMBER DATE IMMIDDE�Y) POLICY MM/DD/YYYY) LIMITS A GEN ERAL LIABILITY COMMERCIAL GENERAL LIABILITY ZAGLB9094600 12/1/2009 1.2/1/2010 EACH OCCURRENCE $ 1,000,000 X PREMISES E (a occurrence) PREMISES (Ea ocaurence) $ 100,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY f .PIF 0- fl LOC PRODUCTS - COMP /OP AGG $ 2 , 000 ,000 X A AUT OMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS ZACAT9086400 12/1/2009 12/1/2010 COMBINED (Ea accid SINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GA RAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXC ESS / UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR I CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ $ A WORKERS AND EMPLOYERS' ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER (Mandatory If yes, describe SPECIAL COMPENSATION L ABILITY YIN ZAWCI9171100 12/1/2009 12/1/2010 X TORY L WOSTATIMITU- S OETH- R EL EACH ACCIDENT $ 1,000,000 EXCLUDED? EL DISEASE - EA EMPLOYEE $ 1,000,000 In NH) under PROVISIONS below EL DISEASE - POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS *Except for ten (10) days cancellation for non -pay. All policy forms apply. This certificate is only a representation and may or may not comply with any written contract. Accwcy CERTIFICATE OF LIABILITY INSURANCE PRODUCER (602) 635 -4848 Fax: (480) 991 -0634 AIMS Insurance Program Managers, Inc. 15230 North 75th Street #1002 Scottsdale AZ 85260 INSURED Essig Pools, Inc. 1800 NE 151st Street North Miami FL 33162 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 INSURER A:Arch Insurance Company INSURER B: INSURER C: INSURER D: INSURER E DATE (MM/DD/YYYY) 11/25/2009 NAIC # COVERAGES CERTIFICATE HOLDER ACORD 25 (2009/01) INS025 (200901) CANCELLATION Miami Shores Village 10050 NE 2nd Avenue Miami Shores, FL 33138 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 TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Peter Godfrey /JB I ©1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Project Address Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Address Oisilot Tu Parcel Number 77 107 Street Miami Shores, FL 1121360070390 Block: Lot: KENNETH GRANT Phone KENNETH GRANT 77 NE 107 ST MIAMI SHORES FL 33161 -7029 (305)757 -2142 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Work: Swimming Pool Additional Info: BUILDING Classification: Residential Occupancy: Bond Retum : Fees Due CCF Education Surcharge Permit Fee Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $1.60 $0.60 $150.00 $3.00 $50.00 ($50.00) $2.40 $157.80 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Pay Date Pay Type Invoice # BPP -3 -10 -37247 03/10/2010 Check #: 12751 03/17/2010 Check #: 96476 Amt Paid Amt Due $ 50.00 $ 107.80 $ 107.80 $ 0.00 s: APPROVE Expiration: 09111!2010 Applicant CeII Valuation: Total Sq Feet: $ 3,000.00 0 Available Inspections: Inspection Type: Fence Final Pool Deck Wall Steel In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. March 17, 2010 Date March 17, 2010 1 BUILDING PERMIT APPLICATION FBC 2004 Permit Type (circle) Owner's Name (Fee Simple Titleholder) EXIJ(Trk C % Phone # 3 Z - 75 7 - z (`f'Z Owner's Address ° 7 ? l 'JE (6 7 .5 City Nl tPtM k-tt511-E3 State zip 3 314 1 Tenant/Lessee Name Phone # Job Address (where the work is being done) FOLIO / PARCEL # t ( - 2 - C J 6 - 067 - 0 3 93 Architect/Engineer's Name (if applicable) ' f Value of Work For this Permit $ . Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Electrical Plumbing Mechanical Roofing -77 kJ t tc? S City Miami Shores Village County Miami -Dade Zip 33 (.4 1 Is Building Historically Designated YES NO Phone # litamg.wzim AA e 0 2O1O BY: Permit NOW to _31 Master Permit No. Contractor's Company Name C � JC,L� (W C • Phone # 33S f (— OCJ Contractor's Address (' (11 F 1$ 1 S 1 ` City 6ki - OMa A A"- l State E';--- Zip 3 3 (4 2 Qualifier Name (DAN-- %U.._ E 5•t CD Phone# 3 - 9 ( 19 - OD (5 State Certificate or Registration No. e..._. (`` 2,c6 Certificate of Competency No. 1 3g - 7.5 Square / Linear Footage Of Work: Type of Work: DAddition ['Alteration ['New [ Repair/Replace ❑ Demolition Describe Work: RE3uQ F -e E S a.o.-)o an if.N. 160 6 L *** * * * * * ** * * ** * * * ** * * * * * * * * * * * * * *** * *, F * * * * * * * * ** **** * * * * * * * * * * *,* * * ** Submittal Fee $ 60 Permit Fee $ /5O Dd CCF $ 1.150 CO /CC Notary $ Training/Education Fee $ 0 •(O Techinology Fee $ a 40 Scanning $ 300 Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ CI tCrn See Reverse side -+ Bonding Company's Name (if applicable) ` Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that_no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR LMPROVEMENTS 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 exceedin ' 2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure w be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of co -° cemen must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued ab -nce of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature 1 Owner or Agent The f ing instrument was acknowledged before me this 1.0 day of t20 1 y�+d�• --+ ; who is personally known to me or who h produced As identificati s fi and w APPLICATION APPROVED BY: (Revised 02/08/06) Sign �LG .� `� l n .• 1 Print. Alwu ,, , �T�ez'nandea ou- 72013 My Commi Exp . , ER �i % SEP * * *' * * * * ** * * * * ** �t *,r*NagD�rAr ,O �r, , i * IN * *�r ** * **** * * *** * *,r L?-7- - a ntractor The for going instrum owledged before me this 1 day of , 20 by who is personally known to me or who has produced as identification and who did take an oath. NO : AR PUBLIC Sign: Print: My Co en mission #DD �1 * * * * * ** * * * &aY�Ydc arc+T� **U11 * Irl/3 BONDED THRII ATLANTIC BONDLNG CO., INC. ission Ex Plans Examiner Engineer Zoning NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. (L"Z 13t — C6 - 7 —n.31 STATE OF FLORIDA: COUNTY OF MIAMI -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 of Commencement. 1. L e g a l description o f p r o p e r t y and street/address: ( - 0 T IS �LC,CK - 2.1) r S '. bor.h fit 1 VA-grr PAZ --33 77 t.0 I07 5i, (v cilivt.l 5# , tL_ 33(C1 2. Description of improvement: f �Ont• ? kt S f' P' t fa6 3. Owner(s) name and address: I �)....A.1 E� (4 - 6 5 interest in property: • Name and address of fee simple titleholder: 4. Contractor's name and address: D' I (`"L L35( G POOLS / IA)C. k 8 66 N C t� 5 c��L} ` A4.61 'Ft- 3314 2 5. Surety: (Payment bond required by owner from contractor, if arm Notary Public Print Notary's N My commission e 123.01 -52 PA 4 8/02 111111111111111111111111111111 1111 CFN 20108, t 1630982 OR Bk 27210 Ps 2574; (fps) RECORDED 03/11/2010 10 :47 :42 HARVEY RUVIN, CLERK OF COURT MIAMI-DACDE COUNTY, FLORIDA LAST PAGE origina in this °iliq on Cld of y hand and Official S -1. � ,a G. T151 O IN _.. Name and address: Amount of bond $ 6. Lender's name and address: nature of Owner Print Owner's Name ki---€' J Nit • 60-eN"''[: Swom to and N PUBLIC-STATE Hernandez Commission # DD90 4 013 ,,,, . ,,` Expires: SEP. 2 , � E ATLANTIC 4G BONDED TIRO ATI.Atr GCO.,IN • ST A: OF F LORIDA, COUNTY ¢ : 1 DARE WITNESS 7. Persons within the state of Florida designated by Owner uw provided by Section 713.13(1Xa)7., Florida Statutes, Name and address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided In Section 713.13 (1Xb), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expira'Non date is 1 year from the date of recording unless a differ nt date • s ied) Prepared XP- 20 �o � P= Ls ,1 . 0-- ,G LS Address: )._4—y.—J F1 33 1&9 Primary Zone: 1000 SINGLE FAMILY 1 - ESIDENCE 2009 2008 , I r 1 RESIDENTIAL - ' INGLE FAMILY Beds/Baths: . 1 Floors: $269 628 x ' 4, n Units: 1 d' • Foota e: 1 329 Lot Size: -,225 SQ FT $50,000/ 948 551 948 egal • ascription: UNNINGS MIAMI - HORES EXT NO 3 PB 2 -33 LOT 15 BLK 210 LOT SIZE 75.000 X 123 • R 13027 - 2983 08861 • R 13027- 2963 0886 00 Assessment Information: 2009 2009 2008 Land Value: $142,387 MENE $127 241 134,41 Buiidin• Value: arket Value: $269 628 x ' 4, ►_l u MI $98,649 , $98,551 Exemption Information: Property Information Map Property Information Map Digital Orthophotography - 2007 My Home Miami -Dade County, Florida i_ a . e This map was created on 3110/ 2010 9134 :22 AM for reference purposes only. Web Site ® 2002 Miami -Dade County. All rights reserved. 0 • 112 ft Summary Details: Psoaerty information: Page 1 of 1 MIAMI -DADE 3;31r]'�k1i111..11.111 oil* No.: Pro ailing ddress: ENNETH A GRANT NE 107 ST MIAMI HORES FL 161 -7029 NE 107 ST Taxable Value Information: httpf/ gisims2 .miamidade.gov /myhome/prinhnap asp? mapurl = http:// gisims2.miamidade.gov /output/md _props... 3/10/2010 2009 2008 axing Authority: Applied Exemption/ Taxable Value: Applied Exemption! Taxable Value: $50.000/ $48 649 $50,000/ $48 551 1 $50,000/ $48,649 $50,000! $48,551 4: 950,000/ 948,649 $50,000/ 948 551 925,000/ $73 649 925,000/ 973,551 Sale Information: ate Date: ,. 1986 1e Amount: 7 000 ale 0/R: r les • ualitication .._ . •. ion: +ales which are qualified I. 'd• Von , i .I= Property Information Map Property Information Map Digital Orthophotography - 2007 My Home Miami -Dade County, Florida i_ a . e This map was created on 3110/ 2010 9134 :22 AM for reference purposes only. Web Site ® 2002 Miami -Dade County. All rights reserved. 0 • 112 ft Summary Details: Psoaerty information: Page 1 of 1 MIAMI -DADE 3;31r]'�k1i111..11.111 oil* No.: Pro ailing ddress: ENNETH A GRANT NE 107 ST MIAMI HORES FL 161 -7029 NE 107 ST Taxable Value Information: httpf/ gisims2 .miamidade.gov /myhome/prinhnap asp? mapurl = http:// gisims2.miamidade.gov /output/md _props... 3/10/2010 • 4,1 arol Shot: °. Vi F:rle TPRD "ED BY _ sA ,_'oP.!ING DEPT FEDERAL BLDG DEPT �"` � SHBJECT i0 COMPLIANCE WITH ALL Sl ATE AND C( I,AN 1Y ri-ULES AND REGULATIONS vi r trl�_ � / Dem p, n ormos Ate a f t rA - Mt fi/r.e smAti OAiI,I� O N A BEARING OF 'MAP OF BOUNDARY SURVEY SCALE : 1 , PAIIIRKt Kew "ACE SOOK 5105ESV PR c g .. +tea ; *�te P e p aoseis • " � lAl� Pd�L PA- Ne titEr" or var. LOT SUBDIVISION ACCORDING TO THE PUBLIC RECORDS OF RtzS Ne.11 WE 1S. t iFog Z t C) T I3 ' GF AS RECORDED IIi PLAT BOOK ' 7. AT PAGE. OF THE I— MOS. COUNTY, FLORIDA. A 101 °h''" ST, g! Ai-i l $4611.6,s r-t.,. ` 3$ t1, . DATE OF Fl€111 SURVEY 0$ - 04 ® ,r t LEGAL DESCRIPTION r 4. 0%, 4S' a BEM t FL A. 33012 • �� A. FAX (345 824- . ?4 VV . p,.... " :��� :��t�30 X24 -0+04a - DATE OF FIRM : FLOC3 : 07 toi um= or Ton Suva TO od MDR. TO MIRK= MORBID DISTIROCONTS, sr ANY Ammo m '.ATI N Of 'mITTCS O N AND/OR ADIAC 7 TO TIM PROM:NTT MI NOT SECURUI LS suio IS SUBJECT TO OPINION OF TITLE. UNDERGROUND !'OUNDATION AND UTILITIES NOT LOCATED. . DATA • sid+ns a rwr�a. _ . wen siestas allesalso • STATE OF FLORIDA COUNTY OF DADE Further, Afflant sayeth naught. Miami Shores Village 10050 Northeast Second Avenue Miami Shores, Florida 33138 -2382 Telephone: (305) 795 -2207 Fax: (305) 756 -8972 www.miamishoresvillage.com AFFIDAVIT The undersigned Affiant, 1)E l` � , does here by attest that the attached survey, performed by CArn.e 5 2NJ E'NC) t / KJC • performed on 41 I P ( , is an accurate representation of the existing conditions and locations of all Structures on the property as of this date. The purpose of the Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey Tess than six (6) months old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which may now exist on the property which are not permitted or which may violate zoning or building code regulations. The Afflant further understands that the existence of any such structures may effect final inspections as applicable to this or other permits. antlProperty er Witness (sign and print) Witness (sign and print) SWORN TO AND SUBSCRIBED before me this I day of �-' l .c==) Afflant is personally known to me, produced as ide ATE OF t+� Hernandez n� Commission # DD904411 SEP. 27, 2013 BONDED 5'JIIW ATLANTIC BONDING CO., INC Maori stiur�age Velavemeat 10050 NE 2nd Ave Miami Shores, Fl 33138 Phone 305-795-2204; Fax 305-756-8972 www.miamishoresvillaqe.com SWIMMING POOL OWNER'S CERTIFICATION DATE 31 t MIAMI SHORES VILLAGE BUILDING AND ZONING DEPARTMENT ATTENTION: BUILDING OFFICIAL I certify that I am the legal owner of the property located at: In accordance with Section 33 -12(0, Code of Metropolitan Dade County, I certify that I understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until a separate permit has been obtained for an approved safety barrier, and such barrier erected, inspected, and approved. I further understand that this certification, however, does not eliminate the need for obtaining a permit and erecting an approved barrier prior to final inspection and use of the pool. Legal Owner Note: This certification is to be submitted with a swimming pool permit application in duplicate.