The URL can be used to link to this page

BPP-11-620Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 164169 Permit Number: BPP -4 -11 -620 Inspection Date: September 06, 2011 Inspector: Dacquisto, David Owner: LOUZADO, LYLLIAM Job Address: 33 NW 98 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ESSIG POOLS INC Permit Type: Pools/Whirlpools /Hot Tubs Inspection Type: Survey Final Work Classification: Addition /Alteration Phone Number Parcel Number 1131010330150 Phone: 305 - 949 -0000 Building Department Comments NEW SWIMMING POOLS AND PAVERS DECK OVER SAND BASE ,0‘_ Ul CV? ' Passed i Cr g_i_o., Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until September 06, 2011 For Inspections please call: (305)762 -4949 Page 1 of 1 4) 0 ts, P '110Arilamet0egamOmmlimpOOMmumMO*.,,,,,,,, 930'h 5r Page 1 of 2 1 1) Miami Shores WInge APPROV77 ZONIW 7:- •' ::W.11Vc -ZOCATIOIY M'4 g 7"11,7:g /W. :i1/\11 AL.C;ic: 0 4-t H 0 N0 0 0 0 F-1 4-4 *I This property described as: All of Lot. 22 and the East 1/2 of Block 128, MIAMI SHORES SECTION NO. 6,, according to the-Plat thereof, as recorded in Plat Book 10, Page 39 of the Public Records of MiAmiDadtyColliaty!OElorida. Lot 21, • • L.F. ELEV. = 13'7442 denotes lowest habitable floor elevation. Elevations shown refer to N.G.V.D. 29 Lowest Adjacent Grade: S.M. # 44-,Sa ELEV. Gar4ge Elev. cz• E.R.P.. mtoPERrtoF: -..Louzado, tylliam, 33 N.W. 98th Street Miami,Sheres, Florida NOT VALID wrissour rut sitgeArtiat AND The ORIGINAL RAISED 1..LORIDA LICENSED SURVEYOR ANDMAPYR ttl A BOUNDARY SURVEY I hereby certify that the survey repre- sented hereon meets the minimum technical standards set forth by the Board of Land Surveyors in chapter 61C17-6 Ronda Administrative Code pursuant to Section ,710:17. Fla. Statutes. There are Ito enaoadunen ts. overlaps, easements appearing on the na t. ocher than as shown hereto V/ 33150 PING 33134 (24 Pointirrc FL MOP'. 115211VVOit aria rearm 1•43. 5-05-03 "Grade Elevations" added. 044,9 7777.75$95.7 FIEL DATE SCALE o9 7,6 oO ifi 11-25-02 "Recertified", Certified T ,.Pahe and,city revised. ,4€,,44 42.0207 er 2 222 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 158156 Permit Number: BPP -4 -11 -620 Scheduled Inspection Date: September 14, 2011 Inspector: Bruhn, Norman Owner: LOUZADO, LYLLIAM Job Address: 33 NW 98 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ESSIG POOLS INC Permit Type: Pools/Whirlpools /Hot Tubs Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1131010330150 Phone: 305 - 949 -0000 Building Department Comments NEW SWIMMING POOLS AND PAVERS DECK OVER SAND BASE Passed 1, Failed Inspector Comments Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. September 13, 2011 For Inspections please call: (305)762-4949 Page. 2 of 30 Y1 jil Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): 11.4 Pr Y /' 14 Y► e Address: '9-3 M IA) (1 0 APR 08201i OOOOO 00 wo 00 Permit No.TP? ®9 Master Permit No. Phone #: �6, city: 1 N l 1 i'- SVLf�sc State: -F 1 Zip: 3 °3 0 s o Tenant/Lessee Name: Phone #: Email: MP Lo U 7 pc- t i) la a ° A -k z) ,C 0N-rx JOB ADDRESS: �'' ' 33 NI LAD E- City: Miami Shores County: Miami Dade Folio/Parcel #: 1 1 31 1 0.� 3 O l • Zip: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: ®o5 d 0V Phone #: 1--c=71 000o Address: l S ST City: ' D / 4-4,-, VI c a State: Qualifier Name: + . 1 �� s State Certification or Registration #: C Contact Phone #: e9 9 GI arDCX D Email Address: pr ►-- ifi .S DESIGNER: Architect/Engineer: PP--e.; £ Zip: ? 1 Cr z Phone #: Certificate of Competency #: Phone #: 1 1 can CD -Ei sa I (n--z S. F-'m I : S2 .2r Value of Work for this Permit: $ 4=) D• S uare/Linear Footage of Work: Type of Work: OAdditioon OAlteration Description of Work: "R ew ORepair/Replace 1 cam. --.-4 i3e c� Ca 0,5 S, ? F 103 t .scR ODemolition % 1 E5r1, ' C •1,---1 1 5 .- (IV 0..cD 5:74 I***************** * * * * ** * **Ix ****** *** * ** *Fees**x ***** * ** * *** * * ***** * * * *** *** * * * * **** x**** Submittal FeL :;' "f Permit Fee $ ' (JQC76) CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ /yaO3 ° ( n 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 comme - t must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued of su posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was a know ged befores The fo day of , 20 11 , by 1 Y 1 1.11‘-'1 -4--f.-.7...1■4--- Ada of Y Signature who is personally known to me or who has produced As identification and o did take an oath. NO S;. Y P ; LIC: or edged before me this kg". v C gal 21 who is personally known to me as _dentifica has produced ion and take an oath. dez DD90441 Expire P. 27, 2018 NDED THRU ATLANTIC Benfi1TB R4a R4 Si Print: My Co i ¢t •ssion Exp , 2013 ATLANTIC BONDLNG CO., INC. *******....*********** *********** ******* ****** ******* * .�: * ***** **GIs *** / * %********* v/ Zoning Structural Review (Revised 07110/07)(Revised 06110/2009)(Revised 3/15/09) Clerk NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPEC110N PERMIT NO.BP-4-4 1° WO TAX FOLIO NO.113101 CS 3 DL- O 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. 11111111111111111111111111111111111111111 1111 CFN 2011R01!57692 DR 8k 27613 Ps 2102► C1PS) RECORDED 03/10/2011 14:46:15 HARVEY RUVIN, CLERK OF COURT MIAMI -DADE CDUNTYr FLORIDA LAST PAGE 1. Legal description of property and street/address: Lori 1 i 1 S%i w . ihh /-ip,, Sh.p,^cs 4- � 3 3 (50 2. Desc t iption of improvement: -�-� l �� '—`'° � c1.--1421. C'f c=4 cc/1g, 3. Owner(s) name and address: kW/Kt . 4/4.2,66 • C ref fil MTh, .s( �� f interest in property: inc- A-vICI Name and address of fee simple titleholder: 4. Contractor's name and address: I8c c i�.l LE [ ST 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ S. Lender's name and address: 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be sery provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: Lu o 0 z 02 0 8. in addition to himself, Owners designates the following persons) to receive a copy of the Lienot's Notice as p in Section 713.13(1Xb), Florida Statutes. u— Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a o different date is specified) gnature of Owner Print Owner's Name Swam to and su Notary Public Print Notary's N My commission expl 23.41 -82 PAGE 4 8142 1 u ,)w--. Prepared by bed before me this day of E z ¢+ IC �rtc�cz Jam ` , 23 Aar .,.,� -e i iE -6TAra 6i Yorleny :Commission #1)1)404911 >'ur... Expires: St?.2, 27, 2013 T: q' r ric Eo tD14G CO, INC„ r— j\ 1- 61, --.-. t, 1 Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit NO. B P P-4 -11 -620 Issue Date: Not Issued Expires:Not Issued Folio Number:1131010330150 Owner's Name: LYLLIAM LOUZADO Job Address: 33 98 Street Miami Shores, FL 33138- Owner's Phone: Total Square Feet: 1031 Total Job Valuation: $ 30,000.00 Contractor(s) ESSIG POOLS INC Phone Primary Contractor 305 - 949 -0000 Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 4/19/2011: Yes Comments: POOL EQUIPMENT CAN NOT BE LOCATED WITHIN THE 10 FOOT SIDE YARD SETBACK. 4/19/11 EQUIPMENT TO BE REPLACED BESIDE EXISTING A/C 1 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 33 NW 98 Street Miami Shores, FL 33138- 1131010330150 Block: Lot: LYLLIAM LOUZADO Owner information Address Phone Cell LYLLIAM LOUZADO 33 NW 98 ST MIAMI SHORES FL 33150 -1736 Contractor(s) ESSIG POOLS INC Phone 305 - 949 -0000 CeII Phone Valuation: Total Sq Feet: $ 30,000.00 1031 1 Approved: Yes Comments: POOL EQUIPMENT CAN NOT BE LOCATED WITHIN THE 10 FOOT SIDE YARD SETBACK. Date Approved: 4/19/2011: Yes Date Denied: 4/8/2011 Type of Work: Swimming Pool Additional Info: Classification: Residential Occupancy: Private Bond Return : Scanning: 6 Fees Due Bond Type - Contractors Bond CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Plan Review Fee (Engineer) Scanning Fee Technology Fee Total: Amount $300.00 $18.00 $13.50 $13.50 $6.00 $900.00 $60.00 $18.00 $24.00 $1,353.00 Pay Date Pay Type Invoice # BPP-4- 11-40580 04/08/2011 Check #: 96885 04/22/2011 Check #: 96940 Bond #: 2037 Amt Paid Amt Due $ 150.00 $ 1,203.00 $ 1,203.00 $ 0.00 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. Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy April 22, 2011 Date April 22, 2011 1 Permit No: 11 -A2O Job Name </--if' , 2011 Miami Shores Viiiage Building Department Building Critique Sheet /9/w " ( f /Legg c e'A- 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 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 1 Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Folio Number:1131010330150 Owner's Name: LYLLIAM LOUZADO Job Address: 33 98 Street Miami Shores, FL 33138- Owner's Phone: Total Square Feet: 1031 Total Job Valuation: $ 30,000.00 Contractor(s) ESSIG POOLS INC Phone 305 - 949 -0000 Primary Contractor Yes Planning and Zoning Criteria and Comments Approved: No Date Denied: 4/8/2011 Comments: POOL EQUIPMENT CAN NOT BE LOCATED WITHIN THE 10 FOOT SIDE YARD SETBACK. PERMIT # j I -- (0°2-`L3 CONTRACTOR: 'SS I ? LS NC SUBMITTAL DATE: &P'2_ I ADDRESS: NAME: ID RESUBMITAL DATES: PROJECT TYPE: (U 1fJ STRUCTURAL FIRE IMPACT FEE ELECTRI AL PLUMBIN HRS/DERM NOC MECHANICAL BLDG Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. ' COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 BUSINESS NAME: COMPLETE CONTRACTOR'S INFORMATION CD I 44 C— BUSINESS ADDRESS: 1 W ME 1 t ST CITYNJD v+k i<:=4) v STATE Ft ZIP CODE 3 3' (... z BUSINESS PHONE: ) 00 ®0 FAX NUMBER ) 14 9 91 -1 1 CELL PHONE ( ) QUALIFIER'S NAME: ✓- I. 1 QUALIFIER'S LIC NUMBER: C- �� ®� E -MAIL ADDRESS (IF APPLICABLE): pe. v r-vi 1 1.> Created on 3119109 BY MLDV I RV 3126109 MLDV 5. c -c�• — STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 ESSIG, DANIEL ROSS ESSIG POOLS INC 1800 NE 151 STREET NORTH MIAMI FL 33162 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque 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.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. 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! AC# ®_l.7 BA DETACH HERE (850) 487 -1395 STATE OF FLORIDA DEPARTMENT OF BUSINESS Abb PROFESSIONAL "REGULATI CONSTRUCTION ° INDUSTRY LICENSING { BOARD" t = BATCH NUMBER LICENSE NB 07/01/2010 098/65969 CPC052505F., The CO MMERCIAL,: POOL /SPA: CONTRACTOR Named' below IS CERTIFIED Under the provisions of Chapter 489 Expiration date: AUG 31, 2012 SEQ# LiO07O1:Q1 2 ESSIG; DANZEL_ROSS, -, ESSIG" POOS I INC 1800 NE! 1515'T''' STREET NORTH MIAMI FL 33162 CHARLIE..CRIST GOVERNOR- ' DISPLAY AS REQUIRED` BY RLIL LIE/ ERIM StORETAR MIAMI•DADE;COUNTY TAX COLLECTOR 1'40 W. FLAGLER ST. 1st FLOOR MIAMI, FL 33130. 2010 LOCAL BUSINESS TAX RECEIPT 2011 FIRST -CLASS MIAMI- DADE'COUNTY - STATE OF FLORIDA U.S. POSTAGE EXPIRES SEPT. 30, .2011 PAID MUST BE DISPLAYED AT PLACE OF BUSINESS MIAMI, FL PURSUANT TO COUNTY CODE CHAPTER 8A - ART. 9 & 10 PERMIT NO. 231 192799 -6 BUSINESS NAME / LOCATION ESSIG POOLS INC 1800 NE 151 ST 33181 NORTH MIAMI THIS IS NOT A BILL — DO NOT PAY RENEWAL RECEIPT NO. 203516-0 STATE* CPC052505 OWNER ESSIG POOLS INC Sec. Type of Business WORKER/S 196 SPECIALTY BUILDING CONTRACTOR 10 THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR UCENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDER'S QUAUPICA- PIONS. PAYMENT RECEIVED MIAMI.DADE COUNTY TAX COLLECTOR: 07/09/2010 09010123001 000045.00 SEE OTHER SIDE DO NOT FORWARD ESSIG POOLS INC 1800 NE 151 ST NORTH MIAMI FL 33181 hd!}t I1111L,t11aLILIil1 # }! L .. aidtllFl II II.E Tli a ',Q�Rp85 CERTIFICATE OF LIABILITY INSURANCE OP IDAI DA 12/01/10 lTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATWELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER BROWN & BROWN OF FLORIDA INC 8000 GOVERNORS SQUARE BLVD 400 MIAMI LAKES FL 33016 -1588 Phone: 305 - 364 -7800 Fax: 305- 822 -5687 CONTACT NAME: PHONE FAX WC, No, Ea0: (A/C, Nap 8800088: PRODUCER CUBMWIR M ESSIG -3 3185$ 8)AFFOROWOCOVERAGe 05100 INSURED Essig Pools, Inc et al 1800 NE 151 ST MIAMI FL 33162 -6010 INSURER A: mar.m. Para Iva of Rar.o. 20478 INSURERS: Valley Forge Insurance Co. 20508 INSURER C: 12/01/11 INSURER 0: $ 1,000,000 INSURERE: DAMAGE TO RENTED pREMISES(Eaommaroe) INSURER F: CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWM1STANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTWTTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I8 SUBJECT TO AU. THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LISTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 08R LTR TYPE OF INSURANCE ADDL INSR 8UBR MD POLICY NUMBER POLICY (MMIDONYTYY Y) POLICY EXP esso01YYYn Ions A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR CPM4026403362 12/01/10 12/01/11 EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED pREMISES(Eaommaroe) $ 100,000 CLAIM&MADE X MED DT (fury one pwson)' $ 10,000 PERSONAL aADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT. AGGREGATE UMITAPPUES PER: POLCY n PJE�CT n LOC PRODUCTS AGO 8 2,000,000 n $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTO9 NON-OWNED AUTOS BUA4O26403376 12/01/10 12/01/11 COMBINED SMILE LIAT (Ea) acolden $ 1,000,000 X BODILY INJURY (Perpeacn) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ X $ UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE 1 AGGREGATE $ DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' I sum DT ANY PROPRIETOR/PARTNEWEXECU$VE OFFICER/MEMBER EXCLUDED? (MendelorVb NFL If yes. dem0le muter DESCRIPTION OF OPERATIONS below Y/N N/A WC4O264O3331 12/01/10 12/01/11 E WCBTATU- oTH- TORY Lem ER EL EACH ACCIDENT $ 1000000 EL DISEASE -EA EMPLOYEE $ 1000000 EL DISEASE - POLICY MIT $ 1000000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (AttachACORD101 Additional Remarks Schedule, if more space M sgWred) ATE HOLDER CANCELLATION MIA -138 Miami. Shores Village 10050 NE 2nd Avenue Miami Shores FL 33138 SHOULD ANY OF ME ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 'ME EXPIRATION DATE THEREOF, NOTICE WILL BE DELS/ERBDIN ACCORDANCE WITH THE POLICY PROVISION& AUTHORIZED REPRESENTATIVE 00 ACORD 25 (2009109) © 1988-2009 ACORD gORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 B P-P - I'1- 620 Inspection Number: INSP - 158165 Scheduled Inspection Date: June 29, 2011 Inspector: Hernandez, Rafael Owner: LOUZADO, LYLLIAM Job Address: 33 NW 98 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ESSIG POOLS INC Permit Number: PL -4 -11 -621 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Pool - Private Phone Number Parcel Number 1131010330150 Phone: 305 - 949 -0000 Building Department Comments PVC PIPING FOR POOL Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments June 28, 2011 For Inspections please call: (305)762-4949 Page 14 of 38 Miami Shores Village .7 v it 0 201 l,' Building Department , 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 l Y: ..... Tel: (305) 795.2204 Fax: (305) 756.8972 " °"...... INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit No. ( f Master Permit No. Permit Type: PLUMBING / �/ OWNER: Name (Fee Simple Titleholder): LOA `' o I t ) / / )Ct Phone #714 �� 277l Address: nJr 9SN r City: IA SI State: Zip: 33/ 6--) Tenant/Lessee Name: Email: JOB ADDRESS: City: Miami Shores County: Phone #: Miami Dade Folio/Parcel #: 113 I n i ®3 3 'c7/ -�� . Is the Building Historically Designated: Yes NO Flood Zone: 3 -lit °i cko .m... Zip :1. CONTRACTOR: Company Name: °6 �Sr— Phone Address: /� -� !r°4- i ( City: N c =i7 --1-' de/1 i ' r State: Zip: 2 l C. Z Qualifier Name: 1:2)-c= r-' �� 1 Phone #: State Certification or Registration #: ��5 Certificate of Competency #: Contact Phone #: 5 `tdr=3-(9 email Address: r m TS lzf:�' 1.O F�C°r DESIGNER: ArchitectBnginz r1: 3 ®P Phone #:LJ-7 Value of Work for this Permit: $ c='"c=(=) Square/Linear Footage of Work: Type of Work: DAddress DAlteration ■''w ORepair/Replace Demolition Description of Work: FY' -7.1 ********* * * ** * * * * * * * * * * * * * * *** * ** * ** * * *F *********** *****+ x*******+x ******** **** ** ***** of Submittal Fee $ Permit Fee $ ..2 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ !,kWatil 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, BOTLF,RS, 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 commed' t must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is iss, : , . In ace of : osted notice, the inspection will not be approved and a reinspection fee will be charged Signature, The fo day of Owner or Agent ing instrument was a 20 , Signature A 1, , gineYnirnan 1 by..^'-► know -,' ged before s e this The fo 611101.--+.`J day of ontractor knowledged before me this J4- who is personally known to me or ' o has produced who is personally known to me or who has produced As identification and who did e an oath. as identification and who did take an oath. A ernandez Co. mission #DD904411 Expires; SEP. 27, 2013 BONDED Tan ATLANTIC BONDING CO., INC. ******** * ******** ***** * ******* ;********************************************** ** ** ** ************ ******* ****** Sign Print: My Co us s ssion Ex ',man ez DD904411 pires, SEP 27, 2013 U ATLAN P[C BONDING CO., INC. APPROVED BY 015---// Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO.11.3JOI 03300- 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. 111111111111111111111111111 111111111111111111 CFN 2011R0157892 OR k 27613 Ps 2102; (fps} RECORDED 03/10/2011 14:46:15 HARVEY RUVIN, CLERK OF COURT MIAMI- C<ACDE COUNTY r FLORIDA LAST PAGE 1. Legal description of property and street/address: LO` j i" ,4/ /i� / /1; t 9iG'ie 4 •3A/1d , mtAnv _ h iyn 31 (emu 2. Description of improvement: qfr"'e'1- - e,T 3.Owner(s) name and address: \i/1(G1 A) IA) C/2 TJl'17t ini . e(`"4- 4 ( -314(-1 interest in property: Name and address of fee simple titleholder: 4. Contractor's name and address: (Sl 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be sery provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: z� -fa 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienot's Notice as proNt t In Section 713.13(1)(b), Florlda Statutes. t'- Name and address: 6 a 9. Expiration date of this Notice of Commencement: (the expiraton date is 1 year from the date of recording unless a Q `o different date is specified) gnature of Owner Print Owner's Name Sworn to and su Notary Public Print Notary's N My commission expl 123.01 -52 PAGE4 8102 bed before me this Prepared by le 1 day of +' , 20 l I . 2 1 Si.� < < �1 ress:" ?:5-1 �! `AL AL4_ tev 1IE -6iAt ei' Xorleny ., Comrxll 1011 # 1)13904411 s� : F.!ipi'rec SV ?. 27, 2013 ',� "• i AI`L!L't't10EONDISOCO.,IN� BONDED T1iR E4 Property Information Map My Home Miami -Dade County, Florida Property Information Map Aerial Photography - 2009 0 111 ft This map was created on 3/8/2011 9:30:28 AM for reference purposes only. Web Site © 2002 Miami -Dade County. All rights reserved. Page 1 of 1 Summary Details: Folio No.: 11- 3101- 033 -0150 Pro •e : 33NW98ST Mailing LYLLIAM E LOUZADO &H ddress: RICARDO & Livin• Units: LYLLIAM RUIZ &H d' Sq Footage: RMANDO r3 NW 98 ST MIAMI Lot Size: HORES FL ear Built: 33150 -1736 Property Information: Primary Zone: 11800 SINGLE FAMILY RESIDENCE CLUC: 1001 RESIDENTIAL - INGLE FAMILY Beds /Baths: /1 Floors: 1 Livin• Units: 1 d' Sq Footage: 1,580 Lot Size: 7,650 SQ FT ear Built: 1951 $50,000/ $108,045 MIAMI SHORES SEC 6 PB 10-39 LOT 22 & E1/2 Legal LOT -21 BLK 128 LOT Description: IZE 75.000 X 102 OR chool Board: ►0070 -1794 12 2001 4 $25,000/ $128,890 •R 20070 -1794 1201 01 Assessment Information: Year: 2010 2009 Land Value: $61,588 127,06 Buildin• Value: $132,525 ' 142,278 Market Value: $194,113 x.269,345 ssessed Value: $158,045 x;153,890 Exemption Information: Year: 2010 2009 Homestead: $25,000 $25,000 2nd Homestead: YES YES Taxable Value Information: Year: 2010 2009 4.0 Applied Applied Taxing Authority; Exemption/ Taxable Exemption/ Taxable • isqualified as a result of Value: Value: Regional: $50,000/ $108,045 $50,000/ $103,890 ounty: $50,000/ $108,045 $50,000/ $103,890 $50,000/ $50,000/ $108,045 $103,890 chool Board: $25,000/ $133,045 $25,000/ $128,890 Sale Information: Sale Date: 12/2001 1 Sale Amount: 4.0 ale O /R: 0070 -1794 ales ales which are q ualification • isqualified as a result of Description: xamination of the deed View Additional Sales http ://gi sims2.miami dad e. gov /myhome /pri ntmap. asp ?mapurl= http: / /gisims2. miamidade.gov... 3/8/2011 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 -(112 Inspection Number: INSP - 161572 Permit Number: EL -4 -11 -622 Scheduled Inspection Date: July 18, 2011 Inspector: Devaney, Michael Owner: LOUZADO, LYLLIAM Job Address: 33 NW 98 Street Miami Shores, FL 33138- Project: <NONE> Contractor: SHINE MAINTENANCE ELECTRICAL Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Pool - Private Phone Number Parcel Number 1131010330150 Phone: (305)688 -2000 Building Department Comments POOL HOOK UP Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP - 158172. cancelled by pool company July 15, 2011 For Inspections please call: (305)762 -4949 Page 16 of 35 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No. 1 (090) Master Permit No. a L APR J 6 2011 ° 00000000401.0404000000C BUILDING PERMIT APPLICATION FBC 20 Permit Type: Electrical OWNER: Name (Fee Simple Titleholder): Address: k) (AJ of r City: rn I R SGL 4'214.D0 1,\11 1 1 n A, Phone #: State: Zip: : 3) '5t✓ Tenant/Lessee Name: 514/C106911,, Phone#: Email: m ),(i1/(� ,�i �v JOB ADDRESS: N �T City: Miami Shores County: Miami Dade Folio/Parcel #: ! 1 .3 / ®1 -®3. g=) I Is the Building Historically Designated: Yes NO Flood Zone: '1"--)1" --r Jvl i.---T.ter, 7z.. --tC-c CONTRACTOR: Company Name: F I Cc--t-v- i C.=9 1 C.c:.--cry t�t' mac. -✓p. Phone #: d=5-c,' Address: 3 1 c-° 64 "-I I (2 .S i City: rca — L--1::::C-4C-32=1 State: T- 1 Zip: 33 D 'ACI--- Qualifier Name: F✓ c--i c-40 5,---cD+""'TC°S Phone #: State Certification or Registration #: FY �c:zi� l� 14--- Certificate of Competency #: Contact Phone #: 35 CeZ303 �e Email Address: CA k O eS161/".C-C. L-r -r-v'1 C ®( • fir'■ DESIGNER: Architect/Engineer: P : (pi - , i r-rcG1(i Phone#:.73 23 :2-4-35 Value of Work for this Permit: $ I --S-W Square/Linear Footage of Work: Type of Work: Address DAlteration Slew ❑Repair/Replace ODemolition Description of Work: 'l'° 1 1--, W Submittal Fee $ Permit Fee $ �� ®� CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ ° Technology Fee $ TOTAL FEE NOW DUE 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 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 Owner or Agent The f r oing instrument was a knowl- . ged before t 1 e this The fo g ing instrument was acknowledged before me this i day o '-'1'7 20 ° I , by , 1�: "� 1 day of c--1°-/ , 20 it , by Signature Contractor U ATLANTIC B who is personally known to me or wh has produced As identification and who did take an oath. APPROVED BY RIDA andez DD904411 i es: SEP. 27, 2013 who is personally known to me or who has produced as identification and who did take an oath. PUBLIC: 1' I Plans Examiner (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) NO Sign: Print: My Comrni or1e ss dea x4411 P27,2013 OIv G L(l IiVG Zoning Structural Review Clerk Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. 'r COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. ' COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME:Sk) l� -c;:1; IC Cc4'1-17- c._. -r ®Y BUSINESS ADDRESS: 385714°' M Ld 125 ST CITY qpc:=I STATE Fl ZIP CODE 330s 4 BUSINESS PHONE: ) ® 20) FAX NUMBER (3 3 ®c)° CELL PHONE ( ) QUALIFIER'S NAME:4r� vL � £ • X0rtC) QUALIFIER'S LIC NUMBER: EC c (S 4— E -MAIL ADDRESS (IF APPLICABLE): Created on 3119109 BY MLDV I RV 3126109 MLDV 1 STATE OF FLORIDA 'DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL" CONTRACTORS LICENSING BOARD SEQ# L10080402123 BATCI-jNUMBER y' LICENSE NBR 108023345 EC 0001514 The ELECTRICAL CONTRACTOR Named below IS. CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2012 SANTOS,_- FRANCISCO E SHINE. MAINTENANCE ELECTRICAL CONTRACTORS CORPORATION 3876 NW. 125 -ST OPA -LOCNA FL 33054 CHARLIE GRIST GOVERNQR DISPLAY AS REQUIRED BY LAW CHARLIE LIEM SECRETARY Mliilril -.DADE COUNTY TAX COL LzcIOfi 1411 W FLACiLER ST. 1st FLOOR MIAMI, ft. 33130 2-010 LOCAL FiUSINE9S TAX RECEIPT 2017 MVO 0/10E COUNTY - STATE OF F1,OI110;3 EXPIRES SEPT. 30, 2011 MUST BE 01SP1_RYEG Al PLACE QV ©US1NESS PURSUANT TO COUNTY CADE CHAPTER AA - ART. 9 & 10 484149-1 lil. lNESL„ NAME I LDGA'1IDN. SHINE MAINTENANCE ELECTRICAL CONTRACTOPS PORE' 3876 NW 125 ST 33454 OPA LOCKA owtiut SHINE- MATNT_ENANCE ELEC CONTR COR 9,,. TNI aP fzkitrikit 146 ELECTRICAL CONTRACT R 14'.15 15 PA'S 1,0C,%1 1,0C,%1 ,_ Ucts N5 T4P 5t'CEIPT, fi ors NOT POithir THt r0:61714 ru vin'.ATE Ar;f F IZI u:- 1111,,U( At-0CW slfi •4i wftt 1 M t5c' - -01X41 r OF1 C,11P,S, flO ' IZEO S ti kiC On.'TNk; 11474:01A, (We! auw c u ['r• t s,Y. 4.4. • r:Rl A 0.0ISFI'11� t,O LOUR ': ilA1Hl{Flf =d- `iff_jir. ti)f Ai-1,1V Ipk 07/22/2010 OIMO4540 ' SEE OTHEff SIDE FIRST •CLA$ S U.S. POSTAGE PAID MIAMI, FL PERM1T N[+. 231 Hfi[ lVki RENEWAL. tmcdPl NO 505330 -1 STATE# E00001514 WORKER /S 1 DO NOT FORWMRD SHINE :[MAINTENANCE ELECTRICAL CONTRACTORS CORP RI:MERTU MARTINEZ PRES 3876 NW 125. ST. OPA LOCKA PL. 33054 I,II1411u1i ;G1iA11 lYlt btlllk! ?t!Yi.{li.1 k14t rffll LV}lcti7 e ® CERTIFICATE T LIABILITY' INSURANCE DA 09/21/10 (21"'� PRODUCER .AII'Motors Insurance ' 11934 S.W. dt i a`tteef Miami, FL 33184 Phone (305)559 -8818 Fax (305)227 -0977 f 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 # INSURE° SHINE MAINTNANCE ELECTRICAL CONTRCTR CORP D/B/A SHINE ELECTRICAL ENGINEER 3876 NW 125 STREET- 1 OPALOCK , R. .%I95I' INSURERA SCOTTSDALE INS. CO. INSURER B: NORMANDY INSURANCE COMPANY INSURER C: LLOYDS INS. CO. INSURER D: PROGRESSIVE INSURANCE CO. INSURER E: COVERAGES INSURER F: THE POLICIES OF =MANCE LIST to HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WffH 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 LTR ADD'L INSRD TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTIVE DATE (MM!DDIYY) POLICY EXPIRATION DATE (MMJDDIYY) LIMITS A . GENERAL LIABLYTe ® GENERAL LIABILITY M ❑ Guns MADE OCCUR WI Blankets/id/tin/7ai.lima: FJFEA -J 07/27/10 07/27/11 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurence) 50,000 MED EXP (Arty one person) 5,000 PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE 3,000,000 n Waiver of Subrogation PRODUCTS - COMP /OPAGG 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER : • POLICY ® PROJECT II LOC D 1 AUTOMOBILE III ® II Mil Lei • ❑ LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS COMBINED SINGLE OMIT (Ea accident) BODILY INJURY (Per person) RY BODILY accident) PROPERTY DAMAGE (Per accident) III GARAGE LIABILITY • ANY AUTO • AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG 1 EXCESS/UMBRELLA LIABILITY II OCCUR 1 CLAIMS MADE • DEDUCT,IaLE ❑ RETENTION $ EACH OCCURRENCE AGGREGATE B 0Y RS' AND ANY PROPRIETOR 1 PAST.NER. /. FXEI FINZE OFFICER/ MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below NHFL100081 09/23/10 09/23/11 TORYuM S ER EL EACH ACCIDENT 500,000 EL DISEASE - EA EMPLOYEE 500,000 EL DISEASE - POLICY UMIT 500,000 0 OTHER DESCRIPTION OF DPIENATKINS / LOCATIONS / VEHICLES J EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS ELECTRICAL CONTRACTOR INCLUDING FIRE & SECURITY SYSTEM, PHONE LINES ELECTRICAL ENGINEERING CERTIFICATE HOLDER CANCELLATION VILLAGE OF MIAMI SHORES 10050 NE 2 AVE MIAMI SHORES, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDE4X0120Z0 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 ACORD 25 (2001/08) QF © ACORD CORPORATION 1988 Miami Shores Viiiage 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 I (We) acknowledge tilt a new swimming pool, spa or hot tub will be constructed or installed at ow 6N Miami Shores, FL, and hereby affirm that one of the following methods will be used to meet the requirements of Chapter 515, Florida Statues and the Florida Building Code R4101.17. Please initial the method(s) to be used: 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 ool Saf Requirements, and upon expiration of the permit, the pool shall be fe . nderstand that not having one of the above installed will constitute a 15 F.S ., an d will be considered as committing a misdemeanor of the second rovided in Section 775.082 or Section 775.083 F.S . This form must be signed the prime contractor. Private Swimmi presumed t. violation •f C to degr- TURE AND DATE iP.22, 013 LADING CO., INC. C WNER'S SIGNATURE AND DATE TARY PUBLIC -STATE OF FLORIDA " Yorleny M. Hernandez Commission #DD904411 pires: SEP, 27, 2013 ATLANTIC BONDING CO., INC. QuAUTY SER i11 i CD, SAFE POOLTM MODEL S087 AREA ENTRY ALARM OPERATION MANUAL INTRODUCTION Congratulations on your purchase of Techko Safe Pool Model S087 safety alarm. The safe pool can be used to provide a high volume alarm alert when children have entered a pool or spa area. The S087 can be used outdoors on wood or metal gates, or indoor on doorways leading directly to potentially dangerous areas. FEATURES • Easy installation for gate on door protection. • Water / Weather resistant • 9 Volt battery power (not included) • High output 110 -120 dB alarm siren • One button BYPASS operation • "Always On" alarm protection IMPORTANT SAFETY TIPS • Alarm siren is VERY loud: NEVER place the unit close to ears • Install the unit high enough to be out of reach of children • Keep this manual for future reference The Safe Pool can provide valuable protection when used correctly. However, it cannot guarantee complete protection against accidents or injuries. Therefore, Techko cannot be held responsible for any loss, damage, or injury that may occur. INSTALLATION WARNING: Read all installation and operation instructions thoroughly before processing with installation.. Before installing. the battery, use a rubber band to temporarily secure the two magnetic sensors together with the arrows pointing toward each other to avoid setting off the alarm. INSTALLING THE BATTERY: 1. Remove the battery cover of the unit and jnstall a new 9 Volt battery .. 2. If you are sensitive to loud sound, please wear ear protection against the loud alarm siren before testing the alarm. 3. once the battery is connected the unit is now ON and Working. To test the alarm siren, make sure you have ear protection before testing. After ear protection is in place, separate the magnetic sensors apart by more than 1 inch. The alarm should sound immediately after the sensors are separated. Press the BYPASS button and immediately secures the two magnet sensors together again to avoid the alarm sounding off unintentionally. MOUNTING: - WARNING: The alarm should be positioned close to the door high enough to be out of the reach of children. Note: As each. mounting application varies, Techko suggests testing the unit .installation location and effectiveness before permanently mounting the S087. REMOVING THE SCREWS AND TAPE FROM THE SENSOR HOUSINGS. Mounting screws • and double -sided tapes are located inside- the sensor housing (See fig. 4). Using a small fiat head screwdriver, gently pry open the recessed sensor spacer of the sensor housing up and remove the screws and double -sided tapes. MOUNTING INDOORS USING DOUBLE —SIDED TAPE Make sure that the mounting surfaces for the double -sided tapes are completely clean: Attach the double -sided tapes onto the rear of the unit, and then secure the unit onto the desired mounting surface. • MOUNTING INDOORS USING DOUBLE -SIDED RAPE Make sure that the mounting surfaces for the double -sided tapes are completely clean. Attach the double -sided tapes onto the rear: of the unit, and then secure the unit onto the desired mounting surface. Fig 1 MOUNTING INDOORS USING SCREWS Using the provided mounting template printed in the manual, mark the position of the screw holes on the desired mounting surface. Drill the screws onto the mounting surface with approximately 1/8 inch of tread remaining. Slide the unit over the screws and secure the unit by pushing it downward as show 1 Fig.1. You may need to adjust the screws towards or away from the mounting surface to provide a more secure fit. Flg 2 Flg 3 MOUNTING THE SENSORS INDOORS Make sure that the arrows of each sensor are 'pointed towards each.bther. Using either the double -sided tape or the screws provided, mount the sensors so that they are less than 1 inch away from each other. Please make sure that the wired portion of the magnetic sensor. is mounted on-the non- moving portion of the mounting surface and•the standard sensor is mounted on the door /gate (See Fig. 2) MOUNTING OUTDOORS ON WOODEN GATES Using the provided mounting template printed in this manual; mark the position at the screw holes . on the desired mounting surface. Drill • the screws onto the mounting surface with approximately 1/8 inch of • tread remaining. Side the unit over the screws and secure the unit by pushing it downward as show in fig. 1. You may need to adjust the screws towards or away from. the mounting surface to provide a ore secure fit. MOUNTING OUTDOORS ON METAL GATES Using the provided nylon wire line; attached the alarm body to the metal gate frame (See fig. 3) MOUNTING THE SENSORS OUTDOORS (WOODEN OR METAL FENCES) Break off the tabs on the side of each. sensor (See fig. 4). Make sure that the arrows of each sensor are pointed in the same direction as the sensor housing before placing the magnetic sensors inside the sensor housing. Snap the sensor spacers (the two cover -lies plastic pieces you pried open to get the double -sided tape and the screws) back into the sensor housing; this creates waterproof protection for the magnetic sensors. Secure the sensors using the nylon wire lies onto the gate frame, make sure that the sensors are pointed towards each other and that the sensors are less than 1 inch apart (See fig. 3) ENSOR • SPACER SENSOR OU !SG Sows= Fig 4 Tape & Screws Located inside 'Sensor Housing PRODUCT INFORMATION The Safe Pool is designed to sound a loud alert when children enter through a safe pool protected door /gate. When properly installed, the Safe Pool wili.allow adults to pass through the protected door /gate and immediately shut off the sounding alarm. When powered, the Safe Pool is always is always in protected mode. The alarm will activate the instant when the door /gate opens by more than 1 inch (when the door /gate opens by more than 1 inch.) Once the alarm activated, it will sound continuously until the BYPASS buttons is pressed. When passing trough the door /gate from the side where the alarm is mounted, press BYPASS. button then open the door /gate, pass trough and close the door /gate within 10 seconds and the alarm will not activate. When passing trough the gate from the opposite side, open the door and quickly press the BYPASS button and close the door quickly. The unit will re-arm within 7 -13 seconds. When the alarm volume become low or the unit does not produce normal alarm sound, replace the 9 -Volt battery. The Safe Pool's p[lactic resists ultraviolet rays from direct sun light exposure. However, slight discoloration over time is normal. WARNING! THE SAFE POOL ALARM IS EXTREMALYU LOUD WHEN ACTIVATED, FOR YOUR SAFETY; NEVER PLACE THE UNIT CLOSE TO YOUR EARS TO TEST THE ALARM. ALWAYS USE EAR PROTECTION AND DIRECT THE UNIT AWAY BEFORE TESTING /ACTIVATING THE ALARM. Important warranty information: A dated proof of purchase is required for warranty service Type SM: System is intended To be self- monitored Customer Service: 1- 888- 8TECHKO (1- 888 - 889 -2456) Monday — Friday 09:00 AM — 4:00 PM Pacific Standard Time E -mail: supportta,techkousa.com Web Site: www.techkousa.com Mfg. By 9767 Research Drive, Irvine, CA 92618 -4826 MADE IN CHINA <rx US PATENT NOTICE THIS PRODUCT IS PROTECTED UNDER FEDERAL PATENT, TRADEMARK AND COPYRIGHT LAWS AND LAWS PREVENTING UNFAIR COMPETITION NO DUPLICATION OR SIMULATION OF THIS PRODUCT BE PERMITTED EXCEPT BY WRITTEN AUTHORIZATION OF TECHKO, INC TECHKO AND THE CONFIGURATION OF THIS PRODUCT ARE TRDEMARKS OF TECHKO, INC. COPYRIGHT TECHKO, INC ALL RIGHTS RESERVED MADE IN CHINA Date Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 SWIMMING POOL OWNER'S CERTIFICATION Miami Shores Village Building & Zoning Department Attention: Building Official I certify that I am the legal owner of the property described as 1f Y2 ( , located at 3 3 r \k( f (ct Shgcs In accordance with Section 33- 12(f), Code of Metropolitan Dade County, I certify that I understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until separate permit has been obtained for an approved safety barrier, and such barrier erected, inspected and approved. further understand that this certification, however, does not eliminate the need for obtaining a permit and erecting and 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. Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RESTRICTIVE COVENANT PROTECTIVE POOL ENCLOSURE KNOW ALL MEN BY THESE PRESENTS: WHEREAS, the undersigned kyu-i i ii tLb (3 is /are the fee simple owner(s) of the following described property situated and being in Miami Shores Village, Florida: Address: 1V IA) q ,q Whereas, the undersigned owner(s) -� L I ftl'1 ! _W-7 !-j) j ) desire to utilize said Lot(s) as a single building site, and the undersigned owner(s) do(es) hereby declare and agree as follows: That the property will not be used in violation of any ordinances of Miami Shores Village or Miami -Dade County now in effect or hereinafter enacted. II. That the purpose of the covenant is to induce Miami Shores Village to issue a permit for a pool where the required enclosure is not on the subject property where the pool is located. III. That if any of our adjoining neighbors remove any portion of their fence or wall, or if our /my property shall fail to meet code requirements for pool barriers, we, as owners will immediately install a protective enclosure to meet code requirements and will obtain a permit for such fence. IV. That, Ilwe, as owner(s) hold Miami Shores Village harmless for any negligence or injury that results from not having the enclosure. V. If enclosure belongs to said property, I agree to maintain & or replace said enclosure in the event that is damaged or removed by any case. NOW, THEREOF, for good and valuable consideration, the undersigned do(es) hereby declare that he /she will not convey or cause to be conveyed the title to the above property without requiring the successor in title to abide by all terms and conditions set forth herein. FURTHER the undersigned declare(s) that this covenant is intended and shall constitute a restrictive covenant conceming the use, enjoyment and title to the above property and shall constitute a covenant running with the land and shall be binding upon the undersigned, his/her successors and assigns and may only be released by Miami Shores Village, or its successors, in accordance of said Village then in effect OWNER SIGN & PRINT I Hereby Certify that on this day personally appeared before me # as identification and he /she acknowled for purposes there in expressed. SWORN TO AND SUBSCRIBED before me on this day of (Revised 05/2209 OWNER SING & PRINT ILIrvl—ilay aed has produced ID e that he /she executed the foregoing, freely and voluntarily, IJ 0 I AVM ill T\.`► \� C -STATE OP FLORIDA •' ,''. Yorieny M. Hernandez `Commission #0D904411 Expires: SEP. 27, 2013 BONDED THP. U ATLANTIC BONDING CO., INC. STATE OF (FLORIDA) COUNTY OF (DADE) Miami Shores Viiiage Building Department SURVEY AFFIDAVIT The undersigned Affiant, kl I M i !;+ , does hereby attest t that (Property owner) The attached survey, performed by 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 (Name of surveyor's company) For address: 5 i) q Y11 0 Performed on (date of survey) is an accurate representation of the existing conditions and 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 seven (7) years old 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 say eth naught. Property Owner Signature V A Property Owner Print Name SWORN TO AND SUBSCRIBED before me this -8 day of ,� c:) Affiant is personally known to me, produced L.11I1 0. wt. LZ a Revised on 5/22/2009/ Revised on 6/12/09 NOTARY PUBLIC-STATE OF FLORIDA Yorleny M. Hernandez ; CO mission n DD90441 Expires; SEP. 27, 2013 BONDED THRU ATLANTIC BONDING CO., INC. identificatio r: L1_'‘1441wig rage 1 012 .t4 v � 75! O 'SO�.F � ' 0`r �S!°�l. ` �5� � fit? '� This property described as: All of Lot 22 and the East 1/2 of Block 128, . MIAMI SHORES SECTION NQ. 6,. according to the -Plat thereof, as recorded in Plat Book 10, Page 39 of the Public Records of MiamiftiDadty coi hhy ,d 1orida . L.F. ELEV. = /3 742 denotes lowest habitable floor elevation. Elevations shown refer to N.G.V.D. 29 Lowest Adjacent Grade: _1 B.M. # ,r --#70 ELEV . Gargge Elev. ,/%io PROPEa3Y OF: _- Lohzado, Lylliam, 33 N.W. 98th Streets Miami: Shores, Fiorida. 'U r VALID WITHOUT 'IDE SIG 4ATURE AND THE ORIGINAL RAISED SEAL OF FLORIDA LICENSED SURVE.1)R AND AIAFPR A BOUNDARY SURVEY 1 hereby certify that the survey repre- sented hereon meets the minimum technical standards set forth by the Board a Land Surveyors in chapter 61C17 -6 Florida Administrative Code pursuant to Section Q72,07. Fla. Statute . There are I%o encroachments. overlap% easements appearins on the Plat other than as shown hereto(° 331-50 Ir4 : •PFtOFESIONAL S<1VEYING AND MAPPING • CANNES & GARCIA, INC. L:B.#1098 • FRAN0ISCO'F. FAJARDO PSM #4767 385 Alhambra Clrclo, Suite #C, Coral Gables, Florida 33134 PH (305:066 -7909 FAX (305}55'3002 lannesgatt al yahoo to F1EL 091 qi -f5 -03 "Grade Elevations added r ..4 ! , P 1 - -- "/G`�h; 11 -25 -02 "Re a. p DATE w /00 SCALE DRAWN BY D ni14 e tified" , Certified To,- .�.Pamel `Map _.City revised. A4' 0? ,07 or. 221389 N. .t4 v � 75! O 'SO�.F � ' 0`r �S!°�l. ` �5� � fit? '� This property described as: All of Lot 22 and the East 1/2 of Block 128, . MIAMI SHORES SECTION NQ. 6,. according to the -Plat thereof, as recorded in Plat Book 10, Page 39 of the Public Records of MiamiftiDadty coi hhy ,d 1orida . L.F. ELEV. = /3 742 denotes lowest habitable floor elevation. Elevations shown refer to N.G.V.D. 29 Lowest Adjacent Grade: _1 B.M. # ,r --#70 ELEV . Gargge Elev. ,/%io PROPEa3Y OF: _- Lohzado, Lylliam, 33 N.W. 98th Streets Miami: Shores, Fiorida. 'U r VALID WITHOUT 'IDE SIG 4ATURE AND THE ORIGINAL RAISED SEAL OF FLORIDA LICENSED SURVE.1)R AND AIAFPR A BOUNDARY SURVEY 1 hereby certify that the survey repre- sented hereon meets the minimum technical standards set forth by the Board a Land Surveyors in chapter 61C17 -6 Florida Administrative Code pursuant to Section Q72,07. Fla. Statute . There are I%o encroachments. overlap% easements appearins on the Plat other than as shown hereto(° 331-50 Ir4 : •PFtOFESIONAL S<1VEYING AND MAPPING • CANNES & GARCIA, INC. L:B.#1098 • FRAN0ISCO'F. FAJARDO PSM #4767 385 Alhambra Clrclo, Suite #C, Coral Gables, Florida 33134 PH (305:066 -7909 FAX (305}55'3002 lannesgatt al yahoo to F1EL 091 qi -f5 -03 "Grade Elevations added r ..4 ! , P 1 - -- "/G`�h; 11 -25 -02 "Re a. p DATE w /00 SCALE DRAWN BY D ni14 e tified" , Certified To,- .�.Pamel `Map _.City revised. A4' 0? ,07 or. 221389