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BPP-11-1869126 IN. BUILDING PERMIT APPLICATION FBC 20 • NGami 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 ,,� Perm ' it No. C (^ t 75 RECEIVED OCT 122011 BY: 0 Master Permit No. Permit Type: BUILDING ROOF G V-797-1915 (F ) i' I �1 �( i�/ i%�� Phone #: OWNER: Name (Fee Sim le Titl holder Address. _ 3111 9q m $ City: l/ I 4 I ' State: /2-- Zip: 7/7 O Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: 3N 7 ij( 9q4$7L City: Miami hryores / Count A: Miami Dade Folio/Parcel #: // O' Oh —049 '�6 / ! V Zip: 33,/ ?© Is the Building Historically Designated: Yes NO 1.- Flood Zone: ri CONTRACTOR: Company Name: 1/ �-s i t9/ = 7 Phone#: 9$V2/9' ~ 20 9'Y Address: 5•4'i2S at: /C 2 hie e'A 93 City: / /! tate: q Qualifier Name: / / (� / 4' e 4/ /1 Phone #: 9$"0-2/- ZO �� C �7 State Certification or Registration #: /!(� ' 5 Certifica of Comppeetenccc #: Contact Phone #: % ,$2 -/q-2 4 Email Address: Ma "'rod /..S `7%/ /. (1 '7 DESIGNER: Architect/Engineer: Phone #: Zip: ,?3 X7 Value of Work for this Permit: $ e Type of Work: ❑Additioi UAlteration Description of Wok: I 4 /4 jr. '1 (° � 1> co-( 1 Square/Linear Footage of Work: C( New ❑Repair/Replace / � ei 5/1, 71\ ❑Demolition *******!** ******* ** ** **** ******* **** * ***** Feed*** �x�x�x* x�w �x* �x�xx��n�x**** �x�x** �xa��xx��x� :�x�u�x *�x *u��x�x�x *�x�x�x Submittal Fee $ yV ' (4 ,► p Permit Fee $ 6.1 0 cc33�, CCF $ CO /CC $ Scanning Fee $ f Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subjec,do, attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first insp ction which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will ncie v ?proved and a reinspection fee will be charged. id Signature Owner or Agent The foregoing instrument was acknowledged before me this 1 day of L, 1.1. k 0- , 20 LL, by HceJA who is personally known to me or who has produced /; Pa j@,, As identification and who did take an oath. NOTARY PUBLIC: Signatur Contractor The foregoing instrument was acknowledged before me this 12- day of 1® ,20ll,by 014-12-kt 4 L TL)41-2-ri who is personally known to me or who has produced D as identification and who did take an oath. NOTARY PUBLIC: Sign: d'1a..'Ll,'G[� t � . '�'‘ Sign: : / / Print: Print: 7:.. '4' % ..., , ...-. V�,sinnn....., - p . p�o'�s� ��' 4 '; t + E 4 , E','• + • , My Commission Expires: _ : �o c. : cp = �n +:s u�,v, pi +no _ Ill: _ . _ Cl NNW mss..,,.tr' to i ti�OSa •• e ***= ******************H�He*iiii'i iiii*114)iiH4 * liesh`sksk*********** *** o *********o********************/ � ****$A R.$s $,. ,4. \\� APPROVED BY / ilitlll`t%„\� \N� %%� / bc'a/ /Plans Examiner /fit// ? l� Zomng My Commission Expires: Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) • Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ,SWIMMING POOL OWNER'S CERTIFICATION Date l0 Miami Shores Village Building & Zoning Department Attention: Building Official I certify that I am the legal owner of the property described as ilf arili f dres.�ec / 4'"/ /tD» 'y,� �� , located at 3/10/7 e5/ 44/q,la, ,14)//e,5 ,✓ -2 33/3Z 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. I further understand that this certification, however, does not eliminate the need for obtaining a permit and erecting and approved barrier prior to fin ins 'cif n and use of the pool. Legal Owner Note: This certification is to be submitted with a swimming pool permit application in duplicate. 4 • 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 PRESS: � ny� WHEREAS, the undersigned / GSf PY � / /, 411e 2 is /are the fee simple owner(s) of the following described property situated and being in Mi mi Shores page, Florida: Address: 3/41 /lfg 94 5/ J'Cf /143/7g Whereas, the undersigned owner(s) ` sitar 4 dpi l 'UP Z 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, Uwe, 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. BURT 4EI, the undersigned declare(s) that this covenant is intended and shall constitute a restrictive covenant concerning the ytise, enjoyment and title to the above property and shall constitute a covenant running with the land and shall be binding Orion 3ne , ndersigned, his/her successors and assigns and may only be released by Miami Shores Village, or its suc cesOrs, iti ordance of said Village then in effect. OWNER SING & PRINT I Hereby Certify that on this day personally appeared before me 11 l A d 6 j `� �� I16 46 1 and has produced ID # s !o LAC (r as identification and he /she acknowledge that he /she executed the foregoing, freely and voluntarily, for purposes there in expressed. SWORN TO AND SUBSCRIBED before me on this A _ day of a: - *bet 20 / 1.164l1/1.'- 4.„,, 4�` NOTARY PUBI4 STATE OF FLORIDA (Revised 05/2209 ENPOLVN E STEV:AIRT r,lY Cif VIISSIC.N r DD961S86 17 )J'%1( /_pzil 19, 2014 `fLM.L1ifN4*yyV'/VV,.'I' • • 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 acknowlled a that a new swimming pool, spa or hot tub will be constructed or installed at 1 ""L 1L1 5 ( 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. e initi ; I the method(s) to be used: The pool will be equipped with an approved safety pool cover that comp lies with ASTM F1346 -91. (Submit Manufacturer's Specifications). A continuous, one -piece (child) barrier meeting the requirements of Florida Building Code R4101.17.1.15 will protect the pool perimeter. The plans shall show the fence location and method of attachment, including one end that shall not be removable without the aid of tools. (Submit Manufacturer's Specifications). A combination of non - dwelling walls and fences (screen enclosure, child fence, masonry fence walls, chain link or wood fence, etc.) will protect t he pool perimeter. The plans must specify t he type and location of all non dwelling walls. Florida Building Code, R4101.17.1 Any combination of protection which incorporates dwelling walls with openings directly into the pool perimeter and all windows and doors will be equipped with exit alarms complying with Florida Building Code, R4101.17.1.9 (Submit Manufacturer's Specifications). Any combination of protection which incorporates dwelling walls with openings directly into the pool perimeter and all doors will be equipped with a self - latching device with positive mechanical latching/locking installed a min. 54" above the threshold. If this option is selected, submit plans showing all types and location of all perimeter protection. The plans must also show the location and type of all openings, and the hardware type for each location. (Submit Manufacturer's Specifications). In accordance with the Code, the pool may not be filled with water without compliance with the Private Swimming Pool Safety Requirements, and upon expiration of the permit, the pool shall be presumed to be unsafe . I understand that not having oneigf th ='a 0 ve installed will constitute a violation of Chapter 515, F.S ., an d will be considered a (cd ittin a misdemeanor of the second degree, punishable as provided in Section 775.082 or Se io l 77 . ' 83 F.S . This form must be signed bage a condor. a` CONTRACTOR'S SIG TURE AN a DATE OWNER IGNATURE AND DATE O IWNER'S NAME PLEAS - RINT) y NOTAI ' PUBLIC CONTRACTOR'S NAME (PLEASE PRINT) NOTARY PUBLIC a!WENDOLr ?d6 `TFr,':'k, T, f oNI:, _ ti Di)06: �n1' E, ptJ I t �Ui.r sua. Co _ ' n,t�,y`./"yhw✓y:IHM�i%nfr>L,w,n Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. _ Job Name f- ,e.(41 STRUCTURAL CRITIQUE SHEET 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:1132060136190 Owner's Name: VERONICA SEGRERA Job Address: 314 94 Street Miami Shores, FL 33138- Owner's Phone: (786)797 -1985 Total Square Feet: 792 Total Job Valuation: $ 21,000.00 Contractor(s) MARS POOLS Phone (954)214 -2844 Primary Contractor Yes 1 Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 10/13/2011: Yes Comments: Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 165396 Permit Number: BPP -10 -11 -1869 Scheduled Inspection Date: December 08, 2011 Inspector: Bruhn, Norman Owner: SEGRERA, VERONICA Job Address: 314 NE 94 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MARS POOLS Permit Type: Pools/Whirlpools /Hot Tubs Inspection Type: Final Work Classification: Addition /Alteration Phone Number (786)797 -1985 Parcel Number 1132060136190 Phone: (954)214 -2844 Building Department Comments NEW IN- GROUND SWIMING POOL AND 400 SQURE FEET PAVER DECK, POOL SIZE 14 FEET BY 28 FEET. Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. December 07, 2011 For Inspections please call: (305)762 -4949 Page 8 of 24 Permit Number: B P P -10 -11 -1869 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 inspection Number: INSP - 167347 Inspection Date: December 06, 2011 Inspector: Dacquisto, David Owner: SEGRERA, VERONICA Job Address: 314 NE 94 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MARS POOLS Permit Type: Pools/Whirlpools /Hot Tubs Inspection Type: Survey Final Work Classification: Addition /Alteration Phone Number (786)797 -1985 Parcel Number 1132060136190 Phone: (954)214 -2844 Building Department Comments NEW IN- GROUND SWIMING POOL AND 400 SQURE FEET PAVER DECK, POOL SIZE 14 FEET BY 28 FEET. colt 744 -i Passed,/5 Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments For Inspections please call: (305)762 -4949 December 05, 2011 Page 1 of 1 DEC 0 5 2011 6 " ': Bi b aee-e aaa-a.e .... .-.p SKETCH OF BouxDAitY SURVEY SCALE: 1 " =20' N.E. 94th STREET 75.00' Total R/W 1T Asphalt 0.5' Curb m 5' Parkway FND.D.Hole LOT 12 BLK 46 FND.LP.1/2a (NO ID) 5 Conc.Walk 0 Conc. LOT 11 75.00' Tile _ Porch 8. FND.I.P.1/2a (NO ID) A 00° b W 1/2 of Lot 10 8 2.10' ONE STORY CBS ro RESIDENCE # 314 29.85' r E.M. s O p�4 Rock 00 GATE Pool Pump RI 11.90' 13.40' 2550' Dirt X10.00' GATE C On X PL 10.00' 13,70' I a rn Dirt 13.70' 71 12.E Z Stone Dirt 5 Wood Fence, 75 00' 'WM. 10' Asphalt—, 15' ALLEY `90° LL X N 475.00' FND.I.P.1/2e (NO ID) C/L 0.20' OBC FND.I.P.112° (NO ID) ht FOR HUMBERTO E. RODRIGUEZ AND VERONICA 1. SEGRERA PROP, ADD) 314 NE 94 STREET, MIAMI SHORES, FL. 33138 CERTIFIED: HUMBERTO E. RODRIGUEZ AND VERONICA 1. SEGRERA LEGAL DESCRIPTION JOB NO: 0606 -194A FIELD DATE: 11 -30 -2011 PLAT OF LOT: 11 & W 1/2 LOT 108LOCK 46 sumnvisioNMIAMI AMENDED SHORES SEECTION 1 PLAT BOOK: 10 PAGE 70 OF: MIAMI -DADE COUNTY, FLORIDA. SURVEYOR'S NOTES: 1.) THE SURVEY OF THE PROPERTY SHOWN HEREON IS IN ACCORDANCE WTH THE DESCRIPTION FURNISHED BY CLIENT. 2.) UNLESS A COMPARISON IS SHOWN, ALL BEARING, ANGLES AND DISTANCES SHOWN ARE THE SAME AS PLAT VALUES. 3.) THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENTS OR OTHER RECORDED ENCUMBERANCES NOT SHOWN ON THE PLAT AND THE SAME, IF ANY MAY NOT BE SHOWN ON THE SKETCH. 4.) UNDERGRAUND PORTIONS OF FOOTINGS, FUNDATIONS OR OTHER IMPROVEMENT WERE NOT LOCATED. 5.) FENCES TIES ARE TO THE CENTER LINE OF THE SAME. 8.) WALL TIES TO THE FACE OF THE SAME. 7. ELEVATION WHEN SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM (1929) UNLESS OTHERIMSE NOTED. 8.) THERE NO ABOVE GROUND ENCROACHMENTS OTHER THAN THOSE SHOWN. (FLOOD ZONE INFORMATION) ZONE ' x OMM 1t 20852 PANEL:12oS6coso2SUFFIX; .DATE :9-11 -200a BASEAA NOTE: DETERMINATION OF FLOOD ZONE LINES WERE BASED ON SCALING OF FEMA MAP LISTED ABOVE NOTE: ALL BEARING HEREON ARE BASED TO THE PLAT BEARING OF ON THE CENTER LINE OF PROPERTY LINE. EASEMENT VIOLATIONS: APPARENT VISIBLE ENCROACHMENTS: ❑YES Dt NO ❑YES LXJNO COMMENTS: ABBREVIATIONS: SWK= Sidewalk, CBS= Concrete Block Structure, CLF= Chain Link Fence, PL= Property Line, DUE= Drainage Utility Easement, IP= Iron Pipe, A/C= Air Conditioner Pad, PIC= Property Comer, DM= Drilled Hole, W/F= Wood Fence, RES= Residence, CL= Clear, IR= Iron Rebar, UE= Utitty Easement, CONC= Conc. Slab, RAN= Right of Way, DE= Drainage Easement, C/L= Center Line, 0= Diameter, TYP= Typical, M= Measured R= Recorded, ENCR= Encroachment, COMP= Computer, ASPH= Asphalt, Nail & Disc., S= Set, FFE= Finish Floor Elevation, 0/5= Offset, P/P= Power Pote, OHP= Overhead Pova3rllne, WM= Water Meter, WPP= Wood Power Pote, E.M. = Electric Meter, M.F =Metal Fence P.F. =Plastic Fence, D.M.E= Drainage Maintenence Easement, C.M.E =Canal Maintenence Easement, L.M.E =Lake Maintenence Easement, M.E.= Maintenence Easement, B.0 =Block Comer, P C =Paint fit rlrtvahtra F■IkFntmd Nit U )Jtt Iriantfinatinn 61.600 B D MeNSIONS INC. Land Surveying Services OFFICE: 14770 SW 43rd WAY, MIAMI, FL 33185. PHONE: (305) 512°4226 FAX: (305) 812 -1914 1 HEREBY CERTIFY: Thoth* attached 'BOUNDARY SURVEY° Odle Nods shown hereon Is hire end ca to the beat or ray MroMedge and barter as rem* wowed and dram under my sapmwshrnmp, dhxtlm,. This survey wmptes with Bre t nlrmaa Teske as contained edopled hytire Ftadde Bkis Bernd at mm MOpt as .027, to Chapter 5J-1 I, Florida Code, fo Chapter 4721527. Florida StsMea. cw DAVID L.FU H R GISTERED LAND SURVEYOR # 4843 STATE OF FLORIDA LB # 0006874 Note: Not Valid Unless Signed and Sealed. SHEET 1 OF 1 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION 111111111111111111111111111111111111111111 CFN 201 1 RB B6S45S8 OR Bk 27856 F'ss 2170 - 2171; (lass) RECORDED 10/12/2011 18 :03006 HARVEY RUVIH, CLERK OF COURT iiIt$11I -t C'E t_OLHTYP FLORIDA PERMIT NO. %PI r /0-1 9 STATE OF FLORIDA: COUNTY OF MIAMI -DADE: TAX FOLIO NO. r'J.m ° e /3 J%1 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. Legal description of property and street / address: /IleO se 54:6 t 5e f ; ,LIP /�/�,0� r,� � t l d4G a' /J1A 4'6 t7 17/ /3— 337 :� r - 41/1 G c / e r 7 6 ' 4 / e 7675 / 2. Description of improvement;a n, CA ,��olU 3. Opwwner(s)yname an address: tti Interest in property: Name and address of fee simple titleholder: 4. ConAractor's m'eAand address: 7/1 co-:5 lR P% , FAQ )1 3 3 3.25) 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 served as provided by Section 713.13(1)(a)7., Florida Statutes. OR BK 27356 PG 2171 LAST PAGE 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(1)(b), Florida Statutes. Name and Address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date oflecording unless a different date is specified) immature of Owner Print Owner's Name by dey, Sworn to and subscribed before me this / day of L? C br- r, , 20 Prepared Notary Public: , qt. tL6(0 R � Print Notary's Name: My commission expires: GWENDOLYN STEWART fedgl' iomiSh1ir,,;, fx,46iag. .� �• `� 'y Aril 19, 2014 V S'd. e��,c, r E,ssaa, Asw Pref)' c' ,1 44 e / /ems q^ 50/(,6e� tz g335,