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BPP-12-786Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 174675 Permit Number. BPP -5 -12 -786 Scheduled Inspection Date: June 13, 2012 Inspector: Rodriguez, Jorge Owner: QUILLIOT, REMY Job Address: 1020 NE 104 Street Miami Shores, FL Project <NONE> Contractor: NATIONAL POOL DESIGN LLC Permit Type: Pools/Whirlpools /Hot Tubs Inspection Type: Final Work Classification: Repair Phone Number (786)925 -4181 Parcel Number 1122320290250 Phone: (305)559 -1020 Building Department Comments POOL RESURFACING 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 - 173042: Permit in plastic box by window Pool is green unable to perform inspection. NB June 13, 2012 For Inspections please call: (305)762 -4949 Page 14 of 19 ti.2u. I2. 93 ANN. JAJ Miami Shores Village Building Department -s SCE' IVED, MAY 0 2 2012 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 No. k7 T ? 12--14 PERMIT APPLICATION Master Permit No. FBC20)o Permit Type: BUILDING �fJ �ROOFING ./ �/ OWNER: Name (Fee Simple Titleholder): /Z(ul 7 LCC Phone#: (3o6) 7 18" 81 Address: I Oa° me. 104 51, City: Wi.M41 61119 e6 State: FL Zip: ;13 3 _.Tenant/Lessee Name: Phone#: %� % — � )-v Email: JOB ADDRESS: 10 2 0 ICE 1) LI 6TR e6 City: Miami Shores County: Miami Dade Zip: 3r 1 Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: �UR'Il?+UA� YoQ (i �N Phone#: l��(i��55I'Il��.© Address: •2103 SLO 14 4 AOe u:Te #f✓ I City: IQ A ►ii State: r. Zip: 33185 Qualifier Name: Al f Rt;' R0b aOU 2Z Phone#: 36 ,S- f 7041!3 State Certification or Registration #: C PC. 1 ' 4- i $ Z s Certificate of Competency #: °' 3DS -.`i 9 -(CJ C) Email Address: Pre,g4i 0l%1/mod /Ao/ dej /s.n •Corn DESIGNER: Architect/Engineer: Phone#: Contact Phone #: tSib Value of Work for this Permit: $ ®') Square/Linear Footage of Work: 3 ?C 4 Type of Work: °Addition Alteration New ORepair/Replace Demolition Description of Work: as a n Ci (� QuJ ;bot4n6 j (r (AT * * * ** ** ** * * * * * * * * * * * * *w *ww *** www *ww **Fee ****** *w * * * * *w * * * * * * * *w *w* * * * * * * * * * *w *www* Submittal Fee $ CO Permit Fee $ i.(3 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ C24) Training/Education Fee $ Technology Fee $ Double Fee $ KO 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 FT FCTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOTT.F,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 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 harged. Signature The fore o' ins ` • gent g g t was acknowledged before me this day of , 20 J1, by_ AM Signature Contractor The foregoing instrument was acknowledged before me this y of 20 % l% by 2 who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: as identification and who did take an oath. NOTARY PUB Sign: Si gn: /�1 .. r Print: £(e✓b J, /Uet Print: My Commission Expi My Commission Expires: ROSARIO D. SILVA Notary Public, State of Florida Commission #DD903514 My Commission Expires Jun. 30, 2013 ******4********* ********** * *+ BAP**** *******w ************* * ***** *i***+k*** *** ***** *** APPROVED BY Plans Examiner ROSARIO D. SILVA Notary Public, State of Florida Commission #DD903514 My Commission Expires Jun. 30, 2013 * * * * * * * * * * * * * * * * * * * * * * * ** Structural Review Clerk (Revised 07 /10/07)(Revised 06/10/2009)(Revised 3/15/09) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH 'MONROE STREET TALLAHASSEE FL 32399-0783 RODRIGUEZ, ALFREDO NATIONAL POOL DESIGN LLC, 15665 SW 10TH LANE MIAMI FL 33194 Congratulations! With this License you become one of the nearly one MOOD Floridians licensed by the Deparbnent of Business and Professional Regulallon. Our professkmals and businesses range from architects to yacht !yokels, from boxers to barbeque restaurants, and they keep Amides economy strong. Every day we work to improve the way we do business in order to sante you better, For information about our services, please log onto www.mythmidalicense.com. There you can find more Information about our dvisb3ris and the regulations that impact you, subscribe to department newsletters and le= more about the Department's initiatives.. Our mission at the Dep.:Variant 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 Flail**, and asigralulafmns on your new license! DETACH HERE 09877 15645 5W 331:54 UNIN;:: TAX 67/12/2011 60020000567. 000075.00 SEE OTHER SIDE NC CONTR; DO NOT FORWARD NATIONAL POOL DESIGN LLC ALFREDO RODRIGUEZ MANAGER 2423 SW 147 AVE 212 MIAMI FL 33185 1► ►111111►►► ►111111111.111111 ►111 ►,11►►1 ► ►1111► ►1111110111 ACCARti CERTIFICATE OF LIABILITY INSURANCE °A 05 /01`�` /112`") THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES 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 policyges) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certaln policies may require an endorsement. A statement on this certificate does not confer rtgh(s to the certificate holder in lieu of such endorsement(s). PRODUCER Insurance Specialists Of South Floc 2750 SW 87 Ave 5204 Miami, FL 33165 Phone (305)264-0003 Fax (305)226 -7614 NA E CT P.Car e►a pNONNo. (305)264-0003 1 NO (305)226 -7614 ADR : peterkarrera@aol.com INSURERS) AFFORDING COVERAGE NAIC 0 INSURER A : Scottsdale Insurance Company n INSURED National Pool Design, LLC 15665 SW 10 Ln Miami, FL 33194- 305 INSURER B: Guarantee Ins Co 10/04/2011 INSURER c : Ascendant Insurance EACH OCCURRENCE INSURER D : �S TO (Ea ice) INSURER E : In COMMERCIAL GENERAL LIABILITY INSURER F : $ 5,000.00 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW 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 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 OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1 TRR TYPE OF INSURANCE INSR POLICY NUMBER (M DDIYYYYFY) (19MIDDNYYVY1 LINTS A GENERAL LIABILITY n n CPS1295651 10/04/2011 10/04/2012 EACH OCCURRENCE $ 1,000,000.00 �S TO (Ea ice) $ 50,x.00 In COMMERCIAL GENERAL LIABILITY MED EXP (Any are person) $ 5,000.00 ❑ ❑ CLAIMS -MADE iie OCCUR ❑ PERSONAL & ADV INJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GENII AGGREGATE LIMIT APPLIES PER: n policy ❑ JAG ❑ Loc PRODUCTS - COMP/OP AGG $ 1,000,000.00 $500 D d $ C AUTOMOBILE LIABILITY ❑ ANY AUTO CA -30223 03117/2012 03/17/2013 COMBINED SINGLE UMIT $ BODILY INJURY (Per Ian) $ 10,000.00 BODILY INJURY (Per as $ 20,00a00 ALL OWNED SCHEDULED ❑ Auros NO OWNED ❑ HIRED AUTOS ❑ AUTOS ❑ ❑ P oP�AMAGE $ 10,000.00 PIP $1K ded $ 10,000.00 ❑ UMBRELLA LIAR ❑ OCCUR ❑ EXCESS LUAB ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DED ❑ RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNERADCECUTIVE OFFIIC EMB R EXCLUDED? (n I 11 yyeess dew under DESCRIPTION OF OPERATIONS below N I A GW 3738 -112 02/2212012 02/22/2013 WC STATU OTH- ►� TORY LIMITS ❑ ER EL EACH ACCIDENT $ 100,000.00 EL DISEASE - EA EMPLOYE $ 500,000.00 E.L. DISEASE - POLICY LIMIT $ 100,000.00 DESCRIPTION OF OPERATIONS /LOCATIONS l VEHICLES (Attach ACORD tat, AddRtonal Romarks Schedule, If more space Is =gonad) Pool Contractor- CANCEUATION _...........__ ___ ______ Miami Shores Village Bldg Dept 10050 NE 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010105) OF © 1988-2010 ACORD CORPORATION. All rights resery ed. The ACORD name and logo am registered marks of ACORD www.sun Departinent of State http://wwwsunbiz.org/scripts/cordetexe?action,-DETFIL&inq... -.• Frevious Next snUat Return To List No Events No Name History Detail by Entity Name Florida Limited Liability Company REAL 7 LLC Filing information Document Number 110000118277 PEUEIN Number Date Filed State Status 273951482 11/15/2010 FL ACTIVE Principal Address 5946 SW 135TH TERR MIAMI FL 33156 Mailing Address PO BOX 565715 MIAMI FL 33256 Registered Agent Name & Address QUIWOT, REMY 5946 SW 135TH TERR MIAMI FL 33156 US ManagedMember Detail Name & Address Tiffe MGR RODIER, ALEXANDRE 2325 MAGNOUA DRIVE MIAMI FL 33181 Title MGR QUIWOT, REMY 5946 SW 135TH TERR MIAMI FL 33156 Annual Reports Report Year Filed Date n 79-s MI 8Z 1- 1031 Data Aprh13 2012 To: Mr. Remy Alex (786)9234181 1020 NE 104 St Miami Shores, FL 33138 rral7miami@g l. icom Pool Rll/ov tifln A2r ent T: (305)778 -8787 I MAY 2 5 2012 ray: From: National Pod Din T: (305)5591020 2423 SW 147 AVE Suite 212 F: (305)38141630 Miami FL 33185 Freddy Rodrigues Email: 'ortgld i National Pool Desk, Inc. scope of work on this project includes the supplying of labor, and maw Poo Finish Pool 117 sh Diamond Brlee Preparation: Pool is to be drained into ground using submennidepumps. Complete preparation ofpool airtime ink Ong of inlet fitting, all tip, and light niches. All loose plaster wlW re reeved. Pod will be etched with is Act at 100% to clean and open poems of cremate surIne. Bond Kote: Ammon ofbigb strength flerglikgg to pool surface This is done to ensure maximum bond ofnew finish to existing surface. Iktglirag brandied on agent Accessories Installation ofone new SP1030 main drain franc and grate, All new inlet fittings, Chemical Startup: Complete ofpool water chaninry. Diamond Rr&e Application of Diamond Brae finish wilt 10-year wammnty. Finish will be acid wasted at 20% to expose full cow of quartz stone. Dial Brite to be chasmn fromstandard series c olds Mud Caps : Installation of new 2" x 6"nwd cap Win tiles, not-skid (new DOH code ), on all pool step edges. Coiorto watch existing wataibtetoes MEW Payment Schedule: 50% upon acceptance 50% upon completion $1,075.00 $1,075.00 Contrail Exelac 1. Any design fees 2. There are no porovvisiam for existbg comlitions. 3. Any plans, paw or professional ;minoring. 4. Any 13linier requhements S Utility, FPL, pie company fns orb for any swims. 6. Any electrical bonding work 7. Any offer items that maybe request it by inks, scope ofwc+k APPROVALS The goal conditions ofthe Contract, the specificanOn, and teem ofd together with this agreement fern the Contra, and they are as Silly apart of Contract as hereto attached or herein . Buyers) Date N+ w • OWNER KNOT SIGN THIS HOME IMPROVEMENT CONTRACT IN BLANK. MAKE CERTAIN ALL WORK WHICH YOU HAVE CONTRACTED FOR IS INCLUDED IN WRITING HEREIN. YOU ARE ENTMED TO COPY OF THIS CONTRACT AT THE TIME YOU SIGN. KEEP IT TO PROTECT YOUR LEGAL RIGHTS FLOIIIDA HUI14DIN(l i..t �tl Ft'k1'Lltnu �.i� kp.I11.411t,r BOUNDARY SURVEY PROUDLY SERVING FLORIDA COAST TO COAST OFF: (877)-894-8001 www.FloridaLandSurveying.com 2400 WEST 80 STREET #5 HIALEAH, FLORIDA 33016 SCALE 1' : 30• LOT -15 BLOCK-2 R=35.48) R= 25.10(8) L= 75.48'(8) L= 14.64'(8) 11- 123'33'267'8) 1>= 33'33'26'(R) T= 65.22(8) T=Z54(R) 01141.68(10A0 C h =14.4 3 (R) (M ) chb=S 6037'43" Eli ch6=S 74'2'17' w(R) N 89'11'0° W o 43. 'R NE 104th. ST. _ � N 89'1110° W 33.17tR)(M) FND NO ID 193' ASPHALT LOCATIQN SKETCH Scale 1 = NT.S. N28 52'(R)(M) o Z 3r t3L �o 68' Lu C/ cc °o 23' 1.12' 68' Jig LO BLO SOUTH LINE SEC 32 -52 -42 F.LP 1/2" NO CAP its FND AUI6 NOT A PART OF THIS PLAT o NO ro LEGAL DESCRIPTION: LOT 12, BLOCK 2, OF "EVENINGSiDE ", ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 44, PAGE 53, OF THE PUBLIC RECORDS OF MIAMI —DVE COUNTY, FLORIDA T vv cops £ f/,fTh fool. FLOOD INFO: Community:Miami Dade Co. 120652 Map & Panel # 12086C0306 Suffix: L Flood Zone: AE Base Flood Elevation:8' CERTIFIED TO: REMY REAL 7 LLC. ThisSev y has been prepared far the exclusive use of the entities caned herein and the Certification does not extend to any unnamed party. SURVEYOR'S NOTES: 1- OYA'ERS}NP IS SUBJECT TO OPIN10N OF TITLE 2 -NO UNDERGROUND IMPROVEMENTS HERE LOCATED 3- ELEVATIONS ARE REFERRED TO NATIONAL GEODETIC VERTICAL DATUM OF 1929 (UNLESS ASSUMED). 4 -THERE MAY BE ADDITIONAL RESTRICTIONS NOT SHO$74 IN STHAT MAY BE FOUND IN THE COUNTY PUBLIC RECORD 5 -LEGAL DESCRIPTION PROWDED BY 6- UNLESS 07HERWSE NO 7- BEFORE ANY CONS MUST BE CHECKED 8-ALL FIEID WITH ELECTRONIC 9-THIS SURVEY IS FOR ANO NOT FOR ANY 10- THIS SURVEY WAS C0MMI7M134178 F ARE THE SAME Yom.: 2,, WERE MADE ACCU 1:7500 LEGEND: R— RADIO L =LENGTH TAN = TANGENT D =DELTA CH= CHORD CHB = CHORD BEARING 'ADDRESS: 1020 NE 104th ST. MIAMI SHORES FL. 33138 LEGEND: P -O.C,= Point of Commencing R. = Record P.0.a= Point of ILeglinhadi M. meowed C.B.W.= Concrete blocs ID. = Identification PVMT= Pavement C/P = Concrete Parch / a Fey F.I.P.= Found bon Pipe I.R.C.= brae Rod and Cep -4-= Chain Lhnk Fence C = Centerline A /C= Air Conditioner P.L = Property Line U.E.= Utility Easement P.O.L = Point on Line B.o.B.= Basis of Bearing iP = Iron Pipe R.O.H.= Roof Overhang Suds = Sidewalk PL = Planter Conc = Concrete C&G= Curb At Gutter CBS q Co Crete Bock Overheat Wire e O a Emoting Devoition RES = Residence FH = Fire Hydrant F.F.E.= Finish Floor Elev. ►VA-, Wood Roof B.C. = Block Comer isY = ENCoa RlDN /D=F Dt�/S _ Aluminum Roof = Aluminum Shed WPP WOOD POWER POLE LP >a UGHT POLE 111 Fly HYDRANT SEC. + SEC110N CPP ig CONC. POWER POLE S V. " SEWER VALVE GM GV of GAS METER GAS V. SAN. • SANITARY MANHOLE S.S. • DRAINAGE MANHOLE NOTE: TRH FLOOD DATA PROVIDED ISFOR INFORMATION PURPOSES ONLY, THE S U R V E Y O R MAKSNOGUARAASTO THE ACCURACY OF THE IN BMAMOD PROVIDED THE LOCAL F.P.M.A. AGENCY SHOULD BE CONTACTED FOR VERIFICATION. OF A The boundary survey of for accuracy or omissions. located. 1 Heresy Certify That the survey of the property deecribed below Is to the best of my krundedge and belief accurate as recently surveyed under my direction; also that there are no above ground encroachments other than those shown, and that this survey meets the minimum technical standards set by the Florida of Ch r 1 of Fl in ve BASIS OF BEARING BASE: BEARING BASE SHOWN HEREON ARE BASED ON NORTH LINE OF LOT 12 BIDCK2 BFANGN89IPD0'W PER PLAT CARI.RiS I'iERNANCEZ PROF1 sIaNAI. SURVEYOR AND MAPPER LB M 7619 05'162012 ELECT FILE CODE #102NE1 � raised/digital Is not valid without the signature seal of the Reside Registered Professional Land Surveyor and Maoaer with the description furnished by the cleat. No search of pubic records has been made by this office limitations. restrictions or easements of record. No underground improve a nts and/or utilities were Permit No: 12 -786 Job Name: May 23, 2012 Miami Shores Village Building Department Building Critique Sheet 1) Provide a signed contract. 2) Provide a detail scope of work on plans. 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 - 762 -4859