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BPP-13-1845 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-197226 Permit Number: BPP-8-13-1845 Scheduled Inspection Date: August 29, 2013 Permit Type: Pools/Whirlpools/Hot Tubs Inspector: Rodriguez,Jorge Inspection Type: Final Owner: BERRY MAN III,JOHN Work Classification: Ad dition/Alteration Job Address:248 NE 98 Street Miami Shores, FL 33138- Phone Number (305)754-1423 Parcel Number 1132060134180 Project: <NONE> Contractor: ALL FLORIDA POOLS AND SPA CENTER Phone: 305-893-4036 Building Department Comments POOL RESURFASING Infractio Passed comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 29,2013 For Inspections please call: (305)762-4949 Page 13 of 28 OR Ok 78780 Ps 3364? tips? RECORDED 08/24.1/2013 10:57:31 HARVEY RUVINY CLERK OF COURT MIAMI•-DADE COUNT}'P FLORIDA ST PAGE NOTICE OF COMMENCEMENT A RECORDED COPY JWM Be POSTED ON T8g JOS SITE AT TIMg OF FIRST INSPECTION PERWT NO. TAX FOLIO NO, STATE OF FLORIDA COUNTY OF 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 Commenceaeat. g I. Legai d on of PrOPFM and street address: Nk — 2 Description of improvement 3. Owner(s) and address: 4-1 :3M e �,l Interest in property: Nara and address of fee simple titleholder. 4. Contractor's name and address: OLt_ S. Suret3r{Payment bond required.by owner from co , ni,,cOUNTY Of We rho coupe Nary and address: I IS a tPUe COpy®r the �.* CLINK �O Amount of bond:$ day o �ngrr�al h7ed in this orRce on 6. Leader's name and address: 0A¢_ Am , AD zo countycourts D.C. of coin 7. Persons within;the State.of Florida designated by 14 ox-omer documents may be served as provided by 713.13(1}{a)7.,l;l 'da Statutes: Name and address: o 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713. 13(1)(b)7.,Flo ' Statutes- Name and address: 4 9. Exp n dat of this Notice of Commencement(the expiration date is 1 year from the date of recording unless a di t da Spec' y; r �pMe1,15S10'AQ ��pil Soto Signa. re 4 er * PiRESY Pri t ner`s Name S o to and subscribed before me this_ ➢ day of f30 Prepared by: Hits..+ chary Public Address: l�"lzr_o 1 a�UD Print Notary's Name tv+tzt, , My Commission Exp 1 AUG 13 203 0 Miami Shares Ville. ----------------- oo Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795:2204 Fox:(305)756.8972 INSPECTION'S PRONE NUMER:(305)7614949 BUILDING permit No. PLR1Vi T APPLICATION Master Permit No. FBC 20 tQ Permit Type BUILDIN ROO ING 1 — OWNER:Name(Fee Simple Titleholder): ���$FIJ �� Phone#: ��� 1®3 � Address: Cat 1�_ Y I�V I> Y1m�tD , y state: Zip: Tenant/l,essee Name: Phone# Email: JOB ADDRESS: City. --- -__ Miami Shores County: Miami Dade 7.rp: 3139 Folio/ParceW. ' 3-140C Is the Building Historically Designated:Yes NO Flood Zone: CONTRACTOR:Company Name: -�Af1-t0A TOOK Phone#. 3o V7'.3' Address: D City: State: Zip: 31 J Qualifier Name: _ hone#: State Certification or Registration#0: C. �°�`�S, Certificate of Competency#: Contact Phone#: rmail Address: DESIGNER:Architect/Engineer: Pltane#. to Value of Work for this Permit:$ 3003 � SquareMnear Footage of Work: 1 4.ddities QA.Iteratior UNie ?CR-par1Repla-.-- Q e::oliai aa: Description of Work: 'a 0/ !6 0 Submittal Fee$ Permit Fee.$ CCF$ COICC$ Scanning Fee$ Radon Fee$ DBPR$ Boud$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ _ TOTAL FEE NOW DUE$_ 1 ` ►��� 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 no4vork 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 AM 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 is regulating construction and zoning. z 1'WARN1NG 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 t&'notice of commencement and construction lien law brochure will be delivered to the person whose property is subject ttachment. Also,a chiie copy of the recorded notice of commencement must be posted at the,jots site for the first inspe lion Id occurs seven (7)days after the building permit is issued In the absence of such posted notice, the inspection will of be appro and a reinspection fee will be charged. Si nature g •. Signature, .. caner or Agent gg Contractor The fore din instru fit was acknowledged before me this y The to=_-19C g instrument was acknow ed before me this �� day of ''' ,2t} ,by � +✓ t y wt4�e/ day of 2015 by PO CitfA,1� who i o o me or who has produced ho is personally kno to me or who has produced identification and take an oath. -as identific did take an oath. NOTARY FU IC• NOT' LIQ Sign: _' 1enI" Print: Pub. �Q' Print" v Pua IONgE6 -- My C ' sion Expires: GXp�� Se °u sow My Commission Ex p` * a?OE �Owysvglal ����A� 6� �►�otr+o�oe Bonded APPROVED BY b Plans Examiner /7 Toning Structural Review Clerk (Revised 07110107KRevised 06110CM)(Revised 3115") ALLFL-2 OP ID:GJ CERTIFICATE OF LIABILITY INSURANCE DA061071201 1� 06/07/2013 THIS CERTIFICATE IS 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 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 endorsemen s. PRODUCER Phone:321-397-3870 CONTACT Insurance By Ken Brown,Inc. NAME: PO Box 941117 Fax:321-397-3888 a"c°0Nn o Ext: ac No): Maitland,FL 327948117 E-MAIL David R.Griffiths ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Amerisure Ins Company 19488 INSURED All Florida Pool&Spa Center INSURERB:Amerisure Mutual Ins.Co 23396 All Florida Distributors,Inc. 11720 Biscayne Boulevard INSURER C: Miami,FL 33181-3110 1 INSURER D: INSURER E: INSURER F: COVERAGES 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. 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. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD MM/DD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CPP2030900070013 07115/2013 07/15/2014 DAMAGE ET Ee Etta ante $ 100,00 CLAIMS MADE �OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY X PRO- LOC $ AUTOMOBILE LIABILITY OMBINEe�DitSINGLE LIMIT $ 1,000,00 A X ANY AUTO CA20662960602 0711512013 07/1512014 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIREDAUTOS LX NON-OWNED PROPERTYDAMAGE $ AUTOS Per acddent X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,00 B EXCESS LIAR CLAIMS-MADE CU205629704031B 07/1512013 0711512014 AGGREGATE $ 2,000,00 DED I X I RETENTION$ $ WORKERS COMPENSATION X WC STATU- I X OTH- AND EMPLOYERS'LIABILITY TORY LJMITS ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Yi" WC205115705 12/3112012 1213112013 E.L.EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEO$ 500,00 If es,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT 1$ 500,00 DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,9 more space is required) Swimming pools - installation, service, or repair - below ground. CERTIFICATE HOLDER CANCELLATION MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building 8i Zoning Dept ACCORDANCE WITH THE POLICY PROVISIONS. Angle AUTHORIZED REPRESENTATIVE 10050 NE 2nd Avenue Miami Shores,FL 33138 `�� , Q,�&L,4" ©1988-201000 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD s.��, of♦. 9>;° .sr 2 gi;. ♦ ;1p,9` �ti T;•r?�•' ', d�: •�♦w ...,. 'n' ♦Dais ��lD�.,G ::.r .f tv,s ;•.e 4•+�.t 't; �fir. ,k(.,;Ax �✓ ji: Z✓, ,,.d . :� ♦ Y .. , ✓'�.�' Y�•11'' ` :u �:d, �i I,sB ld`r'• ;�tg' '.iw. k�,' ,.:•,Fps.•s:;. $E .I,12051100915 ^ aa� ha \ r f Expiratioa date: -AUG 31, `211 .4 ,": 'CO HEN" .f'.ALL Ft L err. ``• ,:xf gip` � � :i '�` �¢e °' MI4�AMI Ft 33181- ro.. '::�: :♦: �.�� y.,p! ` t. •,♦,��t.•.;,'... ��t';^'.cy s. irr'P,1k ryS....�? r .. •:�.^.,�: .•iii' ,:1:�•.�%. (.; :g• B�eeyy,'<Vi WR ;{ , t, S i :f: ; •�{ }A �,���•"` •r i3. #: ;': :a�. A KFN LA GON ,•:.. .�;; ` ,y „SECRETARY _. �[51SR•L�f4AS RE1 ED P E: F 5 '�" e•h �{M ' a '{?. �Npw•M�y� MYAYG y^y ��vi'.fyyy.`4� r3 i' 4 a!� p�/.�.p._�.�.. .. , f !'lt� i rS 4t.?�i9'•` 'T'e +�4y t` •,H".Y4ri!-�•. =13 �T�� ,,.�.• t. r i s P'°fib!e-hJ .r.'i'a' N,�'¢a•�?;..;: .,N `*:. .. FL.E� OA .• U.B.P�TAQE 1 PAID NAPA FL PERMIT'NO. sfixi ''>„.�' ,.�+�„ ••''��.;{.,., n� �� •�.-s• tea, :n }��,'cu�:.t�,;y;.L.=�....._� � 231 10311322-7 THIS IS NOT A BILL.-DO NOT PAY �tuS�y��FL.O��uA P$OLS RENEWAL 11720 BISCAYNE BLVD STATEWNy45q 103132'7 33181 UNIN DADE COUNTY 07111 FLORIDA DISTRIBUTORS INC se"1PrftTY BUILDING CONTRACTOR WORKER/S THE L ONLY DOES NOTT P TNg "mm To YONINa LAWS OP 771E CDUNTY Dq exowr NOR DO NOT FORWARD PEq MAW Tm By ALL FLORIDA POOLS a®cELAW. m OF DAVID COHEN PRES °LDS�A 11720 BISCAYNE BLVD MIAMI FL 33181 PAYMENT NECPJYED ° Qp,CODNTY TAX. 07/18/2012 60010000399 000075.00 Its/ir,dh$c rl 11rrfr rrrljrrl�rrrr���r�rrr�r�r�r�rdds11r* SEE OTHER SIDE i { SS�MI.W.TTN STREET.BUTTE 102 ��X7163 71 �� Walla SURVEY NO. //•'9/08^ LAND SURVEYORS -;� SHEET No. . o rc�r SKETCH OF SURVEY Scare v Cow ^S u � t n (fit p� ,,�J�/�(`((�`�F ( �� r:,t t'' ` � c ��• ` W� � 5,'96 \ LLJ `,VZIEv . 'U��.�� < �- 3i••Qom, U LL r T C) 0 0 a ' ° C lull ...-°: