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PL-12-306Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-180336 Scheduled Inspection Date: October 22, 2012 Inspector: Hernandez, Rafael Owner: BAES, JAMES AND JACQUELINE Job Address: 941 NE 91 Terrace Miami Shores, FL 33138-3219 Project: <NONE> -- k2_ -3©S Permit Number: PL -2-12-306 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Pool - Private Phone Number (305)762-6122 Parcel Number 1132060030050 Contractor: NEW WAVE POOLS & SPAS INC Phone: (954)462-0328 comments INSTALL SWIMMING POOL PIPING INSPECTOR COMMENTS False October 19, 2012 For Inspections please call: (305)762-4949 Page 39 of 45 Inspector Commentp Passed CREATED AS REI PECTION FOR INSP-170265. no plans Failed Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. October 19, 2012 For Inspections please call: (305)762-4949 Page 39 of 45 Miami Shores Village Building Department CEPTE 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 FEB 2 8 2012 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 LBY:--ZA-1 BUILDING Permit No. PL --I I — 3�o PERMIT APPLICATION Master Permit No. FBC 2001 Permit Type: PLUMBING OWNER: Name (Fee Simple Titleehool�de Addreccl- ' to -;I C�/vel LLC Phone#: C\kS' - -6; City: S.• ZiD Tenant&essee Nam: dZZa--, Email- -, ADDRESS: I J V. b q City: Miami Shires County: Nflami Dade Zip: 3� Folio/Parcel#: 1 + J wg -003 - 6bS o Is the Building Historically Designated: Yes NO ✓ Flood Zone: CONTRACTOR: Company Name: � eacl Wave- ?Oo IS i, Spa S ; 2 , Phone#.. 9 -s�, 46 a , o l al Address: I S 314' city: rl- . Qualifier Name: zip: 3 3 3 ol-t State Certification or Registration #: C QC ®a-QQa'T ( Certificate of Competency #: Contact Phone#: q 5 �t 347-964( Email Address: d1 Au.) to VP n0o kS) Covrl x @L. n DESIGNER: Architect/Engineer: &&A S IVo, 3 14 6 -1-1 Phone#: -IS Value of Work for this Permit: $ goo , � SquareaAnear Footage of Work: Type of Work: OAddress OAlteration Description of Work: _ `t IN 5'4 11Q +i o f\ C9 -E Submittal Fee $ 50 • (J.9 Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Doable Fee $ Structural Review $ Ci '['qj d `, p � / TOTAL FEE NOW DUE $` l ODemolition Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) j9hz Mortgage Lender's Address City State Zip Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work (Ir 6tallation 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 no ' e of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. , a certifi py of t ecorded notice of commencement must be posted at the job site for the first inspectio ich occurs s e (7) days iter he bu' ,*g permit is issued In the absence of such posted notice, the inspection will e d and a r pecdon fe wi a cha Signature S { Signature /X//z Owner or Agent ontractor The fore oing instrument awas acknowledged before me this The foregoing instrument was acknowledged before me this � day of � 0 '�c by E6le MgCG A60 day of 2kg [O- bg� : 20 .x, by who i rsonally known to me r who has produced `— who is personally known to me or who has produced As identification d who did take an oath. NOTARY PUBLIC: Sign: I A PC Print: sh My Commission Expires: JULIA AMOSOVA MY COMMISSION # DEM3804 APPROVED BY, S �/'i Plans Examiner Structural Review (Revised 07/10/07)(Revised 06tion2009)(Revised 3/15/09) identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Co r Tres: MARCM A, LAB ICY IE�O��IVyyl��� X615 � �i'Mug1�Ot� Zoning Clerk e * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WMERV COLVEINSATION '" * e CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 05/09/2011 PERSON: CONDELL FEIN: 592128512 BUSINESS NAME AND ADDRESS: NEW WAVE POOLS & SPAS INC 1534 N VICTORIA PARK ROAD FT. LAUDERDALE FL 33304 SCOPES OF BUSINESS OR TRADE: 1- SWIMMIN13 POOL CONSTRUCTION EXPIRATION DATE: 0510812013 10160 11 IMPORTANT. Pursuant to Chapter 440 . OrAIV, F.S, an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation ander this chapter. Pursuant to Chapter 440.05(12), F.S, Certificates of election to be exempL.. apply only Within the scope of the business or trade listed on the notice of election to be exempt, Pursuant to Chapter 440.0503i, F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for Issuance of a certificate. The department shelf revoke a certificate at say time for failure of the person named on the certificate to most the requirements of this section. QUESTIONS? (850) 413-1609 OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL. SERVICES DMSiON OF Wim' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW 9 EFFECTIVE 05/09/2011 EXPIRATION DATE: 05/08/2013 PERSON COWELL COWELL FEIN: 502126512 BUSINESS NAME AND ADDRESS. NEW WAVE POOLS & SPAS INC 1834 N VICTORIA PARK ROAD FT. LAUDERDALE, FL 33304 3fCOPE OF BUSINESS OR TRADE 1- SWIMMING POOL CONSTRUCTION IMPORTANT QPursuant to Chapter 440.054141, F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05021, F.S., Certificates of election to be H exempt- apply only within the scope of the business or trade listed on Rthe notice of election to be exempt E Pursuant to Chapter 440.05031, F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of tate notice or the issuance of the certific te, the person awed on that notice or certificate no longer meets the requirements of this section for issustice of a certificate. The department shell revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. CUT HERE ., QUESTIONS? (850) 413-1609 * Cerry bottom portion on the job, keep upper portion for your records. OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 m C 31- i I�lq I'Vi BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4.000 VALID OCTOBER 1, 2011 THROUGHSEPTEMBER 303 2012 DBA: Business Name: NEW WAVE POOLS & SPAS INC Owner Name: CoNDELL CownL Business Location: 1534 N VICTORIA PK RD FT LAUDERDALE Business Phone: Rece[pt #;18 8 -534 Business Type pooL/mimm COIZR'RACToR CONTRACTOR} Business Opened:11 / 13 / 1981 StaWCounty/Cert1Reg:CPCO2 02 71 Exemption Code:NONEXEMPT Rooms Seats Employees Madam Proteeeknuft 10 r -or vendlrr8 suable" only NiimM�� of Mwnhinau� Vertdltla TVOe: Tax Amount Transfer Fee I NSF Fee I Penalty J Prior Years I Cotiec"M Cost I Total Palo 27.00 0.00 0.00 1 0.00 0.00 1 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax Is levied for the privilege of doing business within Broward County and is non -regulatory In nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that It Is In compliance with State or local laws and regulations. Mailing Address: NEW WAVE POOLS & SPAS INC 1534 N VICTORIA PK RD FT LAUDERDALE, FL 33304 2011 -2012 Receipt $035-10-00002640 Paid 08/25/2011 27.00 .4Q.V-30-2011(WED) 16:56 - .- Titan Insurance Group (FAX)954 491 1636 P.0011001 II CERTIFICATE OF LIABILITY INSURANCE °"'� ' mn'! 11!30!11 THIS CEITIVICATE IS ISSUED AS A MATTER OF INFORMA71ON ONLY AND CONFERS NO (RIC�M U THE CERTIFICATE HOLDER. Tm CER31FICATE DOE$.NOT AFFIRMATIVELY OR.NEGA MELY AMEAW, E)MMD OR ALTER THE COVERAGE AFFORDED BY -THE IPOUCIES SMOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER. ARID THE CERTIFICATE HOL DM pUn "ANJ Ir ft CertalCate holder is an ADDITIONAL INSURED, the poncyple6) must be endorsed. M SUBROGATION IS WAIV8D, sub}ed to - tho Items and conditions of the policy, cortaln Folicks may rarlulre an endorsement. A statement on this Celtf}'iaate does not confer rights to the certMcate holder In lieu of auah endorsenmdts� FRi0DN0[]t m Thin InsU woo Group 1324 E Commercial Blvd G (9154Y21-1942 I rau. Nnk }491-1 SW ME dokess: tmoweM nron.com 0 COVaRAW d " UFS A. AtkdO 09suslry Imumnee Corrrmt Fart Lauderdale, FL 33334 HMO (954)491-1942 Fax 1-1838 INURED s lNsuReR c New Woo Pools & Spas, Inc INgum to • — 1534 N. Mdaria Park Rd INKIM E Fort Laudwdsle, FL 33304- 4824= SuwIrt COVERAGES CMMCATE NUMBER: REVISION NUMBER: THLS G TO CERTIFY `t HAT TTMI POUGIBS OF INSURANCE LISTED BELOW HAVE BEEN 1SWED To THE INSURED NAMED ABOVE FOR THE PC1LtCY PERIOD INDICATED. NOTWITHSTANDING ANY MQUIRamENT, TERM OR CONDITION OF ANY CONTPAOT OR OTHER DOCUMENT WITH RESPECT TO WHICH TM CERTIFICATE MAY BE I$GUIW OR MAY PERTAIN, THE INSURANCE AFFOR13ED BY THE POLICIES DESGRI 0 HER81N 13 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLIC[M. UMITS SHOWN MAY KAVE BEEN REDUCED BY PAID MAIM. yyggS. _ _ LTR TYP9 OP 1N+sURAMog INstt. W.VDD UMaTS 0ENERALUA9RRy p�4q� ogcuRRralcG $ 1.000.000.00 C06OMC1AL GE NIMAI, LIAGI rYDAIAAaE Tt] afNiEG_.. _ 4'8R(11i5aL9 + m nr S 50,000.00 I ❑ ❑ CLAIMsaMAac ® O=UR nen ®w ens ,n s 5.000.00 ' A 1.188000091 Wl14=11 (fI7114d2012 ❑ RMONAL & Acv NLIURIr s ai,000,000 00 GENFRAI,AWREOATP & zow.om.ca 0830R FnCN OF OPERATIONS t LOCATRM rvENIC[ ES 1 h AGdIRb teS, Addltlorc.�1 Ramerke ascheaala, irmere apace la regalreal �crc I IrI4�a I r rluwrr� Miami 5hom Vfte Bldg. Dept. 10080 NE 2M Ave Miami Shom s. FL 33138 Fax 03064601 w 2 ACORD 26 (2010108) OF SHOULD ANY OR THE ABOVE 00CMED POUCIRS BE CANCEL I W ORIS THE >' X (RATION DATE THMOF, NOTICE WILL BE DBLiMM IN A=RDANOE WITH THE POLICY PROVISIO & AUTNORM REPRESI3NTATRB 191968-2010 ACORD CORPORATION. All rigMs reserved. The ACORD narrut and logo are registered nm is of ACORD KEEL Arx GATE I IMIITAPPUES PIM 2 Q M LOC PRODUCTS. COMPMOP AGB $ _ _ $ Cz0 GES Lg1AR —� AUT0117013M LIA13ISrY ANY AUTO ❑ OWNP� ❑ pS(C�7M'pEMAJOD 1-1 FaI M AUTOS ❑ VNty-O�,WN� -❑ 00my INJURY (Por per6 mi S mODILY INJURY (ForaWdaq $ aD A $ UMORELLA LIAR n OGGUR M=311 UA13 CLAIM$MADE NIA EACH OCCURRENDz $ AeMEOATE I OGD17 gpmat $ _ $ `tail ori+ VORKMOMPaasATON AND IVLOY�EW� pU�ASIryryLITY YIN OVA I" L'XCWD�I�y __ &L FACH EL DISEASE-EAEMPLWOYPIs 0830R FnCN OF OPERATIONS t LOCATRM rvENIC[ ES 1 h AGdIRb teS, Addltlorc.�1 Ramerke ascheaala, irmere apace la regalreal �crc I IrI4�a I r rluwrr� Miami 5hom Vfte Bldg. Dept. 10080 NE 2M Ave Miami Shom s. FL 33138 Fax 03064601 w 2 ACORD 26 (2010108) OF SHOULD ANY OR THE ABOVE 00CMED POUCIRS BE CANCEL I W ORIS THE >' X (RATION DATE THMOF, NOTICE WILL BE DBLiMM IN A=RDANOE WITH THE POLICY PROVISIO & AUTNORM REPRESI3NTATRB 191968-2010 ACORD CORPORATION. All rigMs reserved. The ACORD narrut and logo are registered nm is of ACORD