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BBP-13-1465!BUILDING 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 APPLICATION Permit'fype: BUILDING JOB ADDRESS: / 3 !fd A,�101,5Yw- 2U Permit No. Master Permit ROOFING City: Miami Shores County: Miami Dade 'Lip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Mood Zone: OWNER: Name (lee Simple't'itleholder): De e/c-iJ- h Phone#: Address: /�.�® City: 9."e. A, State: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Address: City: v® Qualifier Name: J. JUN 2 SX013 Y_ oovo' om�aeo State Certification or Registration #: cZ IY.S 0'.'Q0 C"ficate of Competency #: Contact Phone# Email Address: DESIGNER: ArchitectlErigineer. Phone#: Value of Work for this Permit: $ 494-0 _� SquardLlnear Footage of Wort! Type of Work: vAddition LJAlteration ONew ORepair/Replace Description of Work: Color thru tile: ov Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO/CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ ' ' Bonding Company's Name (if applicable) Bonding Company's Address city state Mortgage Lender's Name (if applicable) 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 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 cured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEA1'LRS, TANKS and AIR CONDITIONERS, I;1C..... OWNER'S AFFIDAVIT: t 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 %JWIML UI HxGIIL The foregoing instrument was acknowledged before me this ZZ day of, 20 �3, by_i �� ®e.��.. who is personally known to me or who has produced As identification a nn NOTARY PUBLIC: ERT CALl�� ELL ?8: = MY COMMISSION # EE. 7r) tga ' EXPIRES March 08 Sign: ,�. toridallotarysP Print: 7f!✓ t My Commission Expires: APPROVED BY comas wr The fo g instrumentw ackno dged b fo a thisom day o . 20 by hs pernally known to me or who has producaxi and who did take an oath. 1\V I,"% 1 V RJA%- � ,ntida Pu. gp15 Sign: goo s Print: 01 �o`�m:ssloa # �a�ti°�atY My Commission piers eoadedt�`0u9 Plans Examiner (/`7 ZV-1.1 Zoning Structural Review Cleric (Revised 3/12/M12XRevised 07/10817XRevised 06/1WD09)(Revised 3/15819) 00 6229531 STATE OF FLORIDA SIO DEPARTMENT_OE`' BUSINES�nAM PRLICENSINGLBOARDOT�® SE(a#L12072700165 COMrSERCIAL POOL/SPA uu0I-"%1m%-i"`' ,ed below IS CERTIFIED )iration Chapter 0 date: ATJG 31,244er 4>39 FS. BLACK, DAVID A DOLPHIN POOLS AND SPAS INC 1435 GRANT STREET FL 33020 HOLLYWOOD RICK SCOTT GOVERNOR DISPLAY AS REQUIRED BY LAW IGEN LAWSON SECRETARY STATE O? FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKEPT COMPENSATION CONSTRUCTION INDUSTRY CERTIFIr.ATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKEF.S` COMPENSATION LAW 0 EFFECTIVE: 09/18/2011 EXPIRATION DATE: 09/15,'2013 PERSON: DAVID BLACK FEIN: 651'i26630 , BUSINESS NAME AND ADDRESS: DOLPHIN POOLS & SPAS INC ` 1435 GIANT ST ",OLLYAUOD, FL 33010 SCOPE OF BUSINESS OR TRADE: I,� POCLS/SPAS CONSTRUCTION 2- DECKING BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2012 THROUGH SEPTEMBER 30, 2013 DBA: Business Name: DOLPHIN POOLS & SPAS INC Owner Name: DAVID A BLACK Business Location: 1435 GRANT ST HOLLYWOOD Business Phone: Receipt#:188L%M7A6 INE CONTRACTOR Business Type:IPOOL/SPA CONTRACTOR? Business Opened:10/29/2001 State/Co unty/Cert/Reg: CPC 14 5 8 2 7 0 Exemption Code: Rooms Seats Employees Machines Professionals 2 For Vending Business Only Number of Machines: VAndinn TvnA- Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 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: DAVID A BLACK 1435 GRANT ST HOLLYWOOD, FL 33020 2012 -2013 Receipt #03A-11-00006491 Paid 09/04/2012 27.00 I".0�0%24#A w- -.-I .ter -. -.._-.-e--___.__--...__. '� CERTIFICATE OF LIABILITY INSURANCE D"��' 8/13""'' 06!28/13 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 polky(les) must be endorsed. re SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certlf(cais does not confer rights to the certificate holder In Ileu of such endorsement(s). PRODUCER Jackson Insurance Agency 2075 West 761111 Street Hialeah, FL 33016 Phone (305) 824-3464 Fax (305) 8224535 CONTACT Fannia Baez PHONE (305) 824-3464 a No ( 822$535 No. ga E-MAIL Fbaez@JACKSONAGENCY.COM INsu g AFFORDING COVERAGE NAte S INSURER A: Mac Neill Group Inc INSURED Dolphin Pools and Spas, Inc. 1435 Grant Street Hollywood, FL 33020- (754) 2447727 INSURER B: Metchhry Ins Co INSURER c : INSURER D: INSURER E: INSURER F: �vvtrcAt3ta GERTIFIGATE 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. LTR TYPE OF INSURANCE IN UB POLICY NUMBERPOLIO EFF PYYYI OLICY EXIMMIDDP ffiMn LIMITS A GENERALLIABRITY Q COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE 0 OCCUR R] Products -Completed leted O Included ❑ P Ps CLM01001069C 02/16/2013 02/16/2014 EACH OCCURRENCE $ 1,000,000.00 DAMAGE(RENTED 10() 000.E PREMISESS occurrence) $ MED EXP (Any one person $ 5,000.00 PERSONAL &ADV NJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: © POLICY ❑ PRO - _CT ❑ LOC PRODUCTS - COMP/OP AGG $ $ B AUTOMOBILE LL48MM ❑ ANY AUTO ❑ AUTOS D © AUTOS ❑ HIRED AUTOS ❑ AUTOS ❑ ❑ FLC7009557-7 03/28/2013 03/28/2014 COMBINED SINGLE LIMIT accident) 100.000.00 � BOOILY INJURY (Per person) $ 50,000.00 BODILYINJURY(Peracddent; $ 100,000.00 ERTY PROPoddenDAMAGE $ 25,000.00 $ ❑ UMBRELLA L IAB ❑ OCCUR ❑ EXCESS 1JAs ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DED ❑ RETENTION$ $ WORKERS COMPENSATIONWC AND EMPLOYERS LIABRITr Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory In NH) ElE.L Ityes describe under DESdRIPnON OF OPERATIONS below N/A STATU- ❑ OTH- E.L. EACH ACCIDENT $ DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remadm Schedule, If mora space H required) This certificate is solely for the use as " Evidence of Insurance GERTIFIGATE HOLDER CANCELLATION Village of Miami Shores 10050 Northeast 2nd Avenue Miami Shores, Florida 33138 ACORD 25 (2010105) QF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. • -.r. • a• .i ©1988-2010 ACORD CORPORATION. AD rights reserve!. The ACORD name and logo are registered marks of ACORD Vy M 155.15' S05 29'00"E t 3i s �p �/8a.8_ IIS r s ^� S03"09'00"E 14- 0 - �e /0 res Village RULES 1350 N.E. 101 STREET MIAMI SHORES, FL 33 DATE V/3 NS ;JVAC � ss �v d �2 159.95' A ;oto1*CN am 10 M lz� Notes. " J i S't;tdE� THE FIPM M, G; E. ES P S ,t :V1 STIP[ Gr r", MIGUEL ESPINOSA LAND SURVEYING, IN . 10665 SW 190TH STREET SUITE 3110 i MIAMI, FL 33157 PHONE: (305) 740-3319 FAX: (305) 669-3190 LB#: 6463 Accepted By: Surveyor's Legend PROPERTY UNE STRUCTURE R.R. BEARING REFERENCE TEL TELEPHONE FACILITIES iN0 POUND IRON PRE / r rrT.r.+z CONK. BLOCK WALL PIN AS NOTED ON PLAT a CENTRAL ANGLE OR DELTA U.P. UTILITY POLE —X—x— CHAIN-UNK FENCE OR WIRE FENCE LU LICENSE I - BUSINESS R RADIUS OR RADIAL E.U.B. ELECTRIC UTILITY BOX WOOD FENCE LSI LICENSE I ^ SURVEYOR RAD, RADIAL TE SEP. SEPTIC TANK —a --o— IRON FENCE CALC CALCULATED PONY N.R. NON RADIAL D.F. GRAINFIELD SET SET PIN TYP. TYPICAL A/C AIR CONDnMER — - — CENTER LINE A CONTROL POINT I.R. IRON ROD S/W SIDEWALK CONCRETE MONUMENT I.P. IRON PRE OWY DRIVEWAY ® WOOD DECK BENCHMARK NLD NAIL M DISK SCR. SCREEN CONCRETE ELEV ELEVATION PK NAIL PARKER-KALON NAIL DAR GARAGE POINT OF TANOENCY D.H. DRILL HOLE SNCL ENCLOSURE ®P.T. ASPHALT P.C. POINT OF CURVATURE ® WELL N.T.S. NOT TO SCALE BRICK / TILE P.R.M. PERMANENT REFERENCE MONUMENT ® FIRE HYDRANT F.F. FOLNISHE0 FLOOR P.C.C. POINT OF COMPOUND CURVATURE ® Y.X. MANHOLE T.O.B. TOP OF BANK ®WATER P.R.C. POINT OF REVERSE CURVATURE 0.X.L OVERHEAD LIMES E.O.W.EO.W. EDGE � WATER APPROXIMATE EDGE OF WATER P.O.B. PINT OF BEGINNING TX TRANSFORMER LO.P EDGE OF PAVEMENT P.O.C. POINT OF COMMENCEMENT CATV CABLE TV RMER C.V.G. CONCRETE VALLEY GUTTER COVERED AREA P.C.P. PERMANENT CONTROL POINTBUILDING W.Y. WATER METER B.S.L. SETBACK LINE Q TREE M FIELD MEASURED P/E POOL EQUIPMENT S.T.L SURVEY TIE LINE POWER POLE P PLATTED MEASUREMENT CONC. CONCRETE SLAB q CENTER UNE ® CATCH BASIN D DEED __u: e- .,. R/W R%HT-OF-WAY i C CALCULATED c n. .. ..0 ., c4 "P/eV• iC....C. ..... .. E � -h _, -_ICM �>,.... M E� ...-.i-'S .kSENE+;t a.L in }: '.,.. a... i 1350 N.E. 101 STREET MIAMI SHORES, FL 33138 General Notes: ®� 1. The Legal Description used to perform this survey was supplied by O L ` O others. This survey does not determine or Is not to imply ownership. C T 2. This survey only shows above ground Improvements. Underground A utilities, footings, or encroachments are not located on this survey map. 3. If there is a septic tank, wag, or drain field on this surrey, the location T „„_I,,,, of such items was shown to us by others and the information was not I o verified. 4. Examination of the abstract of title will have to be made to determine N "e S recorded instruments. If any, effect this property. The lands shown herein C were not abstracted for easement or other recorded encumbrances not A shown on the plat 4 L 5. Wall ties are done to the face of the wag. A y G. Fence ownership is not determined. P E 7. Bearings referenced to One noted B.R. 6. Dimensions shown are platted and measured unless otherwise shown. 9. No identification found on property comers unless noted. Community Number. MIAMI SHORES VI1-1-AGE/120652 10. Not valid unless sealed with the signing surveyors embossed seal. 11. Boundary survey means a drawing and/or graphic representation of Panel Number. 12086C0306L the survey work performed in the field, could be drawn at a shown scale Suffix: L and/or not to scale. 12. Elevations if shown are based upon NGVD 1929 unless otherwise Date of Firm Index: 9/11/2008 noted. Flood Zone: AE / VE 13. This is a BOUNDARY SURVEY unless otherwise noted. 14. This survey Is exclusive for the use of the parties to whom it is Base Flood Elevation: 9/11 certified. The certifications do not extend to any unnamed parties. Date of Field Work: 212812012 Date of Completion: 3/1/2012 REPUBLIC NATIONAL TITLE INSURANCE COMPANY ISSUED THROUGH ATTORNEY'S TITLE FUND FLORIDA, INC., OLD`.,, TITLE SERVICES, LLC, REGIONS BANK, DIB/A REGIONS MORTGAGE ISAOA/ATIMA, . Its'successors and/or assigns as their interest ma ar eg escnption: THEREOF AS RECORDED IN PLAT BOOK 55, PAGE 83, OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA PRINTING INSTRUCTIONS: MIGUEL ESPINOSA LAND SURVEYING, INC, Whileviewing the survey in any Acrobat Reader, select the 10665 SW 190TH STREET File Drop-down and select "Print” Select a color printer, if available, or at least one with 8.6"x SUITE 3110 14" paper. MIAMI, FL 33157 Select ALL for Print Range, and the # of copies you would like PHONE: (305) 740-3319 o print ouL FAX: (305) 669-3190 Under the "Page Scaling" please make sure you have LBM 6463 selected "None." Do not check the "AutoRotate and Center" button. Check the "Choose Paper size by PDF"checkbox. Click OK to Print. f, ,. RIGHT -SIZED SALT CHLORINATION n c:r .. _ Turbo Cells come in three sizes for in ground pools —40,000, 11 Th three sizes enable you to right - 25,000 and 15,000 ga ons. e size your salt system for the most efficient and cost-effective chlorination possible. The Turbo Cells automatically generate a self -renewing supply of fresh, pure chlorine for water that's clean, clear and luxuriously soft. Turbo Cells sold separately SALT CHLORINATION FOR IN -GROUND POOLS Salt chlorination with Sense and Dispense professional -grade Aqua Rite Pro takes pool and spa sanitization and chemistry management to new levels, building upon the industry- leading salt chlorinator — Aqua Rite. This integrated solution automatically senses sanitization and pH levels and dispenses a self -renewing supply of pure chlorine generated from salt, while controlling pH. Integrating chemistry automation with sanitization eliminates the need for an additional device on the pool pad and lowers installation costs. So now you get the most consistent water quality possible, water that's brilliant, soft and silky smooth, for the best possible pool experience. Aqua Rite provides complete pool and spa sanitization using ordinary salt. Its extremely safe electrolytic technology converts a small amount of salt — approximately one teaspoon per gallon of pool water — into a virtually endless supply of fresh, pure chlorine. This environmentally friendly and self -renewing process produces up to 1.45 pounds of chlorine a day, enough to keep the water in a 40,000 -gallon pool clean, clear and luxuriously soft. 'For pools over 40, 000 gallons, use additional units. SALT CHLORINATION FOR ABOVE -GROUND POOLS 0 AQUO i rot'' Salt ChilonnaLion This is the affordable all -in -one salt -chlorine -generation solution for above -ground pools. Aqua Trol includes the Salt Chlorination Control unit, an 18,000 -gallon Turbo Cell and plumbing kit. CITY OF MIAMI - BUILDING DEPARTMENT NOTICE OF COMMENCEMENT Please file at 22 N.W. 1st Street, Miami PERMIT NUMBER: FOLIO NUMBER: State of Florida County of Miami -Dade I f 1111 l fill Il' Ili 11111 l Il 111 l I Cll^ N 2 0 13RD X6702?6 OR Ek 28787 f:'s 3692; Ops) RECORDED. 080/23/2013 11:20:21 HARVEY RUVINY CLERK OF COURT MIAMI-DADE COUNTY? FLORIDA LAST PAGE The undersigned hereby gives notice that improvements will made to certain real property, and in accordance with Chapter 713.23, Florida Statuses, the following in provided in this Notice of Commencement. Stree addrre�ss:,4200 j42Z S � ,;b nd Legal description of property: �� &au Owner' name -:a g L: L''a &ze'erw and address: /25770 ��/S'4�r � %yi p,. �',��✓ s' Interest in property: -_"F✓ �'s� Name of fee simple titleholder (if other than owner) and address: Contractor's name and address: f ® Phone number: :r?? z Amount of Surety bond- :(Payment bond required by owner from contractor, if any) Surety's name- and address: Phone number: Lender's name: and address: Phone number: Persons with 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 Statues, Name* and address: Phone number: In addition to himself, Owner designates the following person(s) to receive a copy of a Lienor's Notice as provided in Section 713.13(1)(b)7, Florida Statues, Name: and address: Phone number: Expiration date of this Notice of Commencement: (the expiration date is one [1] year from the date of recording unless a different date is specified) ` Owner's Tignature ® Owner's Name (printed) Sworn to d s bs� cribd befo ane on this ` y of '200— By: ��'�� `"�- ersonally Known, or Produced ID Notary Public: 4`— Print Notary Public Name: -�'—" a OF FLORIDA, COUNTY OF DADE Oath taken Oath not taken ii i $` � ��lfiratns'isi'[Idd•CDpj7' Commission ExDiration: .._ dresS 4COMMISSt°,:> 07DA�� Seal. vit and .C. ow %n Rev. Dec/21/2010 Generated on Jun/21/2013 9:12 AM