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PL-14-2237
Ll Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-221465 Permit Number: PL -10-14-2237 Scheduled Inspection Date: December 04, 2014 Inspector: Diaz, Osvaldo Owner: ENCARNACION, SHIRLEY Job Address: 1125 NE 92 Street Miami Shores, FL -33138 - Project: <NONE> Contractor: CLEARWATER POOL AND PATIO sunamg uepartment comments Permit Type: Plumbing - Residential Inspection Type: Mai as Work Classification: ofri�P vats Phone Number Parcel Number 1132050270380 Phone: (305)986-2588 EXTEND EXISTING RETURN THROUGH NEW ENTRY Infractio Passed Comments STEPS I INSPECTOR COMMENTS False December 03, 2014 For Inspections please call: (305)762-4949 Page 13 of 46 Inspector Comments Passed s%tel Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. December 03, 2014 For Inspections please call: (305)762-4949 Page 13 of 46 BUILDING PERMIT APPLICATI F1 BUILDING ❑ ELECTRIC Miami Shores Village Building Department ®cT 1® 20,4 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC20/0• Permit NoApp 2C Permit Nam=— EXTENSION RENEWAL PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: /l / City: Miami Shores County: Miami Dade Z(o• Folio/Parcel#: Is the Building Historically Designated: Yes Occupancy Type: Load: Construction Type: Flood Zone: BFE: NO FFE: OWNER: Name (Fee Simple Titleholder): ��i��S� c�uea�.d Phone#: Address:/-0-!�zx- 1,"A- 9-7- s -T City: 42il2,,,-P7z ¢S�/ .l State: 7-- zip: Tenant/Lessee Name:Phone#: Email: /40�E/z--a mow.. ,® f CONTRACTOR: Company Name: s d c�, Phone#: -2 5? Address: p -52-J 11!7 (=--7- city: _ x®-v'epol State: Zip: Qualifier Name: A(Phone#: Ztjr7- State Certification or Registration #: ,2 "-d- Certificate of competency #: DESIGNER: Architect/Engineer: la"V Phone#: Address: �•C4 ;$W '.9>6 4- P, City: /�710'77 a State: Zip: /& Value of Work for this Permit: $ /00, m Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee $ Permit Fee $ _ lso, oe-y CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address o ' 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property Is subject to attachment Also, a certiti'ed copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is Issued. in the absence of such posted notice, the Inspection will not be approved and a reinspection fee will be charged. Signature m OWNER or AGENT The foregoing instrument was acknowledged before me this day of��. �. . 20 O . by +Ply L"'!7 CEI r' ✓i`,�,,fi6i�o is p rsonaIly known to me or who has produced as Identification and who did take an oath. NOTARY PUBLIC: MEE --'=' • • The foregoing instrument was acknowledged before me this vllp day of ��_J- . 20 (4 . by l�l1.�vl�6/!�� . wh is personally known me or who has produced as Identification and who did take an oath. NOTARY PUBLIC: e 7; (,/- , " �_' 1, 1 /V/ %� Sign: Sign: Vo': IAAj RC -111A611 t c �e_ Seal: ;8 'd' % TAMARA Seal: ,,•'"' a" = MAMOAER In COWSSiON # EE 84= ¢r +r_ W COBANl1SSION # EE SM EXPIRES Ds�ember� 1y,.,20�1.6� pp p s EXPIIR��pEES: Dewadiw 1�,�2�o1ley� ''.!(f„i1.' ITi114WY 11YY NQ�. VIWGYi1LLN0 MIN\.., "'- �•rWWV UiN01}Tltm IKQII�f�I* � «�ttl �� ** Ig �**� I�l>11Qt7(I>jlrll�l1�1lj1 l& {I>$I$* ** �� Ix�l � li>flljtJflljtill$ APPROVED BY Plans Examiner Structural Review (RevisedO2/24/2014) Zoning Clerk r ..- 40 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 MANHEIMER, KENNETH DAVID CLEARWATER POOLAND PATIO 8266 SW 193RD STREET MIAMI FL 33157 Congi' tul tjomitfi'ss tcense you one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better: For information about our services, please log onto www.myflorldallcense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department 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 Florida, and congratulations on your new license! (850) 487-1395 DETACH HERE RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY a SPATE QF;FLpRIDA DEPARTMENT Of: 8US E;AA SSD PR6#EiSl0NAj- REGI COi15R1lC'� fNitJSTRY LCSi�tG fi30AttD MAUFa. 6812812014 DISPLAY AS RE QUI ALLST-2 OP ID: GJ ACORO` OF LIABILITY INSURANCE DATE/Y)CERTIFICATE 06/06/2014 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 endorsement(s). PRODUCER Insurance By Ken Brown, Inc. PO Box 948117 CONTACT NAME: David R. Griffiths A/CC, N Ext : 321-397-3870 ac No): 321-397-3888 E-MAIL ADDRESS: Maitland, FL 32794-8117 David R. Griffiths 07/01/2014 07/01/2015 INSURERIS) AFFORDING COVERAGE NAIC # INSURER A:Amerisure Mutual Ins. Co 23396 MED EXP (Any one person) $ 51000 INSURED All Star Pools Inc Clearwater Pools & Patio DBA PO Box 832783 INSURER B:Amerisure Ins Company 19488 INSURER C: INSURER 0: Miami, FL 33283 INSURER E: INSURER F : LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS 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. ICY LTR TYPE OF INSURANCE DD B POLICY NUMBER POLICY EFF EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 0 OCCUR GL13124321802 07/01/2014 07/01/2015 EACH OCCURRENCE $ 1,000,000 PREMISES (EaAGE TO occurrence)$ 100,000 MED EXP (Any one person) $ 51000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑PRO r LOC JECT OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident $ UMBRELLA LIAR EXCESS LIAS OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ B WORKERS COMPENSATIONX AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 38099 05/04/2014 05/04/2015 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: Ren Manheimer, State License #CPC1457917 MIAMISH Miami Shores Village 10050 N.E. 2nd Avenue 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 POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD