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PL-14-278Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-219965 Permit Number: PL -2-14-278 Scheduled Inspection Date: October 02, 2014 Permit Type: Mechanical - Residential Inspector: Diaz. Osvaldo Owner: OLIVA, TERESA Job Address: 301 GRAND CONCOURSE Miami Shores, FL 33138 - Project: <NONE> Inspection Type: Final Work Classification: Pool Heater Phone Number (305)807-1210 Parcel Number 1132060133850 Contractor: STEPHEN MATTHEW ELBAZ PLUMBING LLC Phone: (786)333-8534 comments POOL HEATER GAS LINE INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-207166. provide drop test and provide sediment trap at connection Failed 6� Correction v Needed r� ❑ , , z-- Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. October 01, 2014 For Inspections please call: (305)762-4949 Page 12 of 32 Stephen Matthew Elbaz Plumbing LLC 717 NE 10th Ave. Apt. 2 Hallandale FL 33009 Lic# CFC 1428186 Drop Test Report Florida Building Code, Fuel Gas Section 406.1 Date 09/17/2014 Permit #PL -2-14-278 Address 301 Grand Concourse 0.5 Pound Natural gas system Performed drop test on existing gas system at 8 inches of water column for 20 minutes Contractor Print' Contractor sign* Notary sign* Sworn to and subscribed before me thisf7Day of 20By l�uw e/4�o7 OF Personally Known ( ) Produced ID Stamp ", ^; MICHAEL J FAMANO o. Notpry PUMtc - Sto of Florida •fig My Comm. E*ms Wv 1, 2015 •'� �i Commiseft N EE 144M7 +•'h, rt1 �,,, ` 801" r4o No" NoWy AM tr'- BUILDING i Shores Village uilding 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 FBC 20 1 Permit Type: Permit No. 21 l L/ Master Permit No. app / 3 a? -4-j OWNER: Name (Fee Simple Titleholder): 7- ,re �L i V Phonek _300: VOUPo Address: 3(21 Gi'gn,&l eoAleOurdS^� City: 11/l i�c; i ,S/yar•.GS State: A-2 Zip: 3 313 4j' Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: SDI �r1�cl c-owc ar-5-e City: Miami Shores County: Miami Dade Zip: 3 3 / 3 s— Folio/Parcelk Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: IJ on; _7 r71n .�►� end if _ City: Qualifier Name: State Certification or Registiation #: Q__J--C _ — / Y Z i5( K(e Certificate of Competency #: Contact Phone#: ,®�� Z3 0? Email Address: �_c%i��►� , ca* 'IF DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ a� �DU a . S uare/Linear Footage of Work: 414YW%Warlut, LIAddar€ss��r R ,Sn Alteration w "�� aRap.airJReplace ODemolition Description of, Work: tlC++ca$- T' -,W Submittal Fee $ Permit Fee $_.;CF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ 1 b 9. 2N 0 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 secured for ELECTRICAL V+t,,PI;IMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS�L�C..... 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 c)g7nmencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issue . In the absence of such posted notice, the inspection will not be approvpWt qnd a reinspection fee will be charged. Signature l YA JL/J-fK Signature / �... Owner or Agent Contractor The foregoing instrument was acknowledgedbefore me this day of , 20 &, by 1 0?!eSA CUV%4 • , who is personally known to me or who has produced Xi Z ,1�1 " As identification and who did take an oath. NOTARY `' .C/ �o-WV PLe�� MICHAEL J FABIIMIO Sign: .� � Notary Public - Side of F1 a �V My Comm. ExBiros Noy 1, Print: The foregoing instrument was acknowledged before me this day of Op"? , 200—/, by 54Paj�,an s ,&Vba-- who i personally known me or who has produced as identification and who did take an oath. NOTARY Sign: Print: MICHAEL J FABIAN0 Notary Public - SWO o ��«° ;; Bonded Through N dMW tfo ty A4�1. sN o r Commission #t EE 140447 My Commission Expire My Commission E 401 F`oP, ,,, Bonded Through Nacional N APPROVED BY 1-L t✓Plans Examiner " Zoning Structural Review (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Clerk n STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 ELBAZ, STEPHEN M STEPHEN MATTHEW ELBAZ 717 NE 10TH AVE APT 2., HALLANDALE BEACH PL'DMBING LLC FL 33009 r (850) 487-1395 ` STATE OF FLDIW AC# .G 21# 3 3q5- Congratulations! With this license you become one of the nearly one million DEPARTMENT OF � 9=0S AM Floridians licensed by the Department of Business and Professional Regulation. I � PROVEggIO , REGETLATZON Our professionals and businesses range from architects to yacht brokers, from II =y boxers to barbeque restaurants, and they keep Florida's economy strong. I CFC1428186 Oa/,Q ``1`12 127006207 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.myfloridalleense.com. I CRRTZFIEI} FLUIl1 Ii(° b' T9ACTOR There you can find more information about our divisions and the regulations that ELBA, S%3 ., M Impact you, subscribe to department newsletters and learn more about the STEPHEN M8' i11?11NG L Departments 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. ? IS CLRTIFX= under the provisions of cb.489 Fs Thank you for doing business in Florida, and congratulations on your new licensel s,3�atam date, Aug 31, 2014 ti126e0261166 DETACH HERE AC# 6243395 STATE OF FLORIDA DEPARTMENT OF BUSIME99 AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SE(N L12080201766 The PLUMBING CONTRACTOR Named below I9 CERTIFIED Under the provisions of Chaptei,,4_$_g�r'1FSj Expiration date: AUG 31, 2014 - ELBAZ, STEPHEN M STEPHEN MATTHEW ELBAZ PLUMBING."SLC 717 NL 10TH AVE APT 2 HHALLANDALE BEACH FL 33009 ` RICK SCOTT GOVERNOR DISPLAY AS REQUIRED BY LAW REN LAWSON SECRETARY 108/02/203.2,,11270015207 CFC142818:9 The PLUMBING CONTRACTOR Named below I9 CERTIFIED Under the provisions of Chaptei,,4_$_g�r'1FSj Expiration date: AUG 31, 2014 - ELBAZ, STEPHEN M STEPHEN MATTHEW ELBAZ PLUMBING."SLC 717 NL 10TH AVE APT 2 HHALLANDALE BEACH FL 33009 ` RICK SCOTT GOVERNOR DISPLAY AS REQUIRED BY LAW REN LAWSON SECRETARY 03-12-2012 we I. ,w� JEFF ATWAT'ER STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 03/05/2012 PERSON: ELBAZ FEIN: 800235983 BUSINESS NAME AND ADDRESS: STEPHEN MATTHEW ELBAZ PLUMBING LLC 717 NE 10TH AVE WEST APT #2 HALLANDALE FL 33009 SCOPES OF BUSINESS OR TRADE-- 1- RADE1- PLUMBING NOC AND DRIVERS 3- PLUMBING EXPIRATION DATE: 03/05/2014 1:401:401 2- 2- CERTIFIED PLUMBING CONTRACTOR IMPORTANT: Pursuant to Chapter 440 . 0604), 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 under this chapter. Pursuant to Chapter 440.0602), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05{13), 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 shall revoke a certificate at any time for failure of the porsoa named an the certificate to meet 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 DIVISION OF WORKERS COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO 13E EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 03/05/2012 EXPIRATION DATE: 03/05/2014 PERSON: STEPHEN ELBAZ FEIN 800235983 BUSINESS NAME AND ADDRESS: STEPHEN MATT14EW ELBAZ PLUMBING LLC 717 NE 10TH AVE WEST APT 02 HALLANDALE, FL 33009 SCOPE OF BUSINESS OR TRADE 1- PLUMBING NOC AND DRIVERS 2- CERTIFIED PLUMBING CONTRACTOR 3- PLUMBING IMPORTANT F Pursuant to Chapter 440.06(14), F.S., an officer of a corporation who 0 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 440.05(12), 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 440.05(13), 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 shall revoke a certificate at arty time for failure of the person named on the certificate to meet the requirements of this section. CUT HERE QUESTIONS? (850) 413-1609 * Carry bottom portion on the job, keep upper portion for your records. OWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2013 THROUGH SEPTEMBER 30, 2014 DBA: STEPHEN MATTHEW ELBAZ PLUMBING LLC Receipt#:PLUMING/LWN SPRNM/C Business Name: Business Type:(PLUMBING CONTRACTOR) Owner Name: STEPHEN M ELBAZ Business Location: 717 NE 10 AVE APT 2 HALLANDALE Business Phone: 786-333-8534 Business Opened:03/15/2010 StatafCounty/CertlReg:CFc142 818 6 Exemption Code: Rooms Seats Employees Machines Professionals 1 For Vending Business only Nwnber of Machines: Vending Tvne: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 1 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: STEPHEN MATTHEW ELBAZ PLUMBING LLC 717 NE 10 AVE APT 2 HALLANDALE BEACH, FL 33009 2013 -2014 � w�;�� Licrrzs f!I L_ 717 NE ICMAVEAPI r++�tnnDfU.E UGH, FL S:iD09 WIF DRS°11-JS-1�6SEX SAM DRWEFt of a yhck commirms cvauttm Receipt #03A-12-00012917 Paid 09/27/2013 27.00 Miami Shores village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if - 1 . f 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore, you may be personally liable for the worker compensation injuries of go person allowed to work under this permit. Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Owner !rIJII�J�LJ Print Name: we S a Signature: State of Florida ) County of Miam '-D d Sworn to and su cri pre me 1 ABIANO day of �.a 8,�,�Qli Rubllo - e of Flmtda -_. .. Mj W.Expires Novi. 2015 By air opo,• Commission # EE 140447 „ (SEAL) Type of Identification produced ,o0A1 0Contractor n" Print NameL.a,. 144 Signature: State of Florida ) County of Mi Sworn to and su c day of �1u :1 �N B Y (SEAL) Tvpe of Identification MICHAEL J FA91AN0 ®pig Fate of FIVIN oi,t% F,xpiies Nov 1. 2015 Commission 0 EE 140447 goaded fiIwMh NaUonai Nstery AM %5/ 1u_ Ji i 110 0 1119 WUP-MAll; g a g, !, e � .' I a, , 1 0 1 a. - �. e 12 if rdiiing"t I I I I I IAN NONNI slu"s 91UM&Q, W v TITNE IM FIL a Stephen Matthew Elbaz Plumbing LLC. 717 NE 10 Ave#2 Hallandale FI 33009 Lic #CFC 1428186 if oWcayde 3 01 6 -a -A jvj lvg,�,y Natural ga _ em 0.5 Pound Number of units on new line 7 Pool heater 385.000 BTU/'S Run► 11 5CN q6 j ?VIAM-1 SW)RES VILLAGE l' APPROVED I BY DATE ZONiNG ' i. *y" -z -C sSiRUCTURAL ELECTRICAL` PLUMBING 'i'MECHAN -AL. t 25 750 G _..1 iiJ C:Mi'LIAN,E WITH �\LlrEuERAL, rall t p. < .• ?L N, LOUN1'Y RULES AND REGULATIONS . •••••• . • if oWcayde 3 01 6 -a -A jvj lvg,�,y Natural ga _ em 0.5 Pound Number of units on new line 7 Pool heater 385.000 BTU/'S Run► 11 5CN q6 j ?VIAM-1 SW)RES VILLAGE l' APPROVED I BY DATE ZONiNG ' i. *y" -z -C sSiRUCTURAL ELECTRICAL` PLUMBING 'i'MECHAN -AL. t 25 750 G _..1 iiJ C:Mi'LIAN,E WITH �\LlrEuERAL, rall t p. < .• ?L N, LOUN1'Y RULES AND REGULATIONS --57 0 b Y0 Q Co✓Lcav)-S e_ t� Ll co 2 DOA rAcb tQ IIS4,1 s C.J A t g6te! pr jo C4) G ccs cy ®G d Z7 S" 'i 0(9 ( 3 6 c1' sC 6 G Gam, q i ✓1 I'lc4' c o v1 o t �*k7 L OAC4.1/ 049tdl Cq(C_ to � Loci ic, � /!- A wti p S cl A J ->t 7, "J 2,4:�- v 10, L t 2 Gam, q i ✓1 I'lc4' c o v1 o t Panel Type: Panel Size: 'Loc A Panel Name: A Main Breaker: 7,cc> Amps Panel Voltage: Panel Phase: I Panel Mount: pe -,c e _5 5 e Panel Wim- , //) r% AYC . L, ICVA 0 IwAr -S) - 15,-& i- -& � () LA -7 '-) b B R K E R Name of Load IA5 ?6?541 is I T- C- b e C I R # 1 C IR R # 2 Name of Load jvkq5jvr K E R M M q P S T5— k- le GM A 3 4 20 MO. 15- , V v — ree- P c, it 0 V e- 5 7 9 6 8 10 On" 61 C dq Cow C, 4141 Vx ll 12 to C, it rec. 13 15 17 19 14P 16 18 20 r -41C 44j U A I 30 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 L, ICVA 0 IwAr -S) - 15,-& i- -& � () LA -7 '-) b Panel,Type: �kvvv-mqb, 0 Main Breaker: i 2s- Amps Panel Voltage: f zuG Panel Size : tZ Panel Phase: I Panel Mount: Panel Name: f-2) Panel Wires .44 1 F"IATC- S- 0 0, -B R KP ES R Name of Load c R # C R # Name of Load B R K E R —T—A-- M 1 2 I L � 0 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 — — ------------- ----- ----- ------ 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 401 El=F1 S- 0 0, � J m �iami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 SWIMMING POOL OWNER'S CERTIFICATION Date Miami Shores Village Building & Zoning Department Attention: Building Official I certify that I am the legal owner of the property described as located at 301 r -4-t In accordance with Section 33-12(f), Code of Metropolitan Dade County, I certify that I understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until separate permit has been obtained for an approved safety barrier, and such barrier erected, inspected and approved. further understand that this certification, however, does not eliminate the need for obtaining a permit and erecting and approved barrier prior to final inspection and use of the pool. Legal Owner Note: This certification is to be submitted with a swimming pool permit application in duplicate. Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 NOTICE OF REQUIREMENTS RESIDENTIAL SWIMMING POOL, SPA AND HOT TUB SAFETY ACT I (We) acknowledge that a new swimming pool, spa or hot tub will be constructed or Installed at 3 U ti Miami Shores, FL, and hereby affirm that one of the following methods will be used to meet the requirements of Chapter 515, Florida Statues and the Florida Building Code R4101.17. Please initial the method(s) to be used: The pool will be equipped with an approved safety pool cover that comp lies with ASTM F1346-91. (Submit Manufacturers Specifications). A continuous, one-piece (child) barrier meeting the requirements of Florida Building Code R4101.17.1.15 will protect the pool perimeter. The plans shall show the fence location and method of attachment, including one end that shall not be removable without the aid of tools. (Submit Manufacturer's Specifications). A combination of non -dwelling walls and fences (screen enclosure, child fence, masonry fence walls, chain link or wood fence, etc.) will protect t he pool perimeter. The plans must specify t he type and location f all non dwelling walls. Florida Building Code, R4101.17.1 Any combination of protection which incorporates dwelling walls with openings directly into the pool perimeter and all windows and doors will be equipped with exit alarms complying with Florida Building Code, R4101.17.1.9 (Submit Manufacturer's Specifications). Any combination of protection which incorporates dwelling walls with openings directly into the pool perimeter and all doors will be equipped with a self -latching device with positive mechanical latching/locking installed a min. 54° above the threshold. If this option is selected, submit plans showing all types and location of all perimeter protection. The plans must also show the location and type of all openings, and the hardware type for each location. (Submit Manufacturer's Specifications). In accordance with the Code, the pool may not be filled with water without compliance with the Private Swimming Pool Safety Requirements, and upon expiration of the permit the pool shall be presumed to be unsafe. I understand that not having one of the above installed will constitute a violation of Chapter 515, F.S ., an d will be considered as committing a misdemeanor of the second degree, punishable as provided in Section 775.082 or Section 775 083 F.S. This form must be signed by the o er/agent and the prime contractor. 161VY 3 ) ( CONT CTOR'S SIGNATURE AND DATE OWNER'S SIGNATURE AND DATE 94 4 �� L--'-- . esa DGVa- C1ONTRAC PAE (PLEASE PRINT) OWNER' INT) 1 + , KERYIEN.4 DOSTALY + A urate o0.RTALY N Public, State of Rorida iP No ubUc, State of Florida Commission# EE 167413 CommkWon t EE 167413 My comm. expires Feb. 7, 2016 My comm. expires Feb. 7, 2016 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RESTRICTIVE COVENANT PROTECTIVE POOL ENCLOSURE KNOW ALL MEN BY THESE PRESENTS: WHEREAS, the undersigned % irey- �fj' 6 / 4— islare the fee simple owner(s) of the following d ribed property situated and being in Miami Shores Village, Florida: Address: 4) c'i f /�� G (� C a Whereas, the undersigned owners) -4 S ,(¢- desire to utilize said Lots) as a single building site, and the undersigned owner(s) do(es) hereby declare and agree as follows: I. That the property will not be used in violation of any ordinances of Miami Shores Village or Miami -Dade County now in effect or hereinafter enacted. 11. That the purpose of the covenant is to induce Miami Shores Village to issue a permit for a pool where the required enclosure is not on the subject property where the pool is located. III. That N any of our adjoining neighbors remove any portion of their fence or wall, or if our/my property shad fail to meet code requirements for pool barriers, we, as owners will immediately install a protective enclosure to meet code requirements and will obtain a permit for such fence. IV. That, I/we, as owner(s) hold Miami Shores Village handless for any negligence or injury that results from not having the enclosure. V. If enclosure belongs to said property, I agree to maintain & or replace said enclosure in the event that is damaged or removed by any case. NOW, THEREOF, for good and valuable consideration, the undersigned do(es) hereby declare that he/she will not convey or cause to be conveyed the title to the above property without requiring the successor in title to abide by all tends and conditions set forth herein. FURTHER, the undersigned declare(s) that this covenant is intended and shall constitute a restrictive covenant concerning the use, enjoyment and title to the above property and shall constitute a covenant running with the land and shall be binding upon the undersigned, his/her successors and assigns and may only be released by Miami Shores Village, or its successors, in accordance of said Village then in effect lX-,S a LJ r V0.. OWNER SIGN & PRINT OWNER SING & PRINT I H?Tby Certify that on this day rsonally appeared before me 1 - at s cy � and has produced ID # Utl Rentiflgtion and he/she acknowledge that helshe executed the foregoing, freely and voluntarily, for purposes there in expressed. SWORN TO AND SUBSCRIBED before me on this _day of Cee— . 20 NO 0 ORIDA (Revised 05)2209 T. =DOWSTALYLY NoFlorida7413My . 7, 2016 BOUNDARY SURVEY SCALE. 1 = 30 6� �s \O� • 1 ° .3. I Metal shed PD, i l/2° I.P. �o 3'C.0.5. Wall C W.F. I f Brrch Lne A Planter +/3.GrJ' D = CENTRAL ANGLE R 1 , 0 = DIAMETER B.C. = BLOCK CORNER n = TYPICAL S.W. =SIDEWALK A =ARC DISTANCE D = CENTRAL ANGLE R = RADIUS 0 = DIAMETER B.C. = BLOCK CORNER TYP = TYPICAL S.W. =SIDEWALK PL. =PLANTER C.G. = CURB & GUTTER V.G. = VALLEY & GUTTER E.M. = ELECTRIC METER STY. = STORY FD. SEC. =SECTION 1/2°1•P MH = MANHOLE CL= CLEAR d F.F.E. = FINISH FLOOR ELEVATION' ° 31GB.s. Wall * W.F TWO 5TORY C. B. -9. Res.# 30 / F F Bev.: / 2.06' 10.39' O Q 1 132°21 j 2 ° a 8 /.,39' (R (M) ° a PK Nail ° a NE 95th 5t. 12 /l lO 9 B 7 6 5 NE 94th 5t. 2 m LOCATION MAP N.T.S. PROPERTY ADDRE55: 301 Grand Concourse Miami Gam, FL. 33138 Slq0re"- LEGAL DESCRIPTION: Lot 25, Block 28, of MIAMI 5110RE5 SECTION 1, according to the plat thereof a5 recorded in Plat Book 10, at Page 70, of the Public Records of Miami Dade 29p Q. County, Florida. ° Ilk 4 ° `r1 ° ° V JOB NUMBER: 1307/ l �h • �°` C".. NOTE: 4 O 01 �ELEVATION5 ARE REFERRED TO MIAMI DADE COUNTY BM# N -5G8 ELEV.= 9.G5' OF N.G.V.D. OF1929 4 P BASED ON THE FLOOD INSURANCE RATE MAP OF THE FEDERAL EMERGENCY AGENCY REVISED ON 9-11-09 THE HEREIN DESCRIBED PROPERTY IS SITUATED WITHIN: ZONE X BASE FLOOD ELEV. N/q COMMUNITY NUMBER120652 PANEL NUMBER 0302 SUFFIX L LEGAL NOTES � V THIS SURVEY DOES NOT REFLECT OR DETERMINE OWNERSHIP. EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO AC= AIR CONDITIONED UNIT ° ° - ° ° a 13 /4 N �O ° °° q 3 /5 /6 a D.M.E. = DRAINAGE MAINT. EASEMENT � c� l7 NE 95th 5t. 12 /l lO 9 B 7 6 5 NE 94th 5t. 2 m LOCATION MAP N.T.S. PROPERTY ADDRE55: 301 Grand Concourse Miami Gam, FL. 33138 Slq0re"- LEGAL DESCRIPTION: Lot 25, Block 28, of MIAMI 5110RE5 SECTION 1, according to the plat thereof a5 recorded in Plat Book 10, at Page 70, of the Public Records of Miami Dade 29p Q. County, Florida. ° Ilk 4 ° `r1 ° ° V JOB NUMBER: 1307/ l �h • �°` C".. NOTE: 4 O 01 �ELEVATION5 ARE REFERRED TO MIAMI DADE COUNTY BM# N -5G8 ELEV.= 9.G5' OF N.G.V.D. OF1929 4 P BASED ON THE FLOOD INSURANCE RATE MAP OF THE FEDERAL EMERGENCY AGENCY REVISED ON 9-11-09 THE HEREIN DESCRIBED PROPERTY IS SITUATED WITHIN: ZONE X BASE FLOOD ELEV. N/q COMMUNITY NUMBER120652 PANEL NUMBER 0302 SUFFIX L LEGAL NOTES � V THIS SURVEY DOES NOT REFLECT OR DETERMINE OWNERSHIP. EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO AC= AIR CONDITIONED UNIT ° ° - ° ° a W.M. = WATER METER U.E. = UTILITY EASEMENT �O ° °° q C.B.S. = CONCRETE BLOCK STRUCTURE P.C.P. = PERMANENT CONTROL POINT D.M.E. = DRAINAGE MAINT. EASEMENT P.O.B. = POINT OF BEGINNING P. . =POINT OF COMMENCE FD.= FOUND IRON PIPE = OVERHEAD UTILITIES . C.B. =CHORD BEARING (C) =CALCULATED (M) =MEASURED EN)C. =ENCROACHMENT99 N E 9 4 t h �0%s SEGEND RES. = RESIDENCE — AND ABBREVIATIONS =CENTER LINE 5 �alt Paveme— 2'As nt P/L =PROPERTY LINE L =MONUMENT LINE 75' TOTAL R/W RNV= RIGHT OF WAY C.L.F. = CHAIN LINK FENCE W.F. = WOODEN FENCE = ELEVATION CONC. = CONCRETE SLAB DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THE PROPERTY. THIS SURVEY IS SUBJECTTO DEDICATION, LIMITATIONS, RESTRICTIONS, RESERVATIONS OR EASEMENTS OF RECORDS. LEGAL DESCRIPTION PROVIDED BY CLIENT. THE LIABILITY OF THIS SURVEY IS LIMITED TO THE COST OF THE SURVEY. UNDERGROUND ENCROACHMENTS, IF ANY, ARE NOT SHOWN. THIS FIRM HAS NOTATTEMPTED TO LOCATE FOOTING AND/OR FOUNDATIONS AND/OR UNDERGROUND IMPROVEMENTS OF ANY NATURE. IF SHOWN BEARINGS ARE REFERRED TO AN ASSUMED MERIDIAN. IF SHOWN ELEVATIONS ARE REFERRED TO N.G.V.D. OF 1929. THE CLOSURE IN THE BOUNDARY SURVEY IS ABOVE 1: 10000. THIS SURVEY IS NOT INTENDED FOR NEITHER DESIGN NOR CONSTRUCTION PURPOSES. FOR THOSE PURPOSES A TOPOGRAPHIC SURVEY IS REQUIRED. CERTIFIED TO: DATE OF FIELDWORK: July l /, 20/3 Teresa Oliva REVISED ON: &[E'TU1,-)0 Qo Professional Land Surveyor & Mapper 14317 S.W. 45th Terrace Miami, Florida 33175 Tel: (305) 552-7504 Fax: (305) 229-8068 I hereby certify that the attached Sketch of Survey of the herein described property is to the best of my knowledge and belief, a true and correct representation, of a field survey performed under my direction. And also meets the Minimum Technical Standards as set forth by the Florida Board of Professional Surveyors and Mappers in chapter 5J-17.050 thru 5J-17.052 F.A.C. pursuant to Section 472.027 F. S. ARTURO R. TOIRAC P.S.M. 3102 Not valid vkhout the signature and the original embosed seal of a Florida Licensed Surveyor and Mapper.