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BPP-15-316Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-228153 Permit Number: BPP -2-15-316 Scheduled Inspection Date: May 28, 2015 Permit Type: Pools/Whirlpools/Hot Tubs Inspector: Rodriguez, Jorge Inspection Type: Final Owner: HAGUE, TREVOR Work Classification: Repair Job Address: 299 NE 99 Street Miami Shores, FL 33138-2434 Phone Number (305)393.4461 Parcel Number 1132060134580 Project: <NONE> Contractor: MASTER DIAMOND POOL SERVICE CORP Phone: (786)419-1260 ounumg ueparunent %Aumments POOL,RESURFACE WATER LINE TILE, COPING, RESURFACE DECK PAVERS. INSPECTOR COMMENTS False May 27, 2015 For Inspections please call: (305)762-4949 Page 8 of 32 Inspector Comments Passed Failed Correction Needed ❑ Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. May 27, 2015 For Inspections please call: (305)762-4949 Page 8 of 32 Project Address Parcel Number Applicant 299 NE 99 Street 1132060134580 TREVOR HAGUE Miami Shores, FL 33138-2434 Block: Lot: Owner Information Address Phone Cell TREVOR HAGUE 299 NE 99 Street (305)393-4461 MIAMI SHORES FL 33138 - Contractors) Phone Cell Phone MASTER DIAMOND POOL SERVICE C (786)419-1260 Approved: In Review Comments: Date Approved:: In Review Date Denied: Type of Work: Swimming Pool Occupancy: Private Additional Info: RESURFACE POOL, WATER LINE TILE, C Bond Return Classification: Residential Scanning: 3 Fees Due Amount CCF Miami Shores Village DBPR Fee 10050 N.E. 2nd Avenue NE DCA Fee Miami Shores, FL 33138-0000 ` Phone: (305)795-2204 Project Address Parcel Number Applicant 299 NE 99 Street 1132060134580 TREVOR HAGUE Miami Shores, FL 33138-2434 Block: Lot: Owner Information Address Phone Cell TREVOR HAGUE 299 NE 99 Street (305)393-4461 MIAMI SHORES FL 33138 - Contractors) Phone Cell Phone MASTER DIAMOND POOL SERVICE C (786)419-1260 Approved: In Review Comments: Date Approved:: In Review Date Denied: Type of Work: Swimming Pool Occupancy: Private Additional Info: RESURFACE POOL, WATER LINE TILE, C Bond Return Classification: Residential Scanning: 3 Fees Due Amount CCF $4,60 DBPR Fee $3.51 DCA Fee $3.51 Education Surcharge $1.60 Permit Fee $234.00 Scanning Fee $9.00 Technology Fee $6.40 Total: $262.82 Valuation: $ 7,800.00 Total Sq Feet: 1500 Pay Date Pay Tvoe Amt Paid Amt Due Invoice # BPP -2-15-54479 03/16/2015 Credit Card 02/12/2015 Credit Card $ 212.82 $ 50.00 $ 50.00 $ 0.00 Avauaoie Type: In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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 ._Eutbetrnore, ► aluthorize the above-named contractor to do the work stated. March 16, 2015 Authorik d Signature: Owner / Applicant / Contractor / Agent Ua[e Building Department Copy March 16, 2015 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 MAR 13 2015 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BY: FBC 201D BUILDING Master Permit No 3' �PERMIT APPLICATION Sub Permit No. � � BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleho one#: 20 S in ` ift Address: City: �A;r.kiT �a�& State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: f� un �Z�� Phone#: Address: I ? J (�� -) r City: _k'a � State: IrL Zip: 71 % Qualifier Name: one#: State Certification or Registration #e IL(Sd' (? Certificate of Competency #: DESIGNER: Architect/Engineer: �� C. I� �% �( �] Phone#: Address: i City: State: Zip: Value of Work for this Permit: $ 0 0c) ci U 0 Square/Linear Footage of Work: o c, c.) Sy t j Type of Work: ❑ Addition c Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: Qe 6-\ GC/I ► W. 'r I "&e (.l -e - rC aftf , -eiL> s', i r+fit ^• Specify color of color thru tile: Submittal Fee '$' Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ :Pq �r 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 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 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. Signature f �— OWNER or AGENT The foregoing instrument was acknowledged before me this 9 day of Wd e 20 /S , by -1 �ZL Por *,;Jqv1 /&5 4 f as who is personally known to me or who has produced b4yY.200- &04/-82- LZ f -O as Signature ° CONTRACTOR The foregoing instrument was acknowledged before me this day of It"Ok' M6 .20 1 s , by Aer � M04 -,o z who is personal) known to me or who has produced identification and who did take an oath. identification and who did take an oath. as NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: V etk S �c,.-� 70 Seal:,Le OPM. ; Seal: 68ARIOS Wll==w I a'-. ME tW:OMS: F&uary 1, 2017 Wd ] .� ' l APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) �• - • • -i �.-i. •• .. - �. 1 . • t i. a •• • M�- • Miami Shores Village Building Department - 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 •i • •-ifs •• r. • �`I 1 r c • • - .mal • D 1� • -1-17m- •« • • 2- • Certificate must specify thedescxiption of operations or contractor license number. ■■rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr■ F*k--?1k **3ZLrG ►ni3 ■■rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrri BLG ESSADD1 /-,P�/g--C/%CITY. G STATEZZIP 'ti`s '� 'ti. ' • I �! / y% � :,�- . ; s; ►r_lT i m STATE OF FLORIDA DEPARTMEN LSF BUSINESSANt7 PROFESSIONAL,GULATION CPC1458168 El D7/03/20 4 STATE OF FLORID► -- DEPAENT OF BUSINESS ANI CVV filV-F1 cT�F�>=ro IS CERTIFIED F tlete :' AUG 31. Vic& L94tl7Q 5' too ICENSED GENERAL LICENSED POOL IMPORTANT STATE OF FLORIDA' to Chapter 440.05{14). F.S:. an cow of a DEPARTMENT OF FINANCIAL SERVICES ' I who elects exemption� ilr;:s.c�a .byt ai cettihc�� DIVISION OF WORKERS`. COMPENSATION 1 F election under this section may fnbt m .b or cw,penwo urs mss I CONSTRUCTION, INDUSTRY EXEMPTION p ~.ERMCATE OF RMTM TO BE9 EWr PINY! FLOWA I �- Pursumrt to Chapter 440.x(12), .5 ,Certifies crfelection"bD A owrm lS compEmemmm r.AW CD be exempt.. apply only within tte"scope 1holaudnessorhmb " 5FFEG M DATASM3=3 IMM7101 DATA S93=15 I " fisted on the notice of etec tim.lip be exempt I cru: aLivoz PERcv IN Pww� io chapter 440.t> (uy, F.S.,"N of elec ron to be I. IE exempt ail certificates of election to be wwmpt shall be BUSINESS NAME AND ADDRESS. =Nett to revocation if, at any tfi�e:attr to it l of the mom -' I MASTER DIAMOND POOL'SERVICE CORPor I E the Issuance of the cerate. itre person named on the I 4A PLUS CONSTRUCTIONAIi N�1GENtENT notice or no lot .meots the segoremenffi of Oft I section for Issuance of a certificate. The departraerd shall revolte 1711 SW 137 CT I a aertlikets at any time for fatlrae of tie person named an the MIAm FL 33175 I ca:rtilicate to mit the vequbwmft oftlrds secftL SCOPES OF BUSINESS OR TRA I ICENSED GENERAL LICENSED POOL ` 2015 isinm A:C)'R ff CERTIFICATE OF LIABILITY INSURANCE DATE ("'=°"""'' . 03/11/15 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 WANED, 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 NAME CT Iliana Machin New Horizons Insurance Group 5545 SW 8th St Suite 106-MD'ML PHONE(305)267-4410 AIC No (305)267-4186 machinilianaa@bellsouth.net -ADMiami, INSURERS AFFORDING COVERAGE NAIC # FL 33134 INSURER A: GRANADA INSURANCE CO Phone (305)267-4410 Fax (305)267-4186 INSURED INSURER B INSURER C: MASTER DIAMOND POOL SERVICE CORP INSURER D'. 1711 SW 137 Ct INSURER E: MIAMI, FL 33175- 7864192131 INSURER F: LIwrrcwues 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. ILTR TYPE OF INSURANCE IN SUER POLICY NUMBER POLICY EFF MMIDONYM MPMID Y EXP LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE 0 OCCUR ❑ 0185FL00039440-2 09/21!2014 09/21/2015 EACH OCCURRENCE $ 500,000.00 DAMAGE ETO RENTED occurrence $ 100,000.00 MED EXP (Any one person $ 5,000.00 PERSONAL & ADV INJURY $ 500,000.00 ❑ GENERAL AGGREGATE $ 1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: ❑ POLICY ❑ PRO- ❑ LOC PRODUCTS - COMPlOP AGG $ 0.00 $ AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ AUTOOWNED S ❑ AUTOS ULED ❑ HIRED AUTOS ❑ AUTOS ❑ ❑ COMBINED BI,d1SINGLE LIM(EaB $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ P OPERaI DAMAGE er accr eM $ $ ❑ UMBRELLA LIAB ❑ OCCUR ❑ EXCESS LIAB ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DED ❑ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERMIEMBER EXCLUDED? (Mandatory in NH) ElE.L If yes, describe under DESC IPTION OF OPERATIONS below N / A WC STATU-OTH- ❑ TORY LIMITS ❑ ER EL EACH ACCIDENT $ DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Swimming Pool Services CPC1458168 CERTIFICATE HOLDER CANCELLATION Miami Shores Village 10050 NE 2nd Ave Miami Shores, FL 33138 ACORD 25 (2010106) QF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THIRREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10 ACORD CORPORATION. All rights reserved. name and logo are registered marks of ACORD ha �� tri �.r-- CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDiYYYY) TYPE OF INSURANCE 03/11/15 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 WANED, 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 New Horizons Insurance Group 5545 SW 8th St Suite 106 Mlanil, FL 33134 Phone (305)267-4410 Fax (305)267-4186 CONTACT ILIANA MACHIN PHONE (305)267-4410 � No (305)267-4186 ADL machiniliana@bellsouth.net INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: GRANADA INSURANCE CO INSURED INSURER B: MASTER DIAMOND POOL SERVICE CORP INSURER C: INSURER D: 1711 SW 137 CT INSURER E: MIAMI FL 33175 786-410-,1260 INSURER F: nnvicewn_cc -�•"�� VVMlj WF"Mi"Rl Rl RfimGw• 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. LNNTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE AD ISR UBR POLICY NUMBER POLICY EFF Mfp N POLICY EXP MMIp LIMITS A GENERAL LIABILITY V COMMERCIAL GENERAL LIABILITY FI ❑CLAIMS MADE © OCCUR ❑ 0185FLOOM712-2 10/02/2015 EACH OCCURRENCE $ 5W ,WO.00 DAMAGE TO RENTED PREMISES occurrence $ 1()0,000-0010/02/2014 MED EXP (Anyone person $ 5,000.00 PERSONAL & ADV INJURY $ 500,000.00 ❑ GENERAL AGGREGATE $ 500,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: ❑ POLICY ❑ PRO- ❑ LOC PRODUCTS - COMP/OP AGG $ 0.00 $ AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ AAUTOWNED ❑ AUTOS ❑ HIRED AUTOS ❑. AUTOS COMBINED SINGLE LIMIT accident BODILY INJURY (Per person) $ BODILY BODILY INJURY (Per accident $ P OPER7Y DAMAGE $ er acci ent El ❑ ❑ UMBRELLA LIAR ❑ OCCUR ❑ EXCESS LIAB ❑ qLJUMS-MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DED ❑ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) IfESCE.L yyes describe under DRIPTION OF OPERATIONS below NIA WC STATU- OTH- ❑ TORY LIMITS ElER E.L. EACH ACCIDENT $ DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) GENERAL CONTRACTOR LIC # CGC1519479 .1.-- —W9% CANCELLATION Miami Shores Village 10050 NE 2nd Ave Miami Shores, FL 33138 ACORD 26 (2010106) 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. 1988-2010 A RPORATION. All rights reserved. AGORD-nii)T94nd logo are registered marks of ACORD r.. Notice to Owner - Workers' Com Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 nsation Insurance Exemation 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. 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 and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature:. ¢ !A r-a-- er State of Florida County of Miami -Dade ,, oo The foregoing was acknowledge before me this �_ day of � -/,OL d'CA , 20 ! . By 12 e V O I% D O U y ha S &qpe who is personally known to me or has produced 0200 - KO - 9 2 - 2 2 9 -0 as identification. , Notary: mom= SEAL: EXPM February 1, 2017 ,j n�'+, Boded TMn No�ty Pu6tattedala�s MAR 1 % zm Master Diamond Pool Services Corp 1711 SW 137 Court, Miami FL 33175 3/12/15 State of Florida County of Miami Shores Before me this day personally appeared Percy Munoz who, being duly sworn, deposes and says: I Percy Munoz will be on the only person/Contractor allowed to work on this project at 299 NE 99th Street, Miami Shores FL 33138 Sworn to and subscribed before this 12day of March 201 ,lene�cy mvnpZ Print, Type, Stamp of Notary row P�®� Notary Public State of Florida • Joanna M Feliciano oa My Commission FF 082753 ®vn� Expires 01/12/2018 14SPS.com® - USPS TrackingTM Page 1 of 2 English Customer Service USPS Mobile Register / Sign In Valpsi`OW Customer Service) USPS Tracking' —a Have quesfiorlsT We're hereto help. Tracking Number: 70140510000077367154 Expected Delivery Day: Friday, March 13, 2015 ON ABOUT.USPS.COM Product & Tracking Information Available Actions Postal Product Extra Svc: Mout USPS Home First -Class Mail® Certified Mail' Return Receipt Electronic DATE & TIME STATUS OF ITEM LOCATION Text Updates March 12,2015,11:47 am Delivered MIAMI, FL 33181 Terms of Use FAQs Email Updates Your Item was delivered at 11:47 am on March 12, 2015 in MIAMI, FL 33181 March 12, 2015, 1:02 am Departed USPS Origin MIAMI, FL 33152 Facility March 11, 2015, 7:44 pm Arrived at USPS Origin MIAMI, FL 33152 Facility March 11, 2015, 6:04 pm Departed Post Office MIAMI, FL 33153 March 11, 2015,12:24 pm Acceptance MIAMI, FL 33153 Track Another Package Tracking (or recelpt) number Track It HELPFUL LINKS ON ABOUT.USPS.COM OTHER USPS SITES LEGAL INFORMATION Contact Us Mout USPS Home Business Customer Gateway Privacy Policy Site Index Newsroom Postal Inspectors Terms of Use FAQs USPS Service Updates Inspector General FOIA Fortes & Publications Postal Explorer No FEAR Act EEO Date Government Services National Postal Museum Careers Resources for Developers Copyright O 2015 USPS. Ali Rights Reserved. https://tools.asps.com/go/TrackConfirniAction?qtc tLabels1=70140510000077367154 3/12/2015 1, All Florida Pool and Spa 11720 Biscayne Boulevard, North Miami, FL 33181 (305) 893-4036 This certified letter is to confirm we are no longer moving forward with your company at 299 NE 99th Street, Miami Shores FL 33138. A copy will of this letter will be sent to Miami Shores Building Department once we confirm delivery. Thank you Trevor Hague 1/10/15 BUILDING PERMIT APPLICATION Miami Shores Village Building Department FEB 12 1015 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 ° INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 201 C' Master Permit No. ,►ter' 5 — -9 i Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP (` `- CONTRACTOR DRAWINGS JOB ADDRESS: ---� 1 1 ' V � +� V +rRe. + Com: Miami Shores County: Miami Dade zip: 33139 Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: 305393-gq(01-A OWNER: Name (Fee Simple Titleholder): TyeyoY H agla , y)yjstle B61r re✓a. Phone#: 305- (413- 5 91$ Address: Z99 NE 19'1"' siyee-r City: Miami A Dye f State: FL Zip: 33) 3 9 Tenant/Lessee Name: Phone#: Email: WSBA A `` ADL- Cc"t-A , TR t VDRb})A 6 U E & 6MA 1 L . Ca Iii ' CONTRACTOR: Company Namen - A 1� t -lc f+�f cd� S �� Phone#: I `� • e�'7 %�� Address: �_ 1 0 I I CdA (Z City: NO ( Qualifier Name: State Certification or Registration #: DESIGNER: Architect/Engineer: of Com 33 if- I Address: City: State: Zip: 00 Value of Work for this Permit: $ ��OZ1 Square/Linear Footage of Work: S®® Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: ('V- -i I) c cc Iso Specify color of color thru tile: ^^�� ,,11 Submittal Fee $__ Permit Fee $o�� • W Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) CCF DBPR $ CO/CC $ Notary $ Double Fee $ Bond $ nn TOTAL FEE NOW DUE $ 2 kL - ,, M Bon8ing Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zi 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The ng instrument was acknowledged before me this day of ®� 20 IS by —$*Z' h� is personally known to me or who has produced ^� ! I identification and who did take an oath. NOTARY PUBLIC: Sign Print as The foregoing instrument was acknowledged before me this d yf 20I S by who is personally known to me or who has produ x as identification and who did a NOTARY Seal: — �, ..F>j�sia � ��:' Se 1•p11 SOO a v;0610 1,(.f rAPPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Street 2 of 4 (&YM Related Data) - See Stmt 3 of 4 for Legal Demuipft, Cwff=Wns. Property and other Survey related data. SURVEY IS NOT COMPLETE WITHOUT ALL SHEETS �10� ti®3A •` 4 !f J LOT 2 LOT I ) BLOCK 33 I i 810(3:33 -f— Fir ire • N 0 0••000 oa 0. flP SOX. WALK 22' PARKWAY v I 81 10 A5PHALT AC0 55 NbAD - (15! ALLM �r—x x LOT 22 2.9' E. I- eo•••• x • • e e•• • j • 4 ••••• •! s *0900 p e • N 0 0••000 oa 0. flP SOX. WALK 22' PARKWAY v I 81 10 A5PHALT AC0 55 NbAD - (15! ALLM �r—x x LOT 22 --r— WC' • — CfCARPOl� • d•••• \ / TZ F1,T NOT 2.7 LOT 23 3. 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ALLY ARE A55l1MED AND REFEREN= Tt1IJ=. -Famcr v Pm"Im. tandrecswayiq�s Iualg�A9a�edRatda Pl t�mas al bmiciiMMUZON sanmrtgmd�t labaAaebca�lsaalcaer�ea�ea Ow By: IN= "- 4 TII��aeylasbea►iseredbyllengtsl�su�gol� 21000 Boca Rio Road - Ste. Al2 Date ofFiddWbik:'1(IVM3 AID 7 r- " Ic Boca Raton, FL 33433 ": - - i.AND SURVEYING - RESIDENTIAL SERVICES No: (561) 367-3587 Fax: (561) 465-3145 1 R: Proudly Serving Florida's Land Title & Real Estate Industries www.LwWtwSulvey.com I Rte: j