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BPP-13-1852Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 nspection Number: INSP-222273 Permit Number: BPP -8-13-1852 Inspection Date: December 15, 2014 Permit Type: Pools/Whirlpools/Hot Tubs Inspector: Dacquisto, David Inspection Type: Survey Final Owner: REBELO, ALEJANDRO Work Classification: New Job Address: 353 NE 94 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132060136110 Project: <NONE> Contractor: DREAM POOLS OF SOUTH FL Phone: (305)910-9595 Building Department Comments SWIMMING POOL, SPA AND DECK Infractio Passed Comments INSPECTOR COMMENTS False we co (� Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-222164. THE REQUIRED DECK SIDE YARD SETBACK IS 10 FT. THE REQUIRED REAR YARD SETBACK IS 5 FT. &/0 <<=i= Failed Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. For Inspections please call: (305)762-4949 December 15, 2014 Page 1 of 1 Miami Shores Village Building Department 40050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: JOB ADDRESS: BUILDING Permit . CV—� Master Permit No. ROOFING City: Miami Shores ,�County: Miami Dade Zip: ��i bb Folio/ParceW 0 - �N1P- v?- U I I (� Is the Building Historically Designated: Yes Zone: & ( Q OWNER: Names (Fee Simple Titleholder): -,QP O Phone#:W'- f , Address: L �) & �� V� City: M,I J�b6 �"" State- Tenant/Lessee Name: Phone#: Email: Company Name=Q9211MINWHA ice/ ' If1 RAI Suite: ZiD: • n sii R' /i M ' i State Certification or Registration #: Contact Phone#:, -T-----7R)8--o DESIGNER: Address: of Competency #: Value of Work for this Permit: $�� Square/Linear Footage of Work: G ��' Type of Work: ❑Addition ❑Alteration ❑New ❑Repair/Replace ❑Demolition Description of Work: Di.ej — Color titin tt1C: Submittal Fee $ Permit Fee $ I4DCCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ 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 Zip 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 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 aIl 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 co ncement must be posted at the job site for the first inspection which occurs seven U7days after the building permit is issued n t abjenMof such posted notice, the inspection will not be approved and a reins con fee will be charged. /—V W .0�% / � er or Agent The foregoing instrument was acknowledged before me this day f 20 , by 0Lft&1d1JA0 who is y known t me or who has produced As identification and who did take an oath. NO Sig, Prin My Contractor The foregoing instrument was ackn wledged before me this day of �. 20 P.2 by who is�k�nownme or whohas produced as identification and who did take an oath. APPROVED BY �//Plans Examiner z--0 36 Structural Review (Revised 3/12n2012)(Revi 07/10/07)(Revised 06/10n209)(Reviud 3/15/09) NO Sigr Prin My Zoning Clerk NOTICE OF COiWMENCEMENT A 1=1101M CM MUST BE POSTED OM TRi ITSTISICTIM PERMIT NO. TAX FO _ STATE OF FLORIDA: ° eoA---Q COUNTY OF MIAMI-DADE: THE UNDERSIGNE=D hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Le_QaLdescription of 2. Description of 3.Owner(s) name and address: Interest in property Name and address of fee simple titleholder. 4. Contractor's name�adc rm and phone_,limbe 20130648333 BOOK 28776 PAGE 969 :08/16/2013 10:40:22 AM EY RUVIN, CLERK OF COURT, MIA-DADE CTY Space above reserved jam' use of retarding office MA. -A-`\ of retarding S. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number. Amount of bond $ 6. Lender's name and address:-- 7. ddress:-7. Persons within 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 Statutes, Name, address and phone number. 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Llenor's Notice as provided In Section 713.13(1)(b), Florida Statutes. Name, address and phone number._.. - 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date Is speaifisdj WARNINQ TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING 'TWICE FOR IMPROVEMENTS TO YOUR PRO RTY A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU I N TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NO OF COMMENCEMENT.n n Signatures) of .r s ' Authorized Prepared By _ Print Name Title(Office STATE OF FLORIDA COUNTY OF MIAMI-DADE The fo g 'ng instrurnTit was ac ledged be By ❑ Indiv as me this day of Aa Z* — or ❑ produced the following type of is signature of Notary Public: Print Name: (SEAL) for VERIFICATION PURSUANT TO SECTION 92525 FLORIDA STATUTES " Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true, to best of my knowledge and belief. Signature(s) of Owner(s) or s Authorized Officer/Director/Partner/Manager who signed above: ey s'' —MATE OF FLORIDA, COUNTY OF DADE �,o oou� +S 01-M Mx3 W12 1 HEREBY CERTIFY that the foregoing is a IW and correct copy of the otigiml on file in this office. 1S a AD 20� HARVEY RUVIN, Clerk of 1'irc ' and Co ' C�Ourts rD�#> ilty Clprk .rw Zvi 01-26-2012 JEFF ATWATER 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: PERSON: FEIN: 01/26/2012 EXPIRATION DATE: 01/25/2014"- ESPINO ROBERT'S JR 830498493 P.USINESS NAME AND ADDRESS: /[IREAN POOLS OF SOUTH FLORIDA INC 6031 SW 129TH CT MIAMI FL 33183 SCOPES OF BUSINESS OR TRADE: 1- SWIMMING POOL CONSTRUCTION IMPORTANT: Pursuant to Chapter 440 . 05114!, F.S.: an officer of a corporation who elects exemption from this chapter by filing a certificate of election ander this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.06112►, F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed an the notice ofelection 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 person named on 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 BE EXEMPT FROM FLORIDA WORKERS COMPENSATION LAW I* EFFECTIVE 01/26/2012 EXPIRATION DATE: 01/25/2014 PE:RSOM ROBERT ESPINO JR FEIN: 830498493 BUSINESS NAME. AND ADDRESS: DREAM POOLS OF SOUTH FLORIDA INC 6031 SW 129TH CT MIAMI, FL 33183 SCOPE OF BUSINESS OR TRADE 1- SWIMMING POOL CONSTRUCTION IMPORTANT F Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who O elects exemption from this utter by filing a certificate of election L under this section may riot 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 E the notice of election to be exempt. R 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 any 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 ACO RD,� CERTIFICATE OF LIABILITY INSURANCE8/13/2013° nATE W% PRObUCER ' THIS CERTIFICATE IS ISSUEDAS A MATTER OF INFORMATION A&D ALL -LINES INS ASSOC INC 5600 SW 135 Ave, Ste 106 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Miami, FL 33183 POLICY NUMBER 463-67RI INSURERS AFFORDING COVERAGE MAIC # INSURED DREAM POOLS OF SOUTH FLORIDA, INC. INSURER A: CENTURY SURETY INS. CO INSURER B: GENERAL LIABIUTY 6031 S.W. 12 9 CT. INSURER C: MIAMI, FL 33183 INSURER D. INSURER E: THE POLICIES OF INSURANCE LISTEDBELOWHAVE 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT FAILURE TO DO SO SHALL TYPE OF INSURANCE POLICY NUMBER I U� CINE DATE ( EXPIRATIONI LIMITS AUTHORIZED REPRESENTA Arnen Uc inn n4 inet GENERAL LIABIUTY EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY $ PREMISES (Ea oaaa�w) 50,000 MED EXP (Any orleperson) $ 1,000 CLAIMS MADE [j)OCCUR A L1740000011 03/31/13 03/31/14 PERSONAL &ADV INJURY $ 1000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ JECT LOC POLICY PROEl AUTOMOBILE LIABILITY COMBINED SINGLE OMIT $ ANYAUTO (Ea acddoM ALLOWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (P- P—) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Peracdder� PROPERTY DAMAGE $ (PerecdcleM GARAGE LIABILITY AUTO ONLY- EAACCIDENT $ ANYAUTO OTHER THAN EAACC $ ALITOONLY: ACG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LLABIUTY TORY LIMITS ER E.L. EACH ACCIDENT $ ANY PROPRIETOMPARTNUMD ECU IVE OFFICERIMI R EXCLUDED? E.L. DISEASE- EA EMPLOYEE $ descrOmwider EL DISEASE- POLICY UMIT $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS POOL INSTALLATION SERVICE & REPAIR rcer�rrrerc urs .yrs • "_G� r-MMrcf I Amu CITY OF MIAMI SHORES SHOULD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 10050 NE 2ND AVE. THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN MIAMI SHORES, FL. 33138 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY la INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTA Arnen Uc inn n4 inet NACORD CORPORATION 1988 FIR. 4N ASS k fBCOT rlTsTR��A U.S. POSTAGE PPND NIIA NI. FL PERMIT NO 237 619425-2 THIS IS NOT A BILL — DO NOT PAY RENEWAL '%V0M6ff NSOUTH FLORIDA INC STATED 1"R$7603645865-7 6031 SW 129 CT 33183 UNIN DADE COUNTY DAM POOLS OF SOUTH FLORIDA INC 'Y § TY BUILDING CONTRACTOR- WORKE1/S THIS IS ONLY A LOCAL MC[EQ8 TAX RECi7PT. R DOE8 NOT PERMIT THE HOLDER TO VIOLATE ANY 01087M REWHATORY OR ZONNG LAWS OF THE DO NOT FORWARD COUNTY OR CIM NOR DOES R EXEwr THE HOLDER FROM AM OTHER On Ltcmm REQUOM BLAW.T YYDREAM POOLS OF SOUTH FLORIDA INC � OF cL QUAUFCAA. MIURIL ESPINO PRES 6031 SW 129 CT PAYMENTRECERFED MIAMI FL 33183 ARM -DADS COUNTY SAX -09/04/2012 Il Ii i II i Iii i 60040000150 issliTSFiiTsssll�sstsss ssss ss f ss : t„ ss ssss T , s 000075.00 57 SEE OTHER SIDE STATE OF FLORIDA -- DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION i CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET •��'�`• TALLAHASSEE FL 32399-0783 ESPINO, ROBERTO DREAM POOLS OF SOUTH FLORIDA INC 6031 SW 129 COURT MIAMI FL 33183 f Ii STATE OF FLowA AC# , 2 2 8 5 a .- S Congratulationst With this license you become one of the nearly one million i Floridians licensed by the Department of Business and Professional Regulation. DEPA TATT OF BIISINESS AND pRp ES3IQN: 38GULATION 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 betted CPC14580 1 07��6/2 118206226 For information about our services, please log onto www.myfloridalicense.com. CERT RESLIDBNTIAL.- .POQI,SPA CONTR There you can find more information about our divisions and the regulations that ESPINO, impact you, subscribe to department newsletters and learn more about the DREAM POOL4L0RIDA INC Department's initiatives. , i Our mission at the Department is: License Efficiently, Regulate Fairly. We i - 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! ? ' IS CffitTIFfiSD under the provisions of ch.489 Fs sapiration date: AUG 31, 2014 L120726C1316 DETACH HERE U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008 National Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name ALEJANDRO REBELO Policy Number. A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIL Number 353 NE 94 ST City MIAMI SHORES State FL ZIP Code 33138 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOT 22 & W 20 FT OF LOT 13, BLOCK 45, MIAMI SHORES SEC. 1, PLAT BOOK 10, PAGE 70. A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 25°51'42.40"N Long. 80°11'25.23'W Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 8 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 2.534 sq ft a) Square footage of attached garage 518.1 sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade 15 within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b 2.240 sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State VILLAGE OF MIAMI SHORES 120652 MIAMI - DADE FL B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12086C 0302 L 9-11-09 Effective/Revised Date Zone(s) AO, use base flood depth) ® feet ❑ meters 10.80 9-11-09 X N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ® No Designation Date: N/A ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones Al A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, ARIA, ARAE, AR/Al-A30, AR/AH, AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: N-568 ELEV: 9.65' Vertical Datum: NGVD 1929 Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) fj Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. l certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. ❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ❑ Check here if attachments. licensed land surveyor? ® Yes ❑ No , Certifier's Name FRANCISCO L. NUNEZ License Number 6382 f✓�� Title LAND SURVEYOR Company Name Address 28 City MIAMI State FL ZIP Code 3312 Si a Date 7-12-13 Telephone (786) 357 6204 /12) See reverse side for continuation. Replaces all previous editions. Check the measurement used. 10.02 ® feet ❑ meters 13.05 ® feet ❑ meters N/A. ❑ feet ❑ meters 10.18 ® feet ❑ meters 10.80 ® feet ❑ meters 10.02 ® feet ❑ meters 10.84 ® feet ❑ meters N/A. ❑ feet ❑ meters SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. l certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U. S. Code, Section 1001. ❑ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ❑ Check here if attachments. licensed land surveyor? ® Yes ❑ No , Certifier's Name FRANCISCO L. NUNEZ License Number 6382 f✓�� Title LAND SURVEYOR Company Name Address 28 City MIAMI State FL ZIP Code 3312 Si a Date 7-12-13 Telephone (786) 357 6204 /12) See reverse side for continuation. Replaces all previous editions. L.1.•A1 1V1• %0"1% 111 wA1 L., p/ayci IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No_ Policy Number. 353 NE 94 ST City MIAMI SHORES State FL ZIP Code 33138 Company NAIC Number. SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments CROWN OF ROAD ELEV.= 10.56' LAT / LONQ. _TA IED BY GPS Date 7-12-13 CTI E -WILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zos and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. or Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION rhe property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or community -issued BFE) )r Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. property Owner's or Owner's Authorized Representative's Name %ddress City State ZIP Code signature Date Telephone 'omments Check here if attachments. SECTION G - COMMUNITY INFORMATION (OPTIONAL) e local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8 -G10. In Puerto Rico only, enter meters. 1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed, surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) 2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. 3. ❑ The following information (Items G4 -G10) is provided for community floodplain management purposes. 34. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued '. This permit has been issued for. ❑ New Construction ❑ Substantial Improvement 3. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum a. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum 10. Community's design flood elevation: ❑feet ❑meters Datum .oval Official's Name Title :ommunity Name Telephone signature Date ;omments Check here if attachments. .MA Form 086-0-33 (7/12) Replaces all previous editions. 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) ackngWedge that a new swimming pool, spa or hot tub will be constructed or Installed at 77)S'7? N e, Q"1 .5Z Miami Shores, FL, and hereby affirm that one of thefoll nwio g 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 Manufacturer's Specifications). A continuous, one-piece (child) barrier meeting the requirements of Florida Building Code R41 7.1.15 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 of 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 viola"IoDaKhapter 515, F.S ., an d will be considered as committing a misdemeanor of the second MRAtIRE abffN on 775.082 or S .083 F.S . This form must be signed actor. E� °S SIGNATURE AND DTE irz Miami 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 c� Miami Shores Village Building & Zoning Department Attention: Building Official I certify that I am the legal owner of the property described as & 0 e cit{ C—A- , located at ud� 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. I 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 am 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 RESTRICTIVE COVENANT PROTECTIVE POOL ENCLOSURE KNOW ALL MEN BY THESE PRESENTS: WHEREAS, the undersigned --Q ' 7��10 is/are the fee simple owner(s)_0 the following described property situated and being in Miami Shores Village, Florida: Address: Whereas, the undersigned owner(s) desire to utilize said Lot(s) 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. II. 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 I any of our adjoining neighbors remove any portion of their fence or wall, or if our/my property shall 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, Uwe, as owner(s) hold Miami Shores Village harmless 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 tide to the above property without requiring the successor in title to abide by all terms 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,'m__ rdance of said Village then in effect. OWNER SIGN & PRINT OWNER SING & PRINT I Hereby Certify that on this day personally appeared before me_ UAI uta'leikio and has produced ID # as identification and helshe acknowledge that he/she executed the foregoing, freely and voluntarily, for purposes there in expressed. SWORN TO AND SUBSCRIBED before me on thisy of (Revised 0512209 Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT s' PERMIT #: 1 DATE: t M / (NAME) Contractor OR Owner o Architect Picke p 2 sets of I and (other) Address:. �� e From the building department on this date in order to have corrections done to plans And/or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Wii ding Department to continue permitting process. Acknowledged by: (Signature) PERMIT CLERK INITIAL: RESUBMITTED DATE: l /; 1-3, PERMIT CLERK INITIAL: Miami Village Shores Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 September 4, 2013 Permit No: BPP13-1852 Building Critique — Syed Ashraf 1. 1) Provide DERM/DOH approval. 2. 2) Provide affidavit of child safety. Structural Critique — Syed Ashraf 1. Electrical Critique Mechanical Critique Plumbing Critique 1. 1. FBC 107. PROVIDE HEALTH DEPT. APPROVAL voided,Plan review is not complete, when all Items above are corrected, we will do a complete plan review. If any sheets are -., Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Date: �R `2-�- d t 3 Permit No: 13 P - I -; - Plumbing Critique Osvaldo "Ozzie" Diaz Chief Plumbing Inspector Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re -submittal drawings. BOUNDARY SURVEY SCALE: 1" = 20' i d o�15 ALLEY FD•02 10' Asphalt Pavement 112 P. + 32.3 A3,gl° loo 1a/ /o °64 V I 10.35'. . Asphalt BLOCK- 5 i Q.52, LOT- 2 Conc'_5tap5 Pra\�Qa # W. 20ft of Lot l3 Q' F i p 2I A /12. la o 2� 9.52' l5. / l' ONE STORY �s Res. # 353 d F F Elev.: 13.05' 30\ B. 70' Gar. Elev.: l0. l8' b 34.55' Rs � ° ql9 19.10 9.92' to\�' �o an Conc. Walk � 9 BLOCK- 45 Remainder of LOT- 13 1 44 s B.C. @ Lot l7 PROPERTY ADDRE55: 353 NE 94th 5t. Miami Shores, FL. 33138 LEGAL DESCRIPTION: Lot 12 � West 20.00 feet of Lot 13, Block 45, of MIAMI 5HORE5 5ECTION ONE, according to the plat thereof a5 recorded in Plat Book 10, at Page 70, of the Public Records of Miami Dade County, Florida. JOB /NUMBER: BASED ON THE FLOOD INSURANCE RATE MAP OF THE FEDERAL EMERGENCY AGENCY REVISED ON 9- / / -09 THE HEREIN DESCRIBED PROPERTY IS SITUATED WITHIN: ZONE X BASE FLOOD ELEV. N/A COMMUNITY NUMBER / 20652 PANEL NUMBER 0302 SUFFIX L LEGAL NOTE5 THIS SURVEY DOES NOT REFLECT OR DETERMINE OWNERSHIP. EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THE PROPERTY. THIS SURVEY IS SUBJECT TO 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 NOT ATTEMPTED 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 FIEF WORK: July l 2, 20 l 3 Alejandro Rebelo REVISED ON: UPJ@0� `V' O Leo HVUPJIRLS Professional Land Surveyor & Mapper 2825 NW 11th Street Miami, Florida 33125 Tel: (786) 357-6204 Fax: (305) 443-1608 I hereby certify that the attachedSkrtrh of Survey of the herein described property b to the best of ny knewWge 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 Frofeselwal Surveyors and Mappers In chapter 5J-17.050 thru 5J-17 FA rs nt to action 472.027 F. S. ,F �� Tre and the or hal emto s seal of a and Mapper / . Asphalt .. Driveway A Rs � ql9 e 4 �l 0 Disk 4 o . (� () ° . 45' s eeQal a ° a ° e a e ° Asphalt 22.5a Parkway O K .. M \03y NE 94th St. tQyy. 1Q,56. 2a Asphalt Pavement 75' TOTAL R/VV NOTE: ELEVATIONS ARE REFERRED TO MIAMI DADE COUNTY BM# N -5G8 ELEV.=9.G5' Of N.G.V.D. 929 LEGEND AND ABBREVIATIONS - CENTER UNE FD. = FOUND IRON PIPE AC =AIR CONDITIONED UNIT C.O. - CURB & GUTTER A - ARC DISTANCE P/L =PROPERTY LINE O.H.L. - OVERHEAD UTILITIES W.M. =WATER METER V.G. = VALLEY & GUTTER D = CENTRAL ANGLE MIL = MONUMENT UNE C.B. = CHORD BEARING U.E. - UTILITY EASEMENT E.M. = ELECTRIC METER R = RADIUS RM = RIGHT OF WAY (C) = CALCULATED C.B.S. - CONCRETE BLOCK STRUCTURE STY. = STORY 0 = DIAMETER C.L.F. = CHAIN LINK FENCE M =MEASURED P.C.P. = PERMANENT CONTROL POINT SEC. = SECTION B.C. - BLOCK CORNER W.F. a WOODEN FENCE (R) =RECORD D.M.E. = DRAINAGE MAINT. EASEMENT MH. = MANHOLE TYP = TYPICAL = ELEVATION ENC. =ENCROACHMENT P.O.B. =POINT OF BEGINNING CL = CLEAR S.W. = SIDEWALK ppm' CONIC. = CONCRETE SLAB RES. - RESIDENCE P.O.C. -POINT OF COMMENCE F.F.E. = FINISH FLOOR ELEVATION PL =PLANTER 1 44 s B.C. @ Lot l7 PROPERTY ADDRE55: 353 NE 94th 5t. Miami Shores, FL. 33138 LEGAL DESCRIPTION: Lot 12 � West 20.00 feet of Lot 13, Block 45, of MIAMI 5HORE5 5ECTION ONE, according to the plat thereof a5 recorded in Plat Book 10, at Page 70, of the Public Records of Miami Dade County, Florida. JOB /NUMBER: BASED ON THE FLOOD INSURANCE RATE MAP OF THE FEDERAL EMERGENCY AGENCY REVISED ON 9- / / -09 THE HEREIN DESCRIBED PROPERTY IS SITUATED WITHIN: ZONE X BASE FLOOD ELEV. N/A COMMUNITY NUMBER / 20652 PANEL NUMBER 0302 SUFFIX L LEGAL NOTE5 THIS SURVEY DOES NOT REFLECT OR DETERMINE OWNERSHIP. EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THE PROPERTY. THIS SURVEY IS SUBJECT TO 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 NOT ATTEMPTED 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 FIEF WORK: July l 2, 20 l 3 Alejandro Rebelo REVISED ON: UPJ@0� `V' O Leo HVUPJIRLS Professional Land Surveyor & Mapper 2825 NW 11th Street Miami, Florida 33125 Tel: (786) 357-6204 Fax: (305) 443-1608 I hereby certify that the attachedSkrtrh of Survey of the herein described property b to the best of ny knewWge 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 Frofeselwal Surveyors and Mappers In chapter 5J-17.050 thru 5J-17 FA rs nt to action 472.027 F. S. ,F �� Tre and the or hal emto s seal of a and Mapper / r ANTONIO CANELAS, P.E. LIC. No. 74099 7805 SW 24 ST SUITE 106 MIAMI FL, 33155 305 261 0321 Miami -Shores Village Building and Zoning Department Miami, Florida. Reference: Soil Statement Residential Swimming Pool Property of Alejandro Rebelo 353 NE 94 ST Miami Shores, FL 33138 To Whom It May Concern: Soil Statement: Date 10-3-13 A field inspection was conducted on 10-3-13 of the swimming pool excavations for the above - referenced property. The existing site has been observed and evaluated, and we conclude that the conditions are similar to those upon which the design was based (allowable bearing capacity equal to 2000 psf . In addition, we conclude that the soil is adequate to support the Required Bearing Pressure of 650 PSF imposed by the new swimming pool. If you should have any questions regarding this matter, please do not hesitate to contact us. Sincerely, L 10-3-13 Antonio Canelas, P.E. Uc #: 74099 Attached: Photographs of Excavation BUILDING PERMIT APPLICATION PT ILDING ❑ ELECTRIC ❑PLUMBING ❑ MECHANICAL Miami Shores VillageLWVV4 Building Department ..M 0&4.014 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 20 Master Permit No. R-A2!3--� Sub Permit No. ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 3 Citv: Miami Shores 2 rnuniv- Miami Dade lin: 3 �J 1 Po L� Folio/Parcel#:1 !!�a WU 11 Qom) Is the Building Historically Designated: Yes NO _ Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWN Addr City: Tenant/Lessee Name: Email: CONTRACTOR: Company Name: Address: City: Qualifier Name: State Certification or Registration #:� Iii, 10VJ ?rX Aj_�Certificate of Competency #: _ DESIGNER: Architect/Engineer: �� Q APhone#: Address: c) 41Il r City: M State: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: Addition ❑ Alteration ❑ New ❑ Repair/Replace Description of Work: Specify color of color thru tile: Submittal Fee Scanning Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) Permit Fee $ CCF $_ Radon Fee $ DBPR $ Training/Education Fee $ W Zip: ❑ Demolition CO/CC $ Notary Double Fee $ Bond $ 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 t , 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 su In the absence of such posted notice, the inspection will not be approVp dl�einspection fee will be charged. JSignature 16MVWNER or AGENT PP OOma. The foregoing instrumt was acknowledged before me this ZM day of i 20' by r" who i ersonally known me or who has produced as identification and whoAid take an oath. NOTARY PUBLIC: Seal: The foregoing instrument was acknowledged before me this day of 20 by n who is p rsonally known me or who has produced as identification and vydicjtake an oath. NOTARY Print: Seal: APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA 0 _ DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH •�� TALLAHASSEEMONROE STRFLT32399-0783 ESPINO, ROBERTO DREAM POOLS OF SOUTH FLORIDA INC 6031 SW 129 COURT MIAMI FL 33183 (850) 487-1395 Congratulations! With this license you become one of the nearly one million STATE OF FLORIDA AC# 6 2 28 58 5 DEPARTMENT OF BUSINESS AND Floridians licensed by the Department of Business and Professional Regulation. PROFESSIONAL REGULATION Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. CPC1458041 07/26/12 118206226 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.myfloridalicense.com. CERT RESIDENTIAL POOL/SPA CONTR There you can find more information about our divisions and the regulations that ESPINO, ROBERTO impact you, subscribe to department newsletters and learn more about the DREAM POOLS OF SOUTH FLORIDA INC 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. is csRTxF=en ,�nagr she provisions of ch.489 Fs Thank you for doing business in Florida, and congratulations on your new license! Expiration sate: AUG under 2014 Ls of C .489 DETACH HERE THIS gOGU, T HAILS A COI OR. EDB CKG O LA0 •MIC ®'P' -'R LATIN- • LWEAAApRK'' PAT€N�T,,,ED PAPERAG# 6228585 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ# L12072601316 NUMBERDATE BATCH LICENSE NBR 07/26/2012 118206226 CPC1458041. Tile rLZ-5-LVZMT1AL VUUL/5PA CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 ESPINO, ROBERTO DREAM POOLS OF SOUTH FLORIDA INC 6031 SW 129 COURT MIAMI FL 33183 RICK SCOTT KEN LAWSON GOVERNOR SECRETARY _ _ ._ DISPLAY AS REQUIRED BYLAW Local Business Tax Receipt Miami -Dade County, Staie of Florida THIS IS NOT A BILL - DO NOT PAY 6194252 BUSINESS NAME/LOCATION DREAM POOLS OF SOUTH FLORIDA INC 6031 SW 129 Cr MIAMI FL 33183 LBT .RECEIPT NO. EXPIRES P'EaEWaL SEPTEMBER 30, 2014 6458657 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 NESS OWNER 1gg SPECIALTY BTYPE OF U LDING CONTRACTOR PAYMENT RECEIVED DREAM POOLS OF SOUTH FLORIDA INC BY TAX COLLECTOR Worker(s) 1 CPC1457603 $75.00 09/23/2013 ECHECK-13-009366 This Local Business Tax Receipt only confirms payment of the Local Businm Tax. The Receipt is not a license, permit or a certification of the holder's qualifications, to do business Holder must comply with say govern merpalot nongovenrmental regulatory laws and ra pdremems which apply to the business The RECEIPT N0. above must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-276. 10,V77 Tr,,17,:iii ;,..L� I!... !tel_:...! '.V: L: =71- 06/03/2014 08:40 3053872918 A AND D ALL LINES PAGE 01/01 DATE(mmu 1YYYY} ACORD. CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUEDAS A MATTER OF INFORMATION PR01771C£R ONLY ANIS CONFERS NO RIGHTS UPON THE CERTIFICATF. LVEND OR (S CERTIFICATE DOES NOTCOVERAGE A&D AIM—LINES INS ASSOC INC ALTER THE AFFORDED Y THE O1, BELOW 5600 SW 135 ,Avt. r She 106 mi.ami, FL 33183 INSURERSAFFORMNGCOVERAGE NAIL# INSUR5o DREAM pooLS OF SOUTH FLORIDA, INC. INSURER A: TE HE INAURER B: 6031 S.W. 139 CT. INSURER c: MIAMI , PL 33183 INSURER 0: INSURER E! CCiVERAGES 15dF POU00OF INSUWLNOE UVEDBEUARHAVE BEEN ISSUEDTO THE INSURED NAMED A 0VEFDR THE pOUQy PERIOD INDICATED. NOTWTHSTANDING VNTfi RESPECT TO WIQCH THIS CPRTIFiCATE MAY B� ISSUED OR *ANY REOUIREMM TERM OR CONDITION OF ANY CONTRACT OR OTHLR DOCUMENT TOALLYHETERM9, OtCLUSIONSAND CONDITIONS OF SUCH ,*Y PERTAIN, THE INSURANCE AFFORDED 9Y THE pOUC58DES0RIBED HERVN ISSUBJECT ;'POUCIES. AGGREGATE LIMITS SROM MAY HAVE REM REDUCED SYPAID CLAIM& POUCYNUMEER oAi'E p�� a M �UCY TIDN DATTEE LIMITS TYPEOF INSURAN_M EACH OCCURRENCE b 1.000,000 q.ENERAL LIASILftY PRUNIM i£8 � } E COMMERCIAL GENERAL LIABILI Y `CIA@ I'M OCCUR raEDI7cPUUga�atsrn+l $ L1740000011 03/31/14 03/31/15 PERSONAL&ADVINJURY s A GENERAL AQW9609 9 2,000,000, PRODUCT COMPICP AM $ GENtAC4REGATE LIMITAPKESPffiTI '1 POLICY JsHTLOC AUMMCAILE UABAItY CAM9IIIED SINGLE LiMR s (Ea at�tmm4 :u r. ANYAUTO ALLOWN£D AUYOS (Pat wILY IN.ILIFNt S (Pat p6fm) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ �ataaaip+� I .• NON-CMED AUT*9 PROPERTY DAMAGE S • (perneNtlartp AUTO ONLY -EAACCOEW S GARAGELIABIM pAAC0 S ANYAUTO OR AUl0O AGG S m EACH OCCURRENCE & 77- pcEwum*RBLLA U "L11Y OCCUR AGGREOAi+ S l� ICLAIMSMAM 5 S DEDUCTIBLE i RE, MMON S Pay hs R {ryO MSCOMPENSATION AND EMPLOYERW LIAIPLTY EL EACH AO=2NT E ANY VWJVMVPRARTNERSKKAVM EL (ASEAN- EAEMPLOYM S OFFicowzmam E» Ilyea,tl88AlIIels:d� E.LDISEAEE.POUOYL;vWT S :' SPl3CiALPROYIStONSb91d+< DES tiIPTION OF OPE 4TIomsiLOG4lIONS/V£HI0.mIF�34U1-AMADDED IEGALPROVISIONS EYENDO SP -.&L INSTAI,LATTON SERVICE & PMAIit a•L; P K 'T• F CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THEABWEDE5CAIRE0POucIESszt)gNGEI cneePOaRrilEr�xf'IRnrCIN CITY OF XnkWn SROREH DATE YHEREOP, THE IWUMlo INSURER VYILLEN13SAVOR TO MAIL 30 DAYS WRITTEN 10050 NE 2ND AVE. NOTICE T9 TNF CERTIFICATE HOLDER NAMED TO THE L6PT, • • FAURE TO DO SO SHALL MI14MI SHORES, YL. 33138 WFCSE NO OBWATION OR LIADILITY 0 ..,N Ki N INSURER, TM AGENTS OR REPRESEN'IATMES. AUTHORIZED REPRESENTATI , ' ;'.e1' CORD CORPORATION1988 �Ai'#215 (200110$) •a^� ore' JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA 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: 1/25/2014 EXPIRATION DATE: 1f25=16 PERSON: ESPINO ROBERT JR FEIN: 830498493 BUSINESS NAME AND ADDRESS: DREAM POOLS OF SOUTH FL 6031 SW 129 COURT MIAMI FL 33183 SCOPES OF BUSINESS OR TRADE: LICENSED POOL CONTRACTOR Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by fiko a certificate of election under this section may not recover benefits or compensation wider this chapter. Pursuant to Chapter 440.05(12), 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 9, at any time after the filing of the notice or the issrramoe or 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 shag revoke a certificate at any time for fMm of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS? (850)413-1609 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. 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 anyperson 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. Print Signa State of Florida ) County of Miami -Dade } Sworn to d subscribed before me day of , 20. A. LIM Print Nam Signature: State of rlonda ) County of Miami -Dade) �� Sworn to subscribed before me this 7;70 of , 20 M , 2014 BUILDING PERMIT APPLICATION ❑BUILDING NELECTRIC F_JPLUMBING ❑ MECHANICAL JOB ADDRESS: City: Miami Shores Folio/Parcel#• C Occupancy Type: Load OWNER: Name (Fee Simple Titlel Address: y� — G City: Miami Shores Village - Building Department ��,��•'� 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 20 Master Permit No. -'b Sub Permit No. 6, ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ PUBLIC WORKS Ej CHANGE OF [:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS the Building Historically Designated: Yes NO Construction Type: Flood Zone: BFE: FFE: State: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Address: 0 hone City: bState: Tj Zip: `3-Q. 80 Qualifier Name: ` Phone#: State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: N63 FIJ I City: State: Zip Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: 1A Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: I ba_ ►►NnS�i aml Specify color of color thru tile; Submittal Fee Permit Fee CCF $, CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews (ReAsed02/24/2014) Bond $ 2 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 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 tMabsence of such posted notice, the inspection will not be approvedgpd p reinspgction fee will be charged. OWNER or AGENT The foregoing instrument was acknowledged before me this day of20 by ho is rsonally kn9yin to me or o has produced as identification and who did take an oath. NOTARY PUBLId The foregoing instrume,# ald day of e me or who has produced identification and who di Seal: Seal: was acknowledged before me this 20 by 6A�o is per Wally knower o as take an oath. 16 ��x��x>K*�x�**�*��x**�x�x**��*>x>k>K�x�x>xx�>k>a��x�**�*>K��x�x>K«*>k>k�**mix**�x�x*>k�x*�x�**>x�>x��>K*�*�*�>«�>k��*��*x�>•�>K>k�>�>k�>K�**�x�x e, P lel, APPROVED BYPlans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING I ZLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS JOB ADDRESS: FBC 20 Master Permit No. 6L6-1'/� Sub Permit No. LleL- I ")�- 1 E]REVISION ❑ EXTENSION ❑RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: City: (Fee Simple Titleholder): Tenant/Lessee Name: Phone#: Email: .. ih/ sw `. `� R U ,iUState: Tj Zip: Qualifier Name: Phone#: -h r State Certification or Registration # a. DESIGNER: Architect/Engineer: W Value of Work for this Permit: $ S Type of Work: Addition ❑ Alteration ❑ New Description of Work: �� t )11►via, Specify color of color thru tile:, Submittal Fee $ Scanning Fee $ Technology Fee $_ Structural Reviews $, (Revised02/24/2014) Certificate of Competency M City: VVI lAk4 State Zip: Sc Footage of Work: �C ❑ Repair/Replace ❑Demolition Permit Fee $ 4.3C)t.) CCF $ CO/CC $ Radon Fee $ Training/Education Fee $ DBPR $ Notary $ Double Fee $ Bond $ 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 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 ' s d. in the absence of such posted notice, the inspection will not be approved and a reins ion fee will be charged. OWNER or AGENT The foregoing instrument was acknowledged before me this day of 20 by P=Ae�2](Dwho is pe o ally known 44? me or who has produced as identification nho did take an oath. NOTARY PUB 16 Pri Seal: The foregoing instrument"was acknowledged before me this day of 20 by t),,who is p sonally know o me or who has producedas identification ando did take an oath. NOTARY PU Print: Seal: APPROVED BY t5-5- 'y Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Ifl ING Miami Shores Village wilding Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 PERMIT APPLICATION )�fkUILDING ❑ ELECTRIC ❑ ROOFING ❑PLUMBING [:]MECHANICAL ❑PUBLIC WORKS 20 Master Permit No.F Sub Permit No. )i REVISION ❑ EXTENSION ❑RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: -M QI INV "N City: Miami Shores�yCounty: Miami Dade Zip: b�6 �2 Folio/Parcel#: � 0 { 1 10� 110 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name Fee Simple Titleholder): Phone#:ru - ®0 Address: City: State• R1 Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Address�4729'k4 S: City: V.1 4-4� Qualifier Name: State Certification or Registration DESIGNER: Architect/Engineer: Address: In �� n a nU'-F. Certificate of Competency #: O1A J A) Phone#: sc City: State Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Description of Work: % �lO N ( g q 1 VIG� Ain) f% ❑ Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ s 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 $ 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 brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice ocom ncement m st be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. 1 theItof such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature OWNER or AGENT The foregoing instr ment was acknowledged before m this ay of Ar— 2�know y I nnwho is rso me or hohas produced as identification and who did take an oath. NOTARY PUBLICI L�T'�ii.✓p 711 1 W' CO The foregoing instr ent was bcknowledged before me this ay of j— 20 by wh is personally know to me or who has produced as identification and NOTARY Sign Print: Seal: Seal: did take an oath. r)LTRAN # FF132922 t'K7/,4,/,-/!�-7ZoningAPPROVED BY (G (( Plans Examiner Structural Review Clerk (Revised02/24/2014) V STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD WE 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 ESPINO, ROBERTO DREAM POOLS OF SOUTH FLORIDA INC 6031 SW 129 COURT MIAMI FL 33183 Congratulations! With this license you become one of the nearly 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.myfloridalicense.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! DETACH HERE RICK SCOTT, GOVERNOR (850) 487-1395 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CPC1458041 I$SUED: 08/31/2014 CERT RESIDENTIAL-OOUSPA CONTR ESPINO, ROBERTO `;.. DREAM POOLS:OF SOUTH FLORIDA INC IS CERTIFIED under the provisions of Ch.489 FS. Expiration date : AUG 31, 2016 L1408310005904 KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER The RESIDENTIAL POOL/SPA CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 ESPINO, ROBERTO - DREAM POOLS OF SOUTH, FLORIDA INC 6031 SW 129 COURT MIAMI FL 33183 ISSUED: 08/31/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1408310005904 011163 Local Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOTA BILL —DO NOT PAY 6194252 BUSINESS NAME/LOCATION RECEIPT NO. AL DREAM POOLS OF SOUTH FLORIDA INC RENEWAL 6031 SW 129 CT MIAMI FL 33183 LBT EXPIRES SEPTEMBER 30, 2015 Must be displayed at place of business Pursuant to County Code Chapter SA —Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS PAYMENT RECEIVED DREAM POOLS OF SOUTH FLORIDA INC 196 SPECIALTY BUILDING CONTRACTOR BY TAX COLLECTOR CPC1457603 $75.00 07/21/2014 Worker(s) 1 CHECK21-14-028532 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is notovelramental permit or a certification of the holders qualifications, to do business. Holder must comply with amt g or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT N0. above must be displayed on all commercial vehicles — Miami—Dade Code Sec 8a-278. For more information, visit www miamidade aovkexcollactar '�RD- CERTIFICATE OF LIABILITY INSURANCE DATE(MMDD/YYYY) PRODUCER A&D ALL -LINES INS ASSOC INC 5600 SW 135 Ave, Ste 106 Miami, FL 33183 463-6781 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLIC ES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED DREAM POOLS OF SOUTH FLORIDA, INC. 6031 S.W. 129 CT. MIAMI, FL 33183 INSURER A: WIESTERN HERITAGE INS Co. INSURER B: INSURERC- INSURER D. INSURER E: L:UVt 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSRD POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1.000,000 RENTED EMSE Ea occurarical $ 50,000 COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ 1,000 CLAIMS MADE . w . OCCUR A L1740000011 03/31/14 03/31/15 PERSONAL a ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 21,000,000 I PRODUCTS-COMP/OP AGG $ 1.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PiFr.T 171 RO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANYAUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIREDAUTOS BODILY INJURY $ NON-OWNEDAUTOS (Peraccident) PROPERTY DAMAGE $ (Peracaident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ EA ACC $ ANYAUTO OTHER THAN AUTOONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR 0 CLAIMSMADE DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION AND WCSTATU- OTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERWEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ Ityes, describe under DISEASE -POLICY LIMIT $ SPECIAL PROVISIONS blowE.L. OTHER DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS POOL INSTALLATION SERVICE & REPAIR CICATE HOLDER CELLATION CITY OF MIAMI SHORES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 10050 NE 2ND AVE. DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN MIAMI SHORES, FL. 33138 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT F (LURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF TH URER, ITS AGENTS OR REPRESENTATIVES. UTHORIZED REPRESENTATI r m.urcu w Iwuvutvl 6 06RD CORPORATION 1988 JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA 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: 1/25/2014 EXPIRATION DATE: 1/25/2016 PERSON: ESPINO ROBERT JR FEIN: 830498493 BUSINESS NAME AND ADDRESS: DREAM POOLS OF SOUTH FL 6031 SW 129 COURT MIAMI FL 33183 SCOPES OF BUSINESS OR TRADE: LICENSED POOL CONTRACTOR Pursuant to Chapter 440.05(14), 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 440.05(12), 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 Uma for fatlure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS? (850)413-1609 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. 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 any 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 c'ONTF.W& Print Signa State of Florida ) County of Miami -Dade) Sworn to d s bs ribed day of ` By before me this 20. FF132922 State of Florida ) County of Miami -Dade) Sworn t=db before m s day ofrqo I - IM of Miami Shores Village CIS Building Department a jjj q14 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 y' Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 201` ] BUILDING Master Permit No. ' 'qo PERMIT APPLICATION Sub Permit No. B: 22 ❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS R JOB ADDRESS: �3 s ®(P qq S_�_ c City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 111 0122 ) 10 �1I Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): k��&,G Phone#:'�> A Addr City: Tena Emai, CONTRACTOR: Company Name: Phone#: J Address: SW City: M 1�_jState: Zip: Qualifier Name: State Certificatii DESIGNER: Architect/Engineer: Phone#: Address: City: State Value of Work for this Permit: $ Square/Linear Footage of Work: — Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace Description of Work: Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ '� Radon Fee $ Zip: ❑ Demolition 'C CCF $ CO/CC $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 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 abSTnce of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT C TRACTOR The foregoing instrument as acknowledged before me this day of by who is p�20 na ly know o me or who has produced as identification and wWo did take an oath. NOTARY PUBLIC: Sign: A., Print: Seal: The foregoing instrument Was acknowledged before me this I day of !' - 20 by who is rsonally know to me or who has produce as identification and who id take an oath. NOTARY PUBLIC: 11,614 Print: Seal: APPROVED BY (1-Q /o- G- /-1 Plans Examiner Structural Review (Revised02/24/2014) Zoning Clerk BOUNDARY SURVEY SCALE: 1" = 20' F %" p.. ... LP 4'.4 a,e Asphalt DEC 15 201 • p2 m N r LOT- l2 20ft of Lot l 6.70 fig.::: ::::•:::•:::;?:o :` /5 ' A L L E Y •:•::.PD. :.. p:.::•• ........ lO'Aspha/tPavement::; :112 I.P. '-X0 2::::: + 32.3 /':>.::'.' ::?::;; :.: ''::::.:_.: isi : i::•::•:::•::•:;•::::•::;•::::•:c•: 13� 1. Ui 13.45' ! i-' I PD. 0 LLLLL— L �7r LLLLLLL 13.37' LL /0.65' LL— LLL ' L /O �+ L L SPA L �L L 99 1 LLLLLLLL— q 20.6�5'l ONE STORY C13.5. Res.# 353 F F E/ev.: 13.05' Gar. Elev.: / 0. l 8' LL LL a Cone. Walk d ' 6 0 •d . a a d d a' l 5/ .93' (P,) d .. . e.. 22.50' Parkway NE 9407 5t. o'? 20' A*&It Pavement 751 TOTAL R/W 13.37' 10.07' cvn, BLOCK- 45 Remainder of LOT- l 3 LOCATION MAP NOT TO SCALE PROPERTY ADDRE55: 353 NE 94th St. Miami Shores, FL. 33138 LEGAL DESCRIPTION: Lot 12 * West 20.00 feet of Lot 13, Block 45, of MIAMI SHORES SECTION ONE, according to the plat thereof a5 recorded in Plat Book 10, at Page 70, of the Public Records of Miami Dade County, Florida. -NOTE: nl ELEVATION5 ARE REFERRED TO MIAMI DADE COUNTY 5M# N -5G8 ELEV.=9.G5' OF N.G.V.D. OF 1929 a' Wad *Dow e JOB NUMBER: l 4 / 033 BASED ON THE FLOOD INSURANCE RATE MAP OF THE FEDERAL EMERGENCY AGENCY REVISED ON 9- l I -09 THE HEREIN DESCRIBED PROPERTY IS SITUATED WITHIN: ZONE X BASE FLOOD ELEV.N/A COMMUNITY NUMBER l2OG$2 PANEL NUMBER 0302 SUFFIX L ....---••------------ DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THE PROPERTY. THIS SURVEY IS SUBJECT TO 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 NOT ATTEMPTED 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: Oct. 20, 20/4 Alejandro Rebe/o REVISED ON: Dec. 9, 20 / 4 A= ARC DISTANCE CONC.= CONCRETE O.H.= OVERHEAD UTILITIES RMF- RIGHT-OF-WAY `o= ELEVATION = CATCH BASIN A��41UJ �OQ 12. 4OQ AC= AIR CONDITIONED UNIT .LI P.C.P.= PERMANENT CONTROL POINT LLLI 'O G 6.65' Gas P.O.B.= POINTO OF BEGINNING Meter ® =WATER METER QS = SANITARY SEWER p2 m N r LOT- l2 20ft of Lot l 6.70 fig.::: ::::•:::•:::;?:o :` /5 ' A L L E Y •:•::.PD. :.. p:.::•• ........ lO'Aspha/tPavement::; :112 I.P. '-X0 2::::: + 32.3 /':>.::'.' ::?::;; :.: ''::::.:_.: isi : i::•::•:::•::•:;•::::•::;•::::•:c•: 13� 1. Ui 13.45' ! i-' I PD. 0 LLLLL— L �7r LLLLLLL 13.37' LL /0.65' LL— LLL ' L /O �+ L L SPA L �L L 99 1 LLLLLLLL— q 20.6�5'l ONE STORY C13.5. Res.# 353 F F E/ev.: 13.05' Gar. Elev.: / 0. l 8' LL LL a Cone. Walk d ' 6 0 •d . a a d d a' l 5/ .93' (P,) d .. . e.. 22.50' Parkway NE 9407 5t. o'? 20' A*&It Pavement 751 TOTAL R/W 13.37' 10.07' cvn, BLOCK- 45 Remainder of LOT- l 3 LOCATION MAP NOT TO SCALE PROPERTY ADDRE55: 353 NE 94th St. Miami Shores, FL. 33138 LEGAL DESCRIPTION: Lot 12 * West 20.00 feet of Lot 13, Block 45, of MIAMI SHORES SECTION ONE, according to the plat thereof a5 recorded in Plat Book 10, at Page 70, of the Public Records of Miami Dade County, Florida. -NOTE: nl ELEVATION5 ARE REFERRED TO MIAMI DADE COUNTY 5M# N -5G8 ELEV.=9.G5' OF N.G.V.D. OF 1929 a' Wad *Dow e JOB NUMBER: l 4 / 033 BASED ON THE FLOOD INSURANCE RATE MAP OF THE FEDERAL EMERGENCY AGENCY REVISED ON 9- l I -09 THE HEREIN DESCRIBED PROPERTY IS SITUATED WITHIN: ZONE X BASE FLOOD ELEV.N/A COMMUNITY NUMBER l2OG$2 PANEL NUMBER 0302 SUFFIX L ....---••------------ DETERMINE RECORDED INSTRUMENTS, IF ANY, AFFECTING THE PROPERTY. THIS SURVEY IS SUBJECT TO 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 NOT ATTEMPTED 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: Oct. 20, 20/4 Alejandro Rebe/o REVISED ON: Dec. 9, 20 / 4 A= ARC DISTANCE CONC.= CONCRETE O.H.= OVERHEAD UTILITIES RMF- RIGHT-OF-WAY `o= ELEVATION = CATCH BASIN A��41UJ �OQ 12. 4OQ AC= AIR CONDITIONED UNIT D.M.E.= DRAINAGE MAINT. EASEMENT P.C.P.= PERMANENT CONTROL POINT TYP = TYPICAL 'O B.C= BLOCK CORNER ENC.= ENCROACHMENT P.O.B.= POINTO OF BEGINNING U.E.= UTILITY EASEMENT ® =WATER METER QS = SANITARY SEWER Professional Land Surveyor & Mapper C.B.= CATCH BASIN FD.= FOUND P.O.C= POINT OF COMMENCE W.F.= WOOD FENCE wv (C)= CALCULATED I.F.= IRON FENCE R= RADIUS VIM= WATER METER Coj = POWER POLE DG = WATER VALVE 14317 S.W. 45th Terrace Miami, Florida 33175 CL.= CLEAR (M)= MEASERED (R)= RECORD 0= DIAMETER JO = LIGHT POLE ® =TV BOX C.L.F.= CHAIN LINK FENCE MIL= MONUMENT LINE RES.= RESIDENCE q= CENTER LINE 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. Z�� RTURO R. TOIRAC P.S.M. 3102 Not validLow:, the signature and the original embosed seal of a Florida Licensed Surveyor and Mapper.