BPP-15-1571 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-237585 PermitNumber: BPP-6-15-1571
Scheduled Inspection Date: December 21,2015 Permit Type: Pools/Whirlpools/Hot Tubs
Inspector: Rodriguez,Jorge Inspection Type: Final
Owner: VERA, EDUARDO Work Classification: New
Job Address:950 NE 95 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132050070120
Project: <NONE>
Contractor: ROSMEL POOL INC Phone: (305)592-7900
Building Department Comments
NEW POOL, DECK AND SPA Infractio Passed Comments
SPA 38 SQFT INSPECTOR COMMENTS False
DECK 2182 SQFT
POOL 512 SQ FT
Inspector Com ents
Passed �� 2,(/
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
December 18,2015 For Inspections please call: (305)762-4949 Page 5 of 51
FOR. EDUARDO J.VERA AND KATHRYN ROONEY-VERA JOB NO: 1101-020A
SKETraCH OF BO, • I� i DA T SURVEY FIELD DATE: 11-18-2015
Mp.ADD. 950 N.E.95th STREET,MIAMI,FL 33138
N.E. 95th STREET
20'Asphalt CERTIFIED:
SCALE' f1*0' EDUARDO J.VERA AND KATHRYN ROONEY-VERA.
31.5'Parkway
LEGAL DESCR/P710N• :000:9
P.O.C. FND.I.P.1" FND.I.P.I/2 The following described portion of Lot 7 os shown on Plat,of Go�ggmmFrient Lot 4 of ••
NO ID 100.00 Section 5,and the North 1/2 of the NE 1/4 of the SE 1/4 of Secflon b,TowrSship 53'.
B.C. South,Range 42 East,recorded in Plat Book 5,at page 90,of the'PUb�C Record! •• •••• •
P.O.B. 1 0' 8.00' 11.00'
W 208.5Q' 89� Dade County,Florida,to-wit: •••••0 0
00 0000 .
5 Commence at the northwest comer of Lot"F'of Plat of GovemmentoLat 4,of Section. 0 9
V 00 �p D� 5,and N 1/2 of NE 1/4 of SE 1/4 of Section 6 of Township 53 South'Rc3rygD•42 Eos:'•••• ••�•
IS Dade County Florida,according to the plat thereof recorded in qqt k 5,at e •
�'' 90,of the Public Records of Dade County,Florida;thence run Ea�sttlolo�r the noIAM g0:. ...•
line of said Lot T'for a distance of 208.5 to a point of beginning;Ven'cL run south •••• •
along a One parallel with the west One of said Lot"F'for a distancobt j2Q'feet to a 9 •
point;thence run East along a line parallel with the said north line of sailot"F'for a 0.09 0
®rid distance of 100 feet to a point;thence run North for a distance of 220 feet morgdr *
W r I€ less to a point on the north line of said Lot"F",said point being 1001%df Eost to the, 0• •••
Z °= ,�--, r.., point of beginning;thence run west along the north One of said Lot 7 for a distance• •
"� 'F7 of 100 feet to the point of beginning.
•
Asphalt Driveway SURVEYORT NOTES.
y 1.)THE SURVEY OF THE PROPERTY SHOWN HEREON IS IN ACCORDANCE WITH THE
DESCRIPTION FURNISHED BY CLIENT.
2.)UNLESS A COMPARISON IS SHOWN,ALL BEARING,ANGLES AND DISTANCES SHOWN
ARE THE SAME AS PLAT VALUES.
3.)THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENTS OR OTHER
Concrete RECORDED ENCUMBERANCES NOT SHOWN ON THE PLAT AND THE SAME,IF ANY MAY
V NOT BE SHOWN ON THE SKETCH.
——— 4.)UNDERGRAUND PORTIONS OF FOOTINGS,FUNDATIONS OR OTHER IMPROVEMENT
WERE NOT LOCATED.
35.60' 'o 23.30' Q. 5.)FENCES TIES ARE TO THE CENTER LINE OF THE SAME6.)WALL TIES TO THE FACE OF THE SAME
7-ALEVATION WHEN SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM
21.80' m (1929)UNLESS OTHERWISE NOTED.
B.)THERE NO ABOVE GROUND ENCROACHMENTS OTHER THAN THOSE SHOWN.
AIC TWO STORY CBS o oRESIDENCE#950 v _A/C o - (FLOOD ZONE INFORMATION)
A/C N _ �+ < ZONE:X COMM:120652 PANFL-12086CO306 SUFFIX L DATES-11-2009 BASE N/A
1 ' 80.70' 0• a 'fG I I F= NOTE:DETERMINATION OF FLOOD ZONE LINES WERE BASED ON SCALING OF FEMA MAP LISTED ABOVE.
NOTE:ALL BEARING HEREON ARE BASED TO THE PLAT BEARING OF N/A
CL c 40.60' 0 ' fl�1 6 i " # ON THE CENTER LINE OF N/A PROPERTY LINE,
ri c i Stone Tiles E.M.
EASEMENT VIOLATIONS. ❑YES ®NO
10.65' �� 21.00' 32.70' CL ' APPARENT VISIBLE ENCROACHMENTS: ❑YES X NO
8.3
6.20' 1.0 ' ColOENTS:
Ii POOL b �\ i ABBREVIATIONS:
S.
Sidewalk,CBS-Concrete Block Structure,CLF=gain Link Fence,
,o CD
m c 00 i PL=Property Line,DUE=Drainage utility Easement,IP=Ira,Pipe.
r o o A/C=Air Conditioner Pad,P/C=Property Comer,OM=Drilled Hole,
b -0 � wEasemant,C0NC Conc.Slab,WIN=Right of W,RES-Residence,CL= ay,DE=Drainage Easement,
CJL=Center Line,0=Diameter,TYP=Typical,M=Measured,R-Recorded,
01�754.93' ! r ENCR=Encroachment,COMP=Computer,ASPH=Asphalt,N/D=Nail&Disc..
15.00' 1.0 S=Set,FFE=Finish Floor Elevation,o/S=onset,PIP=Power Pole,
30 0 3OHP=Overhead n Ni Water � ticF�1 DEC Y ZU15 E. =Electric Meter,M.F=MeaFence,P.F� D E�raiood power nage
Maintenance Easement,C.M.E-;anal Maintenance Easement,L.M.E.=Lake
Maintenance Easement,M.E.=Maintenance Easement,B.C.=Block Comar,
P.C.=Point of Curvature FND=Found NO ID=No Identification.
GL(D BAL —ft=
D MENSIONS INC.
� ,`,� r` ..�n,..�„ r9
POO[-;.ff] 10.50'I
Pump b Land Surveying Services G'�i. j
6'
Wood F. o �� OFFICE: TAVIL
FLIT H
FND.I.P.I/2 100.50' FND.I.P.1/2' 14770 SW 43rd WAY, REGISTERED LAND SURVEYOR#4843
(NO 10) (NO ID) MIAMI F� 33185. STATE OF FLORIDA
PHONE: (J05 512-4225 LB#0006874
FAX: (305) 512-1914Note:Not Valid Unless
Signed and Sealed. SHEEL X OF--L-
SET
FIELD DENSITY TEST OF COMPACTED SOILS
ASTM D-6938-08a
Date:November 11,2015
GEOTEC No.D-151111-449
PROJECT: POOL DECK AT:
950 NE 95 ST
MIAMI SHORES,FL 33138
MOISTURE DENSITY RELATIONSHIP(MODIFIED PROCTOR)ASTM D-1557-07
GAUGE SERIAL— _
S1f AilA1�T
Na. Ii�1SPf1t' 11�DIS
62691 LIME ROCK 130.2 8.6
3iEQi3II VOMPAII(WHN{%j. 95% N/A
MATERIAL ON SITE
BACKFILL SUB4:SE J1A.S . - X --BPAD I.$R VATS
IINT IST ERC. 111tPORT SOURCE
DENSITY TEST RESULTS
T� LOCATIONS MELD DRY FIELD(°A) FIELD(%) RESULTS
No DENSPPY ` M019L COMP.
1 NORTH AREA OF POOL DECK 128.6 10.9 98.8 PASS
2 SOUTH AREA OF POOL DECK 124.4 10.4 95.5 PASS
3 WEST AREA OF POOL DECK 126.7 9.1 97.3 PASS
4 EAST AREA OF POOL DECK 123.8 8.2 95.1 PASS
NOTE:
SeveSva 3n' 2W! �;;,<; . aY/zr' In % Y." 3181# ti4
%P-e-g.
e�og839jp1g- DRY
MOISTURE I DENSITY CURVE
132.00
130.00
128.00
126.00
124.00-
0 122.00
Z
9120.00 - Respectfully Sub itted
0118.00GEOTEC CONSULTING GROUP�RP.
116.00
114.00
112.00
6.67% 6.84% 9.090A 11.63% Ricl a P.E.
MOISTURE CONTENT% Professioi�rE '.. o.56712
State of Florida
GEOTECHNICAL,CML STRUCTURAL ENGINEERS—13093 SW 133 CT.MIAMI,FL 33186-P:(786)319-0355/P:(786)380-0734
garcia5229@bellsouth.not
EMILLANO OROZCO, P.E.
Professional Engineer
81 7 SW 122 AVE.
MIAMI FL. 331 B4
PHONE: (786) 715 - 7125
AUGUST 28,2015
Building Official '
Building and Zoning Department
MIAMI SHORES
OWNER: Mr. EDUARDO VERA
ADREESS: 950 NE 95 ST. MIAMI FL. 33138
For design purposes, in this project a bearing value of 2000 psf has been utilized.
This bearing value is typical of a soil with combination of undisturbed sand and
limerock.
The pool has been excavated and after a visual inspection we are attesting that
the soil conditions are similar or better to the used in the design.
Should you have any questions or require additional information, please contact me
at (786) 71 5 - 71 25 at your earliest convenience.
Sincerely,
I
s
EMILIANO OROZCO, P.E.
Professional Engineer
License No. 66341
�s R;s s, Miami Shores Village PermXt Tjrpe P€I�l' "'OWHOtTu .
g 10050 N.E.2nd Avenue NE
yl/t?rk ClatZ New
Miami Shores,FL 33138-0000
3 Perm if'status. APP��}VEp
Phone: (305)795-2204
_ �ox � �15 Expiration: 0 /20/2016
Project Address Parcel Number Applicant
950 NE 95 Street 1132050070120
EDUARDO VERA
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
EDUARDO VERA 950 NE 95 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
Valuation: $ 60,500.00
ROSMEL POOL INC (305)592-7900
_.. _ . . __ _.....,,. --------- Total Sq Feet: 2730
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Fence
Date Denied: Final
Type of Work:Swimming Pool Occupancy:Private Pool Deck
Additional Info: Bond Return: Wall Steel
Classification:Residential Scanning:5 Review Electrical
Review Structural
Review Mechanical
Review Planning
Review Planning
Review Plumbing
Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Building
Bond Type-Contractors Bond $500.00 Invoice# BPP-6-15-56102 Review Building
CCF $36.60 Review Building
CO/CC Fee $50.00 06/25/2015 Check#:12837 $200.00 $2,572.06 Review Structural
DBPR Fee $27.23 08/19/2015 Credit Card $2,572.06 $0.00 Review Structural
DCA Fee $27.23 Bond#:2763
Education Surcharge $12.20
Permit Fee $1,815.00
Plan Review Fee(Engineer) $80.00
Plan Review Fee(Engineer) $80.00
Plan Review Fee(Engineer) $80.00
Scanning Fee $15.00
Technology Fee $48.80
Total: $2,772.06
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing infotion is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the ab:Vn=rk stated..
GLUAA August 24, 2015
Authorized Signature:Owner / Applicant / Contractor / Agent 1A Date
Building Department Copy
August 24,2015 1
0' rAliami Shores Village
10
Building Department JUN 29 2015
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax:(305)756.8972
�o) `� INSPECTION'S PHONE NUMBER:(305)762.4949
FB;C 220 IC)
BUILDING Permit
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: '150 QE- 55 54 . Mli5ie-�, FL
City: Miami Shores County: Miami Dade Zip: 3313 'X
Folio/Parcel#: I I - -AA Ln v 0():] -®1,;t Q
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): t AUCA Cdn 424-CL Phone#:
Address: 95c) 13£ �' r
City: "lary-1_nbc�fe-s State: Vr L Zi 35
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Qo'b -el Phone#:
Address: 'ACS ' l
City: 00r-Se I Stater Zip:
Qualifier Name: y-± V qy-P 161 Phone#: 305_�. i.�-1 C1
State Certification or Registration#: - Pr i gtU ICA Certificate of Competency#:
Contact Phone#: ,� '���1 GI Email Address: C!�1t Q CT I a CQ
DESIGNER:Architect/Engineer:,jEja,2j,joy-\n��Z[(�,Y� ' 1plei Phone#: `1 -1 ► Q5
Value of Work for this Permit:$
�� � DU Square/Linear Footage of Work:
Type of Work: ❑Addition ❑Alteration ❑New ❑Repair/Replace ❑Demolition
Description of Work:
Color thru file:
�xxxn�xa�x���xx�xxxxx�xxxx��xxxxxxxxxxxxFees�xxx�xxxxxxx�xxxxx�xxxx��xxx�xxx��x�xxnxx��x
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
}
+ ' T
Bonding Company's Name(if applicable) �e ,
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable) A
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for 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 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_
O gent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this J
day of- me- 20► ,by ei 10 cAn V e'r0%. day of J,by i dt h
who personally known t me or who has produced who is er nail known to me who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
14
Print: �„)2- JAel5tQ, -Arran Print: U 2 Ne Ilan a anf:3
My Commission Expires: 9eletl;'�q�s � My Commission Expires���a..�P.,,,° s uz Helen'Ao'9 011
ao r°a. r
0vve&Arlj®�� uZ BION#50190 �a�`,' �scom ISSION#FF0190rs8
a eC, .AM 192017 O% R DMRES: MAY 19,2017
,•y, aPIREa• MAY °� RONNOTARY
xxx � xx xxxxx x'+� xx s xxxx x x>kxxx xxxxx xx xxxx xxxxxxxx ` x � 'R0NNoTARxx xxxx
°jsaeeeeea`` ) ] l
APPROVED BY �� IS Plans Examiner ,? I I 1 y Zoning
A� Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
NEW POOL CONTRACT DATE: 6/5/2015
7777 _V aweLER cow-_
CUST NAME: EDUARDO J.VERA R 0 S, Ny�L }CPC-1456804
CUST ADDRESS:950 NE 95 ST MIAMI SHORES,FL 33138 POOLS & U T D O O R S PHONE:305.592.7900
CUST NUMBER: 305 803 0381 8045 NW 36 ST SUITE 540 MARCOSQROSMELPOOLS.COM
CUSTEMAIL eduardoverav@gmail.com DORAL,FL 33166 WWW.ROSMELPOOLS.COM
POOL FORM: RECTANGULAR POOL SIZE: 15'X 37' SPA TYPE: RECTANGULAR SPA SIZE: 6'X 6'
NiltrA{ f< 1FWOt[tjWHAT )MV1�DDI ["): E)LTRAS:CRUh41ApES.{ll;;lC ��f�tEi�l<�JC -
t; PLANS&PLAN RUNNER
POOL EXCAVATION&HAUL AWAY MATERIAL TANNING LEDGE 6'X 9'WITH UMBRELLA HOLE
POOL DEPTH[3FT-5FT] 2,182 SQ.FT.TRAVERTINE PAVER DECK
STEEL REINFORCEMENT FORM[#3 RE-BAR[301N]/ONE LAYER] HEAT PUMP 140 K BTU-JANDY PRO SERIES JE
200 L FT.OF RETAINING WALL
POOL CONCRETE SHELL 3500 PSI[SHOTCRETE USED] M AQUALINK SYSTEM PDA-PS4
6 iN CONCRETE WADS PRESSURE VACCUM POLARIS MODEL 280
6 IN-8 IN BOTTOM CONCRETE SHELL SALT SYSTEM-PRO SERIES AQUAPURE
3 SHALLOW-END STEPS 4 DECK JETS
5 FT SWIM-OUT BENCH AT DEEP-END OF POOL REMOVE SLAB
FIRST AND SECOND BACKFILLS 1 EXTRA SKIMMER y� } i}1
-.'• 3:cF,c14
SIYEIYIIiL� '-Vi/ # \7i -
SCHEDULE 40 PVC PLUMBING[BY CODE]
12 IN DOUBLE WIDE MOUTH SURFACE SKIMMER
ANTI VORTEX MAIN DRAINS WITH VENT LINE TOTAL COST FOR POOL+EXTRAS= $ 65,000.00
3-6 RETURN LINES WITH ADJUSTABLE HEADS[DEPEND ON POOL SIZE) 15% WHEN CONTRACTSIGNED $ 9,750.00
VACUUM UNE 25%WHEN EXCAVATION COMPLETED $ 16,250.00
RE- $, A ; e; � k CiL ',� 4xm' 30%WHENSHOTCRETEAPPLIED $ 19,500.00
ELECTRICAL WORK[SOFT OF EXPOSED PIPE INCLUDED] 20%WHEN TILE&COPING INSTALLED $ 13,000.00
ELECTRICAL UPGRADES,UNDERGROUND OR ATTIC WORK WILL BE QUOTED SEPARATE 5%WHEN PUMP&FILTER INSTALLED $ 3,250.00
ELECTRICAL HOOK-UPS,TRANSFORMER AND 24 HOUR TIMER 3%WHEN POOL PLASTER APPLIED $ 1,950.00
6 JANDY LED NICHEL.ESS LIGHTS COLOR 2%AFTER APPROVAL OF FINAL INSPECTION $ 1,300.00
PRE-FABRICATED EQUIPMENT PAD ANY DEWATERING OR DEMUCKING ANY STRUCTURAL REINFORCEMENT
JANDY FLOWPRO PUMP 2 HP[2 SPEED] POOL BARRIER(FENCE TO CODE&BATTERY ALARMS BY OWNER);PERMIT FEES
JANDY 150 SQ.FT CARTRIDGE FILTER ► E a x;
IN LINE CHLORINATOR[NOT INCLUDED IF CUSTOMER BUYS SALT SYSTEM] LIFETIME WARRANTY ON POOL STRUCTURE
" 10 YEARS OF DIAMOND BRITE WARRANTY
TRAVERTINE COPING[6 IN X 12 IN] 3 YEARS OF WARRANTY ON ALL POOL EQUIPMENT
STEPS AND SWIM-OUT BENCH EDGE TILE[BY CODE] 11 YEAR OF WARRANTY ON ALL OTHER WORK PERFORMED
RIVER ROK POOL INTERIOR SURFACE PLASTER
' NOTES
.:.+ 5.�,. >'!' via r,�y °..., :r .,,.w..;.._ .t,t;- `�F•W%,. �S 5�`3' -�' 3i�'�f
JOB SITE CLEAN UP AND 30 DAYS CHEMICAL MAINTENANCE
FINAL WALKTROUGH WITH CUSTOMER
' �5fi, x.u;.k..,s��4.d...�'t'g`'"�3 .err � �v ?�� ,..��w4r s4�+ �U �n-�,r�.y�`t.Y",,"'r.��,,:. •_ �.
oe
ROSMEL POOLS,INC SALES ASSOCIATE &WC&'WXUTHORJZED SIGNATURE
THIS"CONT-AAMS.NOTMAUDAMCMA Pii<O
C.OWNER �RONf ROSMi.PLS,111t , ¢
This contract,including the general terms and conditions on the reverse side hereof,which are incorporated herein by reference,constitute the entire agreement between the parties hereto and is not
binding upon contractor unless and until same is accepted in writing by a duly authorized officer or agent of contractor.Contractor shall not be bound by any oral or written statements or
representations not included in this contract which have been made or may be made by any persons purporting to act for or on behalf of contractor.This contract supersedes any prior written or verbal
agreements,which shall all become null and void with the signing of this contract.All prior agreements must be included in writing in this contract In order to be valid.
10
,oil u1111, Miami shores Village
Building Department
1pRlpA 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 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:
Owner
State of Florida
County of Miami-Dade
The foregoing was acknowledge before me this S day of Ju ,2015 .
By ay C.—Y, CC.,_ who is p rsonally kn to or has produced
as identification.
Notary: �y.
SEAL: 0Ao',IY P
Luz HeleA9 A1W11
. Ma_ # 81R.; 5
"EXPIRES:
MAY 19,2017
,iaaapos��p`
MWAARONNUI-
ROS MEL
�ffi-
POOLS & OUTDOOR ENVIRONMENTS
Date: 0 U151 J®15
State of FI or--# A a
County of 170.J.0-
Before me this day personally appeared W'i r-t ha Q&v e l a. who, being duly sworn deposes
and says:
He or she will be the only person working on the project located at:
c►S0 OE: 01551• W" M*' Shores F L 3---1-13t
Sworn to(or affirmed)and subscribed before me this S day of
20 15 by
Personally known
Or produced identification
Type of Identification produced
I_ua Helew Agumn
.�� `•• ..
'":�'•' •�+"eWMMISSION#FF019058
,2017
`° VIZRONNOTARMW
Print,Type or Stamp Name of Notary
8045 NW 36 Street-Suite 540 Doral- FI 33166 Sales 305-592-7900
Fax 305-592-7997 www.rosmelpools.com
CPC-1456804
' 06/17/2015 14:10 3052281525 CITINSLRANCE PACE 06/31
,..
aR CERTIFICATE OF LIABILITY INSURANCE as xfi
r THIS i ATE m ISSm AsA TfBR OF INFO ONIOt;:,
t'l�INBG1iANC34 ARCS' CORP ONLY AND CONFERS NO RIGHTS UPON THE CMtnFICATS
!• ., HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTENT? OR' ' .
NZOT JF AGZZR Or ,64IT,8 213 ALTER THE COVERAGE AFFORDED BY THE POLICIES 8[1
M, Z FL 33844 INSURIM AFFORMNQ COVERAGE =J
y ,,1 ,R05=Z ,P00LBr IIOC. INSURERA:COLONY Ilit'StlRA1y1C$ COMPANY
8045 Im 36 ST., S=2w $40 INSUIRER0
DORAL, IPL 33866 INSLRiERI}
GPS
UCIES OF INSURANCE LIMO BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE ICOR THE POLICY PERIOD JNDICATED.NOTW1TF18YANDt(Z�'3,
-
ANI"' QUIREF,MIENT,TERM OR CONDnMN 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
ICES,AGGREGATE uMiTB SHOWN MAY HAVE BEEN REDUCED BY PAip CLAIMS.
TYPE OF INStRANCE POLICY NMBIR T e LIMITS
�d6RH.LABILITY EACH OCCURRENCE $1,0000,a ao'' .
IAL GENERAL L muN 0111E WMAGs cm RM) $ 100,00
OLAIMSMADE ®OCCUR MEDW ony ons mm) s 5&0
GU026239-01 06120115 06120116 PJ3RSONAL&ADVINIURY s1,oao a A
r
G GLNFRAL.AGM13ATE 51 a s o,o o
AW04ATE L[Wr APPLIES PBFZ PRODUCTS.COW?10F AGG 111,000g-0
.
PRa LOC
1 9QMONLE UAMUW y'
1
COM8Ml2LE LUT $
Itv3 ANYAUTO ACtntl a.'
ALL OWNED AUTOS �L NJtiRY
SCHEDULED AUTOS $
HRRED AUTOS 80DILY INJURY
NON DAUMS (Fst80tJfQ811t) S
FROMTY DAMAC
(Iver sol} $ .t�..
p s4 ELIABILITY AUTO ONLY.EAAC,C=NT S
SgWAUYO OTHERTHAN EAACC i
R v.. y.
AU10Ow_r. AGO $
LIABILITY EACH OCCURRENCE $
<` UR CLAWWOE AGGREGATE $ :r. .'?•J.
s+ .GBDUCTRU
+•';3' k• •RETEhI'TtON
WABLITY
E L EACH ACCID54T $
. ILL.OW •EA EMPLOYSE
i;r fir.
ELL OME SE-POLICYUMIT $
••OTHER
ii
0 PTI�V OF OPElATIOM6IL000 AD=BY ENDDRBEMEN`rM4K3AL PROVISIONS
'• :•fir `:.:•:
Ir TB HOLDER AobflTOMAL eT IMBURER CANCELLATION
SHOULD ANY OP THE ABOVE DESCRMW POLIC16 BE CANCELLED SM0 TW Mow- e.
IdIA>'ET SHOR>!39 VILL'1t^sIS aIItLs?IXCd DPT DATE TI83REOF,TME 198URdCi INBt1RBR awL1.IINWAVOR TO aeaL DAYS
10950 K.8 2JM ILt►.$. NOT=TO THE CERTIFICATB HOLDER MWMW TO MiE LEFT.BUT FAIUMTO DO soSMA�
JMTAJU BSORL$, FZ 33138 IMP*=NO OBLIGATION OR UAlfUW OF AMY FM UPON THE MUCK tis AGENTS
�:�.sy#..• TiVB, w•i•:i.
Esus(7197) 0 ACQRD U31R iAnON 1988 .
t
pill 1111111111 11111!!I!!111111!11 I IIII!IIII 11111 '
CFN 2011RO230798
OR Sk 27646 Pss 0982 - 9861 (Sass)
RECORDED 0411112011 11:47:.59
HARVEY RUVIN► CLERK OF COURT
DOCUMENT COVER PAGE MIAMI-DADE COUNTY► FLORIDA
For those documents not providing the raluked
space on the fit page,this cover page must be attached. i illi!!11111111111 Hill 111111111111 Bill 1111 IN
CFN 2011RO399654
It must describe the document in sufficient detail to OR ek 27726 Pas 1729 - 17930 (Sass)
prohibit its transference to another document. RECORDED 0611712011 16:01:33
HARVEY RUVIN► CLERK OF COURT
An additional recd fee for this MIAMI-DADE COUNTY► FLORIDA
riling page must be remitted.
ft—above the fire uvea far,�og oltice up)
Document Title:
Azl_ ow 4 z /10 jWJ_j
(Mortgage,Deed,Construction Lien,E
Executing Party:
Legal Description:
(If Applicable)
As more fully described in above described document.
Return Document To/Prepared By:
Cr A
F.S.695.26 Requirements for recording instruments affecting real proms
(Relevant excerpts of statute)
(1) No Instrument by which the title to real property or any Interest therein is
conveyed, assigned, encumbered, or otherwise disposed of shall be recorded by the
clerk of the circuit court unless:
(e) A 3-inch by 3-Inch space at the top right-hand corner on the first page
and a 1-Inch by 3-inch space at the top right-hand comer on each subsequent page
are reserved for use by the Berk of the court...
CLINGY 156 Rev.04M 1
Book27726/Pagel789 CFN#20110399654 Page 1 of 5
• Return to:CC(,At, fill 1111111111111110111111111 1
r *.Guaranty Trust&Title,Inc
1909 Tyler Street,Ste 306 OR Bk 27201��RO 1344664 5141 Goss)
H011ywood,FL 33020 RECQRDED 03/01/220it 189331!7
PREPARED BY AND RETURN TO: HEARRVVEYY RUVIMr4CLLER OF COURT
MYRON SANDLER, ESQ. MIAMI-OADE COUNTY. FLORIDA
4020 Sheridan Street
Hollywood,Florida 33021
WARRANTY DEED
This WARRANTY DEED made the a_ day of V444 2011 by
PEGGY L. BORUCHOW,AN UNREMA.RRIED,whose address is 1393 F s Drive East,
Highlands,NC 28741,party of the first part,hereinafter called the Grantor,to EDUARDO
J. VERA AND KATHRYN ROONEY VERA, HUSBAND AND WIFE, whose address
is 950 NE 95 Street, Miami Shores, FL 33138, parties of the second part, hereinafter
called the Grantees.
(Wherever used herein the terms "Grantors"and "Grantee" include all the parties
to this instrument and the heirs, legal representatives and assigns of individuals, and the
successors and assigns of corporations)
WITNESSETH: That the Grantor for and in consideration of the sum of TEN
($10.00) DOLLARS, and other valuable considerations, receipt whereof is hereby
acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys and
confirms unto the Grantees all that certain land situate in Miami-Dade County, Florida,
*****ThisvWied is beihq re-recorded to add the legal description which was erroneosuly
cmmitted.**
EXHIBIT A ATTACHED HERETO
**This Deed is being re-re-recorded to addthe folio # that was erroneously ommi,tted.***
SUBJECT TO:
1. Conditions,restrictions, limitations and easements of record if any,the setting
forth herein of which is not meant to reimpose same.
TOGETHER with all the tenements,hereditament and appurtenances thereto
belonging or in anywise appertaining,
TO HAVE AND TO HOLD,the same in fee simple forever.
AND the Grantor hereby covenants with said Grantees that the Grantor is lawfully
seized of said land in fee simple, that the Grantor has good right and lawful authority to
sell and convey said land, and hereby fully warrants the title to said land and will defend
the same against the lawful claims of all persons whomsoever, and that said land is free
of all encumbrances, except taxes accruing subsequent to December 31,2010.
Book27726/Page1790 CFN#20110399654 Page 2 of 5
f
IN WITNESS WHEREOF,the said Grantor has signed and sealed these presents the day
and year first above written:
Signed,sealed and deliv d
in the presence of.-
(Signature
f(Signature itness 56'em PEGUT1. HORU H w
ow VKL
0
Name Witness)
i
( ted erne of ess)
STATE OF FLOJUDA
COUNTY OF rt/_
The foregoingarranty Dee s sworn to and subscribed before me by PEGGY L.
BORUCHOW,this is, day of2011,who:
( is/are personally known to me;
(U�produced current (State)Driver's License(s)as identification;
,,5U produced i tificati
OF N
P O N TARY
COMMISSION NO.:
MY COMMISSIONEXPIRES:
W aim How"
rhdo
Book277261Page1791 CFN#20110399654 Page 3 of 5
Agent's File Number: 100404
EXHIBIT 'A'
LEGAL DESCRIPTION
The following described portion of Lot"F"as shown on Plat of Government Lot 4, of
Section 5, and the North 1/2 of the NE 1/4 of the SE 1/4 of Section 6, Township 53
South, Range 42 East, recorded in Plat Book 5, at page 90, of the Public Records Dade
County, Florida, to-wit:
Commence at the northwest comer of Lot"F"of Plat of Govt, Lot 4, of Section 5, and N
1/2 of NE 1/4 of SE 1/4 of Section 6 of Township 53 South, Range 42 East, Dade
County, Florida, according to the plat thereof recorded in Plat Book 5, at page 90, of the
Public Records of Dade County, Florida;thence run east along the north line of said Lot
"F"for a distance of 208.5 to a point of beginning; thence run south along a line parallel
with the west line of said Lot"F"for a distance of 220 feet to a point;thence run east
along a line parallel with the said north line of said Lot"F"for a distance of 100 feet to a
point;thence nun north for a distance of 220 feet more or less to a point on the north
line of said Lot"F", said point being 100 feet east to the point of beginning; thence run
west along the north line of said Lot"F"for a distance of 100 feet to the point of
beginning.
Folio# 11-3205-007-0120
Book27726/Page1792 CFN#20110399654 Page 4 of 5
• OR SK 27602 PG 1514
• LAST PAGE
OR BK 27648 PG 0986
• MIAMI SHORES VILLAGE GE
Building Department
10050 NE 2 Ave, Miami Shores FI, 33138
Tel: 305-795-2204- Fax: 305-756-8972
Permit No. REOC-2-11-188 4
�ra
MU
Certificate Of Re-Occupancy
Address: 950 NE 95 Street T
City: Miami Shores Village
State: Florida
Zip: 33138 y
b
This certificate verifies that the referencero W
p party has been inspected by Miami Shores
Village and has been determined to presently comply with schedule of regulations of
Miami Shores Land and Development Code pertaining Solely to the requirement that
. each one-family dwelling is used and intended to be used for a one-family dwelling
purpose only; however, this certificate does not constitute any representation or
warranty as to the condition of the dwelling or other structures on the premises
described herein, or any aspect of such condition, and interested persons are advised
and encouraged to make their own inspections of the premises in order to determine the
condition thereof.
Building Officials;Approval:
✓ivnan, CBO
2!0 �
•
Book27726/Page1793 CFN#20110399654 Page 5 of 5
6/542015 Property Search Application-Miami-Dade Countv
� a � THE
PROPERTY
Summary Report
Generated On:6/5/2015
Property Information ..
Folio: 11-3205-007-0120 t
r -
Property Address: 950 NE 95 ST ;
EDUARDO J VERA
Owner
KATHRYN ROONEY VERA
Mailing Address 950 NE 95 ST
MIAMI SHORES,FL 33138
Primary Zone 1400 SGL FAMILY-3001-3250 SQ
Primary Land Use 0101 RESIDENTIAL-SINGLE
FAMILY:1 UNIT
Beds/Baths/Half 5/4/1
Floors 2
Living Units 1
Actual Area 4,393 Sq.Ft
E
Living Area 3,415 Sq.Ft
Adjusted Area 3,626 Sq.Ft
Lot Size 22,000 Sq.Ft Taxable Value Information
Year Built 1962 12015 2014 2013
County
Assessment Information Exemption Value 1 $50,000 $50,000 $50,000
Year 2015 2014 2013 Taxable Value 1 $490,347 $486,059 $478,137
Land Value $670,956 $594,412 $401,856 School Board
Building Value $126,185 $122,921 $122,921 Exemption Value $25,000 $25,000 $25,000
XF Value $3,300 $3,330 $3,360 Taxable Value 1 $515,347 $511,059 $503,137
Market Value $800,441 $720,663 $528,137 City
Assessed Value $540,347 $536,059 $528,137 Exemption Value 1 $50,000 $50,000 $50,000
Taxable Value 1 $490,347 $486,059 $478,137
Benefits Information
Regional
Benefit Type 2015 2014 2013 Exemption Value $50,000 $50,000 $50,000
Save Our Homes Cap Assessment Reduction $260,094 $184,604 Taxable Value 1 $490,347 $486,059 $478,137
Homestead Exemption $25,000 $25,000 $25,000
Second Homestead Exemption $25,000 $25,000 $25,000 Sales Information
Note:Not all benefits are applicable to all Taxable Values(i.e.County,School Previous OR Book-
Board,City,Regionaq. Sale Price Page
Qualification Description
02/03/2011 $0 27648-0982 Corrective,tax or QCD;min
Short Legal Description consideration
5-6 53 42.506 AC 02/03/2011 $675,000 27602-1512 Qual by exam of deed
PL OF GOVT LOT 4 PB 5-90 02/03/2011 $0 27726-1789 Corrective,tax or QCD;min
BEG 208.5FTE OF NW COR LOT F I I consideration
S220FT E100FT N220FT TO N/L LOT F 12/13/2010 $100 27525-4130 1 Life Estate interest
W10OFT TO POB
The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property
Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at hftp://www.miamidade.gov/info/disclalmer.asp
Version:
SgORFS
Miami Shores Village
Building Department sell
10050 N.E.2nd Avenue
Miami Shores, Florida 33138 h �6
el: (305)795.2204
F . 305) 756.8972
Page 1 of 1
Permit No: 13 1 S- f S� 9
M.
Structural Critique Sheet
'X'f s +k-th.L
s
ao A 0 1 49 L4 e
STOPPED REVIEW
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.
Mehdi As of