Loading...
PL-15-2036 E .,cYMT a 9 Miami Shores Village 10050 N.E.2nd Avenue NW jy Miami Shores,FL 33138-0000 Phone: (305)795-2204 Expiration: 21/201 EV Project Address Parcel Number Applicant 68 NW 100 Street 1131010180460 Miami Shores, FL 33150- Block: Lot: ARTHUR MCDEVITT Owner Information Address Phone Cell ARTHUR MCDEVITT 68 NW 100 Street MIAMI SHORES FL 33150- 68 NW 100 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone Valuation: $ 500.00 La Casa de las Piscinas Inc Total Sq Feet: 0 Type of Work:POOL REPAIRS Available Inspections: Type of Piping: Inspection Type: Additional Info: Main Drain Bond Return: Final Classification:Residential Scanning:1 Rough Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee Invoice# PL-8-15-56694 $2.25 08/25/2015 Check#:275 $159.10 $0.00 DCA Fee $2.25 Education Surcharge $0.20 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $159.10 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction a d zoning. Futhermore,I authorize the above-named contractor to do the work stated. August 25, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy August 25,2015 1 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-241276 Permit Number: PL-8-15-2036 Scheduled Inspection Date: December 02,2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: MCDEVITT,ARTHUR Work Classification: Pool - Private Job Address:68 NW 100 Street Miami Shores, FL 33150- Phone Number Parcel Number 1131010180460 Project: <NONE> Contractor: La Casa de las Piscinas Inc Building Department Comments POOL REPAIRS Infractio Passed Comments INSPECTOR COMMENTS False !Inspector Comments Passed E�/ 6 Failed / l `J Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. December 01,2016 For Inspections please call: (305)762-4949 Page 6 of 40 Miami Shores Village -r Building Department AUG 12 2015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 1 Tei:(305)795-2204 Fax:(305)756-8972 L INSPECTION LINE PHONE NUMBER:(305)762-4949 c�C°i FBC 20 14 BUILDING Master Permit No. SVP- LS PERMIT APPLICATION Sub Permit No. - C 5-- ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL PLUMBING ❑MECHANICAL ❑PUBLIC WORKS E] CHANGE OF ❑CANCELLATION [:] SHOP CONTRACTOR DRAWINGS i �s JOB ADDRESS: � ? ✓G� �) ::�7' ` Miami Shores County Miami Dade z1D• / -5--D FoIIq/Parke : 1s the Building Histortcally Deslgrated:Yes NO Occupancy Type: Load: Construction type: Flood Zone: BFE: FFE: �c � f� /e-Pi Phone: OWNER:Name(Fee Simple TFdehotder): /C) �• -'Ille— Address: qty; '� r `' Z® CA State Zi 'Lp: J Tenant/lessee Name: Phone# Email: �-� lc CONTRACTOR:Company Name: v_� Phone#: Address• O`Cw- J� state: f- G Zip: 1 .f Qualifier Na me• 3 C_ l v �e Phone.#: State Certification or Registration#: G i�C `� / Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: -State, Zip: Value of Work for this Permit:$ � P r Square/Unear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New L_1 Kepair/Replace ❑ Demolition Description of Work Specify color of color thru tile: Submittal Fee$ V Permit Fee$ w i7 CC$ CO/CC$ scanning Pee$ Keeton I"$ DBPR$ Notary$ Technology Fee$ TrainkWEdueatlon Fee$ Dobe Fee$ Structural Reviews$ _____ Bond$ TOTAL FEE NOW DUE$ I S9 e (ReafsedWA4r"4) n w " Bonding Company's Name(if applicable) Bonding Company's Address City State ��� Tip Mortgage Lender's Name(if applicable) A Mortgage Lender's Address s° city / State Zip Application Is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the Issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500,the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. t Signature Signature CONTRACTOR WNER or AG NT The foregoing in ment was acknowledged before me this The foregoing instrume owledged before me this day of I IC dJ a- ,2t) LT by ! day of ' 20 .by tp Luej 1 C.6 ro is personally known to Y" ►"�� C, 7 gis Personalty known to me or who has produced ! ' L- as me or who has produced as identification and who did take an oath. Identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign* Print: a exb%-- Print: Seal: Seal: �,ot"�p'e., VIVIANA GARCIA * Notary PWft-Side of Florida .•ki��"''' MARIE FI(tUEROA MYChun.i Jvn 27.2016 a08 � :y' Notary Public•State at Florida Comminift0 EF 2121 sssssss � I11$'I�'lNtB:'�iR�1112Pg, s**+�*ssssssssss.****** s* w. ssss**** +•���OF F� ••' Commission#EE 879464 APP Plans Examiner Zoning •IIIHF Structural Review Clerk IRe0%d02/24/2014i Jun,01 1�09:52a LACASA/PERM IT SO LVER 1-305-647-7685 p.2 KEN LAY4501%SEGFtE GARY RICK SCOTT,C:OVERNOR STATE OF FLORIDA REGULATION - DM%RTMENTBuSMSS AND PROFESSIONAL TRUCTlON INDUSTRY LICEPM G BOARD = - - CONS POQUSPA ISI The RESIDENTIAL . Named below IS CERTIFIED Under the provisdans.of Chapter 489 FS. Exp'ttagm date: AUG 31,2016- 0 RODRIGUM MARIA C }A CASA DE LAS PISCINAS INN 2 MIAMINW 1STH ERRACE ■ ■ 'L� _-_ issuer: oelforZvia 0743DISPLAYAS REQUIRED 6Y LAW S€ # L140MIDO 1 Jun 01 1509:53a LACASA/PERMITSOLVER 1-305-647-7685 p.3 /• ,o2M4 Local Business Tax Receipt Md mi-Dade County. S#ate of. >Florica TFAS M NMA BILL _DoHOTPAY 5637708 EXPIRES NAS INC *WMAL SEPTEMBER 30, •20'15 LA DE IAS p1SCIN6880746 Must be dispiay®d at place of business 2601 NW 18 TM Pucsuantto Couoi Cade N1L4Mt A 33125 Chapter SA—Art.9&10 erzC,Syph OF 13LOIN905 VAYIUIEN C�kY@D awNe� 196 SPECIALTY BUDDING CONTRACTOR By TAx.�...r earott LA CASA DE LAS pLsC NASINC CPC1456Sa7 $45.00 07/11/2014 Worker(s) 2 CREDMRD—I4-026424 r�me �ofR mel�o]�- + ca�°' t° N � r �s� i or negp"fr MM,mgubftgy laws aad nq WM&ai m @te 6 Ti.aeffiq No.nbgte gnat bedWaVW an an COMM WveL'rcles-Nfamdv_oaft ewle Sec So-M —�4J-.1011[IVR1fd'Ol�w� �a� t100r _ t Jun 01 1509:52a LACASA/PERMITSOLVER 1-305-647-7685 P.1 Repod Viswet 4214 i JEFF A'tAWTMSTATE OF'FI-oIDr<1 CtaEF PISA-OMCM DEPARTMENT()F F'WWCIALSERVICES DIVOM OF WORKERS'Cp1MPENSAT*M ••CERTIFICATE OF RC1 H TO BE MMMPT FROM FLORIDA VJORKERV COMpgNSA"M N LAW. CONSTRUCTION INDUSTRYon taw Tt�is gmtlhe indfMMdual Ifsted baba has eleded W be e7p mt from Flo Tf2'11Wa w20► �,COmpat�satii �ECTIVE DAM 212312x15 C pER50N: ItpDRIGUEZ MARIA FOH; 650219797 $USMESS NAIVE AND ADDRESM LA CASA DE LAS P1.SCIMPS MC 2601 law 1S TERR MIAMI FL 33125 SCOPES OFBUSINFSS OR TRADE LIabWrRACENSED PCK)L TCR p�./.�ootmC 'MO�SI�+aT•RS.a�6Hmcasm4 Od�'era°y0mton EII'dy `!u it�ttf+s��� �7anC�7safdbf�la0. loQRSP1ar4�6LQ'L91.Fa$cglB� m� ems- 6mo�+'fe6�9 d?q tlnaa94o1w eum�ad °1o1vdivP�° •7+uamauT;o�mrv�oea9�Rd�:.eua+txk.W�cl aae[nA�e•TM'°�°rtn'etN'�m�okco Maae��naomeeadoeamtitamroia��ae �no►�X73-7sos ', DFSF2-DYJG25ZCaMFr-KM OF ELW71C u TO BE E7OWT FE MASW 0&73 �pppN4?�CeIrDRGXV W... ht�s-ll �.comlerrepo�naw�l�eportVle�►e�� ►tcBD7(�Ii6fER6eP7 Jun. 1. 2015 10: 38AM TORRES INS AGENCY No- 4156 P. 1 A�R�� CERTIFICATE OF LIABILITY' INSURANCE 6/1/2015" THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the cettllleate holder Is an ADDITIONAL INSURED, the policy(les)must be endorsed. If SUBROGATION 15 WAIVED,subject to the terms and conditions of the policy,eettaln policies may require an endorsement. A statement on this certificate does not confer tights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Karla BArnat Torres Insurance Agency Inc. PHONE (305)57.2-5880 C No:(305)518-5651 6135 NW 167 STREET # E25 E'MAIL ADDRESS.kbernet@torrosinsuraneeagency.cam INSURER(S)AFFORDING COVERAGE NAZCA Miami Lakes FL 33015 INSURERA:COv±n 'ton Specialty Insurance INSURED INSURER B La Casa Ae Las P±solnaa, Inc. MSURBRC; 2601 NW 18 Tarr INSURER D: INSURER E• Miami FL 33135 INsuRSRr-- COVERAGES CERTIFICATE NUMBER:CL151722972 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP wwh POLICY NUMBER_ IMwDD1yyM IMWDDNYYYILIMITS GENERAL LIABILITY EACH OCCURRENCE $ 500,000 X COMMERCIAL GENERAL LIABRITY EPREMISES(EA oCgf7enG9I $ 100,000 A CLAIMS-MADE F0ODOUR 3$1053-00 1/8/2015 l/8/207.6 MED EXP"one person $ 5,000 X $500 RX/PD PER CLAIM DED PERSONAL&ADV INJURY $ 500,000 OE14ERALAGGREOATE 3 500,000 GEHLAGGREGATELIMITAPPLIESPER: PRODUCTS-COMPIOPAGG S 500,000 X POLICY PROLOC g AUTOMOBILE LIABILITY 'd t U 1 ANYAUTO BODILY INJURY(Per perron) S ALLpWNEO SCHEDULED AUTOS AUTOS BODILY INJURY(Peezaideaij S NO -OHIREDAUTOS AUT SEED PHO AMAOE $ S UMBRELLA LIAROCCUR EACH OCCURRENCE $ 4EXCES$UAB HCLAIMS-LIADE AGGREGATE $ 0EO RETENTIONS S WORKERS COMPENSATION VVC STATU- 107w AND EMPLOYERS'LIABILITY YfN ANY OFFICER dEMBER�EXCLUDEO?�UnVE N rA E.L.EACH ACCIDENT S (Mandatory in NH) E L DISEASE-E0.EMPLOYEE g Ry a 2"f"under DESGIRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES `A((aehACORD 701•A6diUonel RemMe Schedule,II more spaoo Is requTred) Swimming pool installation service & repair located at 2601 Nlw 1S Tarr Miami, 8'1 33135 CERTIFICATE HOLDER CANCELLATION (305)7S6-0972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami. Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. Building Depatmentr 10050 NO 2nd Avenue AUTHORIZED REPRESENTATIVE Miami Show Village, FL 33138 ACORD 25(2010106) ©9988.2010 ACORD CORPORATION, All rights reserved. 1N8025(201005).ol The ACORD name and logo are registered marks of ACORD I Miami shores Village L% .�d Building Department _ � R1DA 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation Insurance Exemption 4= 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 r� The foregoing was acknowledge before me this / day of ,As yJ f ,20 IJ7 By r-C e n"&LA Q a%%Q; who is personally known to me or has produced L as identification. Notary: SEAL: MARIE HGUEROA _ °E Rotary Public-State of Florida 'E 7 •.,�Fo fid;°' Commission#EE 672464 n JW. LA CASA DE LAS PISCINAS INC/2601 nw 18 terr.Mia F1.33125 Swimming pool company State of Florida County of Dade Before this day personally appeared, Maria C. Rodriguez , who being duly swom, deposes and says that she will be the only person working at the project location at 68 nw 100 St, Miami Shores, FI. 33150. Sworn to and subscribed before me 7 th day of August,2015 By Maria C.Rodriguez Produced ID by drivers license#R362543476230 Viviana M. Garcia Notary public EE212108 + Way PGT-Stdo of Ro • my Cm.Egon J"27.20 16 C� EE 2/21 ,, MSM MWont