MC-13-854 A
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-223141 Permit Number: MC-4-13-854
Scheduled Inspection Date: December 01, 2014 Permit Type: Mechanical - Residential
Inspector: Perez,JanPierre
Inspection Type: Final
Owner: HOLT,JAMES Work Classification: Pool Heater
Job Address:361 NE 97 Street
Miami Shores, FL 33138-0000 Phone Number
Parcel Number 1132060135760
Project: <NONE>
Contractor: SWIMMING POOLS OF FLORIDA INC Phone: (305)597-3950
Building Department Comments
MECHANICAL WORK FOR SWIMMING POOL Infractio Passed Comments
CONSTRUCTION INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-189931. CANCELLED BY
ESTEVAN CONTRACTOR 305-597-3950
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
November 26,2014 For Inspections please call: (305)762-4949 Page 14 of 27
- ,
Miami Shores Village '''
Building Department V
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER: (305)762.4949
FBC 20
BUILDING Permit No.
PERMIT APPLICATION Master Permit No. CJI ?
Permit Type: MECHANICAL
JOB ADDRESS: V J
City: Miami Shores County: Miami Dade Zip: ItL
Folio/Parcel#: Z��n bl
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): Phone#:
Address:
City: State: Zip:
Tenant/Lessee Name: Phonek
Email:
CONTRACTOR:Company Name: `/S Phonek
Address: ( %-A ow
City: 1 State: Zip: ��k l(
Qualifier Name: P Phonek
State Certification or Registration#: r Certificate of Competency#:
Contact Phone#: �, Sdf c�� �� Email Address: Cgp n S� 6D `�j pn 1 > ( )on.
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:3 1 Square/Linear Footage of Work:
Type of Work: ❑Address ❑Allteration ❑New I ❑Repair/Replace ❑Demolition
Description of Work: 1200) rYl eG�� )1 ,5 t(21 J 0i—t! 6 n
�x���:������+x�*��xxxx�x�:x�:x*�*�•xx�x�xx�x
Submittal Fee$ Permit Fee$ r 0�V t)e CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$ lYL
11 '
1
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
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 n4earovd and a reinspection fee will be charged.
Signature Signature
Owner or Agent C actor
The foregoing instrument was acknowledged before me this v� The foregoing in trument was ackno dged befor,m this C)
day of ,2013,by �YYI eF. � C�� 1 T, day o i -120 j3 by � r,(�Y��
who is personally known to me or who has produced aijnP who is personally known to me or who has produced�'L�nV
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC NOTARY BLIC:
Sign: Sign: X 114r?
�' A E Y ublP
Print: ' Not #AE1 Print
Ex Malortda �/ �„�,• COM Mar?,# 2018
My Commissio x�i „,�:•� Commission! E 2016 My Corn t EE 176938
E 178938
��xxxx*x�x�*�*x�*�*��x�x�����«*xxxa•xxx:x�x*xx��xxx�*�mxx�x*�xxxx�x*x�*x*��*xxxx:xx��x�*xxxx���*�*x�x>K�xxx*xxx
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
ORR
Miami shores Village
Building Department
10050 N.E.2nd Avenue
OR Miami 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) acknowl dge that a newkswimm g pool, spa hot tub will be constructed or installed at
2�4f Il�- Q� I'S IV ;710t,0t• % , CAS 1�1-_Miami Shores, FL, and hereby
affirm that one of the following methods will be used to meet the requirements of Chapter 515,
Florida Statues and the Florida Building Code R4101.17.
Please initial the method(s)to be used:
The pool will be equipped with an approved safety pool cover that comp lies with ASTM
F1346-91.(Submit Manufacturer's Specifications).
A continuous,one-piece(child)barrier meeting the requirements of Florida Building Code
R4101.17.1.15 will protect the pool perimeter.The plans shall show the fence location and method of
attachment,including one end that shall not be removable without the aid of tools.(Submit Manufacturer's
Specifications).
A combination of non-dwelling walls and fences(screen enclosure,child fence,masonry
fence walls,chain link or wood fence,etc.)will protect t he pool perimeter.The plans must specify t he type
and location 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,R 101.17.1.9(Submit Manufacturer's Specifications).
Any combination of protection which incorporates dwelling walls with openings directly into the
pool Oe4neter and all doors will be equipped with a self-latching device with positive mechanical
latching/locking installed a min.54"above the threshold. If this option is selected,submit plans showing all
types and location of all perimeter protection.The plans must also show the location and type of all
openings,and the hardware type for each location.(Submit Manufacturer's Specifications).
In accordance with the Code,the pool may not be filled with water without compliance with the
Private Swimming Pool Safety Requirements,and upon expiration of the permit,the pool shall be
presumed to be unsafe.I understand that not having one of the above installed will constitute a
violation of Chapter 515,F.S.,an d will be considered as committing a misdemeanor of the second
degree,punisha s provided in Section 775.082 or Section 75. F.S.This form must be signed
by the owner/a t d the prime contractor.
CO RA 0 ' S G ATUR AN DATE
ANGELA A w
CONTRA PRINTMar 7,2016 WNE I3VfTLA 9AEZ
om ssion#EE 176938 _ r �'State of f
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NOTARY PUBLIC EE 1769301e
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Building Department
OR to
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
WIMMING POOL OWNER'S CERTIFICATION
Date Z-o A Q I --;s
Miami Shores Village
Building &Zoning Department
Attention: Building Official
I certify that I am the legal owner of the property described as
19 Z 20 Unk qL located at �)(Or o c q - S�
\ ami s�er i es .
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
pool. r
Legal Owner
Note:This certification is to be submitted with a swimming pool permit application in duplicate.
Miami Shores Village
Building Department
SPR 17 2014
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
�J Tel:(305)795.2204 Fax:(305)756.8972 _"ar
INSPECTION'S PHONE NUMBER: (305)762.4949�Y'
FBC
BUI LDI NG Permit N � -�`7
PERMIT APPLICATION Master Permit No 13— es-1—
Permit Type; M ECHAN"I//CAL r&'
JOB ADDRESS: . V V1;+-
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: t l nj&6- -&113 v e
I sthe Building Historically Designated: Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): V(i nets Phone#:
Address: Ala q7-4't
City: e4.h'Li 9 2oy-eJ State: �� Zip: 33 05 .
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: 51jly'*h I r U PceRCY' % Phone#: _306-597-3750
Address: e I Il'1 " 56 '5--�
City: A.i`A.l'y * State: Zip:
Qualifier Name: Ni r YVt1P,l 4/ew1r.tVj,-Z Phone#:
State Certification or Registration#: U�G"j /cam;�68 Certificate of Competency#:
Contact Phone#: Email Address: CO3 S-pa T--/-Ccen
DESIGNER:Architectngineer: 00 Phone#: -3c)5- ;;?6'1-
'E �l
Do
Value of Work for this 6C3 Squarefl-inear Footage Work:
Typed Work: ❑Add ss B ❑Alterati &New ❑Repair/Replace ❑Demolition
De=lptlon d Work:
et*h,,,yo,cro
es
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$
1 NNIN,
. . 1
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
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 commencem must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the a se c such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
QV—
Signature Signature
Y, Ow r or Agent Mntractor
The fore ingi strument was ackledged before The fore Ming i strument was acknowl dged befo e m this,
day of ' .20��by _J�-�-' 'S m s day of ,20� by �n 6 �
w is personally known to me or who has produced who's personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTA R IC: NOTARY P LIC:
Sign: Sign: ny
Print: 3°tea ;t Florida Print: _ a
- My Comm. Exp n: Phar 7, 201 b %;' •�� MY mm. Expues Mar 7,2016
My Commission Exp My Corr= iofi, ,. s: Commission u
Q FOF F,;r`' Commissic'] a t_t '�h4s8 EE 176938
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APPROVED BY 1 �la s Examiner Zoning
Structural Review Clerk
(Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)