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BPP-15-2335 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-243452 PermitNumber: BPP-9-15-2335 Scheduled Inspection Date: January 12,2016 Permit Type: Pools/Whirlpools/Hot Tubs Inspector: Rodriguez,Jorge Inspection Type: Final Owner: RESPONDEK,CAROL Work Classification: Addition/Alteration Job Address:1162 NE 105 Street Miami Shores, FL 33138-2108 Phone Number Parcel Number 1122320280150 Project: <NONE> Contractor: ALL FLORIDA POOLS AND SPA CENTER Phone: 305-893-4036 Building Department Comments RESURFACE EXISTING POOL WATERLINE TILE Infractio Passed Comments COPING SAND SET PAVER SYSTEM OVER EXISTING INSPECTOR COMMENTS False POOL DECK Inspector Comments Passed I Failed e- Correction Needed Re-inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid January 11,2016 For Inspections please call: (305)762-4949 Page 6 of 34 Fte �C 8 � �.23: 5 r sK„oR i, Miami Shores Village ■ Peat TY islI?tirinaolslHQt Tubs 10050 N.E.2nd Avenue NE Dark Acidlt>onlAlterat on "• ""'� Miami Shores,FL 33138-0000 '°�arssm ` Phone: (305)795-2204 „ gate 1 ?l1912015 Expiration: 0411612016 Project Address Parcel Number Applicant 1162 NE 105 Street 1122320280150 CAROL RESPONDEK Miami Shores, FL 33138-2108 Block: Lot: Owner Information Address Phone Cell CAROL RESPONDEK 1162 NE 105 ST MIAMI SHORES FL 33138-2108 Contractor(s) Phone Cell Phone $ 27,000.00 ALL FLORIDA POOLS AND SPA CENT 305-893-4036 Valuation: ._. Total Sq Feet: 00 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:RESURFACE EXISTING POOL WATERLI� Bond Return: Wall Steel Classification:Residential Scanning:3 Review Planning Review Building Review Building Review Plumbing Review Electrical Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $16.20 Invoice# BPP-9-15-57082 DBPR Fee $12.15 10/19/2015 Check#:310546 $836.50 $50.00 DCA Fee $12.15 Education Surcharge $5.40 09/15/2015 Check*310326 $50.00 $0.00 Permit Fee $810.00 Scanning Fee $9.00 Technology Fee $21.60 Total: $886.50 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 assu responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELE41rt' BING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDall foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and I authorize the above-named contractor to do the work stated. October 19, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy October 19,2015 1 Miami Shores Village ' ' ' BuildingDe artment Fny EP 152015 i, p _ 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 2(' r/% BUILDING - Master Permit NoRY29 4!, PERMIT APPLICATION Sub Permit No. &/BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION RENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS CHANGE OF ❑CANCELLATION SHOP L CONTRACTOR DRAWINGS JOB ADDRESS: �+a N£ 10Sj 4 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 110 aa32 — (39•also Is the Building Historically Designated:Yes NO Occupancy Type: Load: (�Construction Type: Flood Zone: BFE: FIFE: OWNER:Name(Fee Simple Titleholder): QAM� 4%j ew be Y, Phone#: Address: Iva, tAs- IQ6A* City: btga, bwa+e State: Zip: ) Tenant/Lessee Name: &AIY Phone#: Email: 'n\ i. CONTRACTOR:Company Name: tom. Lcit4 ���- Phone#: 'TJS %53'"-6L Address: n, ` 1ao b1�C�.�Pt City: ,V l&wl State: TL • Zip: Qualifier Name: .1, to &Vfu-. Phone#: State Certification or Registration#: 4 "'ksi Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑%ff%_-betj%_ Repair/Rep/llace ❑ Demolition Description of Work: 4_Jt e � �tIe `,p SugSun C'xJe.r X��L, Specify color of color th u tile: Submittal Fee$ ro' ®u Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24//27014) r i Bonding Company's Name(if applicable) I✓1� Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) PAy 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. signature"("6( f/L411 Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this (-�� -5 daQ ( T {�y of_ 41, 20 M by i _day of a201S by `!Yn. \ 16 , . e sonally kn who i to *D4yist0 QQ%*V .w anally know to me or who has produced as me or who has produced as identification and who did ke an oath. CDNo �Z identification and who did take OpHEN 17 NOTARY PUBLIC: �SS10N8 p11 NOTARY PUB ►;;°8<�c My MISS�ONE� aj2 Qy PUBS, C� Yo;•"'• * SES.4 etNota�lgeN * so Nomrysvotos � � d 9�b6 '�� gondedttdu8�d9 Sign: b®� Sign: ' rint: Pr' t: Seal: S I: APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) • • • c • :>:• :: • • e • - .w r LICENSE NUMBER r: a, ❑ ❑ f1 5 n 7,�j i 'r•'FF i4 wo2i0.. ' z1,. .. E1d'[` b i�_ •�•L � 1 1 � w � � -1 '•111 1 r1 i L �,s±�� t11iw 11 Z4 } ✓1�Pf t 1�j` p 1 i,� 3 r"2.. �x i �1- � 5�'�k �fZk �`�r"y� fy "6� .t t L �_'^ Y y p o i 3jh, ``x iv bl C} �'1'l1 r 1�.Nii Trk �.Y �,r - dF "xy.w-f'�a; a'•w'vt11 '�'x g �`7n 1.P� rr •">1Hil. i( �¢ rx rF K� ��sa 7 a' v. r v�ga f. asp ' tsa C a,4W 1 `� NO �2 stis ,rt tii. 5 4.iY,�ti v 1 �t t r�yxxtt �y� j a .,��z 4 atal > r. 4vg rt,ztff3� ��,]� �• 1 1:e�'�r �,-�yz "1 z�`���� ��f'�,� �z� - tura' �s r fih �f t'1 ALLFL-2 OP ID:GJ .44cORU DATE(MMIDDIYYYY) 16*� CERTIFICATE OF LIABILITY INSURANCE 06/30/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pol)cy(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Insurance B Ken Brown,Inc. NAME: David R.Griffiths PO Box 94817 ac°Nn o EM:321-397-3870 A No):321-397-3888 Maitland,FL 32794-8117 E-MAIL David R.Griffiths ADDRESS: INSURE S AFFORDING COVERAGE NAIC# INSURERA:Amerisure Ins Company 19488 INSURED All Florida Pool 8:Spa Center INSURERB:Amerlsure Mutual Ins.Co 23396 All Florida Distributors,Inc. 11720 Biscayne Boulevard INSURER C: Miami,FL 33181-3110 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MMIDD MMIDD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 AMAGE TO RENTED- CLAIMS-MADE a OCCUR CPP2030900090015 07/15/2015 07/15/2016 PREMISES Ea occurrence $ 100,00 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,00 GEHL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY jRa � E-1 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident A JX ANY AUTO CA20562960901 07/15/2015 07/15/2016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X NON-OWNED PR PERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 2,000,00 B EXCESS LIAB CLAIMS-MADE CU20562970702 07/15/2015 07/15/2016 AGGREGATE $ 2,000,00 DED I I RETENTION$ $ WORKERS COMPENSATIONPER X I OTH- AND EMPLOYERS'LIABILITY X STATUTE ER A ANY PROPRIETORIPARTNEWEXECUTIVE YIN WC205115707 12/31/2014 12/31/2015 E.L.EACH ACCIDENT $ 500,00 OFFICERIMEMBER EXCLUDED? ❑N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEd$ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Swimming pools-installation,service,or repair-below ground. CERTIFICATE HOLDER CANCELLATION MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ACCORDANCE WITH THE POLICY PROVISIONS. Building&Zoning Dept. Angie AUTHORIZED REPRESENTATIVE 10050 NE 2nd Avenue Miami Shores,FL 33138 ©1988-2014 ACORD CORPORATION. All rights reserved. :ORD 25(2014/01) The ACORD name and logo are registered marks of ACORD SURVEYOR'S REPORT: SURVEY DATE: N ,, , ,, MAP p BOL V DA RY SURVEY LYING AND D BEING IN THE CITY OF SOUTH - REST, 0 EAST A DA The date of completion of original field Survey was on March 28,2014. Aw LEGAL DESCRIPTION: IR Affi West 7 feet of Lot 17 and all of Lot 16 and the East 8 feet of W E Lot 15 in Block 1 of"MIAMI SHORES ESTATES"According to the Plat thereof as Recorded in Plat Book 47,at Page 58,of o the Public Records of Miami-Dade County,Florida. Q Containing 13,500 sq.ft.,more or less,by calculations. cc JLLJ • •+. 0 a �� �I • S .. • PropertyAddress: ; .•••.• 1162 NE 105 Street Miami Shores,Florida 33138 015 30 13 ry •••••• Folio No.:11-2292-028-0150 � • • ACCURACY: > t ��•�� • The accuracy obtained by field measurement methods andffiSCALE ^ � U office calculations of closed geometric figures meets and 1 " = 30' • •• exceeds the Minimum Technical Standards requirement for Suburban Area(Linear: 1 foot in 7,500 feet as d • Rule 5J-17-05 of the Florida Administrative feet) in ode. EAST 7. ri 0 • r• ••••• a Elevations of well identified features as depicted on e E 2 • Survey Map were measured to an estimated vertic �- L: ••••• position accuracy of 1/100 of a foot on hard surf es and I I' I!! U • 1/10 of a foot on ground surfaces. I O W 0- O W J w Well i O dentified f / T "-�-N 0 f- eatures as depicted on the � Pi u e Ma F�: Y � / o U were measured to an estimated horizontal sition p �NIS � (4�� z w accuracy of 1/10 of a foot. r / FOUND IRON —N—OUL— (iJ —01L wM❑D L O U _J � 4 LOCATION MAP I r ,,,✓✓✓ PIPE :::.i� xa '.1. a II'(�,'��;V "II °,, sa (NOT TO SCALE) This Mop of Survey is intended to be display at a scale of ��V �-y � � (NO ID.) L � �� _- I` q Q � � � � One inch equals Thirty feet or smaller. / WALL - L Et FOUND IRON PERTINENT INFORMATION USED FOR SUR 0.2' NORTH I L`h,h lit o I PIPE (NO ID.) IVO0.3' WEST Io 1. � / o tj.: t o GRAVEL North arrow direction is based on an assumed Meridia I� I.L " N I z•a Ic" LL`L` LL WEST 7' Bearings shown hereon are based on the centerline o NE � i I PLANTER I OF LOT 17 105th Street with an assumed bearing of East,said On to be j� Peij7y1( %A /'� 9 9 considered a well established and monumented fine. / 14.35' 20• This property appears to be located in Flood Zone"A L. CLF & WALL 21 � 3.00' 2 90' the Base Flood Elevation being 8.0,as per Federal 0.3' EAST I o $ I CLF Emergency Management Agency FEMA) h Co pmunity-Panel Numberr 12086(Village of Miami Shores), I )RY �w-I' 1.0' WEST Ma No.306,Suffix L,Ma Revised Do e:September 11, i TE 0V 07 21.20' N 2009. 11.60 2nd STORY h � 1 All elevations shown hereon are based on the National 6 w L N G I T V D E Geodetic Vertical Datum of 1929,and a Benchmark 1 , -19 �� 06 9.9'1 LINE (nLo^I 06 supplied by the Public Works Department of Miami-Dade `� I 1 ,, - �j`� �" ,,,J I =____ w w I County,Florida. h V., 1b,", V8V�14. 1-d U41'� Z< 8 � 1=_== ONE-STORY x Z o * g S U R V E Y O R S REMAINDER OF _� - C.B.S.BUILDING J J I i REMAINDER OF Benchmark:B-26-RA Elevation:+17.23(N.G.V.D.29) 3 0 1 �___= HOUSE No.1162 I 1 3900 N.W. 79tH AVENUE,SUITE 601 Located at the NE 105th Street(Biscayne Canal)-Bridge LOT 15 BLOCK 1 o v u7 I Q I LOT 17 BLOCK 1 DORAL, FLORIDA 33166 over Canal. CAIN FLOOR ELEVAMON:7.49 POOL (P.B. 47- PG.58) 1 ADDITION ELEVATION:8.07 PUMP I (P.B. 47- PG.58) PHONE:(305)463-0912 FAX:(305)5I3-5680 (Warranty Deed,recorded on August 2,1991 in Official LU ( _ 1 J WWW.LONGITUDESURVEYORS.COM Records Book 15215 at Page 413,of the Public Records of I - 48.45' 20 2' M Miami-Dade County,Florida.) LO I �_ _ y LEGEND: ,a I Y :V� Legal Description was furnished by client. C.B.S. = CONCRETE BLOCK STUCCO c I o :x-^h T7 `'.: v I c I hereby certify:That this'boundary Survey and the RESTRICTIONS: = CENTERLINE po 1 3 o (M) = MEASURED VALUE N O Survey Map resulting therefrom was performed under Since no other information were furnished other than that is (R) = RECORD VALUE <0- N I LUM 1 3 I I Z my direction and•a true and correct to the best of my C_ _,,. knowledge and belief and further,that said"Boundary cited under pertinent information,the Client is hereby P.B.G. = PLAT BOOK =Z o i 1 P CAL)5 --17 7'-- i (�1r V" � + Survey"meets the Intent of the applicable provisions advised that there may w legal restrictions a the Subject Pc. = PAGE �J J I � J 1 y` of the"Minimum Technical Standards for Land Property that are not shown on the Survey Map that may be AC = AIR CONDITIONING UNI �� found in the Public Records of Miami Dade County. LO 6 a i Surveying in the State of pursuant to Rule C.L.F. = CHAIN LINK FENCE The Surveyor makes no representation as to ownership Or = CHAIN LINK FENCE I �� Surveyin through ate o Florida",Fl i the Florida possession of the Subject Property by any entity or individual WM - WATER METER I e.a I I Administrative5thro Code and its implementing law, that may appear on the Public Records of this County. -.- . WATER METER ST 8 n' Chapter 7 d the d its i Statutes. No excavation or determination was made as to how the R/W - RIGHT-OF-WAY .t�_ OF LOT 15 1 I � `� 4 Subject Property is served by utilities. `til gli. I 1 LONGITUDE SURVEYORS,UCI. I 0.70' C.B.S. I * a Florida Limited Liability Company No improvements were located,other than those shown. CONCRETF_,. _ yyALL 1 2.5' Florida Certs pte of Autboraaf n Number L67335 No underground foundations,improvements and/or utilities I DECK. were located or shown hereon. 1 3' PURPOSE OF SURVEY: ` EST 90.00' (R&M) SET " SET I N IRON P E BY- _ lu The purpose of this survey is for a certificate of occupancy. v IRON PIPE CLF & WAI CAP L 7335 \Q��C.�J< <''� Eduardo M.Suarez,PSM Signa re atl: q T� CAP LB 7335 1.T SOUTI BISCAYNECA] Registered Surveyor and Mapper 56313 CLIENT INFORMATION: �� iL ! C.B.S. WALL (� Q This Boundary Survey was prepared at the insistence of and SEP 15 2015 (P.B. 47- PG.58) 1.0' SOUTH 0ot/ State of Florida certified to: NOTICE: Not valid without the signature and original raised seal of a Florida Licensed Surveyor and Allan and Carol Respondek �Y. Mapper.Additions or deletions to Survey Maps by JOB NO.:14150 DRAWN BY:CA other than the signing party are prohibited without the FIELD BOOK:EFB SHEET 1 OF 1 written consent of the signing party.