BPP-15-2642 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-256400 Permit Number: BPP-10-15-2642
Scheduled Inspection Date: April 14,2016 Permit Type: Pools/Whirlpools/Hot Tubs
Inspector: Rodriguez,Jorge
Inspection Type: Final
Owner: BLAKE, MARY ALICE Work Classification: Repair
Job Address:9632 NE 5 Avenue Road
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060170140
Project: <NONE>
Contractor: ALL FLORIDA POOLS AND SPA CENTER Phone: 305-893-4036
Building Department Comments
RE SURFACING EXISTING POOL Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-256114. CREATED AS
REINSPECTION FOR INSP-245918. Gate must be self closing
04/07/2016
Failed CANCELLED BY IRA
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
Apra 13,2016 For Inspections please call: (305)762-4949 Page 16 of 29
E
Miami Shores Village g y
t 10050 N.E.2nd Avenue NE x
••• Miami Shores,FL 33138-0000
Phone: (305)795-2204
Expiration: 04/23/2016
Project Address Parcel Number Applicant
9632 NE 6 Avenue Road 1132060170140
MARY ALICE BLAKE
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
MARY ALICE BLAKE 9632 NE 5 AVE RD
MIAMI SHORES FL 33138-2443
Contractor(s) Phone Cell Phone Valuation: $ 3,950.00
ALL FLORIDA POOLS AND SPA CENT 305-893-4036
_._ .. �..........F_..._ _� Total Sq Feet: 850
Approved:In Review Available Inspections:
Comments:
Date Approved::In Review Inspection Type:
Final
Date Denied: Review Planning
Type of Work:Swimming Pool Occupancy: Review Building
Additional Info:RE SURFACING EXISTING POOL Bond Return
Classification:Residential Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $2.40 Invoice# BPP-10-15-57459
DBPR Fee $2.25 10/19/2015 Check#:310546 $50.00 $119.90
DCA Fee $2.25
Education Surcharge $0.80 10/26/2015 Check#:310584 $119.90 $0.00
Permit Fee $150.00
Scanning Fee $9.00
Technology Fee $3.20
Total: $169.90
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 forgoing informatio I ccurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above- ntractor to do the work stated.
October 26, 2015
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
October 26,2015 1
t6
t/S Miami Shores Village
�w Building Department OCT 1 20,5
4
10050 N.E:2nd Avenue,Miami Shores,Florida 33138 8Y.
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20/�/ar*�
BUILDING Master Permit NooaP/f>/ —_ 2Z
PERMIT APPLICATION Sub Permit No.
UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [–]RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION 0 SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City Miami Shores County Miami Dade Zip: 3-5/38
Folio/Parcel#: //' 32o(v'O!7- ®/yp Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): W'O'ey .gf%�Grc 0.61440.6144/� Phone#:�'Z/ - 138
Address:
32 "V4.
,,����
City: W40M/ Mew State: Zip: 33/3
Tenant/Lessee Name: Phone#:
Email: 1
CONTRACTOR:Company Name: ifl 1`–/O�Ci e�0 TOo Phone#:�' ofle Z3�
Address: &7 /• C.d (/14
City: State: Gam• Zip:
Qualifier Name: Phone#:�'�_ 3,9
State Certification or Registration#: C:,0� Cf• 62'Y,570 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: 4.e City: State: Zip:
Value of Work for this Permit:$ �§gzqj-Gd Square/Linear
Footage of Work: tp�
Type of Work: ❑ Add' ' ❑ A ration ❑ New L_•IJ Re air/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee$ ��'L:a qC`2 Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ rr
TOTAL FEE NOW DUE$ L l 9. 9 —
s
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lenders 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.
SignatureKaw AR&enmel—
Signature
OWN or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
_V1 day of �`� ,20 1� by �-day of OCT ,20 I S by
A-V oa 40-jv- ,who i ersonal y kno o A-it()Z<*S.- ,whoersonally kno
3h to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUB
Sign: Sign:
Zeal:
N Pr'
,�.. 25-LUIS
•'°g4e �y CO !'SSS o251T eal: * EXp tES:0No�sY
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APPROVED BY t Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
e r
MARY ALICE BLAKE
DURABLE POWER OF ATTORNEY
1,MARY ALICE BLAKE, hereby appoint and empower my daughter,PATRICIA M. BROWER,
and my son,THOMAS E.BLAKE,as my true and lawful attorneys-in-fact,to act for me and in my
name and on my behalf to do the following. The concurrence of both my attorneys-in-fact is not
required.
A. Collect, receive, and receipt for any and all sums of money or payments due or to
become due to me.
B. Sue in my name and behalf for the recovery of any and all sums of money or
payments due or to become due to me and to collect on any judgments recovered by me and execute
satisfactions of the same.
C. Initiate, defend, continue, or settle suits on my behalf or to enforce the exercise of
these powers granted to my attorney-in-fact.
D. Hire or discharge (with or without cause) employees including, but not limited to,
physicians,nurses, attorneys, and domestics.
E. Deposit to or withdraw from, or draw checks or drafts upon, any and all savings or
checking accounts,money market funds,or any other type of account in my name;open,modify,or
close any such accounts in my name in any bank or financial institution or with any insurance or
brokerage firm; and endorse my name to any and all negotiable instruments.
F. Pay any and all bills,accounts,claims,and demands now or hereafter payable by me.
G. Receive and endorse for deposit in any account any payments that I receive from any
branch or department of the United States or other government,including without limitation,Social
Security payments, Department of Veterans Affairs payments or grants, Medicare or Medicaid
payments, and tax refunds.
H. Represent me before any office of the Internal Revenue Service or any state agency;
prepare and sign any tax return on my behalf;receive confidential information regarding tax matters
for all periods,whether before or after the execution of this instrument;and to make any tax elections
on my behalf.
I. Receive and open my mailtcharptlypaikng address,and otherwise represent me
in any matter concerning the U.S. Posta?5ervj* •• •
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Durable Power of Attorney ••• ••• Page I
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J. Borrow money and to otherwise incur or guarantee indebtedness for which I will be
liable,and to secure any such indebtedness by mortgage or other security interests encumbering my
assets.
K. Act for me in any business or enterprise in which I am now or have been engaged or
interested or with respect to any trust in which I have a beneficial interest.
L. Manage all assets and properties belonging to me or in which I have any interest,and
to expend whatever funds my attorney-in-fact deems proper for the preservation, maintenance, or
improvement of those assets or properties.
M. Compromise, arbitrate, or otherwise adjust claims in favor of or against me or any
assets or entity in which I have an interest, and to agree to any rescission or modification of any
contract or agreement.
N. Participate in any type of liquidation or reorganization of any enterprise.
O. Join with other persons with whom I own property as joint tenants with right of
survivorship or as tenants by the entireties in any transaction regarding that property.
P. Vote and exercise all rights and options, or empower another to vote and exercise
those rights and options,concerning any corporate stock,securities,or other assets;to enter into or
approve agreements for merger, reorganization, or equivalent transactions with respect to any
company or enterprise;to delegate those rights to an agent;and to enter into voting trusts and other
agreements or subscriptions.
Q. Exercise all rights and options, or empower another to exercise those rights and
options, concerning sole proprietorships, general or limited partnerships,joint ventures, business
trusts,land trusts,limited liability companies,and other domestic and foreign forms of organizations.
R. Buy, sell, exchange, lease, convey, and grant options with respect to any real or
personal property, and to negotiate for and to enter into contracts and agreements of every nature,
concerning real or personal property,including homestead or exempt property. Any such contract,
agreement,or lease will be valid and binding for its full term even if it extends beyond my lifetime
or the duration of this power of attorney.
S. Exercise all powers even though my attorney-in-fact may also be acting individually
or on behalf of any other person or entity interested in the same matters.
T. Transact all business, ma4, e4tt'te aidoia*'A'oaJedge all contracts, orders, deeds,
bills of sale, assurances, promissory notes,'rne$tgaJes'and o1heOnstruments of any nature which
may be requisite or proper to effectuate any matter or things pertaining to or belonging to me.
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U. Make gifts for estate planning purposes;change the beneficiaries of any life insurance
policies or other qualified or nonqualified benefit plans;create or fund revocable or irrevocable trusts
for the benefit of myself or of other persons; and consent to the creation or extension of trusts
established by other persons for my benefit.
V. Continue or discontinue my membership in any club or other organization.
W. Accept or resign on my behalf from any offices or positions which I may hold,
including any fiduciary positions.
X. Continue, use, or terminate any charge or credit accounts.
Y. Employ and compensate any investment management service,financial institution,
or similar organization to advise my attorney-in-fact and to handle all investments and to render all
accountings of funds held on my behalf under custodial, agency,or other agreements.
Z. Enter into any safe deposit box for which I am a lessee and add or remove items;and
to enter into or terminate any safe deposit box lease or lease for vault space.
AA. Disclaim any property interest that I would otherwise receive.
BB. Demand, obtain, review, and release to others medical records or other documents
protected by the patient-physician privilege, attorney-client privilege, or any similar privilege,
including all records subject to,and protected by,the Health Insurance Portability and Accountability
Act of 1996, as amended ("HIPAA"). I designate my attorney-in-fact as my "personal
representative"under HIPAA.
CC. File or process claims for any medical bills with all insurance companies through
which I have coverage, including but not limited to Medicare and Medicaid, and to receive from
Blue Cross/Blue Shield or any other insurer information obtained in the adjudication of any claim
in regard to services furnished to me under Title 18 of the Social Security Act.
DD. Invest in assets,securities,or interests in securities of any nature,including(without
limit) commodities, options, futures, precious metals, currencies, and in domestic and foreign
markets or investment funds, including common trust funds;to trade on credit or margin accounts
(whether secured or unsecured); and to pledge assets for that purpose.
I further authorize my attorney-in-fact to take all other actions as may be necessary or appropriate
for my personal well-being and the manapeme4 of tpyaffairs,as>idly and as effectively as if made
or done by me personally. •• • •
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Despite the foregoing powers,my attorney-in-fact may not(i)deal with insurance policies I own on
the life of any of my attorney-in-fact, or (ii) except as specifically authorized by this power of
attorney, distribute assets so as to discharge a legal obligation of my attorney-in-fact.
My attorney-in-fact shall keep full and accurate inventories and accounts of all transactions for me
as my agent. Such inventories and accounts will be made available for inspection upon request by
me or by my guardian or personal representative. My attorney-in-fact need not file any inventory
or accounts with any court or clerk.
Any third party to whom this power of attorney is presented may rely upon an affidavit by my
attorney-in-fact stating,to the best of my attorney-in-fact's knowledge and belief,that this power has
not been revoked,that I am then living,and that no proceedings have been initiated to determine my
incapacity. No third party relying on this power and that affidavit will be liable for any losses,
damages, or claims caused by compliance with the action requested by my attorney-in-fact, unless
that third party has actual knowledge of my death or the revocation of this power.
This durable power of attorney will not be affected by my subsequent incapacity except as provided
in Chapter 709 of the Florida Statutes. It is my specific intent that the power conferred on my
attorney-in-fact will be exercisable from the date of this instrument,notwithstanding my subsequent
disability or incapacity, except as otherwise specifically provided by statute.
If any part of this power of attorney is declared invalid or unenforceable,that decision will not affect
the validity of the remaining parts.
My attorney-in-fact do not have an affirmative duty to act under this power of attorney and will not
be liable for any claim or demand arising out of any acts or omissions,except for willful misconduct
or gross negligence.
In witness whereof,I have executed this durable power of attorney on September 23, 2004.
MA ALICE BLAKE
Signed in the presence of:
K / 0Z) N6- 67/
Signature Street Address
l&n/ , 0C33`6�
Prin name .. ... . .City, State ad ZIP
:Aejktr &��A
Signature Street Address
461 . :'.
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Printed name ••• • • City, State and.
Durable Power of Attorney ••• • 0:0 Page 4
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STATE OF FLORIDA
COUNTY OF MIAMI-DARE
The foregoing instrument was acknowledged before me on September 23,2004,by MARY
ALICE BLAKE.
(Official Notary Signature and Notary Seal)
i-f K. r°dii-49 t-r�Ll--
(Print,Type,or Stamp Commis ,.#A&of
Notary Public)
Personally Known OR Produced Identification e„ % - r�op
Type of Identification Produced iAiofo'�RkVQA /fica- D--
Pgao-5,?l-a a-bYl
K.=W501\PMS6329.wpd
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Durable Power of Attorney •;• ; ; ; 0:0 Page 5
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