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BPP-15-1946 A \\30 f), Miami Shores Village Building Department MAR 1 1.2016 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 �3y: INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 BUILDING Master Permit No.g'�ls - I�`�-� PERMIT APPLICATION Sub Permit No. FE-IBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 11 4�.-' F.- -q G" 5r City: Miami Shores County: Miami Dade ZIP: FoiiolParcei#:`I C:�'2 -7 J is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name : (Fee Simple Titleholder: ( Phone#: 40M- 4' Addrs: Aj City State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: ESSIG POOLS, INC Phone#: 305-949-0000 Address: 1800 NE 151 ST City: NORTH MIAMI State: FL Zip: 331625 Qualifier Name: DANIEL ESSIG Phone#: 305-949-0000 State Certification or Registration#: CPC052505 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State Zip: Value of Work for this Permit:$:-:3- Square/Linear ffotage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work:�-� �� ).!,t c-,-- 4f t-'V'=.r ✓ Specify color of color thru tile: I� Submittal Fee$ - C�N Permit Fee$ !1 ` Q CCF$ d CO/CC$ Scanning Fee$ -CD Radon Fee$ DBPR$ ;L. Notary$ Technology Fee$ - Training/Education Fee$ - L Jl,� Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ t (Revised02/24/2014) r K • a 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 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. /n the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature v �-�" Signature OWNERorAGENT CONTRA R The foregoing instrument was acknowledged before me this The foregoing instrumen1t was acknowledged before me this �� -)day off l�h�a'G` ,20 t ,by 'day of I-�� 20 ,by who is personally known to DANIEL ESSIG who is personally known to �me or who has produced as me or who has produced as identification and who did take an th. identification and who did take an YOR(F TARY PUBLIC• NO A PUBLIC: Y CO • /L� oe M FlLENY�,j r� Septe�G`sJ,•�cn ion,/e �. •• ycomoSs. F�. :vin '�� ® N,z Z ePfembP,ao2 n9 r �� ® o� S o. SiSig �� b�a•�; Prin #FF �:'�= Print �' ®`� •�.• Seal: �u/i�:de W11BF ��`� Se L IIIIII o Off`4 �IUU16H1�`,� flaflakakfle akfle fle fle&flefle&fle fle flefle fle&fle fle dzLf — Structural akak&akflkfleflkfleakfleflkakakakflefle#fleflefleAPPROVED BY Plans Examiner Zoning Review Clerk (Revised02/24/2014) 5nortFs G Miami Shores V11age Building Department 10050 N.E.2nd Avenue �ORNA Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR/ARCHITECT Permit WZE21.5- 1q Owner's Name(Fee,simple Title Holder):_M14j O- A-% P-A-9-4-k Phone#: e45A-=tsc,- tz�tc, Owner's Address [ Lr-3 K)2 City: 3 K--Ll State : �ei— Zip Code: -�3-3 l . Job Address(of where work is being done): (I,G-a Q-i�- q-l! ' -{- City: Miami Shores State:_Flodda Zip Code: 33 6`6 Contractor's Company Name:22U; Corp Phone#: 7?L Address: 1� Nv.1 .214 City: iM a1 tAl State:_ Zip Code: Qualifier's Name : tltooev (1 NU ri 110- Lic. Number:0& b!5 0 Architect/Engineer of Record Name: Phone#: Address: City: State: Zip Code: Describe Work: fc-,,ciL r�jJs �G... �, �..d r ►� +\,e- cn^ de�� I hereby certify that the work has been abandoned and/or the coptractor/architect is unable or unwilling to complete the contract. I hold the Building Official and the Miami S ores harmless for all legal involvement. Signature �A Com, Signature AJ-Aurl, o, e�orAgi3nt ® 'tontrador r MOWThe foregoing instrument was aknowiedged before me ^ �Ahe foregoing instrument was aknowiedged before me this L9-day of 1��20i�,byR (— l�s this 1':1 day of 20C by L%fU L Who is personally known to me or who has produced who is personally known to a or who has produced KXCT--c,Yll as indentification. p— d�Kx— as Indentiflcation. Notary Pu li • Notary Public: Sign: Sign: Seal: ogasY°ve! Notary Public State of Florida Seal: ¢v"Aue Notary Public State of Florida ? Sindia Alvarez °• `� Sindia Alvarez ca My Commission FF 156750 4 .r , ®4 My Commission FF 156750 jFOF°Ro� Expires 09/03/2018 '�>uf'N,o0 Expires 09/03/2018 r" 3/2/2016 Property Search Application-Miami-Dade County OFFICE RF THE PROPERTY APPRAISER Summary Report Generated On:3/2/2016 Property Information ` Folio: 11-3205-027-0350 '. KE JN 3 Property Address: 1163 NE 92 ST Miami Shores, FL 33138-2934 Owner MIGUEL A PARRA CRISTY P SIERRA Mailing Address 1163 NE 92 ST ' MIAMI SHORES, FL 33138 USA x.._ Primary Zone 1100 SGL FAMILY-2301-2500 SQ Primary Land Use 0101 RESIDENTIAL-SINGLE FAMILY: 1 UNIT Beds/Baths I Half 2/2/1 Floors 1 �r Living Units 1 r Actual Area 2,098 Sq.Ft Living Area 1,798 Sq.Ft Adjusted Area 1,948 Sq.Ft Taxable Value Information Lot Size 9,375 Sq.Ft 2015 2014 2013 Year Built 1956 County Assessment Information Exemption Value $50,000 $50,000 $50,000 Year 2015 2014 2013' Taxable Value $278,000 $275,397 $270,589 School Board Land Value $285,750 $253,500 $171,000 Exemption Value $25,000 $25,000 $25,000 Building Value $136,711 $134,276 $135,376 Taxable Value 1 $303,000 $300,397 $295,589 XF Value $19,869 $20,105 $20,341 City Market Value $442,330 $407,881 $326,717 Exemption Value $50,000 $50,000 $50,000 Assessed Value 1 $328,000 $325,397 $320,589 Taxable Value 1 $278,000 $275,397 $270,589 Benefits Information Regional Benefit Type 2015 2014 2013 Exemption Value $50,000 $50,000 $50,000 Save Our Homes Cap Assessment Reduction $114,330 $82,484 $6,128 Taxable Value $278,000 $275,397 $270,589 Homestead Exemption $25,000 $25,000 $25,000 Sales Information Second Homestead Exemption $25,000 $25,000 $25,000 OR Note:Not all benefits area licable to all Taxable Values i.e.Coun ,School Previous pp � � Sale Price Book- Qualification Description Board,City,Regional). Page 08/05/2011 $388,000 27797 Qual by exam of deed Short Legal Description 2353 BAY LURE PB 44-63 06/01/1998 $184,000 18142- Sales which are qualified LOT 23 BLK 2 0625 LOT SIZE 75.000 X 125 15768- Sales which are disqualified as a result of OR 18142-0625 0698 1 12/01/1992 $0 2614 examination of the deed 11/01/1991 $130,000 15294- Sales which are qualified 2777 The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp Version: 4 7n; rvo. B '�'?'-' �' 6► Miami Shores Village PfX7t1yF►B'�flC1jSlWOO `hI 10050 N.E.2nd Avenue NE Wlgl ,r COa,$SttiGc7b6n. R Ir.,,"' Miami Shores,FL 33138-0000 r M1t` PerTf} stl _*. I ��tox� Phone: (305)795-2204 ° FS ��_ �'ts us414419t 1 tit: Expiration: 10/111 016 Project Address Parcel Number Applicant 1163 NE 92 Street 1132050270350 Miami Shores, FL 33138- Block: Lot: MIGUEL AND CRISTY PARRA Owner Information Address Phone Celt MIGUEL AND CRISTY PARRA 1163 NE 92 Street MIAMI SHORES FL 33138- 1163 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 3,500.00 ESSIG POOLS INC 305-949-0000 m. .._ Total Sq Feet: 860 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final Date Denied: Review Electrical Type of Work:Swimming Pool Occupancy:Private Review Electrical Additional Info: Bond Return: Review Electrical Classification:Commercial Scanning:3 Review Electrical Review Planning Review Planning Review Building Review Building Review Building Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Building CCF $2.40 Review Building DBPR FeeInvoice# BPP-7-15-56565 $2.25 DCA Fee $2,25 07/31/2015 Check#:582 $50.00 $124.90 Education Surcharge $0.80 04/14/2016 Check#:300512 $ 124.90 $0.00 Notary Fee $5.00 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $3.20 Total: $174.90 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 foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-named contractor to do the work stated. _ April 14,2016 Author attire'. caner /._applicant / Contractor / Agent Date Building Department Copy April 14, 2016 1 �,usrM Miami Shores Village O ' Building Department -1 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 c inr Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 20 14ts4k BUILDINGMaster Permit No. Epri S PERMIT APPLICATION AIMEVkl� Sub Permit No. rp� 11LDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 116 ?2 A26 2 City: �- tc>jV\% Miami Shores County: Miami Dade Zip: V Folio/Parcel#: l/-3 205 O�. 3 SO Is the Building Historically Designated:Yes C NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: r-N OWNER:Name(Fee Simple Titleholder): ` C\�-ics- Phone#: `�'4� - � � -� '�� Address: I /A _�) K) C, q2 S r-e( 1 City: ®"�, -C� State: \o f, CJ c, Zip: Tenant/Lessee Name: Phone#: he Email: t4, �-> eJl��, ►�� „,n-cL1_s CONTRACTOR:Company Name: © fFT Grp e---4Ze_ �:S� C�6 Phone#: R6 -312 Address: �� �Y\ 0J City: —State: Zip: 3 31 2S Qualifier Name: /"� ek`p goyyi e c V i CA`�� CCS Phone#: ����'-3 12- r 3 State Certification or Registration M Certificate of Competency M O M 0 Cf DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ ��� Square/Linear Footage of Work: (Q® Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace q ❑ Demolition y Description of Work:_;n 5,d c �nc O C��� — �� �C9-C-� ��e ittOD b C�C�:,`� tr Specify color of color thru tile:' & Submittal Fee$ ��� t� 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$ (Revised02/24/2014) 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 i� � 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. in the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature R:1 Signature (J / OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 7 L� ,201-s by _ day of a% y4f ,20 19' by 17 A,who is personally known to J'u-#j�: 14 U �f'?�,who is personally known to me or who has produced as me or who has produced G/Z�� � ®���f s identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: ' Sign: Print: Print: MO RODRIGUEZ Sao N ,.•o.��o�•.,, ER 0 I U 'tasay+�toN I�NeFI�xll�p�8 �.�•;a'a'o'••. Seal: 4 4+s Notary Public-State of Florida Seal: 69ti0S0 d�#uolsslmwop � •. , My Comm.Expires Sep 23,2017 de seJ dx wwo A rr LIOZ'£Z S ! 3' � W • � Commission#FF 050469 ep i f0 stet$-ollQnd�(JetoN =�,+ cP Bonded Through National Notary Assn 3n91t1t] OWSVU3 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) CTQB Construction Trades Qualifyinq Board BUSINESS CERTIFICATE OF COMPETENCY 06BS00597 4 'ROHI CONCRETE & FINISH CORP D.B.A.: MURILLO HOMER VIRGILIO Is certified under the provisions of Chapter 10 of Miami-Dade County VALID FOR CONTRACTING UNTIL 09/30/2016 _ 116661 Business TqJ(,,eceI Mlaml Dade eCOutly, ;54att3 of Florida- f TNIS �S ItiiOTA BILL +DO NOTPAy _ '5804f l BUSINESSNgIV MOCATION RE I2�PT NQ - EXPIRES, `. RQHI CONCRETE&FINISH CORP f tNtaw.` sEPTEMBER 30, 24'CT 60152393 817NW Myer beispiayed,at place of b4$t i MIAMI FL:3125 '` PfsuattttdiCau #V n CO-Ow,,'12y w haptai SA: Art .9&1 a OWNER'�i SEC.TIE OF 48INSS �T RQ�11 CONCRM FlNI$ CO + X 96 SP4 IALTY UIV 11 CONTRACTOR PAYMENT;TA)#r�i'RECEIVED 68S00 97 $Y TAX OLLE/r'TQR VVorker(s) 1 $45.00!A9/30/2015 CRED64RD-16-00 This Louai Busine.s�'pxlleceipt ony confirms paymentoftbe LociRl Busin T The Rec¢pt is not a!icon se, I permit;gin certificallonof the holder sgnalificatians,,to do business.Holdermn&t ogmply with any govp nma�rta or,aoogovgrnmem#LFagalatory laws and Nquiremr wbic�oPgty to the bUainess — The'RECEIIPT N0.ahoveTnust he displays�l on all cguuuerchd vehicles Al�iatll!Rada Coda$er,8a-27g Forpigeation, xt�HnetYir miamidade g�llr! actor _ 0713112015 13:16 (FAX) P.0011001 CERTIFICATE Off' LIABILITY INSURANCE ��07131/1-5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONPSRS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,SXTEND 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 cartlflcate holder 18 An ADDITIONAL INSURED,the pollcy(les)must be endorsed. If SUBROGATION 19 WAIVED,subiact Lo the torms and conditions of the policy,certain policies may require an endareemenL A statalnant on this oortificate does not confer rights to the certificate holder in Ilau of such andorsement(s). PRODUCERLUCIAEstrella NAME Accurate (305)228-8727 lA[CFAX Nak (30b)226-8767 8300 West Flagler Suite 114 luclaealmlle6bellsouth.nat Miem1.FL 33144 INGURM81 AFFORDING gogMae NAIC# Phone (306)228-8727 Fax (306)226-8787 INSURSRA: Qraeella 1ASUrArIft CO. INSUREb INSURER B. Rohl Concrete&Finish Corp INSURER c: 817 NW 24th Ct INSURER 0; _ Miami,FL 33126- (786)312.6131 INSURER E; INSURER F COVERAGES CERTIPICAT9 NUMBERS 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 18 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDfIIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SURRp�Ll LTR POLICY EFF hAM/D TYPE INSURANCEuRANOE POLICY NUMBER LIMITS GENERAL WAHILITY TY . —._.. ® COMMERCIAL GENERAL LIASIUTY1000 000.00 El ElCLAlMB.MADE © OCCUR $ 100,000.00 A ❑ OISSFLOOOSS133 04/01/2015 04/01/2016 MED EXP(Any one arson $ 5,000.00 PERSONAL&ADV INJURY $ 1,000,000.00 GENERAL AGGREGATE $ 1,000,000.00 QEN'L AGGREGATE LIMITAPPUES PER PRODUCTS-COMP/OP AGO 81 1,000,000.00 ® POLICY ❑ PRO• ❑ LOC _ S AUTOMOBILE LIABILITY MBl INQlE LIMIT ❑ ANY AUTO BODILY INJURY(Per person) S.��� ❑ NOOS ED AUTOS BODILY INJURY(Per addenta ❑ HIRED AUTOS ❑ p�WNED OPE YAMAQE S ❑ $ UMBRELLA LIAB ❑OCCUR EACH OCCURRENCE B ❑ BMOESS LIAR CLAIMS-MADE -� A/30REOATE 6 El DEB F1 AM ---•---•--- WORKERS COMPENSATION $ AND EMPLjOY9W LIABILITY WC 8TATU- OTH ANY PROPRIETORIPARTNERJEXECUTIVE/N $ --- OFFICERIMEMSER EXCLUDEDB NIA E.L.EACH ACCIDENT (My sp�s, ry In NN) E.L.DISEASE.FA EMPLO $ WARIPTION O OPERATiONB below EL DISEASE-POLICY LIMIT $ T DIMCRiPTLON OR OPERATIONS 1 LOCATIONS I VEHICLEB(Attach AOORD 101,Addldonal ROT—M Schedule,n mors space Is regetrad) License Number 06BS00597 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Miami Shares THE F"IRATION DATE THEREOF.NOTICE WILL BE DELIVERED IN 10050 Northeast 2nd Avenue ACCORD THE POLICY PROrSIONS. Miami Shores,Florida 33138 :AAUTHO A Fax:305-73s-8972 cia Es ACORD 26(2010105)QF ® RD CORPORATION. All rights reserved. The ACORD name and 1090 are registered marks of ACORD 9/4/2014 Report Viewer /1 1100% r JEFF ATWATER •�Qan ' CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 9/21/2014 EXPIRATION DATE: 9/20/2016 PERSON: MURILLO HOMER V FEIN: 204524300 BUSINESS NAME AND ADDRESS: ROHI CONCRETE&FINISHING CORP 817 NW 24 CT MIAMI FL 33125 SCOPES OF BUSINESS OR TRADE: CONCRETE CONSTRUCTION NOC Pursuant to Chapter 440,05(14),F.3.,an oRleer of a eorpotatlon who elede ezemptlon from tide chapter yy Oling a certdlwte of efediat order tins section may not recover bene5fa or compensation under this chapter.Pursuant to Chepter440.OS(12),F.S,CerYfleales of eleUfon to be exempt.apply only within the snipe of the buetneas orbede Meted on the no of election M be exempt Wrsuanl to Chapter 440.05(13),F.3.,Notices of election to be exempt end eartllimtas of eledlon to be exempt shall be subJeel to revaoeUOn H.at any time ager the ttlut9 of the rro0ce or the�suenea of the cerOScete. the person named on Ne no5ee or certi0rate no longer rnaeb the requiremertb of this eeetlon for Issuance at a certlOrate.The department shad revoke a DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07.12 QUESTIONS?(850)413-1609 0 https://apps8.fldfs.com/crreporMewer/reportV!ewer.aspx?data=kdvpginc9D7Q3gH6TER6ePl KMZ%2fSz5bXKYfBxkrekeESoPVy1v4NPOPN42XeirDR.. 1/2 ROHI CONCRETE&FINISHING CORP. Date july 29/2015 1 Homer Murillo will be the only person working at 1163 ne 92 st.miami shores Fl. 33138 instaling paver signature r� ��� �"���� Date July 29/2015 State of Florida The foregoing instrument was acknowledge before County of miamidade me this 29 day of iuly 2015 by Homer Murillo who is personally known to me or who has produced FI. drivers license M640-338-71-470-0 Seal as identification ERASMO ROORI6UEZ .P».,, Notary Public Notary Pubilc-State of FlWa • My Comm.Expires Sep 23,2017 Commission#E FF OSOM print n /me Erasmo Rodriguez •,,� �°F,`t• Bonded Through Natiansi Notary A Commission No. FF 050469 1 t►i yNOREs yr Miami V Village Building Department tOR1DA 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. 42f�t-q Signature: loell 5.4 1 9. Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this day of T N�/ 20 . By [�/1 411-(11? ,(,t 1 Zip�� who is personally known to me or has produced (s 0— — — 7,00 as identifica n�!�.,�1J'3'� EHASb10 RODRIQUft °. e`�c+ Notary Public-State of Fieft Notary: `mss .; My Comm.Expires Sep 23,2017 'IMMO RODRIGUEZ Commission#FF 050469 SEAL: Bonded Through National Notary Assn. ♦y�,®REQ a1 Miami Shores illage - -�� wilding Department FlOR1Up' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 SWIMMING POOL OWNER'S CERTIFICATION Date I J Miami Shores Village Building &Zoning Department Attention: wilding Official I certify that I am the legal owner of the property described as L " ' L�2� Z located at 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. Legal Owner Note:This certification is to be submitted with a swimming pool permit application in duplicate. O Miami shores V11age e ye BUIlding Department AOR 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RECEIPT PERMIT#._Bp P t DATE: LO L L i ❑Contractor (NAME) ;6-Owner ❑Architect Picked up 2 sets of plans and (other) Address: I `-�3 KD,5- ':5c2"`4- S-lY t From the building department on this date in order to have corrections done to plans And/or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue fitting process. Acknowledged by: (-j (Signature) PERMIT CLERK INITIAL: :5� RESUBMITTED DATE: S15 PERMIT CLERK INITIAL: V r =, l/yr-=r.-r4=a== L W cT+l .r—JA j e— !T M v ` `P ) ° tv UH � n 77 90 N ®, � 0 XWE 000 `D - Miami Shores Village APPROVED BY • q . .. .• .• ZOMNG DEPT L_DG DEPT )/� . : .� IUOJEGT or • • • • •• •• NCE �ALL FEDERAL "T,"TE A.No Ur!N"(r3GLES AND REGULATIONIS ICY: LOCA110H MAP m rw ...... gp ease- ,, I{A6 Ol ®e oB 0•ee•0 :000:0 • sees* • 0 00000 I�/0 y• 1 Y/ 1 • •0000• ,' \b��•/ •• •• • •esu• �. •ecce , as 14.( ✓ 00000 sees•• •• 0•e0 • • • • e lz;aSn 5s-31 75o®` Be ss e PROPERTY ADDRESS: 1163 NE 92 Street Miami Shores,Florida 33138. LEGAL.DESCRIPTION:Lot 23,Block 2,`BAY LURE",according to the plat thereof; as recorded in Plat Book 44,Page 63,of the Public Records of Miami-Dade County,Florida. FOR:MIGUEL PARRA. CERTI)EY TO:MIGUEL PARRA MARTINEZ-ESTEVE&LOPEZ-CASTRO. FIRST AMERICAN TITLE INSURANCE COMPANY. AMERICAN INTERNET MORTGAGE,INC,its successors and/or assigns- sAffiflMmEm Ham t)yhle a sY moa conducted fa•1hs purpose of a'Bavndwy Survv 'only and b Drat Intended to Wheats the regulatory MW ff VAT � IPOoAcl ctbno of any fedssal.atatG rim or lord eg�q.tword,cmnm or other entity. ( ) CEt91RED CLF. aiAni IF<K FENff 2)The accuracy obtained by maamrrenerta and calculations on this survey,meats and oaeee8e the Minlnum Teclmlod Standards ( R� t%F. V=FENCE ,mento tar a suburban area(1 foot in 7,500 foot)as spatl6 sd to Chapter 61617-6.Randa Admtrdstrativa Cade. (Cala) CALOMAWD 00 ancREM 71dm Surosy doss not retiest or dhntemina omnsrabfp CS FCtdaD Me 61tic iLvOBARTr *7 laoissnm daepriptkn sae prvWded by the client and to sub)act to worry dsdirxtIcn%IlsnRatlemN raskictimro resamations Or ii® FCIR�ID�-BAtID WAN NOLE Fa/H I�01AtD DRdI.IICLE WAVER METER Evmmluat}mu oa Abstract of Tltlm FOUND NAL W19 PME wID haw to be made to doterm6he recorded bhakama+ts,if any affecting the prapety, FMD i�i. �D75C tP. UDHI'PME 5)areh of Pure Records not perbrmaII by Gds office• AtJfl 51UCC0 P.C.P. raWAroff CIMJiRCL 6)No aft was made by this office to baste any unde Vv=d utHfties and/or structures wMIn or abutting the sub)att CAT ff BASIN pCDtT TYPICAL. P.L. PM aF CaammmOit prq-t7)This�sorvey has been prapor•d for the eualucivs use of the entities named hereon only and the certification hsraw do not �) Comm LM Pec �t���� .ft LEE to any unoorn�parties MONMO T LLME PULE _ 8)Thio survey was prepared for a Mortgage Transaction only. Not to be used for design and/or construction purposes without IROPBtIY LIKE D 1L� diA8sgS7c Atm.._ the cmrrsemt of ihle oflka. c" CLEAR � �` B)Utility facfiill-wip In URRy Easements not noted oe uddadiom. (nWAFADEM . 1 )Orivewoya or portions thhreof wRhlr Raadwayn not noted m vida4law or enoroodnnerta 91)FoundattarL oo46ps ardern�th Ohs geed aufaee brat may ernes beyard the boundary lines of the borsin damWOM WCA a Yi�tC-pared ors trotLAND UM #AQ bon Piothervlea stated RLBtrmA fERffIGItE ff i.Jtj 31TCf S LB 45QFarre owenad S.1IL 22md•TMUCE ,ayement ar LinitaBaa-rds �far rhTdr tnfamatton woe not fivntshed oa de rot Imply ar accept roaponabi lty for t6 C 6.)R.Ot�(•35]65 - 305 ?26-D073- b5] U.Mate au6mritbs prier to amy dodge maik ar the hareem-daer:bad petal for Sulding and Zanies - 1 I��eProfessionn d Land Surveyor end Mapper in re;hooaAie charge Rolando Ortiz LS 431$State of Merida. '� - 17)This erney Is not valid wttlnaut the dgnakra anal tyre raised sed of a Florida Licensed Land Surveyor and Mapper. 1 harabr raartify to the above named Brat and/or pesa s 6wt the Sketch of Survey of the teri bed property 1s ttrue and Zmeat to the beat Df lamoled!Fl end belief,as recently enrveyad end platted under my draetlam dao that meets 4be Minbnnam T Standards sat in the 61Gi7-6, . Flafdo Admlrietrativ Coda,pu muart to Section 472.027 Florida Stahrtes. BY. ROLANDD ORTIZ LS 4312 DATEn JDH Nl1NBEeeR.r SKETCH KLMER. Ifi2AUP1 HYn REYISIL7NSn OR: RICARDO ORTiZ LS 5629 107-Z3-ZO// �? Z� v Z �� 410C P MAPPER Al LAND F RVEYDR it NAPS STATE OF FLMA. 1S ®RAS l.1 Miami V. -tijage":"oes, shores •••••• so o pp p� ■rrr nnr� Building ®epdttMent'.••i ••..•• 10050 N.E aTd%venu@...;• • '�p�.pRIDA Miami Shores, Florida 33138 ••;••• Tel: (31VIO9.2204•..% •• • Fax: (3Q5�150.8972 • • ...... • NOTICE OF REQUIREMENTS ' ' :*Soo: RESIDENTIAL SWIMMING POOL,SPA AND HOT TUB SAFETY ACT •• • I� (We)�edge that a new swing pool, spa or hot tub will be constructed or installed at BB �� 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). Is^L f 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, R4101.17.1.9(Submit Manufacturer's Specifications). Any combination of protection which incorporates dwelling walls with openings directly into the pool perimeter 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,punishable as pr vided in Section 775.082 or Section 775.083 F.S.This orm must be signed b the ownerlagent aVe e contractor. TRACTOR'S SIGNAT OWNER'S IGNATURE AND DATE �d1oN oa`v I L E SIG NT) W S ME LEASE P = •� ® a� srn • a TA L C i'� Od' L`�� e '.• �';�,�qJ�;�•�,� ••.• `tea 's�B���1l�l���p�p2'``', O R10 lddSa`°�,� jq g - - ''r' r '� .5' �� to r ,,,., - r--• i ]17 Removable ; �:. z. 0000 0000•• � ���,�I���� u � ��_�'�_v �I '•� ,� _: - "--•�q � :��? �'( 5299 {� , 0000•• 00_00 _ •�••••• Y � ���_�� �'I y{ k'!1. � Road* ..� t^^. Uy"•n ;., �I.�( • �ff'I^— exp,t'T�j,ys•�— x-! Llf I '^^fir^ •,__= A�y n� 9•a_� H I i A IL u 4_P R�L�Q�d.� �1'i 11 I!•� ,• L ''�� S• �.� ut' �'4 I' • _: #' • • 0000•• p � �:' t.. '• � P '�' � �.rd rt` ••• • 0000• � vs "'= 8-H 8 9 �.'ui; 9 2 a 2 9 •• •• • •••••• 90 • . . 00660 . 0066.. • . . •00006 4• 0 6000 f . 0 Ma n ufac .a-.. G,srl 1'.r� 1. b I vii was et'i r it p a` _ d'e 'y .p .f t l' � '7. �'t�'• �i ]' `ne: .`;i - i:x�• �` E;: �� � ����. �*� t�;l �.�i{: lE_ e���:�����'����.I��z �"' I'� ��E �_�'� "•.� I�I't r fu 60 runue ���.E_I�;���4, sm 6,-'2,'9P-j8075 X =%le C-3-1.4 vJ!$I .1t�_.t3 -aiurn?r-UMI 1.e�..[r•U6fU I Fele. � by C;-i d sr h t sLea ter s.ia� �ifer��:tl1 ,��`Ti��=! GI ��R���� M1 LT!!§r�� �;� '.,j 7L�r�. �. � +� Nil � � 4-,ems.,. � �, �� �e,�. „t ,r, a e^i-. ^-e a STf�4�NGTi-� NilULU�M 1-ES k ER, A��.`rlr�lr �� boy/ 01, 37 36. ;�, 8 7 -i pletf d pool i'~erxe Is assetrib..ed 4,I,i x—pinta and., Saby ��;a�and mesh t-rt•�ioned e-b-me sa xrpcfea, ���amprisinf cd 5 pole per 103 ficcot car 12 fool section- Polies Mserted with u,"Pastia compo rte. sleeves fri-to o0a.l! deokin (Le.: eared Pavers. Con.-crat , VV-oodl and eefl fns C nn c'Md wfth !aafehe con—inect- rs. The prood.uct curripm-etely assernbfed and irr&taited vL(K1 wNhIstand 321,4 bs�, bwst. AJ rrt sli has a minimum of C10% twsparenc� t testfng. resu is provided by- American test Labs o Svouth Harida and I uttirtE-ti ineal:r. of Flarida Tpastirrp. and C nsulting �Feu it"te ,, Testirig report-ATL rebt # 0Cm.0�{_-1-0in our ,j.unc or, with Baby Gluard Jric, VnAr In coon- pli"anr.e v0th. ak TM standard F-222, 188-0-5 In ori: pl"Lar:rne, With Building. Code,-- 4424.2,17. 1 throug t -4-'24.2--.17, -14 proof Darder 2010 In �aam---pliance %oft-h Californi.a Co6p, 115,992 1.15929 1n ornplianoef-. witti Rr 101 .1 T 1.15 c-04 1` Minimum 'fe's-riceheight is 4811 Fe-ri.-ce will be installed a minimum ir-f 0" off pnoN edge Fence %Mll be p rmanenVy attached in, one area a tool must i-e us.,ed to remove. °ance). .* See attach-ed e tai 'it ni')b/2UU1'.1.:14 ya4/4lb'Jbl BABY GUARD INC PAGE 01/01 9999 • • 99.. . 9999.. •• • . . 9.0.90 .. 9. • � 9999.. _ 00.00. • ajai E..,>£iuot"m dFaj r1-,n for1'a.k:1. Safety�'L'k�C�2tl •••• . . •••''• ^ a� with building code: 42,4.2.7.' and R-4101.17.1.15-04 •••• • �.oli ce 9999. 9999.. . • • 9999. 9999.. .. .. 9999.. • . 9999.. 840:06 :0900: 9. 0 1, FGX11 POS _D_ I: a' ;i '+— f - Hex screw to beJasten i- :'� br,,LEt to pole nd deck DEQ LEVEL 1 11?28/2006 11:08 9547416951 BABY GUARD INC PAGE 03/03 • • sees sees•• Babv Guard ground inef.+a`€ia speo • •• sees•• •• •• sees** ese•e• • • sees• s• • •.ee. e • ee.•• • • • sees•• see• • • I 4 i f i i t � All ground installs are set in a 8 Inch x 6 inch quiet Create k'`5ower, oath a '€3 Inch pvc din spike. Baby guard 5299 hiatus rd sunrise Fludda 33351. 954-741-6351 • • •••• 0.0000 00 • . . • , •••••• •• 00 0400•0 • •60004 0 0000•• 0000 • • • • • • 0000•• •00• • 00000 ��RFS Gr 0.00 • • •• •• �4e MiamishorEtS illage .• 0000•• Building De ,av#milif :....: _ 10050 N.E.2nd Av2gVL ; ' Miami Shores, Florida 33138 �l®1L>®A Tel: (305) 795.2204 Fax: (305) 756.8972 SURVEY AFFIDAVIT STATE OF(FLORIDA) COUNTY OF(DADE) IUD The undersigned Affiant, � ^0""r—"does hereby attest that (Property owner) The attached survey,performed by 5EiEil<✓ � Y ✓ (Name of surveyor's company) For address: Performed on 1 (date of survey)is an accurate representation of the existing conditions and locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than seven (7) years old old. The Affiant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits. Furth r,Af iant say .01-) � , th au, - �_ Property Ow er Signature Property Owner Print Name SWORN TO AI)lD pSUBSCRIBED before me this day of N1��GL� r 2 0l y Affiant is ersonally known to me, prgdoc�g� as ide ification. ,•`�1�,'.....,��/fig '��•'s�a��iuyJPe�q�Z.�. a0• ac�P,y. Golaeo N ._tom Revised on 5/22/2009/Revised on 6/12109 y��`�Ja y Q .