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BPP-16-202 (2) P � i Miami Shores Village �. 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 Phone: (305)795-2204 Expiration: 09/24/201 Project Address Parcel Number Applicant 549 NE 95 Street 1132060140740 Miami Shores, FL Block: Lot: JOHN ROSSETTI Owner Information Address Phone Cell JOHN ROSSETTI 549 NE 95 ST MIAMI FL 33138-2731 Contractor(s) Phone Cell Phone Valuation: $ 20,150.00 PARKWOOD POOLS INC (954)583-3355 --- -- — �- - Total Sq Feet: 1329 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: Bond Retum: Wall Steel Classification:Residential Scanning:8 Review Electrical Review Electrical Review Plumbing Review Structural Review Plumbing Review Planning Review Planning Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Planning Bond Type-Contractors Bond $ $12.860 . Review Building CCF $120 Invoice# BPP-146-58445 Review Building CO/CC Fee $50.00 03/28/2016 Check#:2240 $1,904.74 $50.00 Review Building DBPR Fee $9.07 01/26/2016 Check#:1141 $50.00 $0.00 Review Mechanical DCA Fee $9.07 Bond#:3030 Education Surcharge $4.20 Permit Fee $604.50 Pian Review Fee(Engineer) $120.00 Scanning Fee $24.00 Technology Fee $16.80 Work without Permit Fee $604.50 Total: $1,954.74 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,PLUM G,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I dY at the ffofeggoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. he re 1utltoriz�dth above-named contractor to do the work stated. (( March 28,2016 Authorized ignature: er / Applicant / Contractor Date Building Department Copy March 28,2016 1 5 �►� V- Miami Shores c^!Mage REC-E-TVFID— Building Department JAN IV -40151 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 SA FBC 20(q BUILDING Master Permit No. up [(0- 20b. PERMIT APPLICATION Sub Permit No. (BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL ❑PLUMBING [:] MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 549 N E 95 Slfazt City: Miami Shores County: Miami Dade zip: 3313? Folio/Parcel#: l(-3206-014- 6'7qo Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): Jeer.. C, (L _. Phone#: 305-5$6-R75S Address: $Wg F,O 95 0%pt City: Miam1 .c�uwaA State: FC, zip: 331138 Tenant/Lessee Name: 0 1 A Phone#: Email: 1_a0ha 0 e;iluf&ra-alva.o. Ca nti CONTRACTOR:Company Name: ���1f.�tJukk�nal I�oo�c Tc. Phone`#: 454-S&3-335X Address: (v l(vI W %SUA':Sc-S". n City: /204dt aw ++ State: FC. Zip: 333 t 3 Qualifier Name: �idQ AdPhone#: qJ -707-lgCrl State Certification or Registration#: CPc 145'/8gR Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: l City:wQl fie1d &a&L State: Fr- Zip: Value of Work for this Permit: Square/Linear Footage of Work: 0,0 Type of Work: ❑ Addition ❑ Alteration 2 New ❑ Repair/Replace Demolition Description of Work: IS7wL [y� - '?Co t/Ut Zaktl 3,a 3O 4 1(o om-- ut~. Sao VOL Specify color of color y thru tile: f' Submittal Fee$' °0A1 Permit Fee$ 604° 50 CCF$ � � � �� CO/CC$ � c� Scanning Fee$ 2-4103 Radon Fee$ C7 .O-� DBPR$ U� Notary$ � r1 Technology Fee$ I*G • 90 Training/Education Fee$ �' 20 Double Fee$ (0131+. y Structural Reviews$ ® Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) r s s Bonding Company's Name(if applicable) AIA Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) 01A 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 fast 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 rehaspection fee will be charged. Signature Signature 04,..e( ,4---- OWNER or AGENT CONTRACTOR The for oing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of A 20 I b ,by 4_day of 20 IS ,by �ehn 2d6ec. .who is personally known to ) who is personally known to me or who has produced Agri J4LiS+i Ca&1Ae 1 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: Print: Seal: C RYL MORGAN Seal: ff' REB.tu1y 25987 o ,..... 4�;; 20.2019 N, ' MY COMMISSIONFF008874 '3!• t53 FbsbsRkm EXPIRES June 28,2017 ****** FloeldaNataeygarvtaa, am 3�A ****** ********* yr APPROVED BY Plans Examiner Zoning (/6 Structural Review Clerk (Revised02/24/2014) 9vas• STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 ADAMS, DAVID WILLIAM PARKWOOD POOLS INC 6761 W SUNRISE BLVD#16 PLANTATION FL 33313-6000 Congratulationsl With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, DEPART .�y T OF BUSINESS AND and they keep Florida's economy strong. PROFI= INAt°REGULATION Every day we work to improve the way we do business in order to CPC1457879SSU .. 06/16/2014 serve you better. For information about our services,please log onto www.myflorLdalicense.com. There you can find more information CERT COMM0OQj1Sf'AI OIdTR about our divisions and the regulations that Impact you,subscribe ADAMS,.DAVI - to department newsletters and learn more about the Department's PARKWOOD initiatives. Our mission at the Department is:License Efficiently,Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, IS CERTIFIED under-th.e provisions of Ch.489 FS. and congratulations on your new licensel Exphtla,aate:AUG 31,2016 L1406160001089 DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CPC1457879 9 The COMMERCIAL POOL/SPA CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2016 ADAMS, DAVID WILLIAM PARKWOOD POOLS INC 6761 WEST SUNRISE BLVD_ #16 PLANTATION FL X3313 `�4 . • R®'WAR® COUNTY LOCAL BUSINESS TAX RECEIPT _ 115 S.Andrews Ave., Rm.A-100, Ft. Lauderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2015 THROUGH SEPTEMBER 30,2016 ®BA: ReCe$pt 'POOL A/M2IRINE CONTRACTOR Business Name:PARKWOOD POOLS INC Business Type:(COMMERCIAL PooL/SPA CONTRACTOR) owner Nasse:DAVID W ADAMS/QUAL Business Opened:03/12/2009 Business Location:6761 W SUNRISE BLVD 16 State/County/Cert/Reg:CPC1457879 PLANTATION Exemption Code: Business Phone: Rooms seats Employees Machines ProfeaeionaEs 2 For vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27,00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature.You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location.This receipt does not indicate that the business is}egal or that it is in compliance with State or local laws and regulations. Mailing Address: DAVID W ADAMS/QUAL Receipt #13B-14-00010245 6761 W SUNRISE BLVD STE 16 Paid 09/01/2015 27.00 PLANTATION, FL 33313 2015 - 2016 Q®AUWAon A'"AO ImIr 9 1 At-A1 Q1101fickia IrAV ®CP111=10'r PARKW 1 OP ID:SO CERTIFICATE OF LIABILITY INSURANCE DA W1 412015 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 policy(les)must be endorsed. K SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain polities may require an endorsement. A statement on this certificate does not confer rights to the Certificate holder in lieu of such endorsemen s. PRIER ruinACT David R.Griffiths Insurance By Ken Brown,Ina. PO Box 048117 PH�E 321-397-3870 N,.321-397-38118 DavidR, sFL 84-8117 IN AFFORINOCOVERAGE NAACP INSUIMA:Amerisure Mutual ins.Co 23396 01SURED Parkwood Pools,Inc. INSURERS: Suitel6-18 6761 W.Sunrise Blvd. INSURER C: Plantation,FL 33313 WSURER 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. LTR TYPE OF INSURANCEmmon SLOR POLICY NUMBER POLICY POLICY EXP LASTS A X CoAl1ERCU L GENERAL.LIABWTY EACH OCCURRENCE $ 11000. —7 CLAS*4AAW —1 OCCUR P20978150102 07H0/2015 07MQ12016 p , $ 100-004, FXX Pool Pop MWpXPam pomm $ 5, PERSONAL&ADVINMY $ 1,000,00( Geft AGGREGATE LMT APPLIES PER: GENERAL AGGREGATE $ 2►000, POLICY M JEC 0 LOC PRODUCTS-COMPIOPAM $ $0001 onot $ AUTOMOBILE LIAA9I.I.ITY $ ANYAUTO BODILYQQURY(Pwpw=) $ A��JT-f SCIAUT MM BODILYWd1RY(Fer ) $ HI WAUTOS OWNED t�ONIIVID AUTOS $ UMBRELLA LIASOCCUR EACH OCCURREICE $ EXCESS UAB HCLAS AGGREGATE $ DEO 1 1 REfENT10N $ WORKERSCOMPENSArm AND EMPLOYERS'LIABIJTY YIN X ATUTE X _ A ANY P ETORIP� 52 09/23/2015 09/2312016 E.L EACH AoCgmff $ 1,000, EXCLl$OED4 � IA E.L -EAEMPLOYEE $ 1,0001 PTION CF OPERAT b +r EA.DISEASE-POLCYLMT 1,0N,0010 :1T DESCRIPTION OF OPERATION$I LOCAIMM I VEHICLES(ACORD 101,Adteea,al Remmke 8ehadule.may!,e aKaohed B more apeoe Is►equtreV) Swimming Pool Contractor CERTIFICATE HOLDER CANCELLATION MI MISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10050 N.E.2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE )>0J-4d g. %49" ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD