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BPP-15-2165 (2) Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-261067 Permit Number: BPP-8-15-2165 Scheduled Inspection Date:June 27,2016 Permit Type: Pools/Whirlpools/Hot Tubs Inspector: Mesa, Michel Inspection Type: Final Owner: GERVAIS, MATHIAS Work Classification: New Job Address:96 NW 92 Street Miami Shores, FL 33150- Phone Number (786)942-7767 Project <NONE> Parcel Number 1131010160070 Contractor: AQUARAMA POOL INC Phone: (305)934-4226 Building Department Comments NEW SWIMMING POOL AND DECK InfracUo Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-260519. CREATED AS REINSPECTION FOR INSP-258917. CREATED AS REINSPECTION FOR INSP-242129. need pool barrier inspection(barrier needs corrections), need M.S.V Zoning Dept approved final survey on site. Failed D 6-7-16 NEED POOL BARRIER INSPECTION APPROVED FIRST. Correction � 6-7-16 Needed NEED POOL BARRIER INSPECTION APPROVED FIRST. FRONT GATE STILL MISSING SELF LOCKING LATCH MIN 54"HEIGHT. Reins ction No ch se pe ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. June 24,2016 For Inspections please call:(305)762-4949 Page 19 of 37 "NBPP-# ti P Miami Shores Village ■E `Pg,Iri �te i�CilrktB {1) IIiICJ! 10050 N.E.2nd Avenue NW Wo� 5 � Miami Shores,FL 33138 0000 taf � PRt3NEQ Phone: (305)795-2204 o � � �ZR� i Expiration: 5/29/2016 Issixa j3alte�'i�1 p. Project Address Parcel Number Applicant 96 NW 92 Street 1131010160070 MATHIAS GERVAIS Miami Shores, FL 33150- Block: Lot: Owner Information Address Phone Cell MATHIAS GERVAIS 96 NW 92 Street (786)942.7767 MIAMI SHORES FL 33150- .___ _..... 96 NW 92 Street MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone Valuation: $ 19,500.00 AQUARAMA POOL INC (954)529-4552 .. Total Sq Feet: 286 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Fence Date Denied: Final Type of Work:Swimming Pool Occupancy: Pool Deck Additional Info:NEW SWIMMING POOL AND DECK Bond Return: Wall Steel Classification:Residential Scanning:3 Review Electrical Review Planning Review Planning Review Planning Review Building Review Building Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Structural Bond Type-Contractors Bond $500.00 Review Plumbing CCF $12.00 Invoice# BPP-8-15-56842 Review Plumbing CO/CC Fee $50.00 08/24/2015 Credit Card $50.00 $1,263.56 DBPR Fee $8.75 12/01/2015 Check#:2364 $ 1,263.56 $0.00 DCA Fee $8.78 Bond#:2916 Education Surcharge $4.00 Permit Fee $585.00 Plan Review Fee(Engineer) $120.00 Scanning Fee $9.00 Technology Fee $16.00 Total: $1,313.56 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,MECHANIPC_AL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify- at a foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futher I authorize the above-named contractor to do the work stated. December 01,2015 Authorized Sign u e:O er / Applicant / Contractor / Agent ate Building Depa ment Copy December 01,2015 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 nspection Number: INSP-257492 Permit Number: BPP-8-15-2165 Inspection Date: April 25, 2016 Permit Type: Pools/Whirlpools/Hot Tubs Inspector: Dacquisto, David Inspection Type: Survey Final Owner: GERVAIS, MATHIAS Work Classification: New Job Address:96 NW 92 Street Miami Shores, FL 33150- Phone Number (786)942-7767 Parcel Number 1131010160070 Project: <NONE> Contractor: AQUARAMA POOL INC Phone: (954)529-4552 Building Department Comments NEW SWIMMING POOL AND DECK Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed �J Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. 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"' Lor Ir I LEGEND AND ABBREVIATIONS : .: :i:i.iiii:ii;: o _ iiiiii., .i,t..€.;ii o I O A=ARC DISTANCE MIL=MONUMENT LINE App=ELEVATION CATCH BASIN s•:;:t xa;?;;iyie:i:;: e O AC=AIR CONDITIONED UNIT O.H.=OVERHEAD UTILITIES 17.55' c g V 4'W.F B.C.=BLOCK CORNER P.C.P.=PERMANENT CONTROL POINT =WATER METER S =SANITARY SEWER _ ® O 4'WALL C.B.-CATCH BASIN P.O.B.=POINTO OF BEGINNING yyy ® B, I (C)=CALCULATEDP.0C.- POINT OFCOMM E �Q1- POWER POLE - WATER VALVE 4'W.F. 4' - - W.F. - - CL. CLEAR R RADIUS 0 - =TV BOX LLLLLLLLLL �L C.LF.-CHAIN LINK FENCE (R)=RECORD LIGHT POLE E 22222222221 t LLLL _ _ CONC.=CONCRETE RES.=RESIDENCE e O _ 1 a.6 - -FPL TRANS. 40. L -FIRE HYDRANT D.M.E.=L DRAINAGE MAI - to a 1.70 - G NT.EASEMENT RNV-RIGHT-OF-WAY L ENC.-ENCROACHMENT = I POOL EQUIPMENT LLLLLLLLLL9I.�LLL L NP. TYPICAL LLLLLLLLL L FD.=FOUND U.E.=UTILITY EASEMENT =CONC.POWER POLE 'o 1. LLLLLLLLLLLLLLLL bt - M -MANHOLE D POOL � _ ON P/L F.F.ELEV.:FINISHED FLOOR ELEVATION W.F.-WOOD FENCE O :''';:'......?''' '':_:`:::. LLLL L L A LLII II 6II 11� ..LL V I.F.=IRON FENCE W.M.=WATER METER y y LLLLLL�LL`L`L`L`GLLL p _ L LLLL L.F.ELEV.:LOWEST FLOOR ELEVATION 0-DIAMETER 0 L LLLLLLLLLL 6 3 D -72.60' - - JOB NUMBER. 1 O 55 LLLLLLLLLLLLLLLL (M)=MEASERED -CENTER LINE ••d N LLLLLLLLLLLLLLLL LLLLLLLLLL . LLLLLLLLLLLLLLLLLo0 LL BASED ON THE FLOOD INSURANCE RATE MAP OF THE FEDERAL EMERGENCY AGENCY REVISED ON 9-11-09 THE HEREIN 0 4 A 0O DESCRIBED PROPERTY IS SITUATED WITHIN: O 0 30.00' --�.._ fl - JII�C1R ZONE X BASE FLOOD ELEV. WA COMMUNITY NUMBER 120652 PA 03 '0.�•OOr _ U NEL NUMBER 02 SUFFIX L FD. 6'W.F. W ._.n J / '�— — — — — — — — — — —� - 'CONC. ENCE LEGAL NOTES a IL �� e ut r- .no l` A - THIS SURVEY 2 MMERM , DOES NOT REFLECT OR DETERMINE OWNERSHIP.EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO 0 AOT-8 ��'p DETERMINE RECORDED INSTRUMENTS,IF ANY,AFFECTING THE PROPERTY.THIS SURVEY IS SUBJECT TO DEDICATION,LIMITATIONS, . I LOT-7 RESTRICTIONS RESERVATIONS OR EASEMENTS OF RECORDS.LEGAL DESCRIPTION PROVIDED BY CLIENT.THE LIABILITY OF THIS SURVEY I. p P IS LIMITED TO THE COST OF THE SURVEY.UNDERGROUND ENCROACHMENTS,IF ANY ARE NOT SHOWN.THIS FIRM HAS NOT ATTEMPTED TO LOCATE FOOTING AND/OR FOUNDATIONS AND/OR I UNDERGROUND IMPROVEMENTS 0F ANY NATURE.IF SHOWNBEARINGS ARE REFERRED TO AN U ID .I SH LE ION ARE REFERRED T 19 I i S W`I 6 S E O N.G.V.D.OF 29.THE CLOSURE N THE BOUNDARY I SURVEYI AB V 1• 10000. W ISwS�VH►Y 18 NOT INTENDED FOR NEITHER DESIGN NOR CONSTRUCTION PURPOSES.FORTH SE' �_% d PURPOSES ATOPO:RAPHI00U� 1I*E;UIIF • i 0 C;fa;Pl.1t'PILE Ail FH ALL F L'E'nL ° �'e • •• DATE OF FIELDWORK: MARCH 24, 2016 CERTIFIED T& MATH/AS PAUL GERVAIS REVISED ON: PROPERTY ADDRESS: 96 NW 92ND ST. MIAMI SHORES, FL. 331 50 ••• •:• ••• ••: �'� 1 hereby certify that the attached Sketch of Survey of the herein • • • • • 000 • • described property is to the best of my knowledge and belief,a true LEGAL DESCRIPTION: THE NORTH 65.00 FEET OF LOT 7 AND THE WEST 5.00 FEET OF THE NORTH 85.00 FEET OF LOT 1 1 , OF MIAMI SHORES �� • •� • andconedrepresentation,ofafieldsurveyperformedundermy LO MANOR, ACCORDING TO THE PAT THEREOF AS RECORDED IN PLAT BOOK 45, AT PAGE 1 3, OF THE PUBLIC RECORDS OF MIAMI DADE COUNTY, FLORIDA. ••• �• 696 ••• ••• direction.And also meets the Minimum Technical Standards as set forth by the Florida Board of Professional Surveyors and Mappers in Q,--���,--�O ,--�❑ chapter S5J-17.050 thru 5J-17.052 F.A.C.pursuant to Section 472.027 N OTE: •• I��`{ • :S�• •((Y1 PROFESSAIZAL•LA4Dt.IRWY©R &•MAPPER ELEVATIONS ARE REFERRED TO MIAMI DADE COUNTY BM# N/A ELEV.= N/A OF N.G.V.D. oF1929 • • • ••• • • • THERE MAY BE EASEMENTS RECORDED IN PUBLIC RECORDS NOT SHOWN ON THIS SURVEY. 1 431 7 S.W.:ST:Orji�ACE;NrAw Fy.pRlpp 33175 ARTURO R. TOIRAC P.S.M. 31 02 TEL: (3097•%542-75x4 F•AX:13e5P22998066 Not valid without the signature and the original embosed seal of a Florida Licensed Surveyor and Mapper. DATE(MMVD/YYYY�1 ACj0RD- CERTIFICATE OF LIABILITY INSURANCE PRODUCER 4129/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ADVANTAGE INSURANCE OF AMERICA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4520 NW 7th St HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Miami, FL 33126 OPS) 649-5566 INSURERS AFFORDING COVERAGE NAIC# ................. INSURED INSURANCE ................... 2941 S.W. 155 LANE NS�RER C .. DAVIE, FL 33331 INSURER 0 ......_........_..___._w 30 9 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY WAVE BEEN REDUCED BY PAID CLAIMS. .................. LTR INSIPID, r TYPE OF INSURANCE POLICY NUMBER z ! -111.1MM7 OtW DAT_jMMMONY) LIMITS GENERAL LIABILITY :EACH OCCURRENCE �$1,000,000.00 X COMMERCIAL GENERAL LIABILITY j PREM�lt,§(Ejj�u $ 5040 000 CLAIMISMADE Lx OCCUR i MED EXP(Anyone person) A� --5-,9.00.00 ' GLN01421AX 03/28/16 03/28/17 PERSONALS,ADV INJURY $1,000, .......... 000.00............ GENERAL AGGREGATI� GEN*L AGGREGATE LIMIT APPLIES PER] $2��_qOO,0 00.00 ...............- PRODUCTS COMPIOPA PRO- ............... _$ M INCLUDED POLICY jECT "LOC AUTOMOBILE LIABILITY :ANYAUTO COMBINED SINGLE LIMIT {Ea aGcidenU ALL.OWNED AUTO$ ...... ........... SCHEDULED AUTOS 80DILYINJURY (Per person) HIRED AUTOS BODILYINJURY NOR-OWNEDAUTOS .............. PROPERTY DAMAGE (Per accdeni) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANYAUTO ........... OTHER THAN EAACC AUTOONLY. AGG i$ EXCESSIUMBRELLA LIABILITY 4ACH OCCURRENCE OCCUR .......... CLANS MADE ................. �AGGREGATE ---------- DEDUCTIBLE ........... RETENTION .................. ....... :$ WORKERS COMPENSATION AND Wc TATU. I I OT*H- EMPLOYERS'LABILITY 70R�IIMITS £R ........................................... ANY PROPPIETOWPARTNERIEXECUTIVE El EACH ACCIDENT OFFICERMEMWR EXCLUDED? ............. Ify9s.descriDeundr E L DISEASE-EA EMPLOYE 4$ SPECIAL PROVISIONS below - ""-" OTHER E. DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT t SPECIAL PROVISIONS LIC#CPCI456811 CERTIFICATE HOLDER CANCELLATION VILLAGE OF MIAMI SHORE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 1055 NE 2 AVE DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN MIAMI SHORES,FL 33138 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SHALL DATE THEREOF. NOTICE I 'H ED T T E HE-I C To T ' IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE T ACORD26(2001108) RD CORPORATION 1988 MAKA ACOSTA 1 AGENT I 'Qsr'v a A ATT IH e - an DEPARTMENT, F FIN WAt' #: 41 "EMP" `"FROM FL4:"- t3RKEf± r E AT16LAW � .. CON STRUCTION MP led to � takes' +� law, 4/17/201,6. 4A76,2018 41111'x 7 !ERDO" Jo 5 �y7 2002042,3 Z -71 OL � •. v, IRAP , 0 , C0 LICa �s QCT �� tl . " � ntio =")�R: riciP� 2,- s:" # e� app, i tl $ 1 c� � tw �wdbe . . �. ?s t, ' , t attic it r �€ ii mor rte �:: : rsi name-0i moo*ftl mts this s �Wi nce a !e+d ict Xj�h J3 Al3.a 4. 4,..,. ,i•.,' SED NIT a..�i �.>.,.w...-m..,: � >.�..-:r.._. K,.'� _ •°•'- ..._ �' .,<.E"_. .m..' - v . ...,gyro- .d Kf CRIVED Miami Shores Village � Building Department AUG 24 2015 �l g 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 201 / BUILDING Master Permit No.TLW VS-- 2(65- PERMIT (65- PERMIT APPLICATION Sub Permit No. BUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL [—]PUBLICWORKS ❑ CHANGE OF ❑CANCEL TION ❑ SHOP f CONTRACTOR DRAWINGS JOB ADDRESS- 0 314MS 26 1V �C! -S4 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3101-016-0070 Is the Building Historically Designated:Yes NO X Occupancy Type: SFH Load: Construction Type: Flood Zone: SFE: FFE: OWNER:Name(Fee Simple Titleholder):Mathias Gervals Phone#:786-942-7767 Address:92 NW 96 st City. Miami Shores State: FL Zip. 33150 Tenant/Lessee Name: Phone#: Email: mgervais@thesetaihotel.com CONTRACTOR:Company Name: Aquarama Pools, Inc. Phone#: 305-934-4226 Address: 304 Indian Trace 503 City: Weston State: FL Zip: 33326 Qualifier Name: Jose Yzquierdo Phone#: 305-934-4226 State Certification or Registration#: CPC1456811 Certificate of Competency#: DESIGNER:Architect/Engineer: Vicente Franco Phone#: 305-305-5631 Address: 10776 nw 84 In#5 city. Miami State: FL Zip: 33178 Value of Work for this Permit:$ 1l 45(5-0 Square/Linear Footage of Work: •Y Type of work: ❑ Addition ❑ AlterationX�!ew ❑ Repair./R`e�pl ce Demolition Description of Work: 00 Specify color of color thru tile: Submittal Fee$ Permit Fee$_ —a�R E-3 -CAD CCF$ CO/CC$ � J Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ 'E;C5 . TOTAL FEE NOW DUE$ (Revised02/24/2014) �y 'Z6 ° �� ' 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER orAGEN CONTRACT R The foregoing instrumen as acknowledged before me this The foregoing instrum nowledged before me this w day of '20 15" .by 10 day f 20 I S .by c(/ who is personally known to �2 who is personally known to me or who has produced as me or who has produced _ as identification and who id take an oath. identification and who did take ahi ath. NOTARY PUBLIC: NOTARY PUBLIC: BERTO SANCHEZ �"` Sign: r Public-State of Florida Sign: o°� �pu''•, " '"` •• Commission rY FF 245271 Print: OMM- rieS Print: .• Commission a FF '4�271 1My Omm. piles un Seal. Bo►uledthr NaftW Assn. (Votary Seal: %,°�1i�°•'� BOIL Nnnona N �airr Assn x�a1�>ua�lxas>Asa/s«>k>�smrr»1�x�s�r><1���>�sss >«x1sa1�1 glesa�>t*a�$re1x�*�«�1�:1as�*s�sssal��ss*s*spa**1xs*1xa>xs+ee*�slmisa*+xss,w>uswlx�l����xw r � APPROVED BY Plans Examiner bZoning /x7;7/ Structural Review Clerk (RevisedO2/24/2014) 0 `�! Miami Shores Village uu nm Building Department �tORt1Dp° 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RESTRICTIVE COVENANT PROTECTNE POOL ENCLOSURE KNOW ALL MEN BY THESE PRESEN WHEREAS,the undersigned (r' istare the fee simple owners)of the following described property situated and Ding in iami Shores Village Florida: Address: N Whereas,the undersigned owner(s) rYG�t desire to utilize said Lot(s)as a single building site,and the undersigned owner(s)do(es)hereby declare and agree as follows: I. That the property will not be used in violation of any ordinances of Miami Shores Village or Miami-Dade County now in effect or hereinafter enacted. II. That the purpose of the covenant is to induce Miami Shores Village to issue a permit for a pool where the required enclosure is not on the subject property where the pool is located. III. That if any of our adjoining neighbors remove any portion of their fence or wall,or if our/my property shall fail to meet code requirements for pool barriers,we,as owners will immediately install a protective enclosure to meet code requirements and will obtain a permit for such fence. IV. That,I/we,as owner(s)hold Miami Shores Village harmless for any negligence or inju that results from not having the enclosure. V. if enclosure belongs to said property,I agree to maintain&or replace said enclosure i the event that is damaged or removed by any cam. NOW,THEREOF,for good and valuable consideration,the undersigned do(es)hereby declare that he/she will not convey or cause to be conveyed the title to the above property without requiring the successor in title to abide by all terms and conditions set forth herein. FURTHER,the undersigned declare(s)that this covenant is intended and shall constitute a restrictive covenant concerning the use,enjoyment and title to the above property and shall constitute a covenant running with th�land and shall be binding upon the undersigned,his/her successors and assigns and may only be released by Miami Shores Ilage,or its successors,in accordance of said Village then in effect. IGN&PRINT OWNER SING&PRINT 1 eb CertifYthat this day personally appeared before me a� dnd has produced ID # = OAA _a identifisatioa.and he/she acl Medge that he/she executel the foregoing,freely and voluntarily, for purposes there in expressed. SWORN TO AND SUBSCRIBED before me on this day of 20 N OF FtDAF orida (Revised 05/2209 ?i°� °i # FF 245271 Comm or' telly Comm Exulies Jun 29,2019 a Bonded thiuugh National rotary Asn. 5N°RES s , Miami Shores Village Bills Building Department 10050 N.E2nd Avenue �ORIDP' 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 (Wg},a�Jcnowledge Im' pool, spa or hot tub will be constructed or installed at IV W �n �T 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.(Sub it 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,punis as provided in Section 775.082 or Section 775.083 F.S.This f n must be signed by the own ag t and antractor. (07" v "S t� �S CONTR GNATURE AND DATE IGNATURE AND DATE u%,e- tJ S C €2PRIN I ,�1rp"P(je4 tate of Florida ,,,,,,, ', ,``OSPgV PVB WC Z ° 245271Statf, W1 Florida nom.ii-ores Jun29.20 '• # F :%a�211 N• • SNI °'E F, h n nrarinnat Nart�Y ,, My Comm.Expires G. ?019 Y°f F1,. Banded through Nati,,,, -'..wy 4ssn. ♦SNuR.1 r? .... null" Miami Shores Village Building Department OR1DA 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 SWIMMING POOL OWNER'S CERTIFICATION Date )to Ils— Miami Shores Village Building &Zoning Department Attention: Building Official I certify that I am the legal owner of the property described as 11V 12-4e-j EeA/?A t s ►r�.^ r�C , located at 1Jv rS 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. 2016 details - Business Tax Account AQUARAMA POOLS INC - TaxSys- Broward Co... Page 1 of 1 B ARD RAM COU lc s,/VAE 6000j �Tp ..r Records,Taxes&Treasury Div.Home Search Reports Shopping Cart ATTENTION TAXPAYERS:Please be advised of the NON-REFUNDABLE processing fees for credit and debit card transactions.Credit cards are charged 2.55%of the amount charged($2.00 minimum fee).Domestic Visa Consumer Check cards will be assessed a fee of$3.95 per transaction if you select'Debit Card'.Thank you. Broward County tax bills were mailed October 30th,2015 to the current mailing address on record with the Broward County Property Appraiser's Office(www.bcpa.net).All taxpayers with Escrow tax accounts will receive Courtesy bills mailed in mid-November. 2 Business Tax Account#97234 Account details a Account history ........ 2016 2015 2014 2013 2012 PAID PAID PAID PAID PAID Account number: 97234 Owner(s): JOSE J YZQUIERDO/QUAL Business start date: 04/15/2006 304 INDIAN TRACE#503 Business address: AQUARAMA POOLS INC WESTON,FL 33326 304 INDIAN TRACE#503 Mailing address: AIQUARAMA POOLS INC WESTON, FL 33326 304 INDIAN TRACE#503 Physical business location: WESTON WESTON,FL 33326 Print account application (PDF) lq: Print exemption application (PDF) Receipts And 0cmipations, Receipt 1894072 PAID 2015-10-06$29.70 CONTRACTORS 10/01/2015-09/30/2016 Units:2 Receipt#03A-1 5-00000142 POOL/MARINE CONTRACTOR Documentation Required by Occupation: State Certification OR Broward Cert.of Comp.(each year) Document Received: CPC1456811 https://www.broward.county-taxes.com/public/business tax/accounts/97234 11/25/2015 From: 08/20/2015 13:31 9443 P.001/001 DATE(M WDD/YYYY) AMM. CERTIFICATE OF LIABILITY INSURANCE 8 20 2015 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ADVANTAGE INSURANCE OF AMERICA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4520 NW 7th St ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Miami, FL 33126 (305) 649-5566 INSURERS AFFORDING COVERAGE NAIC# INSURED AQUARAMA POOLS INC. INSURER& CANAL INDEMNITY INS.CO. INSURER B: 304 INDIAN TRACE ## 503 INSURER c: WESTON FL 3332 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICYPERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAYPERTAIN,THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAYHAVE BEEN REDUCED BYPAID CLAIMS. INSR ADDI POLICY EFFECTIVE PCXICYEXPIRATICMI LTR NSM POLICYNUMBER DATE MM/OD DATE MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000.00 X COMm�RCIAL GENERAL LIABILITY PREMSEsccl (Ea ouace $ 50,000.00 CLAIMS MADE ®OCCUR MED EXP(Any one T�sm) $ 5,000.00 X GL102816 03/24/14 03/24/15 PERSONAL.&ADvIPDuRY $1,000,000.00 GENERAL AGC*REG4TE s2,000,000.00 GEN'L AGG lEG4TE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ INCLUDED FICUOYE-15POT F LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO (Ee accident) $ ALLOWNED AUTOS SCHEDULED AUTOS BODILYINJURY $ (Per Prion) HIRED AUTOS BODNON-OWNEDAUTOS (pore INJt) $ (Per accident) PROPERTY DAMAGE $ (Peracciderd) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANYAUTO OTHERTH/W EAACC $ A ITOO LY: AGG $ EXCESSAWBRELLA LIABILITY EACH OCCURRENCE $ OCCUR FICLAIMISMADE AGC3tEGATE $ DEDUCTIBLE $ RETENTICN $ WORKERS COMPEfdSAT1OVM0) TA U-1 EMPLOYERS'LIABILITY TORYLIMITS ER ANY PROPRIETOR/PARTNERlDECUTNE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? If yes,des ribsunder E.L.DISEASE-EA EMPLOYEE $ SPECIAL PRO VISICNS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTICN CF O'ERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BYENDCRSEMENT/SPECIAL PROVISIONS SWIMMING POOL CONSTRUCTION OF NEW POOLS INSTALLATION SURFACING OR BELOW GROUND AND REMODELING OF EXISTING POOLS. CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE SHOULD AN OF THE ABOVE DESCRIBED POLICIES BE CMICELLED BEFORE THE EXPIRATION 10050 NE 2nd Ave DATE TI-ERECF•THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN Miami. Shores, FL 33138 N0110E TOTHE CERTIFICATE HOLDER NAA,4ED To THE LEFT-,BUT FAILURE To Do So$HALL IMPOSE NO OBLIGATION OR LIABILITy OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENiA ACORD26(2001/08) pA D CORPORATION 1988 SKOREs lose tiu, Miami shores Village Building Department �LORIDp` 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. Signature:- Owner State of Florida County of Miami-Dade j '` The forego'ng w acknowledge before me this L V day of ,20�. By G who is personally kn9to me or has produce fication. ,,��HY pI�� ROBE T FZ Notary: ro;a ,` c-State of Florida Commissionit FF 245274 SEAL s My Comm E xpaes Jnn 29,2019 °`a,w �'�, 9ond9dtWough Natlonai Naar, e August 21, 2015 State of Florida County of Miami Dade Before me this day personally appeared Jose Yzquierdo, who being duly sworn, deposes and says: That he will be the only person working on the project located at 96 NW 92 st, Miami Shores, Florida. Sworn to and subscribed before me this 211 day of August, 2015 by Jose Yzquierdo, who is personally known. tJ � O SMO:l�ida u Stater ���� xpires Ju�Jli�l. o r 304 Indian Trace#503,Weston,FL 33326.Ph:954-5294552.Fax:954- 7-6426 Techko USA-ALARM PROTECTION PRODUCTS -MODEL: S 187D Page 1 of 1 EXIHWr Qualm,,Service,Integrity,Cornmitment to Excellence Print Close Window Model: 5187D-SAFE POOL One unit per single entry/opening(and/or with its screen by using the second set of sensors). Can not be used for 2 windows next to each other. Magnetic sensor entry alarm "Always on"alarm protection Adult pass-through auto reset button High output 110-115 dB alarm Water/weather resistant housing Magnetic sensor for additional door/screen door Low battery LED display CONTAINER: Addtional pass-through button for delayed entry from either side door or fence 20 FT:9,600 pcs. 40 FT:19,680 pcs. Intended for interior or exterior use 40 HQ.22'896 Imo. 9V battery operation(not included_ UPC Barcode:014575 18701 1 Pool Guard Alarm USA Patent No.5,473,310 and No.6,727,819 ETL Approved under UL 2017 Standards I i www.techkomaid.com Office Products(888)883-2456 1 Security Products(949)380-7300 so•• y • • **see* •••••• •goes• •goo e • • • rage• eogee• ••ogee see • • • • gee• eg•ee• •• • • r•r•r• • •soot• e • •e • '-ttn-//terhknmaid_enm/Reciiritvinm]/S1 R7D_himl 5/1/2014 BOUNDARY SURVEY - N SCALE: 1" = 20' 1- ) nW s3no STY.. - -- - « : II c•:............ :- :::. .......... 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'��•�, e e � ••• 0000 ••••�• -:• a 17.55, e 0 23.70' \v a 29.70 LEGEND AND ABBREVIATIONS •• •••••• •• 0000•• •• • 0000•• ^ ~`T A=ARC DISTANCE MIL=MONUMENT LINE 00 • µ f ' e Q AC=AIR CONDITIONED UNIT O.H.=OVERHEAD UT1LMES +0' -ELEVACIftle• =CATCHrBASIN • 24 00 19 B.0=BLOCK CORNER P.C.P= ® WAT� R1Ef PERMANENT CONTROL POINT :•• ••;*E••• C.B=CATCH BASIN P.O.B.=POINTO OF BEGINNING = R ®•=SANITARY SEWNR -- - (C)=CALCULATED P.O.C.=POINT OF COMMENCE POWEIRIP88E • =WATER VA•VE• CL.=CLEAR R=RADIUS •••••• •• 0 0 0 0 DAIE STORY l 15 I Remainder of C.L.F.=CHAIN UNKFENCE (R)=RECORD =LIGHT V� • •• (( •=TV BO�0•••• M Q CONC.=CONCRETE RES:RESIDENCE • =•== O Q LOT l l DJN.E=DRAINAGE MAINT.EASEMENT RNV=RIGHT-OF-WAY ®=FIRE•FjYD�/�(�J =FPL TRANS. • ENC.=ENCROACHMENT TYP=TYPICAL • • • • FD=FOUND U.E=UTILITY EASEMENT • • i••�s=CONC.POWER POLE F.F.ELEV.:FINISHED FLOOR ELEVATION W.F.=WOOD FENCE © =MAN41OLE • • • • I.F=IRON FENCE W.M.=WATER METER 0 • • •0•••• 16.1(7 20.20 •• • • ••• • • __ _--__ __ N L.F.ELEV.:LOWEST FLOOR ELEVATION !a=DL4METER _« x _ Conc Slab Q (M)=MEASERED (j--CENTER LINE JOB NL/A11B�.R: 150333 40.25 ' in BASED ON THE FLOOD INSURANCE RATE MAP OF THE FEDERAL EMERGENCY AGENCY REVISED ON 9-/ /-09 THE HEREIN L e• l 1.85' I DESCRIBED PROPERTY IS SITUATED WITHIN: On P/L ZONE X BASE FLOOD ELEV. /WA COMMUNITY NUMBER L20652 PANEL NUMBER 0302 SUFFIX L LEGAL NOTES _ ___�;.���:.��.,: 25.55' o e•.. ' xtx• :•s_. e N THIS SURVEY DOES NOT REFLECTOR DETERMINE OWNERSHIP.EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO =`= «". M DETERMINE RECORDED INSTRUMENTS,IF ANY,AFFECTING THE PROPERTY.THIS SURVEY IS SUBJECT TO DEDICATION,LIMITATIONS, x x= ?x= 4'C.LP. 3 RESTRICTIONS,RESERVA �� TIONS OR EASEMENTS OF RECORDS.LEGAL DESCRIPTION PROVIDED BY CLIENT.THE LIABILITY OF THIS SURVEY O IS LIMITED TO THE COST OF THE SURVEY.UNDERGROUND ENCROACHMENTS,IF ANY,ARE NOT SHOWN.THIS FIRM HAS NOTATTEMPTED 30 0c' �9 TO LOCATE FOOTING AND/OR FOUNDATIONS AND/OR UNDERGROUND IMPROVEMENTS OF ANY NATURE.IF SHOWN BEARINGS ARE x• REFERRED TO AN ASSUMED MERIDIAN.IF SHOWN ELEVATIONS ARE REFERRED TO N.G.V.D.OF 1829.THE CLOSURE IN THE BOUNDARY xx-x'-"`'``y`°'"-''•':°• l 05.00, SURVEY IS ABOVE 1:10000.THIS SURVEY IS NOT INTENDED FOR NEITHER DESIGN NOR CONSTRUCTION PURPOSES.FOR THOSE '< "`•rM'y`x:,••••^-••- PURPOSES A TOPOGRAPHIC SURVEY IS REQUIRED. ...««xx�:�;.:::::•:.xx::•::•;:. — — — — — — — — — — — — — — — — — 41 COW.Peace Remainder of b DATE OF FIELD WORK: March 17, 2015 N CERTIFIED TO: LOT- LOT- 7 0 a•- B Mathias Paul Gervais REVISED ON: Southern Title Group, Inc. I hereby certify that the attached Sketch of Survey of the herein rs;'•:=;,_:<= . :xt:i:-«•>« Chicago Title/ne Company described property Is to the best of my knowledge and belief,a true New Penn Pinanoalal, LLC and correct representation,of a field survey performed under my 15AOA I ATIMA direction.And also meets the Minimum Technical Standards as set /� (� forth by the Florida Board of Professional Surveyors and Mappers In NOTE: L=�G�4M G�3 oO W o 40� e chapter S, 5J-17.050 thru 5J-17.052 F.A.C.pursuant to Section 472.027 ABOVE GROUND ENCROACHMENTS NOTED: N: Professional Land Surveyor tis Mapper ALLEYEASEANT5 ACCORDING TO THE PLAT HEREON: N/A 14317 S.W.45th Terrace Miami,Florida 33175 ALLEY ACCORDING TO THE PLAT HEREON:N/A ARTURO R.TOIRAC P.S.M.3102 ELEVATIONS ARE REFERRED TO MIAMI DADE COUNTY BM# N/A ELEV.= N/A OF N.G.V.D. OF 1929 Tel:(305)552-7504 Fax:(305)229-8068 Not valid out the signature and the original embosed seal of a Florida Ucensed Surveyor and Mapper,