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BPP-16-1375 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756.8972 Inspection Number: INSP-268106 Permit Number: BPP-5-16-1375 Scheduled Inspection Date:October 05,2016 Permit Type: Pools/Whiripools/Hot Tubs Inspector: Mesa,Michel Inspection Type: Final Building Owner. RODIER,ALEXANDRE&EMILIE Work Classification: Addition/Alteration Job Address:1009 NE 104 Street Miami Shores,FL 33138-2655 Phone Number Parcel Number 1122320290140 Project: <NONE> Contractor: NATIONAL POOL DESIGN LLC Phone: (305)559-1020 Building Department Comments NEW SWIMMING POOL,SPA AND PAVER DECK RINET3 ommeftft INSPECTOR COMMENTS False THIS PERMIT IS TO REPLACE PERMIT NUMBER BPP-2-14-352 Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-268024. Need to provide pool barrier Failed � C b ee Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. October 04,2016 For inspections please call:(305)762-4949 Page 11 of 21 .16-1376 Miami Shores Village ,ftPermu7 te:Poolsl� �rlp+c �MQt Tubs 10050 N.E.2nd Avenue NE Work Gl'assfficawrt:Alt itibfl Miami Shores,FL 33138-0000 ti Phone: (305)795 2204 s "Permit Sf�S:'APPROVED Issue date.5 �5't201r s Expiration: 11/212016 �... Project Address Parcel Number Applicant 1009 NE 104 Street 1122320290140 Miami Shores, FL 33138-2655 Block: Lot: ALEXANDRE&EMILIE RODIER Owner Information Address Phone Cell ALEXANDRE&EMILIE RODIER 2325 MAGNOLIA Drive MIAMI FL 33181- 2325 MAGNOLIA Drive MIAMI FL 33181- Contractor(s) Phone Cell Phone Valuation: $ 25,000.00 NATIONAL POOL DESIGN LLC (305)559-1020 . . .,.. _.... Total Sq Feet: 485 i'. 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 i Wall Steel Classification:Residential Scanni "! 1 Review Planning �t Review Plumbing Review Electrical JOB AT � 6 ►, Review Building a, Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $15.00 Invoice# BPP-5-16-59848 DBPR Fee $11.25 DCA Fee $11.25 05/19/2016 Check#:18675 $50.00 $777.50 Education Surcharge $5.00 05/25/2016 Check#:18808 $777.50 $0.00 Permit Fee $750.00 Scanning Fee $15.00 Technology Fee $20.00 Total: $827.50 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I 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-nac ra the work stated. May 25, 2016 Authorized Signature:Owner / Applicant / ntractor / Agent Date Building Department Copy May 25, 2016 1 Miami Shores Villageby 6 7RECF'TVW'%ff Building Department 20,6 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 2014 Ste► BUILDING Master Permit No.1BI�j(P— 13�� PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION �ENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP Z CONTRACTOR DRAWINGS JOB ADDRESS: 2,✓ 2 S 8�A �Q L 1(A City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11 Z-- 3 Z-® Z q0 1 1-10 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: ;;�� Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): A Z�r�0 i2- ?-Od 1&0- Phone#: 3 ` 3 8--7 ' )2- l '1 Address: Z Y Z 5 I-1A 6-fj0 t,1°0c DP-1,9-ta City: M! 1 eft �r_s State: Zip: 331 &t Tenant/Lessee Name: Phone#: :r"(C, 1 �i Email: A R--®A l� (9 !1"A 1 L . Lm � 03- ` 2-8-3�syJ� CONTRACTOR:Company Name: N A 1A ONJA (✓ POD L J)tS) 6� Phone#: 3 - 575Y-10'20 Address: '2\47- 3 11"16Z Z City: (f+r x I State: F7— Zip: 331 �S Qualifier Name: I�-t'aF� � F-0d tom, 5,J6 i Phone#: 3- 37,5'9 — f02-Z State Certification or Registration#: C t s` f� Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 24 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: ?NfL_ - Cve pt:�_e4-,1 1 A -- 35 2- Specify Specify color of color thru tile: Submittal Fee$ ®•� _Permit Fee$ y CCF$ I �� CO/CC$ Scanning Fee$ 5 • Radon Fee$ 1 ( �� DBPR$ , ( ' Notary$ Technology Fee$ a® r GZ� 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 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 or AGENT ONTRACTOR The foregoing instrument was acknowledged beforeme this The foregoing instrument was acknowledged before me this day of 0-444 120 1/0 by A day of 1-1,4q ,20 I by M& X 46,11 tK who is personally known to k2eodRtZ .who is per onflly�n�onto me or who has roduce - 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- /1 �� ®� ,�.< s MARIA THERESA PING Seal: _ Notary Public-State of Florida Seal: ��►�"° MARIA THERESA PINO Public State of Florida Notary sW� Commission#FF 15368 . y '•'•y,F, o?.� My Comm.Expires May 7,2017 Commission#FF 15368 • io i�i�. '••,�;,oF�n�?•` My Comm.Expires May 7,2017 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) APR-23-2014 10:07A FROM: TO:3057568972 P.1 06-11-2012 JEFF ATWATER STATE OF FLORIDA CHIEFI9NANCiALOFIMIC@R- DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS` COMPENSATION +� CERTIFICATE OF ELECTION TO BV 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: 06/11/2012 EXPIRATION DATE: 06/11/2014 PERSON: RODRiGUEZ ALFREDO FEIN: 261806357 BUSINESS NAME AND ADDRESS: NATIONAL POOL DESIGN LLC " 2423 SM 147 AVE APT 212 NIANI FL 33188 SCOPES OF BUSINESS OR TRADE: 1- SMIiNINfd POOL CONSTRUCTION IMPORTANT: Pursuit to Ckapter 440 . NAML F.S., a officer of a Corporatios rbb Stam esemptisn iron this Chapter by iUlip a Certificate of alecttas ender ibis section may net recover benefits or conpusatiu under qts. chapter: Parente to Chapter 440.061121. F.S., Certificates of *]action to be saetpt.„ apply only within the awe* of tbs badness or trade listed on the notice of slecneW to be MOM Pirsnaat to Chapter 440.06115 F.S.. Notices of stages to be oaatpi end certificates of election to be eswipt Mall be soh)tct to revocation if. at ny tits after th* filing d the notice or the ieague* of the Certificate, the penia Rated oa to notice or certdiests no IseOer Waste the requirements of WS sedtne ler a Issuance ei a certtitcete Tdepartmen $bell $evoke a Certificate at any cite for fatlare.of tke person "Mod os the Cor"ltcsts to most to rawranam of title states. DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 QUESTIONS? (850) 413-1609 PLEASE CUT OUT THE CARD BELOW AND•.RETAiN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FIDIMC1AL SeRIOVES F IMPORTANT DIVISION OF N►aft MW COMPENSATiON Pursuant to Chaliter 44(.05(14), F.S, an officer of a corporation who CONSTRUCTION INDUSTRY 0 elects exemption from this chapter by filing a certificate of election CERTIFICATE OF ELECTION TO 98 ExEmPT PRou FLORIDA L under this section may not recover benefits or compensation under this WORKERS'COMPENSATION LAW D chapter. EFFECTIVE DO/11/2012 EXPIRATION DATE: 06/11/2014 pmt to Chapter 440.05112). F.S.. Certificates of election to be PERSON: ALFREDO ROD RIGUEZ H exempt- apply only within the scope of the business or trade listed on FEIN: 281808357 E the notice of election to be exempt BUSINESS NAME AND ADDRESS: E Fursuertt to Chapter 440.05(13), F.S., Notices of election to be exempt 2423 S L Pool.AVEAPT etc and.certificates of election to be exempt shall be subject to revocation tats sur 131 5 nPT zt: 14, at any time after the filing of the notice or the issuance of the MtaM4 q 33768 certificate, the person muted an the notice or certificate no lonifer meets the requirements of this section for issuance of a certificate. The department WWI a c" m SCOPE OF BUSINESS OR TRADE person named anrevoke the certificate f I most thotirrte for failure of the I_ SWU MiNo POOL cotSritticna11 section. requiretnentlzs roi this O.UESTIONS7 (850) 413-1609 CUT HERE + Carry bottom portion On the job. keep Upper portion for your records. DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11