PL-16-3156 10 1
pWO" IL
Miami Shores Village
10050 N.E.2nd Avenue NE k t8
Miami Shores,FL 33138-0000 Y
Phone: (305)795-2204
- � Expiration: 05/2812017
Project Address Parcel Number Applicant
310 NE 99 Street 1132060135580
Miami Shores, FL 33138- Block: Lot: DONALD J HAYDEN
Owner Information Address Phone Cell
DONALD J HAYDEN 310 NE 99 Street (305)799-5198
MIAMI SHORES FL 33138-
310 NE 99 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 950.00
PRECISION POWER&CONTROL,COI (305)345-2161
:... Total Sq Feet: 0
Type of Work:NEW POOL PUMP&POOL LIGHT Available Inspections:
Additional Info:NEW POOL PUMP&POOL LIGHT Inspection Type:
Classification:Residential Final
Scanning:1 Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Review Electrical
W.W.
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee $4 50 InVO1Ce# EL-11-16-62107
DCA Fee $4.50 11/29/2016 Check#:4263 $263.60 $50.00
Education Surcharge $0.20 11/17/2016 Cash $50.00 $0.00
Permit Fee-Additions/Alterations $300.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $313.60
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.
November 29,2016
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
November 29,2016 1
� s
Miami Shores Village - '- =' ` I
Building Department Nov 1 2016
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 Jc--
FBC 20 l(p -313(4
BUILDING Master Permit No.BPP-945-2257--
PERMIT APPLICATION Sub Permit No.
Q BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RRENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 310 NE 99th Street
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-3206-013-5580 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):Donald Hayden Phone#:
Address:310 NE 99th Street
city: Miami Shores State: Florida Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Miami Custom Swimming Pool Corp. Phone#: (305)592-8066
Address: 1065 Bass Point Road
city. Miami Springs State: FL Zip. 33166
Qualifier Name: Jose Quinones Phone#: (305)725-4765
State Certification or Registration#: CPC 1458439 Certificate of Competency#:
DESIGNER:Architect/Engineer: Kenneth Pfeiffer Phone#: (786)235-2435
Address:8754 S.W. 206th Lane city: Miami State: FL Zip: 33189
Value of Work for this Permit:$ � � �®� Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: ® L to P&4-rY, /-" its — Z�Jr
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ �� CCF$ CO/CC$
Scanning Fee$ Radon Fee$ ® DBPR$ L1 • Notary$
Technology Fee$ 7�5 Training/Education Fee$ Z- 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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
1
Signature Signature
OWNER or AGENT �ONTRA&0/
The foregoing instrument was acknowled d before me this The foregoing instrument was acknowledged before /m�ee this
r® day of 20 �� by day of Q\/ 20 ` co ,by
who ispersonally known to TMt GU)Ill "-S ,who is personally known to
me or who has produced as me or who has produced( r do DY IV-C
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Si n: '
Print: d Pfe Print: c!, I-<--�
Seal: Seal:MILA
IN
� ALyApEr I MAHARAI K GONZALEZ
MY= COMMISSION#GG044802
COMMISSION#FF 0 4 EXPIRES:November 2,2020
+se�,�pti BaNedTAru
APPROVED BY G7 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Miami Custom Swimming Pool Corp.
1065 Bass Point Road
Miami Springs, FL 33166
(305) 592-8066
Fax: (305) 883-8966
miamicustom@yahoo.com
RICK SCOTT, GOVERNOR KEN LAWSON,SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION,INDUSTRY LICENSING BOARD ,4
CPC145M39
9
The COMMERCIAL POOUSPA CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2016
' QUINONES,;JOSE E v ��
MIAMI CUSTOM SWIMMINtfCOL CORP
1065 BASS POINT RD._
-
MIAMI SPRINGS .. FL~33166
r �d •
ISSUED: 0750/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1407300002033
ST�►TE OF F1Q�IDA".
DEp fMl T QF$bSINESS AND
pROFEOIL ULATION
CPC1458439 u .:07/30/2014
CERT COMPPNTR
QUINONES,:IOSIr'I `
MIAMI C -CORP
IS CERTIFIED undertheFprovisions of Ch.489 FS.
Expiration date:AUG 31,2016 X1407300002033
000269
Local Bsi 'T '� .
Miam,j E ade County,
State=� of` Florida
=Li iS IS-NO BILL - DO NOT PAYLL
2347516
BE7SINESS NAMEA=ATION RECEIPT 1110.
MIAIW CUSTOM S1MMMtNC-000 CORP RENEYI►Ai. EXRt�E
SE PT
1055 BASS POINT RD 2467041 EN($;ER
W SPRINGS'FL 33156 Must be d
Misplayed at lrlaceofbusiness
Pursuant to CountyQ de '-
Chapi:erBA-Art.9&10
OWNER SEC.TYPE OF BUSINESS
MWMI CUSTOM SWIMMING POOL CORP 196 SPEC MECHANICAL CONTRACTOR PAYMENT RECEIVED
Worker(s) 1 CPC 1468439 BY TAX COLLECTOR
$45.00 09/02/2014
0230-14-005408-
This Local Business Tax Receipt 0*confirms payment of the Local Business Tax.The Receipt is not a Hennse,
PMmptoracertifiratoe.ofthe holder'squalificatim todobusiness. Holdermosttamplyprit6errygoveralaautei
Of-06"overnmer afrealatoryl mquimmemsw".,MiytothebaBiaos
The BECEIFT No.above muRbe displayed on all Cu menial vehicles—N> min Code Sec 8e-_276.
Formorehulormation,"mmI midade xcoHecbrtr
'MIAMadADE
MIAMI-DADE COUNTY -STATE OF FLORIDA N/A October 07,2015
RM LOCAL BUSINESS TAX RENEWAL
2347516 2015 -2016 APPLICATION RECEIPT:2467041
STATE#CPC 1458439
DBA/BUSINESS NAME: BUS.COMMENCEMENT DATE:11/01/1990
MIAMI CUSTOM SWIMMING POOL CORP SEC TYPE OF BUSINESS
BUSINESS LOCATION: MECHS SPEC MECHANICAL CONTRACTOR
1065 BASS POINT RD 1
MIAMI SPRINGS,FL 33166
OWNER/CORP. APPLICATION DETAILS
MIAMI CUSTOM SWIMMING POOL CORP FEE AMOUNT
PHONE# 305-592-8066 Receipt Fee 30.00
UMSA Fee 0.00
1065 BASS POINT RD Beacon Council Fee 15.00
MIAMI SPRINGS,FL 33166 Bingo Permit Fee 0.00
Nightclub Permit Fee 0.00
Multi-Municipal Contractor Fee 0.00
Restricted Contractor Fee 0.00
Library Fee 0.00
NAICS CODE: 238990 Transfer Fee 0.00
Doing Business without a License Penalty 0.00
Late Penalty 0.00
Collection Cost 0.00
NSF Fee 0.00
Prior Years Due 0.00
Amount Recently Paid
TOTAL AMOUNT DUE: 0.00
.................................................................................................................................................................................................................................................................................................................
If no longer in business,please notify us in writing. To pay online go to www.miamidade.gov/taxcollector
Review and correct the information shown on this application. To pay by mail,make check payable to:
Miami-Dade County Tax Collector
A 25%penalty will be assessed to anyone found operating Business Tax
without a paid local business tax, in addition to any other 200 NW 2nd Avenue
penalty provided by law or ordinance(Sec 8A-176(2)). Miami FL 33128
To pay in person go to:
A Certificate of Use and/or City Business Tax 200 NW 2nd Avenue
Receipt may also be required. (305)270-4949,fax(305)372-6368
A service fee of not less than$25.00 up to a minimum of 5%
will be charged for all returned checks.
t RETAIN FOR YOUR RECORDS t
.................................................................................................................................................................................................................................................................................................................
MIAMI-DADE COUNTY- t DETACH HERE AND RETURN THIS PORTION WITH YOUR PAYMENT + N/A October 07,2015
STATE OF FLORIDA
LOCAL BUSINESS TAX RENEWAL
I 2467041
2015 -2016 APPLICATION IIIII�IIIIIIII�III�IIIIIIII IIIIIIIII�II IIIII�II�III�III S ATE#CPC 1458439
2347516
BUSINESS LOCATION:
1065 BASS POINT RD
MIAMI SPRINGS,FL 33166 BUS.COMMENCEMENT DATE:11/01/1990
SEC TYPE OF BUSINESS
OWNERICORP. MECHS SPEC MECHANICAL CONTRACTOR
MIAMI CUSTOM SWIMMING POOL CORP 1
APPLICATION IS HEREBY MADE FOR A LOCAL BUSINESS TAX RECEIPT OR PERMIT FOR THE BUSINESS PROFESSION
OR OCCUPATION DESCRIBED HEREON.I HAVE BEEN INFORMED OF ALL ZONING RESTRICTIONS IMPOSED ON THIS RECEIPT.
I SWEAR THAT THE INFORMATION IS TRUE AND CORRECT.
MIAMI CUSTOM SWIMMING POOL CORP
JOSE E QUINONES PRES
1065 BASS POINT RD SIGNATURE REQUIRED SEE INSTRUCTIONS ABOVE
MIAMI SPRINGS,FL 33166 Please pay only one amount.The amounts due after Sept 30th Include penalties
per FS 205.053.
If Received By Oct 31,2015 Nov 30,2015 Dec 31,2015 Jan 31,2016
Please Pay $0.00 $0.00 $0.00 $0.00
7000000000000000000000002467041201600000004500000000000009
ACC7R�' DATE(IsuutotrmY�
CFERTIFICATE OF LIABILITY INSURANCE 09103/2015
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO MOWS'UPON THE CERTIFICATE HOLDER.THi3
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEN% EX•1 END OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($). AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT, If the certillc ift holder is an ADDITIONAL INSURED,the potiay(Ies)must liq endorsed. E'SUBROGATION IS WAIVED.subject W
the terms and awditions ial"die paliey,certain policies may require an endonaament A Statement an this certificate dogs not confer rights to the
certificate holder in Iisu of such endoraemertac).
PPJZUCM UAOVI ar CARIDAD DIAZ -
P&C INSURANCE AGENCY PHONa •. 305-223-9400 FAC,AC, 305-223.6800
9445 S.W.40TH ST SUITE 106 � , porr.urance.aggnt�maO.com
ROU $AEMMCOVERAGE NAICs
MIAMI FL 33165 Nsuw,: BASS UNDERWIWTRS
wMuarro MURER8; NORMANDY INSURANCE COMPANY
Miami Custom Swimming Pool corp c;
10830 N.w,•22 Sty D;
E:
MIAMI FL 33172- 194SURFR F,
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER-
THIS IS TO CERTIFY TIJAT'tHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN I$SUED 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 16 SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LIM TYPE OF IRKWANCE 6uBR POLICY NUMBx EXP Ll0E1T8
C09MOICIALGEISIERALLMAWly EACHOCCLIIRENCE $ 300.000
CLAIMS-MADE OCCuR UWAUE END 100,000
MED EXP ane e�y S 9,000
DVA206376-o0 0410712018 04/04/2016 PERSONAL.a ADV IMAIRY s W0*000
GEN'L AGGREGATE LOUT APPUES PER: I GENERAL AGGRE(IAT6 S 9001000
PoucY F7 ❑LOC PRooucrs-COTAPIOPApG $ INCL
S
OTHER:
AUT MCMLE UASILT Y tNED MWMBINf0.E uw M
ANY AUTO BODILY INJURY(PW DBIw) 5
ALL OWNED pC�TTpggly(A BODI.YINJURY(Perwddffi) $
AUTOSWWI411MEDHIRED AUTOSq,SCHEDULED
AUTOS
UMBRE.IA ul- OCCUR EACH OCCURRENCE $
EXCESS LIAR (1, MS-MADE NIA AGGREGATE $
OEO $
NR)RKBRBCONPBNSATION
AND EMPLaYWW LWRA1T7Y100,000
ANY PROPRIEMMPAR1NEIVEXSCUTNE YN NIA WC-76-0418 08/01/2415 0810112078 E.L.EACH ACCIDENT $
A 0FROERAaE AER MMVMC!
in NH) E.L.DI E- A 64tFLgYE $ 500,000
�nndetefy
tepee daae+�mWer 100,000
�sL1�IPTiaN�QPERATIONs eww• E,L.61S6AME-POLICY UMIr S
DESORWYM OP OPSRAnONS r LOCAYMSI VEH[o r tAooFD M Addidonal Remsft Soule,maybe attached V moire spam Is reqdved1
POOL AND SPA CONTRACTOR CPC1468432 EXPIRATION DATE 08(31/2016
NEW SPA AT 310 NE 99 ST MIAMI SHORES,FL 33128
CERTIFtC TE HOLDER EE.6 ON!
SHOULD ANY OF THE ABOVE DESCROWD POLIp68 BE CANCELLED BEFORE
THE EXPIRA461 DATE THEREOF, .K*TYcE• V4L as.OELMFRF-M IN
MIAMI SHORE VILLAGE ACWRDANOE WfrH THE POLICY PROVISIONS.
10050 NE 2-AVE au1HtD •
MIAMI SHORES.FL 33137
01988-2014 ACORD CORPORATION. All dgtfs reamed.
ACORD 25(2014101) The ACORD name and logo are registered maft of ACORD
s + Miami Shores Village
"' "'n" BuildingDepartment
05 .2nd Avenue
RIpA 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 (We) acknowledge that a new swimming pool, spa or hot tub will be constructed or installed at
310 NE 99 ST Miami Shores,FL 33138-2437 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.(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 W considered as committing a misdemeanor of the second
degree,punishable as provided in ectio. 775.082 or Section 775.083 F.S.TWfomust be signed
by the er/ ent the prim contactor.
'CO �A J.4L
TOR S IGN ND DATE 0 NER'S SIGNATOR
Jose Quinones Donald
CONTRACTOR'S NAME(PLEASE PRINT) OWNE S E(PLEA PRINT)
NOTj;; ARY
COELLO ,o��aA
* * W COWISSION;i FF 018011 My CoMmISSION#E 5938
EXPIRES:May 14,2017 * Q EXPIRES:January 12i 2017
Nr4lE��d-' BandedThraBWpNuWyServI dggrf0F4`oP�o - gudgetNelary
e
Miami Shores Village
t Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RESTRICTIVE COVENANT PROTECTIVE POOL ENCLOSURE
KNOW ALL MEN BY THESE PRESENTS:
WHEREAS,the undersigned Donald Hayden is/are the fee
simple owners)of the following described property situated and being in Miami Shores Village,Florida:
Address: 310 NE 99 ST Miami Shores , FL 33138-2437
Whereas,the undersigned owner(s) Donald Hayden
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 )eir 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,Uwe;as owners)hold Miami Shores Village harmless for any negligence or injury that results from not
having the enclosure.
V. If enclosure belongs to said property,I agree to maintain&or replace said enclosure in the event that is
damaged or removed by any case.
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 the land and shall be
binding upon the undersigned his/her successors and assigns and may only be released by Miami Shores Village,or its
successors,in dA AV
ccordance aid Village then in effect
WNRSI & _ / OWNER SING&PRINT
I Hereby Certify !!t on Isis day personally appeared before me ��u L, J i4c'zt� ced ID
# as identification and he/she acknowledge that helshe executedthe fo oing,freely and volu
for purposes there in exp r ed. (
uvr
SWORN TO AND SUBSCRIBED before me on this t day of 1 .20/
ao1 �Pu* A Qll S
EE 145938
NOgr� (j$01Wra Q j@1 17
(Revised 05/2209 �jq�OFF�.OL Ba�edTtwg dy�Notmy SWAM