BPP-15-2161 xl )�
Pf�rt13 . ,2 �?1
o yst Miami Shores Village efft'ttt 7"p l'�c o� Iftlrlp" Hot Tubs ;
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000 ljasC;1tt,
F+1! Status:AP`p
Phone: (305)795-2204 ,
�p15 Expiration: 0 1
K
�
Project Address Parcel Number Applicant
358 NE 101 Street 1132060135280
PATRICE AND SCOTT SMITH
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
PATRICE AND SCOTT SMITH 358 101 Street
MIAMI SHORES FL 33138-
358 101 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 26,000.00
ROSMEL POOL INC (305)592-7900
_.. ._. Total Sq Feet: 1180
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 POOL AND DECK Bond Return:BOND NOT NEEDED JF Wall Steel
Classification:Residential Scanning:3 Review Building
Review Building
Review Planning
Review Planning
Review Planning
Review Mechanical
Review Electrical
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Structural
Bond Type-Contractors Bond $0.00Review Plumbing
CCF $15.60 Invoice# BPP-8-15-56835 Review Plumbing
Correction Resubmission Fee $50.00 08/24/2015 Credit Card $50.00 $934.00
DBPR Fee $11.70 10/09/2015 Check#:13082 $934.00 $0.00
DCA Fee $11.70 Bond#:2871
Education Surcharge $5.20
Permit Fee $780.00
Plan Review Fee(Engineer) $80.00
Scanning Fee $9.00
Technology Fee $20.80
Total: $984.00
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 A I(DAVIT: certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction d zoning. Fut ermore,I au orize the above-named contractor to do the work stated.
�G October 09, 2015
Aut orized Si ature:Owner / Applica / Contractor / Agent Date
Building Department Copy
October 09,2015 1
Miami Shores Village
Building Department AUG z ��
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 BY:
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20ig5
BUILDING (waster Permit NoTR - l S- ZI C
PERMIT APPLICATION Sub Permit No.
ZBUILDING r--] ELECTRIC ❑ ROOFING [] REVISION ❑ EXTENSION ❑RENEWAL
[]PLUMBING r-� MECHANICAL ❑PUBLIC WORKS F-1 CHANGE OF F-1 CANCELLATION [:] SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 358 u-W- 1c)1 s-
City: Miami Shores County: Miami Dade zip: 3 1
Folio/Parcel#: 1 1 . 320!a • 01 A.5 28 O Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): Scdrt-(-' ,it h Phone#:
Address: ;52 NE 101 St. ,
City: M �®►rv;i S Inc cc State: 1=t_ zip: 3313£s
Tenant/Lessee Name:__ IJ 11.A Phone#:
Email:
CONTRACTOR:Company Name: "nrae-1 Phone#: 305.5sk-m o
Address: I_DL45 1X..-5 3L S4 . -45140
City: 17orm 1 State: Fl_ Zip: 5511,
Qualifier Name: ,r+".A Vaunejds, Phone#: 305.5�ia-7 9Q�
State Certification or Registration#: C''PG 1 X15 r.RQ!4 Certificate of Competency#:
DESIGNER:Architect/Engineer: "r-;d. 44eic,iaJOACze 1 "ll�0�3 Phone#: aQ5:Twn -N-'It-!�
Address: 1 3441 $tom aar -Te.rr. City: rNa; State: L zip: am-15-
Value of Work for this Permit:$ a C., D o Co Square/Linear Footage of Work: pow
Type of Work: ❑ Addition ❑ Alteration 2PNew ❑ Repair/Replace
❑ Demolition
Description of Work: M C4,j lac e-L
Specify color of color thru tiles
Submittal Fee$ Permit Fee$a&O ` Cjo CCF$ CO/CC$ SO-®®
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ T ' oo
(Revised02/24/2014)
Bonding Company's Name(if applicable) 1.,J 1 A •
Bondin Company's Address 14 {.
ity State Zip
Mortgage Lender's Name(if applicable) #J &
Mortgage Lender's Address tJ #
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 meat 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 ATT,0RNEY 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,-- z Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument eras acknowledged before me this
s�O day of Ay Iy P20 %S , by .2 C:) day of 20 IS ,by
Sr kn;+n who isrsonally know o who is ersonally know to
me or who has produced 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 01Sign:
Print: pycuS G Print: v r r]e'7i
'yF
Seal: Seal: _ MARTINEZ
4�Y MARCOS A MARTINEZ * �+= MY CCCMMISSION Ik FF X89
MY COMMISSION#FF 008W EXPIRE5 Y 2017
*: a,•., .�: M8 15,
EXPIRES:May 15,2017 �f; �•° BorMed TnN
Bomb Thru Nofmy Publb Undembts Notary Public lkrderwrlters
/lam
APPROVED BY
d-1
Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
. :-• I I Ili NII illll ILII i ii Ilial Illli I li l 1
C.FN 21013R0327048
OR: 8k 28600 Pgs 1844 - 1845# (lass)
• Guaranty Trust&Title,Inc. RECORDED 04/25/2013 15:25:53
1909 Tyler St.,Suite 306, DEED DOC TAX 0060
HARVEY RUIVItdr CLERK OF COURT
Hollywood,Florida 33020 MIAMI-DADE COUNTYr FLORIDA
Parcel ID No: 11-3206-013-5280
CORRECTIVE WARRANTY DEED
Made this ',////6"//3 by Benjamin D.Mearig and Ann J.Mearig,husband and wife,whose
address is: 530 Anita Lane,Millbrae,CA 94030 hereinafter called the grantor,to Patrice Gillespie-Smith and
Scott F.Smith,wife and husband,whose post office address is:358 NE 101 Street,Miami Shores,Florida
33138 hereinafter called the grantee:
(Whenever used herein the term"grantor"and"grantee"include all the parties to this instrument and
the heirs, legal re-ptacatatives and assigns of individuals, and the successors and assigns of
corporations)
Witnesseth, that the grantor,for and in consideration of the sum of$TEN AND NO/100 DOLLARS
($10.00) and other valuable considerations, receipt whereof is hereby acknowledged, does hereby remise, release,
and quit claim unto the grantee forever,all the right,title,interest,claim and demand which the said grantor has in
and to,all that certain land situate in Miami-Dade County,Florida,viz:
The West 1/2 of Lot 4 and all of Lot 5,Block 39,An Amended Plat of Miami
Shores Section No. 1, according to the map or plat thereof, as recorded in Plat
Book 10, Page(s) 70,of the Public Records of Miami-Dade County,Florida.
This Corrective Warranty Deed is being recorded to correct and replace the Warranty Deed
executed by Benjamin D. Mearig and Ann J. Mearig, husband and wife to Patrice Gillespie-Smith and Scott F.
Smith,wife and husband, dated June 22,2012, filed June 27,2012 in Official Records Book 28166,Page 2138, of
the Public Records of Miami-Dade County, Florida, which contained an erroneous Folio number and is commly
known as:358 NE 101 Street,Miami Shores,FL 33138. This Deed is to correspond with Corrective Warranty Deed
filed 08/08/2012 in Official Records Book 28221,Page 3156.
Subject to:
1. Taxes for 2012 and subsequent years.
2. Conditions,restrictions,reservations,easements ad limitations and zoning ordinances,if any,but not
reimpose some,
Together with all the tenements, hereditaments and appurtenances thereto belonging or in anywise
appertaining.
Quit Claim Deed
OR BK 28600 PG 1845
L-AST PAGE
To Have and to Hold, the same together with all and singular the appurtenances thereunto
belonging or in anywise appertaining,and all the estate,right,title,interest,lien,equity and claim whatsoever of the
said grantor,either in law or equity,to the only proper use,benefit and behoof of the said grantee forever.
In Witness Whereof, the said grantor has signed and scaled thcse presents the day and year first
above written.
Signed,sealed and delivered in our presence:
,� fJ
� tsean
Benjamin D.'
witness Pri Name Address. 530 Aorta Lane,Millbrae,CA 94030
J
Witness Print Name '
State of California y!
Countyof `jcaltrl I �` 1�i� 4
The foregoing instrument was acknowledged before me this t 1 V ,by Benjamin D.Mearig,
who is personally known to me or who has produced_ c as identification.
My Commission Expires WiTz
JOHNEY MUNAYER
Commission# 1898158
m Notary public-California z
San Francisco County D
M Comm.Expires Aug 1,2014
Quit Claim Deed
S�uRBy+
Lltt
.193i
sell
,,,,,� Miami Shores Village
�. �'� Building Department
O
�IRNP
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 SL.d+� �mrE-� is/are the fee
simple owner(s)of the following described property situated and being in Miami Shores Village,Florida:
Address: 3S% nl E t o t< 54_ N1 is m i ��i,pre �1., 33138
Whereas,the undersigned owner(s) SLo't t' <m 1+"
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 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
7,rs
iccordM-
--OWNER
age then in effect.
SIGN&WINT OWNER SING&PRINT
S;L,* F _tk
I Her2jb Certify that on this day personally appeared before me S_r ' 5M j and has produced ID
# 10L 1A_ as identification and he/she acknowledge that he/she executed the foregoing,freely and voluntarily,
for purposes there in expressed.
SWORN TO AND SUBSCRIBED before me on this Qday of 20 5
NOTARY PUBLIC STATE OF FLORIDA
(Revised 05/2209
-.iq`•� "y�G; MARCOS A.MARTIN
* •= MY COMMISSION#FF 008989
EXPIRES:May 15,2017
Bonded Thru Notary Public Underwriters
♦5�0REs Gi
Miami shores Village
soon 31111111" Building Department
�t10050 N.E.2nd Avenue
OR1Dp'
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) acknowledje that a new swimming pool, spa or hot tub will be constructed or installed at
358 Nt 1 f 5+. ii,-Niiami 5har s I F� L ab 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 init' 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 will be considered as committing a misdemeanor of the second
degree,punishable as provided in Section 775.082 or Section 775.083 F.S.This form must be signed
by the owne lament and the prime contractor.
CONTRACTOR'S SIGNATURE AND DATE OWNER'S SIGIIATURE AND DATE
M lvfha &4+J 11V
CONTRACT R'S NAME(PLEASE PRINT) OWNER'S N E(PLEAS PRI T)
V IQ N TARY PUBLIC
MARCOS A MARTINEZ
COMMISSION#FF 008989 MAR
COS A MARTINEZ
e EXPIRES:May 15,2017 MY COMMISSION#FF 006989
p ;c°•'' Bonded Thru Notary Public Undarwrtera '� 4 EXPIRES:May 15,2017
Bonded Thru Notary Publ c Undenr
♦5�OREs Lr
' ... " Miami Shores Village
Building Department
�20RiDp'
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
SWIMMING POOL OWNER'S CERTIFICATION
Date -i 1a0 1 as 15
Miami Shores Village
Building &Zoning Department
Attention: Building Official
I certify that I am the legal owner of the property described as
►AJ;25rf+Esq' ►crt AA ail 110+-✓ 51 V-30)
Miami Sho -e.5 Rem I *m A ►o- located at
In accordance with Section 33-12(f), Code of Metropolitan Dade County, I certify that
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.
r �
��� 14770 SW 43rd WAY, SCALE: 1"=20' JOB ISO: 12OW45A
M E NS I 0 N S INC MIAMI,FL 33185. FIELD DATE:03-04-2015
PHONE: (305) 512-4225 TYPE OF PROJECTS
. Land Surveying Services FAX: (305) 512-1914 BOUNDARY SURVEY
FOR: SCOTT F.SMITH AND PATRICE GILLESPIE-SMITH The W 1/2 of LEGAL DESCRIPTION: AN AMENDED PLAT OF MIAMI
PROP.ADD: 358 N.E. 101st STREET,MIAMI SHORES,FL 33138 LOT: Lot 4&all Lot 5 BLOCKt 39 SUBDIVISION:SHORES SECTION No.1
PLAT BOOK:—10—PAGE: 70 OR MIAMI-DADS COUNTY,FLORIDA.
N.E. 101st STREET _
�q5 I 75.00'Total RMI �p
q•
20'Asphalt
in
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Conc. 22'Parkway Cn
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FND.I.P.1/2"
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No FN9Do
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B.C. aWLV
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4
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14.00
WV 5.00' 8.00' n W
40.50' I �� PL •
1.00' x.47'_
CL GAR=8.83'
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F.F.E.=10.54' �0 o�
AICONE STORY CBS I 8
M o RESIDENCE#358 I m
0c v I no
m
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m w I 13.50' x " v
J I
F.F.E.=10.04' d 10.35' cc
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F orch
LL 26.00' I Ii
J I CERTIFIED T0:
0 I �x SCOTT F.SMITH AND PATRICE GILLESPIE-SMITH
Qy I
Lot 5 Block 39 F The W 1/2 of Lot 4
0.20' �% I Block 39 x
CL 61,
I I
g tOJ PI �J89S'f7
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LJ'C.L.F. W. 0 8
75 0' 1.00' FND.I.P.1
(NO ID) o W P P
Cl) 15' ALLEY 9'Asphalt
SURVEYORS MOTES.
1.)THE SURVEY OF THE PROPERTY SHOWN HEREON IS IN ACCORDANCE WITH THE
DESCRIPTION FURNISHED BY CLIENT.
2.)UNLESS A COMPARISON IS SHOWN,ALL BEARING,ANGLES AND DISTANCES SHOWN
ARE THE SAME AS PLAT VALUES.
3.)THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENTS OR OTHER ABBREVIATIONS.-
SWK=Sidewalk,CBS=ABBREVIREVIe Block 3Wcanre,CLF-Chats Link Fence,
RECORDED ENCUMBERANCES NOT 3HOWN ON THE PLAT AND THE SAME,IF ANY MAY PL=Property Lh .DUE= a Ud ty Easement IP=Iron Pipe,
NOT BE SHOWN ON THE SKETCH. AICs Ah CmMifkmar Pad,PIC= ropy Comer,D/H=Drilled Hole,
4.)UNDERGRAUND PORTIONS OF FOOTINGS,FUNDATIONS OR OTHER IMPROVEMENT WIF=Wood Fence,RES=Residence,CL=Clear,IR-Iron Rebar,UE-Uttity
WERE NOT LOCATED. Easmnant,CONC=Cole.Slab•RIW=Right of Way,DE=Drainage Easement,
S. FENCES TIES ARE TO THE CENTER LINE OF THE SAME. CIL-Carrier Line,0=Diameter,TYP=Typical,M=Measured,R=Recorded,
9. WALL TIES TO THE FACE OF THE SAME. ENCR=Encroachment,COMP=Computer,ASPH=Asphalt,NID=Nall&Disc.,
7.)ELEVATION WHEN SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM S=Set,FFE=Finish Fkla Elevation,OIS=Offset P/Po Paver Pole,
(1929 UNLESS OTHERWISE NOTED. OHP-Overhead Pov erlft WM=Water Meter,WPP-Wood Parer Pole,
8.)THE NO ABOVE GROUND ENCROACHMENTS OTHER THAN THOSE SHOWN. E.M.=ElecMc Mete,M.F=Metal Fence,P.F.=Plastic Fence,D.M.E.=Dminege
Maintenance Easement C.M.E.-Canal Maintenance Easement L.M.E.=Lake
9)BENCH MARK USED IS N-802 ELEVATION=8.98'NGVD 1929 Maintenance Easement M.E.-Maintenance Easement B.C.=Bbck Come,
P.C.=Poled of Curvature,FND=Fomd,NO ID=No IdentlOcadon.
(FLOOD ZONE INFORMATION) IREMYCERM-
TW Do ath.h.d"MMARY SURVEY'of ea,=Ma alwon Innson b trw=d CM d t.Sr
120652 1208600302 BASE: °"l°'°"`"°"' pand°.o°`°"ee`"'"e'�a'a.a"'dundamysupwvWena°
ZONE: X COMM: PANEL: SUFFIX: L DATE'9-11-2009 N/A m,edea,nu,=a.a,,aoA„Ea,.me,,,,rnama,ananTd.WSand d.aaoptw ,�.
7DAVID
itaeraalautBow�taetM aconhin.dInChaphrOJ47. am.
NOTE:DETERMINATION OF FLOOD ZONE LINES WERE BASED ON SCALING OF FEMA MAP LISTED ABOVE, wM� Tz '&an,m.
NOTES ALL BEARING HEREON ARE BASED TO THE PLAT BEARING OF N/A ON THE CENTER LINE OF N/A PROPERTY LINE.EASEMENT VIOLATIONS: 0 YES N No L. FUTCH
APPARENT VISIBLE ENCROACHMENTS: 11 YES ®NO REGISTERED LAND SURVEYOR#4843
STATE OF FLORIDA LB#WM74
COMENTS: NOTE:NOT VALID UNLESS
SIGNED AND SEALED SHEET 1 OF-1-1
e f APPLICATION #:AP1184183
y; STATE OF FLORIDA -SC-1 PERMIT #:13599238
DEPARTMENT OF HEALTH DOCUMENT #:F11006386
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVF.L DATE PAID:04/10/2015
FEE PAID:375.00
RECEIPT #:13-BID-2743694
APPLICANT: Gillespie Smith -
AGENT: Statewide Septic
PROPERTY ADDRESS: 358 NE 101 St Miami, FL 33138
LOT: 6 BLOCK: 39
SUBDIVISION: ID#: 11-3206-013-6280
CHECKED [X) ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION SBiiBACKS
( ] [Oil TANK SIZE [11 900.00 (2) ( 1 [271 SURFACE WATER FT
( l [021 TANK MATERIAL Polyethylene [ 1 [281 DITCHES FT
( 1 [03] OUTLET DEVICE [ 1 (291 PRIVATE WELLS FT
( 1 [041 MULTI—CHAMBERED ( Y N ] ( 1 [301 PUBLIC WELLS FT
[ 1 [051 OUTLET FILTER Tuf-Tite EF-4 ( 1 [311 IRRIGATION WELLS FT
[ 1 [061 LEGEND 1. 70-109-20DC3 2. [ l [321 POTABLE WATER 40 FT
[ l [071 WATERTIGHT [ 1 [131 BUILDING FOUNDATIONS
( 6 FT
1 (081 LEVEL
[ 1 [..41 PROPERTY LINES 5 FT
[ l [09] DEPTH TO LID [ l l%51 OTHER FT
DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM
[ J 1101 AREA [l] 375 121 SQFT [ 1 ['.61 DRAINFIELD COVER
[ ] [11J DISTRIBUTION BOX HEADER X [ 1 [371 SHOULDERS
[ l [121 NUMBER OF DRAINLINES 1. 4.00 2. [ 1 pa) SLOPES
[ 1 [13] DRAINLINE SEPARATION [ J [ 91 STABILIZATION
( 1 [141 DRAINLINE SLOPE
[ 1 (151 DEPTF OF COVER ADDITIONAL INFORMATION
( 1 [161 ELEVATION [ ABOVE / BELOW IBM 31.20 I l (4:11 UNOBSTRUCTED AREA
[ l (171 SYSTEM LOCATION [ ] [V11 STORMWATER RUNOFF
[ 1 (181 DOSING PUMPS j ) [521 ALARMS
[ 1 [191 AGGREGATE SIZE [ 1 [431 MAINTENANCE AGREEMENT
[ 1 (20) AGGREGATE EXCESSIVE FINES [ 1 [S4] BUILDING AREA
( 1 (211 AGGREGATE DEPTH [ l [45) LOCATION CONFORMS WITH SITE PLAN
FILL / EXCAVATION MATERIAL [ 7 [=5J FINAL SITE GRADING
[ l (221 FILL AMOUNT [ 1 [4 7 1 CONTRACTOR Teresa J Solomon(Statewide
[ 1 [233 FILL TEXTURE [ 1 1481 OTHER ADS ARC 24
[ ] [241 EXCAVATION DEPTH ABANDONMENT
( 1 [251 AREA REPLACED [ 1 [4191 TANK PUMPED
[ 1 [261 REPL7►CEMENT MATERIAL ( ] ['`01 TANK CRUSHED 6 FILLED
Comments: Comments are on page 2.
CONSTRUCTION [ APPROVED DISAPPROVED l " l Dade CHD DATE: 06/26/2015
Engi tis 1 y of Mayt n[Departmentof Health in Dade Cou
FINAL SYSTEM [ APPROVED DISAPPROVED ]: Dade CHD DATE: 06/26/2015
(Explanation of Viola.^.iona on following Page) �'ng neer ng pec a .an e e1�r n of Health In Dade Co
DH 4016, 08/09 (Obsoletes all previous editions which may not be t.sed)
Incorporated: 64E-6.003, FAC Page 2 of 3
EH Database v 1.0.1 API 184183 EID1599238
r
APPLICATION a.AP1184183
STATE OF FLORIDA PERMIT #:13-SC-1599238
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT #:F11006386
� CONSTRUCTION INSPECTION AND FINAL APPROVAY: DATE PAID:04/10/2015
FEE PAID:375.00
Comment RECEIPT #:13-BID-2743694
Violation Number
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Comments
-New 900 gal.septic tank.
-Tptal of 4 drainlines-3 line with 6 chambers, 1 line with 7 chambers.
Total of 25 ARC24 chambers for 375 sq ft trench drainfield.
-42"of sand
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedioom),for a total estimated flow of 300
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DH 4016, 08/09 (Obsoletes all previous editions which may npt be used)
Incorporated: 64E-6.003, FAC Page 2 of 3
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U.S.DtPARTMENTOFHOMELANDSECURITY ELEVATION CERTIFICATE
FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008
National Flood Imurance Program Important: Read the Instructions on pages 1-9. Expiration Date:July 31,2015
SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name SCOTT F.SMITH AND PATRICE GILLESPIE-SMITH Policy Number
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number.
358 NE 101 STREET
City MIAMI SHORES State FL ZIP Code 33138
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
THE W1/2 OF LOT 4&ALL LOT 5 BLK 39 AN AMENDED PLAT OF MIAMI SHORES SECTION NOA PB 10 PG 70
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)RESIDENTIAL
A5. Latitude/Longftude:Lat.2552'04.27"N Long.60°11'25.18'W Horizontal Datum: ❑ NAD 1927 ® NAD 1983
A6. Attach at least 2 photographs of the building If the Certificate is being used to obtain flood insurance.
AT Building Diagram Number 8
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) 1.500 sq ft a) Square footage of attached garage 204 sq ft
b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings In the attached garage
or enclosure(s)within 1.0 foot above adjacent grade 12 within 1.0 foot above adjacent grade 2
c) Total net area of flood openings in A8.b 1.654 sq In c) Total net area of flood openings In A9,b 168 sq in
d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number B2.County NameTFL
3.State
120652 VILLAGE OF MIAMI SHORES MIAMI-DADE
B4.Map/Panel Number B5.Suffix B6.FIRM Index Date B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
12086CO302 L 9-11-2009 Effective/Revised Date Zone(s) AO,use base flood depth)
9-11-2009 1 X N/A
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item B9: ® NGVD 1929 ❑ NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes ® No
Designation Date:j /meq ❑ CBRS ❑ OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations-Zones Al A30,AE,AH,A(with BFE),VE,V1 V30,V(with BFE),AR,AR/A,ARAE,AR/A1-A30,AR/AH,AR/AO.Complete Items C2.a-h
below according to the building diagram specified in Item AT In Puerto Rico only,enter meters.
Benchmark Utilized:N-802 ELEV=8.98' Vertical Datum: NGVD 1929
Indicate elevation datum used for the elevations in items a)through h)below. ®NGVD 1929 ❑NAVD 1988 ❑Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a)Top of bottom floor(including basement,crawlspace,or enclosure floor) $.7' ®feet ❑meters
b)Top of the next higher floor 1 .04' ®feet ❑meters
c) Bottom of the lowest horizontal structural member(V Zones only) N19. ❑feet ❑meters
d)Attached garage(top of slab) 8.83' ®feet ❑meters
e)Lowest elevation of machinery or equipment servicing the building 8.78' ®feet ❑meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 8.6' ®feet ❑meters
g)Highest adjacent(finished)grade next to building(HAG) 8.7' ®feet ❑meters
h)Lowest adjacent grade at lowest elevation of deck or stairs,including structural support IN/A._ ❑feet ❑meters
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation
information.I certify that the information on this Certificate represents my best efforts to interpret the data available.
1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Cade,Section 1001.
® Check here If comments are provided on back of form. Were latitude and longitude in Section A provided by a
® Check here If attachments. licensed land surveyor? ® Yes ❑ No
Certfier's Name DAVID L.FUTCH License Number 4843
Title PRESIDENT Company Name GLOBAL DIMENSIONS,INC.
Address 14770 SW 43 WAY City MIAMI State FL ZIP Code 33185
Signature Date 03-04-2015 Telephone 305-512-4225
FEMA Form 086-0-33(7/12) See reverse side for continuation. Replaces all previous editions.
ELEVATION,CERTIFICATE, page 2
IMPORTANT:In these spaces,copy the corresponding Information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number.
358 NE 101 STREET
City MIAMI SHORES State FL ZIP Code 33138 Company NAIC Number.
SECTION D—SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
Copy both sides of this Elevation Certificate for(1)community official,(2)Insurance agent/company,and(3)building owner.
Comments A/C=8.78'SECOND FINISH FLOOR ELEVATION=10.54'CROWN OF THE ROAD ELEVATION FOR NE 101 STREET=9.10'
LATITUDE AND LONGITUDE VALUES DERIVED FROM MIAMI-DADE COUNTY ORTHO RECTIFIED IMAGES AND CONVERTED USING CORPSCON
CONVERSION PROGRAM.DETERMINATION OF FLOODZONE LINES WERE BASED ON SCALING OF FEMA MAP LISTED ABOVE.
Signature Date 03-04-2015
SECTION E—BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(without BFE),complete Items E1—E5.If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B,
and C.For Items E1—E4,use natural grade,if available.Check the measurement used.In Puerto Rico only,enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade(HAG)and the lowest adjacent grade(LAG).
a)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑below the HAG.
b)Top of bottom floor(including basement,crawispace,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided In Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor
(elevation 02.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG.
E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building Is ❑feet ❑meters ❑above or❑below the HAG.
E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? ❑Yes ❑ No ❑ Unknown.The local official must certify this information in Section G.
SECTION F—PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION
The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-Issued or community-issued BFE)
or Zone AO must sign here.The statements in Sections A,B,and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑Check here If attachments.
SECTION G—COMMUNITY INFORMATION(OPTIONAL)
The local official who is authorized by law or ordinance to administer the oommunity's floodplain management ordinance can complete Sections A,B,C(or E),and G
of this Elevation Certificate.Complete the applicable Items)and sign below.Check the measurement used in Items G8--G10.In Puerto Rico only,enter meters.
G1.❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who
Is authorized by law to certify elevation information. (indicate the source and date of the elevation data in the Comments area below.)
G2.❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO.
G3.❑ The following information(Items G4—G10)is provided for community floodplain management purposes.
G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for. ❑New Construction ❑Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters Datum
G9. BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters Datum
G10.Community's design flood elevation: ❑feet ❑meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑Check here if attachments.
FEMA Form 086-0-33(7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 3 Building Photographs
See Instructions for Item A6.
IMPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt., Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number:
358 NE 101 STREET
City MIAMI SHORES State FL ZIP Code 33138 Company NAIC Number:
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions
for Item A6. Identify all photographs with date taken; "Front View" and 'Rear View"; and, if required, "Right Side View" and "Left Side
View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as
indicated in Section A8. If submitting more photographs than will fit on this page,use the Continuation Page.
FRONT VIEW
03-04-2015
FEMA Form 086-0-33(7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 4 Building Photographs
Continuation Page
IMPORTANT: in these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number:
358 NE 101 STREET
City MIAMI SHORES State FL ZIP Code 33138 Company NAIC Number:
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs
with: date taken; "Front View" and "Rear View'; and, if required, "Right Side View" and "Left Side View." When applicable,
photographs must show the foundation with representative examples of the flood openings or vents,as indicated in Section A8.
REAR VIEW
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03-04-2015
FEMA Form 086-0-33(7112) Replaces all previous editions.
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Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
nspection Number: INSP-282580 Permit Number: BPP-8-15-2161
Inspection Date: June 08, 2017 Permit Type: Pools/Whirlpools/Hot Tubs
Inspector: Dacquisto, David Inspection Type: Survey Final
Owner: SMITH, PATRICE AND SCOTT Work Classification: New
Job Address:358 NE 101 Street
Miami Shores, FL 33138-
Phone Number
Parcel Number 1132060135280
Project: <NONE>
Contractor: ROSMEL POOL INC Phone: (305)592-7900
Building Department Comments
NEW POOL AND DECK Infractlo Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed I� CREATED AS REINSPECTION FOR INSP-282488. POOL DECK MUST BE
` l SET BACK NOT LESS THAN 5 FT FROM THE REAR PROPERTY LINE
SHOW DIMENSION ON SURVEY.
Failed El
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
For Inspections please call: (305)762-4949
June 08,2017 Page 1 of 1
��� 14770 SW 43rd WAY, SCALES 1°=20' JOB NO; 1205-045A
OLU'DMIMI,Fl. 3FIELD DAM 05-31-2017
ME N S I 0 N S INC■ PHONE: (305) 512-4225 TYPE OF PROJECTt
La,nd Surveying Services FAX: (305) 512-1914 FINAL SURVEY
FOR: SCOTT F.SMITH AND PATRICE GILLESPIE-SMITH The W 1/2 of LEGAL DESCRIPTION: AN AMENDED PLAT OF MIAMI
PROP.ADn: 358 N E 101st STREET MIAMI SHORES FL 33138 LOTS Lot 4&all Lot 5 BLOCKS 39 SUBDIVISIOM SHORES SECTION No 1
PLAT BOOKS 10 PAG& 70 OF, MIAMI-DADE COUNTY,FLORIDA.
N.E. 101st STREET _
G5 75.00'Total RNV
20'Asphalt
Ar� FM x
4 � 6ai M 3 y:
Conc. 22'Parkway
41r�^� Eli`
FND.I.P.112= 5'Conc.Walk 75.00' FND.I.P.1/2°
NO ID NO ID RECEIVED
�b 8y= I hti B.C. W
177.62' ►7 JUN o
ec � Q� X2017
to ro (,.) I N N qq
I
I c 14.00' 9.97'
5.00' 8.00' t` 8.00' $10.80' � W
1.00' 4T 40.50' PL Z
CL x� o 1
GAR=8.83 I Ii
F.F.E.=10.54' 1 �;
x
ONE STORY CBS I Im
C o RESIDENCE#358 1
0 0 I n o Ali fir'
Go In x I L ,� -+ .. G
VZ I
1 13.50' I- mo II C N1 i_
C I I
J x F.F.E.=10.04' al 010.00'
0.35, s
o o CL Z u
E.M41.00' �j c
10.04' []
x
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P� c C>
r IIs
2 . u7
LL Pump o 6.00' J CERTIIFIED 76.
Lot 5 Block 39 8. 0' 5.90' c i I SCOTT F.SMITH AND PATRICE GILLESPIE-SMITH
c c 35.00' 5.00 v
1 rn Th W 1 of Lot 4
I o Block 9
5.00' POOL I
CL'L
5.00' S 30.00'
40.00' ,I 6'Wood . W.MI 6.50'
75.008 1.00' FND.I.P.1/2°
(NO ID) o
15' ALLEY ai 9'Asphalt "'
SURVEYORS NOTES:
1.)THE SURVEY OF THE PROPERTY SHOWN HEREON IS IN ACCORDANCE WITH THE
DESCRIPTION FURNISHED BY CLIENT.
2.)UNLESS A COMPARISON IS SHOWN,ALL BEARING,ANGLES AND DISTANCES SHOWN
ARE THE SAME AS PLAT VALUES. ABBREVIATIONS:
3.)THE LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR EASEMENTS OR OTHER SWK=Sltlewalk,CBS=Concrete Skick Shuctae,CLF=Chain Link Ferree,
RECORDED ENCUMBERANCES NOT SHOWN ON THE PLAT AND THE SAME,IF ANY MAY PL=Property Line,DUE=Dratnaga U ft Easement IP=Iron Pipe,
NOT BE SHOWN ON THE SKETCH. AICP Ab Condiilerer Pad,PIC=P��p�y Comer,D/H=DriUad Hde
4.)UNDERGRAUND PORTIONS OF FOOTINGS,FUNDATIONS OR OTHER IMPROVEMENT WIF=Wood Fence,RES=R�idanw CL=Clear,IR=Iron Rear,LIE=UtI ty
WERE NOT LOCATED. F.asernent CONC=Cont.Slab,RRA+=Right of Way,DE=Drainage Easement
S.)FENCES TIES ARE TO THE CENTER LINE OF THE SAME. CIL=Cantu Line.0-Diameter,iYP=T M-Measured•R=Recorded,
B. WALL TIES TO THE FACE OF THE SAME. ENCR=Encroachment COMP= Wilt Asphalt WD=Na&Disc..
7. EVATION WHEN SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM S=Set FFE=Finish Fou Elevathn, Offset PIR'Power Palo,
(1929 UNLESS OTHERWISE NOTED. OHP'Overhead Powerlin%WM=Water Meter,WPP-Wood Powe Pct%
SJ THE NO ABOVE GROUND ENCROACHMENTS OTHER THAN THOSE SHOWN. E.M.=Elecuic Meter,M.F=Meal Ferree,P.F.=Plaspc Farce,D.M.E D.M.E.
Mabnenerce Easement C.M.E.=Canel Mabnernerce Easement L.M.E.=Lake
9)BENCtf MARK USED IS&802 ELEVATION=8.98'NGVD 9828 Maintenance Easement M.E.=Maintenance Easement B.CCpft*Comer.
P.0=Pdmt of Ctrrva me,RID-Fend,NO ID-No Wen
1 XHtEBY I�RiffY:
(FLOOD ZONE INFORMATION) toseams.daoam�wrewrarmarmr.m�mee...ra.aa.�.ara,.
X 120652 12086C0302SUFFIX DATE BASE bvduIykgo odp°a°°�°a`a�."°�r.'wAd�. army` .d
ZONE:_COMM: PANEL: L 9-11-2009 N/A dhcb&7m,.mwyw aamo rtm�7widwarmaw..m>rd
Freida aftdP(ofa.iond ad aaNtladrla417,
NOTE DETERMINATION OF FLOOD ZONE LINES WERE BASED ON SCALING OF FEMA MAP LISTED ABOVE /p ID c/
NOTE:ALL BEARING HEREON ARE BASED TO THE PLAT BEARING OF N/A Ef1iU e
ON THE CENTER LINE OF N/A PROPERTY LINE.
EASEMENT VIOLATIONSi ❑YES N NO DAVID L. FUTC
REGISTERED LAND SURVEYOR#4843
APPARENT VISIBLE ENCROACHMENTSt ❑YES ®NO STATE OF FLORIDA LB#0006874
COMMENTS NOTE:Nor VALID UNLESS SHEET 1 OF—L-1
SIGNED AND SEALED