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PL-17-2605
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-291570 Permit Number: PL -11-17-2605 Scheduled Inspection Date: December 12, 2017 Inspector: Hernandez, Rafael Owner: PROPERTIES LLLP, HB GROWTH Job Address: 278 NE 103 Street Miami Shores, FL 33138-2431 Project: <NONE> Contractor: ROCKET PLUMBING CORP Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Drainfield Phone Number Parcel Number 1132060134860 Phone: (786)663-9238 Building Department Comments PUT A NEW SEPTIC TANK OF 900 GLS AND MAKE A NEW DRAIN FIELD BED CONFIGURATION 200 SQFT Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments approval HRS on file r1/ December 12, 2017 For Inspections please call: (305)762-4949 Page 16 of 32 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Parcel Number Permit NO. PL -11-17-2605 Permit Type: Plumbing - Residential Work Classification: Drainfield Permit Status: APPROVED Issue Date: 1116/2017 Expiration: 05/05/2018 Applicant 278 NE 103 Street Miami Shores, FL 33138-2431 1132060134860 Block: Lot: HB GROWTH PROPERTIES LLLI Owner Information Address Phone Cell HB GROWTH PROPERTIES LLLP 17071 W DIXIE Highway NORHT MIAMI BEACH FL 33160- 17071 W DIXIE Highway NORHT MIAMI BEACH FL 33160- Contractor(s) ROCKET PLUMBING CORP Phone Cell Phone (786)663-9238 Valuation: Total Sq Feet: $ 2,000.00 200 Type of Work: PUT A NEW SEPTIC TANK OF 900 GLS AN Type of Piping: Additional Info: PUT A NEW SEPTIC TANK OF 900 GLS AN Bond Return : Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $1.20 $4.50 $3.00 $0.40 $300.00 $9.00 $1.60 $319.70 Pay Date Pay Type Invoice # PL -11-17-65527 11/01/2017 Cash 11/06/2017 Check #: 3362 Amt Paid Amt Due $ 50.00 $ 269.70 $ 269.70 $ 0.00 Available Inspections: Inspection Type: HRS Approval Final Review Plumbing 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 AFFID construction and �VI I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating gnii. Futhermore, I authorize the above-named contractor to do the work stated. Authorizegnature: Owner / Applicant / Contractor / Agent Building Department Copy November 06, 2017 November 06, 2017 Date 1 A.lk,rkD 1,0keq- 3©5 3 I P 610 I D BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC PLUMBING ❑ MECHANICAL JOB ADDRESS: Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 ❑ ROOFING ❑ PUBLIC WORKS (o354r RECEIVED NOV 2017 sf'1, FBC 20 ( 41 - Master Master Permit No. PL 1i— ZbOS Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ CHANGE OF ❑ CANCELLATION ly,SHOP CONTRACTOR DRAWINGS City: Miami Shores Folio/Parcel#: (1- 32nb —ok3 Occupancy Type: Load: OWNER: Name (Fee Simple Titleholder): Address: City: County: Miami Dade Zip: 33 138 4800 Construction Type: Is the Building Historically Designated: Yes NO Flood Zone: BFE: FFE: o'N P(o t P.r-kz5 1D3 �• t Phone#: k1ii ty i Shol'PS State: Flnricto, Zip: 33 (3sb Tenant/Lessee Name: Phone#: Email: 0C t( -e CONTRACTOR: Company Name: ((3 10 w 410 Sfr. Address: Phone#: 301 3110 'to q8 City: Qualifier Name: State: F(D/ r G Zip: 33 1 {o Roarf c o Grateie , crc. (42982} State Certification or Registration #: Phone#: Certificate of Competency #: Phone#: 34r).1- 31b `fo`f�, DESIGNER: Architect/Engineer: Address: City: State: Zip: Value of Work for this Permit: $"44444.4279"°" . 00 :It Square/Linear Footage of Work: Type of Work: E Addition G kt ❑ Alteration EVNew ❑q Repair/Replace ❑ Demolition Description of Work: FpL m � c1, t�1 i, 4 k 9oo q . et/6 d o iio, k ,e a, Msut) »%Gi/I #40 Oad Gal i9iffell +0/1 aco 51,4.)0/1e. ..pct - Specify coloroof��color thru tile: W Submittal Fee $ ►U Permit Fee $ e CCF $ ' • 12-:-52 CO/CC $ Scanning Fee $ Radon Fee $ J DBPR $ L • SQ Notary $ Technology Fee $ 1 lf/ti/ Training/Education Fee $ 0 (4 0 Structural Reviews $ (Revised02/24/2014) Double Fee $ ll- 1473 Bond $� T TOTAL FEE NOW DUE $ co 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 0 NER or AGENT The foregoing instrument was acknowledged before me this °‘ day of 6a -0 Q.(' ,20 V- Signature CONTRACTOR The foregoing instrument was acknowledged before me this by l4‘ day of °c4"° , 20 (T , by jca11 @4eL05 %Ot ks , who is personally known to me or who has produced M &A L 44 23- 50 "33I `19 as identification all y t +Si take aip�pp ALOp z s ? ' ��•• • MY COMMISSION # GG 112721 NOTARY PUBLIC..`¢ � b EXPIRES: June 7, 2,021 " ... Bonded Tru Notary Public Underwriters Sign: .�ep N1�,o iSJvC Print: V(, V1 ck 1L0?t Seal: Lodi -►coo 6-owao me or who has produced identificatio , who is personally known to as Sign: Print: Seal: **********************************ssss*******s*********r**************************************************** APPROVED BY (Revised02/24/2014) 1 1- Plans Examiner Zoning Structural Review Clerk STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: (HB Growth Properties LLLP) PERMIT # :13 -SC -1788028 APPLICATION # : AP 1306388 DATE PAID: FEE PAID. RECEIPT #. DOCUMENT #: PR1074982 PROPERTY ADDRESS: 278 NE 103 St Miami, FL 33138 LOT: 3 BLOCK: 36 SUBDIVISION: PROPERTY ID #: 11-3206-013-4860 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS' MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ A [ N [ K [ 900 ] GALLONS / GPD New Septic Tank CAPACITY 0 ] GALLONS / GPD CAPACITY 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ D [ 200 ] SQUARE FEET New Drainfield Bed Confiau SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [x] BED [ N F LOCATION OF BENCHMARK: FFE 12.21' NGVD I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D FILL REQUIRED: 0 T H E R [ 0.00 ] INCHES [ 27.00 ] [I INCHES [ 75.00 ] INCHES / FT ][ABOVE/ BELOW ]BENCHMARK/REFERENCE POINT / FT ] [ ABOVE / BELOW b BENCHMARK/REFERENCE POINT EXCAVATION REQUIRED: [ 60.00] INCHES The system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow of 300 gpd. 1.- Install a 900 gal. septic tank with an approved filter 2.- The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E -6.013(3)(f) FAC. 3.- Install 200 sf. of drainfield in Bed configuration. 4.- Install 12" of slightly limited soil at the bottom of the drainfield. SPECIFICATIONS BY: APPROVED BY: Frank DATE ISSUED: 09/05/20 7 izaire TITLE: Engineering Specialist II TITLE: Engineering Specialist II Dade CHD EXPIRATION DATE: 12/04/2017 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC v 1.1.4 AP1306388 SE1046525 Page 1 of 3 DOCUMENT #: PR1074982 Invert elevation of drainfield to be no less than 6.46' NGVD 7.- Bottom of drainfield elevation to be no less than 5.96' NGVD Required drainfield area based on rule 64E -6.015(6)(c)2. Install a new drainfield to achieve Drainfield size requirement. The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E -6.013(3)(f), FAC. NOTICE OF RIGHTS A party whose substantial interest is affected by this order may petition for an administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for administrative hearing must be in writing and must be received by the Agency Clerk for the Department, within twenty-one (21) days from the receipt of this order. The address of the Agency Clerk is 4052 Bald Cypress Way, BIN A-02, Tallahassee, Florida 32399. The Agency Clerk's facsimile number is 850-413-8743. Mediation is not available as an alternative remedy. Your failure to submit a petition for hearing within 21 days from receipt of this order will constitute a waiver of your right to an administrative hearing, and this order shall become a 'final order'. Should this order become a final order, a party who is adversely affected by it is entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a second copy, accompanied by the filing fees required by law, with the Court of Appeal in the appropriate District Court. The notice must be filed within 30 days of rendition of the final order. STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATION APPLICANT: HB Growth Properties LLLP APPLICATION # API306388 PERMIT # 13 -SC -1788028 DOCUMENT # SE1046525 CONTRACTOR / AGENT: Rocket Plumbing LOT: 3 SUBDIVISION: BLOCK: 36 ID#: 11-3206-013-4860 TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE TOTAL ESTIMATED SEWAGE FLOW: AUTHORIZED SEWAGE FLOW: UNOBSTRUCTED AREA AVAILABLE: PLAN: [X]YES [ ]N0 300 GALLONS PER DAY 500.00 GALLONS PER DAY 450.00 SQFT BENCHMARK/REFERENCE POINT LOCATION: ELEVATION OF PROPOSED SYSTEM SITE FFE 12.21' NGVD [ NET USABLE AREA AVAILABLE: 0.20 ACRES RESIDENCES -TABLET 1500 GPD/ACRE UNOBSTRUCTED AREA REQUIRED: OR / OTHER -TABLE 2 ] 2500 GPD/ACRE 450.00 SQFT 27.00 [ INCHES / FT ] [ ABOVE / BELOW ] BENCHMARK/REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES SURFACE WATER: N/A FT DITCHES/SWALES: N/A FT NORMALLY WET: [ ]YES [X]NO WELLS: PUBLIC: N/A FT LIMITED USE: N/A FT PRIVATE: N/A FT NON -POTABLE: N/A FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT SITE SUBJECT TO FREQUENT FLOODING? 10 YEAR FLOOD ELEVATION FOR SITE: SOIL PROFILE INFORMATION SITE 1 [ ]YES [X ]N0 FT [ MSL / USDA SOIL SERIES: Munsell #/Color Urban land Texture Depth 10Y 5/1 Sand 0 To 19 REFUSAL Fractured Rock 19 To 19 OBSERVED WATER TABLE: 72.00 ESTIMATED WET SEASON WATER TABLE HIGH WATER TABLE VEGETATION: INCHES [ ABOVE / ELEVATION: [ ]YES BELOW NGVD POTABLE WATER LINES: FT 10 YEAR FLOODING? [ ]YES [X]NO] ] SITE ELEVATION: 9.96 FT [ MSL / SOIL PROFILE INFORMATION SITE 2 NGVD USDA SOIL SERIES: Munsell #/Color Urban land Texture Depth 10Y 5/1 Sand 0 To 19 REFUSAL Fractured Rock 19 To 19 ] EXISTING GRADE TYPE: 71 INCHES [ ABOVE / BELOW [X ]NO MOTTLING: [ ]YES [X]NO SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: DRAINFIELD CONFIGURATION: [ ] TRENCH REMARKS/ADDITIONAL CRITERIA [ PERCHED / APPARENT ] ] EXISTING GRADE DEPTH: INCHES Replacement 4-FS/0.60 DEPTH OF EXCAVATION: [X] BED [ ] OTHER (SPECIFY) 60 INCHES SITE EVALUATED BY: DATE: 08/31/2017 Solomon, Teresa (Title: ) (Statewide Septic Connections, Inc.) DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 3 of 4 AP1306388 EID1788028 v 1.0.2 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM EXISTING SYSTEM AND SYSTEM REPAIR EVALUATION APPLICANT: HB Growth Properties LLLP APPLICATION # API306388 PERMIT # 13 -SC -1788028 DOC # RE401166 13 -SC -1788028 CONTRACTOR / AGENT: Rocket Plumbing LOT: 3 BLOCK: 36 SUBDIVISION: ID# : 11-3206-013-4860 TO BE COMPLETED BY A FLORIDA REGISTERED ENGINEER, DEPARTMENT EMPLOYEE, SEPTIC TANK CONTRACTOR OR OTHEE CERTIFIED PERSON. SIGN AND SEAL ALL SUBMITTED DOCUMENTS. COMPLETE ALL APPLICABLE ITEMS. COMPLETE TANP CERTIFICATION BELOW OR NOTE IN REMARKS WHY THE TANKS CANNOT BE CERTIFIED. EXISTING TANK INFORMATION [ 650 1 GALLONS Septic Tank LEGEND: Unknown MATERIAL: Concrete BAFFLED: [ y [ ] GALLONS LEGEND: MATERIAL: BAFFLED: [ y / N [ ] GALLONS GREASE INTERCEPTOR LEGEND: MATERIAL: [ ] GALLONS DOSING TANK LEGEND: MATERIAL: # PUMPS:[ ] I CERTIFY THAT THE ABOVE NOTED TANKS WERE PUMPED ON 08/10/2017 BY Statewide Septic Connections , HAVE THE VOLUMES SPECIFIED AS DETERMINED BY [DIMENSIONS Y FILLING / LEGEND ], ARE FREE OF OBSERVABLE DEFECTS OR LEAKS AND HAVE A [ / OUTLET FILTER DEVICE ] INSTALLED. SOLIDS DEFLECTION DEVICE SIGNATURE OF LICENSED CONTRACTOR Teresa J Solomon (STATEWIDE) 08/31/2017 BUSINESS NAME DATE EXISTING DRAINFIELD INFORMATION [ 200 ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM NO. OF TRENCHES [ ] DIMENSIONS: 10.00 x 20.00 [ ] SQUARE FEET SYSTEM NO. OF TRENCHES [ ] DIMENSIONS: X TYPE OF SYSTEM: [X] STANDARD [ ] FILLED CONFIGURATION: [ ] TRENCH [X] BED [ ] MOUND [ ] [ DESIGN: [X] HEADER [ ] D -BOX [X] GRAVITY SYSTEM [ ] DOSED SYSTEM ELEVATION OF BOTTOM OF DRAINFIELD IN RELATION TO EXISTING GRADE 48.00 INCHES [ ABOVE / BELOW SYSTEM FAILURE AND REPAIR INFORMATION [ 01/01/1938 ] SYSTEM INSTALLATION DATE TYPE OF WASTE [x] DOMESTIC [ ] COMMERCIAL [ 300 ] GPD ESTIMATED SEWAGE FLOW BASED ON [ ] METERED WATER IX] TABLE 1, 64E-6, FAC SITE CONDITIONS: NATURE OF FAILURE: FAILURE SYMPTOM: SUBMITTED BY: [ ] DRAINAGE STRUCTURES [ ] SLOPING PROPERTY [ ] HYDRAULIC OVERLOAD [ ] DRAINAGE / RUN OFF [ ] SEWAGE ON GROUND [ ] PLUMBING BACKUP [ ] POOL [ ] PATIO / DECK [ ] PARKING [ l [ ] SOILS [X] MAINTENANCE [ ] ROOTS [ ] WATER TABLE IX] TANK [ ] D -BOX / HEADER [ ] [X] SYSTEM DAMAGE [ ] [X] DRAINFIELD TITLE/LICENSE Master Septic Tank Contrac DATE: 08/31/2017 Teresa J Solomon (Statewide Septic C DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated 64E-6.001, FAC v 1.0.0 AP1306388 EID1788028 Page 4 of 4 LI • STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR CONSTRUCTION PERMIT Permit Application NumberOD ea). ) PART II - SITEPLAN • = Notes: -7 t N �� l 0 3 �`j- 3 3t 3 SSC Mo�c s re.Pl cs� a .e2 -{-� lc 4,0 -EA.) T,00,-, Site Plan submitted by. Plan Approved By SL(2)2-, .f)J t-7 Not Approved Date County Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015. 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 2 of 4 (Stock Number: 5744-002-4015-6) 11 III 11111110 I OWN ��� �lIMP��dRUUUI IUUI ?TE,U IM!!!1III'IIIIIIIIIIUIIIPI ii lir 1 1011111116111 1111111111111 1111 • II 1111 1 IN I , . ; k A IiiiiIiiIIII ,i si Notes: -7 t N �� l 0 3 �`j- 3 3t 3 SSC Mo�c s re.Pl cs� a .e2 -{-� lc 4,0 -EA.) T,00,-, Site Plan submitted by. Plan Approved By SL(2)2-, .f)J t-7 Not Approved Date County Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015. 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 2 of 4 (Stock Number: 5744-002-4015-6) Scale 1•?20: S N E W C 1 O S U a V E T EDGE OF PAIE)ENT t=° 26' ASPHALT PAVEMENT 75' PL1tIC RUT -OF -WAY t, N.E. 103rd ST. EDGE OF P4YEl1EN 5' COPE sDEWWA+.K \Q1i RP lit NO I.D. 1.49• CL - N • ■ d REMAINDER ft LOT -4 ao ." BLOCK -36 fi w' LL - 0 3 '0 1.55CL-- 24.00' 10.00' � t 1.00' { CONC. �.� DRIVEWAY SOUTH RI0.HT-414A1' LIE - 5.00 (RIM) w 2 J 3' CO'tC._ WALK ` 20' PARKWAY *0. PLANTER, n PRO 278 tt/AI (FO DES Lot: "OA the Boo! Rea Then t><oIH that r likes ;tube May i Thel . . the s meal 13i OCR �\or 102.02'(RLM). • • • r CHER • mixesaid .. . •- .+ FP ir2• • NO I D. •' NO I • 'fl • BOW • • • dorm• •••• •.•• •••• • shit. • • • • or ath •.•• •..• 22.55' GARAGE 10.36' 11.75 '1, 1 3'7(4'• P• 1175' • LOT -4 W000 DECK BLOCK -36 14.50' 1 -STY Res. #278 H.F.F.E. 12.60' Areas !1.603se. 10.45 L.F.E. 12.15'* 17.35' w n PLANTER./ —25.00'------ _ 'T' TRF EAST 1/2 [end Atex= t8. --X'>.x L — 1/1' p - �7K FNOO I.D. g -i- r tO20 aces 9.45' 25.77--- LOT-3 BLOCK -36 4' CHAIN LINK FENCE jv x'-1.g5Ct 13.21A .bE CE --•s ae— 75.00'(R&M)4C• CV • • • •".,y it • . • •• •• • I W • 48Qlet • ;. • to a• n • • • • • • ; 72 • • • • loot k • • • r' • an0 a p•..• • • • W Iloltz6 and m --LW* CL IC- ILI others Legal The LOT -2 BLOCK -36 RIEC'`�i1T V F.C.% NAV 0017 PERMIT #:2L1 1 -ZbOS M arni Shcres Village APF'1OVED BY DATE 7'DNIN.3 DEPT a 7F'T ACU 'T 10 31'; MP-.If'NICE WI 1'1-1 Ali FEDERAL N, ! rtLL_S AND GOULATIONS Legal Z etaetx Skltd WWI atat I LIST ACI LIMITED POWER OF ATTORNEY Know AN Men by Ther. pmts. that Ni GrowthWI", Limited Partnership, ('propem, pe) have s ILP, • Floridaylimited ientts dots make, ave made, constituted and appointed, constitute and appoint Jand by chest pre Juan Morales lawful attorney for them and in their name, Pie and stead.. Giving and granting unto Juan Monies full power andauthority to do and perform all and every act and thing whatsoever requisite and necessary to be done to :► making and terminating contracts with respect to any and all utilities (including electricity, gis• water, and waste management) for residential real estate owned by communicating and acting on PropeKY Owner's behalf with respect to all homeowner's association matters relating to a residential property; Property Owner ("Residential Property ' ): i signing Notices of Commencement associated with roof work; -0 fining out, signing, and registering documents related to resolution of construction hens; and registering and filing out documents with respect to Residential Property with any and all applicable authorities with jurisdiction over natters affecting the Residential Property; provided, however, that no power is granted hereunder to encumber any Residential Property or take any action that would be adverse to the interests of the Property Owner or any of its officers, members, or affiliates This limited Power of Attorney win remain in effect until December 31, 2017, unless earlier revoked by Property Owner upon notice. The authority granted 1:o the Attorney•In-fact by this Limited Power of Attorney is not transferrable to any other party or entity. in Witness Whereof, we have hereunto set our hands and seals on this 19°' day of September 2016. and deiiserrd in the NB Growth Properties LILLY a Florida Limited Liability Limited Partnership By: Eagle RHGP. Inc Signature a Florida ftgrfrij Primed Signature FLORIDA OF BROWARD instrument was acknowledged o ledged before me this 14* Da) of September 2016 by Bartosz Ictiatof HB Gro%sth Properties LLLP, a Florida limited Liability Limited ly known to or has produc a~'4\ JULIANA GOMEZ rev CMirrSSKY.+ ♦ rr r rn Ra • 4. 0/04 EXPsrir:4 kikeor*- i ten 4)% 113 Not and county aforesaid X.1,4(..1 444 kw SEPTIC ELEVATION CERTIFICATE DATE: 08-31-17 BUILDING STREET ADDRESS: 278 NE 103 STREET CITY: MIAMI SHORES STATE: FLORIDA ZIP CODE: 33138 PROPERTY OWNER: HB GROWTH PROPERTIES LLLP FOLIO #: 11-3206-013-4860 LEGAL DESCRIPTION: LOT 3 & E1/2 LOT 4 BLK 36" MIAMI SHORES SEC 1 AMD" PB 10 PG 70 MIAMI DADE COUNTY ELEVATION INFORMATION CROWN OF THE ROAD: 10.43 GRADE AT DRAINFIELD AREA: 9.96 ATTACHED GARAGE (AT THE DOOR): 9.98 TOP OF BOTTOM FLOOR: 12.21 TOP OF NEXT HIGHER FLOOR: N/A 1. 2. 3. 4. This the This drains This insurance. Elevations certificate Florida certificate certificate Aiosefanlul@,ymail.com742 i 4114 rn. ...) Surveyor's is NOT valid without the licensed Surveyor and Mappers. elevation is to obtain permits care/repair/restore/treatment or elevation must not be used are based on the National Geodetic J. AF Surveying Services signature modification. Notes: and the original raised seal of for an existing Septic Tank and for the purpose of acquiring flood Vertical Datum of 1929 1 2492 Hialeah, Phone w 72"d Street FL. 33016 (786)416-1018 ( ) F GINO URLANO PROFESSIONAL SURVEYOR STATE OF FLORIDA NO. 5044 Fax (305)817-9709 Local Busjness Miami -Dade County, State of 0 -THIS IS NOT A BILL.- DO NOT pAy 7153901.. UMW G Com A.I RIGO:; 2® � O ACERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/23/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER INSURE SAFE, INC. 2300 SW 57th Ave Miami FL 33155 CONTACT NAME: (a/CNfJ EMr 305-303-7080 (c, No): 305-267-4206 ADDRESS: insuresafeinc©yahoo.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Accident Insurance Company LIABILITY COMMERCIAL GENERAL LIABILITY INSURED Rocket Plumbing Corp, 11310 SW 46 Street Miami FL 33165 INSURER B: RetailFirst Insurance Company IGO6A014841-00 INSURER C : 06/05/2018 INSURER D : $ 1,000,000 INSURER E : $ 100,000 $ 5,000 INSURERF: CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVNTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTRINSR TYPE OF INSURANCE ADDL SUBR WVD POUCY NUMBER POLICY EFF (MM/DD/YYYY) POUCY EXP (MM/DD/YYYY) LIMITS A GENERAL %< LIABILITY COMMERCIAL GENERAL LIABILITY IGO6A014841-00 06/05/2017 06/05/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 $ 5,000 MED EXP (Any one person) CLAIMS -MADE OCCUR pERSONAL 8. ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES POLICY JECT PER: LOC $ AUTOMOBILE UABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAR EXCESS LIAB _OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ __ $ DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' UABILITYTORY FFICER/MEMER/ EXCLUDED? ECUTIVE OFFICER/MEMBER PROPRIETOR/ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below YY N / A 520-48402 07/28/2017 07/28/2018 WC STATU- LIMITS OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule If more space Is required) Commercial and Residential Plumbing only. License # CFC1428828 CELLATION I Miami Shores Village Building Dept. 10050 NE 2nd Avenue Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All nghts reserved. The ACORD name and logo are registered marks of ACORD