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PL-18-1127 Ponvit NO. PL-4-18-112? Miami Shores Village t Permit Type Plumbing-Residential �. 10050 N.E.2nd Avenue NEP Volt r� ' Irk Classification. Draitafield Miami Shores,FL 33138-0000 Phone: (305)795-2204 Permit Status::APPROVED coR�or* Expiration: 10/28/2018 issue Date:x11/2018 Project Address Parcel Number Applicant 210 NE 102 Street 1132060480010 Miami Shores, FL 33138-2427 Block: Lot: VIVIANA MONARI Owner Information Address Phone Cell VIVIANA MONARI 210 NE 102 Street MIAMI SHORES FL 33138- 210 NE 102 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 5,000.00 A AMERICAN SEPTIC&PLUMBING (305)866-5600 (786)236-5599 Total Sq Feet: 300 Type of Work:DRAIN FIELD REPAIR 300 SQ FT IN TRE Available Inspections: Type of Piping: Inspection Type: Additional Info:DRAIN FIELD REPAIR 300 SQ FT IN TRE HRS Approval Bond Return: Final Classification: Residential Scanning:3 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Owners Bond $500.00 Invoice# PL-4-18-67337 CCF $3.00 05/01/2018 Check#: 1421 $ 121.25 $550.00 DBPR Fee $2.25 DCA Fee $2.00 05/01/2018 Check#:239 $500.00 $50.00 Education Surcharge $1.00 04/27/2018 Credit Card $50.00 $0.00 Permit Fee $150.00 Bond#:3737 Scanning Fee $9.00 Technology Fee $4.00 Total: $671.25 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 ce 'fy that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructiona d inth r 77 e, I the abovezna ed contractor to do a work stated. �� rG May 01, 2018 Authori d Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy May 01, 2018 1 274 o T OSTDS/`' %eel .DJNlS,G 4 1. 1805 SW 26th Street • Miami, Fl , 33 17-5Date E d r ess - - _-' - -- -- OST # _w Cc,mments: ..__ _— Miami Shores Village ? r �= Building Department APR 27 101 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 26�A BUILDING Master Permit No. PERMIT APPLICATION sub Permit No. ❑BUILDING (-1 ELECTRIC ROOFING ❑REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP }� CONTRACTOR DRAWINGS JOB ADDRESS: "" I�L ST City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: �- 32aP"048-00i O Is the Building Historically Designated:Yes 'NO Occupancy Type:�_Load: 13/P Construction Type: 0/ft Flood Zone: PO BFE: NSA FFE: OWNER:Name(Fee Simple Titleholder): V 1 Vl an0, 1"�w f Phone#: 3 0- 3�QO (0 695-1 Address: 2-10 pie I o Z St City: 0) 1 h4C-C-5 State: !PL Zip: 3313 g Tenant/Lessee Name: Phone#: Email: n CONTRACTOR:Company N.acme: t[ A- VI Pt�49 '-•749A "F& t- p�tM�1A a, )ne-Phone#: 3 as gV(O�6660 U Address: l� �7 SC&41 1 b look p yv City: Ir i%aO, - State: FLA • Zip: . 33 8 Qualifier Name: W"14m 1+1&c1.- W.04Ar' Phone#: State Certification or Registration#``,, SE 00001 SP' 3 rtificate of Competency#: DESIGNER:Architect/Engineer. (_t n Phone#: Address: ff City: State: Zip: Value of Work for this Permit:$ OO Square/Linear Footage of Work: 30 O Sfl Type of Work: ❑ Addition ❑ Alteration ❑ New 44 Repair/Replace ❑ Demolition Description of Work: ©":r kel i V`Q,Qetitr ado Se, f•- t o Vye4-J^ (.o1r�dZA�/vt-'Rw+• a'S poH4 pe./,nn*+ . Specify color of color thru tile: Submittal Fee$ Permit Fee$ p) CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) i Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage lender's Name(if applicable) a Mortgage lenders 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. 1 understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC.... OWNER'S AFFIDAV1r: 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 on estimated value exceeding$2500,the applicant must promise in good faith that a copy of the notice of commencement and construction lien low 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 o,xurs seven(7J days after the building permit is issued in the absence of such pasted notke, the Inspection will not be approved and a reinspection fee will be charged. Signature Signatu OWNER or AGENT ONTRACTOR i The foregoing Instrument was acknowledged before me this The f r oing instru ent was acknowledged before me this &&%ay of AP(41 L_.. 20 by by CW-r day of r h 20 1 43 VI V II&W A• O%O J'4 fy,who is personally known to . I`� I lhl 1 L 0,9 o s rsonally known to me or who has produced N yS Ml VWEX ii..l C..asne who has produced as Identification and who did take an oath. identification and who did take an oath. 3NOTARY PUBLIC: NOT PU IC: Sign. Sign: Print: t Print:RIP- ° " NEIL PATEL 2ataRr a�e�c NANCY GOLDRING Se p"e '�°9 NOTARY PUBLIC.STATE OF NEW YORK kali y � QUALIFIED IN KINGS COUNTY MY COMMISSION#GG 059069 J + E�' . REG.#41PA6155654 N Vr ', w. 9 k V, ' EXPIRES:February 15,2021 MY COMMISSION E P Fpr F��� ssassss ssssssssssssssssssssssssssssssssssssssssssssssssss �� �";" WrySero(*s APPROVED BY ( Plans Examiner Zoning Structural Review Clerk (Rftbed02/24i2M4) 4/27/2018 Property Search Application-Miami-Dade Countv OP" ERT1 APPRAISER OFFICEO * THF� ., � �� Summary Report Generated On:4/27/2018 Property Information2' Folio: 11-3206-048-0010 !a 210 NE 102 ST ° Property Address: ) Miami Shores,FL 33138-2427 Owner VIVIANA MONARI ";• Mailing Address 210 NE 102 ST � •' � MIAMI SHORES,FL 33138 USA PA Primary Zone 0900 SGL FAMILY-1901-2100 SQ ' 0101 RESIDENTIAL-SINGLE �' �• � Primary Land Use „ FAMILY: 1 UNIT Beds/Baths/Half 3/3/0 Floors 1Fi Living Units 1 Actual Area 3,200 Sq.Ft Living Area 2,220 Sq.Ft t taI Adjusted Area 2,630 Sq.Ft Lot Size 10,618.4 Sq.Ft Taxable Value Information Year Built 1981 2017 2016 2015 County Assessment Information Exemption Value $0 $0 $0 Year 2017 2016 2015 Taxable Value $567,072 $517,409 $502,160 Land Value $318,242 $265,339 $254,593 School Board Building Value $225,759 $228,810 $231,861 Exemption Value $0 $0 $0 XF Value $23,071 $23,260 $15,70 ......... _-...... ___......... Taxable Value $567,072 $517,409 $502,160 Market Value $567,072 $517,409 $502,160 City Assessed Value $567,072 $517,409 $502,160 Exemption Value $0 $0 $0 Benefits Information Taxable Value $567,072 $517,409 $502,160 Regional Benefit Type 2017 2016 2015 Exemption Value $0 $0 $0 Note:Not all benefits are applicable to all Taxable Values(i.e.County,School _.... - """ _....... Taxable Value $567,072 $517,409 $502,160 Board,City,Regional). Short Legal Description Sales Information VAZQUEZ SUB Previous Price OR Book- Qualification Description Sale Page PB 115-23 02/17/2017 $100 30430-3622 Corrective,tax or QCD;min LOT 1 BLK 1 consideration LOT SIZE 81.68 X 130 01/12/2015 $100 29510-0165 Corrective,tax or QCD;min OR 20464-1152 05 2002 4 consideration 11/07/2014 $100 29510-0164 Corrective,tax or QCD;min consideration 10/31/2013 $590,000 28897-1276 Qual by exam of deed The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp Version: ♦ °R'•s Miami Shores Village Building Department artment 10050 N.E.2nd Avenue ORIOp Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 Notice to Owner Workers' Compensation Insurance Exemption r - . - - . _ .1 .x ;.7 ;,' F-mow . ,-a �x Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers'Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers'compensation coverage. Corporate officers or members of a limited liability company(LLC) in the construction industry may elect to be exempt if 1. The officer owns at least 10 percent of the stock of the corporation,or in the case of an LLC,a statement attesting to the minimum 10 percent ownership;. 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt.. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers'compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers'compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Owner State of ri)pi Ycwt4 Coutrty of Miter'Bads" VA The foregoing was acknowledge Wore me this � day of L— ,20 By—VLV V I A wi A M osk"1 who is personally known to me or has produced 94 "O.S L 1C_as identification. Notary: NEIL PATEL ,w h to NOTARY PUBLIC.STATE OF NEW YORK SEAL: :(� QUALIFIED IN KINGS COUNTY REG,#01PA6155654 MY COMMISSION EXP,11/13/2018 SEP000947 AMERICAN SEPTIC 8y PLUMBING INC. 12555 BISCAYNE BOULEVARD#970 NORTH MIAMI,FL 33181 NORTH DADE(305)866-5600 BROWARD(954)922-2119 SOUTH DA DE(305)254-8600 FAX(305)8916905 4/19/2018 State of Florida County of Dade \, I I a, (YL/' Before me this day personally appeared, V"��'�'�'`� who, being duly sworn, deposes and says: That he or she will be the only person,working on the project located at: 210 NE 102 Street Miami Shores, FL 33138 Contra cto Signature I SwQ��o armed a d s scribe befor me this day of Ir I , 2018, By ►fTr I 44,\/L,f44,\/L, D D ma-�Ck- Personally know OR Produced Identification Type of Identification Produced rint, Typ or tamp Name of Notary, NANCY GOLDRING IN MY COMMISSION#GG 059069 9, * EXPIRES:February15,2021 '4 o` FOF FJ;Q` Bonded Thru Budget Notary Services t SKETCH OF SURVEY PROPERTY ADDRESS 2 10 NE 102 5T.MIAMI 5MORE3.FL.33138 (BOUNDARY SURVEY) LEGAL DESCRIPTION SCALE: 1" 20' LOT 13LOCK SUSDMS*N -VAZQUEZ SUBDIVISION ACCORDING TO THE PLAT THEREOF AS RECORDED IN PtAT S" IIS AT PAGE 23- OF THE PUSUC RECORDS OF MIAMI DAM COUNlY. FLORIDA. t /V D NW 102 ST. APR 2 7.2018 ——— c7s.ou TOTAL RAM I-AMMIT M "'0 Ll M < Z 0 -1111/j11 Lij IS, uj ey-I 5-b; LL > < --j -0! 25.00' C I LLI ZPS M W ..... < Cl_ > ONE STORY 2 .. ': 04 - z �& RESIDENCE 0 f F— 0 N* 210 Do Z; 0 Z tl 43.73' Z 0 W C) < C3 MOO' 28.75 E 0 1 — e61401 �l 0 0 L —j m z ' !D ol N m U) to I. W/pAOC OL W 130.00' LOCATION SKETCH (N.T.S.) Al te ;j iz zy ""o ON TM?W-M.AIWNCE PALE MW Of TW FMMW DAMMff MMOMNoW AGENCY CER nm M. RK REVISIONS lrVISEp '109TME lIF7gE7t1M.-M-g.-M"N zm x DAM RAW armim COMMUNITY 420622 PM4M MWOM Q3Q2 suFnx L VMMONAM NU WORLD TITLE LLC. LEGAL l0Qf"Z%Zr IN5URA4=Co NOTES�.-4 TI'm suffIcy bm"M emm OR comeow CMCUP.INC. A010—M4=L mpw ft 4.L— Er.+eunoR of SUCCE-55M ANWR&WIGN5 I Is"T I',,Wil—-vt to ac mpm To oErma.E N=ftm ANY.MTI uwxftm�mIr�==Q—R.A-STM=is uftma To omwmq, EMM (W RMOM LEQ&DCSCRPftpft MlOff,THE LM OF 110"lEy IS UW=To TW COW op TME PJAM UNOOlCAt7RqDI'MACHMIDM Ir Alff.AM 4W*Mft T nft W4 IM ATM Tl' MOTM AM/M FOUMOATb"A"/OR L*,IX3IOR&�M or N&TLW-F MMEL JESUS I3ARAy AM SUMM"Me M*pM MR 1:10W Tf"SuRyu Is tvr RCFM�M FOR MOTMI OESM WM CopASTFCjCT�4 M"SM ucENW Na GW4 Tvm --y it--k .-W by 19630 FRANJO RD. CUTLER BAY, FL 33157 PHOW—(305) 283-0632 LEGEND AND 6BBREMATIONS FAX: (305) 250-5769 ORDER No. 14-502 ----------------------- "A : "AVA ml�Ciloom'j"m WW UP umff,OMA V,9��L*m RM CIE)lqft�AllM aa\rnU—PIL Law= tLr� CH. •c� FLOM Dow 'Y/— F13" CL POLE P&P. Powmew 00NMOL Pow• pWWW Of -- Ck FjWg MFA*MW PA. Net SM •SMO M ZcL UP. CA 00 PAA pre 0/0 W.=Comm cam ce..M RECORD �awr SLY IMM N-Ut 145T TO SME 6 O&TA sm ux UMOY C43919R 7� . 1 STATE OF FLORIDA PERMIT #: 13-SC-1839226 DEPARTMENT OF HEALTH APPLICATION #. AP1339208 ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID: SYSTEM FEE PAID: CONSTRUCTION PERMIT RECEIPT #: DOCUMENT #: PR1102806 r CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Viviana Monari PROPERTY ADDRESS: 210 NE 102 St Miami, FL 33138 LOT: 1 BLOCK: 1 SUBDIVISION: PROPERTY ID #: 11-3206-048-0010 [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 TQ• MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT' IN THIS PERMIT BEING MADE iNt'l�.j,••AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE••WITH , OTjjj. FEDEIRL:• •••0 • STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY: 000• 0000 ••••:• • SYSTEM DESIGN AND SPECIFICATIONS •�:::• :10 •• :0000: 0 00 0000• T [ 1,050 ] GALLONS / GPD •0000• • Septic Tank � CAPACITY .•• • • ..... A [ 0 ] GALLONS / GPD CAPACITY •• •• •• 0000•• N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK 12:0•GALLONS]• • • K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES P& 24IRRS • #Rumps [• ••] f • • :••••• 0000• D [ 300 ] SQUARE FEET New Drainfield Trench Con SYSTEM i •' • ••••.• ;•••• R [ 0 l SQUARE FEET SYSTEM •• • A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ 7 MOUND [ l I CONFIGURATION: [x] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: FFE 11.50' I ELEVATION OF PROPOSED SYSTEM SITE [ 14.401 [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 50.401 [ INCHES FT ] [ABOVE BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 36.001 INCHES O 1-EXISTING 1050 gal septic tank with and approved filter TO REMAIN. 2.-The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance T with s.64E•6.013(3)(0 FAC. H 3.-Install 300 sf.of drainfield in ....TRENCH... configuration. $ 4.-Invert elevation and Bottom of drainfield to be no less than 7.80'& 7.30' NGVD respectively THIS PERMIT IS NOT FOR ANY ADDITIONS. R (Comments Continued on Page 2.) SPECIFICATIO14S BY: CONTRACTOR TITLE: APPROVED BY: TITLE: Environaental Specialist II Dade CED 19mck Perera DATE ISSUED: 04/17/2018 EXPIRATION DATE: 07/16/2018 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 v 1.1.4 AP1339208 SE1073170 DOCUMENT #: PR1102806 The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow of 400 gpd• 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)(0, FAC. . :..... ....:. { c 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.,,,,, • •....' • 0000.. .. . .... • 0000.. 0000 • 0000.. • ...... •• ...... . • • • 0000 • •• 0000. • •. 0000 .. .. .. 0000.. 00..0. • 0 • • 0000.. ...... . . . • 0 0 .0 . 00000 .0.000. S-TA _oFFLOR#DA �rr�w !'►'T6.s-wi-t'rNc LIMA! TH DEPAM 1 IVIGIV 1 yr I Iv +•-• • ' APPLICATION FOR CONSTRUCIi ION PERMIT Permit Apptication Number 3 ---------------------------PART 11-SiTEPLAN -------------------------- Scale: Each block re resents 10 feet and 'i inch= feet- t r1 L f\j vi 9147 p� -e o 1 0 . . •' • ... 0000. ( •• . 06.19 . 10 tvk 0 00 0*000 13, ,3 p • .9.169 666 • 999. . • • • ra • •.. 9 9 6 i. J _ 0000 .19i •� 6 0 6 �•: e Notes: Site Pian submitted by Not Approved Ike Plan Approved By ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT .Page 2 of 4 DH 4015,08/09(Obsdetes previous edidor%s which may not be used) Wcwposate& v,.4.nnaaniF.fl �JLVutif`�u:i u� - i