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PL-18-1138 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-302910 Permit Number: PL-4-18-1138 Scheduled Inspection Date:June 27,2018 Permit Type: Plumbing -Residential Inspector: Hernandez,Rafael Inspection Type: Final Owner: SULLIVAN,PATRICK&SARAH Work Classification: Drainfield Job Address:150 NE 107 Street Miami Shores,FL 33161-7032 Phone Number Parcel Number 1121360070200 Project <NONE> Contractor: ALL PRO PLUMBING SEPTIC AND SEWER INC Phone: (305)635-3002 Building Department Comments INSTALL REPAIR DRAINFIELD tnfractio Passed Comments INSPECTOR COMMENTS False t Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection a Fee No Additional Inspections can be scheduled until re-inspection fee is paid June 26,2018 For Inspections please call:(305)762-4949 f Page 8 of 26 41442�", 'Envfronmeift.tDIVISION OF Health Florida HealthROO • Miami-Dade County OSTDSIWell Division 11965Sw26th Street•A4ismi,FL 331.75 Inspector _ P r 1 A )4rr c+ Date Address j j D OSTDS# Comments: Signature i Permit NO. PL-4-1&1138 sK° s y� Miami Shores Village Permit TyPe:Pltambirr9-Residential 10050 N.E.2nd Avenue NE Pen 1 Wort(Glass iCafl n:Drainfield — Miami Shores,FL 33138-000 Permit`Status:APPROVED Phone: (305)795-2204 F�RIDp' Issue date:51412018 Expiration: 10/3 Y2018 Project Address Parcel Number Applicant 150 NE 107 Street 1121360070200 PATRICK&SARAH SULLIVAN Miami Shores, FL 33161-7032 Block: Lot: Owner Information Address Phone Cell PATRICK&SARAH SULLIVAN 150 NE 107 Street MIAMI SHORES FL 33161-7032 Contractor(s) Phone Cell Phone Valuation: $ 3,800.00 ALL PRO PLUMBING SEPTIC AND SE (305)635-3002 - � Total Sq Feet: 300 Type of Work: INSTALL REPAIR DRAINFIELD Available Inspections: Type of Piping: Inspection Type: Additional Info:INSTALL REPAIR DRAINFIELD HRS Approval Bond Return Final- Classification:Residential Scanning:3 Review Plumbing i Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Owners Bond $500.00 Invoice# PL-4-18-67349 CCF $2.40 DBPR Fee $2.25 05/04/2018 Check#:20450 $ 119.65 $550.00 DCA Fee $2.00 04/30/2018 Check#:20443 $50.00 $ 500.00 Education Surcharge $0.80 05/03/2018 Credit Card $500.00 $0;00 Permit Fee $150.00 Bond#:3743 Scanning Fee $9.00 Technology Fee $3.20 Total: $669.65 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 'g.QF�thermor uthorize the above-named contractor to do the work stated. J �Gr`CJ1 May 04, 2018 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy May 04,2018 1 Miami Shores Village RECEiVEL ' g APR 3 0 7818 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 FBC 20tH Q BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION MRENEWAL ME PLUMBING ❑MECHANICAL MPLIBLICWORKS M CHANGE OF E:]CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 150 NE 107 Street Cites Miami Shores County: Miami Dade Zip: .3 1 Folio/Parcel#:112136-007-0200 Is the Building Historically Designated:Yes NO_ C Occupancy Type: -J FP—' Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):Sarah Sullivan Phone#: Address:150 NE 107 St City: Miami Shores State: FL Zip: 33161 Tenant/Lessee Name: OVIW- -- Phone#: Email: CONTRACTOR:Company Name.. !pP kv,)5!ji hone#: 305-635-3002 Address: 1930 NW 21 Terrace City. Miami State. FL Zip. 33142 Qualifier Name: Barry Teixeira /+ r� 'V Phone#: 305-206-4473 State Certification or Registration M GFC- Y a y E' Certificate of Competency#• DESIGNER:Architect/Engineer: A Phone#: Address: p City: State: Zip: Value of Work for this Permit:$ D�'L� Square/Linear footage of Work: �S Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: S47Sb1 �12A -�7 _ Specify color,of color thru tile: • Submittal Fee$ Permit Fee$ O J CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ S s TOTAL FEE NOW DUE$ (Revised02/24/2014) q S Bonding Company's Name(if applicable) i 1. Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) ) A— 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 approv and a reinspection fee will be charged. Signature ?' Signature 0/ 0 or AGENT ., CONTRACTOR The foregoing instrument was acknowle efore me this efoing instru entwas cknowledged before me this day of 20 � byday of 20. by who is per II known to IYG wh rson �e or who has produced as me or who has pr duced as identification and who did take an oatb__ _ identification and who di take an oath. NOTARY PUBLIC: �iY°itEVELYN AP.TOLA ?Z?' ': MY coNiMISSiON#FF 950401 NOTARY PUBLIC: '' += EXPIRES:Februar/7,2020 ' F•o Bonded Thru Notary Public Underwriters 8„15•'• Sign:(OD Sign: Print:_•�',,, '�7n otpR UB�, Seal: Seal: =_; *°” Notary Public State of Flori °• ' Commission # FF 960737 My Comm.Expires Feb 22,2020 r .. APPROVED BY Il 13tf Plans Examiner Zoning Structural Review Clerk r (Revised02/24/2014) ,4%27/2018 Property Search Application-Miami-Dade County 31TRAISER OFFICE OF HE PROPERTY" 'A" 'P y Summary Report Generated On:4/27/2018 Property Information w . Folio: 11-2136-007-0200 t•. ; x Property Address: 150 NE 107 ST r $ = A' g' Miami Shores,FL 33161-7032 e. t Owner SARAH C SULLIVAN "f ► ti, z Mailin 150 NE 107 ST I g Address MIAMI SHORES,FL 33161 USAF PA Primary Zone 1000 SGL FAMILY-2101-2300 SQ 0101 RESIDENTIAL-SINGLE Primary Land Use FAMILY: 1 UNIT ' Beds/Baths I Half 3/2/0 Floors 1 t , ' Living Units 1 "` Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 1,802 Sq.Ft Lot Size 9,300 Sq.Ft Taxable Value Information Year Built' 11938 2017 2016 2015 County Assessment Information Exemption Value $50,000 $50,000 $50,000 Year 2017 2016 2015 Taxable Value $172,5551 $167,978 $166,463 Land Value $232,690 $199,874 $164,822 School Board Building Value $125,419 $125,419 $125,419 Exemption Value $25,000 $25,000 $25,000 XF Value $1,608 $1,620 $1,375 Taxable Value $197,555 � $192,978 $191,463 Market Value 1 $359,717 $326,9131 $291,616 City Assessed Value. 1 $222,555 $217,978 $216,463 Exemption Value $50,000 .$50,000 $50,000 Benefits Information Taxable Value $172,555 $167,978 $166,463 Regional Benefit Type 2017 2016 2015 Exemption Value $50,000 $50,000 $50,000 t Save Our Homes Cap Assessment Reduction $137,162 $108,935 $75,153 Taxable Value $172,555 $167,978 $166,463 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Sales Information t. Note:Not all benefits are applicable to all Taxable Values(i.e.County,School OR Board,Ci Regional). Previous �'Re g Sale Price Book- Qualification Description Page Short Legal Description _ 06/25/2015 $100 20121 Corrective,tax or QCD;min consideration DUNNINGS MIAMI SHORES EXT NO 3 PB 42-33 21264- LOT 4 BLK 208 04/01/2003 $262,000 2902 Sales which are qualified LOT SIZE 75.000 X 124 18579 OR 21264-2902 0403 1 04/01/1999 $135,000 1304 Sales which are qualified 02/01/1995 $0 16716- Sales which are disqualified as a result of 3257 examination of the 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/disciaimer.'asp Version: t i RICK SCOTT, GOVERNOR KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION • , CONSTRUCTION INDUSTRY LICENSING BOARD CFC1427464 . - The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 TEIXEIRA, BARRY GEORGE 4` .� ..� 0 �■ ALL PRO PLUMBING SEP71MAND SEWER.INC �` '- • :� 1930 NW 21 TERR MIAMI FL 33142^ ISSUED: 06/23/2016 DISPLAY AS REQUIRED BY LAW SEQ# L1606230000739 { 000552 Local Business Tax Receipt Miami-Dade County, State of Florida -THIS IS NOT A BILL-.DO NOT PAY 60841.49-,:. . _- - s BUSINESS NAME/LOCATION RECEIPT NO. ALL PRO PLUMBING SEPTIC AND SEWER INCRENEWAL EXPIRES 1930 NW 21 TERR-, 6346647; SEPTEMBER 30 2018 MIAMI FL 33142 Must be displayed at place of business Pursuant to County Code Chapter 8A-Art.9& 10 OWNER SEC:.TYPE OF BUSINESS ALL PRO PLUMBING SEPTIC AND SEWER 1K PLUMBING CONTRACTOR PAYMENT RECEIVED r BARP.Y..G.TEIXEIRIA-QUALIFIER -CFC.1427464�'_= BY TAX COLLECTOR Worker(s).: . T $495`0`:.10/24/.20.1T CREDITCARD-18-003320- 3 This Local Business Tax-Receipt-only.confirms payment-of the-Local.Business Tax. The Receipt is nota license, `c• permit;ora certification of the holders qualifications,to do business. Voider most comply with-any governmental— - -= or nongovernmental regulatory laws an .' uirements which-apply to the-business:-- --- — i —"- 4 The RECEIPT N0:above must be displayed on all commercial vehicles-Miami-Dade Code Sec Ba476. For more information,visit www.mlamidade govRaxcollector [ ''4CC' 0 CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDD/YYY1/) 1 04/27/2018 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(ies)must have ADDITIONAL INSURED provisions or 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 CONTACT Kelly Brown Charlie Brown and Associates Inc. PHONE (772)559-5334 aC No): (813)433-5377 1827 River Watch Blvd. AE-MAILDDRESS, kelly.walterl@yahoo.com Tarpon Springs,FL 34689 INSURER(S)AFFORDING COVERAGE NAIC If Phone (772)559-5334 Fax 813 433-5377 INSURERA: INSURED INSURER B: All Pro Plumbing,Septic&Sewer,Inc. INSURERC: 1930 North West 21st Terrace INSURER D: AmTrust INSURER E: Miami FL 33142 INSURER F: COVERAGES 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. 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ALT R ADDTYPE OF INSURANCE INSR UBR POLICY NUMBER MM/DDY EFF MM/DDr EXP LIMITS LTR ❑ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ AMAGE❑ RNTED CLAIMS-MADE [:] OCCUR PREM SO ESEaEoccurrence $ ❑ MED EXP(Any one person) $ ❑ PERSONAL S ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ❑ POLICY ❑ JERCOT- LOC PRODUCTS-COMP/OP AGG $ ❑ OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ❑ ANY AUTO BODILY INJURY(Per person) $ OWNEDSCHEDULED ❑ AUTOS ONLY ❑ AUTOS BODILY INJURY(Per accident) $ HIRED ❑ NON-OWNED PROPERTY DAMAGE $ ❑AUTOS ONLY AUTOS ONLY Per accident ❑ $ ❑ UMBRELLA LIAB ❑OCCUR EACH OCCURRENCE $ ❑ EXCESS LIAB ❑CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION S6 PER OTH- AND EMPLOYERS'LIABILITY Y/N A LITE ER ANY D OFFICER/MEMBEREXCLUDED?ECUTIVE� N/A AWC1105046 03/21/2018 03/21/2019 E.L.EACH ACCIDENT $ 1,000,000.00 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000.00 If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space Is required) License number CFC1427464 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village Bldg Dept. THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 10050 NE 2nd Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE C 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103)OF The ACORD name and logo are registered marks of ACORD Af_OROS DATE(MMIDOIYYVY) `..� CERTIFICATE OF LIABILITY INSURANCE 04/27/2018 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 I REPRESENTATIVE OR PRODUCER;AND THE CERTIFICATE HOLDER. IMPORTANT: N the certificate holder is an ADDITIONAL INSURED,the pollcy(les)must be endorsed, It SUBROGATION IS WANED,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 ; CONTACT NAME ROBERTO A GONZALEZ Nima Enterprises Inc Dba United Ins E i tAP"io°NN (305)541-3810 FAX No): (305)541 3811 215 SW"17th Avenue Suite #217 I, ^ADZES• robadriangabotmail.com Miami,FL 33135 INSURERfSI AFFORDING COVERAGE NAIC X Phone (305)541-3810 Fax (305)541-3811 INSURER A: ARCH SPECIALTY INSURANCE COMPANY INSURED I REB: . ALL PRO'PLUMBING SEPTIC AND SEWER INC, INSURER C: I BARRY G TEIXEIRA SEPTIC SERVICE } INSURER D; INSURER E: 2930 NW 21st TERRACE, KAMI FL 33142 INSURER F COVERAGES 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 I INDICATED. NOTWITHSTANDING ANY PiQUiREMENT,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 AOIX SUBR - POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INS POLICY NUMBER IMMIDDIYYYYI M LIMITS COMMERCIAL GENERAL LIABILITY ? EACH OCCURRENCE _$ 1,000,000.00 F-1, CLAIMS•MADE WOCCUR IDAMAGETORENTED NT D_MEMISxicc $ 100,000-00 ❑ MED EXP(Any are person: $ 10,000.00 A Y AGLOO4435101 01/10/2018 01/10/2019 ❑ PERSONAL a ADV INJURY s 1,000,000.00 I 1 GENL AGGREGATE LIMIT APPLES PER: GENERAL AGGREGATE $ 2,OD0,000.00 ❑ POLICY W jE� 1:1LOC Pi20DUCTS-COMPAP AGG $ 2 000,000.00 ❑ OTHER TERRORISM S 0.00 AUTOMOBILE LIABILITY -CO SINGLE LIMB $ f ❑ ANY AUTO BOD LY INJURY(Por person) I S ❑ ALLLOS NSD ❑ SCHEAUTOLED BODILY INJURY(Pei acc $ ❑ HIRED ALTOS ❑ AN OU TN.-0Sw N ED =I%RTY DAMAGE $ !I UMBRELLA LIAB ❑OCCUR EACH OCCURRENCE $ ❑ EXCESS LIAB ❑CLAR-0S•MADE AGGREGATE $ ❑ DEC 0 RETENTION$ $ i WORKERS COMPENSATIONPER OT14, AND EMPLOYERS LIABILITY YIN PRO OFFiCER1MEMBER DCRC.L�UED? NIA E.L.EACH ACCIDENT , ) $ (Mandatory In NH) E.L DISFJ45E-EA EMPLOYEI $ M yes,descdbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $ 1 t I I 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Addttwnat Remarks Schedule,N more space Is mquhed) PLUMBING CONTRACTOR-RESIDENTIAL-COMMERCIAL-SEPTIC CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN BUILDING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 AVE AUTHORIZED REPRESENTATIVE MIAMI SHORES,FL 33138 -- OFFICE 305-795.2204 ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101)OF The ACORD name and logo are registered marks of ACORD m —4 00. 111 m RALLEGIDID: 11"EftW, .EIiALDEBC P71Qft: +BROWAMC)OUlfrt'AFOOM E Miami Shares Vi11N=-fvfflr,S7 E87' E ef,v�watXTEN.1fOM NMrACODRDINO To THEPtAT < ■cocw-CATCH jmE U�1I C 'fir: ASRECOMED0PLAYSM42,1 Q ■�� RV a- •CK&JNUetFEWE APPROVED -- TSHOULDER 33 OF THE PueucREcoRMofKANWADR ■CCF1CfiETE L1QFiT1�Olfi - - `! m' 3wu " 'O0 � °1bWnW ZONING DEPT � _ ■esus ,� t�- .�G"l�' � �•�, � 'OtARPM M BLDG DEPT ' ► . •DELTANC7ltRitALAN10LE) r CRTiFt�AT1aHS. rt .._. . ■ELEVATION SUE3JEC C TQ GO pi JCE WITF�, TSy �CONC =NB9��o ��25.00:�}rip $ARA SULLIVAN iNi�1f!' FRP Nr ■�C9TM OLEVATION T A, li(R C ' •6=0FPAVEfATHr ! )LES ANDREG IO'IS OORAIER p, u ■VMCFWAY STATE AND COl INN W ■ a f s . y . � RECEIVED H ■N+IIVERT i. Q.f 'IDR pq +FQL!l1QIROIIIQ>f ■ �� - x__,�.-'•� APR'3 0 1018 n^ 29. J PaD{IttIa,��HAltyANDtf16C PROPOSED AREA • �Y�`'•l!s O �MVHff DnDE wYfl ,i.i�MV,� f a- ■NQItTH ONiE BTORV ,?3: ;F {A a- ■IiAL AND Df6C (,'gD R$$RDSl10E ■VVALFEM* p� 9160 J +OPFl=AE0W=9" N LOT 4,BLOCK 20f1 d ryExrsY 3S 6N�L oFesEr +Fs •ions ,: w .... KATSOOK m PALM DEMN RECOf= so 6 W Ati 2 �. S L A/ • • • • ••.• •••••• •POIHT OFGMATUR£ 4 12.t r t yb •••• •••• •• 7K 1C ■PAGE �►�r �l • • •POM1rQF�WNE"1G Lap •••�•• •••• •••••• ■POINrDF GOiMNNENIKT t+ ' •'rp t+ •••••• • • • aftAMFENCE • • • • • •RIGK!'OrMt!►V bom Kwaim Alm will RBf'1O�8' • •fir al 1f! *ON ROD Cf� A/- 7Jv �L�i wtfi EQ/LOTAF9MftV Mil /FI . � G �I I N •SETt % OOt�C '^F"�' �LOEArr7E1a1RitoNFtlloYtDEDiY4' M/IIIi>E� +UfUIY F.Ab�5VA t6Mr OANEWAYV, vmnv rp kl�� INFiF.�/.1 ��.. • ...... ■ POLE 1• Nl6RGU��• mIACItT®QOC . •YlDOD FA[OE T ( qua 7 LD p;:'r 11i0Y1MQllEM TW5fAC0i1DMArtie wY K m swoo4 — _ _F3P 1 W �B�_ AP W ADSrta1tAL1AAT�li of IIFC�O,IYK►r walt�f 111Ea lOINICTif T1ia�ue a�oORDs OF ttr��P'Guo _r •` COINRf1YQfR600I1A I.AWJ" fl �.TamatfR14Yf6FaRO6MMEYAYGEPJIItl'QiIEANI i E wAspinr (N TMIi>tYw"is NOT TO!lVA40PORGDfrTRUCT 11f10N&0EODMV0riGM.0AlWOFlM fMOMAXWORLFMrOEgGN. � 70�OfE0i►1lJYSt10MNtBL9W�REFfAEHCEbtbTf�i _".'_�." `� A�-SEMpIM111tfI�11EN0i:NiM•R#•T1iflA� cc) aftly&r wy FLf�ZID�IE flATA '[FIELD : EVfSiOf13: QATE: SCALE 1"AZO' FORTH 9Y THE FLORIDA BOARD OF PR0FE$SKK&L BLRtVEvM ��I�KTY��( m rnr AspZONE:X WA LOtAWN OF WROVE MENS CUM48 CADD: DJC AND MAPPERS W 17.R.(iRDA A MISTRATM OODE - m 10TIM STREET ODIAMMITV V 12M Man BY:JBP 3IfO ,!q.i71f1 f'H12 A fI1DFFIKs 039!L WVME lk ! 411 P $)ORJM MWEYOfR MND MAPPER iS FM "Jan; v NOT VALID WI TF OUTTHE SKWATuf�AND yle ORK IM RAM m 3Hf�TaK 1 Ofs 1 VEALOFAFLORRDALRCEff' WSRN ORANI) •• .• . .• PERMIT #: 13-SC-1841583 STATE OF • • • • • • • • • • DEPARTMENT OFIHEALTH '• DA ' ' ' ' �DPLICATION #: AP 1340798 ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID: SYSTEM • • ••• • • • FEE PAID: CONSTRUCTION PERMIT : : • • •' : : • ': '•' r • • ••• • • • • • •RECEIPT #: • • • • • • • • • • 'DOCUMENT #: PR1103923' .. . . . .. ... .. CONSTRUCTION PERMIT FOR: OSTDS Repair •• :'� :�• �� •• APPLICANT: Sarah Sullivan " ' ' ' • ' "' •• PROPERTY ADDRESS: 150 NE 107 St Miami, FL 33161 LOT: 4 BLOCK: 208 SUBDIVISION: PROPERTY ID #: 11-2136-007-0200 [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 [ 750 ] GALLONS / GPD Septic Tank CAPACITY A [ 0 ] GALLONS / GPD CAPACITY N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] o K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ 300 ] SQUARE FEET New Drainfield Bed Conf, SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [X] STANDARD [ ] FILLED-_ [ ] MOUND [ J I CONFIGURATION: [ ] TRENCH [X] BED [ ] N F LOCATION OF BENCHMARK: FFE 11.25' I ELEVATION OF PROPOSED SYSTEM SITE [ 6.00 ] [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE ( 44.00 ] [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 12.00] INCHES EXCAVATION REQUIRED: [ 50.00] INCHES ' O 1.-EXISTING 750 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...BED... configuration. E 4.-Install 12"of slightly limited soil at the bottom of the drainfield. 5.-Invert elevation and Bottom of drainfield to be no less than 8.08'& 7.58' NGVD respectively R THIS PERMIT IS NOT FOR ANY ADDITIONS. The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow of SPECIFICATIONS BY: Barry Teixeira TITLE: APPROVED BY: TITLE: Environmental 'Speia3� st}II Dade CHI) Erxck Pexera F imi-"acuCouny DATE ISSUED: 04/24/2018 •'• •�. C;' ':;i;EXR�ioRATION DATE: 07/23/2018 DH 4016, 08/09 (Obsoletes all previous editions which may n used) Incorporated: 64E-6.003, FAC - Page 1 of 3 ,4318 1.1.4 AP1340798 x .. .. . . . .. .. . . . . . . . . . . . .;PR1103923 The licensed contractor installing the system is responsible for instalin;tle minimum c&e jory of sanklg taccordance with s. 64E-6.013(3)(f),FAC.Required drainfield area based on rule 64E-6.015(6)(cF. ••• • . Install a new drainfield to achieve Drainfield size requirement. .. . . . .. •.. .. . ... . . . . .. . .. . . . . . ... .• s r STATE OF 9L-ORWA:': ;•.•; �- DEPARTMENT DF HEA-T.+J APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION.PERMIT •. ; PermitftpVcatipn N1mpber 13 any • • • • • • • -------------- --- --------PART It-SI'I'EP1!AN -=------------------------- 3,13 Scale: Each-block represents 10 feet and 1 inch=40 feet �' �` `"S t$A rw�' i I Tfi re are no pertinent features on adjacent properties and or across the street that may >xw� W .affect the new system installation. ASPNAL WODUNR S TL. Pl lob ' • RID RPtrr 7s i 1P' .Q' V MOM calummm m fill+ • � NRW ; ;o ► �{ 3 ` r� �P _o :'_ FPW S��' Z �a5.S o'.r v�...«.. '-1- ..• TROP a I` d' { mjuw S. - CONI ^• � _:•?t- F/. S �}- � _'�oRivEwAY i Vis. - W t � � r Notes: E'xss• � 5 ��s A 7SO yvyt,.-ws "0 Gam- r�--0 Lx"6Lvper.", 3,00 Su? 1+ ori.. .-rte :v Site Plan submitted by: Title Plan'Approved Si Not Approved Date gy County Health Department ALL CHANGES MUST BE APPROVM BY THE-COUNb?HEALTH DEPARTMENT DH4M5.08109(Obsok tes Pr$AOM&NOW which may sot be usecO if oxgorAe& 64E 6.a01,FAC , Page 2 ofd. (Stock Number:5744-tit)22-4015.8} NOTICE OP•R16—IT:• -F: A party whose substantial interest is affected Py tPis ordgr aX petition for an administrative hearing pursuant to sections 120.569:441 211.57,F1oQdd Stdtitel.•Such proceedings are governed by Rule 28-106, Florida Adi6nis1rative to&; A ee iitien: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 receigtolt4is grdeli Tf gjadgrgss of the Agency Clerk is 4052 Bald Cypress Way, BIN A-02,Tduahisded, Pdrida 323M The Agency Clerk's facsimile number is 850-413-8743. • • • • • • • • •• • • • O • ••• •• 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. a