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RC-16-1931 (2) Water and Sewer PO Box 330316 * 3071 SW 38 Avenue MIAMI-MOAADE Miami, Florida 33233-0316 T 305-665-7471 VERIFICATION FORM MjaTM&&Q§NIS NOT VALID WITHOUT A PAID INVOICE AND EXPIRES ONE YEAR FROM THE DATE ON FORM ATLAS PAGE: D8-B INV#: 23635 FORM#: 201657770 DATE: 8/11/2016 .......................... NAME OF OWNER: MIROVA RESIDENCE REMODELING M2016015403 PROPERTY ADDRESS: 15-450NE103ST .............................] I PROPOSED USAGE 1682 SF MASTER BEDROOM ADDITION&INTERIOR ALTERATION PER PAPER PLANS NO. OF UNITS: i 'REPLACES: PREVIOUS FSFR PER'--C—BB"'-ACC—#-8484447453 ........ LISAGE/NO. OF UNITS: PROPERTY LEGAL: iREPLAT OF TR C MIAI SHORES BAY PARK ESTS PB 64-97 LOT 13-14 BLK 5 FOLIO NUMBER: Ll 1-3205-031-0040 GALLONS PER DAY INCREASE: PROPOSED FLOW: 320! PREVIOUS SQUARE FOOTAGE: F 37829] 0 NEW CONSTRUCTION PREVIOUS FLOW: F3201 PROPOSED SQUARE FOOTAGE: 4,421 INTERIOR RENOVATION ADOPTED FLOW: CRITICAL HABITAT SEWER ONLY THIS IS TO CERTIFY THAT THE MIAMI-DADE WATER AND SEWER DEPARTMENT DOES HAVE A(N)___8 INCH WATER MAIN ABUTTING THE SUBJECT LEGALLY DESCRIBED PROPERTY. WE ARE WILLING TO SERVE THE SUBJECT PROPERTY,(OR,IF"WILL HAVE",UPON PROPER CONVEYANCE AND PLACEMENT INTO SERVICE OF WATER FACILITIES BY THE DEVELOPER UNDER AGREEMENT WITH THE DEPARTMENT,(AGREEMENT ID# N/A) SUBJECT TO PROHIBITIONS OR RESTRICTIONS OF GOVERNMENTAL AGENCIES HAVING JURISDICTION OVER MATTERS OF WATER SJJPPLY OP..% WITHDRAWAL. Barbara Endquez-Niv A, -wsineSs- Represent-Mla-- BY: 0009.0 NTATIVE AUTHORIZEMBe'?- 0 ....... .........................!!�•%0.00........... 0000. NEW BUSINESS COMMENTS: VF=30.00 • ........... --...----._._....------...._._.._0.0_0_0.----....__...._.....-- 0000 • -THIS ISTOCERTIFY THAT THE MIAMI-DADE WATER AND SEWER DEPARTMENT DOES NOT HAVE INCH GRAVITY SEWER MAIN ABUTTING THE-SUBJECT LEGALLY DESCRIBED PROPERTY. WE ARE WILLING f0_6%%% THE SUBJECT PROPERTY,(OR, IF"WILL HAVE",UPON PROPER CONVEYANCE AND PLACEMENT INTO SERVICE OF SEWER • SEWER FACILITIES BY THE DEVELOPER UNDER AGREEMENT WITH THE DEPARTMENT, (AGREEMENT ID#N/A). SUBJECT TO PROHIBITIONS OR RESTRICTIONS OF GOVERNMENTAL AGENCIES HAVING JURISDICTION OVER MATTERS OF SEWAGE DISPOSAL. FURTHERMORE, APPROVAL OF ALL SEWAGE FLOWS INTO THE DEPARTMENT'S SYSTEM MUST BE OBTAINED FROM D.E.R.M. THE ANTICIPATED DAILY WATER AND/OR SEWAGE FLOW FOR THIS PROJECT WILL BE:NO GALLONS[0] GALLONS PER DAY INCREASE. Barbara Enfiquez-thew Business BY: Representative ATURE OFREPROSENTATIVE AUTHORIZED BY NEW BUSINESS COMMENTS: 7HRS AL DATED:—10/14/2016 AP-1253979 THIS VERIFICATION LETTER CERTIFIES THE AVAILABILITY OF A WATER AND/OR SEWER MAIN ONLY,AND IT DOES NOT GUARANTEE THE EXISTENCE OF A WATER SERVICE LINE OR OF A SEWER LATERAL WITH SUFFICIENT DEPTH TO SERVE THE PROPERTY. FOR ADDITIONAL INFORMATION CALL 786-268-5360.SHOULD IT BECOME NECESSARY TO INSTALL A SERVICE LINE AND/OR A SEWER LATERAL WASD REQUIRES THAT THE DEVELOPER RETAINS SERVICES FROM DESIGNERS AND CONTRACTORS WITH SKILL SETS FOR DESIGNING, BUILDING AND CONNECTING TO PUBLIC WATER AND SEWER SYSTEMS. CONTACT NAME: ISABELLA ROSETE Printed On:10/19/2016 NB: Barbara Enriguez 53 PM06: t CONTACT PHONE: 305 -015 6: PR: AUTHORIZED BY: ko< ol S NOTE: ALL SHEETS MUST RE REVIEWED MIAMI-DADE COUNTY DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES Herbert S. Saffir Permitting and Inspection Center 11805 SW 26th Street(Coral Way) • Miami, Florida 33175-2474 • (786) 315-2000 APPLICATION FOR MUNICIPAL PERMIT APPLICANTS THAT REQUIRE PLAWREVIEW FROM MIAMI—RADE FIRE RESCUE AND/OR ENVIRONMENTAL SERVICES a . PROVIDE MUNICIPAL PROCESS NUMBER HERE U. Job Address. - 4-d Contractor No. �_ z W i F _ �p� o o Last four(4)digits of Qualifier No. Folio -�20 �- 0 ow a a Contractor Name O Lot Block — ccc Qualifier Name .. 6 a� Subdivision_- PBpg_ --__— p o } J2 v z Address Metes and bounds— — City State_Zip [ ] New Construction on [ ] Demolish co Vacant Land [ ] Shell Only Current use of property S,A0 10. U.w [ ] Alteration Interior �] Addition Attached r — ww [ ] Alteration Exterior [ ] Addition Detached Description of Work Q-> [ J Relocation of Structure [ ] Re-Roof R� Enclosures e� e_ room �dc��TtoY\ Ca [ ], [ ] Foundation Only [ ] Repair [ ] Tent Sq. Ft. 2Ps� 1 4!? Units—Floors Z _ [ ] Repair Due to Fire Value of Work :5 O,,OHO { - [ MBLD` N [ ] Chg. Contractor Owner%k` -n�� 2 X l iP.Am 0jcnVo�� a Category w F [ ] Re-Issue 2 Address X50 N1=�1 o376 MELE — a y [ ] Re-Stamp City[Ain.m, Shot�S State_aZip0a � 2 [ ] MPLU q z [ ] MLPG [ ] Revision w Pho4:7 ) a MMEG w [ ] Not Applicable for 3 Last four(4)digits of; •• :'•••• [ ] FIRE Fire Owner's Social Security No. . • w ---- • O Z a H i - F �-•- •.• ' • .•• Name I ccl�O1`Ql, 1p'��l _ Owner zg Address ZS3� �Jhl FAST` ww Address 2�- ,Sr. �`S�t •... • Oa, • l ••• -i • wY City�I}o�y�— State Zip Z City •••*State�Zip ,• r� `%' `� • a cc W s Phone _;���� S� a Phone�����.� �+•.: ' Z 'I am requesting a Special Request Plan Review(SRI)to be scheduled as soon as possible. There is a minimum charge of • .�QQ one-hour.Please contact the Fire Department for current rate. UaN CLWw 1`t Request: —. Date: _, s Mw w 2^�Request: __— _- Date: _ 3,d Request: -- - ----- _—__.-- Date:,--- z ate:,-- — 5 1 am requesting Optional'Plan Review(OPR)to be scheduled as soon as possible at the rate of$75 for each discipline. cL.2' Additional review fees may apply. d0 1`Request:. ---_--- —_-- Date: —.—.. FW O w I 2nd Request: --- Date:cc 1 3'd Request: — — — - --------------- Date: --- ----- _a 123..,01-192 Ons �. 4 U.S{,pEPARTMENT OF HOMELAND SECURITY ELEVAtION CERTIFICATE FEW.RAL EMERGENCY MANAGEMENT AGENCY * OMIT No, 1660-D008 Notwnal Flood insurance Program „fmpprt�lnt: Read the mhtructions on p2gesF=9- Expirefi©n Date,July 31,2015-4 SECTION A .PROPERTY INFORMATION FOR INSURANCE COMPANY USE Alf,' Builth q oowwn�er s Name Policy Number' VIKFORINEX LLC 15-152 \" A2, Building Street Address'(including Apt.,Unit,Suite,and/or Bldg..No.)or P.O.Route and,Box No. C:ompatty MAIC Number, 1450 N.E. `103RD ST. .4 . _ Mty State ZIP Code IAMI SHORES FLORIDA 33138 A . Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) LOTS 13 &,14, BLOCK 5, P.B. 64, PAGE 97 A4. Building Use(e.g., Residential,Non-Residential,Addition,Accessory,etc.) RESIDENTIAL` ` A Latitude/Longitude Lat. N25°52'12.4Xo'ng, W$0°10'01.20' Horizontal Datum:-'o NAD 1927 0 NAD 1983 A&, Attach at least 2 photographs of the building if the Certificate is tieing used to obtain flood insurance. A7,. Building Diagram Number 8 . A$.`For a building with a crawispace or enclosure(s): A9. For a building with an attached garage: a a) Square footage of cravrlspace or enclosure(s) 3,519 sq ft a) Square footage Of attached garage 400 sq ft b) plumber of permanent flood openings in the crawlspace b) Number of permanent flood openings in th ched garage or enclosure(s)within 1.0 foot above adjacent grade 10 within 1.0 foot above ad' nt grade c) Total net area of flood openings in A8.b 1,280 sq in• c) Total net area of oo� P Ings in A9.b N A sq in d) Engineered flood openings? ❑-'Yes No d) Eng,'�ineere , 0 opphl'. s Q Yes 0 No SECTION B—FLOOD INSURANCE RATEry RM)INFORMATION ri . B1;NFIP Community Name$Community Number B2.County Name � ��'t�;F� �3 �� �yB3;` tate CITY OF MIAMI SHORES 120652r MIAMI—DAD , � 'E �a LORIDA B4.Map/Panel Number B5.Suffix B6.FIRM Index Date B7.FIRM Panel �`� B8.'FloodViµ' r Base flood elevation(s)(Zone Eff cc� vised Date '1 Zones}t AO,use bass flood depth) 12O86C0306 L 9/11/09 B10:. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item ' E3 F4S Profile 0 FIRM 0 Community Determined E] Other/Source: 1'�Li • irate elt�A bn datum ugdtl`fpr BFE in Item 139: a NGVD 19,29, Q NAVD 1988 [] Other/Source: 812. Is the bLWcVgg Ltated in s Coastal Barrier Resources System(CBRS)area dr Otherwise Protected Area(OPA)? Q Yes 0 No •:••D15signatidh Date:N/A 0 • "" Q CBRS E3 OPA •:•... .. .: 'SECTION C—BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) CT."$u'iding elevations are based on: �} Construction Drawings* Q Building Under Construction* }� Finished Construction "''A flew E14%49q rertificatg tr Ir4e required when construction of the building is complete. (46"Arations'Zone's A1A30,•AI'_,AH,A(withBFE),`VE,Vi V30,V(with BFE),AR,ARIA,ARAE,AR/Al-A30,AR/AH,.AR/A0.Complete Items C2.a—h • bel5w according to the bdiltintbgram specified in Item A7.to Puerto Rico only,enter meters. .Wchmait jtilized: B-150090 Vertical Datum: NC;VD 9929 indicate Ava$oh'datum DsVltrithe elevations in items a)through h)below. 0 NGVD-1929 I3.NAVD 1988 0 other/Source: •••D furan-usgd'ibt Dyilding el8vatioft must be the same as that used for the BFE. , d •••' Check the measurement used. a)Top of bottom floor(including basement,crawlspace,or enclosure flodr)i 8 25 feet ff meters ti)Top of the next higher floor 10. 28 feet (�meters { .' c) Bottom of the lowest horizontal structural member(V Zones only) N ®feet ]meters d)Attached garage(top of slab) 6 85 feet Q meters ei) Lowest elevation of machinery or equipment servicing the building 7 07 Q feet 0 meters i .•, ; (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 6 50 feet meters g)-Highest adjacent(finished)grade next to.building(HAG) t 6. 70 feet Q meters hj Lowest adjacent grade at lowest elevation of deck or stairs, including structural support /A. -N feet E]meters t d' SECTION D—SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION ' Thi4�certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation infdhtriation.I certify that the information on this Certificate represents my best efforts to interpret the data available. '? 1 urgerstand that any false statement may be punishable by'fine or imprisonment under 18 U.S. Code,Section 1001. 10-heck here if comments are provided on back of form.` Were latitude and longitude in Section A-provided by a J18/16 ® -Check here if attachments. licensed land surveyor? Yes ❑ No i Certifier's Name Adis N. Nunei License Number 5924 Title Reg_Land Surveyor Company Name Blanco Surveyors,Inc. PLS#5924 Ad ress 555 N Share Dr. City Miami Beach State FL ZIP Code 33141 Sig `t e Date2/18/'16 Telephone 305-865-1200 F Afl Fnrm nRR_n_RA(7/17) cirio fnr r".+in=iatinn 0 .i a.. .a.........r;+: ELEVATION CERTIFICATE page 1 ; - IMPORTANT: In these spaces,copy the corresponding informlatich from Section A. EOR INSURANCE COMPANY USE Building Street Address(including Apt., Unit,Suite,and/or Bldg'.No.)or P.O.Route and Box No. 1450 N.E. 103 ST. Policy Number. Crty MIAMI SHORES "State ZzttpPCode Companyl�AlCNumber, FLORIDA 33fT , SECTION D—SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION(CONTINUED). t, Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments LATITUDE & LONGITUDE OBTAINED BY GOGGLE. ,r LBM# B-50 THE ROAD ELEVATION: 5.;72' ON CENTERLINE, ON' CENTER OF ROAO:' LOCATOR: 3250 S ELEV: 10.02' ,s Date 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 Ricb only,enter meters. E1. Provide elevation information for the foflowing and check the appropriate boxes t,Qshow whether:the elevation is above,or,below the hi est adjacent andth owes a laces gra a(LAG). a)Top of bottom floor(including basement,crawlspace,or enclosure)is Q feet [],meters ❑above or Q below the HAG b)Top of bottom floor(including basement,crawispace,_or-enclosure)is- - Q feet Q meters Q above or Q--below the LAG. E2. ;For Building Diagrams 6-9 with permanent flood openings provided in Section A Items B and/or 9(see pages 8-9 of,nstructions),the next higher floor (elevation C2.b in the diagrams)of the building is Q feetQ meters Q above or Q below the HAG. E3. Attached garage(top of slab)is 1 Q.feet Q meters Q above or Q below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is feet Q [J meters Q above or Q 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? Q Yes Q No Q 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 forZone A(without s9P%M44ssbed or community►seued!FE) 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 . StItt,.. Z4,GO*& Signature 000000 •• • •••'• s Date . Telep!lone. 0.090 Comments • • 0.0.00 0 . + . .....r .. 0000.. •• FN Cheek here if att9ghments. SECTION G—COMMUNITY INFORMATION (OPTIONAL) •0,0 0• 1 The local official who is authorized by law or ordinance to administer the community'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•Q The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architir.t who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)' G2.Q 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.Q 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 Q Substantial Improvement -G8. _Elevation_of_as-builtlowest-floor-(including-basement)-ofthe building: —Q feet Q ne#ers`--Datum G9. BFE or(in Zone AO)depth of flooding at the building site: I:7 feet Q meters, Datum G10:Community's design flood elevation: feet Q Q meters Datum 1 Local Official's Name Title i Community Name Telephone Signature Date Comments [] Check here if attachments. �0 atAa l � P Miami Shores Village JUL 12 2016 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 4_ Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 ' r FBC26I1-( -BUILDING Master Permit No'VC__1(P — PERMIT APPLICATION Sub Permit No. r BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP J� CONTRACTOR DRAWINGS JOB ADDRESS: I 4-� i✓ ��"`T ��1°-�� ` City: Miami Shores County: Miami Dade Zip: r Folio/Parcel#: 0�V— 00%0 Is the Building Historically Designated:Yes NO i .Occupancy Type: Load: Construction-Type: Flood Zone: BFE: FFE: F ,,,,OWNER: Name(Fee Simple Titleholder): )i k30r'o o-e n Phone#: K Address: )Li..s'o A '"1 City: j!. ec ti 51��,�p.-.f State: T .•" Zip: 3�� Tenant/Lessee Name: i rl Phone#: I Email: . CONTRACTOR: Company Name: Phone#: f Address: City: State: Zip: ' Qualifier Name: Phone#: r State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: v C K�2. Phone#: as Address: a J� City: cLQ State / p: Value of Work for this Permit:$ �S . O( Q Square/Linear Footage of Work: �'1 S�3 "'Ci Type of Work: a Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: c � .o l` _ _ '� 9 L.� Yll� _:> t u lcx�t• - �� Sc j}> N specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ P Structural Reviews$ Bond$ i TOTAL FEE NOW DUE$ i , ' (Revised02/24/2014) 1 ' r ^ ` ' LOCATION SKETCH sit LLLLLLLLLLLL;' L 16 LL LLL L LL! LIL 4-:Fr_ L LL Li i4 i LLL'L ONE STORY _LLL 11C.S.3.RESIDENCE L 1450 L E3 ch 40D TERRAc POOL PUMP LOT 12 18.501 b� LOT 13 POOL 00 BLOCKS BLOCKS 36.00' 0 00 000 FD.DRILL 0000* HOLE LOT 14. X11 LOT 15 e 0 000000 W., 0000 0 .7. 0 0 WATERWAY Tan 59.101 0000 0 0*0 FD.Di 0900 HOLE ABBREVIATIONS- Property Address: 1450 N.E. 103 rd St., Miami Shores, FL. 33138. S� =S�IDEMEW�E��ZONCRETE BLOCK STRUCTURE,CLF=CHAIN LINK FENCE.PL=PROPERTY LINE,DUE=DRAMAGE UT:ILITYEASEM ENT,IP=IRON I PIPE. LeRal Description: Lots 13 and 14 in Block 5 of REPLAT OF TRACT"C", MIAMI SHORES BAY PARK ESTATES, F�FOUND.AJC=AIR CONDITIONER PAD,PIC=PROPERTY CORNER.DIH=DRILLED HOLE,WIF=MODEN FENCE,RES=RESIDENCE.CL-C LEAR.RB=REBAR. according to the Plat thereof, recorded in Plat Book 64, Page 97, of the Pub ic Records of Miami-Dade - UE=UTILITY EXSEMENT. CONC=CONCRETE SLAB. RAN-RIGHT OF WkY DE=DRAINAGE EASEMENT. C[LcCENTER LINE, O=DtAMTER, TYP=TYFICAL, M=MEASURED.R=RECORDED.ENCR=ENCROACHMENT COMP=COMPUTER.ASH=ASPHALT.NID=NAIL&DISC.S=SET FEE=FINISH FLOOR ELEVATION, County, Florida. ' ' � `