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DS-14-1976(Os Miami Shores Village Building Department 10050 N.E.2nd Avenue; Miami Shores, Florida 33138 BUIL PERMIT APPLICATION JUN102015 BY: Tel: (305) 795-2 Fax: (305) 756-8972 NUMBER: (305) 762-4949 FBC 20 1_0 Master Permit No 1 J 7 ?==> Sub Permit No. ®BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION 0 RENEWAL PLUMBING ❑ MECHANICAL 0 PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP /L " CONTRACTOR DRAWINGS ( JOB ADDRESS: a `I �(/ C �s 7' City: Miami Shores q County: Miami Dade. _ Zip: Folio/Parcel#: //-.dad -0/g Occupancy Type: Load: Is the Building Historically Designated: Yes { NO Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): A7f0 (a [ I `� Phone#: 7k6 -�(:) Address: G ( /17e— 'Ss 1 City: 4 C ok S k o ✓gy m State: -CZ.. Zip: 3 ✓ 1 3 ii Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company 4La 0 et`e S-610 Cow S117(CI a "f Phone#: 9('c 7 9? Address: MOO Of' vl (v (2-k . -� City: Co, ✓ot L v-i f-I4 �`� S / State: L Qualifier Name: J 6'3 u S Lia\ at Z 9 GL`e Z-- Phone#: "ZT(Cp - 2 9 - 7 074 State Certification or Registration #: C6 e S 0 S a O8 Certificate of Competency #: (� Phone#: ‘6�- : 3�'-- g,2, Address: 7760 // VI ((Vf' #.6-0C'City: W t'tim ' State:R" Zip:l r3 3 / 5yo DESIGNER: Architect/Engineer: 'Value of Work for this Permit: $ c I c' a vti -0(49,e etc c`G oad' Zip: 3 3 ( 3 V Type of Work: ❑ Addition Alteration n New ❑ Repair/Replace V e(Al CO(4C +V v� acre pet(fe 'Vek /V'wt/ets Description of Work: ,v1/c.e Square/Linear Footage of Work: �� (c a s n Demolition M Y tl rt Specify color oficolorftiru tile:= w4 Submittal Fee •<' - Permitfee $- Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ • Bond $ v - 13 .11 rt"yl•1. :, ..,+, CCF $ r!, 2 ' w -1 a'3 • NCO/CC $ Y DBPR $'tk, Notary $ (Revised02/24/2014) TOTAL FEE NOW -DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State r -^�"."`"" .""Zip""""_`. Mortgage Lender's Name (if applicable) r"mot �. ; t;. 'f �� g ''r : I I t Mortgage Lender's Address "Ir( y- �'� `v" o'Y-'X' ZrrfY 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 .f such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature OWNER or AGENT The foregoing instrument was acknowledged before me this Signature CONTRACTOR The foregoing instrument was ack .wledg-• .efore me this S+h day of JUrL , 20 IS , by jS-F�. day of Ju r'& , 20 i s , by Pir-l-urn Cad i \lo. , who is personally known to .)eskis VIA(9 ,ems , who is personally known to me or who has produced FC. t7r vp,s (ico V\ -�- as me or who has produced FL -0r iverS Licons.r. as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Prin .prrocJ M. (maS Seal: 10 Asiri14& JERROD M. JONES • a•. fa TA. Commission # FF 197851 4-... Expires Februa, 27, 2019 APPROVED BY rso (7 Sign: 7)1 . Print: Jevrodl M mtie_� Seal: Plans Examiner r+ir".�iiyy JERROD M. JONES =.r ; = Commission # FF 197851 i .. -.'a: Expires February 27, 2019 .1:tli (:r Bonded Thru Try Fin Nsuranc.800.386.7019 Zoning (Revised02/24/2014) Structural Review Clerk 'ACORU® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 06/09/2015 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 pollcy(ies) 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 INSURED ALL CITY INSURANCE INC - ACI 275 FONTAINEBLEAU BLVD. SUITE 190 MIAMI FL 33172 ONE STOP CONSTRUCTION, INC. LICENSE # CGC 1505208 4214 SW 2ND TERR MIAMI COVERAGES FL 33134- CERTIFICATE NUMBER: NAME: CARMEN RODRIGUEZ PHONE (305) 463-9431 GMAILaALLCITYINS.COM In;.201549 INSURER(S) AFFORDING COVERAGE IAIC_Ho):(305) 436-6797 DiBURERA:WESTERN WORLD INSURANCE C INSURER B : NAIC INSURER C : INSURER D : INSURER E : INSURER F • 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. INSR I TR TYPE OF INSURANCE ADDL MICR SUER wun POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP QIIMIOOIWYYI LIMITS A GEIERALLIAeILITY A COMMERCIAL GENERAL LIABILITY X FORM OCCUR NPP8268670 02/18/201502/18/2016 EACH OCCURRENCE $ 1,000,000 DRENTED PRAEM SFSGE O(Fe occurrence) 8 100,000 CLAIMS -MADE MED EXP (Any one person) $ 5,000 X NI BLANKET PERSONAL & ADV INJURY $ 1,000,000 $ 2,000,000 GGEEN'L )I GENERAL AGGREGATE AGGREGATE LIMIT APPLIES PER: POLICY PRO- I I LOC PRODUCTS - COMP/OP AGG $ 1,000,000 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAR EXCESS LIAR _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ D DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS Y I NWITS NIA WCY I STATU-OTH- MI E.L. EACH ACCIDENT $ E.L DISEASE - EA EMPLOYEE $ below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION ONE LICENSE LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace is required) OF OPERATIONS I STOP CONSTRUCTION # CGC-1505208 CERTIFICATE HOLDER CANCELLATION Al 000080 MIAMI SHORES VILLAGE 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. AUTHORED REPRESENTATIVE &atm 066-(k, ACORD 25 (2009/09) 01988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 3/12/2015 100% Report Viewer JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION • • CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW • • CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 3/12/2015 EXPIRATION DATE: 3/11/2017 PERSON: VELAZQUEZ JESUS FEIN: 043736889 BUSINESS NAME AND ADDRESS: ONE STOP CONSTRUCTION INC 4214SW2TERR MIAMI FL _ 33134 SCOPES OF BUSINESS OR TRADE: LICENSEDGENERAL CONTRACTOR Pursuant to Chapter 440.05(14). F.S.. an ofacer of a corporation who elects esemption from this chapter by filing a certificate of elation under this Notion may not recover benefits a campensatbn under this aygar. Piwsuant to Chapter 440.05(1 F.S.. C4eort ates a ela tion to to exempt... apply only within ar scope a fel busness be beadle hated on the nake a slxlbn to be. P after the e to Chapter Mo.05(1J . F.S.. ante of a SMabh t0 bs exempt and named tee a election to exempt .snit be to equine orh n. at cry time aver tOYnp oa notice a fhwanee a thu Certificate the person named an the notice or certificate no longer moats the reputements a th s section for iuth ere of a certificate. The department stall revoke's certificate at DFS-F2-0wC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609 https:`//apps8.tldfs.com/cmeportviewer/reportViewer.aspx?data=kdvpginc9D7Q3gH6TER6eP1 KMZ%2fSz5bXKYfBxkrekeESoPVy 1 v4NPOPN42XeirDRGXV WIu... 1/2 Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit NO. DS-9-14-1976 p •Permit Type: DrivewayslSidewalks/Slabe r ru Work Classification: Addition/Alteration Permit Status: APPROVED issue Date: 4/28/2015 Expiration: 10/25/2015 Parcel Number Applicant 841 NE 95 Street Miami Shores, FL 1132060142940 Block: Lot: ARTURO CADILLA Owner Information Address Phone Cell ARTURO CADILLA 841 NE 95 Street MIAMI SHORES FL 33318- 841 NE 95 Street MIAMI SHORES FL 33318- Contractor(s) Phone ONE STOP CONSTRUCTION INC (786)299-7209 Cell Phone Valuation: Total Sq Feet: $ 5,500.00 800 Approved: In Review Comments: Date Approved:: In Review Date Denied: Type of Work: REPLACE EXISTING DRIVEWAY FOR PAV Bond Return : Scanning: 3 Classification: Residential Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $3.60 $2.00 $2.00 $1.20 $125.00 $9.00 $4.80 $147.60 Pay Date Pay Type Invoice # DS-9-14-52909 04/28/2015 Check #: 1684 09/10/2014 Credit Card Amt Paid Amt Due $ 97.60 $ 50.00 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Foundation Review Planning Review Building 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, PLUM G, MECHAfjUCAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I ce ify,that all theforegoinginformation is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. F thermore, I authorize the above -named contractor to do the work stated. April 28, 2015 Authorized fgnature:Owner / Applicant Contractor / Agent Date Building apartment Co. April 28, 2015 1 • Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 10 yy Permit No.DS 1�f�-- /97 � Master Permit No. Permit Type: BUILDIN ! ROOFING JOB ADDRESS: 841 95St City: Miami Shores County: Miami Dade zip: 33138 Folio/Parcel#: 11-3206-014-2940 'Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): Artur C dilla State: Pain) Address: 841 NE 95 St City: Miami Shores Tenant/Lessee Name: Phone#: (786)252-2803 zip: 33138 Phone#: Email: acadilla65@gmail.com CONTRACTOR: Company Name: One Stop Construction Inc. ,Address: 1000 Ponce de Leon Blvd. Suite 208 City: Coral Gables Qualifier Name: Jesus Velazquez State: FI Phone#: (786)299-7209 Zip: 33134 Phone#: (786)299-7209 State Certification or Registration #: (50.5 `ZOO Certificate of Competency #: Contact Phone#: 8 Cv 2. 4i 7_(9C Email Address: ,e SV 5 e- @ S `T Co N b'[ ,2.-/ c,"(, ; CO "(1 Phone#: (305)778-1276 DESIGNER: Architect/Engineer: William Plasencia 5sex�c-PQ Value of Work for this Permit: $ — Square/Linear Footage of Work: Type of Work: ❑Addition Description of Work: ❑Alteration ❑New ❑Repair/Replace ❑Demolition 5 12p .0 E A \"T Q Y i v WAy Color thru tile: ***************************************Fees************************ Submittal Fee $ Scanning Fee $ Q CO Notary $ c Double Fee $ (� Permit Fee $ t 25 CD CCF $ 2 • 63. 0 CO/CC Radon Fee $ 2 'Cb DBPR $ 2 CO BonL Training/Education Fee $`t • 2-0 Technology Fee $ . eo Structural Review $ TOTAL FEE NOW DUE $ 9 1 - d 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 NOTI E OF COMMENCEMENT." Notice to Applicant: As a condition to th ..•4? a} i J1 i . ;� mit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of co :, •, j' �; d construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy • e 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. t the absence o such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature c Owner or Agent The foregoing in trument was acknowledged before me this day of / 0 6 , 20 , by who i As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: ******************** APPROVED BY * LL4pri,TeValif JESSE WALTERS Notary Publics�- State of Florida My Comm. lans xami e Signature Contractor • The f• egoing I trument wasd�acknowledged be , day of f' p ,42Q , 20IJ , by who has produced who/is personally kno to me or who has produced V 210-o id tification and who did take an oath. NOTARY P_ . LIC: Sign: Print: My Comm': sion *************** Structural Review (Revised 3/12/20 1 2)(Revised 07/ I 0/07)(Revi sed 06/l0/2009)(Revised 3/15/09) A DELGADO SION # FF029457 : June 20, 2017 oning Clerk DBPR - VELAZQUEZ, JESUS DAER; Doing Business As: ONE STOP CONSTRUCTI... Page 1 of 1 Licensee Details Licensee Information Name: VELAZQUEZ, JESUS DAER (Primary Name) ONE STOP CONSTRUCTION INC (DBA Name) Main Address: 4214 SW 2ND TERR MIAMI Florida 33134 County: DADE License Mailing: LicenseLocation: 4214 SW 2ND TERR MIAMI FL 33134 County: DADE License Information License Type: Certified General Contractor Rank: Cert General License Number: CGC1505208 Status: Current,Active Licensure Date: 02/05/2003 Expires: 08/31/2016 Special Qualifications Qualification Effective Construction Business 08/20/2003 View Related License Information View License Complaint 6:23:33 PM 9/9/2014 1940 North Monroe Street, Tallahassee FL 32399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida Is an AA/EEO employer. Copyright 2007-2010 State of Florida. Privacy Statement Under Florida law, email addresses are public records. If you do not want your email address released in response to a public -records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. *Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emails provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. Please see our Chapter 455 page to determine if you are affected by this change. https://www.myfloridalicense.com/LicenseDetail.asp?SID=&id=01 ED05D6638D4E003E42... 9/9/2014 9 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption 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. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore, you may be personally liable for the worker compensation injuries of any person allowed to work under this permit. Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. I j� Owner Print Name: I 111- '�(D C �]�e (Ct Signature: (�e�l.(J `�=�(�10 e,‘ State of Florida County of Sworn to a day of By (S T scribetd before me this eck , 20 I 4 . Oct. 8, 2017 (O b 7c ZU Contractor I - A Print Name: Signature: c State of Florida ) County of Miami -Dade) I Sworn to and subscribed before me this ,20 l- LAURA MAYER NOTARY PUBUC STATE OF FLORIDA Corm* FF085329 dijs a$;o-62-xi10-0 F(_,Zo A t &Zs• ago- 32-Y76-0 day of arhod Type of Identification p Miami Shores Village Building Department 10050 NE 2 Ave, Miami Shores, Fl 33138 Tel: (305)795-2204 • Fax; (305)756-8972 10/24/2016 To: Current Owner 841 NE 95 Street Miami Shores, FL Permit: DS-9-14-1976 Address: 841 NE 95 Street Miami Shores FL Dear Sir or Madam, Our records indicate that the above referenced permit has expired without obtaining the proper final inspection. In order to serve you better, we need to keep our files up to date. As per section 105.4.1 of the Florida Building Code, "Every permit issued shall become invalid (expired) unless the work authorized by such permit is commenced within six months after its issuance, or if the work authorized by such permit is suspended or abandoned for a period of six months after the work is commenced, or completed without obtaining the final inspection of the work performed.." Please be advised that open permits will hinder your ability to obtain new permits, refinance or sell this property. Please contact the Building Department, within 15 days of receipt of this letter in order to take care of this matter. Sincerely, id Z!p G Ismael Naranjo CB ) Building Director Mission: To protect promote & improve the health of all people In Florida through integrated state, county & community efforts. FroM HEALTH Vision: To be the Healthiest State in the Nation Rick Scott Governor John H. Armstrong, MD, FACS State Surgeon General & Secretary August 28, 2014 William Plasencia R.A. 7700 N Kendall Drive, Suite 506 Miami, FL 33156 RE: Modification to a Single Family Residence - No Bedroom Addition Application Document Number: AP1157115 Centrax Permit Number: 13-SC-1555506 841 NE 95 Street Miami, FL 33138 Lot: 13 Block: 75 Subdivision: Miami Shores Sec 3 Dear Applicant, This will acknowledge receipt of a floor plan and site plan on 08/18/2014 for the use of the existing onsite sewage treatment and disposal system located on the above referenced property. No objection. Covered terrace addition. Reviewed by Y.Martin on 8/28/2014. This office has reviewed and verified the floor plan and site plan you submitted, for the proposed remodeling addition or modification to your single-family home. Based on the information you provided, the Health Department concludes that the proposed remodeling addition or modification is not adding a bedroom and that it does not appear to cover any part of the existing system or encroach on the required setback or unobstructed area. No existing system inspection or evaluation and assessment, or modification, replacement, or upgrade authorization is required. Because an inspection or evaluation of the existing septic system was not conducted, the Department cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use. You may request a voluntary inspection and assessment of your system from a licensed septic tank contractor or plumber, or a person certified under section 381.0101, Florida Statutes. If you have any questions, please call our office at (305) 623-3 00. I Engineering Specialist II Department of Health in Dade County Florida Department of Health in Dade County • • , Florida PHONE: (305) 623-3500 www.FloridasHeaith.com TWITTER:HealthyFLA FACEBOOK:FLDepartmentofHealth YOUTUBE: tldoh