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PL-18-3418Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 1223 NE 102ND ST, Miami Shores, FL 33138 Contacts ; w Permit NO.: PL-11-18-3418 perrnit Type: Plumbing Residential Work Ctassrficattron': Septic/Drainfield T Petrnit Status: Approved Issue Date: i1/26/2018%1 Expiration: 05/08/2019 Parcel Number 1132050250140 DANIEL & MARYANNE DAMMRICH 1223 NE 102 ST, MIAMI SHORES, FL 33138 Owner Description: INSTALL 300 SQFT OF DRAINFIELD ALFONSO SEPTIC CONTRACTOR INC JOSE BOLANOS 1391 W 36 ST, HIALEAH, FL 33012 Business: 7862514099 Contractor Valuation: $ 4,700.00 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $3.00 DBPR Fee $2.47 DCA Fee $2.00 Education Surcharge $1.00 Permit Fee $114.50 Scanning Fee $9.00 Technology Fee $4.11 Total: $186.08 Inspection Requests: 7 2-4949 Payments Total Fees Credit Card Credit Card Amount Due: Date Paid 11/26/2018 11/09/2018 Amt Paid $186.08 $136.08 $50.00 $0.00 Building Department Copy In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construct '• and zoning. Futhermore, I authorize the above named contractor to do the work stated. ized Signat,re: Owner / Applicant / Contractor / Agent Date November 26, 2018 Page 2 of 2 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 Tel: 305-795-2204 Fax: 305-756-8972 Inspection Number: INSP-001896-2018 Permit Number: PL-11-18-3418 Scheduled Inspection Date: November 28, 2018 Inspector: Massenet, Maykel Owner: DANIEL & MARYANNE DAMMRICH Address: 1223 NE 102ND ST Project: Miami Shores, FL 33138 Contractor: ALFONSO SEPTIC CONTRACTOR INC JOSE BOLANOS Permit Type: Plumbing - Residential Inspection Type: Pi,u`mbing inF aI Work Classification: Septic/DrainfieId Phone Number: Parcel Number: 1132050250140 Phone Number: 7862514099 Building Department Comments INSTALL 300 SQFT OF DRAINFIELD Checklist Item General Comments Passed False Comments Inspector Comments Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. DIVISION OF Environmental Health Florida Health Miami -Dade County OSTDS/Well Division 11805 SW 26th Street• Miami, FL33175 Inspector 7SC' A rif eCt4S(At Address 2Sri Comments: Signature Date gyp_ 36_ /$ DIVISION OF Environmental Health Florida Health 9�0� Miami -Dade County fit OSTDS/Well Division FQ 11805 SW 26th Street • Miami, FL 33175 Inspector }-'Rt4lT4' f.c s A- 'V f ' r ' Address Comments: Signature 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 BUILDING PERMIT APPLICATION ❑ BUILDING ❑ ELECTRIC ROOFING fd PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: / 2 2 tJ F- I Q `i FBC 20 (? 131.h Master Permit No. pug) -341 V Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ CHANGE OF CONTRACTOR City: Miami Shores County: Miami Dade Folio/Parcel#: // -,3 "._.o -C) 2- --()( Li () Is the Building Historically Designated: Yes Occupancy Type: 'r \ Load: Construction Type: Flood Zone: OWNER: Name (Fee Simple Titleholder): N lZ tut e` \ iSJ A M lA Pa ell Phone#: Address: /1)`R ►ut3• 2- �- City: (- q '1 04 l RQ State: Flo ❑ CANCELLATION ❑RENEWAL ❑ SHOP DRAWINGS Zip: 3j3 NO BFE: FFE: zip: 3 3 I 3 ,P Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: A 1(201VS0 � Pi7 C (.o 1T11.4 (o& Address: 1//9�Y/ (W)e5T B6 Sr City: /-J//S- // ( li State: 1 14- Qualifier Name; (^fj e ( r)t1Q (aZS( State Certification or Registration #: Q ioci 7 ( 2 . Phone#: 786- :2_ 5/_C%o y/ Zip:3Es;124 Phone#: Certificate of Competency #:5 4 o I 1 (9 7 DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 9200 Type of Work: ❑ Addition ❑ Alteration Description of Work: Square/Linear Footage of Work: 300 New ❑ Repair/Replace ❑ Demolition (Ue-;7"/d 11 oOSc,LFr or bap i►vrc.-/ Specify color of color thrurtile: Submittal Fee $ q1 Q Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $ DBPR $ Notary $ Double Fee $ Bond $ OD ` Oo (Revised02/24/2014) TOTAL FEE NOW DUE$ 1 -36 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 $2560, 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 occue en (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be,appry and d a rnspection fee will be charged. Signature OWNER or AGENT The foregoing instrument was acknowledged before me this a,� day of Se Prepo, , 20 / , by DAtof IU[..l,L , who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Pri as ,r'o*+%+ice• JOSE BOLMIOS 141. : % MY COMMISSION GO231457 ;;i0 EXPIRES: October 8, 2022 APPROVED BY i/—/ 3 -41 Plans Examiner Zoning Signature NTRACTOR T foregoing instru -nt was acknowledged before me this day of S'r , 20 by 5me-cA who is personally known to me or who has produced CIA t CP\ ' — as identification and who did take an oath. NOTARY PUBLIC: S Print: rr can _ti; S NZ I�2�Pi•.e< MAII k,.i < O :4LEZ MY CC r ON # w 044602 Seal: MAHARAI K. GONZALEZ MY COMMISSION # GG 044602 EXPIRES: November 2, 2020 Bonded Thru Notary Public Underwriters ************ Structural Review Clerk (Revised02/24/2014) Alfonso Septic Contractor, INC. 1391 West 36 Street Hialeah, FL 33012 Alfonsoseptic@gmail.com Date: September23,2018 State of Florida County of Dade Before me this day personally appeared Jose Bola nos who, being duty sworn, Deposes and says: That he or she will be the only person working on the project located at: 1223 NE 102 ST Miami Shores FLA. actor Sig .ture Sworn to (or affirmed) and subscribed before me this by SOS 01 c r O 5 Personally Know OR Produced Identification Type of Identification Produced It MAHARAI K. GONZALEZ MY COMMISSION# GG 044602 EXPIRES: Nov Pudic Underwriterser ,220 Bonded Thru Notary Print, Type or Stamp Name of Notary Alio 25 day of S e .20 1CthOfO I 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 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 BW YO i"t 1`'OWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: er State of Florida County of Miami -Dade The foregoing was acknowledge before me this 5- day of S' ePre u-t b G'. By i)AA6414t tcIt Notary: SEAL: ,20f>P/ who is personally known to me or has produced as identification. 9/25/2018 Property Search Application - Miami -Dade County Summary Report Property Information Folio: 11-3205-025-0140 Property Address: 1223 NE 102 ST Miami Shores, FL 33138-2617 Owner DANIEL J DAMMRICH MARYANNE DAMMRICH Mailing Address 1223 NE 102 ST MIAMI SHORES, FL 33138 USA PA Primary Zone 1400 SGL FAMILY - 3001-3250 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY: 1 UNIT Beds / Baths / Half 3/2/0 Floors 1 Living Units 1 Actual Area 2,193 Sq.Ft Living Area 1,843 Sq.Ft Adjusted Area 2,076 Sq.Ft Lot Size 9,123 Sq.Ft Year Built 1950 Assessment Information Year 2018 2017 2016 Land Value $328,428 $328,428 $305,620 Building Value $189,435 $222,755 $225,765 XF Value $907 $917 $926 Market Value $518,770 $552,100 $532,311 Assessed Value $518,770 $543,489 $532,311 Benefits Information Benefit Type 2018 2017 2016 Save Our Homes Cap Assessment Reduction $8,611 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description PB 42-25 BAY BREEZE SEC MIAMI SHORES LOT 6 BLK 186 LOT SIZE 74.170 X 123 OR 12624-634 0785 4 Generated On : 9/25/2018 Taxable Value Information 2018 2017 2016 County Exemption Value $50,000 $50,000 $50,000 Taxable Value $468,770 $493,489 $482,311 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value $493,770 $518,489 $507,311 City Exemption Value $50,000 $50,000 $50,000 Taxable Value $468,770 $493,489 $482,311 Regional Exemption Value $50,000 $50,000 $50,000 Taxable Value $468,770 $493,489 $482,311 Sales Information Previous Sale Price OR Book -Page Qualification Description 06/04/2015 $695,000 29656-3755 Qual by exam of deed 11/11/2008 $380,000 26656-3794 Sales which are qualified 09/01/2005 $649,500 23901-3447 Sales which are qualified 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: PERMIT #: 13-SC-1875571 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION #: AP1363182 ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID: SYSTEM FEE PAID: CONSTRUCTION PERMIT RECEIPT #: DOCUMENT #: PR1153075 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Daniel J Dammrich PROPERTY ADDRESS: 1223 NE 102 St Miami, FL 33138 LOT: 6 BLOCK: 186 SUBDIVISION: Bay Breeze PROPERTY ID #: 11-3205-025-0140 [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 [ 900 ] GALLONS / GPD Existing Septic TANK TO REMAIN CAPACITY A [ 0 ] GALLONS / GPD CAPACITY N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER+24 HRS #Pumps [ ] D [ 300 ] SQUARE FEET NEW DF IN BED CONFIG SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [x] BED [ ] N F LOCATION OF BENCHMARK: FFE 12.68'NGVD I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D FILL REQUIRED: 0 T H E [ 36.20 ] [ [ 66.24 l [) INCHES INCHES / FT ] [ ABOVE /J BELOW / FT ] [ ABOVE Jf BELOW BENCHMARK/REFERENCE POINT BENCHMARK/REFERENCE POINT [ 0.00] INCHES EXCAVATION REQUIRED: [ 00.00] INCHES 1.-EXISTING 900 septic tank with and approved filter TO REMAIN. 2.- Install 300 sf. of drainfield in BED configuration. 3.- Existing SAND at the bottom of the drainfield to remain. Any spoil material UNDERNEATH THE DRAIN FIELD within 24" vertically that has visible signs of effluent shall be removed as part of the repair. 4.- Invert elevation and Bottom of drainfield to be no less than 7.66' & 7.16 ' NGVD respectively THIS PERMIT IS NOT FOR ANY ADDITIONS._ (Comments Continued on Page 2.) R SPECIFICATIONS BY: Jose :Enos TITLE: Registered Septic Tank Contractor APPROVED BY: TITLE: Engineering Specialist II Dade CHD DATE ISSUED: 09/11/2018 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC EXPIRATION DATE: 12/10/2018 Page 1 of 3 v 1.1,4 API 363132 SEII03051 � DOCUMENT #: PR1153o7a ___( Comments continued onpage u) 5,Perimeter ofexcavation area shall beouleast uft wider and longer than the proposed absorption trench. The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 300 gpo. The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E'0.018(3)(0. FAC. Required dminfia|darea based nnrule O4E'O.O15(8)(c)2. Install anew druinfie|dtuachieve Dnoinfie|dsize requirement. 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. ►-)F-'At-zTMENT OF HEALTH APPLICATION FOR CONSTRUCTION PERMIT Permit Application Number Scale: Each block represents 10 feet ggd 1 inch = ^: -, There Iv no perment Te , fir° rt�s 2Pd trots the street , tin { f r' hi* is i 23 PART II - SITEPLAN ` • t s Notes: i 27% 1U ff �. 102 Sr- U-((41444 Po fl S F/'• 33 i $ VP - Site Plan submitted Plan Approved By vt- 00 Alto& �t. end a 1 A1Ul-- DateOc! O7_1?- 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, PAC (Stock Number: 5744-002-4015-6) Page 2 of 4 SKETCH O BOW =./ iJ'\ DAIRY J,�J J E 0 10 20 40 1 inch = 20 ft. LEGEND (C) = Calculated CL. = Clear = Center Line CONC. = Concrete CBS. = Concrete Block Stucco = Delta ENC. = Encroachment F.F.EL. = Finish Floor Elevation F.I.P. = Found Iron Pipe F.I.R. = Found Iron Rod F.N. = Found Nail F.N&D. = Found Nail & Disc F.D.H. = Found Drill Hole I.D. = Identification L = Length = Monument Line (M) = Measured 0/L = On Line R = Property Line (P) = Plat P.C. = Point of Curvature P.B. = Plat Book PG. = Page R = Radius (R) = Record R/W = Right of Way U.E. = Utility Easement SYMBOLS �Tr CED OH /1 >< AIR CONDITIONER CABLE TV CATCH BASIN CONCRETE POLE ELECTRIC BOX MANHOLE WATER PUMP WATER HEATER WATER METER WOOD POLE EXISTING ELEVATION COVERED AREA CHAIN LINK FENCE (C.L.F.) METAL FENCE (M.F.) OVERHEAD LINES PLASTIC FENCE (P.F.) WOOD FENCE (W.F.) WIRE FENCE (WR.F.) vz7z/zrzzi CBS. WALL SCALE:1' 20' cbs 15' ALLEY (P.B. 42, PG. 25) F.I.P. 3/4" No I.D. / / co Or� 9'08'54"(M) / LOT 1, BLOCK 186 F.I.P. 3/4" No I.D. 5.5' 9' ASPHALT 42.91' (M)(R) LOT 6, BLOCK 186 c0rlc. DRIVEWAY < 25.40' %'425' 0 4.20' ONE-STORY RESIDENCE # 1223 16.70' o T oRel _ — %oi 15.30' N) 16.70' 90'(C) 15' ALLEY (P.B. 42, PG. 25) x 0.31' 0.56' 10.00' / x V \ 4 o 3cn 9.94' F.I.P. 3/4" No I.D. • • • • • • • •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •. .. •••• PERMIT #: Miami S icres • • • • •• • • • • . • • • • • • • • • .. • • IA loge APFROVEO t)NING DEPT BY DATE B DG DEPT OBJECT 1.0 CCMPLIANCE WI FI-I ALL FEDERAL SATE ANL) CC it j `{ i{UL_S AND REGU�.ATIONS II W PLUMBING PLANS Approved :tASftyYii'�CYiCj lbr Sc: Tl11�� .�Q ltii* �afr) ' SI No-P �3/4 pprnved 89. 57'° (M)(R).. 5' S)DEWALJ< 24' PARKWAY 0.20' WEST 281.00' 19' PAVEMENT 75' R/W N.E. 102nd STREET F.I.P. 3/4" No I.D. (BLOCK CORNER) • o \uc-,Dcc;Vu-<sv-R]J NE +o¢ s,\.-<s3i-,223 wC ,@ sr a.q 7/./.. 3