PL-18-3567Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Issue Date:12/05/2018
Parcel Number
Permit NO.: PL-11-18-3567
Permit Type: Plumbing - Residential
Work Classification: Septic/Drainfield
Permit Status: Approved
Expiration: 06/03/2019
10585 NE 6TH AVE, Miami Shores, FL 33138 1122310120030 1
Contacts
DANIELA PELLICCIOTTI Owner
10585 NE 6 AVE, MIAMI SHORES, FL 33138
Other: 30540IS583
STATEWIDE SEPTIC CONNECTIONS Contractor
TERESA SOLOMON
13680 NW 19 AVE BAY#10, OPALOCKA, FL 33054
Business: 9549630082
Description: REPLACE SEPTIC TANK AND DRAINFIELD Valuation: $ 6,500.00 Inspection Requests:
305-762-4949
Total Sq Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$4.20
DBPR Fee
$3.41
DCA Fee
$2.28
Education Surcharge
$1.40
Permit Fee
$177.50
Scanning Fee
$9.00
Technology Fee
$5.69
Total:
$253.48
Payments
Date Paid Amt Paid
Total Fees
$253.48
Credit Card
12/05/2018 $203.48
Credit Card
11/30/2018 $50.00
Amount Due:
$0.00
Building Department Copy
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regu)4ting construction a zoning. Futhermore, I authorize the above named contractor to do the work stated.
Owner / Applica Contractor / Agent
Date
December 05, 2018 Page 2 of 2
XIQ)
Miami Shores Village RECEIVED
'\ry Building Department-
r i)nr$
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
-.-Tel: (305) 795-2204 Fax: (305) 756-8972 '
INSPECTION LINE PHONE NUMBER: (305) 762-4949 o s} .,rm��c." s ; -r r-
BUILDING Master Permit No. Q ��
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING REVISION EXTENSION RENEWAL
`PLUMBING ❑ MECHANICAL M PUBLIC WORKS CHANGE OF CANCELLATION ❑ SHOP
7� CONTRACTOR DRAWINGS
JOB ADDRESS: I058 S IAE 6 n ,,
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 1 C-2-23 1 " 012-0030 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
,o C
OWNER: Name (Fee Simple Titleholder): D GI y) G I GI Pe, I I )'YfC�` O a 1 Phone#: 301 Lr -1 %-
City: State: fL Zip: 3,3t 3k
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:
/Company
,�Name: Btote i«� �/iG � e# 10 &S III Phon339�9(50
Address: ` ,11c�0 I `� W t 1 Avc '- io
City: ® Lna Cko State: � Zip: 3-?>OS T
Qualifier Name:
State Certification or Registration & M () 9 1 1 Z6 2 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State:
Value of Work for this Permit: $ S oo Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New IX Repair/Replace
Description of Work: RQ o1a re.Sf'i G ±6 ►) I',' t- 1`
Specify color of color thru tile:
Zip:
❑ Demolition
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Technology Fee $,
Structural Reviews $
(Revised02/24/2014)
Radon Fee $
Training/Education Fee $
DBPR $
Notary $
Double Fee $
Bond $ 0-1) •cO
7
TOTAL FEE NOW DUE $ J
2p3'`t(3
Bonding Company's Name (if applicable)
Bonding Company's Address +
city
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address'
City
State
VE
Zip
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 approved and a reinspection fee will be charged.
�( Signa
4)), _�:
OWNER or AGENT
X
The foregoing instrum nt was acknowledged before me this
day of 20 by
(VOY\-re, RO ) CCi!RPm ho is personally known to
me or who has produced 1=7'f�� u as
identification and who did take an oath.
NOTARY PUBLIC:
Seal:
Notary Public State of Florida
Teyana Solomon
My Commission GG 266641
orw Expires 10/17/202
****
APPROVED BY
I
Signature i'e. S
CONTRACTOR
The foregoing instrument was acknowledged before me this
day orf 20 1 , by
zT�-- who is personally known to
P Y
me or who has produced �(A (_ [) as
identification and who did take an oath.
NOTARY PUBLIC:
C
Sig .
—'P
Seal: �s*�
****************
Plans Examiner
Notary Public State of Florida
Teyana Solomon
My Commission GG 268641
Expires 10/17/2022
Zoning
(Revised02/24/2014)
Structural Review
Clerk
Property Information
Folio:
11-2231-012-0030
Property Address:
10585 NE 6 AVE
Miami Shores, FL 33138-2049
Owner
DANIELA PELLICCIOTTI
Mailing Address
10585 NE 6 AVE
MIAMI SHORES, FL 33138 USA
PA Primary Zone
Primary Land Use
..........
1100 SGL FAMILY - 2301-2500 SQ
0101 RESIDENTIAL -SINGLE
FAMILY: 1 UNIT
Beds / Baths / Half
2/2/0
Floors
2
Living Units
1
Actual Area
3,445 Sq.Ft
Living Area
2,572 Sq.Ft
Adjusted Area
2,794 Sq.Ft
Lot Size
14,100 Sq.Ft
Year Built
1951
Assessment Information
Year
2018
2017
2016
Land Value
$514,674
$514,674
$411,738
Building Value
$295,745
$299,796
$202,565
XF Value
$5,047
$5,104
$5,161
Market Value
Assessed Value
$815,466
$815,466
$819,574'
$819,574,
$619,464
$337,321
---------------
Benefits Information
Benefit
Type
2018
2017'
2016
Save Our Homes Cap
Assessment Reduction
�$282,143
Homestead
Exemption
$25,000
Second Homestead
Exemption
$25,000
Note: Not all benefits are applicable to all Taxable Values (i.e. County, School
Board, City, Regional).
Short Legal Description
GOLF VIEW EST CORR PLAT PB 41-58
LOT 4
LOT SIZE 94.000 X 150
OR 18951-0493 07 1999 1
Generated On : 11/30/2018
Taxable Value Information
2018' 2017 2016
County
Exemption Value
$0
$0
$50,000
Taxable Value
$815,466
$819,574
$287,321
School Board
Exemption Value
$0
$0
$25,000
Taxable Value
$815,466
$819,574
$112,321
City
Exemption Value
$0
$0
$50,000
Taxable Value
$815,466
$819,574
$287,321
Regional
Exemption Value $0
Taxable Value $815,466
$0
$819,574
$50,000
$287,321
Sales Information
Previous Sale
Price
OR Book -Page
Qualification Description
05/25/2016
$1,010,500
30102-1236
Qua[ by exam of deed
07/01/1999
$267,500
18951-0493
Sales which are qualified j
11/01/1995
$184,500
17023-0078
Sales which are qualified
06/01/1990
$168,000
14596-1401
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/disciaimer.asp
Version:
S�HoRf S Gi
t` �t
Miami shores Village
Ly� Building Department
0
��ORIDa
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Notice to Owner — Workers' Compensation Insurance Exemption
I lurid l Lnw regtures Workers Compensation insurance coverage under Chapter 440 0l the Florida Statutes. 1-la. Stat. 1 tO.O
allow, corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to
ubtairin, a buildinlI permit. Pursuanl to the Florida Division of %Vorkcrs• Compensation Emplovcr 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:
I . 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. "Elie 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 mernbers 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 ;ontractor is requesting a permit under this workers compensation exemption and has acknowledge that he or she will not use
clay labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will
he the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of
\�orkers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors.
13Y SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CON"EN"
I
I
Signa ure: _
} Owner
Mate tf Florida
i
1 County of Miami -Dade
The foregoing was acknowledge before me this 2" day of Nov 20 16.
By_ 4Q VJ%CA ���' 1 cc i V+i who is personally known to me or has produced
as identification.
',�otar�
SEAL: - - - - - -
A � Notary Public State of Florida
Teyana Solomon
j +� My Commission GG 268641
NOTICE OF
COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT THKE OF FIRST INSPECTION
PERMIT NO,
STATE OF FLORIDA
COUNTY OF DADE
TAX FOLIO NO.1 1 - Z�31 _Q L Z-003C
THE UNDERSIGNED hereby gives notice that improvements will be made to
certain real property, and in accordance with Chapter 713, Florida Statutes,
the following information is provided in this Notice of Commencement:
Legal description of pro rty and street address: .s -,N 1 rn) S �S 33139
1 �t 4- poi v y ew :F- s-ts
2. Description of improvement: R--Q 2' A M SC ei G K 1 n f , C (V'
3. Owner (s) name and address: DQ e I e la R
ell 1 GJ O 10.SPS NE b Urn')
SV-P L 3313 8
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address: tC1t-e-,z) C z R&IG C* S (ViG 136BO ,VW 1 1 i 1►t/ #1 a
Oar U fCr, M, 330,S4 b6 3S91+98p
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond: $
6. Lender's name and address:
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13
(1) (a) 7., Florida Statutes:
Name and address:
8.1n addition to himself, Owner designates the following person (s) to receive a copy of the L ienor's Notice as provided in Section 713. 13 (1)
(b) 7., Florida Statutes:
Name and address:
9. Exoirl6on date of this
Signature of Owner
Print Owner's Name
Sworn to and
Notary
Print N
of Commencement (the expiration date is 1 year from the date of recording unless a different date is specified)
l GL h \ C 1, rilno t I 1 cc i o � Prepared by: ��(�c �1'� �ttO��Y'"1�✓�
before this day of �20 -7 &S 3� 49 60
Address: j?j (� so 1�w tCj Are— 4 w
+Opo� Locfc g Ft- 3- o)c)D -
My Commission '
Pj
Notar=-
X TeyaX +1 IEy C�ixpr
Fam 104
'P 1
�3-�sc�—�--
OROERf:D B
N, PA
1 14 Fl, n 1 '19
PROPERTY ADDRESS: 10585 NE 6711 AVE, NIIAMI Stiorrs, I-LCRICIA 33139 SUPVEY NUMBER: f Lwz, ;IAI 01
FIELD WORK DATE: REVISION DATE(S): forv() A!1A1a)jRj • 6 6•
FL 1605. 1663-01 ee
60UNDARYSURVEY
AAA411-DARECOUAITY
ee . . .
e1A C/ a 'o
LOT 3
N 59*57'36* E 149.07'(M)
'a N 90-0000p It 150.00- (P)No 10
A
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@ t c' P"Cr A140 WALL OWWR5riir 401 OfTeRI'Mito
Lij O NE 105th 5TRfET
hereby cert" MBoundary Survey of the
hereon des e?lhproph as been made under
my directi , andffbI the t of my knowledge
and belie it s ru on accurate representation
of a sury AMoiRRM Standards of Practice
set forth the rd of professional
Surveyors apper i . n cpter 5j— 17 of the
Florida Adml
,uhYL
RONALD W. WALLING
State of 'ilid. Professional Surveyor and Mapper
License N.. 6473
RECEIVED
!-I
GRAPHIC CCiALE
I inch = 40' f N
— n(TllL he the U111% W1,fthk1,,AW1h— Lilb.11lyfn the S
Oihe, sh—h— C—fi,a
FLOOD INFORMATION:"POINTS
OF INTEREST
By PERFORMING A SEARCH WITH THE LOCAL GOVERNING
NONE VISIBLE
MUNICIPALITY OR WWWFEMA.GOV. THE PROPERTY APPEARS TO BE
LOCATED IN ZONE X. THIS PROPERTY WAS FOUND IN THE VILLAGE
OF MIAMI SHORES VILLAGE, COMMUNITY NUMBER 120652, DATED
09/11/09.
AFFILIATE
CLIENT NUMBER: DATE: 04118)18
#
MEMBERS
BUYER; Da'icla Pell,ciotti
SELLER:
CERTIFIED TO: DANIELA PELLICIOTTI; LISA PIZARSCN, P.A. 4
This is page H
ge 1 of 2 and is not valid without all pages, Now,, Ro"'if P lym,l II To :" 1 I,j I
s
' 9n STATE OF FLORIDA • — ` r — • •
DEPARTMENT OF HEALTH DATE PfAbo • • : -.0069
'
•
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAW" ' • •�•�,
• • • • • • • •
SYSTEM RECEIP% ' • • •
•so •• •••••
•�`*' W0 1+` ` noCUMErf't" 11 f�R11 R�4867 •`
.....
g
CONSTRUCTION PERMIT FOR: OSTDS Repair • • . • • • i • . "":
APPLICANT: Daniela Pellicciottl • • • • """'
•
PROPERTY ADDRESS: 10585 NE 6 Ave Miami, FL 33138
LOT: 4 BLOCK: SUBDIVISfON: GOIfViewEstates
PROPERTY ID #: 11-2231-012-0030 [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 [ 1,050 ] GALLONS / GPD New Seotic Tank 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 [ 160 ] SQUARE FEET New Drainfield Trench Con SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ J MOUND [ ]
I CONFIGURATION: [X] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: FFE15.25
I ELEVATION OF PROPOSED SYSTEM SITE [ 43.201C INCHES FT I ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE (103.201E INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D E
0
T
H
E
R
ILL REQUIRED: [ 0.00 ] INCHES EXCAVATION REQUIRED: [ tiU.UU ] INCHES
1.- Install a 1050 gal. septic tank with an approved filter
2.- The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance
with s. 64E-6.013(3)(f) FAC.
3; Install 150 sf, of drainfield in ....TRENCH... configuration.
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 7.15' & 6.65' NGVD respectively
THIS PERMIT IS NOT FOR ANY ADDITIONS.
SPECIFICATIONS BY' Teresa Solomon TITLE: Master Septic Tank Contractor
APPROVED BY: ti.., a- V7' TITLE: Environmental Specialist II Dade CHD
Erick Parara
DATE ISSUED: 11/21/2018 EXPIRATION DATE: 02/19/2019
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 AP1383933 SE1131709
••••.•
STATE OF FLORIDA � ......
DEPARTMENT OF HEALTH .. .
APPCICATIONiF6n CONSTRUCTION PERMIT
• • • • • • '�1�t:t-t Grc '�, 4'-f-�i,-�,�t� `��.'u��rr� .•.:.. i
�4t i' 3r ��C c+tt•, tT � c Perrni(AppliCrIllon. NuRiter '. .' . •
0000 00000
•
•
... PART II-tlCTEPLAN -- ___--i•..., �StaleE2rhb!or�e.1•000 •.••••10(eel and 1 inch (eel,
•
_ WIVEY NUM9CR: C[, a i{AJ.G ka • A • • •
,1 (. L. pp ��,f �EV;S�Cl1 DA C(V ros o ', '- _. • •
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Abr;,�Qon t)<N - rl
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Site Plan Submitted
Plan Approved
1�
J
—
By Not Approved Date w-i,--
County Health Department
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
Sl ch N bet; (Obcoleles previous editions vihlctr may not be used} Incorporaled: 64E-6,001, FAC
(Block Number, 57a4_pp2.ap}5-0)
Pape 2 D14
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