PL-18-1923,4H�S yam! Miami Shores Village
10050 N.E. 2nd Avenue NE
" Miami Shores, FL 33138-0000
yam` Phone: (305)795-2204
F�ORtDA
Permit NO. PL-7-18-1923
Permit Tyre: Plumbing - Residential
Pe` n ' Work Classification: Drainfleld
Permit Status: APPROVED
Issue Date: 7125/2018 1 Expiration: 0121/2019
Project Address Parcel Number Applicant
122 NE 92 Street 1132060133280
JOSE A. BLANCO
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
JOSE A. BLANCO 122 NE 92 Street (786)970-2529
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
MR C'S PLUMBING & SEPTIC INC (305)651-7859
Type of Work: INSTALLATION OF DRAINFIELD
Type of Piping:
Additional Info: INSTALLATION OF DRAINFIELD
Bond Return :
Classification: Residential Scanning: 3
Fees Due
Amount
Bond Type - Contractors Bond
$500.00
CCF
$1.80
DBPR Fee
$2.25
DCA Fee
$2.00
Education Surcharge
$0.60
Permit Fee
$150.00
Scanning Fee
$9.00
Technology Fee
$2.40
Total:
$668.05
Valuation: $ 2,450.00
Total Scl Feet: 300
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL-7-18-68255
07/17/2018 Credit Card $ 50.00 $ 618.05
07/25/2018 Check #: 1464 $ 618.05 $ 0.00
Bond #: 3837
Available Inspections:
Inspection Type:
HRS Approval
Final
Review Plumbing
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 perm�Yl"isum sponsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECT04CAV,PWYBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFID�I cbrlt t atilt -the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and z m P.ut re. I authorize the above -named contractor to do the work stated.
July 25, 2018
Authorized Signature: Owner / Applicant / Contractor / Agent uate
Building Department Copy
July 25, 2018 1
Miami Shores Village
BUILDING
PERMIT APPLICATION
Building Department' =r
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 JUL 17 2m I
Tel: (305) 795-2204 Fax: (305) 756-8972 �-
INSPECTION LINE PHONE NUMBER: (305) 762-4949 Co jY:_`=-�_( �
FBC 20 4-'=t
Master Permit No. 21 &— 1 of 2J
Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL
QPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 122 NE 92 Street
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:11-3206-013-3280 Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Jose Blanco Phone#:
Address:122 NE 92 Street
City: Miami Shores State: FL Zip: 33138
Tenant/Lessee Name: NA Phone#:
Email:
CONTRACTOR: Company Name: Mr. C's Plumbing & Septic Phone#: 305-651-7859
Address: 19932 NW 2 Avenue
City: Miami state: FL Zip: 33169
Qualifier Name: Kemble Ettrick Phone#: 305-651-7859
State Certification or Registration #: SR061536 Certificate of Competency #:
DESIGNER: Architect/Engineer: NA Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 2450.00 Square/Linear Footage of Work: 300
Type of Work: ❑ Addition ❑ Alteration ❑ New A Repair/Replace ❑ Demolition
Description of Work: Installation of drainfield
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ /PC - cc CCF $ CO/CC $
Scanning Fee $ Radon Fee $ 2 • CAD DBPR $ 2 Notary $
Technology Fee $ Training/Education Fee $ Double Fee $ //ll
Structural Reviews $ Bond $ � d V
TOTAL FEE NOW DUE $ 19
(Revised02/24/2014)
Bonding Company's Name (if applicable)
tondi" Company's Address
14
City
NA
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
NA
State
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 nowapproved and a reinspectio ll be charged.
Signatu
The
OWNER or AGENT
instrument was acknowledged before me this
day of Q-u Iq 20 by
�� Ct who is personally known to
Signature qt)it—
CONTRACTOR
The foregoing instrument was acknowledged before me this
day off,, 20 �a by
lS� "C w o is personally known to
me or who has produced as me or who has produced
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
as
JVV��
2/
Sign:
Sign:
Print: l0K0, Av-UA
Print:
/dh
PAr�iv.
Seal:
Y►
;a�`•°�ir: DONALD MARTIN
Seal:
Yi'•.
M" DONALD MARTIN
' `i
' '_ MY COMMISSION # GG102743
:�?
_
MY COMMISSION # GG102743
EXPIRES May 09, 2021
EXPIRES May 09, 2021
APPROVED BY /'���
Plans Examiner
Zoning
Structural Review Clerk
(Revised02/24/2014)
Property Search Application - Miami -Dade County Page 1 of 1
OFFr-POF
. THE PROPERTY
Summary Report
Property Information -
Folio:
11-3206-013-3280
122 NE 92 ST
Property Address:
Miami Shores, FL 33138-2814
Owner
JOSE A BLANCO
SARA A SANDBERG
Mailing Address
122 NE 92 ST
_...._.__._.__.___.._._...._.__.-_.--______.-_._.__.____.._ _®�
MIAMI SHORES, FL 33138 USA
__-.._........_
PA Primary Zone
_..
1000 SGL FAMILY - 2101-2300 SQ
Primary Land Use
j0101 RESIDENTIAL - SINGLE
iFAMILY
: 1 UNIT
Beds / Baths ! Half
' 2
Floors
1
Living Units i
1
Actual Area �
Sq.Ft
Living Area
Sq.Ft
Adjusted Area
2,611 Sq.Ft
Lot Size
9,825 Sq.Ft �T
Year Built
1947
Assessment Information
Year
Land Value
..._. ..._.................. _______..... _.... __._.._._._..............
Building Value
2018
$245,690
$219,788
2017i 2016
$245,690�$245,690
__.... _---------- -
$221,6121 $223,436
XF Value
$35,735
$36,1471$36,560
Market Value
$501,213
$503,449€ $505,686
Assessed Value
$501,213
$503,449 $505,686
Benefits Information
Benefit Type 2018'-� 2017 2016
.._...... _.............
_..._
Homestead Exemption $25,000' $25,000 $25,000
Second Homestead Exemption TM $25,0001 $25,000 $25,000
Note: Not all benefits are applicable to all Taxable Values (i.e. County,
School Board, City, Regional).
Short Legal Description
MIAMI SHORES SEC 1 AMD PB 10-70
LOT 12 & W1/2 LOT 11 BL K 24
LOT SIZE 75.000 X 131
OR 16444-5482 0794 1
Generated On : 7/17/2018
Taxable Value Information
2018;
2017;
2016
County
Exemption Value I
$50,000
$50,000
$50,000
Taxable Value
$451,213
$453,449
$455,686
School Board
Exemption Value i
Taxable Value
$25,000
$476,213
$25,000
$478,449
$25,000
$480,686
City
Exemption Value
1
$50,000
$50,000
$50,000
Taxable Value
.__...__._......_.........____._.w___t__.__....__�......_
Regional
$451,213
... ....._......
$453,449
_._.__.___.__�.......
$455,686
__._.. _ _......
Exemption Value
........_..........................
Taxable Value
$50000
$451,213
-$50,000
$453,449,°
. ..$.5_..0,000
.... -._..... ....
$455,686
Sales Information
Previous
OR Book -
Price
Qualification Description
Sale
_
Pa a
9
29678
06/24/2015
$625,000
Qual by exam of deed
1917
16444-
07/01/1994
$127,500
Sales which are qualified
5482
----________
.........
00000-
. __._......... .....
Sales which are disqualified as a result
09/01/1976
$1
00000
of examination of the deed
00000-
05/01/1975
$67,500
Sales which are qualified
00000
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 hftp://www.miamidade.gov/info/disclaimer.asp
Version:
https://www.miamidade.gov/propertysearch/ 7/17/2018
- --- N.E. 92nd STREET —
•PE IT • •
ni ShrrCS Vilhlge
•• • • • • �•• •• D
APPROVED • • • PI
' ' ' • • • • PONR
�� • • • • • . FOU 1 L 8
ONING IRON PIPE • • " IRON
DEP7 75:00' '
G EPTO .67' (P) �Al ( A2 175.00' (P)
SUBJECT '0 CrMPi.1ANCE WI fy ALL FE ERAL
! STATE ANL, (-( I,N, r L , N N
LOT 12
8LOCK 24 10.3'
l 15.5'
' 11.4' I a
\���` 4•, I� o� 26.5'
JUL 17 2018 � 9'8 ,.s BUILDING � � I �Xf 1 (j0c
�1122a� rvt�� ►�. .
- LOT 13 l��Q
BLOCK 24 �� : � 22.8
16.8' ► 1 10.2'
TILES' s (
SURVEY NOTES _
CONCRETE DRIVE CROSSING PROPERTY
BOUNDARY ON SOUTHERLY SIDE OF LOT
CONCRETE WALK CROSSING PROPERTY ye
I
BOUNDARY ON NORTHERLY SIDE OF LOT .
ZTHERE ARE FENCES NEAR THE I g'9 15.4' POOL [ I
BOUNDARY OF THE PROPERTY
w "
F- r
FOUND 1/2"
:IRON PIPE c�
A1= 90-00'35" (C) A4 50.00' .
25.00' VAt
A2= 89'59'25- (C)
A3= 89'55'00" (C) 15.0' ALLEY (P) II
A4= 90-05'00" (C) (IMPROVED)-
122 NE 92 St. Miami-t yn
le
Xt s4i vc�) ra,}-
w
S .. t�'111/1 h fo I r k
r
f
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. • •
. . ..
• % •
STATE OF FLORIDA • • : : ;.; ; ••• •
DEPARTMENT OF HEARTH • • : • ; ; ' •
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT •' • '; • • • • •
CONSTRUCTION PERMIT FOR:
APPLICANT: lnse Rlannn
OSTDS Repair."; ; : • • : • ' •
PROPERTY ADDRESS: 122 NE 92 St Miami, FL 33138
LOT: 11-12 BLOCK: 24
PROPERTY ID #: 11-3206-013-3280
PERMIT # : 13-SM-1859588
APPLICATION # : AP 1352917
SUBDIVISION: Miami Shores Sec 1 Amd
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1125055
[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 existina septic tank CAPACITY
A [ ] GALLONS / GPD CAPACITY
N [ ] 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 Bed configuration drainfield SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND []
I CONFIGURATION: [ ] TRENCH [X] BED [ ]
N
F LOCATION OF BENCHMARK: FFE 11.9' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 4.80 ][ INCHES FT ][ ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 54.80][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ ] INCHES EXCAVATION REQUIRED: [ 62.00] INCHES
O
T
H
E
R
1.-Existing 900 gal. septic tank, certified by Mr. C's Plumbing & Septic on 6/29/2018, to remain.
2.-Install 300 sf of drainfield in bed configuration.
3.-Install 12" of slightly limited soil at the bottom of the drainfield.
4.-Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed or drain trench.
5.-Invert elevation of drainfield no less than 7.83' NGVD. 6.-Bottom of drainfield elevation no less than 7.33' NGVD.
The system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow of
400 gpd. **THIS REPAIR PERMIT IS NOT FOR ANY ADDITIONS**
SPECIFICATIONS BY: KEMBLE ETTRICK
APPROVED BY:
rxlanda Omiaca
DATE ISSUED: 07/11/2018
TITLE:
TITLE: Engineering Specialist II
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
Dade CHD
EXPIRATION DATE: 10/09/2018
Page 1 of 3
v 1. 1.4 AP1352917 6B 10 F; 51. 83
• ...
•liOiICE:OF TS
A party whose substantial, intewst is gffeeted by this order may petition for an
administrative hearing pursuant�to s�Args'1..20.569 gnd;120..�W, Florida Statutes. Such
proceedings are governed by Rine 2:3-106, a9riOa AdmiAistCaI:ve 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 froti toe, reeept of this order. The address of the
Agency Clerk is 4052 Bald Cypresg,"k 4114 02, �allaV* ssee, Florida 32399. The Agency
Clerk's facsimile number is 850-4A&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.
!- � - t � -7,-;