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PL-18-3575Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address F� @ FfIn-Tj I �� Issue Date: 01/30/2019 Parcel Number 236 NE 103RD ST, Miami Shores, FL 33138 1132060134890 Contacts Permit No.: PL-12-18-3575 Permit Type: Plumbing - Residential Work Classification: Drainfield Permit status: Approved Expiration: 06/03/2019 CLARISSA RODRIGUEZ DAMON STINSON Owner 236 NE 103 ST, MIAMI SHORES, FL 331382431 A SUPER SEPTIC & DRAIN FIELD INC Contractor BRYAN K ZERO 7701 W 18 LN, HIALEAH, FL 33014 Description: FRAIN FIELD REPAIR TO REPLACE PL17-2536 Valuation: $ 2,900.00 Inspection Requests: 49 TotalSq Feet: 0.00 Fees Amount Application Fee - Other $50.00 Permit Fee $51.50 Total: $101.50 Building Department Copy Payments Date Paid Amt Paid Total Fees $101.50 Credit Card 01/30/2019 $51.50 Credit Card 12/03/2018 $50.00 Amount Due: $0.00 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. OWN VIT: I ce�that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws re ulating constr tion and oning. uthermore, I authorize the above named contractor to do the work stated. 0 , Authorized Signature licant / ' Contractor / Agent ` Date January 30, 2019 Page 2 of 2 BUILDING PERMIT APPLICATION ❑ BUILDING i' EEPLUMBING ❑ ELECTRIC Miami Shores Village PrCr iV EDDEC 03 Asa Building Department C(,f�.� 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 4)-rA INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20171- Master Permit No.? Sub Permit No. ❑ ROOFING REVISION ❑ EXTENSION RENEWAL MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: c 9 '3 b 1 U S T2 �1- Folio/Parcel#: I/ - 3Q 04- G/ 1 412�70 Is the Building Historically Designated: Yes NO ✓ Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder)�� Cs� R D d Ri Tv o ti Phone#: Address:,-) 5 A rY k' 1 D 1 City: Mi' A m" J Pau- State: P 1. zip: --,33 i 3 F Tenant/Lessee Name: Email Phone#: CONTRACTOR: Company Name: 4 S,44* rr �L,��pn,r� ✓ /� �N Phone#: Address: '��%Q� fir/ l S' Anh 4-- City: 6��1 %,v4 N State:/ Zip: 13 0,1 Qualifier Name: 3a55- 36'A/- o//' State Certification or agistration #: q R n/ 6/ 770 Certificate of Competency #: 'S6 0161 qo) oZ DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ c;7, %G d Square/LinearrFF,000ttage of Work: o7a Type of Work: ❑ Addition El Alteration ❑ New LJ Repair/Replace ❑ Demolition Description of Work: 1 Ju 1W 1-7i P I RJ 12n y 2 Specify color of colorthru tile: Submittal Fee $ �b C17 Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $ DBPR $ CO/CC $ _ Notary $ Double Fee $ _ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City 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 not be approved and a reinspection fee will be charged. Signature OWNER or AGENT The foregoing instrument was acknowledged before me this _ day of �l J� 20 ��, by Iris Sci �.�Yf tpr&ally known to me or who has produced 'I�1 �C— as identification and who did take an oath. NOTARY PUBLIC: MAHARAI K. GONZALEZ Signature CONTRK>WR The foregoing instrument was acknowledged before me this _ 1 day of t-�� 2d by YI-A an --I�'C KQwho is personally known to me or who has produced, i r n as identification and who did take an oath. NOTARY PUBLIC: Print: .: Seal: III :o EXPIRES:November2,2020 Seal: F -, o?= Bonded Thru Notary Public Underwriters It MAHARAI K. GONZALEZ EXPIRES: November 2, 2020 Bonded Thru Notary Public Underwriters ************************************************************************************************************ APPROVED BY (d'� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Propert Search Application - Miami -Dade County Page 1 of 1 OFFICE OF THE PROPERTY APPRAISER c„ Summary Report Property Information Folio: 11-3206-013-4890 Property Address: 236 NE 103 ST Miami Shores, FL 33138-2431 Owner CLARISSA RODRIGUEZ DAMON STINSON Mailing Address 236 NE 103 ST MIAMI SHORES, FL 33138 USA PA Primary Zone 1000 SGL FAMILY - 2101-2300 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY: 1 UNIT Beds / Baths / Half 3/2/0 Floors 1 Living Units 1 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 2,120 Sq.Ft Lot Size 11,300 Sq.Ft Year Built 1950 Assessment Information Year 2017 2016' 2015 Land Value $304,996 $ 553,884 i $ 443,829 Building Value $105,576 $105,576' $105,576 XF Value $35,442 $35,848 $22,941 Market Value $446,014 $395,308 $372,346 Assessed Value $347,301 $340,158 $337,794 Benefits Information Benefit Type 20177000$25,000 Save Our Homes Cap .............. Assessment Reduction $98,713 Homestead Exemption $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 1 5341 6 53 42 MIAMI SHORES SEC 1 AMD PB 10-70 !LOTS 8 & 9 BLK 36 LOT SIZE 100.000 X 113 OR 18616-2546 05 1999 5 Generated On : 10/25/2017 Taxable Value Information 2017 2016 2015 County Exemption Value $50,000 $50,000 $50,000 Taxable Value 1 $297,301 $290,1581 $287,794 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value $322,301 $315,158 $312,794 City Exemption Value $50,000 $50,000 $50,000 Taxable Value $297,301 $290,158 $287,794 Regional Exemption Value Taxable Value !=5$50,0001$50,000 $90,158 $287,794 Sales Information Previous OR Book - Price Qualification Description Sale Page 28055- 02/23/2012 $333,000 Qual by exam of deed 0171 18616- Sales which are disqualified as a result 05/01/1999 $0 2546 of examination of the deed 18277 08/01/1998 $145,000 Sales which are qualified 0481 17379- Sales which are disqualified as a result 10/01/1996 $0 4197 of examination of the deed 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: http://www.miamidade.gov/propertysearch/ 10/25/2017 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: cLARRISSA RODRIGUEZ PROPERTY ADDRESS: 236 NE 103 St Miami, FL 33138 LOT: 8-9 BLOCK: 36 PROPERTY ID #: 11-3206-013-4890 SUBDIVISION: PERMIT #: 13-SM-1796789 APPLICATION #: AP1311696 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1079589 [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 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 [ 225 ] SQUARE FEET NEW DF IN TRENCH CON SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [x] STANDARD [ ] FILLED I MOUND [ ] I CONFIGURATION: [x] TRENCH [ ] BED [] N F LOCATION OF BENCHMARK: FFE13.1 I ELEVATION OF PROPOSED SYSTEM SITE [ 31.20] INCHES FT ]( ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 67.20It INCHES FT ][ ABOVE BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.001 INCHES EXCAVATION. REQUIRED: [ 48.00] INCHES O T H E R 1.-EXISTING 900gal. septic tank with and approved filter TO REMAIN. 2.- Install 225 sf. of drainfield in__. TRENCH.... 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 trench. (Comments Continued on Page 2.) SPECIFICATIONS BY APPROVED BY: DATE ISSUED: [i. Super •• ••• -T1T,-K. TITLE: F.nginegfing Specil'Ist; II Dade CHD anis X Gonzalez &i �• • • •• • •• 10/19/2017 ••• ' • EXPIRATION DATE: 01/21/2018 DH 4016, 08/09 (Obsoletes all previous editions which may pot ??a•usied) Incorporated: 64E-6.003, FAC ':' i • • ' : i • v 1.1.4 jP1311W60 • eo*-"051020 Page 1 of 3