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PL-19-251Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: PL-02-19-261 Permit Type: Plumbing - Residential M Work Classification: Septic/Drainfield Permit Status: Approved Issue Date:02/06/2019 Expiration: 08/05/2019 Location Address Parcel Number 1080 NE 92ND ST, Miami Shores, FL 33138 1132050270400 Contacts Guco Holdings Ilc Owner Juan Cortes 13750 sw 80 ave, Miami, FL 33158 Other:7867185524 amjiri86@gmail.com ALFONSO SEPTIC CONTRACTOR INC Contractor JOSE BOLANOS 1391 W 36 ST, HIALEAH, FL 33012 Business:7862514099 Inspection Description: INSTALL A NEW 1050 GALLONS SEPTIC TANK AND Valuation: $ 4,800.00 Requests: 4949 400 SOFT OF DRAINFIELD Total Sq Feet: 0.00 Fees Amount CCF $3.00 DBPR Fee $2.52 DCA Fee $2.00 Education Surcharge $1.00 Permit Fee $168.00 Scanning Fee $9.00 Technology Fee $4.20 Total: $189.72 Payments Date Paid Amt Paid Total Fees $189.72 Cash 02/05/2019 $50.00 Cash 02/06/2019 $139.72 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 regulating construction and zoning. Futhermore, I authorize the above named contractor to do the work stated. thorized S nature: Owner / Applicant / Contractor / Agent Date February 06, 2019 Page 2 of 2 DECEIVED Miami Shores Village F B 05 2019 Building Department BY: '`� 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 l BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING FBC 20 k� Master Permit NoTu Gf` 215\ Sub Permit No. ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: !O 80 N 6 q L STD City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11 --R 20S�-02-7 ^ V YD0 Iss}the �Building Historically Designated: Yes NO �K Occupancy Type: �— Load: Construction Type: RePA(� Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Q" 0 "00-kQI14G Phone#: Address: j o b O NC q tr j �g j. City: jyq/a-w Gl4o, -,eS State: f Lb Al OA a 33i3b Tenant/Lessee Name: Phone#: j Email: UA h CO SpC -3 1tj • CO(YI CONTRACTOR: Company Name: ca Mde)Afl 1AeTDh Phone#: 78&. ZSr-`lo99 Address: City: State: /'/p Zip: Qualifier Name A a Phone#: 78G� 5l �fbCt State Certification or Registration #: SR, DT712.7G Certificate of Competency #: G4 Q 1-7 1 q .2 % DESIGNER: Architect/Engineer: Phone#: Address: 9 City: State: Zip: Value of Work for this Permit: $ 10 Ov Square/Linear Footage of Work: YW Type of Work: ❑ Addition Alteration ❑ New F2!q Repair/Replace ❑ Demolition Description of Work: I K,15 ( 641 IA Ne w (U I CJ aL\k o NS S ? k-A i P `1 A P/Z P� tih 1/00 -o /`(" Or ter e- (cif Specify color ��o/f��color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Training/Education Fee $ CCF $ DBPR $ ..a-s-..+..s- a .yew. ...w•-.,:.rrr..--r....w...n P, _.7 ItV ¢ •'! • ' Notary $ Double Fee $ Bond $ S OO ' (Do TOTAL FEE NOW DUE $ 13�i •�Z (Revised02/24/2014) C 3(�I'' --� Z i Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State WE 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 lV Signature OWNER or AGENT The foregoing instrument was acknowledged before me this Qtt2 day of re 20, by ro(qCd-S who is personally known to me or who has produced Y e^':�0 1\ R 1 %W L-- as identification and who did take an oath. NOTARY PUBLIC: CONTRACTOR foregoing instrumenF-k- as acknowledged before me this -1Mr day of 20 I by IDS -A,- q\AD S who is pers pally known to m or who has produced Y�y I rr as identifi NOTARY PUBLIC: Sign: Sign: \ Print: Print: S ',••••�-•._ J0SEBOLAN09 Seal: '� IIIYONtt302�1�57 .r EVMOd"8,210 ******** ******************** APPROVED BY ��/g Plans Examiner Structural Review did to MY COMMISSION i FF 214MI ********** Zoning Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 1 OFFICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: 11-3205-027-0400 Property Address: 1080 NE 92 ST Miami Shores, FL 33138-2933 Owner GUCO HOLDING LLC Mailing Address 2700 SW 3 AVE 2F MIAMI, FL 33129 USA PA Primary Zone 1100 SGL FAMILY - 2301-2500 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths / Half 3/2/0 Floors 1 Living Units 1 Actual Area 2,314 Sq.Ft Living Area 1,813 Sq.Ft Adjusted Area 2,002 Sq.Ft Lot Size 8,802.5 Sq.Ft Year Built 1949 Assessment Information Year 2018€ 2017 2016 Land Value $316,890` $316,890 $295,060 Building Value $150,150 $139,339 $139,339 XF Value $0 $0 $0 Market Value $467,040 $456,229 $434,399 Assessed Value $467,040 $433,802 $394,366 Benefits Information Benefit Type 2018 2017 2016 Non -Homestead Cap Assessment Reduction $22,427 $40,033 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description BAY LURE PB 44-63 LOT 1 BILK 3 LOT SIZE 70.420 X 125 OR 16863-0603 0795 1 COC 26334-2631 02 2008 6 Generated On : 2/5/ Taxable Value Information 2018 2017 2 County Exemption Value $0 $0 Taxable Value $467,040 $433,802 $394. School Board Exemption Value $0 $0 Taxable Value $467,040 $456,229 $434 City Exemption Value $0 $0 Taxable Value $467,040 $433,802 $394. Regional Exemption Value $0 $0 Taxable Value $467,040 $433,802 $394 Sales Information Previous OR Book - Price Qualification Description Sale Page 30874- 02/16/2018 $520,000 Qual by exam of deed 0107 26594- 09/26/2008 $360,000 Sales which are qualified 0575 26334- 02/01/2008 $310,500 Other disqualified 2632 26334- Sales which are disqualified as a rest 02/01/2008 $0 2631 1 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 Appra and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at hftp://www.miamidade.gov/info/disclaimer.asp h,ttps://www.miamidade.gov/propertysearch/ 2/5/2019 Detail by Entity Name Page 1 of 2 Florida Department of Slate I%# ,li I!.ii'3 di brg I :i /.� it�, ,aLri, �yai �i7�N{•.�;i ,'� t r t ,,:'fr+raNr Department of Stale / Division of Corporations / Search Records / Detail By Document Number / Detail by Entity Name Florida Limited Liability Company GUCO HOLDING LLC Filina Information Document Number L17000110818 FEI/EIN Number 82-1580988 Date Filed 05/18/2017 State FL Status ACTIVE Last Event LC AMENDMENT Event Date Filed 09/27/2017 Event Effective Date NONE Principal Address 2700 SW 3 Avenue Suite #2F MIAMI, FL 33129 Changed: 02/19/2018 Mailina Address 2700 SW 3rd Avenue Suite #2F MIAMI, FL 33129 Changed: 02/19/2018 Registered Agent Name & Address EPGD ATTORNEYS AT LAW, P.A. 2701 PONCE DE LEON BLVD. 202 CORAL GABLES, FL 33134 Authorized Person(s) Detail Name & Address Title MGR CORTES, CARLOS 2700 SW 3 AVENUE, SUITE #2F MIAMI, FL 33129 DIVISION OF CORPORATIONS http://search. sunbiz. org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 2/5/2019 Detail by Entity Name Page 2 of 2 Title MGR CORTES, JUAN 2700 SW 3 AVENUE, SUITE #2F MIAMI, FL 33129 Title Manager Gutierrez, Nicolas Carera 18 #94-30 Apt. 502 Bogota, Colombia 110221 CO Annual Reports Report Year Filed Date 2018 02/19/2018 2019 02/04/2019 Document Images 02/0412019 -- ANNUAL REPORT View image in PDF format 02/19i2018 -- ANNUAL REPORT View image in PDF format C5271117...--_LL',_Amendmelit View image in PDF format W1812017 -- Florida Limited Liability View image in PDF format --;d. JePa:-mien: of S-W--% ";'—" of Co'PoraV— http://search. sunbiz.org/lnquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 2/5/2019 Alfonso Septic Contractor, INC. 1391 West 36 Street Hialeah, FL 33012 Alfonsoseptic@gmaii.com Date: November 2, 2018 State of Florida County of Dade Before me this day personally appeared Jose Bolanos who, being duty sworn, Deposes and says: That he or she will be the only person working on the project located at: 1080 NE 92 ST Miami Shores FLA. Contract r Signature Sworn to (or affirmed) and subscribed before me this by b 0 V�i1D S QJ Personally Know OR Produced Identification Type of Identification Produced y4x Ai )ta ry U YANAD7FF MY COMMISS31 EXPIRES: M9 Bonded Th. NotwriteR I s+ day of �Ib_.20_tq, Notice to Owner - Workers' Corn Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 nsation Insurance Exemation 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 BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature:"•"`--4—'' Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this day of YLCC?7A , 20. BY_ �% A ti LA r&A Te who is personally known to me or has produced as identification. Notary: JOSE BOLA" SEAL: +$` , .� MYC0W1S"IGG23147 sx EXPIRES: O*W 8, 20n w STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: (Guco Holding LLC) PERMIT #: 13-SC-1919519 APPLICATION # : AP 1 394809 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1200447 PROPERTY ADDRESS: 1080 NE 92 St Miami, FL 33175 • • • • • • •••• •••••• LOT: 1 BLOCK: 3 SUBDIVISION: ••.' •• • • [SECTION, TOWNSHIP, RMG% O'1?ARCEL NUMER] PROPERTY ID #: 11-3205-027-0400 •••••• • • [OR TAX ID NUMBER] • •••••• •••• • ••• •-- • • • • • SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND" ',4RNDARDS• OQF •#NOT: SF44*040 381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SY9TEM'•DOES GUARAiZ=e SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CH.4Nn-:IN MATHRIAL FACie WHICH SERVED AS A BASIS FOR ISSUANCE OF AAN THIS PERMIT, REQUIRE THE PPLICT •TO 'MODIFY••Aii& PERMIT APPLICATION. SUCH MODIFICATIONS MAY •••••• RESULT IN THIS PERMIT BE :NG, VDE NML AND •VOID.• ISSUANCE OF THIS PERMIT DOES NOT EXEMPT •••••• THE APPLICANT FROM COMPLIANCL *ITH :OTRNR FEDERAL,• STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. •••• SYSTEM DESIGN AND SPECIFICATIONS T [ 1,050 ] GALLONS / GPD NEW Septic 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 [ 400 ] SQUARE FEET NEW Drain Field in Bed Co SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [X] BED [ I— N F LOCATION OF BENCHMARK: FFE11.38 I ELEVATION OF PROPOSED SYSTEM SITE [ 1.00p ] [ INCHES / FT ] [ ABOVE / BELOW ] BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE r 5L p [ INCHES/ FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCA TION REQUIRED: [ 46.001 INCHES 1.- Install a NEW 1050 gal. septic tank with an approved filter 0 2.- Install a NEW 400 sf. of drainfield in ... BED... configuration. REPAIR PERMIT T 3.- Install 12" of slightly limited soil at the bottom of the dpinfield. 4.- Invert elevation and Bottom of drainfield to be no.less than 7.31 - &.6:81 ' NGVCFr &city HEALTH h1IAMI-DADE COUI H THIS PERMIT IS NOT FOR ANY ADDITIONS. / NOT VALID FOR ADDITI® E R......................................................r...�........................................................................................ SPECIFICATIONS BY: Alfozy§o/eptW. TITLE: APPROVED BY: c DATE ISSUED: 01/29/2019 TITLE: OPS ENVIRONMENTAL SPECIALIST III DH 4016, 08/09 (Obso1 tes all previous editions which may not be used) Incorporated: 64E�6 003, FAC Dade CHD EXPIRATION DATE: 04/29/2019 v 1.1.4 AP1394809 SE1150183 Page 1 of 3 DOCUMENT #: PR1200447 13(3)(f) 6.- Perimeter of excavation area shall be at least 2 ft 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 400 gpd. Required drainfield area based on rule 64E-6.015(6)(c)2. Install a new drainfield to achieve Drainfield size 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 be:on3e ja 'final • • • • • • • • • • order'. Should this order become a final order, a party who is adversely affected byjt LS;;titled • • • • • • • • to judicial review pursuant to Section 120.68, Florida Statutes. Review proceeding % of* 0 • • * 0 :' • •': • • • governed by the Florida Rules of Appellate Procedure. Such proceedings may be cdfiMenced • • • • • •; • • by filing Notice Appeal with the Agency Clerk of the Department of•Oea�tA and e : •: • •' •' • one copy of a of .. ... . second copy, accompanied by the filing fees required by law, with the Court of App;;L irL.the ...... • • appropriate District Court. The notice must be filed within 30 days of rendition of the final -*order• ....:. r j 4 —j-erMn-7kppu0auon nrumner - --------------------------PARTII-SITEPLAN---------------------- ;ale: Each block re resents 10 fleet and 1 inch = 40 feet. NO 1f l l NI Tru Cxit S...,., , ,. > > . :e Plan SUM an Approved. - Date r-:�-r-�- County Health Departr ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT Page 4015, 10/96 (Replaces HRS-H Form 4016 which may be used) )ck Number: 5744-002-4015-6) r ww0 mew4S oLb. W.uP. wMr. -Northeast 92nd Street s it am AlOw l Pavwdwg bt • N Bayahore Or. W f 1,� f Parkway W111 e 5O NwtW o 3 -!I- I Palm wo 25 IS 2 oak 3oa x FIP N8922'45•w No 61 JOB # 18-190 AFA �C DAB o2-2t-2ot8 Company, Inc. PB 44-63 iK1&W o •••• :F • • Id • • •••• •••••• • • • 0 . • • • ••••••• •••• •••• • •••• •••• ••••• 00000 • • • • • • • 4 • • • • • • • •••.•• •••••• • •••.•• • •• • . • • •.•• Lot 2. 3bck 3 D-tw. 851s V FIP No a J tJJ `z z c <LLJ 0 J LL J Li I Q cl: - < �- U) W i Q ' v n. LJ z _ � y < W zz a N 'i� iY daoeb bemn ia.ttre Old AaGaale..p.pr>tOoatbem.rb the beg o, arrq bwow1 0 m.bbdief.SijrLl low= Wad Nowia•.bow•bmae• Swveyor Not= o Survey 6 hwompleoe wkbwAM I of t �C— Sok ofAawieB !'= 20• DrawnBy. Af.Pro Ogee 02-21 -2018 � �� �� CvmplRdFidd SWwYDAc 02-21 2018 JS / P.•.arx / APA&coNPANV WCLRrl4W PrWreaerat Lure awvy aMWMW — Lan& rss:s PH. 3OS4364MJ'L 28&493#M � Air Yi/�Im.Qr��•�wd. tidane/SaI PLUMBING PLANS Approve*" Date�ls/g r,, PlInnoved Date DIVISION Of •• Environmental Health Florida Health *A O Miami -Dade County O eQ� OSTDS/Well Division �z 11805 SW 26th Street • Miami, FL 33175 Inspector %tItm- �AL�3� N�'Date .- Address /o eo L/C ' L ,;—OSTDS # /� r- 3i 4602 Comments: Signature