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PL-17-2814L/YEN �'toRioA Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit NO. PL-11-17-2814 Permit Type: Plumbing - Residential Perill'it Work Classification: Septic Permit Status: APPROVED issue Date: 11/3012017 1 Expiration: 05/29/2018 Project Address Parcel Number Applicant 1569 NE 104 Street 1122320320160 ALAIN &CARLY GONZALEZ Miami Shores, FL Block: Lot: Owner Information Address Phone tee„ ALAIN & CARLY GONZALEZ 1569 NE 104 Street (786)277-9756 MIAMI SHORES FL 33138- 1569 NE 104 Street MIAMI SHORES FL 33138- Contractors) Phone Cell Phone PULLES PLUMBING COMPANY (786)295-0256 Type of Work: REMOVE PUMP OUT EXISTING SEPTIC TAN Type of Piping: Additional Info: REMOVE PUMP OUT EXISTING SEPTIC TAN Bond Return : Classification: Residential Scanning: 3 Fees Due Amount CCF $4.80 DBPR Fee $4.50 DCA Fee $3.00 Education Surcharge $1.60 Notary Fee $5.00 Permit Fee $300.00 Scanning Fee $9.00 Technology Fee $6.40 Total: $334.30 Valuation: $ 8,000.00 Total Sq Feet: 400 Pay Date Pay Type Amt Paid Amt Due Invoice # PL-11-17-65761 11/29/2017 Credit Card $ 50.00 $ 284.30 11/30/2017 Credit Card $ 284.30 $ 0.00 Available Inspections: Inspection Type: HRS Approval Final Review Plumbing Ej 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 fore ing informa io ccurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhe�mere-t�orize the above -named cont ctor to do the work stated. November 30, 2017 Authorized Signature: Owner / Applicant Building Department Copy November 30, / Contractor / Agent Miami Shores Village RECEIVED BUILDING PERMIT APPLICATION Building Department NOV 29 2017 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 0—IfTel: (305) 795-2204 Fax: (305) 756-8972 4-1 INSPECTION LINE PHONE NUMBER: (305) 762-4949 -�J- F C 201" Master Permit No. R C I - 1151(40 Sub Permit No. ?I tz� ` zA 1_0 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL [PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP C CONTRACTOR DRAWINGS JOB ADDRESS: Z'C/ 7 zGJ � S�/— City: Miami Shores County: Miami Dade Zip: �`•�� Folio/Parcel#: t!lG p Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): ,+eaY CO­'ZZ,�4eZ_ Phone#: Address: City: State: Zip: 39 /Y1 90 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: Pe3 Phone#:'e: � Address: c City: "Sta'te: Zip: �� �rP— , Qualifier Name:,d�` / r✓r� ��� Phone#: State Certification or Registration #: C t� C Q���v (� 3Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: tjo o t Value of Work for this Permit: Square/Linear Footage of Work: Type of Work: ❑ Addition © Aiteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: iC 17- '�/mil i/�llyi �irrsn'c� S��T1C �1-.- 1-&4,-, 7fg-'k Specify color of color thru tile:, Submittal Fee $ Scanning Fee $ Technology Fee $_ Structural Reviews $ (Revised02/24/2014) Permit Fee $ 3e'l! .-- CCF $ CO/CC $ Radon Fee $ d�s DBPR $ Notary $ Training/Education Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 2V `so BondingNmpany's Name (if applicable) Bonding Company's Address City State 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien low 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 f egoing instrument was acknowledged before me this da of Tom"" 1, by h s ersonally known t me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: CLARISSA A. RODRIGU Seal: MY COMMISSION # GG 041376 P -1 EXPIRES: December 30, 2020 ''•.P,! ;ta`` Bonded Thru Notary PuW Un&mr wm as Signature C TRACTOR The fore oing instrument was acknowledged before me this 21 day of NOV 20 �, by ) ITV (Cr�A. s errsoonnally known to me or who has produced 4A L ( �i as identification and who did take an oath. NOTARY PUBLIC: Print: MAHARAI K. GONZALEZ MY COMMISCOMMIS!0N # UU 044602 Seal: EXPIRES: November 2, 2020 Bonded Thru Notary Public Underwriters ************************************************************************************************************ APPROVED BY Plans Examiner Structural Review (Revised02/24/2014) Zoning Clerk 11/29/2017 Property Search Application - Miami -Dade County OFFICE OF THE PROPERTY Summary Report Property Information Folio: 11-2232-032-0160 Property Address: 1569 NE 104 ST Miami Shores, FL 33138-2665 Owner ALAIN GONZALEZ CARLY GONZALEZ Mailing Address 1569 NE 104 ST MIAMI SHORES, FL 33138 USA PA Primary Zone 1300 SGL FAMILY - 2801-3000 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths / Half 4/3/0 Floors 2 Living Units 1 Actual Area 4,580 Sq.Ft Living Area 2,911 Sq.Ft Adjusted Area 3,296 Sq.Ft Lot Size Year Built 8,925 Sq.Ft 1967 Assessment Information Year 2017 2016I 2015 Land Value $477,544 $339,136 ._......... $312,324 Building Value $342,290 $271,426 $273,650 XF Value $27,117 $27,317 $17,798 Market Value $846,951 $637,879 $603,772 Assessed Value $731,582 $347,317 34 $4,903 Benefits Information Benefit Type 2017 2016 2015 Save Our Homes Assessment Cap Reduction $290,562 $258,869 Portability Assessment Reduction Reduction Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Senior Homestead Exemption $50,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description RIVER BAY PARK ADDN PB 40-72 LOT 17 BLK 3 LOT SIZE 75.000 X 119 OR 13018-2636 0986 4 Generated On : 11/29/2017 Taxable Value Information 2017' 2016'` 2015 County Exemption Value _+ $50,000 $100,000 $50,000 Taxable Value $681,582 $247,317 $294,903 School Board Exemption Value $25,000 $25,TA Taxable Value $706,582 $322, City Exemption Value $50,000 $50,000 $50,000 Taxable Value $681,582 $297,317 $294,903 Regional Exemption Value $50,000 $50,000 ElE$50,000 Taxable Value $681,582' $297,317 $294,903 Sales Information Previous Sale Price; OR Book -Page ription Qualificatio�De 11/22/2016 $1,050,000 30341-3921 Qual by exad 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: •. FOUND DRILL HOLE FENCE _ 0.1'W SEAWALL CAP 0.4'N 0.6'W 1.5' CONC_ SEAWALL C.B.S.- WALL 6' WOOD M 0.5'E— Y 11.96' () 0.8'E- 0 J u') m cD � � 9.95' 0.6'E — O 0.1'W_ I . . ... . . . ... RECEIVED :::•.•: : . ....... .... NOV 2 9 2 •• •• • • • • •• • •• ••• ••• •• ••• • BISCAmi DRAINAGE CANAL (75' RIGHT—OF—WAY) •• • • • •• ••• •• • ••• • • • • •• • CONC /-1,35' CON • • • • • • • • DAVITS SEAWALL AP • • ' 16.;0,: •' • • • 75.00�'�� 'W OD OC 15.45' 9o• 'LJn 1Y 6a0POOL ' •"� N 15.1'X 35.1' M •i •F �'CONC �DECI<. ' � � •:::•r::• .:.: 1� ::f }::}::-::COVERED AREA::•:i.�:Y�::•::::r ::i^p� �. -. : to /14.60' :.::./ /14.60' .::•:•::: 5.05' 2 STORY C.B.S. RESIDENCE #1569 FINISH FLOOR ELEV.-7.29' j • GARAGE FLOOR ELEV=5.72' 00i//8.30' u/_ , _ / / /14.45'i x- 10.00' r ,z4 FOUND 1 DRILL HOP'�ll o/s 0.45'(N) 0.1'E 4' CHAIN LINK FENCE (TYPICAL) PLANTER 0 x — r 3.90' n 6.3' ,:ASPHALT N6 DRIVE 9.90, 1.45, 11.45'/ S'i✓ N ` PLANTER LOT 17 ' N N BLOCK 3 N FOUND 3/4- IRON PIPE o/s 0.14'(N) 9 Y U Q Q C w F a g Q Iu Q c� i Lli L U L rc Cn fi rC .. -E a m � z �... U L) .�. C] w � ) O � I� C� D U Q m Z U W �. Q O m m c~n o• ' '•I: `�4' CONC WALK''••.- �75.00 � '•.-�•.•�• P.P. I I ��•'':• I FOUND 1/2' SITE B.M. I o IRON PIPE SET NAIL j o M I o o/s 0.25'(N) ELEV.=3.79' N 1 ui 0.10'(E) IN •N. E. 104th0 TREET :' y:,(50' RIGHT—OF—WAY SIiE B.M. ,18' ASPHALT PAVEMENT SET NAIL: :ELEV.e3.67':'=' 250.00' FOUND PK NAIL AT P.C. u ••• • • •• •• • STATE OF FLORIDA • •••• • • . • • . • DEPARTMENT OF HEAAH : : : •; ONSITE SEWAGE TREATMENT •b •DISIPOSAL' •' SYSTEM CONSTRUCTION PERMS ' ' ' ' "' ••• ••• ••• •• ••• • •• •• ••• •• CONSTRUCTION PERMIT FOR: OSTDS Repair• • • i•i .. i i• •• APPLICANT: • • • • • • • • • Alan -&Carly Gonzalez .. ... .. PROPERTY ADDRESS: 1569 NE 104 St Miami, FL 33138 LOT: 17 BLOCK: 3 SUBDIVISION: PROPERTY ID #: 11-2232-032-0160 PERMIT #: 13-SC-1799342 APPLICATION # : AP 1 31 3283 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1081523 [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 [ 300 ] GALLONS DOSING TANK CAPACITY [ 67.00 ]GALLONS @[ 6 ]DOSES PER 24 HRS #Pumps [ 1 ] D [ 400 ] SQUARE FEET SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [x] BED [ ] N F LOCATION OF BENCHMARK: F.F Elevation: 7.60' NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 31.50][ INCHES FT ][ ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 43.50][ INCHES FT ][ ABOVE BELOW BENCHMARK/REFERENCE POINT L' D FILL REQUIRED: [ 6.001 INCHES EXCAVATION REQUIRED: [ 30.001 INCHES O T H E R 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 400 sf. of drainfield in ... BED.... configuration. 4.- Install 12 " of slightly limited soil at the bottom of the drainfield. 5.- 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: Jorge M Millan TITLE: TITLE: Engineering Specialist II oania X Gonzalez DATE : IS SUED : 11 /07/2017 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC EXPIRATION DATE: Dade CHD 02/05/2018 Page 1 of 3 v 1.1.4 AP1313283 SE1052878 . . ... . . . ... .. .. . . . .. .. . . . . . . . . . . . • • • • • • • • DOCUMENT # • • ••• • • • • ••• (Comments continued on Page 2) ' • • • • • • PR1081523 .. • . . •. •.. .. -Invert elevation of drainfield-to-be-no less-thar�j.5' NC'jVD. • • • - Bottom of drainfield elevation to be no less than 4.0' NGVD - This permit includes the abandonment of the existing septic tank. ,ie system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of 400 Performing Lift Dosing. Pumps must be certified as, suitable. for distributing sewage effluent. Required drainfield area based on rule 64E-6.015(6)(c)2. Install -a new drainfield to -achieve Drainfleld-size requirement. 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. . . ... . . . ... .. .. . . . .. .. . • NOTE F •G TS . . ... . . . . ... A party whose substantial interest is affected by this order may petition for an administrative hearing pursuant toSecti:)ns 120.5Q%and •V-0.5'P; Florida Statutes. Such proceedings are governed by Rule,28-JO6,•Florida,4dministrative Code. A petition for administrative hearing must be inuiFtiftit'and*MbsTbe reCdiVeti 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 \Va)A fitlyV07.T4WhaA9ee, Florida 32399. The Agency . ... . . . . .. . Clerk's facsimile number is 850-413-8S4g. • • • • • Mediation is not available as an alternativd reniddy." 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 Scal Notes: , A . • ..• . . • ... .. .. . • . .. .• . • • . • . . . • . . 'SfAf QF PL'bRIDA DEPARTMENT OF HEALTH APf1.LlG,k.TIgl`4 Ff EONbTRUTi0N PERMIT • hermit Application Number ...... ..... ... --------------------- =M-:-I PARTgL-PI-T PLAN--------------------------- . ... • • • . .. . • . • • .. ;h block represents 10 feet ap4'1 Wh1-*4CCfdet:....' , l v / /"%@1d I'' f itr'trJ~act ` 7"y �'S' -Au t4 ,eei /�s�ry ` � �ei"� `7fs r��''i s%✓"'�S/ ert. Site Plan submitted by: G��-s''��G ` �_.✓ Plan Approved Not Approved Date BY 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, FAC Page 2 of 4 (Stock Number: 5744-002-4015-6)