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BPP-18-2968Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 600 NE 97TH ST, Miami Shores, FL 33138 Contacts Permit No.: BPP-09-18-2968 I j*^ _^ Permit type: Pools/Whirlpools/Hot Tubs I_pj U Work Classification: New Permit Status: Approved Issue Date:11/06/2018 Expiration:03/27/2019 Parcel Number 1132060171680 EDUARDO J GONZALEZ Owner FLORIDA POOL PATIO CORP Contractor 600 NE 97 ST, MIAMI SHORES, FL 33138 CLAUDIO SEBASTIAN VALERO Mobile: 7864592356 12241 SW 99 ST, MIAMI, FL 33186 Business: 3058150181 Inspection Requests: Description: NEW SWIMMING POOL Valuation: $ 20,000.00 305 762-4949 TotalSq Feet: 42S.00 Fees Amount Application Fee - Other $50.00 CCF $12.00 Certificte of Completion for Single Fam $50.00 and Duplex DBPR Fee $9.00 DCA Fee $6.00 Education Surcharge $4.00 Permit Fee $550.00 Planning and Zoning Review Fee $35.00 Scanning Fee $15.00 Structural Review ($45) $45.00 Technology Fee $15.00 Total $791.00 Payments Date Paid Amt Paid Total Fees $791.00 Credit Card 11/06/2018 $791.00 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 regulating constructi d zoning. Futhermore, I authorize the above named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Date November 06, 2018 Page 2 of 2 BUILDING PERMIT APPLICATION Miami Shores Village BuildingDepartment R�c��v�.o sEP z s 201e 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 An FBC 201 Master Permit No. F?e 1P 18 -2gCoo Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: eco � gT c -� ` �� t J�p-ve2_3 J,,D ( �� City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): G���i�ly �� ����t� E Z Phone#: Address: (00 �h___ Cy 51 City: M �\ 1r yYe N State: V_ Tenant/Lessee Name: Email CONTRACTOR: Company Name: -TA+O^ ck� 1 1" ' 1 Phone#: Address: 1 22 tl (� cr' 5 T 3 l S-D1�I City: H1State: Zip: fJp`�� Qualifier Name: G l � C (o Uo �P Y"o Phone#: 3l CJLS�V� State Certification or Registration #: Cf' c / q TD3 1 S )- Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ O Square/Linear Footage of Work: Li 2S . Type of Work: ❑ Addition ❑ Alteration Od New ❑ Repair/Replace ❑ Demolition Description of Work: t40-P-) C7 0-y-n I f1� !�Q6L Specify color of color thru the: Submittal Fee $ Scanning Fee $ Permit Fee $ CCF $_ Radon Fee $ DBPR $ Technology Fee $ Training/Education Fee $ Structural Reviews $ (Revised02/24/2014) CO/Cc $ Notary $ Double Fee $ Bond $ _Z::�o ' TOTAL FEE NOW DUE $ --I '::�[ l " C-0 11- q ! ' co r 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 ted notice, the inspection will not be a ayed_ans_a reins1_ pection fee will be charged. Sign Signature , OWNER r AGENT �� CONTRACTOR The foregoing instrument was acknowledged before me this` The foregoing instrument was acknowledged before me this 7_t'�-day of s 120 by /1271 day of 1� , 20 10 by r �lcca -• 210 Gc)�Z4 1677 who is personally known to 6 4ve((J who is personally known to me or who has produced FL /_> L as me or who has produced as 0. identification and who did take an oath.�� _ �� _ 3�3 � Identification and who did take an oath. NOTARY PUBLIC- 3//`)NOTARY PUBLIC: Sign: Sign: Print: Print. �i�(c yt�cJ2S ,�o'�` CYNTHIA GAVOT Seal: `�= Notary Public - State of Florida Seal: r 'a; Commission # GG 018640,1�; NADINE A�3UA3 I '-',r a Fed:•' My Comm. Expires Aug 4, 2020 ': MY COMMISSION M GG0904 y =? EXPIRES Aril t4 �J07 APPROVED BY / Plans Examiner D 24 Zoning Structural Review Clerk (Revised02/24/2014) 9/28/2018 Property Search Application - Miami -Dade County OFFICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: 11-3206-017-1680 Property Address: 600 NE 97 ST Miami Shores, FL 33138-2471 Owner JODY C DIAMOND EDUARDO J GONZALEZ Mailing Address 600 NE 97 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 3,180 Sq.Ft Living Area 2,238 Sq.Ft Adjusted Area 2,677 Sq.Ft Lot Size 13,000 Sq.Ft Year Built 1955 Assessment Information Year 2018 2017 2016 Land Value $389,620 $389,620 $324,852 Building Value $287,032 $176,539 $176,723 XF Value $3,986 $4,020 $4,053 Market Value $680,638 $570,179 $505,628 Assessed Value $680,638 $556,190 $505,628 Benefits Information Benefit Type 2018 2017 2016 Non -Homestead Cap Assessment Reduction $13,989 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 MIAMI SHORES SEC 4 AMD PB 15-14 LOTS 9 & 10 BLK 100 LOT SIZE 100.000 X 130 OR 17291-1436 0796 1 Generated On : 9/28/2018 Taxable Value Information 2018 2017 2016 County Exemption Value $50,000 $0 $0 Taxable Value $630,638 $556,190 $505,628 School Board Exemption Value $25,000 $0 $0 Taxable Value $655,638 $570,179 $505,628 City Exemption Value $50,000 $0 $0 Taxable Value $630,638 $556,190 $505,628 Regional Exemption Value $50,000 $0 $0 Taxable Value $630,638 $556,190 $505,628 Sales Information Previous Sale Price OR Book - Qualification Description Page 01/11/2017 $0 30462-0500 Corrective, tax or QCD; min consideration 01/11/2017 $865,000 30384-3784 Qual by exam of deed 12/07/2015 $553,400 29883-3012 Financial inst or "In Lieu of Forclosure" stated 07/01/1996 $165,000 17291-1436 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.miamid ade.gov/info/disclaimer.asp Version: Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RESTRICTIVE COVENANT PROTECTIVE POOL ENCLOSURE KNOW ALL MEN BY THESE PRESENTS: WHEREAS, the undersigned is/are the fee simple owner(s) of the following described property situated and being in Miami Shores Village, Florida: Address: 600 MG7 m bi rtiav-r.% Whereas, the undersigned owner(s) Oa desire to utilize said Lot(s) as a single building site, and the undersigned owner(s) do(es) hereby declare and agree as follows: I. That the property will not be used in violation of any ordinances of Miami Shores Village or Miami -Dade County now in effect or hereinafter enacted. 11, That the purpose of the covenant is to induce Miami Shores Village to issue a permit for a pool where the required enclosure is not on the subject property where the pool is located. III. That if any of our adjoining neighbors remove any portion of their fence or wall, or if our/my property shall fail to meet code requirements for pool barriers, we, as owners will immediately installs a protective enclosure to meet code requirements and will obtain a permit for such fence. IV. That, I/we, as owner(s) hold Miami Shores Village harmless for any negligence or injury that results from not having the enclosure. V. If enclosure belongs to said property, I agree to maintain & or replace said enclosure in the event that is damaged or removed by any case. NOW, THEREOF, for good and valuable consideration, the undersigned do(es) hereby declare that he/she will not conveyor cause to be conveyed the title to the above property without requiring the successor in title to abide by all terms and conditions set forth herein. FURTHER, the undersigned declare(s) that this covenant is intended and shall constitute a restrictive covenant concerning the use, enjoyment and title to the above property and shall constitute a covenant running with the land and shall be binding upon the undersigned, his/her successors and assigns andb Miami Shores Village, or its successors, in accordance of said Village then in effect. OWNER SIGN & PRINT I Hereby Certify that on this day personally appeared before me E'Wo t 2" Z and has produced ID #iSaSt-a/o,7R—3�23Ridentification and he/she acknowledge that he/she executed the foregoing, freely and voluntarily, for purposes there in expressed. G SWORN TO AND SUBSCRIBED before me on this 1 '7 day of 51e'R 20 4 r, CYNTHIA GAY]4,.2020 Notary Public • State Commission Al GG NOTARY I TATE OF FLORIDA (Revised 05/22 ���.,°;;;`�, My Comm. Expires Au Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 NOTICE OF REQUIREMENTS RESIDENTIAL SWIMMING POOL, SPA AND HOT TUB SAFETY ACT I (We) acknowledge that a new swimming pool, spa or hot tub will be constructed or installed at &CEO Lle Ci l 51 Miami Shores, FL, and hereby affirm that one of the following methods will be used to meet the. requirements of Chapter 515, Florida Statues and the Florida Building Code R4101.17. Please initial the method(s) to be used: The pool will be equipped with an approved safety pool cover that complies with ASTM F1346-91. (Submit Manufacturer's Specifications). A continuous, one-piece (child) barrier meeting the requirements of Florida Building Code R4101.17.1.15 will protect the pool perimeter. The plans shall show the fence location and method of attachment, including one end that shall not be removable without the aid of tools. (Submit Manufacturer's Specifications). A combination of non -dwelling walls and fences (screen enclosure, child fence, masonry fence walls, chain link or wood fence, etc.) will protect the pool perimeter. The plans must specify the type and location of all non dwelling walls. Florida Building Code, R4101.17.1 Any combination of protection which incorporates dwelling walls with openings directly into the pool perimeter and all windows and doors will be equipped with exit alarms complying with Florida Building Code, R4101.17.1.9 (Submit Manufacturer's Specifications). Any combination of protection which incorporates dwelling walls with openings directly into the pool perimeter and all doors will be equipped with a self -latching device with positive mechanical latching/locking installed a min. 54" above the threshold. If this option is selected, submit plans showing all types and location of all perimeter protection. The plans must also show the location and type of all openings, and the hardware type for each location. (Submit Manufacturer's Specifications). In accordance with the Code, the pool may not be filled with water without compliance with the Private Swimming Pool Safety Requirements, and upon expiration of the permit, the pool shall be presumed to be unsafe. I understand that not having one of the above installed will constitute a violation of Chapter 515, F.S ., an d will be considered as committing a misdemeanor of the second degree, punishable ,as-provtde`d in Section 775.08 ec oti-- n--M. 3-F-.S :-Thig form must be signed by the ownerlaaghfasdihe prime contracto� CONTRACTOR'S SIGNATURE AND DATE It ANFFDATE C1GU6r u �c�Q CONTRACTOR'S AME (PLEASE PRINT) OWNER'S N PLEASE _ A c,- ublic A GAYOT Notary Public -State of Florida ° Commission # GG 018640 NOTA �:, L{�AY COMMISSION # GG090407 N UBLIC �., OF,�d% - My Comm. Expires Aug 4, 2020 !tc,FvP` EXPIRES April 04, 2021 Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 SWIMMING POOL OWNER'S CERTIFICATION Date ` ef-- �1— l !) Miami Shores Village Building & Zoning Department Attention: Building Official I certify that I am the legal owner of the property described as located at 33�33 . 6)00 NT G.� e.1 In accordance with Section 33-12(f), Code of Metropolitan Dade County, I certify that I understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until separate permit has been obtained for an approved safety barrier, and such barrier erected, inspected and approved. I further understand that this certification, however, does not eliminate the need for obtaining a permit and erecting and approved barrier prior to fina in_ sne 'on and use of the pool. iT.-IcWOMM CYNTHIA GAYOT Notary Public - State of Florida Commission � GG 018840 Note: This certification is to be submitted with a swimming pool permit appiica ri . Expires Aug 4. 2020 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November:;0, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 600 N.E. 97th Street City State ZIP Code Company NAIC Number Miami Shores Florida 33138 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View", and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. • • • ••- • Vie. ••• • 6*0 00 goo 0.00 I • • 1 • • • •1•• •�•••• • • ..'Se: Photo Three I Photo Three Caption Side View: 05/17/2018 Clear Photo Three I Photo Four Photo Four Caption Side View: 05/17/2018 Clear Photo Four FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 600 N.E. 97th Street City State ZIP Code Company NAIC Number Miami Shores Florida 33138 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. S 3 6:t t ' • _e ♦ 81 ile, �� • • • • • • • mn MIM iy 'T�. .. Photo One Photo One Caption Front View: 05/17/2018 Clear Photo One x� r � [ 6 Ph= Two Photo Two Caption Rear View: 05/17/2018 Clear Photo Two FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 600 N.E. 97th Street City State ZIP Code Company NAIC Number Miami Shores Florida 33138 SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. G1. ❑.'TWipformation in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, .. •ent1neer, oreare iitrett who is authorized by law to certify elevation information. (Indicate the source and date of the elevation cleta ip the Comments area below.) G ❑ A�communityeiiieitfcompleted Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) • , or ZQge AO. ... • 133. ❑ TRe foilowing.igfpLrpation (Items G4—G10) is provided for community floodplain management purposes. 4. Permit Number ;•;' �: G5. Date Permit Issued G6. Date Certificate of • ' Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) building: ❑ feet ❑ meters of the Datum G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 600 N.E. 97th Street City State ZIP Code Company NAIC Number Miami Shores Florida 33138 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is aboV&l Blow the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). • • * • • • • . • • • • •• a) Top of bottom floor (including basement, 69000 • • crawlspace, or enclosure) is ❑x feet ❑ meters Qabove • or ❑ bl� mAe HAQ• • b) Top of bottom floor (including basement, • • • • crawlspace, or enclosure) is ❑x feet ❑ meters Da; ove.or ❑PNow the LAO'. .... E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (sed P;§@,Cf 1-2 of Wtryctions),• •: the next higher floor (elevation C2.b in • • • • • • • • •' the diagrams) of the building is ❑x feet ❑ meters Q•aixw0 or ❑ below the HA3.• E3. Attached garage (top of slab) is ❑x feet ❑ meters ❑ above or ©br.Mthe HAG.. • • • • E4. Top of platform of machinery and/or equipment •. • .. . :... servicing the building is Z feet ❑ meters ❑ above or af1214ve the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7115) Replaces all previous editions., Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 600 N.E. 97th Street City State ZIP Code Company NAIC Number Miami Shores Florida 33138 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* Z Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations — Zones Al—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), AR, AR/A, AR/AE, AR/A1—A30, AR/AH, AR/AO. Complele.1tems C2 .a—Itibelow according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. • • BenL`%ark Utiliz;d' WbCo. BM # SC-49 Vertical Datum: NGVD 1929 • • • IndttA$Q%vatiortdVIVused for the elevations in items a) through h) below. • • . -X NGVD 15 9 ❑ NAVD 1988 ❑ Other/Source: "' Datyrti for bai�dlrUdlevations must be the same as that used for the BFE. • • Check the measurement used. :. • a) VO.8fbottom liggr'( wluding basement, crawlspace, or enclosure floor) 8.88 ❑x feet ❑meters "� • b) To•po•fe the next�f4R�r�loor 11.19 x feet ❑meters .... c) 139:9rp.4 the lowest hprizontal structural member (V Zones only) N/A ❑x feet ❑ meters �..; d) Attactlq garago (toprof slab) 8.58 ❑x feet ❑ meters • e) Lowest 8levation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) 9.48 feet ❑meters f) Lowest adjacent (finished) grade next to building (LAG) 8.45 ❑x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 8.73 ❑x feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 7.90 ❑x feet ❑ meters structural support SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. / certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑x Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number Odalys C. Bello Iznaga LS 6169 Title Professional Land Surveyor and Mapper c. e Company Name Bello & Bello Land Surveying Corp. J e fug y Here Address 12230 SW 131 Avenue, Suite 201 City State ZIP Code Miami Florida 33186 Signature Date Telephone Ext. (305) 251-9606 Copy all pa es of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) For A5: Long. and Lat. determined by GNSS RTK GPS Survey No. 18494 C2 e) Denotes Elevation of A/C Units located on the East side adjacent to the existing structure. Highest Crown of Road Elev.= 9.07' FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 4 J.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 Federal Emergency Management Agency Expiration Date: November 30, 2018 rational Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: Eduardo Gonzalez; Jody C Diamond A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 600 N.E. 97th Street Sege City State ZIP Obde• • • • •See Miami Shores Florida 3313,8 • • A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) • • • •.. "• Folio # 11-3206-017-1680 Lots 9 and 10, Block 100, MIAMI SHORES SECTION 4 AMENDED, PB 15, P9,12t .. •. A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential ••••.. "• A5. Latitude/Longitude: Lat.25°51'52.22"N Long. 80°11'06.03"W Horizontal Datum: EaAA.Q.1 927 0 "AD 1983... A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. • • •..' A7. Building Diagram Number 1B ' 0••• �• • • •• A8. For a building with a crawlspace or enclosure(s): • �• a) Square footage of crawlspace or enclosure(s) N/A sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in d) Engineered flood openings? ❑ Yes ❑x No A9. For a building with an attached garage: a) Square footage of attached garage 545.00 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes ❑x No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State Village of Miami Shores 120652 Miami -Dade Florida B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) Revised Date 12086C 0306 L 09-11-2009 09-11-2009 X N/A B10. Indicate t,.e source cf the Base Flood Elevation (BFE) data or base flood depth entered in Item 139: ❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source: 611. Indicate elevation datum used for BFE in Item B9: ❑x NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: 812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 j, U`S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 41 Fedcral Emergency Management Agency Expiration Date: November 30, 2018 National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Policy Number: Eduardo Gonzalez; Jody C Diamond A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number: Box No. 600 N.E. 97th Street City State ZIP Code Miami Shores Florida 33138 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Folio # 11-3206-017-1680 Lots 9 and 10, Block 100, MIAMI SHORES SECTION 4 AMENDED, PB 15, PG 14 A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat. 25051'52.22"N Long. 80°11'06.03"W Horizontal Datum: ❑ NAD 1927 ❑x NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 1B A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) N/A sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in d) Engineered flood openings? ❑ Yes ❑x No A9. For a building with an attached garage: a) Square footage of attached garage 545.00 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? []Yes ❑x No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State Village of Miami Shores 120652 Miami -Dade Florida B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) Number- Date Effective/ Zone(s) (Zone AO, use Base Flood Depth) Revised Date 12086C 0306 L 09-11-2009 09-11-2009 X N/A 610. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139: ❑ FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item 69: ❑x NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes ❑x No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 1 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 20,18 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 600 N.E. 97th Street City State ZIP Code Company NAIC Number Miami Shores Florida 33138 SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ❑x Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations — Zones Al—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), AR, AR/A, AR/AE, AR/A1—A30, AR/AH, AR/AO. Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized: M-DCo. BM # SC-49 Vertical Datum: NGVD 1929 Indicate elevation datum used for the elevations in items a) through h) below. ❑x NGVD 1929 ❑ NAVD 1988 ❑ Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 8.88 ❑x feet ❑ meters b) Top of the next higher floor 11.19 ❑x feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A ❑x feet ❑ meters d) Attached garage (top of slab) 8.58 ❑x feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 9.48 ❑x feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 8.45 ❑x feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 8.73 x❑ feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 7.90 x feet ❑ meters structural support SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑x Yes ❑ No ❑ Check here if attachments. Certifier's Name License Number Odalys C. Bello Iznaga LS 6169 Title Professional Land Surveyor and Mapper Company Name Bello & Bello Land Surveying Corp. � a / S,,,c & l& 9 Cr ��ff Address 12230 SW 131 Avenue, Suite 201 City State ZIP Code Miami Florida 33186 �_50 Date Telephone SignatVgesoltthh�isElevation Ext. -30 — Iq (305) 251-9606 Copy aCertificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including type of equipment and location, per C2(e), if applicable) For A5: Long. and Lat. determined by GNSS RTK GPS Survey No. 18494 C2 e) Denotes Elevation of A/C Units located on the West side adjacent to the existing structure. Highest Crown of Road Elev.= 9.07' FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 2 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 600 N.E. 97th Street City State ZIP Code Company NAIC Number Miami Shores Florida 33138 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items El—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑x feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑x feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑x feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑x feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑x feet ❑ meters ❑ above or ❑ below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 3 of 6 ELEVATION CERTIFICATE OMB No. 1660-0008 Expiration Date: November 30, 20,18 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 600 N.E. 97th Street City State ZIP Code Company NAIC Number Miami Shores Florida 33138 SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official completed Section E for a building located in Zone A (without a FEMA-issued or community -issued BFE) or Zone AO. G3. ❑ The following information (Items G4—G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) ❑ feet ❑ meters Datum of the building: G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum G10. Community's design flood elevation: ❑ feet ❑ meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments (including type of equipment and location, per C2(e), if applicable) ❑ Check here if attachments. FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 4 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number: 600 N.E. 97th Street City State ZIP Code Company NAIC Number Miami Shores Florida 33138 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. r.cti i l 4 t y ak Photo One Photo One Caption Front View: 01/30/2019 Clear Photo One 4 *9 .�X t ., � .:.•'�''e�';� �'� !fir .�;�` Photo Two Photo Two Caption Rear View: 01/30/2019 Clear Photo Two FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30, 20r18 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 600 N.E. 97th Street Policy Number: City State ZIP Code Miami Shores Florida 33138 Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and 'Rear View'; and, if required, 'Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. Photo Three Photo Three Caption Clear Photo Three Photo Four Photo Four Caption Clear Photo Four FEMA Form 086-0-33 (7/15) Replaces all previous editions. Form Page 6 of 6