PL-19-1055Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 05/20/2019
Location Address Parcel Number
922 NE 91ST TER, Miami Shores, FL 33138 1132060000030
Contacts
Permit No.: PL -05-1 9-1 M
Permit Type: Plumbing - Residerlittal
Work Class*otfon: Septic/oninfield
Permit status: Approved
Expiration: 11/18/2019
Description: INSTALL DRAINFIELD & SEPTIC TANK Valuation: $ 4,000.00 Inspection Reguests:
=7 2-49
Total Scl Feet: 0.00
Fees
FLOCABER INVEST ONE LLC Owner
N/A N/A
922
MR C'S PLUMBING & SEPTIC INC Contractor
KEMBLE ETTRICK
Business: 3056517859
$50.00
CCF
Description: INSTALL DRAINFIELD & SEPTIC TANK Valuation: $ 4,000.00 Inspection Reguests:
=7 2-49
Total Scl Feet: 0.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$2.40
DBPR Fee
$2.10
DCA Fee
$2.00
Education Surcharge
$0.80
Permit Fee
$90.00
Scanning Fee
$9.00
Technology Fee
$3.50
Total:
$159.80
Payments
Date Paid Amt Paid
Total Fees
$159.80
Credit Card
05/10/2019 $50.00
Credit Card
05/20/2019 $109.80
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 rTA
'fo ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNE AI I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulati co nd zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner
/ Applicant / Contractor / Agent
Date
May 20, 2019 Page 2 of 2
RECEIVED
Miami Shores Village MAY 10L
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 1
FBC 20 1 :� --
BUILDING Master Permit No. PL os- ` I O 5
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
b CONTRACTOR DRAWINGS
I/ JOB ADDRESS: I )U6 !I 7&' m(,C
City: Miami Shores County: Miami Dade Zip: 33 13
Folio/Parcel#: ;tO6 - 600 —6d 30 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: P Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): V lotb W J o%V r& • Phone#:
Address: oC a 71 e_ 1)k,7k s6T bk so>
City: �7+L State: IFS-- Zip: '5570
Tenant/Lessee Name: Ph
Email
CONTRACTOR: Company Name: I, r 61S J1 UA%�i Phone#: 365-c v Zd P!
Address: I yf5a Alk) 24: /, Of
City: _M/dA/ State: Zip: 3316
Qualifier Name: K�"titl3G6 �/ Phone#:.
State Certification or Registration #: jl= 4% I r7 56 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 66oly Square/Linear Footage of Work: .300
Type of Work: ❑ Addition ❑ Alteration ❑ New ['Repair/Replace ❑ Demolition
Description of Work: r
Specify color"of color'thru "tile: `
Submittal Fee $� Permit Fee $ 'y CCF $ ' `' CO/CC'$"^ s`
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
DBPR $
Notary $
Double Fee $
Bond $ 6—T
TOTAL FEE NOW DUE $ 1 V `� 0
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 on 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
6 day of MAY 20 9 by
er / °or- who is personally known to
me or who has produced
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
6 day of Ah V 20 /9 by
KC—AA" :alZ A— who is personally known to
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
Structural Review Clerk
(Revised02/24/2014)
C
Sign:
Sign:
Print:
Print:
ra�-
Notary Public-StateofFlorida
Commission p GG 141708
Seal:
4KEM6LEETTRICKSeal
+P r ' 'MY COMMISSION If GG102743
Mey 09, 2021My
Comm. Expires Sep 19,2021B.^rded teru.� %EtlCra! 4Chry Asir.
EXPIRES
######## # # #
# # # # ## # ######################################################################
APPROVED BY
/ ' 3�g
Plans Examiner
Zoning
Structural Review Clerk
(Revised02/24/2014)
5/10/2019 Pronertv Search Application - Miami -Dade County
OFFIC"E OF THE PROOP"RT" APPRAIS'ER
Summary Report
Property Information
Folio:
11-3206-000-0030
Property Address:
922 NE 91 TER
Miami Shores, FL 33138-3220
Owner
FLOCABER INVEST ONE LLC
Mailing Address
2871 SOMERSET DR 200
FORT LAUDERDALE, FL 33311 USA
PA Primary Zone
0900 SGL FAMILY - 1901-2100 SQ
Primary Land Use
0101 RESIDENTIAL - SINGLE
FAMILY: 1 UNIT
Beds / Baths / Half
3/2/1
Floors
1
Living Units
1
Actual Area
Sq.Ft
Living Area
Sq.Ft
Adjusted Area
2,226 Sq. Ft
Lot Size
12,375 Sq.Ft
Year Built
Multiple (See Building Info.)
Assessment Information
Previous
2018 2017
Benefit
Year
2018
2017
2016
Land Value
$334,051
$334,051
$271,978
Building Value
$153,749
$153,749
$153,749
XF Value
$24,478
$24,657
$24,835
Market Value
$512,278
$512,4571
$450,562
Assessed Value
$512,278
$512,457
$239,645
Benefits Information
Previous
2018 2017
Benefit
Type
2018 2017 2016
Save Our Homes Cap
Assessment Reduction
$210,917
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
6 53 42.284 AC
E75FT OF W169FT OF S165FT OF
S1/2 OF SE1/4 OF NE1/4 OF SEI/4
LOT SIZE 75.000 X 165
OR 17759-1371 0297 5
Generated On : 5/10/2019
Taxable Value Information
Previous
2018 2017
2016
County
Exemption Value
$0
$0
$50,000
Taxable Value
$512,278
$512,457
$189,645
School Board
Exemption Value
$0 $0
$25,000
Taxable Value
1 $512,278 $512,457
$214,645
City
Exemption Value
$0 $0
$50,000
Taxable Value 1
$512,278 $512,457
$189,645
Regional
Exemption Value $0 $0 $50,000
Taxable Value 1 $512,278 $512,457 $189,645
Sales Information
Previous
Price
O Book-
Qualification Description
Prev
e
Page
09/29/2017
$100
30720-3381
Corrective, tax or QCD; min
consideration
09/28/2017
$100
30720-3379
Corrective, tax or QCD; min
consideration
09/22/2016
$100
30345-4522
Corrective, tax or QCD; min
consideration
07/22/2016
$430,000
30183-0265
Forced sale; under duress; foreclosure
prevention
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
Detail by Entity Name
Florida Department of State
LrA
g,g�,w, ^'y<" :malt I/A*j'p<?� ? is rl' fai ��tj 1 X t d i:•G!r": itA�
Department of Stale / Division of Corporations / Search Records / Detail By Document Number /
Detail by Entity Name
Florida Limited Liability Company
FLOCABER INVEST ONE LLC
Filina Information
Document Number
L15000139170
FEI/EIN Number
35-2540616
Date Filed
08/14/2015
Effective Date
08/11/2015
State
FL
Status
ACTIVE
Last Event
LC AMENDMENT
Event Date Filed
05/07/2018
Event Effective Date
NONE
Principal Address
20801 BISCAYNE BLVD
STE 403-1001
AVENTURA, FL 33180
Changed: 05/08/2018
Mailing Address
20801 BISCAYNE BLVD
STE 403-1001
AVENTURA, FL 33180
Changed: 05/08/2018
Registered Agent Name & Address
MCH CONSULTING USA
20801 BISCAYNE BLVD
STE 403-1001
AVENTURA, FL 33180
Name Changed: 05/08/2018
Address Changed: 03/07/2017
Authorized Person(s) Detail
Name & Address
Title Manager
Page 1 of 2
DIVISION OF CORPORATIONS
http://search. sunbiz.org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 5/10/2019
Detail by Entity Name
Berlioz, Nicolas
2871 Somerset Drive
Apt 200
LAUDERDALE LAKES, FL 33311
Title AMBR
FLOCABER HOLDING LLC
20801 BISCAYNE BLVD
STE 403-1001
AVENTURA, FL 33180
Annual Reports
Report Year
Filed Date
2017
03/07/2017
2018
01/24/2018
2019
01/28/2019
Document Images
Page 2 of 2
01128/2019 -- ANNUAL. REPORT I
View image in PDF format
0510V2018_LC Amendment F777iew
image in PDF format
01/24f2018 — ANNUAL REPORT
View image in PDF format
03/23/2017 — CORLCAUTH F777Trnage
in PDF forrnat
03/07/2017 -- ANNUAL REPORT
View image in PDF format
07131/2016 -- ANNUAL REPORT
View image in PDF format
d8/1.4i2U15_- Fign a Limited Liability
View image in PDF format
F. o: ;r= C"?parrm ant of S ta:.1% rvi.'.:en of i:,rp:;: nt::ms.
hnp:Hsearch. sunbiz.org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 5/10/2019
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT
SYSTEM
CONSTRUCTION PERMIT FOR:
APPLICANT: (FlocabarIm
PROPERTY ADDRESS: 922
LOT: NA BLOCK
PROPERTY ID #: 11-3206-00
DISPOSAL
OSTDS Repair
int)
Ter Miami, FL 33 38
NA S IVISION:
PERMIT #:13 -SC -1944
APPLICATION #: AP1411094
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PRI 224766
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCO ANCE WITH SPECIFICATIONS AND STANDARDS OF SE�TION
381.0065, F.S., AND CHAPTER 64E-6, F.A. Z. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE
SATISFACTORY PERFORMANCE FOR ANY SPECIF C PERIOD OF TIME. ANY CHANGE IN MATERIAL FP.CTS,
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 NOTT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVE PMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 900 l GALLONS / GPD NEW SEPTII
A [ 0 ] GALLONS / GPD
N [ 0 ] GALLONS GREASE INTERCEPTOR C
K [ ] GALLONS DOSING TANK CAPACITY
D [ 300 ] SQUARE FEET NEW DF IN BED C(
R [ 0 ] SQUARE FEET
A TYPE SYSTEM: [X] STANDARD [ ] E
I CONFIGURATION: [ ] TRENCH [X] BE
N
F LOCATION OF BENCHMARK: FFE...... 11.90' NGV[
I ELEVATION OF PROPOSED SYSTEM SITE [
E BOTTOM OF DRAINFIELD TO BE [
L
D FILL REQUIRED: [ 0.00 ] INCHES
1.- Install a 900 gal. septic tank with an approved
O 2.- Install 300 sf. of drainfield in... BED....... config
T 3. -Install 12 "of slightly limited soil at the bottom of
H 4.- Invert elevation and Bottom of drainfield to be no
THIS PERMIT IS NOT FOR ANY ADDITIONS_
E
.................................... .
SPECIFICATIONS BY: Mr C'sl,&.b Sept
APPROVED BY:
izaire
DATE ISSUED: 05/02/201 jr
DH 4016, 08/09 (Obsoletes all previous edi
Incorporated: 64E-6.003, FAC
, 1.1.4
TOINSTALL CAPACITY
CAPACITY
Y [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
[ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
IG SYSTEM
SYSTEM RE'P'S
A 0rR PERMIT
IUUNTY
NS
807L INCHES FT ][ ABOVE SELOW BENCHMARK/REFERENCE POI
80 [ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE PO]
: [ 62.00 ] INCHES
drainfield.
than 7.34'& 6.84' NGVD respectively.
TITLE:
Environmental Manager
EXPIRATION DATE:
which may not be used)
AP1411094 SE1174294
Dade CHD
07/31/201
Page 1 of
DOCUMENT #: PR1224756
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 300
gpd.
Required drainfield area based on rule 64E -6.015(6)(c)2.
Install a new drainfield to achieve Drainfield size requirement.
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Florida health
`Miami -Dade County
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Date
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