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DS-19-1437Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 1209 NE 96TH ST, Miami Shores, FL 33138 Contacts Permit NO.: DS-06-19-1437 p� VIM J Permit Type: Driveways/Sidewalks/Slabs c Work Classification: Addition/Alteration Permit Status: Approved Issue Date:08/16/2019 I Expiration: 02/12/2020 Parcel Number 1132060143820 DAVID JATIVA Owner 1209 NE 96 ST, MIAMI SHORES, FL 33138 Mobile: 7867090902 AA RELIABLE CONSTRUCTION INC Contractor ABEL ALMAGUER 1679 NE 174 ST, NORTH MIAMI BEACH, FL 33162 Business: 3058043933 Inspection Description: PLAIN CONCRETE DRIVEWAY (SQUARES) Valuation: $ 4,000.00 Inspection Requests: 4949 TotalSq Feet: 440.00 Fees Amount Application Fee - Other $50.00 CCF $2.40 Concrete/asphalt/pavers, slabs, dways, $50.00 swalks DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.80 Planning and Zoning Review Fee $35.00 Scanning Fee $9.00 Technology Fee $2.50 Total: $153.70 Building Department Copy Payments Date Paid Amt Paid Total Fees $153.70 Credit Card 08/16/2019 $153.70 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 clone - one her myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WI DOWS DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing infor ti is acc ate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authoriz 0ove a d contractor to do the work stated. Authorized Signature: Owner / Applicant / I r ! Agent Date August 16, 2019 Page 2 of 2 Miami Shores Village RECEIVED Building Department �u 24 2019 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 13Y: A L�' Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 0w FBC 2q�- Master Permit No.1)5;- (%" PERMIT APPLICATION BUILDING ❑ ELECTRIC ❑ ROOFING ❑PLUMBING [:]MECHANICAL PUBLIC WORKS Sub Permit No. ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: /2 0 9 /t/4�- 9 6 S City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: // - .3206 3 ,?2 O Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): DG3 v Phone#: -7S-6 7 0'I D 90 2 Address: / 2 0 g N `" 'i 6 '1 S 7 City: /Vi 4 rn / S '40A-W-T State: 1-1-Y Zip: Tenant/Lessee Name: Phone#:_ Email: 3-7/39 CONTRACTOR: Company Name: 19 A? / zP G►ti' � LO _r f -:; 'l C • Phone#:.3 6 Fro Address: 7 q N 45r / 7 C-/ _0 �S City: /tJ /9 /3 / State: /el zip: Qualifier Name: 416e / 4 l/r� �, Svc ✓ Phone#: 30-T SO �(3 S? 2 State Certification or Registration #: DESIGNER: Architect/Engineer: of Competency #: Phone#: Address: City: State: �,�J Zip: Value of Work for this Permit: $ � 0 © 0 Square/Linear Footage of Work: 1 I 0 Type of Work: ❑ Addition ❑ Alteration ❑ NewT ❑ Repair/Replace ❑ Demolition Description of Work: P/C; / ✓7 W.'F� S --es Specify color of color thru tile: Submittal Fee $ Scanning Fee $ Technology Fee $_ Structural Reviews $ (Revised02/24/2014) Permit Fee $ Radon Fee $ Training/Education Fee $ CCF $ CO/CC $ DBPR $ Notary Double Fee $ Bond $ eMMw- O;ZN TOTAL FEE NOW DUE $ IS 3 .�� ( S3. 9b 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 an reinspec on fee will be charged. Signature Signature O NER or AG T CONTRACTOR The foregoing inst um ht was acknowledged before me this I 2 day k l 20 (� by T)A U 10 � �rt (✓ f� who is personally known to me or who has produced 107L- b L as identification and who did take an oath. NOTARY4LI Sign: Print: Seal: �� Notary Public State of Florida Barbara M Milanes +� • My Commission GG 328752 Expires0412212023 The foregoing instrument was acknowledged before me this daU W y of _0 F 20 ( 4 by ay I �2 iY (- h-J A6 (ir; 2who is personally known�o me or who has produced identification and who did take an oath. Sign: Print: Seal: ************************* APPROVED BY �A2L/ Plans Examiner Structural Review Notary Public State of Florida r°� Barbara M Milanes < My Commission GG 328752 ,ypExpires 04/22/2023 - as Zoning Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 1 "AFFICE09"'I' THE PROPERTY APPRAISER Summary Report Property Information Folio: 11-3206-014-3820 Property Address: 1209 NE 96 ST Miami Shores, FL 33138-2553 Owner DAVID JATIVA ANDREINA JATIVA Mailing Address 1209 NE 96 ST MIAMI SHORES, FL 33138 USA PA Primary Zone 1400 SGL FAMILY - 3001-3250 SQ _ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths / Half 4/2/0 Floors 1 Living Units 1 Actual Area 3,643 Sq.Ft Living Area 3,143 Sq.Ft Adjusted Area 3,279 Sq.Ft Lot Size 10,125 Sq.Ft Year Built Multiple (See Building Info.) Assessment Information Year 2019 2018 2017 Land Value $382,858 $364,444 $364,444 Building Value $504,638 $510,868 $268,405 XF Value $34,994 $35,433 _...__ $35,874 ......___ Market Value $922,490 $910,745 $668,723 Assessed Value $922,490 $910,745 $265,872 Benefits Information Benefit Type 2019 2018 2017 Save Our Homes Cap Assessment Reduction $402,851 Homestead Exemption $25,000 $25,000 $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 5-6 53 42 MIAMI SHORES SEC 3 PB 10-37 LOT 15 & E1/2 LOT 16 BLK 83 LOT SIZE 75.000 X 135 OR 16706-1949 0295 1 Generated On : 6/24/2019 Taxable Value Information 2019 2018 2017 County Exemption Value $50,000 $50'000 $50,000 Taxable Value $872,490 $8601745 $215,872 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value $897,490 $885,745 M $240,872 city Exemption Value $50,000 $50,000 $50,000 Taxable Value $872,490 $860,745 $215,872 Regional Exemption Value $50,000 $50,000 $50,000 Taxable Value $872,490 $860,745 $215,872 Sales Information Previous OR Book - Price Qualification Description Sale Page 30680- 08/28/2017 $950,000 Qual by exam of deed 2167 23240- Sales which are disqualified as a result 03/01/2005 $0 j 0254 of examination of the deed 16706- 02/01/1995 $131,500 Sales which are qualified 1949 11050- 03/01/1981 $172,000 Other disqualified 1938 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 https://www8.miamidade.gov/Apps/PA/propertysearch/ 6/24/2019 Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LICENCES B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT, D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. ........................................................................................... BUSINESS NAME: BUSINESS ADDRESS: / G 7 q & ,67- / -7 y , CITY N STATE ice/ ZIP BUSINESS PHONE: ( FAX NUMBER (—_) CELL PHONE (3 US) SD 5l 1 S 3 ? QUALIFIER'S NAME: 4,6e 1 QUALIFIER'S LIC NUMBER: RICK SCOTT, GOVERNOR •may �. �Oa wu .1 JONATHAN ZACHEM, SECRETARY dbor''' : STATE OF FLORIDA DEPARTMENT OF BUSINESS --AND PROFESSIONAL REGULATION , CONSTRUC :I'ON'_INDUSTRY=LICENSING BOARD THE GENERAL'CONTRACT 'WPOE(N,IS`CERTIFIED-UNDERTHE PROVISIONS%OF'CHAPTERI489-=FL'ORIDlA_\-STATUTES • i i ' J.� . . Y �,s, J l i ...... '� L`MAGUERI-ABED R5)' _w-AA-CONSTRUCTION INCL*-; 1:�l.1679.:IE174 TH.ST,-�: X, NORTHMIAMI-BEACH 1703162t, _it , I LICENSE�NllMBER:�CGC1517602 EXPIRATION�DA,_TE, � kQGUST 31, 2020 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. II .. t °- Local Business Tax Receipt Miami —Dade County, State of Florida A A Cr,-,.rJ " K.' -THIS IS NOT A BILL - 00 NOT PAY 6521562 i BUSINESS -i"w"F/LOCATION RECEIPT NO. AA RELIABLeCONSTRUCTION RENEWAL I INC 6791926 6181 SW 18TH ST WEST MIAMI, FL 33155 yt t+ LBT EXPIRES SEPTEMBER 30, 2019 Must be displayed at place of business Pursuant to County Code Chapter BA - Art. 9 & 10 SEC. TYPE OF BUSINESS OWNER PAYMENT RECEIVED AA RELIABLE CONSTRUCTION INC 196 GENERAL BUILDING .—BY.TAX COLLECTOR CONTRACTOR 45.00 ' 07/14/2018 Worker(s) 1 CGC1517602 ECHECK-18-20226-1 This Local Besiaess Taz Reatpt o* cmdrots P1inent al the Local Business Taa.Tbe Receipt is note license. r pemrit or a cwdooadm of dw iwkws gnfifimdms. to do beshwss Holder must comply with any oevermnental s or een0overen eetal repelatory lem and requirements which apply to the busiaass. ` The RECEIPT No. above east Ye displayed oo all conmereial vehicles - Whw"ado Code See Ils-VIL ®ANNAM For mors hdemmdoa, visit au.sT(�tM (!=141y 1cm fc Rz Scanned with CamScanner ACCPR O� CERTIFICATE OF LIABILITY INSURANCE DAT O6/24H9 I THIS CERTIFICATE IS }SSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER All Insurance Services 1548 W. 37 St. Hialeah, FL 33012 Phone (305) 822-4472 Fax (305) 556-4354 INSURED A A Reliable Construction Inc. 1679 NE 174 St North Miami Beach, FL 33162 (305) 804-3933 All Insurance Services (305) 822-4472_ — v _ -�c ho). (305) 556-4354 Ifemandez@aisrv.com INSURERA: UNITED SPECIALTY INSURANCE COMPANY INSURERS: PROGRESSIVE INSURER C INSURER E COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR ADD ISUBR POLICY EFF POLICY EXP ! N R TYPE OF INSURANCE -- INSR WVD -- POLICY NUMBER MM/DDIYYW MMIDDfYYYY_)l._ --LIMITS__ GENERAL LIABILITY EACH OCCURRENCE _ $ 1,000,000.00 DAMAGE TO RENTED 0 100,000.00 COMMERCIAL GENERAL LIABILITY PREMISES (Ea occqrrence)__, _$_ A ❑ ❑ CLAIMS -MADE O OCCUR S111004B230292 _MEO EX_P (Any one person) $ 5,000.00 ❑ 06/06/2019 06/06/2020 PERSONAL BADVINJURY $ 1,000,000.00 - -. ... ........ _ -----—._.—.�----- -- ❑ GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER ( PRODUCTS - COMPIOP AGG $ 2,000,000.00 POLICY [PRO- LOC � $--------.....----- ❑ _� Mrr, ❑ AUTOMOBILE LIABILITY Ea ccident ""'- """' BODILY INJURY (Per person) $ 25.000.00 ❑ ANY AUTO B ALL OWNED SCHEDQ AUTOS ❑ AUTOS 07830742-0 07/05/2018 07/05/2019 BODILY INJURY (Per accident; $ 50,000.00 NON -OWNED ❑ HIRED AUTOS ❑ AUTOS _ _ PROPER YDwwAMAGE - Per cce t $ 25,000.00 EACH OCCURRENCE ❑ ❑ - _ ❑ UMBRELLA LIAR ❑ OCCUR $ ❑ EXCESS LIAB L) CLAIMS -MADE AGGREGATE $ ❑ DEl) ❑_.RETENTION _ ❑_WC ST TLI- 0 ER..., - -- --... ....... WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN--- ANY PROPRIEfOR/PARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED? (Myandatory in NH) If DESCRIPTION OF OrPERATIONS below NIA E.L.EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE — $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) GENERAL CONTRACTOR CERTIFICATE HOLDER MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 ACORD 25 (2010/05) OF CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD mmm 31MMY PATRONIS ~ CHIEF FINMICALOFFICER STATE OF FLORIDA Ass -� DEPARTMENT OF FINANCIAL. SERVICES <4 DIVISION OF WORKERS' COMPENSATION emnFiCATE OF ELECTLON TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW ,- f CONSTRUCTION INDUSTRY EXEMPTION This certifies that the indinndual fisted below has elected to be exemPt from Florida W°rkeW Co^ Dn law' i o EXPIRATION DAZE: 10262019 -EFFECTNE DATE: 102612017 R PERSON: AL,MAGUER ASEL mm 208158558 BUSINESS NAME AND ADDRESS: y ' A A RELIABLE CONSTRUCTION INC 1679 NE VAITH ST MIAMI FL 33162 F BUSINESS OR TRADE: Licensed General ContiROOM � yaaift at Skiers" and Drlr•rs who Bled• a+aen0�^ from thb c1�aDtar br 1ws • ° d etadia+ under Pursuant q t s mo pson m t CeWta d etewa+ b be exemyA •• •DWr IMPORTANT: Pursuant to Chaim µ0.OS(14), F, under this ChWW- p�ueM b Ch$VW 4/0-%('3). F.S.. %Oooea d abdim b be �. Otis section may not reoover benetita or com rioted on the aotio• d election to be ` '"Pattar tl» t7rw d th• now* or the bwwm 011 the 0eNnats.00 only within the soope of the b Ahms or trade cation It at any d a aNt Tln daP 'a shaA revoha • exempt and oertiricetes of election to be e>abn •r• brKw � mquYento 0,* ft section tr to a US sedloa person named on the notice or oertl�• named on the oettirit�t• Certificate at any tune for 4ariule of the person o1>ESZ�s? l>sso�►l�-tec DFS-F24DWC-252 CERTIFICATE OF ELECTION TO SE EYRJAPT R1EVISED W13 ` Scanned with CamScanner A A Reliable Construction Inc. 1679 NE 1741" St North Miami Beach,FI 33162 Date: June 22, 2019 State of Florida County of Miami Dade Before me this day personally appeared Abel Almaguer who,being duly sworn,deposes and says That he will be the only person working on the pro- ject located at 1209 NE 96th ST Contractor Signature Sworn to and subscribed this 22 day of June,2019 Subscribed nd !--fore me, this _ 2b2' v �fic U 2D1 a Notary s„�ox3 �p``ti day of -- te County, czouoz,�s WWoo �w in and for j_Q zsL.ers oo e,ewlae State of ? sauel!W q�d Ns1oN Bpuol� W e4�►S /� iJ TAiq at re) Notary Public State of F1041 M MI20GG 23 g26752 anes My Commission expire 88fbaf2 �m *B1,2 +„ � ExO1reg � Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner -Workers' Compensation Insurance Exemption 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 i£ 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 firopi the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU A�" YEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. // 1 � Signature: V�_ State of Florida County of Miami -Dade The foregoing was acknowledge before me this !2 2 day of U_U "E , 20—(—C]—. By 14 if ! D �Ii 4 1 ✓ tq who is personally known to me or has produced L'D L—A P as identification. Notary: SEAL: 1"00 f� Notary Public State of Florida Barbara M Wanes • My Commission GG 326752 jpw� Expires04122/2023 IMlssl2n: To protect, promote & improve the health of all -people in Florida through integrated stale, county & community efforts. yy 1yyyyy�����(tt�����vyyvv yyy HEALTH Vision: To be the Healthiest State in the Nation July 05, 2019 (AA Reliable Const Inc) 1679 NE 174 Street Miami, FL 33162 RE: Contingency Letter Application Document No: AP1421080 Centrax Permit Number: 13-SC-1970489 OSTDS Number: 1209 NE 96 St Miami, FL 33138 Lot:15 Block:83 Subdivision: Ron DeSantis Governor Scott A. Rivkees, MD State Surgeon General Dear Applicant: This will acknowledge receipt of an application dated 06/27/2019 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. Reviewed on 7/5/2019 by Gerard Philizaire. No objection for Driveway construction. NO BEDROOM ADDITION. NO FLOW INCREASE. From a review of your completed application, it has been determined that your existing system appears to meet the minimum standards of F.A.C. 64E-6 for the proposed use. It is approved for use with the plans submitted to this office. If this system should fail, causing an unsanitary condition to exist, steps must be taken to bring the system into compliance immediately. Department approval of the 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 approval requires the applicant to modify the permit application. Such modification may result in this approval being made null and void. Issuance of this approval does not exempt the applicant from compliance with other Federal, State, or Local Permitting required for development of this property. If you have any questions on this matter, please call our office at (305) 623-3500. Sincerely, Gerard Philizaire, Environmental Manager Florida Department of Health www.FloridasHealth.com in DADE COUNTY TWITTER:HealthyFLA 1725 NW 167 St, Opa Locka, FL 33056 FACEBOOK:FLDepartmentofHealth PHONE: (305) 623-3500 . FAX: (305) 623-3645 1 YOUTUBE: fldoh 4 E REC MAP OF BOUNDARY SURVEY LOT 17 BLOCK 83 NORTH SCALE: 1"=20' i --1-1mm, S—hlla ones Vige 1 DA APPROVED 117041IG DEPT ll JUN 2 12019 I FIR 1/2 I I- 9.4'ASPmT N89°38'34"E (C) W ALLEY • 1tj PAVEMENT • �nno�Q�G>w11C /AA\ 7� nn� r5 REMAINDER OF LOT 16 BLOCK 83 I I 1 ^ U� 0 ff% cM M „I'nl(F WITH At' FFDFRAL I, ., rS nrl� !�' nl 11 nTlc 0 o M O N O F, o BLOCK NO ID. O a 0.20 -.-__ I ZZ / EAST 1r1: FL T 18BLOC 83 ! 1ti j N I I 1 O J '0 5.0 PE 38.1' 9F05GL 30.0' o LM I 04 ATc Z N .r 4.0 O . 14,7' LOT 15 F BLOCK 83 I TWO STORY CBS J RES. # 1209 _ 22.0'-- -- ao m 15.4' l'2 a Cc 1 ' 2 L r N N z� " I l15 Z 4.0' Y ABBREVIATIONS: FIP i/z" A-ARCOISTANCE AIC • AIR CONDITIONER PAD AE • ACCESS EASEMENT SM -BENCH MA K SOB - OASIS OF BEARNGS CBS CO BLOCK aSTUCOD e C -CHORD LOT 14 06 - CATCH SAWN BLOCK 83 CHO ORD BEARING CCIGG. CURB & GUTTER CLF -CHAIN LINT FENCE CONIC - CONCRETE OE - DRANAGE EASFMMT ONE - DRAINAGE 6 MAINTENANCE EASEMENT DIW - DRWWAY EAS.•EASEMENT END, - ENCROACHMENT EW - EDGE OF WATER FDH - FOUND DRILL HOLE FF - FINISHED FLOOR ELEVATION Fr -FOUND IRON PIPE . FIR - FOUND PON ROD FN - FOUND NAIL (NO ID) FND - FOUND NAIL & DISK FPL ■ FLORIDA POWER 3 UGHT TRANSFORLERPAD 9AFIIE • INSTALLATION AND MANTE NANCE OF FIRE HYDRANTS. STREET LIGHTS AND GUARD RAYS EASEMENT . V AMD)OWMIAMUMSCOUNTY RECORDS MH -MANHOLE 0 ML - MONUMENT LYE O 018.OFF4ET 01) -PLAT MN M PPCC - PONT OF CURVATURE r r POP - PERMANENT CONTROL POINT Uj LU PE - POOL EQU6 4ENr PAD 0 PAGE pi - FONT OF wTER4EOT10N 0 N PK-PARKIRKAE1.ON(9URVEYNAW PL -PLANTER ON POD-PPOOINTOF� 0 0 PRO - PONT OF REVERSE CURVATURE O PR1A - PERMANENT REFERENCE MONUMENT Z PT -POINT OF TANGENCY Z R -RADIUS DISTANCE (R) -RECORD RAN - RIGHT OF WAY REB. - RESIDENCE SIP -SET IRON PIPE END - SET NAIL &OISK(PK) STL - SURVEY TIE LINE SWK - SIDEWALK 1YPICAL 1UTYJTY SOD( ME -UTYmEASEMENT wW/R a WOOD FENCE 10.00' �pe—I 1-' 6.SWtK. FIP 1lY..: 7a ao' F" 000'00.''E . 75.OfJ' W. Z:. �Le DTw, O' . 4-800: N90VO'00"E 28' ASPHALT NE 96fh STREET PAVEMENT 80' R/w CM%ICATE OF AU'MOSILITK sustrc z aurvay4ng 8L rna(ptainl 15190 SW 136th Street, Suite 20, Miami, Florldl Tel: 306.596,1799 Fax: 306.596A886 PLAT IMAGE: NOT TO SCALE T . • . /1� 1r � Iq i�,. to 11 30 ►1 1Trs '7. 1v s 14 'I 1209 NE 96TH STREET, MIAMI SHORES, FLORIDA 33138 LEGAL DESCRIPTION: LOT 15 AND THE EAST h OF LOT 10. BLOCK 83, MIAMI SHORES ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK OF THE PUBLIC RECORDS OF MIAMI-DADS COUNTY, FLORIDA. FLOOD ZONE INFORMATION: BASED ON THE FLOOD INSURANCE RATE MAP OF THE FEDER MANAGEMENT AGENCY REVISED ON 00/11/09 AND INDEX MAP REVISE THE GRAPHICALLY DEPICTED BIA DINGS) SHOWN ON THIS MAP OF 51 ZONE AL BASE FLOOD ELEVATION IL COMMUNITY NAME & NUMBER y1 %jQ f'S 120a52 MAP & PANEL NUMBER 19O[iSC03Oa SUFFIX L SURVEYORS NOTES: • • • • 1. ELEVATION WHENSHOWN RE�•Tj)•1�29 NAT19tl�` ETIC (NOVD 1929);?VIZ .• • • 2. NO ATTEMPT• AAS )BADE TOUTILITIES UNLFAICLCQg4I�-FOOTINGS/FOUNOM:ONS OF 3.. THE LANDS OHEERNEON H)<VE MOT BEEM A99TRMETED K MATTERS OF YQM06 411Y OTHER PARTIES, SUCH � E F�115, R RESERVATION4. THIS S. ETC- ONLY PLATTED EMENTS AR HEREON AND 15_t�LOj MNSFERASLE 16R AIWGNABWWPREPAREDOMR AND � TO TH� PARP. 5. THE INTENT S SURYEYT AS EAMMUNICATEO A9i'•r11E CERT11 FOR REAL-ES,TOTj•TWSACTiON Ofi.� PAGE REFINANCING) THIS TO BE USED FORSANYOTHER PU roli PARTY(IES��VRAOUT THE OF THIS FIRMP • • • .... • *W�Yi+'�� 6. THIS SURVEY IS NOT INTENDED FOR NEITH€R NOR PURPOSES _r- MESt -PURPOSES. A 1OPOGRAPHIC SURVGY MAY BE 7. ADDITIONS-_ QEEIE�IO NNS TO SURVEY MAPS OR REPORTS BY 0' i ISM WITHlUR•iIRITMEN CC -CENTERLINE PlABTK: ®-TELEPHONE RISER SIGNING PARTY OR P TES •Morg SIGNING PARK' OR P jR11ES. wy - WATER VALVE ®• CABLE TV RISER ®. WATER METER 8. IMPROVEMWTS 900 HAVE BEEN MEASURED T 1 TCA7}1E NEAR EST iODTA FC - CURB KiEi %DAD -ELEVATION (OD') - ORIGINAL LOT DISTANCE TIES HA47 BEER MEASURjjO ELEVATIONS WHEN SHOWN HAVE SEEM MEASURED Td NEARES 1007E HARD SURFACES AND NEAREST TEIiTM•DF A FOOT FOR GROUND OR ' -FRTEHYDRANT A -CENTRAL ANGLE 9. ALL BOUNDARY LUT INDICATORS SET ARE STAMPED LBO 7104. IQ THE BOUNDARY LIMITS ESTABLISHED ON THIS SURVEY ARE BASE( ' LIGHT POLE cm-LMUTYPOLE @ •DRAWAGEMANHOLE DESCRIPTION PROVIDED BY CUENT OR ITS REPRESENTATIVE. 11. FENCE OWNERSHIP NOT DETERMINED. -CATCH BASIN Q SEWER MANHOLE 12. BEARINGS WHEN SHOWN ARE TO AN ASSUMED MERIDIAN, THE CD 9M STREET HAS ASSIGNED A OF N 90V0'00' E - =ENCROACH ENT0 FENCE BOUNDARBEARING 13. TYPE OF SURVEY. BOUNDARY --O^--- _.-„—..— . WOOD FENCE —�—r CHANUNKFENCE �_ ... _-.... OVERHEAD UTiLrrY WIRE SURFACES. CERT/FIED TO: (A PAVERS BUILDING DAVID JATIVA AND ADREINA JARVA ® CADENCE BANK, N.A.ISAOA/ATIMA ZAPICO & ASSOCIA'TES, P.A. OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY TILES OR COVER1AaoN(sT: SURVEYOR'S CERIMCATE. I HEREBY CERTIFY THAT THIS SURVEY IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF AS RECENTLY SURVEYED AND DRAWN UNDER MY DIRECTION AND MEETS THE STANDARDS OF PRACTICE SET FORTH BY THE FLORIDA STATE BOARD OF SURVEYORS AND MAPPERS IN CHAPTER 5J-17 FLORIDA ADMINISTRATIVE CODE PURSUANT TO SECTION 472.027 FLORIDA STATUE SEAL AUTHENTIC COPIES OF THIS SURVEY SHALL BEAR THE ORIGINAL SIGNATURE AND JUAN A SUAREZ RAISED SELL OF TFE ATTESTING REGISTERED PROFESSIONAL SURVEYOR & MAPPER SURVEYORAND MAPPER STATE OF FLORIDA LIC. M6220 DATE ( JOB p FILE PR( SU CAD MLI PARTY Ch SI A • • • • • • • • • • • • • • • • • • • • • • • •• • • • •• ••• •• • • • • • ••• • •• • • •• • • • • • • • • • • • • • • • • • • •• •• • • • •• •• • • • ••• • • • •••