PL-19-1886Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 08/22/2019
Location Address Parcel Number
12 NE 96TH ST, Miami Shores, FL 33150 1132060130660
Contacts
Permit NO.: PL-08-19-1886
Permit Type: Plumbing - Residential
Work Classification: Drainfield
Permit Status: Approved
Expiration: 02/12/2020
CARLA CHUI LE Owner STATEWIDE SEPTIC CONNECTIONS Contractor
12 NE 96 ST, MIAMI SHORES, FL 33150 TERESA SOLOMON
13680 NW 19 AVE BAY#10, OPALOCKA, FL 33054
Business: 9549630082
Description: REPLACE DRAINFIELD Valuation: $ 4,000.00 Requests:
Inspection 305-4949
Total Sq 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
Check # 9792
08/16/2019 $50.00
Cash
08/22/2019 $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 required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: 1 certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating constru gion and zoning. Futhermore, I authorize the above named contractor to do the work stated.
nature: Owner / Applicant / Contractor / Agent Date
August 22, 2019 Page 2 of 2
0
Miami Shores Village RECEIVED
Building Department AUG 16 2 19
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949 �j
FBC 20
!
BUILDING Master Permit No. T U 0 & - I I 1��6
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [-]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
n /` (�-�- CONTRACTOR DRAWINGS
JOB ADDRESS: 1Z., N "1 l� 9 1 r�
City: Miami Shores County:DG•� Miami Dade Zip: 331,38
Folio/Parcel#: 1t'--
)Zo(o-yI3-aG6o Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fees Simple Titleholder):
Address:.[ 1 )- 1 '1 i:-' q Gr- `.�
> \ore-S State:
Tenant/Lessee Name:
Email:
ne#• � "� c6q g
ne#:
ko
CONTRACTOR: Company Name: skc�kf-- & O l��s' ��N �11�, Pho'nee#: `T-1
Address: 15690 N W 1,1� Ave, 1- to
City: Con
^ C Y—cl- (� State:
Qualifier Name: e,,ceSc- �i'� ��Y"L�7► Phone#:
State Certification or Registration #: S%(0 0 l qlo Z Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $43CbUD Square/Linear Footage of Work: 22 S
Type of Work: ❑ Addition ❑ Alteration ❑ New [ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tiler
Submittal Fee $ .,Permit Fee $ CCF $ WCC $ .
Scanning Fee $
Technology Fee $,
Structural Reviews $,
Radon Fee $
Training/Education Fee $
DBPR $
Notary $
Double Fee $
Bond $
(Revised02/24/2014)
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address 1\, ArA-
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 and a reinspection fee will be charged.
-6L
Signature Signaturc/�:�
C.
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day of Pwq v 120 10 by
Cam -le. Ck U ► who is personally known to
me or who has produced J--L� (r) as
identification and who did take an oath.
NOTARY PUBLIC:
Seal:
�00 Notary Public State of Fonda
Teyana Solomon
My COmMisslon GG 268U 1
p Expires 10117/2022
The foregoing instrument was acknowledged before me this nt
day of � ► q U's -f 20 1 C by
7e-►-es go Wr'% who is personally known to
me or who has produced F-1-�� b as
identification and who did take an oath.
NOTARY PUBLIC:
-� Sign:
Pri t
Seal:
e
1
APPROVED BY Yr / Plans Examiner
Structural Review
Notary Public State of Fonda
Teyana Solomon
My CORlmission GG 268841
ww Expires 10/17/2022
Zoning
Clerk
(Revised02/24/2014)
Property Search Application - Miami -Dade County Page 1 of 1
OFFICE OF THE PROPERTY APPRAISER
Summary Report
Property Information
Folio:
11-3206-013-0660
Property Address:
12 NE 96 ST
Miami Shores, FL 33150-0000
Owner
CARLA CHUI LE
REM VALENTINA VERDINI
Mailing Address
12NE96ST
MIAMI SHORES, FL 33150 USA
PA Primary Zone
1100 SGL FAMILY - 2301-2500 SQ
Primary Land Use
0101 RESIDENTIAL -SINGLE
FAMILY: 1 UNIT
Beds / Baths / Half
3/2/0
Floors
1 -
Living Units
1
Actual Area
1,838 Sq.Ft
Living Area
1,524 Sq.Ft
Adjusted Area
1,680 Sq.Ft
Lot Size
13,000 Sq.Ft
Year Built
1940
Assessment Information
Year
2019
2018
2017
Land Value
$389,620
$324,852
$324,852
Building Value
$116,928
$49,148
$116,928
XF Value
$2 197
$0
$2,253
Market Value
$508,745
$374,000
$444,033
Assessed Value
$381,106
$374,0001
$444,033
Benefits Information
Benefit
Type
2019 2018
2017
Save Our Homes
Cap
Assessment
Reduction
$127,639
Homestead
Exemption
$25,000 $25,000
Second Homestead
1 Exemption
$251,000 $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 1 AMD PB 10-70
LOTS 10 & 11 BLK 5
LOT SIZE IRREGULAR
OR 21010-3261 02 2003 1
COC 22266-0689 04 2004 1
Generated On : 8/16/2019
Taxable Value Information
2019
2018
2017
County
Exemption Value
$50,000
$50,000
$0
Taxable Value
$331,106
$324,000
$444,033
School Board
Exemption Value
$25,000
$25,000
$0
Taxable Value
$356,106
$349,000
$444,033
City
Exemption Value
$50,000
$50,000
$0
Taxable Value
$331,1 66
$324,000
$444,033
Regional
Exemption Value
$50,000
$50,000
$0
Taxable Value
$331,106
$324,000
$444,033
Sales Information
Previous
OR Book -
Price
Qualification Description
Sale
Page
30477-
Qual on DOS, but significant phy
03/27/2017
$440,000
1953
change since time of transfer
30113-
Qual on DOS, but significant phy
06/10/2016
$375,000
2326
change since time of transfer
22266
04/01/2004
$315,000
Sales which are qualified
0689
21010-
02/01/2003
$270,000
Sales which are qualified
3261
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:
https://www8.miamidade.gov/Apps/PA/propertysearch/
8/16/2019
1355 NW 97 AV SUITE 200
MIAMI, FLORIDA 33172
TCLCPHONE: (305) 264-2660
FAX; (305) 264-0229
''-?A WN BY: LG.
SURVEY No. 17-0000355-1
Evoun
LAND SURVEYORS SHEET No. 2 of 2
BOUNDARY SURVEY
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TITLE COMMITMENT NOTES: Sar��F Ml SI O DES LLAGim
', FD Lti� rlT+
That I have reviewed the commi(nJent and all (tern •-are shown2o71Ytte
The items shown here forth are per schedule Bll of Errs(`-�rit�an Title Insurance �? 0.00' I
Company Commitmenl File No:CHUI. Effective Date: February 27, 2G�br-1 A N and/o dr..airt�i�I�L R/W
RESTRICTIONS, DEDICATIONS, CONDITIONS, RESERVATIONS, EASE }'On and I
OTHF..R MATTERS SHOWN ON THE PLAT. no fln�i op ` y
Items No 10 Affects Subject Property. Shown on Survey.As recorded in F'.6.10 G.
TERMS AND CONDITIONS OF THE AGREF_MEN7 FOR WATER ANDn�W�I���� �1 IS restored,
FACII ITIES 13ETWEEN MIAMI-OADE COUNTY. and repaired.
Items No 11 Affects Subject Property. Not Plottable. As recorded in l2%ij(5 �•
SUR vrvnu'S NOTE:
. •ri.., of this Survey is I'nr Use in obtaining 'Title insurance and vinanc�nF an
u cLunlrl not be ❑sod Ibc (_pnfitl'UCt10n pUrNOSes.
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
PERMIT #:13-SC-1978868
APPLICATION #:AP1426271
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT # : PR1247387
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Carla Chui -
PROPERTY ADDRESS: 12 NE 96 St Miami, FL 33150
LOT: loll BLOCK: 5
SUBDIVISION:
PROPERTY ID #: 11-3206-013-0660 [SECTION, TOWNSHIP,
RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
ma CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS
381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT
SATISFACTORY APPROVAL •• �F' SECTION
PERFORMANCE FOR ANY SPECIFIC PERIOD OF OF SYSTEM DOES • NOT • GU WHICH SERVED AS A BASIS TIME. Ai�iFi
FOR ISSUANCE OF THIS PERMIT, ANY Cf�GE••.TN MATERIAL FACT$*•
PERMIT APPLICATION. SUCH MODIFICATIONS REQUIRE THE ANLICANT sp ••
ISSUANCE MAY RESULT IN THIS PERMIT •••• •• �iGDIFY•••
OF THIS PERMIT DOES NOT EXEMPT BEIIC •MADE AND STATE, OR LOCALTHE APPLICANT FROM •••••• NULL• VOID. •
PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY, CO QTHE FEDI••�
• • ••�•••
SYSTEM DESIG=ND •••• • •••••
SPECIFICATIONS •
•••••• ••••
] GALLONS / GPD •• •• •• • ••••••
A [ 0 Existing SeDtiC to remain CAPACITY • • • • • • • • •
] GALLONS / GPD
CAPACITY • • • •
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY • • • • ••••••
[MAXIMUM ••••••
K [ ] GALLONS DOSING TANK CAPACITY CAPACITY SINGLE TANK: 25
[ 1 O•Ci�LLON$] :••••0
]GALLONS @[ ]DOSES PER 14 HRS �itij¢s [ • ] •
D [ 225 ] SQUARE FEET NEW Drainfield in Trench SYSTEM
R [ 0 ] SQUARE FEET
A TYPE SYSTEM: SYSTEM
[X] STANDARD [ ] FILLED I CONFIGURATION: [x] TRENCH [] MOUND []
N [ ] BED [ ]
F LOCATION OF BENCHMARK: FFE 12.85 NGVD
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED: [ O.oO ] INCHES
[ 25.40 ] [ INCHES FT ] [ ABOVE BELOW BENCHMARK/
[ 73.44 if INCHES ET ] [ABOVE BENCHMARK/ REFERENCE POINT
1.-invert elevation and Bottom of drain field to be 7-less than 7.23' & 6.73' NGVD respectively. HEs
° 2--EXISTING 900 gal. septic tank with and approved
T 3.- Install a NEW 225 sf. of drain field in TRE/NCHconfiigurratfilter TO on.REMAIN.
H 4.- Install 12" of slightly limited soil at the b tt
9 om of the drain field 5.- Perimeter of excavation area shall begat least 2 ft wider �d� or nger than the proposed absorption trench.
E 6-The licensed contractor installing th4ystem is responsible for installing the minimum category of tank in accordance
R with s. 64E-6.013(3)(0 FAC.
SPECIFICATIONS BY: "
St e JYid
TITLE:
APPROVED BY:
DATE ISSUED:
DH 4016, 08/09
Incorporated:
TITLE: ENGINEERING SPECIALIST II
Fra tz,C'7% f e a nt Dade
08/� 9 CHD
EXPIRATION DATE: 11/05/2019
F(Obsoletes all previous editions which may not be used)
64Er6 003, FAC
v 1.1.4 Page I1 of 3
AP1426271 SE1196645
DOCUMENT #: PR1247387
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.
Ilnstall a new drainfield to achieve Drainfield size requirement.
•
•••.••
•.••
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR CONSTRUCTION PERMIT
Permit Application Number----,,
Le
------ �O.-�-_ -s_--
PART II - SITEPLAN - - - - =� - �
Seale c - - - - - - - -
Notes: —
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Site Plan submitted y:
Plan Approved Not Approved
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
(Stock Number: 5744-002-4015-6) Page 2 of 4
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