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RC-17-1473B PERMIT APPLICATION M1ami Shores Village RECEIVED Building Department JUN 02 117 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 201A Master Permit No.F, cil - III -I S Sub Permit No. *BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [-]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 278 NE 103rd Street, City:_ Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3206-013-4860 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee simple Titleholder): HB GROWTH PROPERTIES LLLP Phone#: 954-774-4616 Address:17071 W DIXIE HWY City: MIAMI State: FLORIDA Zip: 33160 Tenant/Lessee Name: Vacant Phone#: - Email: CONTRACTOR: Company Name: Casanueva Development Corp. ' Phone#: 305-525---3707 Address: 717 Ponce De Lean Blvd #220A City: Coral Gables state: Florida 33134 Qualifier Name: Ricardo Casanueva Phone#: 786-354-6816 State Certification or Registration #. CGC 1511245 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: pCity: State: Zip: Value of Work for this Permit: "� � eee. I Square/Linear Footage of Work: jl 1;?1G, 1 Type of Work: ❑ Addition 0 Alteration ❑ New ❑ Repair/Replace ❑ Demolition Specify color of cakr thru tile: Submittal Fee $ Permit Fee $ 8 CCF $ �' CO/CC $ ' 0 Scanning fee $ - GJ _ Radon Fee $ 14 . _74-r— DBPR $ Technology e $ ZCc Training/Education Fee $ Stru ral Reviews $ C� i Z6 - ao _ --r" -4vIUJ,<X) (Revised02/24/2014) Notary $ Double Fee $ _ CA-3 Bond $� TOTAL FEE NOW DUE Z/ 9-,sq . 32— V J Bonding Company's Name (if applicable) Banding Company's Address City State Mortgage Lender's Name (if applicable) _ Mortgage Lender's Address City State Zip Zi 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. 1 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 wi!i 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 commence t be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. a absence a such posted notice, the inspection will not be approved and a reinspection fee will be charged OWNER or CONTRACTOR The fore oing instrument s ackno ledged before me this The forego. g instrument f as ackn wledged before me this day of Q 20 1 �- by da of ZO _ _ l . by who ' rsonaii ho i rsonally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: —12 Seal: sssssss*sss*ssss+ APPROVED BY (Revised02(24(2014) ' �� MY COMMISSION AG079431 I EXPIRES: MAR 06, 2021 " Bonded through 1st State Insurance as me or who has produced as identification and who did take an oath. NOTARY PUBUCn Print: I Seal: MY COMMISSION #FF991944 EXPIRES: MAY 12, 2020 °i'O Bonded through 1st State Insurance *sssssssssassssss*sssssssssssssssssssss***ssssss**ssssss*sssss Plans Examiner Structural Review Zoning Clerk CASANUEVA DEVELOPMENT CORP. ADDRESS: 717 Ponce de Leon Blvd #220-A, Coral Gables, FL, 33134 Phone:(786)-354-6816 Email: venturaconst2000@aol.com To: HB GROWTH PROPERTIES LLLP 17071 W DIXIE HWY, MIAMI , FL, 33160 PROPERTY ADDRESS: 278 NE 103RD STREET, MIAMI SHORES, FL DATE: 03/16/2017 DESCRIPTION 4 CONTRACT TOTAL BUILDING: $ 20,000.00 - Building contract based on plans provided with the inclusion of- - Trusses, kitchen remodel, flooring, sheetrock and painting. - Labor & materials included. ELECTRICAL: $ 5,200.00 - Electrical work needed based on plans. - Labor & materials included. MECHANICAL: $ 4,000.00 - Change -out existing unit (3.5Ton). - Repair duct work. - Labor & materials included. PLUMBING: - New plumbing work as requested in plans provided. - Labor & materials included. �i1�1/I r A 1 PROPERTY 0, $ 2,800.00 $ 32,000.00 LIMITED POWER OF ATTORNEY Know All Men by These Presents, that HB Development Properties LLLP, a Florida Limited Liability Limited Partnership, ("Property Owner") have made, constituted and appointed, and by these presents does make, constitute and appoint Juan Morales lawful attorney forthem and in their name, place and stead. Giving and granting unto Juan Morales full power and authority to do and perform all and every act and thing whatsoever requisite and necessary to be done to ➢ making and terminating contracts with respect to any and all utilities (including electricity, gas, water, and waste management) for residential real estate owned by Property Owner ("Residential Property"); ➢ communicating and acting on Property Owner's behalf with respect to all homeowner's association matters relating to a residential property; ➢ signing Notices of Commencement associated with roof work; ➢ filling out, signing, and registering documents related to resolution of construction liens; and ➢ registering and filing out documents with respect to Residential Property with any and all applicable authorities with jurisdiction over matters affecting the Residential Property; provided, however, that no power is granted hereunder to encumber any Residential Property or take any action that would be adverse to the interests of the Property Owner or any of its officers, members, or affiliates This limited Power of Attorney will remain in effect until December 31, 2017, unless earlier revoked by Property Owner upon notice. The authority granted to the Attorney -In -Fact by this Limited Power of Attorney is not transferrable to any other party or entity. In Witness Whereof, we have hereunto set our hands and seals on this 19th day of September 2016. Signed, sealed and delivered in the presence of: Witness Signature - I . '-^ 4----�=�_0 Witness Printed Signature STATE OF FLORIDA COUNTY OF BROWARD HB Development Properties LLLP a Florida Limited Liability Limited Partnership The foregoing instrument was acknowledged before me this 19`h Day of September 2016 by Bartosz Uzarowski, as Manager for Development Properties LLLP, a Florida Limited Liability Limited Partnership. He i ersonally know to me or has produced as identification. JULIANA GOMEZ MY COMMISSION #FF10f644 EXPIRES March 13 2f?'rc . ......,....-r-------------- ---------- ---------------------- tso� ass otsa FloridallotaryService.com — otary Public, State an county aforesaid Notary Printed Signature Detail by Entity Name , Page 2 of 3 Detail by Entity Name Florida Limited Partnership HB DEVELOPMENT PROPERTIES LLLP Filing Information Document Number A14000000653 FEI/EIN Number 30-0848360 Date Filed 12/01/2014 State FL Status ACTIVE Principal Address 17071 W Dixie Highway North Miami Beach, FL 33160 Changed: 04/21 /2015 Mailing Address 17071 W Dixie Highway North Miami Beach, FL 33160 Changed: 04/21 /2015 Reqistered Agent Name & Address IWLCHMAN, CHARLES Z, ESQ. 17071 WEST DIXIE HIGHWAY NORTH MIAMI BEACH, FL 33160 General Partner Detail Name & Address Document Number P12000076069 EAGLE RHGP, INC. 17071 W Dixie Highway North Miami Beach, FL 33160 Annual Reports Report Year Filed Date 2015 04/21 /2015 2016 03/27/2016 2017 04/20/2017 Document Images 04/20/2O:f...::.-._ntJNUAL._REf C7,PT View image in PDI format 0z272016 -- ANNUAL REPORT I View image in PDF Format 04,21i2015ANNUAL. REPORT View image in PDF format 12/01/2014 -- Domplic LP View image in PDF format Fio' , Dr art'-' of S are, L`-1 n -. _ a i...i- http://search. sunbiz.org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 5/30/2017 Detail by Entity Name Page 3 of 3 http://search.sunbiz.org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 5/3 0/2017 Detail by Entity Name Page 1 of 2 Fforida DIpartpl,nt of State tr' li,r IC Department of State / Division of Corporations / Search Records / Detail By Document Number / Detail by Entity Name Florida Profit Corporation EAGLE RHGP, INC. Filing Information Document Number P12000076069 FEI/EIN Number 46-0981421 Date Filed 09/06/2012 State FL Status ACTIVE Principal Address 17071 West Dixie Highway North Miami Beach, FL 33160 Changed: 02/05/2015 Mailing Address 17071 West Dixie Highway North Miami Beach, FL 33160 Changed: 02/05/2015 Registered Agent Name & Address Kalchman, Charles Z, Esq. 17071 West Dixie Highway North Miami Beach, FL 33160 Name Changed: 02/05/2015 Address Changed: 02/05/2015 Officer/Director Detail Name & Address Title President, Secretary NAHON,JAMES 17071 West Dixie Highway North Miami Beach, FL 33160 Title VP, Treasurer LIZAROWSKI, BARTOSZ DIvISi WN PF GORP{)R.AY:DNS http://search.sunbiz.org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 5/3 0/2017 . Detail by Entity Name Page 2 of 2 17071 West Dixie Highway North Miami Beach, FL 33160 Annual Reports Report Year Filed Date 2015 02/05/2015 2016 03/27/2016 2017 04/20/2017 Document Images 04/20/201 7 -- ANNUAL REPORT View image in PDF formal 0327,'2016 -- ANNUAL, :fZEPF2T View image in PDF format 02/05/2015 -.ANNUAL REPORT View image in PDF format 01QW2014 --ANNUAL REPORT View image in PDF format 0312412013,.::::._t�NN.*) REF'S3T View image in PDP' format 09106/20'12 -- Domp-fic Profit View image in PDF forma( http://search. sunbiz.org/Inquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 5/30/2017 Detail by Entity Name t Page 1 of 3 Florida Department of State Department of State / Division of Corporations / Search Records / Detail By Document Number / L''IVI''S; ON Of CORPORA= ONS http://search. sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 5/30/2017 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 BUILDING Master Permit No. PERMIT APPLI ATION ❑BUILDING ELECTRIC ❑ ROOFING Sub Permit No. ❑ REVISION ❑ EXTENSION [--]RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: �J N1 L / 9 ri .{{— r`eQ-F s City - 5 k6iWiami Shores County: L>At)6 Miami Dade Zip Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Types KOZ- Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder):x & 46 i0etle % t9MQy p Phone#:W Address: 27Z PC N 3 S'r rp e ( City: N . SS A 6 Ilc�i State: Zip: Tenant/Lessee Name: Phone#: Email: f CONTRACTOR: Company Name: �iL°' iiP> �! G G Y/, t-1 S`Ep/ / _� Phone#:-4i �ZS S 8 7 �j Address: 1 SO.5-a Azt 0-0 AVF, 14 tl6� i City: /Vl6 State: f L, Zip �/j Qualifier Name: e Phone#:.20,1" ✓�7 State Certification or Registration M,4j C %g U /Z It 2_6 Certificate of Competency M DESIGNER: Architect/Engineer: Phone#: Address: City: State: — Zip: _. Value of Work for this Permit: $4/0 !S Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: Submittal Fee $ Scanning Fee $ Permit Fee $ Radon Fee $ .-T CCF $ CO/CC $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ r TOTAL FEE NOW DUE $ (Revised02/24/2014) -kIrmS C\9p S�YKa1U`� �srfi MG1t{.h ?,cat� 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." 4 Notice to Applicant: As a condition to the issuance of a building permit with an estimate%vcee ing $250'the applic t-must promise in goodfaith that a copy of the notice of commencement and construction liwill be dells o the person whose property is subject to attach Iso, a certified copy of the recorded noti omu posted at the job site for the first inspection which o rs sev n (7) days after the building permi iss d.ce of such posted notice, the inspection will not be approve gad -a re' spection fee will be charged. ER or AGENT The foregoing instrument as acknowledged before me this I Yday of U �l� 20 by MOkho is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: APPROVED BY 110A P le I/ CONTRACTOR The foregoing instrut was acknowledged before me this ;4V day of t)9 20 17 by dM A—V '7-V(7Rd e'gao is personallyknownto me or who has produced 01,4 6#f/' identification and w o did take an oath. NOTARY PUBLIC: Sign: Print: Seal: Plans Examiner ,rt Zoning (Revised02/24/2014) Structural Review Clerk U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008 Varional Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date: July 31, 2015 SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name PROP CAPITAL MANAG. Job 09-482-14 JV Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAIC Number: 278 NE 103 ST. Fol.11-3206-013-4860 City MIAMI SHORE State FL ZIP Code 33138 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 3 & E 1/2 OF LOT 4, Block 36, "MIAMI SHORES SECTION 1", PB 10, Pg 70, of Miami Dade County FL. A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitude/Longitude: Lat. 25°52'10"N Long. 80°1V31"WHorizontal Datum: ❑ NAD 1927E 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 11=A A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage 220.0 sq It b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in d) Engineered flood openings? ❑ Yes E No d) Engineered flood openings? ❑ Yes E No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B4. Map/Panel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 12086C 0302 L 09/11/2009 Effective/Revised Date Zone(s) AO, use base flood depth) 09/11 /2009 X N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ❑ FIS Profile E FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item B9: E 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 E No Designation Date: N/A ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings` ❑ Building Under Construction' E 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: D-159 ELEV. 10.32' Vertical Datum: NGVD-1929 Indicate elevation datum used for the elevations in items a) through h) below. E 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) 12.15 E feet ❑ meters b) Top of the next higher floor 12.60 E feet ❑ meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A. ❑ feet ❑ meters d) Attached garage (top of slab) 10.36 E feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 10.91 E feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 10.41 E feet ❑ meters g) Highest adjacent (finished) grade next to building (HAG) 10.48 E feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A. ❑ feet ❑ meters 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. 1 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. E Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ❑ Check here if attachments. licensed land surveyor? E Yes ❑ No Certifier's Name ARMANDO GARCIA License Number 3109 Title PROFESSIONAL SURVEY Company Name Address 8567 CORAL WAY City MIAMI State FL ZIP Code 33155 Signature Date 09-16-14 Telephone 786-290-4184 O _ t FEMA For -33 ( See reverse side for continuation. Replaces all previous editions :TVED MAY 112016 B'Y': ELEVATION CERTIFICATE, page 2 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: 278 NE 103 ST. Fol.11-3206-013-4860 Job 09-482-14 JV City MIAMI SHORE State FL ZIP Code 33 Company NAIC Number: SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments CROWN OF ROAD ELEVATION = 10.88' C(2) E A/C CONDENSER CONC. PAD LOCATED BESIDES THE SOUTH WALL OF THE HOUSE LAT. & LONG BY GOOGLE EARTH SYSTEM. Signature Date 09-16-14 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 ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ 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 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ 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's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑ Check here if attachments. 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 :71 G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters 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 ❑ Check here if attachments. FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. 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: 278 NE 103 ST. Fol.11-3206-013-4860 Job 09-482-14 JV City MIAMI SHORE State FL ZIP Code 33138 Company NAIC Number: 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. Photo ra hs date taken:09/16/14 HOUSE NUMBER VIEW FRONT SIDE VIEW LEFT SIDE VIEW RIGHT SIDE VIEW u FEMA Form 086-0-33 (7/12) Replaces all previous editions. I ELEVATION CERTIFICATE, page 4 Building Photographs Continuation Page 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: 278 NE 103 ST. Fol.11-3206-013-4860 Job 09-482-14 JV City MIAMI SHORE State FL ZIP Code 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. REAR SIDE VIEW IREAR SIDE VIEW IREAR SIDE VIEW I I� FEMA Form 086-0-33 (7/12) Replaces all previous editions. N Scale 1"=20' is WE I EDGE OF PAVEMENT EDGE OF PAVEMENT F GIr 'J8 U 3 NV �0 N.E. 1 0 3 r d ST. 26' ASPHALT PAVEMENT 75' PUBLIC RIGHT-OF-WAY 24.00 -� - — M 10.00' SOUTH RIGHT-OF-WAY LINE 20' PARKWAY 5 CONIC SIDEWALK FIP 1/2" 8.00' 3' i 890 FIP 112" NO I.D. ��. NO LD. NO .0 w CONC.' z CONIC. o DRIVEWAY — N _J o, WALK 0 M W O \� i_J PLANTER lug 1.49' CL� , .72' 22.55' 'oCONC:. 2.60' $ p an FURCH $ GARAGE 14.60' 3.20' CL 10.36' in n i C I 1-STY RH.�S. #22 REMAINDER r 9•56' 60' _ * LOT-2 LOT-4 c I Cea= ±1. 803 sq. * BLOCK-36 BLOCK-36 11.76' tO 10.44' 16.45' b 45, I M N �( WOOD L.F.E. 12.15' m mDECK i y� 17.36' 5.77 2' ' I` w LJ zLL I PLANTER- o , LOT-4 I LOT-3z r BLOCK-36 J BLOCK-36Z - I v w a z xUJ 10 25.00' CO TH E EAST 1/2 Land Area= ±8,540 sq. ft. _ ±0.20 acres 1.65' CL--�14' CHAIN LINK FENCE 1.65' CL 33Q IY 30 wtt O -- OE OE OE OE IP 112' NO I.D. $ v v NO I.D. ,i 17 1 5 ' ALLEY 8 ui I o 9' ASPHALT PAVEMENT G I LOT-20 LOT-21 LOT-22 BLOCK-36 BLOCK-36 BLOCK-36 BLOCK CORNER FIP 112" NO I.D. w 3. V 4 L = M N W Z I'DRO:P F'T;' SS BENCH MARK USED o W 278 N.E. 103 STREET m x U MIAMI SHORE, FI. 33138 BM #D-159, Elev.= 10.32' 1 ° Z ( FOLIO No. 11-3206-013-4860) converted to NGVD 1929. W;1 1 � _-------- -- - W w �¢ 'L i~ p W DESCRIPTION - Y z w ° aft 31 N... 1 0 3 r d T. a i °a w w a In Lot 3 and the East 1 of Lot 4, Block 36, of av = "--- sTR ET - — W �W mw � W W I�._ "MIAMI SHORES SECTION 1" according to I : _ 1'� r �" ' Z 5�5 r� 5 3 `3 Inc c �.. the Plat thereof as recorded in Plat ` m! L. T_ " " "w " W Book 10, at Page 70, of the Public .4 I,o �[< w M a Records of Miami -Dade County, Florida. t . r ; :ri - I j . , HIM 7TR E1;T There may be legal restrictions on the subject Y I j - i o SIeI, c property that are not shown on the Ma of Surve I a— ll that may be found in the Public Records of h'® ( I I I K z Tr- w o a „ is ie nrec e Miami -Dade County, or the records of any other h n e I ; �; ,, I z r a. W ? Y z" . J aZ az public and private entities as their jurisdictions .T s Y-CC t w LU 3 Z Y may appear. _ ° z z s 'G y'.�j aa, .. c ealF�l W-u a�,c 9 U,I'IR aO 0O�NO3U♦-O The Map of Survey is intended to be displayed at r g r. I I,._�� _ w w ww w the stated graphic scale in English units of � a 9 a ;I a u 7 re y :c s »'- :1° �6 ' e M Z n u n n u n n u u u u measurement. Attention is brought to the fact that ,' �n,� 5,, . .. _ . 0 � � m 9 �� said drawing may be altered in scale by the 8 W 3 W - art+ 5TREE.T' Q a� mNm h reproduction process. -` - ' " N This Survey was conducted for the purpose of a W ' w BOUNDARY SURVEY only and is not intended to LOCATION MAP (NOT TO SCALE) • • • o• delineate the regulatory jurisdiction of any federal, • • m • • �• of'i• • • • state, regional or local agency board, commission • Im •_• • W z i or other entity. If shown elevations are referred to N.G.V.D. �29 Q . 4E •z L) •••••• •• > •J J •C• •• Legal description was furnished by the client. The surveyor makes no representation as to 0 0 0 ; • W a • W • The elevations of well -identified features as ownership, possession or occupation of the W g. v Z. • tie • • subject property by any entity or individual. •""o � ; • i %- ° depicted on this survey and map were measured • • • • � w ° i J U o Y W • W • to an estimated vertical positional accuracy of 1/10 Subsurface improvements and/or encroachrrmts• •. vZ Lu �o In • : • foot for natural ground surfaces and 1/100 foot for within, upon, across, abutting or adjacent to ft • • •' LL �� ZAN W w hardscape surfaces, including pavements, curbs subject property were not located and are not shown. O 7 o o > g W � ii• g 4z z o a a a a • and other man-made features as may exist. : • • : 0 : 0 " " 11 " 11 11 11 11 Not valid without the signature and original raised • Z • y a • � • • • Well -identified features as depicted on this survey Mapper. 111 oX. seal of a Florida Licensed Surveyora a �' • and map were measured to an estimated and M per. • Additions and deletions to this Map Survey oCO • • • • • horizontal positional accuracy of 1/10 foot unless 0 otherwise shown. other than the signing party are prohibited without W t 0.0 • . the written consent of the signing party. _I W Legal Description subject to any dedications, W LJ W o W limitations, restrictions, reservations or recorded This Map of Survey has been prepared for the g �'� W J z a Ir easements. exclusive use of the entities named herein and a o o o � z Sketch of Survey cannot be used for construction the certification does not extend to any unnamed party. W X M ° >- purposes. Surveyor not responsible for third party z z z W w M W� z= m= alterations. CERTIFY TO. °U w w LL o o O J �� , it It II 11 LIST OF POSSIBLE ENCROACHMENT: II PRO CAPITAL MANAGEMENT LLC _ _.. _ O a w w u li LL o d U L) - a a SURVEYOR'S CERTIFICATION z Z m o W, z I HEREBY CERTIFY: THAT THIS "BOUNDARY SURVEY" = o LL W z m W Z U, AND THE MAP OF SURVEY RESULTING THERE FROM o , o w o z WAS PERFORMED UNDER MY DIRECTION AND IS w p ? _ c~i° w J Six TRUE AND CORRECT TO THE BEST OF MY o � o o z z 2E J7J Ot-S W KNOWLEDGE AND BELIEF AND FURTHER, THAT SAID ¢ a a m m c6 U rno c� 00 ::BOUNDARY SURVEY" MEETS THE INTENT OF THE II It 11 II II II II W m "MINIMUM TECHNICAL STANDARDS FOR LAND o �q m = " SURVEYING IN THE STATE OF FLORIDA", PURSUANT a a am m U U U U TO RULE 5J17 OF THE FLORIDA ADMINISTRATIVE Survey ey s inot covered by CODE AND ITS IMPLEMENTING RULE, CHAPTER sinot Liability 472.027 OF THE FLORIDA STATUTES. _. Insurance. ORIGINAL 09-17-2014 FIELD DATE — �.,. _ = - -- -- REVISIONS. - -- 09-17-2014 N Y B. CASTEL J.V.D. AERIAL MAP (NOT TO SCALE) PROFESSIONAL LAND SURVEYOR No. 4129 DRAWN - -- STATE OF FLORIDA SHEET No. FLOOD ZONE INFORMATION: Community No. 120652 Land Surveyors & Mapper Panel No. 0302 Suffix: L 8567 Coral Way, Miami, FLORIDA 33155 FIRM Date: 09-11-2009 Telephone: 786-290-4184 Flood Zone: X S 09-482-14