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DS-19-1971��/r Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.. DS-08-19-1971 Permit Type: Driveways/Sidewalks/Slabs Work Classification: Addition/Alteration Permit Status: Approved Issue Date: 12/03/2019 Expiration: 06/01/2020 Location Address Parcel Number 1077 NE 98TH ST, Miami Shores, FL 33138 1132050180240 Contacts ONE POTATO TWO POTATO LLC Owner 107798 Business: 3058285158 DECO CONCRETE INC Contractor JOSE MONNAR 10773 NW 58 St #161, MIAMI, FL 33178 Business:3058285158 m.aguilar@decoconcreteinc.com Other:3053454740 Description: BRICK PAVER DRIVEWAY Valuation: $ 14,000.00 Inspection Requests: 305-762-4949 Total Sq Feet: 2,084.00 Fees Amount Application Fee - Other $50.00 CCF $8.40 Concrete/asphalt/pavers, slabs, dways, $150.00 swalks DBPR Fee $3.00 DCA Fee $2.00 Education Surcharge $2.80 Planning and Zoning Review Fee $35.00 Scanning Fee $12.00 Technology Fee $5.00 Total: $268.20 Payments Date Paid Amt Paid Total Fees $268.20 Credit Card 12/03/2019 $218.20 Credit Card 08/27/2019 $50.00 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�5M"aIrwork will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above named contr rtd do the work stated. Authorized Signature: Owner / Applicant / December 03, 2019 Date Page 2 of 2 Mission: Ron DeSantis Governor To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts. (Deco Concrete, Inc.) 1077 NE 98 Street Miami, FL 33138 Iona HEALTH Vision : To be the Healthiest State in the Nation RE: Contingency Letter Application Document No: AP1433233 Centrax Permit Number: 13-SC-1989779 OSTDS Number: 1077 NE 98 St Miami, FL 33138 Lot: Block: Dear Applicant: November 20, 2019 Scott A. Rivkees, MD State Surgeon General APPROVED FLOR;DA DEPARTMENT OF HEALTH IN MIAMI-DADE Co{1NTY PERMIT#: 33 ~E DATE: Subdivision: This will acknowledge receipt of an application dated 09/12/2019 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. NO OBJECTION FOR RENEWED OF EXISTING DRIVE WAY. 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.FloridsHealth.gov 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 BUILDING PERMIT APPLICATION DECEIVED Miami Shores Village q G 2 7 2019 Bullding Department BY: 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 4jo,% INSPECTION LINE PHONE NUMBER: (305) 762-4949 0 t FBC 20 0 Master Permit No s - G �5_ (1-1 - l Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP j -�y CONTRACTOR DRAWINGS JOB ADDRESS: C�'�©� !l[ < U 50 / � - rity• KAiomi Ck­r_+v KAi­1 n-4- Folio/Parcel#: / / * VI 6 1 U�11 Y J Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): lm�?I�l� l� - Phone#:3/r'9 '!�1 151� Address: _/U% 7 /V ti✓ "L 2,05 736E_ T - y�,, � G 2 City: / I !%j�]y1/ h )'Zh State: Zip: >� , Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: DECO CONCRETE INC Phone#: 305-828-5158 Address: PO BOX 720067 City: MIAMI State: FLORIDA Zip: 33172 Qualifier Name: JOSE MONNAR Phone#: 305-828-5158 State Certification or Registration #: CBC057725 Certificate of Competency #: Dd�NER: Architect/Engineer: Phone#: Ass: City: State: Zip: Value of Work for this Permit: $ tj Square/Linear Footage of Work: & p4 Type of Work: ❑ Addition Alteration ❑ New ❑Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ S - 011z' (Revised02/24/2014) TOTAL FEE NOW DUE $ Z 0 Bonding CoNpany's Name (if applicable) Bonding Comhany's Address City State Mortgage Lenders Name (if applicable) Mortgage Lender's'kddress 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 7Tse of such posted notice, the inspection will not be app v d and a reinspection fee will be charged. Signatu ER or AGENT The foregoing ins runt was acknowledged before come this /^ day o 20 /- / by jfV ,& ' , who is personally known to or who has produced ILL1 W-K (ree4-)ilol as identification and who did take an oath. NOTARY PUBLIC: Sign CONTRAC'TIOR The foregoing instrument was acknowledged before me this � day of .20 _, by OM who is personally knQZM to me or who has produced as identification and who did take an oath. t NOTARY PUBLIC: ,. Sign: j' Sign:_ Print: %i2 f_3_/»• �t11/%//�' Print: Ll �r °� ' MARIA M. AGUILAR Seal: Seal: A4 �'- Notary P ry ublic - State of Floridanj Commission n GG 246536 My Comm. Expires Aug 7, 2022 Bonded through National Notary Assr. APPROVED BY �` �/ Plans Examiner - MARIA A. AGUILAR Notary Public - State of Florida ys`-? Commission „ GG 246536 My Comm. Expires Aug 7. 2022 Bonded through National Notary Ass.-. Zoning Structural Review (Re,ised02/24/2014) Clerk Prepared by and return to: Robert L. Schimmel, Esq. Schimmel, P.A. 1395 Brickell Avenue Suite 800 Miami, FL 33131 305-907-6012 File Number: 2019-06-00554 Parcel Identification No. 11-3205-018-0240 Above This Line For Recording CFN: 20190450602 BOOK 31532 PAGE 1050 DATE:07/19/2019 03:02:28 PM DEED DOC 3,810.00 HARVEY RUVIN, CLERK OF COURT, MIA-DADE CTY Warranty Deed (STATUTORY FORM - SECTION 689.02, F.S.) This Indenture made this f )—day of July, 2019 between Mark H. Sims and Gail A. Haldeman, husband and wife, grantor*, and One Potato Two Potato LLC, a Florida limited liability company whose post office address is 1173 NE 1031d St., Miami Shores, Florida 33138, grantee*, Witnesseth that said grantor, for and in consideration of the sum of TEN AND NO/100 DOLLARS ($10.00) and other good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby acknowledged, has granted, bargained, and sold to the said grantee, and grantee's heirs and assigns forever, the following described land, situate, lying and being in Miami -Dade County, Florida, to -wit: Lot 15, Block 179, REVISED PLAT OF TRACTS 178B, 178C, 179A, 179B, 179C, 180A & N 1/2 OF 180C OF REVISED PLAT OF MIAMI SHORES, SECTION 8, AS RECORDED IN PLAT BOOK 31, AT PAGE 41, according to the Plat thereof, as recorded in Plat Book 43, at Page 69, of the Public Records of Miami -Dade County, Florida and said grantor does hereby fully warrant the title to said land, and will defend the same against lawful claims of all persons whomsoever. * "Grantor" and "Grantee" are used for singular or plural, as context requires. In Witness Whereof, grantor has hereunto set grantor's hand and seal the day and year first above written. Sined, ealed and delivered n our presence: Witness Naiip.-<4Z ytl Yr2!� ar . Sims / 1077 NE 98 St. Miami Shores, FL 33138 Witness Name:, _ Ti (continued on following page) CFN: 20190450602 BOOK 31532 PAGE 1051 Warranty Deed -Sims and Haldeman Page 2 /6ail A. Hald man 1077 NE 98 St. Miami Shores, FL 33138 STATE OF FLORIDA COUNTY OF MIAMI-DADE The foregoing instrument was executed and acknowledged before me this y�`�day of July, 2019 by Mark H. Sims and Gail A. Haldeman, who U are personally known or� have produced driver's licenses as identification (1 Notary'Pabfic; Stat"f-I X\V��yZ11. lscy/M 0 Oho�5510N�F( /��ii �,• G� GN S5.?O�%�J,•. i it � OGG 0E1561 %,.��i� . � Bonded ��'�o°e • � '�� 9F, • �j Fe:.^Sus.• Detail by Entity Name Page 2 of 2 Detail by Entity Name Florida Limited Liability Company ONE POTATO TWO POTATO LLC Filina Information Document Number L17000158648 FEI/EIN Number 82-2302997 Date Filed 07/25/2017 Effective Date 07/25/2017 State FL Status ACTIVE Last Event REINSTATEMENT Event Date Filed 03/28/2019 Principal Address 1173 NE 103RD ST MIAMI SHORES, FL 33138 Mailing Address 1173 NE 103RD ST MIAMI SHORES, FL 33138 Registered Agent Name & Address DEROSA, JAMIE M 1173 NE 103RD ST MIAMI SHORES, FL 33138 Name Changed: 03/28/2019 Authorized Person(s) Detail Name & Address Title AP DEROSA, JAMIE M 1173 NE 103RD ST MIAMI SHORES, FL 33138 Annual Reports Report Year Filed Date 2018 03/28/2019 2019 03/28/2019 Document Images 03/28/2019 -- REINSTATEMENT I View image in PDF format 07;2512017 -- Florida Limited Liability View image in PDF format -.rr:da zGa:-n'znt cf SIa-" .1. is:- of Co'P—tans http://search. sunbiz.org/lnquiry/CorporationSearchISearchResultDetail?inquirytype=Entity... 8/27/2019 �I I CZ V� 1, )IAMI S VILLAGE �Y Y%� RKS REVIEW A Pr: 'VED �'� DAT^ 1.4' 90.0,15" 2.23' WEST Lot - 14 Block -179 III sbwk Ica' ALLEY F ti x` k , Lot - i s o.. Block -179 C!:. � �x C;d?�6 ,wry I 0 __ x a 20. 1' --� J 9�. V a ERRAC x 10 09'x'o` 68,1' N Y, � ►7 ! Q qx GARAGE ELEV.= 8.15' 10,14'- 15.9' �' �1"Sh11K � P 2.68' WEST y o, `fllfa; h F� FOUND,Ztv 900 IRON •PIPi " I 00" i I� 326.291 CIA 236.29' (C) OIlilc base Q f I cON* sand being I along with 6" W pOimet�rOrr tram ONE STORY BUILDING No, 1077 FF ELEV= 9.30' 52.2' VPLANTER 0 10 20 r I SCALE: 1" = 20' � �R7 9 ASPHALT PAVEnENT +r' 1 cv.x , FOUND Yz" 4IRON PIPE ............... LEGAL DESCRIPTION: L o t 15 Block 1 �? ® 6' *- x PO ENED 10-15' Q x, CL CL J C9 O CV d- 4' 16- mow* M I I W-1� 01 22 ASPHALT PAVEr'IE 75TOTAL R!W (PER PLAT BOOK 43 - PAGE 69) N.E. 8TH STREET Property Address. 1077 N.E. 98th Street, Miami Shores, Florida 33138 Project No. 19897 Page 1 of 1 Additions and deletions to this Survey Map are Pmhbted. This Survey Map and Report are not valid without the signature and original raised seat or without the authenticated ekctmWC signature and seal of the undersigning Florida licensed Surveyor and Mapper, 0.6' EAST 79, REVISED PLAT OF TRACKS 178 B, 178 C, •179 A, 17'9 B, 179 C, 190 A, & THE ry NORTH 112 OF 180 C OF MIAMI SHORES according to the plat thereof, as recorded In Plat Book 43, Page 69 of the Public Records of Miami -Dade County, Florida. SURVEYOR'S REPORT AND GENERAL NOTES P (Not valid without the attached Survey Map) f, Legal Description has been fumished by the client. 2. References to "Deed", "Record" or "Plat' refer to documents and instruments of record as part of the pertinent information used for* this survey work. Measured distances, directions and angles along boundary lines are in consistency with corresponding values from records, unless otherwise shown. 3. These lands are subject to additional restrictions of record that were not furnished to the undersigning registered surveyor. A title search has not been performed. Lc 4. North arrow direction B based on an assumed Meridian. Bearings are based on an assumed gneridillin Bloc on a well -established line, said line Is being noted as BR on the Survey Map. 5. Only above ground improvements are shown herein. Foundations, underground features and •utiiifites* have not been located, • • % • • 6. Fence ownership has not been determined. Distances from existing fences to boundary "S"sie approximate. Fence/walls width and conditions must be considered to determine true location elaartds located beyond perimeter fences might or might not be being used by adjoiners. Adjoining pa4lg4we not been investigated. • . • . • • T This Survey Map is Intended to be displayed at the scale shown hereon. Data is expressecl 0 y P. s Survey Foot. 14' . WEST 8. This Survey Map is being prepared for the use of the party/parties that it Is certified to and cioeS CI extend to any unnamed individual, entity or assignee. • 9 FLOODPLAIN INFORMATION: As scaled from Federal Insurance Rape Map (FIRM) of CommJnity fib, St�NCG 120662 (Village of Miami Shores), Panel 0306, Suffix L, revised on Sept 11th, 2009, this real pniperty k, �,,ah falls in Zone "AE" with Base Flood Elevation 8 feet (NGVD 1929) 10.HORiZONTAL ACCURACY: Accuracy obtained thru measurements and calculations meets and exceeds the minimum horizontal feature accuracy for a Suburban area being equal to 1 foot in 7, 500 14' AF.q 11.VERTICAL CONTROL AND ACCURACY: The elevations as shown are referred to the National M Geodetic Vertical Datum of 1929 (NGVD 1929). The closure in feet, as computed, meets the standard of plus or minus 0.05 feet times the squared root of the loop distance In miles. Elevation are based on a level loop from and to the following official Bench Marks: Bench Mark # 1: Miami -Dade County Public Works Department Bench Mark B 400, Elevation = 8.28 feet NGVD 1929 Bench Mark 0 2: Miami -Dade County Public Works Department Bench Mark B-62, Elevation = 8.66 feet NGVD 1929 FouNo Yz' rR0N PIPE VO i HEREBY CERTIFY TO: Gail A,,Hakdeman and Mark H. Sims. That this Survey Conforms to the Standards of Practice as set forth by the Florida Board of Professional Surveyors and Mappers in applicable provisions of chapter 5J-17, Florida administrative code pursuant to Section 472.027 Florida Statutes. This Survey is accurate and correct to the best of my knowledge and belief. Digitally signed by Odalys C Rej,Id Dated: 2019.07.10 14:33:35 -04'00' Odalys C. Bepo4znaga Professional Surveyor and Mapper LS6169 • State of Florida Field Work Date: 07/0312019 =1 LL i CID N d " N 1 N Lu + O� t 0 U U. • Z Z Co r 4111 �•ro a ¢BID 0 IR— to N • . , �uu�wrw�.III B' E d .. .R- tL • LEGEND 6 Ae•REVIATIONS _ COR.'iR•O .... i . crox. BLOCK L "ALL � CKI • TIN • • • _,�. _..k._ L.NK FENCE (CLF) ! t • • ��.._�..... WOOD FENCE (M1P) !) .,}-,. SM METAL BARS FENCE (W) OVEER4AD Im"S pQ • WATER VALVE (wV) e� •POPPER FOIL (Fri GNY AW.OR . WA7eR ME7t$t (LKT'O �jf • COW. uGMr FaE (LF) ® • WELL '!' • STREET SIGN • SANITARY MANIPLE • DRAINAGE MANHOLE O • HANOLE . PME HYDRANT r• CABLE Box (CATV) LO9V7 • FPL TAAWORMEB IiiR . CATCH SAEN W INLET + EXISTRW ELEVATION ,�•� PERMANENT REFERENCE MON VONI (PRIM) MF . PROPERTY CORNER • • PERMYHew CCMAOL PONT (PCP) P.T. . POINT OF TAWGeNCY P C. . PONT OF CURVATURE P,C C. + PONT OF COMPO IO CLRVE P R C. v PONT OF REVeM CLRVE B.N. • BENCH MAW B.R. . NC BEARING REFER[E T.A.M.. TEMPORARY BENCH MARK i PROPERTY LINE E = CENTER LURE M « MONI"NT LWE CMC. +CALCULATED MEAS. . FIEUD MEASURED P. PER PLAT • PBM • PROFES JCNAU SURVEYOR AN MAPPER WC. + AIR COPORIONe R PAD tNCR. . EMCROACMEHEM F.F' ELEV, a FWMMEO FLOOR eLEVATII P.B.. . PLAT BOCK P. PAGE ORB + OFFICIAL RECORD BOW CBS + CONCRETE BLOCK STRUCTw RAV • RK,M OF *AV WV. • ELEVATION SEC. I SECTION T +TOVINLUP