PL-10-19-2566, 390 NE 101st StMiami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address Parcel Number
390 NE 101ST ST, Miami Shores, FL 33138 1132060135260
aom������o� ,•.��aa tag
'ontacts
_.. _....__...�.�,... _.__ .................._..
Inspection Requests
Description: INSTALL DRAINFIELD Valuation: $ 2,490.00
�494��
TO Sq Feet: 0.00
H,
Fees
Amount
Application Fee - Other
$50.00
CCF
$1.80
DBPR Fee
$2.00
DCA Fee
$2.00
Education Surcharge
$0.60
Permit Fee
$50.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$117.90
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$117.90
Credit Card
11/07/2019 $67.90
Credit Card
10/28/2019 $50.00
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 done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANIC L, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the forego g i for tion is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I a h ri t e a'Aoy.�-a8med contractor to do the work stated.
Authorized Signature: Owner / Applicant / Coritractor / Agent Date
November 07, 2019 Page 2 of 2
r r
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
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
RECEIVED
OC 2 8 2019
BY:
F C 20
Master Permit No.-P(J I o _GI�2,�JaCj
Sub Permit No.
REVISION ❑ EXTENSION 7RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION SHOP
/� CONTRACTOR DRAWINGS
JOB ADDRESS: .3 q (! �t l U
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: I- �FFlloo�d'jZ`one: BFE: "FFFjE: %�
MO -
OWNER: Name (Fee Simple Titleholder): �1 <l LJ� �C Y1 ti`�� ^ '`G ►'�`�) P � ne#: 1 —1 — �q
Address:_- 0—A%6Of St.
City: ) Y N � V, ; 'hy r-9 S State: i' (,_ Zip: '
Tenant/Lessee\Name: l _ Phone#:
Email: �UU\r- j C \ V1et' (� r►oky"6L GOW'
CONTRACTOR: Company Name: Mr - Rai�44S 6C Phone#:
Address: Iri 6 ?�� 76A V-
City: )!`1-1, II __ /� , State: Zip: / �—y
Qualifier Name: [�IlJ1 v S ' / 16 �honek: -36 — G � l � � K
State Certification or Registration #: �yg db(' S Certificate of Competency #:
DESIGNER: ArchiLect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear
rF 4tFootage of Work: )
U Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work:
Specify color
-oyyf��color thru tile:
G
Submittal Fee $ " (Z) Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $_
DBPR $
CO/CC $ _
Notary $
Double Fee $
Bond $ -��— ��i� (�-(tgZ'4-
TOTAL FEE NOW DUE $
(Revised02/24/2014)
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 and a reinspection fee will be charged.
Signature U 114r/� Signature
0 OWNER or AGENT
The foregoing instrument was acknowledged before me this
iV
day of
of v Z 20 , by
who is personally known to
me or who has produced I), , V,? 0" ClC 1 K %e- as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal:
MY COMMISSION # GG102743
EXPIRES May 09, 2021
CONTRACTOR
The foregoing instrument /Ws jacknowledged before me this
day of VC(,�� ti� 20 (� by
CL who is personally known to
4,
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:°
DONALD MARTIN
Seal: c _ MY COMMISSION # GG102743
EXPIRES May 09, 2021
as
APPROVED BY I (9 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Property Search Application - Miami -Dade County Page 1 of 1
41
OFFICE OF THE PROPERTY APPRAISER
Summary Report
Property Information
Folio:
11-3206-013-5260
Property Address:
390 NE 101 ST
Miami Shores, FL 33138-2425
Owner
JOHN H DORSCHNER &W
KATHLEEN M
Mailing Address
390 NE 101 STREET
MIAMI SHORES, FL 33138-2425
PA Primary Zone
1000 SGL FAMILY - 2101-2300 SQ
Primary Land Use
0101 RESIDENTIAL -SINGLE
FAMILY: 1 UNIT
Beds I Baths I Half
4/3/0
Floors
1
Living Units
1
Actual Area
3,270 Sq.Ft
Living Area
2,657 Sq.Ft
Adjusted Area
2,899 Sq.Ft
Lot Size
11,804.75 Sq.Ft
Year Built
Multiple (See Building Info.)
Assessment Information
Year
2019
2018
2017
Land Value
$354,284
$354,284
$354,284
Building Value
$202,215
$202,249
$202,284
XF Value
$24,332
$24,537
$24,742
Market Value
$580,831
$581,070
$581,310
Assessed Value
$213,042
$209,070
$204,770
Benefits Information
Benefit
Type
2019
2018
2017
Save Our Homes
Assessment
$367,789
$372,000
$376,540
Cap
Reduction
Homestead
Exemption
$25,000
$25,000
$25,000
Second
Exemption
$25,000
$25,000
$25,000
Homestead
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 1 & 2 BLK 39
LOT SIZE 102.650 X 115
OR 13194-2549 0287 1
Generated On : 10/28/2019
Taxable Value Information
2019
2018
2017
County
Exemption Value
$50,000
$50,000
$50,000
Taxable Value
$163,042
$159,070
$154,770
School Board
Exemption Value
$25,000
$25,000
$25,000
Taxable Value
$188,042
$184,070
$179,770
city
Exemption Value
$50,000
$50,000
$50,000
Taxable Value
$163,042
$159,070
$154,770
Regional
Exemption Value
$50,000
$50,000
$50,000
Taxable Value
$163,042
$159,070
$154,770
Sales Information
Previous Sale
Price OR Book -Page
Qualification Description
02/01/1987
$140,000 13194-2549
Sales which are qualified
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/ 10/28/2019
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: ,John Dorschner
PROPERTY ADDRESS: 390 NE 101 St Miami, FL 33138
LOT: BLOCK: SUBDIVISION:
PERMIT #:13-SC-2008647
APPLICATION # : AP 9 448409
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1267047
PROPERTY xD #: 11-320"13-5260 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF 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 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 NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND
T [ 1,050 ] GALLONS / GPD Septic Tank To Remain CAPACITY
A [ 0 ] GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps
D [ 400 ] SQUARE FEET New Drainfield Bed Conff. SYSTEM
R [ 0 ] SQUARE FEET SYSTEM REPAIR IT
A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND FLORIUA HEALTH JVJI.t Mj-nA-U6 Cal IA14
I CONFIGURATION: I ] TRENCH [x] BED [ ]
NOT VAI ID 1-
F LOCATION OF BENCHMARK: FFE: 11.8'
I ELEVATION OF PROPOSED SYSTEM SITE [ 24.00if ZNCHE3 FT I ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 74.00][ INCHES FT I ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D E
0
T
H
E
R
ILL REQUIRED: L U.UU I INCHES EXCAVATION REQUIRED: L OZ.UUJ INCHES
1.- Invert elevation and Bottom of drainfield to be no less than 6.14' & 5.64' NGVD respectively.
2: EXISTING 1050 gal. septic tank with an approved filter TO REMAIN.
3.- Install 400 sf, of drainfield BED configuration. •�, `F ,` tpj�`
5.- Install 12" Of slightly limited soil at the bottom of the drainfield. "' 11 ill l U1� V IJ r� 7 V iLLA
THIS PERMIT IS NOT FOR ANY ADDITIONS. Or e'%tic Tank am/or
(Comments Continued on Page 2.) ; t0 Til �,ai
SPECIFICATIONS BY: Ylian rraAT
TITLE: Engineering Specialist
YT1G PLATITLE:
iL`eWa1 inspected
Env�•};�gentall�tanager
aBAerepai66.
APPROVED BY:
APPROVED
DATE ISSUED:
101!Ve ' �r---
` f �ii{ '-,. - ---- EXPIRATION DATE:
01/15/2020
DH 4016, 08/09
(Obsolete*) editions editions which may not be used)
Incorporated:
64E-6.003, FAC
Page 1 of 3
v 1.1.4 AP1448409 SE1215999
. , P. a
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SURVEYOR'S CERTIFICAT{ON: We herGu>
certify that the attached "Sketch of Sur
vey' of the above described property Is
true and correct to st cf our kriml.
edge anC Deliel t re t1 Ye4+f
m elrectlon.Z%W l/ J
DONALD W. MCENTOSH ASSOCIATES, INC.
RaR Surveyar 2'B-1'3 Sul. of FW:da
OONN\O W. MetNTO6H
S91 HofiSHO\ "R—T. rl/,v,1 VkYS,
a�orwl ols, e+i1 �+6 Csee� �s4.oux4
NOTE' ALL FIGHTS OF WAY, EASEMENTS.
SET BACK AND ZONING INFORMATION MIST
BE CONFIRMED BY ARCHITECT ANDIIOR
OWNER BASED UPON DESIGN USAGE.
SU QV F
LOTS 1 c2� BLOGKJ'
M 1 AM I S410r r.S, S@c. 1 A Qm
I LA -ASS of MIAM 1 111611 6
WAIm An.
AI:COrdins to Piat Book .F41
the Puelic Remiss of Dada C:WtA M
MAY 11 Iw61 o.N. 34ot1 OPowt! I
4G-7b Ape— ,Ipyq 9D-19
STATE OF FLORIDA
• r • DEPARTMENT OF HEALTH •
APPLICATION FOR CONSTRUCTION PERMIT ; . •. • • • •; •
Permit Application Nter ' • • • •' . • ..:.
. ...... . . .
There are no pertinent featureUMEad' fn sand or across the street that may affect th4 bl^v Septic $y;wm Instalfift"i
PL
� Ap ved Da e
bma proved
,tA l otlrn 9w " T c t)=Jl-4 ,QAd
-t,% C' = t> tCt.c�zCQ I &-) -rt-w- Sowrr—
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Notes: -3q ° n%� i o i st • {V4 cr oi;
In
• •
...... ... .....
• ••..4
Y'e%.
I- S•?-
Site Plan submitt y: �-�
Plan Appro I Not Approved Date l o
By County Health Department
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015, 08A)9 (Obsoletes Previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 2 of 4
(Stock Number: 57444)02.4015-6)