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DS-10-20-2348Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 142 NE 103RD ST, Miami Shores, FL 33138 1132060131750 Contacts Fernando Yanez Owner HOME OWNER Contractor 142 103 HOME OWNER FERNYAN@YAHOO.COM Inspection Requests: Description: NEW DRIVEWAY AND WALKWAY WITH Valuation: $ 10,000.00 EXTENSION OF STAIRS 30§ , N I Total Sq Feet: 1,374.00 Fees Amount Application Fee - Other $50.00 CCF $6.00 Concrete/asphalt/pavers, slabs, dways, $100.00 swalks DBPR Fee $2.25 DCA Fee $2.00 Education Surcharge $2.00 Planning and Zoning Review Fee $35.00 Scanning Fee $9.00 Technology Fee $3.75 Total: $210.00 Payments Date Paid Amt Paid Total Fees $210.00 Credit Card 10/15/2020 $50.00 Credit Card 01/21/2021 $160.00 Amount Due: $0.00 Building Department Copy In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are requiredIforLECTRICAL,PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAI certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulatingconstructd zoning. Futhermore, I authorize the above named contractor to do the work stated. Authoriz6d Signature: CHiner / Applicant / Contractor / Agent Date January 21, 2021 Page 2 of 2 l BUILDING PERMIT APPLICATION Miami Shores Village Fc�xvEr� Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138_. Tel: (305) 795-2204 Fax: (305) 756-8972' INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20 (7:�� Master Permit No.as—(y" 26-234a Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 142. NE 1039-9 .51 City: Miami Shores County: Miami Dade Zip: 3313b folio/Parcel#: Is the Building Historically Designated: Yes NO _ Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 1 Lo"00 JINVO �. Phone#: 3+5'4510•33ZI i) Address: 147- r4E, 103nh 51 City: MLMm 5wae$ State: r-L Zip: 3313FS Tenant/Lessee Name: t�vt�lw �1r /.� Phone#: Email: f S"W �n+ INKS 0,tif •COYA CONTRACTOR: Company Name: Phone#: Address: City: State: Qualifier Name: Phone#: State Certification or Registration #: DESIGNER: Architect/Engineer: Certificate of Competency #: Phone#: p: Address: City: State: Zip: Value of Work for this Permit: $ 4 Square/Linear Footage of Work: 43%4 Type of Work: ❑ Addition ❑ Alteration ❑ New X Repair/Replace ❑ Demolition Description of Work: Of* VJ Aky--- J Dy F.xTWSUAJ CN' S-T&VLS Specify colorofcolor thru tile: Submittal Fee $ .�0 ' (n Permit Fee $ Scanning Fee $ Technology Fee $ Structural Reviews $ Radon Fee $ Training/Education Fee $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ Bond $ 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 _ _ Signature OWNER or AGENNJ CONTRACTOR The foregoing instrument was acknowledged before me this -11 ( day of G 20, by ��Q[V�r•,�cj (•� Al.{� , whho, is personally. known to t' me or who has produced U-Pa 1 LAX;?- identification and who did take an oath. NOTARY BLIC: Sign: w 1 t� Print: s\N Jvc, Seal: I Ii s� APPROVED BY J,< Z ��. y "f- 1 i r. The foregoing instrument was acknowledged before me this day of me or who has produced 20 by who is personally known to identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: as Plans Examiner !.2� - Zoning Structural Review Clerk t (Revised02/24/2014) sVLOREV M. M Rl� Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNER BUILDER DISCLOSURE STATEMENT NAME: feQoirmi 10 :1 • ytof-I DATE: ID 1 "q SO ADDRESS: M_ Nf— 103" trl jj*jN1 J SEjt,1 e-> 'FL 3313b Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have read and understood the following disclosure statement, which entitles me to work as my own contractor; I further understand that I as the owner must appear in person to complete all applications. State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one -family or two-family residence. You may also build or improve a commercial building at a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and with -holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, buildings codes and zoning regulations. Please read and initial each paragraph. 1. 1 understand that state law requires construction to be done by a licensed contractor and have applied for an owner -builder permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a license. Initial 2. 1 understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. Initial 3. I understand that, as an owner builder, I am the responsible party of record on a permit. I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the contractor is required by law to be licensed in Florida and to list his or license numbers on permits and c ntracts. Initial 4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease, hich violates the exemption. Initial_ 5. 1 understand that, as the owner -builder, I must provide direct, onsite supervision of the construction. Initial 6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and jbyounty or municipal ordinance. Initial 7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner -builder permit that erroneously implies that the property owner is providing his or her own labor and materials. 1, as an owner -builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner -builder and am aware of the limits of my insurance coverage for injuries to workers on my property. Initial 8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and. social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for the employee. I understand that my failure to follow these may subject to serious financial risk. Initial 9. 1 agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and requirement that govern owner -builders as well as employers. I also understand that the Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. Initial, 10. 1 understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the Florida Construction Industry Licensing Board at 850.487.1395 or http:/Iwww,mvfloridalicense.com/dbpr/pro/cilblindex.htmi Initial 11. 1 am aware of, and consent to; an owner -builder building permit applied for in my name and understands that I am the party legally and financially responsible for the proposed construction activity at the following address: 142. NE 103Rq St M=Pt'�25N�S.3313b Initial 12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the i ormation that I have provided on this disclosure. Initial Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the Constr4uction industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner -builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. Was acknowledged before me this (3* day of 20 10 By +__F,2NN0V3 �AI�� who was personally known to me or who has Produced there License or13,,�Vu_ U N as identification. ER NOTARY -- My E,XlIkEG b ry2 '••9�- F,`,;',�' Eionded Tlttu Nc.ary Put"lir lir�uerreriters EPARtf) BY: — r • ;r = ACTA /��y/� .... „ a yV 0000. .. SURVEYORS. ,—V) ./ �• • ••• •• �a f - nalacd con, I office s65. 73519161lax: 566. 7442sa7 h. k • • A •y�••• • • PROPS RESS: 142 NE 103RDSTREET, MIAMI SHORES, FLORIDA33138.2329 i SURVEY NUMBER: 195315Z • • • f FIELDWORK DATE: a20rz• •• • • • o1• •9 V )• Ev /20 �^ • • • � • : 00000 19031581 •• •• •♦ • •••••• BOUNDARYSURI/EY o • • •: { • • • MIAMI-DADECOUN7Y _ _ _ • • : ; : • • • • • • • • • • • • • • • • • ei 0 5 35'S3� 050.02' (M) �3 5' E 74.960 \NAI.ICW %1`�'-� iC T IJS�CJ ., ,.:. of STpZfl 5/& Mr 25.00 (D) I 5AT Me I NO 10 �' I NO 1D 1 1 IA— 24 ' ♦ $I.UGK QESx�r1 �t./lal.l<Wl�i LL C � � %14.1' 'O O.]'OFF �` /• (��' �7U S�.T� . ON7it v rog(,pC K pESJ(J DR2J E WA'( RE5 # 14Z �, 3• = 34a x 1 3(o1 , _n �— 22i 1 L W N 9.6' 10.4� 16.4' 3 eI� jj ©� Q — N r N �t tJ LOr 9 I - o C�1 I 0T / O 1 BLK 13 3000 P52 ONU2ETE Vv27+{ C Gii Z0 BLK I3i 3 0 ,'- l— .� � TV' '� 1 1`��i� { �'• SDI/L WN�I1 prZ,0oc.t 0.4' OFF I 2-9' GFF 14YM 3 D 5 W 150.00' (P) hereby ce t _ . oundary Survey of the 5URVr R's NOTES: 1 hereon des e s been made under FAITY OT AP TO BE 5ERVICED BY CWATER AND 5EWER ` �d eNCE O: ' -- _- - T DE1ERrrtINED. N my d' ti nd fi'the t of my knowledge 3 and belie 'tis , ccurate representation of a sury H a meets ;Standards of Practice 30 0 15 30 set forth " the to rd of Professional L , Surveyors pers i opter 5✓-17 of the GRAPHIC SCALE (In Feet) �i�` Florida Adminf e. RONALD W WALLING 1 inch = 30' ft State of Florida Profeselonal Surveyor and Mapper License No. 6473 V e Use of The Survey for Purposes other than Intended, Without Mom verlfimbon, will beat the User's Sale Risk and Without uabllttyto the Surveyor. 1� • lI/ Nothing hereon shall be Cornmeal W Give ANY Rights or Benefits to Anyone Other than those Certified. }� M FLOOD INFORMATION: ' POINTS OF INTEREST BY PERFORMING A SEARCH WITH THE LOCALGOVERNING NONE VISIBLE MUNICIPALITY OR WWW.FEMA.GOV, THE PROPERTY APPEARS TO BE LOCATED IN ZONE X. THIS PROPERTY WAS FOUND IN THE VILLAGE OF MIAMI SHORES VILLAGE, COMMUNITY NUMBER 120652, DATED 09/11/09, i -L 'y --- ----- — ---- • . AFFILIATE CLIENT NUMBER: DATE: 03/21/19 itle Association MEMBERS BUYER FERNANDO YANEZ--��� _-- -- I SELLER: FERNAND0 YANEZ i• ^i ' CERTIFIED TO: FERNANDO YANEZ LAND SURVEYORS. LLC. - Drive I Suite I I Fort Myers, FL 33913 Ij This is page 1 of 2 and is not valid without all pages. 0004 066090 00000 0 00 l REPORT OF SURVEY _ 1903.1582This is page 2 of 2 and is not valid without all pages. LEGAL DESCRIPTION: LOT 9 AND THE EAST 1/2 OF LOT 10, BLOCK 13, AN AMENDED PLAT OF MIAMI SHORES SECTION NO. 1, ACCORDING TO THE PLAT THEREOF, 41 AS RECORDED IN gLAT BOOK 10, PAGE 70, OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA. 40 • • • • JOB SPEMFIC SURVEYOR NOTES: •THE BEARIA(! RE' ERENCE OF SOUTH 90 DEGREES 00 MINUTES 00 SECONDS WEST IS BASED ON THE SOUTHERLY PROPERTY LINE OF LOTS 6,7 & 8, � WITHIN AN AMENDED PLAT OF MIAMI SHORES SECTION NO. 1, ACCORDING TO THE PLAT THEREOF, AS IV,4iLOCATED PRECORD ILAT BOOK 10, PAGE 70, OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTY, FLORIDA. GENERAL60FWf C11F NOTES: • • • •1. The Legol Descriptorased to perform this survey was supplied by others. This survey does not determine or imply ownership. This survey only shows improvements found above ground. Underground footings, utilities and encroachments are not located on this survey map. If there is peptic tan b or drain field shown on this survey, the location is approximate as the location was either shown to Exacta Land Surveyors, LLC. by a third party or it was estimat; by o"etal d1ection, probing rods, and visual above ground inspection only. No excavation was performed in order to determine the exact and accurate location. 4. Thlssury�yis ex velyfor theuseof the parties to whom it is certified. Add Ze onstothissurveymap and report by other than the signing party or parties is prohibited without written consent of the signing party or parties. 0..Dimensions afeINfeetand decimals thereof. 7. Due to varying construction standards, house dimensions are approximate. B. Any FEMA flood zone data contained on this survey is for informational purposes only. Research to obtain such data was performed at www.fema.gov. 9, All corners marked as set are at a minimum a Wdiameter, 18' iron rebar with a cap stamped LBM 8291. 10if yfou are reading this survey in an electronic format, the information contained on this document is only valid if this document is electronically signed as specified in Chapter 5J- 17.062 (31 of the Florida Administrative Code and Florida Statute 472.025. The Electronic Signature File related to this document is prominently displayed on the invoice for this survey which is sent under separate cover. Manually signed and sealed logs of all survey signature files are kept in the office of the performing surveyor. If this document is in paper format, it is rot valid without the signature and original raised seal of a Florida Licensed Surveyor 'I. Unless otherwise noted, an examination of the abstract of title was NOT performed•by�he signinigsurleyor to determine which instruments, if any, are affecting this property. 12. The symbols reflected in the legend and on this survey may have been enlarged or red cedfor clarity. Tpe symbols have been plotted at the center of the field location, and may not represent the actual shape or size of the feature. 13. Points of Interest (POI's) are selected above -ground improvements which may be 16 conflict with boundary, building seZack or easement lines, as defined by the parameters of this survey. There may be additional POI's which are P# shown, not called -out -as POR, of which are otherwise unkhowp to the surveyor These POI's may not represent all items of interest to the viewer. - "' 14. Utilities shown on the subject property may or may not m(ftate the existencaof recorded 6r unrecorded utility easements. 15. The information contained on this survey has been performed exclusively, anc sthe4 of responsibility, of Exacta Land Surveyors,LLC.. Additional logo or references to third party firmsareforinformational purposes only. -$ •' 1. 16. Pursuant to F.S.558.0035, an individual employee or agent may not be held irl�M&agy liable forrregligence. 1 -. House measurements should not be used for new construction or planning.'Measurements should be verified prior to such activity. LEGEND: u nYPo r� � 5RVEYOR'S LEGEND 9URPALL iYTtl:iatesansaxxn { 9 �V'M U�r� a�iaxta meentxE ewcmwtaa f"eN"t'r �� � � e o>mru.ARweam.,A � [R,waoR . auaPURwa to 'L'AtiOR�ARrYWALL— TQ9W= Ib venert aaao raa aATa Q aaoo ��' . mrntele.nMsar uturc oc ua+rrae mROP1VATOl ❑NA1Lw (aCALCULVW F.Qw. EMWWAT61 KTs WnDSCME M RAgtRPOM AE ACCESS EASMEHt as o� Ell ELFaabi NAVOBB NgnX AM5YCANVWSKAL My RIGHrOFVMY ANE ANCHOR EASFMFM an FHD W E JiilEIea OMUM CB'laeR I.S. azS1090C4 ruc CANAL MAwILNANCE ESME Ua MHO INC. INCIOSNE NGND]9 lUTIpNALGEODFM TIC£ RANT£ CUE C0u_,M_r" fr. ai PtAT PET ENIAANCE Vem0u._oF1919 SML SETBAIXIIIE OE DMINAGEEASEMENr W RECORD We MISCTRKUILITNIOX O.CS. ONCONCE're a S.Cl FURVEYCILSURE Wf 0.4E gUINAGEMDImLRYESMt. MIRJEY FF. REEVED FIOOq Q6 Cw CAgMD STl SURVEYTESNE earr. "crSEMENT Lpo"hT ASBl. Ac655at/SETaA .. FAP ®BEEOF ORB ORKIAL R(ORD BOOB SW. SFAMMLL IE/E.E INCAESs`ccass ESMr. A,c AlacoaOrii P,DIt W DIW IME ORV. OmDALMod"E'YOURAE SMD SsnsLU OSC IRaE IRRIW'x)N USFJAEM aG su—boaOD, fOA PNDWNLMETEMWNMEM WA OVERALL W sD5a It LAE uMmDMYF55ESMt. BAP. BACIt. PREVENTOR R FOUND•Cix RPE OPFEET SC0. SCREEN L8E tAINSCAPE MIFPER ESMr. o,, F FOUNDNgN PtPFaCAP OrE OUTSIpEOFSUBIFCT PARCEL SK Se,,C LF, tANDSGPEESMT. BA ""i"RFFFPENCE eEu. a ya0x RE$1MCIpN UNE FYI __aK n_ OK OrOwANG se sPTKTAHt LAZE LVa:ORWIIeC/VE aPM BAYIRD%VANOOW RRC Fp1NDIRa1 ROD8GP OHL OVERHFADUNES SEW. SEN9i MAM1dANCEFASBAFNf BtOG BUILDING PN fWto NAa ON _of_ PAIGFE SIRc seTIR fIJ ME MABRFNANCE FASeAD(t DISC P.UE RIMKUIBfrYFASeWM euc aUh'!f Poprawro WILANDD6c P8 Ptio BOOR SNaD SETI41lapeic aM a—PNIA NkBO x P°NTOf NRwnRE stBFr. sDlwiErtET RnE ROOF ovEwMNG ESMr. BW.. 9A6EMENT F%Oa PAABFRRAION NAR PC.0 POBLr OFCOMPWND S1 SmRY SWA SIDEW .. WoeREMEMr C NPVE RIQiID FOUND PNNALLaOIX PEP. NMAOIRE SV SFWERMLLVE SWFAE STORM WAIEA MANACAAFM CA.. CONOt[rE MOCK iMSPK FOUIO TDB. RIPOF BAMt FASFMIXr C1F. CRAM 1wBfENCE GA0. rdRAGE W. PfxNTOf INIERSEIIpN TBAS TPMPdURYll W TOE TCOMOtOGKALUTROYESND. C.O CLUN OUr GM GAS METER PDa _of QCAVNBW TEL TMEPHO M`Ou TIES uE UnIm EASMEM GY4 WNCNEFEVALL£Y GtrrTw ID IP.O.G P°HIOf COMMeaCFAiei! TVR. TtW,eaVIP aOENPFTWTBIN CJL Carra LINE RL VJMr PP. RN[NFDRPE TX 1nANSOPoABI CN LOVER®PORCii INST. si—i'aEM MIUL Cls CONO¢IESUa IW. INIEASFCTION PAM PENAAMEMREFEEIIH,Brf UA UnUfY RISA CAN CABLENPoSER L LENGm MaiUNENT UG UNDE,YG11i CH _W BEARING IaB LOWf-MISPlESS P! POMrOFTANt )iCY UIi UTTtSTYA6m c— O's-1 LSa uC6NSEf-SURVEYOR PtE POpLEgtpPMFM VF. YIMm-ffNLE (%xIC IONCREtE Ma MAPBOpK P6 PAOE WF. w00De, fBICE CDR TURNER "UM MrteaD sicinc. PLS PROFESSIONAL W105UIIVEWx1 WX w`_ss m CSM' CONCRETE sIDEwKB -.. METALPBKE PlT RANIFA .1, WATER MM OF. DRAIN FIELD lies MR6aD ENDSECIIOt! PSM PRWE410NALSURVEIDRANO WM WAiai ME1FNVALYE BOx OH. DPoLLl1CNF MN M 01E MAPPER WY N4ITEAVALYE D,W DRNEW Y NA tlOtI MOUE R RAORK«RAOML ELECTRONIC SIGNATURE: PRINTING INSTRUCTIONS: OFFER VALID ONLY FOR: FERNANDO YANEZ InconpiRCe accordance wttn Rodda 62awte 4]202S alb Pursuant to t_ While viewing the survey in Adobe Reader, select the ne nectroMc signature—& T M or RWIJa Statute TITLE Jaxlx, Chapter 6M, If Ws document was received elechonlcally via PDF. "Print"button under the"File"tab. mmanas beenleMUPY EMctroM«IN stgnea moerom,wt saes; PDG,EauNmdc lsmnWRM'oflk3al antltraurable Inoberbealldste 2- Select printer with legal sized paper. ' r — — — — — — — — — — — R,eaatmvc slpanRFdPOFalr steruw__.__ 3_Under"Prim Range, dick selea the All"toggle_ i. ',o mutt use a hash raImi,or.A free hash calculator fw a:U.Noa'I a!' 4-Under the Handling" • section, select the number I ' of copies that you would like to print I 5- Unde, the "Page Scaling" selection drop down menu, I LC maaNeHtnaLwar aaadeae ealett"None' I 1 0 OFF %s ea mesucrey POF computers -eiaars <om 6_ Uncherkthe"Auto Rotateand Center'checkbox I I an thealvFaentframwww.Nr rysarxcom 7. eheckthe•Choose Papersize by PDPcheckbox. I OF FUTURE SURVEYING SERVICES I 3. Jlck the squxs Browse button Mtlte uPPerdgnt M1aMcomer ollhe �o,.o ma�and soda aed .w PDFdoaa e a add OK toILixint ON THIS PROPERTY, dK cenreuTE amen M dse Iona dprc nN,d comer ad,e Haan cNanat«. �O�INick ACK+VkM I q.wnc.ea,eaodpamtlgaaManRaha,esHA-t R,eGUleaOlgh sHr.t dwxtenrortnew �MNepbNetnwwxwneyyatms,canwhkn air pnnredmtlse NAmice fortlatsur:ry. 1. In the main print screen, choose "Properties" I' Ox ,,,aad i«t amkeoNts and adaaw+he eF Vth ad'kxdie brtyeras iIs sBde4gagnswlgaaa-1 aaacten areevayaesamemmexNace 2. Choose"Quality"from the options: Ii;t do tIx f II'eted angle {astpage drhissn„ey Fx nproone I W xlnce sM.:y rvn•.s,,,uwn-,,aLcom astFryareinBU Hati,aaaza, IMn W s DDF Is auaunBc. BttwaJ iigt stnrg cfdwatters does nc matN 3. Changefrom"Auto Color or"Full Color' to I date. Tonal demlmt mttol a.......ct aume,oc. I "Gray Scale"- — — — — — — — — — — — — Mission: To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts. Vision: To be the Healthiest State in the Nation December 16, 2020 Fernando J. Yanez 142 NE 103 Street Miami, FL 33138 RE: Contingency Letter Application Document No: AP1605733 Centrax Permit Number: 13-SC-2211292 OSTDS Number: 142 NE 103 St Miami, FL 33138 Lot:9 Block:13 Subdivision: Dear Applicant: Ron DeSantis Governor Scott A. Rivkees, MD State Surgeon General This will acknowledge receipt of an application dated 12/08/2020 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. Reviewed on 12/16/2020. No objection for driveway construction as per your Site Plan. Drainfield must remain uncovered of any material. 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 (786) 315-2417. Sincerely, Z�ui�eLP relkRLo-kBrc vo- Isabel Perez, OPS Engineering Specialist II Florida Department of Health www.FloridaHealth.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 Fernando J. Yanez Page two December 16, 2020 Enclosures cc: