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1099 NE 99 St (5)Inspection Date Approved Correction Re-Insp'n Fee Name Company v 61 lJ-- MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Type Insp'n R 1 IQ l Add 'T t II..I' i Permit No. PGdt — Address i o "l jut. 9q Si- 41,E Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date f 1! � 2. Time Type Insp'n Dr WG■ ?P Permit No. 1 ( - (Qaq • Name 0 "'C—` Address lO 1 V L - - Ct S� Company Phone # For Inspector: l 113 Approved Correction Re- Insp'n Fee Name & Date MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date t `i Time Type Insp'n T(1,SU(.i1 Permit No. 03 .61 ( Name Address Approved Correction Re- Insp'n Fee OtNt_∎L l o 9q 99 3+ CompanyPCO —i- ✓ 1 . Phone # For Inspector: 11 IDS Name & Date Permit No. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 4` Time Type Insp'n /it.61/1 j _ ' . -e 5 l � ep 0 3- ‘3-?• Name O r Address iv 9 Al E 99 � 0 or - Company f 2-4- Phone # '50 9. ` O 73 ' For Inspector: / P /63 Name & Date Approved Correction Re- Insp'n Fee ❑ 'MIAMI SHORES .VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date t Time Type Insp'n mac- -USS Permit No. a P- 0 - Gag Name Address 1 o'-6q NE Compan p0a0 r (lap Phone # 305 - For Inspector:10131 Name & Date Approved ❑ Correction Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ICY-°4-Y5 3 , , y•, Type Insp'n a_ ; .1Z Permit No. PAP 2.003 - ( 02 Name /F' Address 10Q At C- 99 sr • Company Phone# 3o5 9z(r D ? For Inspector: 10 iVkr03 f'$ Name & Date Approved Correction Re- Insp'n Fee • MIAMI SHORES VILLAGE BUILDING DEPARTMENT Ck 305- 795 -2204 \ Building Inspection Request Date! Time Type Insp'n G 6eil.J► J - 9ACC.j Permit No. 03 - 2ci Name 0' EII Address to I ci r E ctc J- Compan Phone # 1 For Inspector: I I Name &Date Approved Correction ❑ Re- Insp'n Fee ❑ Date Type Insp'n11---Q Permit No. '1(5 0a-"I Name O, t S _ Address O`7 C / u Company 1 Phone # Inspection Date 11- 1\3`* Re- Insp'n Fee ❑ Correction MIAMI SHORES''VILL`AGE BUILDING DEPARTMENT c� 305- 795 -2204 o SO Building Inspection Request Date Type Insp'n Permit No. Name Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT N 305- 795 -2204 Building Inspection Request Time lk-wuJclq (t.nc Prx:IS(o 2ct 109'q NE 99Si-- Address Compan Phone # For Inspector: Name & Date 1�i 4,4657 et, bfe)( "fitoivx- iorcyaeAt /Ate, I- L IGDNC LD13 Dump PROJECT NAME � �N PROJECT #: ENG: DATE. 1/ /. 7-43 SHEET /l OF 'I Contractor's Company Name (Z Miami Shores Village Building Department L - (� Permit Type (circle): Building Electrical Plumbing Mezianical Roofing Owner's Name (Fee Simple Titleholder) °t'k C/C C Phone # O W(, Owner's Address 1019 9 3 V City 1 ; /44-ff c State ft. // 22 Tenant/Lessee Name Phone # 5 Zt)5 l %? BUILDING PERMIT APPLICATION FBC 2001 Contract' 's Address City i . Qualifier • M 1I 7 1 I State 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Master Permit No. G 2? Zip r Job Address (where the work is being done) k9 tit ,9 5r, r City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO _65 /C CE tA-C. Phone # v"'/ 666 0022 Zip �� J Architect/Engineer's Name (if applicable) ( • Phone # a)`7 5`l"5 cr? Architect/Engineer's Address )( -0 $ Value of Work For this Permit Square Footage Of Work: Number of: Bays Stories Families Bedrooms Baths Type of Work: ddition ['Alteration ❑New ❑ Repair/Replace ❑ Demolition Describe Work: '( 0/0 C )(2- (f334-Y103 ii- OP(rnnk l * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * ** * * * * * * * * * ** County Escrow Fee $ Permit Fee $ j 1 Notary $ Education/Training Fee $ Tech $ Scanning $ Radon $ Code Enforcement $ Bond $ Struct. $ Minus Plans Check Fee $ Total Fee Now Due $ 3 (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20 _ , by , day of , 20 by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: . My Commission Expires: My Commission Expires: (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. *********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ' ** * ************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION BY: i�r � /OVA 3 Plans Examiner Engineer Zoning Chc10 /02/03 BUILDING PERMIT APPLICATIo FBC 2001 Permit Type (circle): 1C uilding Electrical Plumbing Mechanical Roofing 7,DD lsZ' Owner's Name (Fee Simple Titleholder) Owner's Address City Tenant/Lessee Name Contractor's Company Name Contract 's Address City Qualifier 2 Architect/Engineer's Address State Miami Shores Village Building Department '4 IE ( � _;:11 VIE I1)) i::,:a 2 5 2001 o , Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Zip County Miami -D e NO Phone # iii , 04= 9 fi ST- 4 Architect/Engineer's Name (if ap i licable) / I �R (I) City ` State fa ) *1 2 kr.._ Phone # 55 IS State Zip 7 7 $ Value of Work For this Permit 2 Number of: Bays Stories Families Type of Work: ['Addition ❑Alteration _� ❑New Describe Work: IT v S S t J i) Phone # Zip * * * * * * * ** * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** County Escrow Fee $ Permit Fee $ Notary $ Education/Training Fee $ Tech $ Scanning $ Code Enforcement $ Bond $ Struct. $ Minus Plans Check Fee $ Total Fee Now Due $ 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Master Permit No. ?GO -' Phone # * c 9 Zip Square Footage Of Work: ' c Bedrooms Baths ❑ Repair/Replace ❑ Demolition Radon $ (Continued on opposite side) sa Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Signature NOTARY PUBLIC: NOTARY PUBL Sign: Sign: Print: Print: APPLICATION APPROVED BY: chc7n /o3 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 . the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be ed at he job site for the first inspection which occurs seven (7) days after the building permit is issu • '. e abs e of . ch poste notice, the inspection will not be approved and a reinspection fee will be charged. My Commission Expires: My Commission Expires: (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. Owner or Agent Contractor /� The foregoing instrument was acknowledged before me this The foregoing instu was acknowledged before me this ZS day of , 20 ' by day of who is personally known to me or who has roduced P who is personal As identification and who did take an oath. 20 a, by leCAP Y f l:o Je r(l ro2? � own to me or who has produced • s identification and who did take an oath. Mabel Var s 7 l fl 84 �J P Expires: Jul 13, 2007 Bonded Thru Atlantic Bonding Co., Inc. *************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ' AUG 2 6 2003 %9 z 0 647 - 3 .SI /'azi plans Examin Engineer Zoning NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. 0 3 6 ? TAX FOLIO NO. S 0 ( 7. 00 560 STATE OF FLORIDA: COUNTY OF DADE: OR BK PG 3226 THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street address: I- 1J r / S $4-0 c K 1 78 5 ch 7:i1 v r s t a ,J ,, ,41 1,q-v i , $lta -e s . o ff . ? sT/IeiT 14-rn r 5110 lees FLogi 3 3i3? 2. Description of improvement: C o 9 $ 72u CT, A) 6 4 it) 4 7)7 rT1 o 4 'Ta 77, P Ho v SE . 3. Owner(s) name and address: 101 -�n� °` C F' ! s i7,.�F Q'/�1 1: i L- /0 `� ? /✓ 15 • ? 9 "el-5 s7lLF th14 SHa2 -Es L. 33138 Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and address: /013o/ 5.19. 6 5. Surety:(Payment bond required by owner from,contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) Signature of Owner Print Owners Name J h r`. i0e:i Sworn to and subscribed before me this(- day o Notary Pub Print Notary's Name My Commission Expires: ,V r-rDE (2-,co ��,�,��,JbEz �craF2��r� 64a2. s r i4rr:4tc, FL.. 3 315!0 1 1 a er • tsooae 1 110 : L .. STATE OF FLORIDA, COUNTY OF D 1 HEREBY CERTIFY that this is onbmal +his office on AD 20 WITNESS my . and an. Official Seal. HARVEY RH 1, C , E By Prepared by: ( Gl f r s•L't ► O1l)ei I Address: /0 `l n ) E Tn 5 �- 4 4.441't s L., r t S F L.- 331 3 it 12391.52 2/93 CONT '.• CTOR Name it , ��igj �� ir License No. • r Address ( �_� '� t ('S Telephone .. .0 OW ax r Quali fier Name i _ ( 4� e PROPERTY OWNER Name to 1 COA y q z.. 7Z" ,x/■96 i/v/f/Z Name i /lot' ff /) ,{ ) /r� ( q / 9 ' 'r Address /off N, f r 4ti� / c1 f 3)138 Home Telephone Fax (3a0 97/ 5 Business Telephone Repair Fax Alteration Interior ENGINEER Name to 1 COA y q z.. 7Z" ,x/■96 i/v/f/Z License No. A dress 133 c z So.s '/`-� v�' 7 5 r J c S J 1V / ; 3 T elephone a 7 7 / ‘43z..5 Fax (3a0 97/ 5 ARCHITECT Name ,,AJS1a'r j'S /C7N/ License Noo. PLO /03U2 / /4 0°t),, 6 Address / /t L /v v. , 4_5 izi / 4 (.'i >U/ TX fl /,l,,y/ &n,4�- L . Telephone (305) 53/ 99L 9 Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'l Detachment Other S NORE • • •• • • • • • • • • • • ••• • • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • • • • • • • • • • • Master Permit No. INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: •• • ••. Sullsididry Pena iP MO. • • • • • • • • • • • • • • • • • • • • • PERMIT _ REC VE D m 2 nu., Step 1. Step 2. Job Address: Folio Number Complete the attached permit application which must be signed by the erop ery o .ne r and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of our a p1 atons I, roofing walk will be done, a roofing application must be submit- ted along with this permit application. • • • • •• • • • • • ••• •• Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. A PPLICATION Lot Apt. 1/32£ Of e � Address Subdivision PB Current Use of Property (/ ?KS Proposed Use of Property Ai 5- Tenant Information PERMIT TYPE ( ✓) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Block ascription of Work PG Zoning Squar eet ue of Work PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection /q //s City �G . State /1 di) / Ti Q' /s7 l �l0 b Units Floors Linear Feet 33/3r Zip )3 dg Value Tax Assessed/Appraised Value" Flood Zone Base Floor Elev. Page 2 SEAL: Personally known tate o Florida OF MIAMI -DADE AP 057 %, Angela M Becket My Commission DD15004 V c 6 , Expires November 16, 2006 OR, Produced Identification • .. .. • • • •• •• • • • • • • • • • • • • • ..• • • • • • .. • • • • •••• ••••••• • IMPORTANT NOTICES DO NOT BEGIN ANY WORK WITHOUT �AVING �ZECEI :ED YOIJR VALUATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are Conked top Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SLIALL :3F DEBRIS. 4. SWALES MUST BE PROTEC:I ED FROM BEM DAMA041= B IQIZ171 OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. • • • • • • • • • 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. I •u a -• spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender befor ecording our Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, P' Floor, 05) 679-107 Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 13 -35 of Flor a Statutes. Review the brochure at Village Hall on Constr tion Lien Law and so Contractor. v S Print Name _ Sworn to and subscribed before me this (-7 Si ture of N Public - day • ure o Contractor IS fr ." ,er CD G Print Name day Z � 1� Sworn to an subscribed before me this da of i U SEAL: • otary Pu. is - State of Fl nda p° apt Angola M Better My Committvio, DD15004e Expires November 15, 2008 PERMIT APPLICATION -3 Lj Q Personally known OR, Produced Identification Type of Identification Produced: FL V J L i 0 — f � C� "' —G �� - ' ype of Identification Produced: F.2. FS- a 1-sy""31 (� ELECTRICAL TYPE Minimum Fee QTY. TYPE. Dryer - QT` • • '1'" PI: •Outlet, Applian .e .. • QTY. "I'1'I'E Service Repair QTY. A/C Central 1 -3 Ton Fan Dryer Vents, Number of Outlet, Wall Ventilation, Cost Service, Temporary Air Handler, Tons A/C Central 4 -7 Ton Piping, Flammable Liquid Fire Pump Outlet, Switch Fire Sprinkler System Signs A/C Central 8 -15 Ton Bath Fan - Vented, # Fixture - Fluorescent - Pressure Vessel Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits ' Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL T YPE Minimum Fee QTY. TYPE Condensate Drain QTY. 'I'1'1'E Generator Q'I'1'. "I "1'1'1? Refrigeration, Tons Q "1 A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Solar Water Heater Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Fixture Bath Fan - Vented, # Fireplaces, Number of - Pressure Vessel Pump and Abandon PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. 'I'YP1: Miscellaneous Fixture QTV'. 'TYPE Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet . Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap • Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 • • • • • • • ••• • • • • • • • • •.••••• • •. • • •• • • • • • • ••• • ••• •• • PERMIT APPLICATION • • • • • • vit INSTRUCTIONS: Please indicate the type of work being perfbrme>;l and kuantit�r(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION - � '�J B X „ DAT Zonin: r p ar e Electrical %_11/4Fi 11021§211M r.'PMY r 3 f ..6 Mechanical Plumbin: Fire Public Works Structural VA1--- 4./11/3 Building Official Page 4 OFFICE USE ONLY • •• •• • • • •• •• • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • • • •••• • ••••••• • ••• • • • • CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) O CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review Notary • • • • • • • • 0 PROOF VF tIWNEASHIP (Attach) •• ••• •• • • • •• .0. HIS / fly [zIy1 iPJYAL • • • 4S4pttc l•SU r). • • • • ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ ( x . 60) x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) ' PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com BUILDING PERMIT APPLICATION FBC 2001 $ Value of Work For this Permit ,6 7 � Miami Shorts Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Master Permit No. Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) Phone # Owner's Address City State Zip Tenant/Lessee Name Phone # Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name Phone # Contractor's Address City State Zip Qualifier Architect/Engineer's Name (if applicable) . Phone # Architect/Engineer's Address City State Zip Square Footage Of Work: 1, 066 Number of: Bays Stories Families Bedrooms Baths Type of Work: ['Addition ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition Describe Work: * * * * * * * * * * * * * * * * * * * * * * * * * ** *Fee Calculation -Mist Permits * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** County Escrow Fee $ Permit Fee $ ` A 7t 5 0 Notary $ *� Education/Training Fee $ 1 3 3 Tech $ Scanning $ 5 Radon $ 5: 3 3 Struct. 6 Minus Plans Check Fee $ Fee Totals $ (Continued on opposite side) 1 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20 _ , by , day of . , 20 _ , by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: My Commission Expires: (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. APPLICATION APPROVED BY: Plans Examiner - Zoning Chc6/1 8/03 My Commission Expires: G suivi44-1 22 j VeoL S 7'D riv crgAJinj Figd `3 'f0 l ap /Olirst-4-117NS 1' to Miami Shores Village Building Department BUILDING CRITIQUE SHEET � p/c5 <rz 4,1W14)---f !rq � Q3a I 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Job Name 54,4 07 P 49ro'/s - ^D\603 ?Ne' To! Miami Shores Village Building Department BUILDING CRITIQUE SHEET v,� ^1\83 Job Name 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. l'3‘ 355-71 as 09- DATE OF TREATMENT: NOTICE OF TERMITE PROTECTIVE TREATMENT As REQUIRED BY FLORIDA BUILDING CODE (FBC) 104.2.6 TIME OF TREATMENT: 3: 1 APPLICATOR: / � r BUILDER NAME: PEST CONTROL, INCn� o4,6 �GJ TREATMENT ADDRESS: / 5 ,U e 9 4'3 / h J 4 / 1 - 7 cS S 'L lid JOB #: LOT: BLOCK: UNIT: SPRAY & TAMP '°P.RA-Y-nhAL SPRAY # RESIDENTIAL COMMERCIAL - -wITO CHEMICAL ( ` >u .a 1 % MONOLITHIC CHEMICAL: GALLONS c7 S/F STEMWALL SF JO G. L/F L/F PERIMETER TREATMENT GALLONS DATE OF TREATMENT: TIME OF TREATMENT: APPLICATOR: 300 S. STATE ROAD 7 PLANTATION, FLORIDA 33317 954 -584 -8588 1- SOO- 7494588 FAX: 954 -584 -6117 Engineering CLIENT: PROJECT: CONTRACTOR: PROJECT WINGERTER LABORATORIES INC. wINGERTER LABORATORIES, ' 1820 N.E. 144 St, • North Miami, FL 33181 • Telephone Wg 'Rstvig and Inspection Sennce Established 1949 FIELD DENSITY dd . 4 ! ill . NO: NO: DA IN: INC. (305) 944 -3401 • Fax (305) TESTS 949 -8698 , D PAGE_ P.O. TIME ' c3' ‘'R / NO.: y f � ' i G: / i .! = ...„,:d �✓ = ;'�- j:: () REPORT ORDER , - -d ,6' `' NO.: LOCATION: TEST - . d ` 7 a / ' .-L=' OUT: o • { " /' y 1i o /' -- "I' TIME 'c_' - INSPECTOR:( v ff '' Description of Material: DENSITY TEST PROCTOR INFORMATION SUMMARY OF RESULTS Lab No Field Test # Fill Lift Field Test Location: r p z ' J' !`"' ,, ::;, j...: x y . JC� P,r�`, Retest of Lab No. Moisture ( %) Dry Density (PCF) Probe Depth (In.) Proctor Lb N Lab Optimum Moisture ( %) Max. Dry Density (PCF) Percent Field Compaction Percent Compaction Requirement Tests Status ' ., ? o ✓ : ` V . te a i n, / );,.. 4-1 k A3 i I i `' 4�' f � � ,{ „{� r ' <- 2 A ) ''';? — i 5. It d' . V \ White - Lab • Yellow - Technician • Pink - Client WINGERTER LABORATORIES, INC. Engineering Testing & Inspection Services 1820 NE 144th Street, North Miami, FL 33181 Telephone Miami (305) 944 -3401 - Fax. No. 949 -8698 6- 2 t°CO ED No. 1 REPORT: GEOTECHNICAL SITE INSPECTION JUN 3 0 ZED' CLIENT: Power Builders, Inc. PROJECT: Oneil Residence LOCATION: 1099 N.E. 99` Street, Miami Shores, Florida REPORTED TO: Power Builders, Inc. 12301 S.W. 64t Avenue Miami, Florida 33156 - Attn: Fred Diaz Date of Inspection: June 26, 2003 Purpose of Inspection: To visually confirm the presence of virgin limestone at the bottom of footing excavations. Area of Inspection: Results of Inspection: Inspector: MM Total Time: 1 visit Order No. 03 -1427 Continuous wall footings for addition on east and west side of residence. On this date, as requested by the client, Wingerter Laboratories, Inc. conducted a visual inspection of the above footing excavations. Inspection of the materials at the bottom of the footing excavations revealed the presence of virgin limestone. Therefore, field density testing at the bottom of footings shall not be required. Placement of reinforcing steel and concrete may proceed as planned. Respectfully submitted, WIN ERIjER LABOR IE4, Rafael M. Pina, P.E. Florida Registration No. 50771 1 The original of this report was signed and sealed by the above referenced Florida Registered Professional Engineer in accordance with Rule 61G15- 18.011 of the Florida Administrative Code. j 5 44,x, A vn t-ev° .us Miami Shores Village Building Department T 305 6 Iv/ BUILDING CRITIQUE S • ET 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 716.8972 03 - 6 Permit No Job Na a3 98e( -3 - • Miami Shores 'Villa e g 02) -4evcA /-fir Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) .8972 6 07 Permit No Job Name witvde-at, 03 BUILDING CRITIQUE SHEET • / Lim to • h i. 'i .1_.PAL Ate ,, It , ,,, .. MA .., / air dal AL .0,i IL"f L� 11 • . . AN ,114MIffirNIIMIEINAMIM A. i t2 r-4v.01 4J 7 4' )1 C-e_ae (/ s s — G o OMIONI Et. r:ciF CCC.°.'_rr,T' NAME & CO r.",: N T Y NU1.EEEn Miami Shores 120652 E2. COUNTY NAME 1 Miami -Dade 83. STATE. Florida V,. MAP Ar:2 PANEL 120 2 L 5 C 0 0 9 3 ES SUFFDr. . BE. FtP _ IND D DATE 87. FIR:. PANE_ E CTIV . EJ DATE BE. F AE, o +Nets; EC: BASE FLOOD ___ , TION(S) (2 AO. use 8 - :i. fiagiing) PROES FOLIO !i 30- CROWN OF ROAD 7 . 9 6 Ft NGVD Fa Insurance Cauca. ;y Use: Policy Number Company NAIC Number BUILDING OWNER'S NAME john n'ne BUILDING STREET ADDRESS (Including Apt, Unit, Suite. and'or Bldg. No.) OR P.O. ROUTE AND BOX NO. 1099 N.E. 99 Street CITY Miami PROPERTY DESCRIPTION (Lot and Bloat Numbers, Tax Parce! Number, Legal Desc'ipton, etc.) Lot 15, B1 178Revised Plat of Miami Shores Section 8; Miami -Dade County, BUILDING USE (e.g., Residential, Non - residential, Addition, Accessory, etc. Use a Comments area. if necessary.) RPRi dent i a 1 LATITUDE LONGITUDE (OPTIONAL) ( t; .1;.' or i 1:.,`::. TITLE ADDRESS S 7.1rwTU=_ Lpd Surveyor 92 Fc . L F or . . o FEDERAL EMERgNCY MAI4AGEMENT AGE S t ) CY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Important: Read the instructions on pages 1 -7. SECTION A - PROPERTY OWNER INFORMATION HORIZONTAL DATUM: ❑ NAD 1927 ❑ NAD 1983 STATE SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) 1 0.2 1_.. _ft.(m) n / a .____ft.(m) n / a . _fl.(m) 8.0 . _ft.(m) 7.82 (m) 7.6 tt.(m) 7.8 _ . _tt(m) o h) No. of permanent openings (flood vents) within 1 fL abate adjacent grade, n / a o i) Total aea of all permanent openings (flood vents) in C31t n / hc. in. (sq. cm) Florida SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION Cr. E :A:. venue Miami 8/06/03 O.M.B. No. '67 -0077 Expires December 31, 2005 ZIP CODE 3 31 3 8 Florida. SOURCE: ❑ GPS (Type): ❑ USGS Quad Map • ❑ Otter. E10. Indicate' -•ie source of the Base Fno d Eie:afrd+l (BFE) data or base (cod depth entered in Er ❑ FIS Pro`!e ® FIRM ❑ Community De!- ^Wined ❑ Dther (Des: ite): El. i. India_ 7 ?ie:aon datum used for the BFE in 89: a NGVD 1525 ❑ NAVD 195: ❑ Otne• (Deso ite',: E Is the b. _ _ located in a Cca5.e Seer r Resw'ces System (CE:S' `e t C_,� Y area or Otherwise Pru.c.,, Ass (O� ❑ � \C Dw .c.M Date Cl. Building e.e.a :i ? are based on. ❑ Cons:rutlon Drawings' lX Building Under Ccn5 :•uG?n.' ❑ Finished Cor; ru t 'A nes E c :a_On Certificate wi!; be required when cons`J J iO' Of the building i5 cemp!ete. C2. Booing Diaz.-am Number 1 (Sae the building diagram most simiia• to the building for which Mis r`S i5 being no di ^. M' v ..c. g COfnN - ied - Sc: pages 5 and � . K �, a :, a�., :..e!y represents to bud ding, provide a sketch or photograph.) C3. Elevations - Zores A1 AE, A! A (vita BFE), VE, V1-V30, V (Wit BFE), AR, AR'A, AR'AE. AFIAI -A3C, A.R'.A ,, Complete !tens C3.-a-i aoo (ding to the balding diagram spa ac In Item C2. State the Ca :-m used. G the datum Is dl -e'en: I; Pm the datum used for the EF i' Se Lion E, amver, the datum t0 that used for the BFE. Show field measjrerrrenls and datum conversion ca'i,Jta: o:. Use tine space pro: icec o' the ODinfner.:E area 0' S JJ, or Se-...lion G, as apr:,pra :e, to document the datum conversion. Datum NGVanversion/Comments Elevation reren o? mark used BM3oes the elevation refereno me used appear on the FIRM? ❑ Yes ® No o a) Top of bottom floor (induding basement or endosure) o b) Top of nett higher floor o c) Bottom of lowest horizontal structural member N zones only) o d) Attar - e garage (top of slab) o e) Lowest devotion of machinery and/or equipment servidng the building (Describe in a Comments area) o f) Lowe' ad (finished) grade (LAG) o g) Highest ad,a (finished) grade (HAG) This certification iS to be signed and sealed by a land surveyor, engineer, or architect authorized by.Iaw to certify elevation information. I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code. Section 1001. CERTIFIER SNAJiE LICENSE NUMBER Alberto 'zo- Luaces, P.L.S. 3087 v r ill; Self employed Flori a C "33184 T _ r�• -J.. 305 - 220 -6397 IMPORTANT: In these spaces, copy the corresponding information from Section A For ,mace use 6 STREET ADDRESS (tnc..orc A;:. Uric. Suite. and'or Bog No.) OR P.O. ROUE AND BOX NO. Poky Number CRY STATE ziP CODE Cor pang NAIC Nat ! SECTION 0 - SURVEYOR, ENGINEER, OR ARCHfTECT CERTIFICATION (CONTINUED) Copy be* sides of this Elevation Catfca ;e for (1) community o¢daI , (2) insurance acen.raxnpany, and (3) building Nre', COMMENTS ❑ Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR -F, Section C must be completed. El. Building Diagram Number _(Sete:, the building diagram most similar to the building for which this ce t5 r ate is being m - see pages 6 and 7. If no diagram a~- •ratey represents the building, provide a sketch o' photcvarh.) E2. The top of the bottom floor (including casement or endosure) of the bbiiding is _ ft.(m) _in.(cm) D ab ve or ❑ be km (died; one) the highes' adja grad:. (Use nat.:ra grade, if available). E3 For Building Diagrams 6-E win ope - - ,gs (see page 7), the next hi: e floor or elevated floor (elevation b) of the build : -_ is _ ft.(m) _in.(cm) eXp e the highest a' ate-: grade Complete items C3.h and C3 i on front of roan. E4. The top of the platform of machine' a•,for equipment sevidng the building is _ ft.(m) _in.(cn) ❑ abcve or ❑ below (check one) the hit es t adjacent grace. (Use na:u'a grade, if available). E5 For Zone AO only: If no flood dept num.ti Is available, is the to o!` the bottom floor elevated ir, a.;x.-dance with the w nm,;n y s floodp:ain management ordinance' Q Yes ❑ No ❑ Unknown. The b:,� ofd must ter y this information in Section G. The property owner or ov authorized rep who corpie:es Sections A, 8, C (liens C3.h and C3.i or.;y), an: E for Zone A (wit out a FEMA-issued issue BFE) or Zone AO must sIdn he The se:ernents in Se.iions A, B. 0, and E arc COrre f0 f be :: of r^•-; k90 1 PROPERTY OWNER'S OR OWNER S A; THORIZED REPRESE':TA T IVES NAME ADDRESS S:G^:ATURE COMMENTS LOCAL OFFICIAL'S NAME COMMUNITY NAME SIGtIATURE SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION CITY DATE TELEPHONE SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by la+ a ordinance to administer the cormunity's floodplain management ordnea ca ocrmptete Sections A, 8, C (a E), and G of this Eie: ation Certificate Complete the appticabte iterl,$) and sign belay.. Gt. 0 The information in Section C was taken from other documentation that has been signed and embossed by a fioensed surveyor, engineer, a architecl whoa authorizer by state or total law to certify elevation information. (Indrate he source and date of the elevation data in the Comments area below) G2. ❑ A community offida completed Sewn E for a buldng locoed in Zone A (without a FEMA - issued a community-issued BFE) a Zone AO. G3. ❑ The following information (Items G4-G) is provided for community ftgodplain management purposes. G4. PERMIT NUMBER 65. DATE PERMIT ISSUED G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY ISSUED G7. This permit has been issued for. ❑ New Construr ion 0 Substantial Improvement G8. Elevation of as-but lowest floor (inducf m, base nent) of the building is. G9. BFE a (n Zone AO) depth of flooding at the biking site a: TITLE GL — _ft (m) ft•(m) STATE ZIP CODE ❑ Check here if attachments Datum Datum: 0 BLOCK CORNER CONC. --� GARAGE EL. 6.9'X9.1' 150.66'(R) F.I.P. 0.50' 9.90' N ai ✓ • C 4'X3" — tJ 0.49' K 9.84' 0 0 t� ( 0 N 5.6 N 9 F.I.P. Lri 7.90 v N 7.82 • <. N 12.0' CONC. j// /12.0 / 19.6' 75.00'(R) ---- x -x -x ADDITION // // 1.9 0.36 7 ,17.2'/ r 1 STORY C.B.S. RES. n 1099 N.E. 99 STREET F. FL. EL.10.23 20.4' 8.0 7 0 19.3' 75.00'(R) 74.49'(M) 23.5' PARKWAY .2' /18.2 4 10.19' 18.3' N Q 15.3' 3 21' ASPHALT PAVEMENT 8.03 N.E. 99 STREET X 0 co to N 0 7 F.I.P. F 0.70' X 1 1 1 1 X O 0 Lri M 1 10.16' SPOT SURVEY 1.54' 7.96 NOTES NOT VALID UNLESS SEALED WITH AN EMBOSSED SURVEYOR'S SEAL. ELEVATIONS ARE BASED ON N.G.V.D. 1929, M -D.C. BM# B -62, EL. 8.74 (N.E. 96 ST. & N.E. 10 AVE. ) FLOOD ZONE "AE" B.F.E. 8 C.P.N. 120652 -0093 J (07- 17 -95) • • SCALE 1"=20' -41 Do›- esT LEGEND P.L.S. S /F.I.P. F.FL.EL. 0 .0 CERTIFY TO PROFESSIONAL LAND SURVEYOR SET OR FOUND 1/2" IRON PIPE FINISH FLOOR ELEVATION EXISTING ELEVATION CENTER LINE LEGAL DESCRIPTION JOB No: 03 -101 F.B. No.: 269 -15 DATE: 08 -06 -03 (SPOT SURVEY) 14 16 N.E. 100 STREET TRACT178 A - MIAMI SHORES SEC. 8, REV. (31 -41) 4. N.E. 99 STREET LOCATION SKETCH SCALE N.T.S. 19 — x — CHAIN LINK FENCE (R & M) RECORD & MEASURE C.B.S. CONCRETE BLOCK & STUCCO C.S. CONCRETE SLAB CONC. CONCRETE WE HEREBY CERTIFY: THAT THIS "SPOT SURVEY" OF THE ABOVE DESCRIBED PROPERTY C MINIMUM TECHNICAL STANDARDS ADOPTED BY THE FLORIDA STATE BOARD 0 LAND SURV SECTION 472 -027 FLORIDA STATUTES. LOT 15 BLOCK 178 OF "REVISED PLAT OF TRACTS 178B, 178C. 179A, 179B, 179C, 180A AND N1/2 OF 180C OF REVISED PLAT OF MIAMI SHORES, SECTION 8" AS RECORDED IN PLAT BOOK 31 AT PAGE 41 OF THE PUBLIC RECORDS OF DADE COUNTY, FLORIDA, IN MIAMI SHORES VILLAGE, FLORIDA. ACCORDING TO THE PLAT THEREOF, AS RECORDED IN PLAT BOOK 43 AT PAGE 69 OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY, FLORIDA. V �' �r 4 RE A - i I1 ZO—LUACES ( PLS o. ' • , STATE OF FLORIDA 923 S. '. 22 d. AVENUE, MIAMI, FL. 33184 PHONE: 305 220 - 6397 - FAX 305 226 - 6403 ITH THE URSUANT 14 a- 7' ►S 1 , 13 I- 14. ,, 1, G1c- 1 7 „ ., 17S lg. „ 751 Iq 75' 41 N _ 101•941t ?� 0S.4O': n i l. 1 5' T i '75' 5.4 3.2 0 1.35' 3, G6S. a LA. Drawn by: M•D. Field: P- - r' r Fir /i'4' o V1 Lrrla • • 3AI� SURVEY o ' �� f V.0645. OF pa�iRt►+�euT v4 • F'Pyi"4' a. 50' 15.00' 22' 65P • 4 AL - r NOTES: ..— l C s .... -1 =t•__ _ — ___ F.I.P. =FOUND IRON PIPE NO CAP SHOWN C.B.S. = CONCRETE, BLOCK STRUCTURE P.C.P. = PERMANENT CONTROL POINT P.R.M. = PERMANENT REFERENCE MONUMENT C.L.F. =CHAIN LINK FENCE W.F. =WOOD FENCE D.M.E =DRAINAGE & MAINTENANCE EASEMENT RES.= RESIDENCE tr =CENTER UNE — 'ILA= MONUMENT LINE RAN =RIGHT OF WAY — Q =DIAMETER /F.S. =FLORIDA STATUTE / R= RECORD — M= MEASURED 7 U.E= UTILITY EASEMENT EXMBiAl10N OF AE<S1RACT TF 7TTLE All HAVE To NE MADE 7O VEZOOIE RECORDED NSTRUIENT3, IF ANY *MIMING 7H6 FltaFERTY- UICEROROUND MUTES AND FOUNDATIONS HAVE NOT SOX LOCATED AS 11BS INFORMATION HAS NOT BEEN REQUESTED ALL RKINT OF RAYS SHIN N HOE ARE PIJdJC MUMS 0 1)ERBSr: NOTID 1105 SURVEY HAS A TRAVERSE �. E OF NO LESS THAN 1.00 FOOT N 7.500.00 FEET t. 4 GLe on Ugly CA B S. W 4LL. r'ry - tn • SCALE I' = 20' • • s • LOT LEGAL DESCRIPTION: t( • ... ; • •.• I� RLOCK I7$ SUBDIVISION REVISED PLAT of Tiz.k.cr4 1 786,118L, 17'1A, ricie7 ' C.,•ItoA.Aw o t1' /‘ I eOC. o f Rev PLe of ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK • • 4 3 . .A? eAG�� 6q OF THE MRRmI SI4OR.e PUBLIC RECORDS OF D2 COUNTY, FLORIDA. • • • • •:. : ; • eieer 10 N , RESIDENCE NUMBER-10_99 NE-. qq rh . u &T ; f _ •• .• : • :.. • ••' : : •• j j •• • • • • •• •• Trz,GT 17BA - frA1.•m1 51 6, ,. ZeV• (31 - 41) NOT 4. Fir' 4: P F 1 s P L1r 3438.4o' .997m- 6542_7/F1 T O JOHN G. 01JEI I_ 4 cH RI5TI NR. A, oN.01, - A & 1 - r o R . N E L i T I T L . 105 U IZnu'- FOOD M Al G • Ft_e_ 1 ICI 3 TITLE. 11UIZ.dNGE CoRFOS T1on3 rle LEE G. Ft MACHTE oBER , p•fs, • PNG. #T-.E . CoR• of aMEP -Itd IT5 SUCLES rL5 ffND, p(_ .&(6 ' j . THE FLA. FLOOD INSURANCE RATE MAP DATED 1- 19 PUBUSHED BY THE UNITED STATES LOCATION SKETCH DEPARTMENT OF HOUSING AND URBAtf EVELOPEM 1T, SELN�ATES THE HEREIN DESCRIBED LAND • TD BE SITUATED WITHIN ZONE b►i _ SCALE: r ! IO WE HEREBY CERTIFY THAT THE ATTACHED BOUNDARY SURVEY OF THE ABOVE DESCRIBED PROPERTY IS CORRECT TO THE BEST OF OUR KNOWLEDGE AND BELIEF AS RECENTLY SURVEYED INDER OUR DIRECTION ALSO THAT THERE ARE NO ENCROACHMENTS UNLESS SHOWN. AND 1141S SURVEY MEETS MINIMUM TECHNICAL STANDARDS SET BY THE FLORIDA BOARD CF LAND SURVEYORS AS SET FORTH IN CHAPTER 472.027 (F.S.) AND CHAPTER 21 HH 6 OF THE FLORIDA ADMINISTRATIVE CODE. SOFHJ G. NEI 4 FOR: CI•f - T I.J E 4..• ORDER NO. 1404 WAL K E. iNEGA' DATE: 4-11 PROFESSIONAL LAND SURVEYOR NO. 306 REV STATE OF FLORIDA - Z 3 Z 5 , CARIBBEAN LAND SURVEYORS, INC. 12750 S.W. 25TH TERRACE MIAMI FLORIDA 33175 TELEPHONE (305) 227 -6967 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: [ X ]New System [ ]Existing System [ ]Repair [ ]Abandonment APPLICANT: Oneil, John & Cristine AGENT: OWNER, PROPERTY STREET ADDRESS\ 1099 NE 99 St Miami Shores FL 33138 LOT: 15 BLOCK: 178 SUBDIVISION: Miami Shores [Section /Township /Range /Parcel No.] PROPERTY ID #: 11- 3205 - 018 -0040 [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC DEPARTMENT APPROVAL OF SYSTEM DOS NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME PERIOD. 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 PROPERTY DEVELOPMENT. SYSTEM DESIGN AND SPECIFICATIONS T [ 1050 ]Gallons SEPTIC TANK A [ 0 ]Gallons N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS D [ 571 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ 0 ]SQUARE FEET SYSTEM A TYPE SYSTEM: [ Y ]STANDARD [ N ]FILLED I CONFIGURATION: [ N ]TRENCH [ Y ]BED N F I E L D LOCATION TO BENCHMARK: Finished F1 of Exist. Res. 10.36' NGVD ELEVATION OF PROPOSED SYSTEM SITE [ 33.1 ] [ INCHES ] [ BELOW BENCHMARK /REFERENCE BOTTOM OF DRAINFIELD TO BE [ 63.1 ] [ INCHES ] [ BELOW BENCHMARK /REFERENCE FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 72.0 ] INCHES OTHER REMARKS: Install 1050 Gallons Septic Tank Cat 1 W/ an approved outlet filter. Install 571 Square feet drainfield. Install 42" of Slightly Limited Soil @ the bottom of the drainfield Invert Elevation of the drainfield to be no less than 5.5' NGVD Bottom elevation of the drainfield to be no less than 5.0' NGVD Perimeter of excavation shall be 2 ft wider and longer than the proposed absorption bed. SPECIFICATIONS BY: Andre, Paul DATE ISSUED: 5/23/03 DH 4016, 03/97 (Obsoletes previous editions whi.h may not be used) ic�....v n�.....i.... c'nn_nni_nnic_n■ ---- .,... . ]Holding Tank [ ] Innovative Other ]Temporary [ NA ] TITLE: ' V CENTRAX #: 13 -SG -15986 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 03 -0902- -N APPROVED BY: Andre, Paul TITLE: Professional Engin Dade EXPIRATION DATE: 11/23/04 MULTI - CHAMBERED /IN SERIES: [Y ] MULTI - CHAMBERED /IN SERIES: [Y ] @ [0 ]DOSES PER 24 HRS # PUMPS[ 0 ] [ N ]MOUND [ N ] [ N ] POINT POINT CHD Do, 1 ,t 7 AGENT: , OWNER LOT: 15 BLOCK: 178 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSA SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS APPLICANT: Oneil, John & Cristine • BENCHMARK /REFERENCE POINT LOCATION: Finished F1 of Exist. Res. 10.36' NGVD CENTRAX #: 13 -SG -15986 OSTDSNBR : 03- 0902 -N SUBDIVISION: Miami Shores ID #: 11- 3205 - 018 -0040 OWNER TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PROVTDF RFGISTRATTON N[LMBF,R AND STGN AND SEAT, EACH PAGE OF SURMTTTAT,. COMPT,FTF ALL ITFMS PROPERTY SIZE CONFORMS TO SITE PLAN:[X]YES ( ]NO NET USABLE AREA AVAILABLE: 0.20 ACRES TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [64E -6, TABLE 1] AUTHORIZED SEWAGE FLOW: 500 GALLONS PER DAY [1500GPD /ACRE OR 2500GPD /ACRE] UNOBSTRUCTED AREA AVAILABLE: 1056 SQFT UNOBSTRUCTED AREA REQUIRED: 1143 SQFT ELEVATION OF PROPOSED SYSTEM SITE IS 33.12 [ INCHES ] [ BELOW ]BENCHMARK /REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: SURFACE WATER: N/A FT DITCHES /SWALES: N/A FT NORMALLY WET? [ ]YES [ X ]NO WELLS: PUBLIC: N/A FT LIMITED USE: N/A FT PRIVATE: N/A FT NON- POTABLE: N/A FT BUILDING FOUNDATIONS: 5 "FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 16 FT SITE SUBJECT TO FREQUENT FLOODING: [ ]YES [ X ]NO 10 YEAR FLOOD ELEVATION FOR SITE: 0 FT NGVD SOIL PROFILE INFORMATION SITE 1 Munsell # /Color Texture Depth 9 5Y- 6/9 -T. R GY Sand n to 45 9 5Y -R /1-P VW 1 i t•i r• T,imPC d5 to 79 to to to to to to USDA SOIL SERIES: 15 Urban land SITE EVALUATED BY: Wilfredo Lopez DH 4015, 03/97 (Obsoletes previous editions which may not be used) 10 YEAR FLOODING? [ ]YES [ X ]NO SITE ELEVATION: 0 FT NGVD SOIL PROFILE INFORMATION SITE 2 Munsell # /Color Texture Depth 9 5Y- 6/9 -T, R GY Sand n to Fin 9 5Y -R /1-P VW flnl i t-i r• Li mPR Fin to to to to to to to USDA SOIL SERIES: 15 Urban land OBSERVED WATER TABLE55.00 INCHES [ BELOW ] EXISTING GRADE TYPE: [ APPARENT ESTIMATED WET SEASON WATER TABLE ELEVATION:55.00 INCHES [ BELOW ] EXISTING GRADE. HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO DEPTH: 0.0 INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING:Replacement/0.70 DEPTH OF EXCAVATION:72.0 INCHES DRAINFIELD CONFIGURATION: [ ]TRENCH [ X ]BED [ ]OTHER (SPECIFY) REMARKS /ADDITIONAL CRITERIA: Profile Location: 10.0' South of the North Property Line. 35.0' East of the West Property Line. Building Area 2606 Square feet. Unobstructed area required not available. Existing system must be shown on the site plan w/ a note to indicate that it will be abandoned. DATE: 3/24/03 AGENT: , OWNER LOT: 15 BLOCK: 178 STATE OF FLORIDA ' DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSPiL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS APPLICANT: Oneil, John & Cristine SUBDIVISION: Miami Shores ID #: 11- 3205 -018 -0040 TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PROVTJ)F RFGTSTRATTON NUMBFR AND SI(N AND SFAL EACH PAGE OF SUBMTTTAT,. COMPT,FTF, ALL TTFMS. PROPERTY SIZE CONFORMS TO SITE PLAN:[X]YES [ ]NO NET USABLE AREA AVAILABLE: 0.20 ACRES TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [64E -6, TABLE 1] AUTHORIZED SEWAGE FLOW: 500 GALLONS PER DAY [1500GPD /ACRE OR 2500GPD /ACRE] UNOBSTRUCTED AREA AVAILABLE: 1148 SQFT UNOBSTRUCTED AREA REQUIRED: 1143 SQFT BENCHMARK /REFERENCE POINT LOCATION: Finished F1 of Exist. Res. 10.36' NGVD ELEVATION OF PROPOSED SYSTEM SITE IS 33.12 [ INCHES ] [ BELOW ]BENCHMARK /REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: SURFACE WATER: N/A FT DITCHES /SWALES: N/A FT NORMALLY WET? [ ]YES [ X ]NO WELLS: PUBLIC: N/A FT LIMITED USE: N/A FT PRIVATE: N/A FT NON- POTABLE: N/A FT BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 16 FT SITE SUBJECT TO FREQUENT FLOODING: ( ]YES [ X ]NO 10 YEAR FLOOD ELEVATION FOR SITE: 0 FT NGVD SOIL PROFILE INFORMATION SITE 1 Munsell # /Color Texture 9 AV-AP-T. R MY Rand 9 5Y -R /1 -P VW An1itio T.imaa USDA SOIL SERIES: 15 Urban land Depth n to 45 45 to 79 to to to to to to DH 4015, 03/97 (Obsoletes previous editions which may not be used) 10 YEAR FLOODING? [ ]YES [ X ]NO SITE ELEVATION: CENTRAX #: 13 -SG -15986 OSTDSNBR : 03- 0902 -N SOIL PROFILE INFORMATION SITE 2 Munsell # /Color Texture Depth 7 5Y- Fi /9 -T. R GY Rand 0 to Fin 9 5Y -R /1-P VW Onl i ti e. T.i maq Fin to 79 to to to to to to USDA SOIL SERIES: 15 Urban land OBSERVED WATER TABLE55.00 INCHES [ BELOW ] EXISTING GRADE TYPE: [ APPARENT ESTIMATED WET SEASON WATER TABLE ELEVATION:55.00 INCHES [ BELOW ] EXISTING GRADE. HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO DEPTH: 0.0 INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING:Replacement/0.70 DEPTH OF EXCAVATION:72.0 INCHES DRAINFIELD CONFIGURATION: [ ]TRENCH [ X ]BED [ ]OTHER (SPECIFY) REMARKS /ADDITIONAL CRITERIA: Profile Location: 10.0' South of the North Property Line. 35.0' East of the West Property Line. Building Area 2606 Square feet. Unobstructed area required not available. OK ( See New Site Plan) Existing system must be shown on the site plan w/ a note to indicate that it will be abandoned. OK See New Site Plan 5/23/03 SITE EVALUATED BY: Wilfredo Lopez DATE: 3/24/03 OWNER 0 FT NGVD • i M STATE OF FLORIDA </ DEPARTMENT OF HEALMH ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS APPLICANT: % / / . „ � / Lf n , Nc _ AGENT: r 41 LOT: / 5- -''-BLOCK: / /7 4 ? SUBDIVISION: A /, •Vf /a /25..S PROPERTY ID #:. //3 / G [Section /Township /Range /Parcel No. or Tax ID Number] /°9 - TO BE COMPLETED BY ENGINEER, CHEALTH UNIT EMPLOYEE) OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE P TOTAL ESTIMATED SEWAGE FLOW: AUTHORIZED SEWAGE FLOW: UNOBSTRUCTED AREA AVAILABLE: CHMARK tEFERENCE POINT LOCATION: /U, 3 ' A/ 4 Q 7 4 0 t /, U 1' . ACIsS' Ae -fz/ Gd( Ei AI`ION OF PROPOSED SYSTEM SITE IS 2,2 6, [INCHE /FT [ABOV %BELOW BENCHMARK REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: SURFACE WATER: /f 011i FT DITCHES /SWALES: it/0/06 FT NORMALLY WET? [ ] YES [ N0 WELLS: PUBLIC: /4JOa/ &FT LIMITED USE: /*Ai-FT PRIVATE: /QO »EFT NON - POTABLE: .7,(9, , FT BUILDING FOUNDATIONS: 57 FT PROPERTY LINES: 5r FT POTABLE WATER LINES: 4(„ FT SITE SUBJECT TO FREQUENT FLOODING: 10 YEAR FLOOD E FOR SITE: SOIL PROFILE INFORMATION SITE 1 Munsell Color Texture Depth ,4"4 (o' / Si/VD. O to N 0 7i m / ., 4.t e =to / G 6v /e $ to G 0 0 to to Gr a to 7" USDA SOIL SERIES: a 44 r OBSERVED WATER TABLE: /0 INCHES [ABOVE / ESTIMATED WET SEASON WATER TABLE ELEVATION: HIGH WATER TABLE VEGETATION: [ ] YES [4 NO SOIL TEXTURE LOADING RATE FOR SYSTEM SIZING: d /7® R Re U`�E I.UG DRAINFIELD CONFIGURATION: [ ] TRENCH (-74) BED [ �. EMAR]CS ADDITIONAL CRITERIA: / ®/ZJ / / 2eil 4 0 �/6 /J /M. :r /DE e 55 SITE EVALUATED BY: DH 4015, 10/96 (Replaces HRS -H Form 403 (Pa 3 J which may be used) Stock Number: 5744 - 003 - 4015 -1) : [V] YES [ ] NO NET USABLE AREA AVAILABLE: 0/4( ACRES O GALLONS PER DAY [RESIDENCES -TABLE 1 OTHER -TABLE 2) 5 GALLONS PER DAY (1500 GPD /ACRE OR 2500 GPD ACRE aCgQFT UNOBSTRUCTED AREA REQUIRED: ; / SQFT [ ] YES ['NO 10 YEAR FLOODING? [ FT MSL /NGVD SITE ELEVATION: ,;∎ 4> ele,S L / ' S L" r kr0 /S G � � /� N SOIL PROFILE INFORMATION SITE 2 4 /9t41f 6: BELOWJ EXISTING GRADE. TYPE: [PERCHED / APPARENT) Z... INCHES [ ABOVE / BELOW ] EXISTING GRADE. MOTTLING: [ ] YES [of NO DEPTH: ----- INCHES DEPTH OF EXCAVATION: 6/� 2INCHES ) \OTHER .(SPECIFY) A- ;Poa,�.f PERMIT # e°13 / ] YES [ NO FT MSL/ Munsell Co or to Depth 0 to to to to k t o USDA SOIL SERIES: 1,/;'6b/ L 4 0-4 7N6 R 7\5 /his Page 3 of 3 SEWAGE FLOW: UNOBSTRUCTED AREA: MINIMUM SETBACKS: FLOOD INFORMATION: SOIL PROFILE INFORMATION: WATER TABLE: SOIL TEXTURE: DEPTH OF EXCAVATION: • • INSTRUCTIONS: l' PERMIT NUMBER: Permit tracking number by County Health Department. APPLICANT: Property owner's full name. AGENT: Property owner's legally authorized representative. LOT, BLOCK, SUBDIVISION: Lot, block, and subdivision for lot. PROPERTY ID NUMBER: 27 character number for property (property appraiser ID number or section /township /range /parcel number). PROPERTY SIZE: Check if property at site conforms to submitted site plan. Record net usable area available - lot area exclusive of all paved areas and prepared road beds within public rights -of -way or easements and exclusive of streams, lakes, normally wet drainage ditches, marshes, or other such bodies of water. Record the estimated sewage flow for the establishment from Table 1 (residence) or Table 2 (non - residential), Chapter IOD -6, FAC. Record the authorized sewage flow for the lot based on net usable area and water supply (1500 gallons per day per acre for private water supplies and 2500 gpd per acre for public water supplies). If authorized sewage flow does not equal or exceed the estimated sewage flow, the application must be denied. Record the square feet of unobstructed area available and the amount required. Unobstructed area must be at least 2 times as large as the drainfield absorption area and at least 75 percent of the unobstructed area must meet minimum setbacks in Chapter 10D -6, FAC. The unobstructed area must be contiguous to the drainfield. BENCHMARK INFORMATION: Record the location of the benchmark. If using a surveyor's benchmark record the actual elevation. Record the elevation of the proposed system site in relation (above or below) to the benchmark. Record minimum setbacks which can be meet to all listed features. Actual measurements must be recorded or "NA" for nonapplicable features. Features on site plan or within 75 feet of the applicant lot must be measured. The location of any public drinking well within 200 feet of the applicant's lot must also be verified. Record information on lot's subject to flooding. For lots subject to flooding record 10 year flood elevation for site and actual site elevation. Two soil profiles within the proposed absorption area to a minimum depth of 6 feet or refusal are required. Soil identification will use USDA Soil Classification methodology (Munsell colors and USDA soil textures). Refusals must be clearly documented. Provide USDA soil series if available, record "UNK" if the series cannot be determined. Record the depth of the observed water table at the time of the evaluation. Mark "perched" or "apparent" as appropriate. Record the estimated wet season water table elevation based on site evaluation, USDA soil maps, and historical information. Indicate if there is high water table vegetation present. Indicate if mottling is present and depth. Record soil texture or loading rate for system sizing. If applicable record depth of excavation required. Record "NA" if not applicable. DRAINFIELD CONFIGURATION: Check drainfield configuration required. If other, specify type. ADDITIONAL CRITERIA: Record any additional remarks pertinent to site or installation. Ex. dosing required. SITE EVALUATED BY: Signature of evaluator, title, and date of evaluation. Professional engineers must seal all documents submitted. ELEVATION WORKSHEET ELEVATION OF BENCHMARK / REFERENCE POINT IS: BENCHMARK SITE 1 SITE 2 SITE 3 [ + ] SHOT H.I. H.I. H.I. H.I. [ - ] SHOT [ - ] SHOT [ - ] SHOT