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PL-15-2934 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone:(305)795-2204 Fax:(305)756-8972 Inspection Number. INSP-248776 PermitNumber. PL-11-15-2934 Scheduled Inspection Date: December 08,2015 Permit Type: Plumbing - Residential Inspector. Diaz,Osvaldo Inspection Type: Final Owner . Work Classification: Septic Job Address:2 NW 108 Street Miami Shores,FL 33168- Phone Number (305)773-3101 Parcel Number 1121360110090 Project <NONE> Contractor. STATEWIDE SEPTIC CONNECTIONS Phone:(954)963-0082 Building Department Comments REPLACE SEPTIC TANK AND DRAINFIELD Infractlo passed Comments INSPECTOR COMMENTS False nspector Comments Passed CREATED AS REINSPECTION FOR INSP-248182 canceled ED" no permit Failed Correction Needed V--I'Q(A I,___ Re-Inspection y 6-15 Fee a No Additional Inspections can be scheduled until re-inspection fee Is paw December 07,2015 For Inspections please call: (305)762-4949 Page 28 of a dolf roEti yc. s ti $ �3 �JG4Y1 4+}3"#+ Add A t < ' '-'„�. �a r r ,ass x s S F;•: tNr -FL O (S . -S 4 V 6- 9Y!° t4 Miami Shores Villageliimbir�g�eitlelntl 10050 N.E.2nd Avenue NW Miami Shores,FL 33138-0000 Phone: (305)795-2204 t Expiration: 0511 12016 Iui�t3ate 11f2012016 Project Address Parcel Number Applicant 2 NW 108 Street 1121360110090 Miami Shores, FL 33168- Block: Lot: CAP REALTY LC Owner Information Address Phone Cell CAP REALTY LC 12000 BISCAYNE Boulevard (305)773-3101 MIAMI FL 33182- .j 12000 BISCAYNE Boulevard MIAMI FL 33182- Contractor(s) Phone Cell Phone Valuation: $ 8,500.00 STATEWIDE SEPTIC CONNECTIONS (954)963-0082 Total Sq Feet: 420 Type of Work:REPLACE SEPTIC TANK AND DRAINFIELD Available Inspections: Type of Piping: Inspection Type: Additional Info: HRS Approval Bond Return: Final Classification:Residential Scanning:3 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Contractors Bond $500.00 Invoice# PL-11-15-57833 CCF $5.40 DBPR Fee $4.50 11/20/2015 Check*1017 $782.40 $50.00 DCA Fee $4.50 11/19/2015 Check*1014 $50.00 $0.00 Education Surcharge $1.80 Bond#:2907 Permit Fee $300.00 Scannino'Oee $9.00 Technology Fee $7.20 Total;._.,. $832.40 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertain ing:f.hereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting, is permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required fG7 ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWN ER64FFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I aLd7hbrize the above-named contractor to do the work stated. G November 20,2015 Auth razed Sig ature:Owner / Applicant / Contractor / Agent Date Builc� n partment Copy November 20,2015 1 t R A I Miami Shores Village 19 2015 Building Department -_ 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 BUILDING Permit No. PERMIT APPLICATION Master Permit NoYL1 3— ag3q FBC 20 Permit Type: PLUMBING OWNER:Name(Fee Simple Titleholder): CAO 9-'EAA_TV L1.. Phone#: 30 5- 72 j 3' j Address: 12-oco 61SgNNe Ivo City: o"1 t 4(-11 State: - Zip: 31121 Tenant/Lessee Name: Phone#: Email: .A t.t a CAP 0 401- - (-.,A I. JOB ADDRESS: -2- NW 108 ��-,T City: Miami Shores County: Miami Dade Zip: 166 Folio/Parcel#: 1. 1 - Z 1 NG - O` t - 0 5A U Is the Building Historically Designated:Yes NO X Flood Zone: CONTRACTOR:Company Name: STN'TFCW OF S09Tn Q- Coot 827n aNihone#: -3��C9�" cc �� Address: 1 GAO PAW 19 AVE City: 0 P A-Lo c-r—A State: F-(, Zip: >30S 4' Qualifier Name: le Phone#: State Certification or Registration#: Oct-7 13_'G 2 Certificate of Competency#: Contact Phone#: Email Address: DESIGNER:Architect/Engineer: Phone#: �Sad.� O Value of Work for this Permit:$ v% Square/Linear Footage of Work: I+zo Type of Work: ,DAddress., ❑Alteration ❑New 31Repair/Replace ❑Demolition Description ofo;k s 4��I�L CE Serli G Submittal Fee$" Permit Fee$ �w1 ^Y CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ -1 TOTAL FEE NOW DUE$ �.C-� r 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 reins ection fee will be charged. Signature Signature ��5 Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was ackno-pw-ledged before me this day of 2 ,20 1 by Vt` �'!�j'1�i�i/. fes` day of 20 by-1 j-/zFSpy !;0 LrAA4y, ho is personally known to me r who has produced who is personally known to me or who has produced-T9 s identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLI �illllll Il��jai II �i Sign: S ��i Sign: i��i �/� 'pNpASSION rte• ,;:pSSI6h1•• �,'i Print• -i� 01'2p��r' Print: �i'� • R�. rL' �'• • � .X00 !� O My Commission Expired My Commission Exp' �• y •.,�#Ff923352 t, Q ffi i 9 • i"��1srSte�:M' 0�� i �a�bio�q S�e��:••OQ:gr- �k�k��k�ksk�a�ksksk�asksk�k�k�+��k��k�k�k � a�sRs�sks��sk�Isskik�kskH�ak�ksknksksk�kH�H��k��kH��k�Ssksksksk��ksksksk�aak�IaHaHaH�H�skskiRffi�F��a �skak°kskMa�k�SKssk rtttl/C,S \\\\ s%�rt Nix S1 APPROVED BY s/ �/ Plans Examiner Zoning Structural Review Clerk (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) Prope Search Application-Miami-Dade County Page 1 of 1 OFFICE OF THE PROPERTY APPRMSER y Summary Report Generated On:11/19/2015 Property Information Folio: 11-2136-011-0090 ' Property Address: 2NW108ST Miami Shores,FL 33168-4311 Owner CAP REALTY LC 12000 BISCAYNE BLVD#704 Mailing Address s MIAMI,FL 33182 USA = i , Primary Zone 0800 SGL FAMILY-1701-1900 SQ f . 0101 RESIDENTIAL-SINGLE Primary Land Use d£ FAMILY:1 UNIT Beds I Baths I Half 4/2/0 Floors Living Units a l3 l Actual Area Sq.Ft � Living Area Sq.Ft ra Adjusted Area 1,717 Sq.Ft Taxable Value Information Lot Size 9,194.25 Sq.Ft 2015 2014 2013 Year Built 1952 ___ .__.______ County Exemption Val 0 Assessment Information p Value $0 $0 $99, 2 8 Year 2015 2014 2013 Taxable Value 1 $274,297 $206,289 $0 Land Value $165,565 $99,043 $45,826 School Board Building Value $107,658 $106,158 $117,199 Exemption Value $0 $0 $25,500 XF Value $1,074 $1,088 $1,102 Taxable Value $274,297 $206,289 $73,582 Market Value $274,297 $206,289 $164,127 city Assessed Value $274,297 $206,289 $99,082 Exemption Value $0 $0 $50,500 Taxable Value $274,297 $206,2891 $48,582 _...-- ._........._....._.....------ --..................._.__-- Benefits Information Regional Benefit Type 2015 2014 2013 Exemption Value $0 $0 $50,500 Save Our Homes Cap Assessment Reduction $65,045 Taxable Value 1 $274,297 $206,2891 $48,582 Homestead Exemption $25,000 Sales Information Second Homestead Exemption $23,582 Senior Homestead Exemption $50,000 Previous Sale Price OR Book-Page Qualification Description Civilian Disability Exemption $500 02/20/2014 $280,000 29045-1963 Qual by exam of deed Note:Not all benefits are applicable to all Taxable Values(i.e.County, 05/07/2013 $222,500 28629-4267 Qual by exam of deed School Board,City,Regional). 08/01/1988 $70,000 13779-857 Sales which are qualified Short Legal Description 36 52 41 PB 52-33 DUNNINGS MIAMI SHORES EXT NO 7 LOT 1 BLK 211 LOT SIZE 74.750 X 123 OR 13779-857 0888 1 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.govrnfo/disclaimer.asp \/Amt n• http://www.miamidade.gov/propertysearch/ 11/19/2015 Detail by Entity Name Page 1 of 2 Detail by Entity Florida Limited Liability Company CAP REALTY LC Filing Information Document Number L06000089951 FEI/EIN Number 20-5550248 Date Filed 09/13/2006 Effective Date 09/13/2006 State FL Status ACTIVE Principal Address 12000 Biscayne blvd suite 704 miami, FL 33181 Changed: 04/13/2013 Mailing Address 12000 Biscayne blvd suite 704 miami, FL 33181 Changed: 04/13/2013 Registered Agent Name&Address CAPDEVIELLE, XAVIER 12000 Biscayne blvd suite 704 miami, FL 33181 Address Changed: 04/13/2013 Authorized Person(s) Detail Name &Address Title MGR CAPDEVIELLE, XAVIER 12000 Biscayne blvd suite 704 miami, FL 33181 http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entit... 11/19/2015 Detail by Entity Name Page 2 of 2 t Annual Reports Report Year Filed Date 2013 04/13/2013 2014 01/24/2014 2015 03/05/2015 Document Images 03/05/2015—ANNUAL REPORT view image in PDF format 01/24/2014 ANNUAL REPORT View image in PDF format 04/13/2013 ANNUAL REPORT view image in PDF format 04/26/2012 ANNUAL REPORT View image in PDF format---] 04/08/2011 —ANNUAL REPORT View image in PDF format 03/19/2010 ANNUAL REPORT View image in PDF format 04/25/2009 ANNUAL REPORT View image in PDF format 04/21/2008 ANNUAL REPORT View image in PDF format 04/04/2007 ANNUAL REPORT View image in PDF format 09/13/2006— Florida Limited Liabifi!y View image in PDF format copyright cc)and Privacy Policies State of Florida,Depaitment of State http://search.sunbiz.org/Inquity/CorporationSearch/SearchResultDetail?inquir ytype=Entit... 11/19/2015 4 f PERMIT : 13-SC4639457 STATE OF FLORIDA APPLICATION :AP 121051$ s DEPARTMENT OF HEALTH DATE PAIr: ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FEE PAID: RECEIPT #: DOCUMENT #:PR993767 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: (CAP Realty LLC) PROPERTY ADDRESS: 2 NW 108 St Miami,FL 33168 LOT: 1 BLOCK: 211 SUBDIVISION: PROPERTY ID #: 11-2136-011-0090 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STAND 3 OF SECTION 331,0065, F.S,, AND CHAPTER 64E-6, F,A,C. DEPARTMENT APPROVAL OF SYSTEM ES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME, WHICH SERVED A3 A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THF, ApANY p I IN MATERIAL FACTS, PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MAD ULL am VOID. MODIFY THE ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITTO HER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY, SYSTEM DESIGN AND SPECIFICATIONS T [ 900 I GALLONS / GPD New septic tank CAPACITY A I 0 ] GALLONS / GPD N I 0 ] GALLONS GREASE INTERCEPTOR CAPACITY CAPACITY K [ [� CAPACITY SINGLE TANK;1250 LON3] 7 GALLONS DOSING TANK CAPACITY I (GALLONS @I DOSES I PER 24 HRS #Pumps [ ] D [ 420 I SQUARE FEET bed configuration drainfiel SYSTEM R [ 0 I SQUARE FEET SYS A TYPE SYSTEM: M IX] STANDARD I ] FILLEDMOUND I CONFIGURATION: I I [ I [ ] TRENCH Ixl BED [ ] N F LOCATION OF BENCHMARK: C=F.F.E., 10.67'NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 2.04 7I INCHES FT ][ABOVE BELOW BENCHMARK/ FERENCE POINT L E BOTTOM OF DRAINFIELD TO BE INCHES 145.12 ]I FTI[ABOVE BELOW BENCEMOMK/R 9FERENCE POINT D FILL REQUIRED: 10.001 INCHES EXCAVATION REQUIRED: [ 43.001 INCHES Inspector to verify the existing septic tank is properly abandoned before final approval. O *Invert elevation of drainfield to be no less than 7.41'NGVD. T *Bottom of drainfield elevation to be no less than 6.91'NGVD. H 'THIS PERMIT IS NOT FOR"ADDITION(s)". The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimate flow E of 300 gpd. Required drainfield area based on rule 64E-6.015(6)(c)2. R SPECIFICATIONS BY: Teres Sol mon TITLE; APPROVED BY: Master Septic Tank Contractor TITLE: arlos icaza Dade CHD DATE IssUED: 11/ DH 4016, 03/09 (Obaoletea all The contractor(or designee)is required to perform EXPIRATION DATE' /07/2b 16 Inco Previous f j� tf01trA Wlald B00aaatbbA at the Incorporated: 64E-6.003, FAC time of final inspection.Prior to Final Approval,the DOH V 1.1.4 inspector shall witaRSDAhe soil boring and cone" Page 1 of 3 results to the ori-3inal site evaluation submitted.A reinspection fee will be assessed if the contractor is not at the jobsite at the arranged time. w ! NOTICE OF RIGHTS R A party whose substantial interest is affected by this order may petition for an administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for administrative hearing must be in writing and must be received by the Agency Clerk for the Department,within twenty-one (21) days from the receipt of this order. The address of the Agency Clerk is 4052 Bald Cypress Way, BIN#A02, Tallahassee, Florida 32399-1703. The Agency Clerk's facsimile number is 850-410-1448. Mediation is not available as an altemative remedy. Your failure to submit a petition for hearing within 21 days from receipt of this order will constitute a waiver of your right to an administrative hearing, and this order shall become a'final order'. Should this order become a final order, a party who is adversely affected by it is entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a second copy, accompanied by the filing fees required by law, with the Court of Appeal in the appropriate District Court. The notice must be filed within 30 days of rendition of the final order. STATE OF FLORIDA DEPARTMENT OF HEALTH. . �- i4P 'LICATION FOR-ONSITE SCWEP° �' 1tE11CUlFSTRIJG �MIT Permit Application Number rp , I -------_ ------------- PART II'=SITE PLAN----=