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PL-16-816 r * j Inspection Worksheet ✓{ Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone:(305)795-2204 Fax: (305)756-8972 Inspection Number. INSP-255632 Permit Number. PL-3-16-816 Scheduled Inspection Date:April 06,2016 Permit Type: Plumbing -Residential Inspector. Hernandez,Rafael Inspection Type: Final Owner. ,KALYANI VENTURES,LLC Work Classification: Drainfield Job Address:30 NW 92 Street Miami Shores,FL 33138- Phone Number Parcel Number 1131010170210 Project <NONE> Contractor. STATEWIDE SEPTIC CONNECTIONS Phone:(954)963-0082 Building Department Comments REPLACE DRAINFIELD Infractio Passed Comments, INSPECTOR COMMENTS False Inspector Comments Passed HRS APPROVAL IN FILE Failed El Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-Inspection fee is paid DIVISION OF Environmental Health Florida Health Miami-Dade County OSTDS/Well Division R Q� ll8r 05,SW 26th street•Miami,FL 33175 O Inspector N Date Address � aCr"j OSTDS# T Comments: Signature Miami Shores Village 10050 N.E.2nd Avenue NW r: Miami Shores,FL 33138-0000 550—�M Phone. (305)795-2204 Expiration: 09/25/2016 y4� Project Address Parcel Number Applicant 30 NW 92 Street 1131010170210 KALYANI VENTURES,LLC Miami Shores, FL 33138- Block: Lot: Owner information Address Phone Cell KALYANI VENTURES,LLC 30 NW 92 Street MIAMI SHORES FL 33150- FL Contractor(e) Phone Cell Phone Valuation: $ 2,400.00 STATEWIDE SEPTIC CONNECTIONS (954)963-0082 Total Sq Feet: 150 Type of Work:REPLACE DRAINFIELD Available Inspections: Type of Piping: Inspection Type: Additional Info: HRS Approval Bond Retum: 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-3-16-59172 CCF $1'60 03129/2016 Credit Card $623.30 $50.00 DBPR Fee $2.25 DCA Fee $2.25 03/25/2016 Check#:6050 $50.00 $0.00 Education Surcharge $0.60 Bond#:3035 Notary Fee $5.00 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $673.30 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. in accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS ORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing informatio is acc to and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above nam t ctor to do the work stated. March 29,2016 Authorized Signature:Owner / Applicant / ontra or / Agent Liate I Building Department Copy March 29,2016 1 Miami Shores Village M RRC TiM- Building Department M �o16 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 BY' =, LINE PHONE NUMBER:(305)762-4949 �FBC 20 Mme ' BUILDING Master Permit No. vu 6 -9 ( 10 PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 3® Ow 92- S- r t_t City: Miami Shores County: Miami Dade Zip: '3 31 CJ Folio/Parcel#: 11- 2)(0 1 -• 00-02-1 a Is the Building Historically Designated:Yes NO Occupancy Type: Load: )Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): I-A I 0 1 V Phone#: 7 6 9-6 O Address: 101 S Of-11C M e-A ete W. Dy City: tAlOtrnl State: fil Zip: 331�' Tenant/Lessee Name: Phone#: Email: (,v� CONTRACTOR:Company Name: G C4-1+",(' 1''1 C Phone#: 6Ie(� 6f d� Address: t366 0 N W Pi A-yf, A- t0 a City: ® C- L OWA -State: F71 Zip: J S Qualifier Name:__ Qom{gc N�Q Phone#: State Certification or Registration#: �M®�I 1 126 ' Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ ),Lt 6�7 Square/linear Footage of Work: i Type of Work: ❑ Addition ❑ Alteration ❑ New IX Repair/Replace ❑ Demolition Description of Work: Specify color of�ofllcolor thru tile: r Submittal Fee$ 9) v � Permit Fee$ /J'0 ! CCF$ I "� CO/CC$ ��-\\ Scanning Fee$9 'CZ Radon Fee$ ' O DBPR$_c� S Notary$ 'Z; , W Technology Fee$ C) < "l G Training/Education Fee$ 0" 6 Double Fee--$ 0) Structural Reviews$ Bond$ gw o(3 TOTAL FEE NOW DUE$ I ° 3 Q (Revisedo2/24/2014) . 30 r ► Bonding Company's Name(if applicable) Bonding Company's Address 4 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 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 AGENT CONTRACTOR The foregoing instrument was before me this The foregoing instrument was acknowledged before me this day of d'2� .20 .by ZS day of f\��1( .20 (JG .by ,s N atry 1 d S•►SS men ,who is personally known to �� 5 &PQM C,3 .who is personally known to v me or who has produced - rel-A- (r) as me or who has produced as identification and who d' ake n oath. identification and who did take an oath. NOTARY PUBLIC, NOTARY PUBLIC: Sign: Sign: Print: Print: YORENDRYDEL RIO Seal: n�e MY COMMISSION#FF188880 Seal: =PublicState of FloridaEXPIRES:FEB 12,2018 zIMnded through 18t Stare IllsuranCe n FF 158750l2018 ************************************************************************************************************ APPROVED BY 3' �r Plans Examiner Zoning Structural Review Clerk (RevisedO2/24/2014) PERMIT #: 13-SC-1646750 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION #:AP 1215496 ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID: SYSTEM FEE PAID: CONSTRUCTION PERMIT RECEIPT #: DOCUMENT #: PR997260 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: (Katy and Ventures LLC) PROPERTY ADDRESS: 30 NW 92 St Miami, FL 33150 LOT: 20 BLOCK: na SUBDIVISION: PROPERTY ID #: 11-3101-017-0210 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAR ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANG . IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ 900 ] GALLONS / GPD Septic CAPACITY A [ 0 ] GALLONS / GPD CAPACITY N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ 150 ] SQUARE FEET Trench configuration drain SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [x] STANDARD [ I FILLED [ 7 MOUND [ ] I CONFIGURATION: [x] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: Crown of Road: 11.31'NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 5.16 ] [ INCHEs FT ] [ ABOVE BELOW]BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE 1. 42.84 ] [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 60.001 INCHES O *Amended by B.Olmino on 12/30/2015 to correct from 3 bedrooms to 2 bedrooms,verified by DOH inspector. I.-Existing 900 gal.septic tank,certified by"Day&Night"on 12/09/2015 to remain. T 2-Install 150 sf of drainfield in trench configuration. H 3-Install 12"of slightly limited soil at the bottom of the drainfield. 4-Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed or drain trench. E (Comments Continued on Page 2.) R SPECIFICATIONS BY: TITLE: APPROVED BY: TITLE: Engineering Specialist II Dade CED Betsy Lange- no DATE ISSUED: 12/10/2015 EXPIRATION DATE: 03/09/2016 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FACPage 1 of 3 v 1.1.4 AP1215496 SE979202 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR CONSTRUCTION PERMIT Permit Application Number -- Y PART 11-SITEPLAN Scale: Each block r -eft 10 feet and 1 Inch=40 feet :. ..... ...... _ SZ _.... _ _ . m i Notes:: Site Plan sLihnfted : fidrawn Plan Approxi v Not Approved ? j County Health Department By ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015,08/09(Obscietes previous editions which may not be used) Incorporated: 84E-8.001,FAC Page 2 of 4 (Stock Number. 5744-002-4015-8) Property Search Application - Miami-Dade County Page 1 of 1 .' OFFICE PROPERTY Summary Report Generated On:3/25/2016 Property InformationF,, Folio: 11-3101-017-0210 :1: t. Property Address: 30 NW 92 ST Miami Shores,FL 33150-2227 Owner KALYANI VENTURES LLC Mailing Address 1015 BELLE MEADE ISLAND DRIVE - MIAMI, FL 33138 USA Primary Zone 0800 SGL FAMILY-1701-1900 SQ Primary Land Use 0101 RESIDENTIAL-SINGLE FAMILY: 1 UNIT Beds/Baths/Half 3/2/0 Floors 1 Living Units 1 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 1,493 Sq.Ft Taxable Value Information Lot Size 7,500 Sq.Ft 2015 2014 2013 Year Built 1941 County Assessment Information Exemption Value $0 $0 $0 Year 7$122,049 015 2014 2013 Taxable Value $225,961 $187,709 $170,6451 Land Value $100,962 $67,734 School Board Building Value 912 $102,069 $102,911 Exemption Value $0 $0 $0 XF Value $0 $0 $0 Taxable Value $225,961 $203,031 $170,645 Market Value $225,961 $203,031 $170,645 City Assessed Value $225,961 $187,709 $170,645 Exemption Value $0 $0 $0 Taxable Value $225,961 $187,709 $170.645 Benefits Information Regional Benefit Type 2015 2014 2013 1 Exemption Value $0 $0 $0 Non-Homestead Cap Assessment Reduction $15,322 Taxable Value $225,961 $187,709 $170,645 Note:Not all benefits are applicable to all Taxable Values(i.e.County, School Board,City, Regional). Sales Information Previous OR Book- Short Legal Description Sale Price Page Qualification Description 1 5341 03/27/2014 $180,000 29092-4849 Not exposed to open-market;atypical CANADAY EXTENSION PB 41-71 motivation LOT 20 06/01/2005 $350,000 23549-1475 Sales which are qualified LOT SIZE 75.000 X 100 11/01/2003 $259,000 21883-1599 Sales which are qualified OR 18497-4683 02 1999 1 02/01/1999 $114,000 18497-4683 Sales which are qualified The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at http://www.miamidade.govfinfo/disclaimer.asp Version: http://www.miamidade.gov/propertysearch/ 3/25/2016 Detail by Entity Name Page 1 of 2 Detail by Entity Name Florida Limited Liability Company KALYANI VENTURES, LLC Filing Information Document Number L12000146241 FEI/EIN Number 46-1443305 Date Filed 11/20/2012 Effective Date 11/26/2012 State FL Status ACTIVE Principal Address 1015 BELLE MEADE ISLAND DRIVE MIAMI, FL 33138 Mailing Address 1015 BELLE MEADE ISLAND DRIVE MIAMI, FL 33138 Registered Agent Name & Address SUSSMAN, HAROLD S 5300 N. FEDERAL HIGHWAY FORT LAUDERDALE, FL 33308 Authorized Person(s) Detail Name & Address Title MGR SUSSMAN, HAROLD S 5300 N. FEDERAL HIGHWAY FORT LAUDERDALE, FL 33308 Annual Reports Report Year Filed Date 2013 03/25/2013 2014 04/28/2014 2015 04/27/2015 Document Images http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 3/25/2016 Detail by Entity Name Page 2 of 2 04/27/2015 ANNUAL REPORT view image in PDF format� 04/28/2014 ANNUAL REPORT View image in PDF format 03/25/2013 ANNUAL REPORT View image in PDF format 11/20/2012 Florida Limited Liability View image in PDF format Co1wri,jit ;;and Privacy Policies State of F4-jda,Department of state http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 3/25/2016