PL-15-602 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-230583 Permit Number: PL-3-15-602
Scheduled Inspection Date: May 09,2016 Permit Type: Plumbing- Residential
Inspector: Hernandez, Rafael
Inspection Type: Final
Owner: TAVARES,TIERES Work Classification: Septic
Job Address: 10050 NE 12 Avenue
Miami Shores,FL
Phone Number (305)244-2356
Parcel Number 1132050190370
Project: <NONE>
Contractor: MR C'S PLUMBING&SEPTIC INC Phone: (306)651-7869
Building Department Comments
SEPTIC TANK AND DRAIN FIELD Infractlo Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
reinspection fee is paid
4>4xlg�
DIVISION OF
E202,
Environmental Health
Florida Health An Miami-Dade County
�Q OSTDS/Well Division
�j►� 11805 SW 26th Street-Miami,FL 33175 O
Inspector Date 5
tt Address` osQ N,.D£ to 2 OSTDS# �
Comments:
Signature
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111111111111111111111111111111111111111111111
C-FN 2015RO131194
OR Bk 29518 Pss 1517 - 1519; (3ass)
RECORDED 02/27/2015 12111.24
DEED ROC TAX 4t5U.00
HARVEY RUVIN? CLERK OF COURT
KIANI-RADE COUKTYt FLORIDA
This Document Prepared By and Return to;
RICHARD A. GOLDEN, ES¢
KRAMER AND GOLDEN, P. .
1175 N.E. 125TH STREET SUITE 512
NORTH MIAMI, FLORIDA 33161
KGPA FILE NO.16-15R
ParceiiDNumber, 11-3205-018-0370
Warranty Deed
Thb Indenture, Madethis J1'* dayof February , 2015 A.D., Between
ANDREW CURZON, A MARRIED MAN
of the county ar HUDSON , state of NEW JERSEY ,grantor, and
TIERES TAVARES, AS TRUSTEE OF THE BEYOND ALL REVOCABLE TRUST DATED
01/17/14
whose address is 10050 NE 12 AVENUE, MIAMI SHORES, FL 33138
of the coumy of MIAMI—DADE , state or Florida ,grantee.
MAtuesseth that om mANTOR,Cor and is mowetati m or ltar sum or
------------------------TEN DOLLARS 010)----------------------- DOLLARS,
and other good and voluebla comdasation to GRANTOR in lawd paid by GRANTEE. the receipt whereof is hereby admowiedged, has
granted,ba vhvd attd sold to the saki CRANTM and GRANTBE'S hebs,atm mors and assigns forever,the tbilowing described bund,sit a le,
lying mtd being in the courtly or MIAMI—DADS state or Florida to wit
SEE LEGAL DESCRIPTION ATTACHED HERETO AND MADE A PART HEREOF
Grantor affirmatively states that the subject property is not the
HOMESTEAD property of the Grantor or any member of their family, nor
is the subject property contiguous to the homestead of the Grantor
pursuant to Article X, Section 4 of the Constitution of the State of
Florida. The Grantor's HOMESTEAD address is 1300 Grand Street, Apt.
516, Hoboken, NJ 07030.
and the grantor does hereby lolly wuaunt am title to said latul, wtd will defend the same against Iawfui claims of all petsons whomsoevet
wwo�aursu�brA++�.�mts t�»s>.ssss r�o,Rsda-a
I
Book29518/Page1517 CFN#20150131194 Page 1 of 3
e
Warranty Deed .page 2
Parcel ll)Nombert 11-3205-019-0370
h W➢tneM Whereof,tbo grantor has hereunto ad bis hash arrd Seal rho day and Year fast above wd*r.
Signed,sealed and delivered to our presence:
w�Aa
n&(, /Q d 4 (Seal)
Price d ame:Af' AMRMC N
Witnes P.O.Address I ND FOIC,$16,HOBOKEN,NJ 07030
in d Natae: n
Witness
STATE OF NEW JERSEY
COUNTY OF HUDSON
Tha foragoing irslrumant was noknowledged before me this Q? IA' day or February 064"' , 2015 by
ANDREW CMON, A MARRIED MAN
who is pasonally known tome or who has produced his New Jersey driver t s lia dorkifimadom
ANGH LYNN DIEfFE MERTH Prig Name: � 6
Notary Public
No
Public
CO�t>x�ixNo�I:assacla�rrs t�Y
My Commission Expires My Commission Hxpirax
A f3.2021
t
16-18R tno.ovmmuedEr bDav�rar+ u�a 2ois fstalrw-ssss rammer
Book29518/Page1518 CFN#20150131194 Page 2 of 3
P '
_ OR Bis. 29518 PG 1519
LtAST PAGE
Order No..5135089
Co171rimmidth w Customer Reference: 3446.02
on muwwm acav
EXHIBIT"V
Lot 16, Block 177, Revised Plat of Miami Shores,Section 8,according to the Plat thereof, recorded
In Plat Book 43,at Page 67, of the Public Records of Mlami-Dade County, Florida; and
The Easterly 5 feet of Lot 15, Block 177, Revised Plat of Miami Shores,Section 8,according to the
Plat thereof,recorded in Plat Book 43, Page 67,of the Public Records of Miami-Dade County,
Florida,described as follows
Begin at the Northeast corner of said Lot 15 For Point of Beginning;
Thence run West along the North line of said Lot 15 a distance of 5 feet to a point;
S•i'i�.rl':
Thence run Southeasterly parallel to and 5 feet from the Easterly line of said Lot 15 to a point on
the Southerly line of said Lot 15;
Thence run in an Easterly direction along the Southerly line of Lot 15 a distance of 5 feet to the
Southeasterly corner of said Lot 15;
Thence run Northwesterly along the Easterly line of said Lot 15 a distance of 95.89 feet, more or
less, to the place of beginning.
Said land situated lying and being in Miami-Dade County, Florida.
Copyright An wird r Lend Tide Assoclatim A I rights reserved.
The use of a*Form is ma t Ued to ALTA lirertseas and ALTA members in good standing as of the date /1_
of use. All other uses are prohNed. Reprtnted under license from the Anvwlwn Land Title Association.
ALTA Conwky rd i8H71M(unit FL Modilioetions) 5 of 5
Book29518/Pagel519 CFN#20150131194 Page 3 of 3
P
• ' Miami Shores Village
Building Department MAR 18 2015
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. p/ 1-5-- 6 02�.
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: PLUMBING
OWNER:Name(Fee Simple Titleholder):Ikb O TpcVWOS.f3E�TOt40 kL TAGCPhone#: 3 15- V4L(-Z7 9,0
Address: 100 SO WV1 ( 71 r /4CUl�'
City: /At- l 51+0 s State: FL zip: 3 3 ( ' $
Tenant/Lessee Name: Phone#:
Email: T 15iSE3�1 a fi'-TNC-. C-ot-1
JOB ADDRESS: 1 D o S O (-AE ( Z-TR 1"'rM
City: Miami Shores County: Miami Dade Zip: 33 [32>
Folio/Parcel#: -Z Z-C7 i Q — 0 31 0
Is the Building Historically Designated:Yes NO )41 Flood Zone:
CONTRACTOR:Company Name: k/' t /�iG�b/�^I /J.tilh2 Phone#:
Address: A*32 4116V A1_4"
City: // State: �L zip: 3j/6r!
Qualifier Name: +. L��K Phone#: 2of`G57
State Certification or Registration#: 46/Sr_zl Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ • 5quare/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration` ❑New PRepair/Replace ❑Demolition
Leh, �r.
Description of Work: , 'k T� /
Submittal Fee$ Permit Fee$ �U` CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE , Q
z
7;2
Bonding Company's Name(if applicable)
I NIL,—
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 s t to attach Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first in ection which -curs se n (7) days after the building permit is issued. In the absence of such posted notice, the
inspection w' not be approv d and a rei pection fee will be charged.
LL
Signature Signature
Owner Contractor t
The foregoing instrument was acknowledged before me this®� The foregoing instrument was acknowledged before me this—
day of P14 ,2015,by i COI&S 7-4 V/9 aeX day of�/V� / ,20,1.�.,by
who is personally known to me or who has produced 1 .iZ IVC'k� o is personally known tom r who has produced
�r
T 16 a eM 2WI23As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:- Sign: AJ-
Print: Print:
My p MY COMMISSION 4 EE 877007
M Cortutussior.Expires: Ai :'aE EXPIRES:Apra 14,20t7 My Co e t SHERYL A IMFWOES
W,;.;p Wfl4 Bonded tnru Notary Public undernraers . °ary Public-8
My Comm.E �!01 Florida
Commisal3 2018
AssxlL ��ux
APPROVED BY t-4 V5 Plans Examiner Zoning
Structural Review Clerk
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
PER1dI�' x:13-SC4 5929"
APPLICATION #:AP1180063
STATE OF FLORIDA
DEPARTAENT OF HEALTH DATE PAID'
ONSITE SEWAGE TREATMENT AMID DISPOSAL SYSTEMS FEE PAID:
CONSTRUCTION PERMIT RECEIPT #:
REPAIR
Pfilp. 1P-DA€'sE COL'Wy HEALTH DEPap ""r PR967622
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Andrew Curson
PROPERTY ADDRESS: 10050 NE 12 Ave Miami,FL 33138
LOT: 16 15 BLOCK: 177 SUBDIVISION:
PROPERTY ID #t: 11-3205-M"370 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STAMIDARDS OF SECTION
381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE
SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS,
WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AMID 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 D rPECIFICATIONS
T [ ] GALLONS / GPD Septic(New Tank) CAPACITY
A I 0 l GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @I ]DOSES PER 24 HRS #Pumps [ ]
D ( 30 ] SQUARE FEET Bed Drainfield SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ I
I CONFIGURATION: [ ] TRENCH Ixl BED I I
N
F LOCATION OF BENCHMARK: FFE 11.1'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE 119.20] [ INCHES FT ] I ABOVEABELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 69.20 ][ INCHES FT ][ABOVE)I BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 62.001 INCHES
"**THIS PERMIT IS NOT FOR ADDITIONS""
O 1.Install a 900 gal min.septic tank with an approved filter.
T 2.-The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance
H with s.64E-6.013(3)(f),FAC.
3.-Install 300 sf of drainfield in bed configuration.
E 4.-Install 12"of slightly limited soil at the bottom of the drainfield.
5.-Perimeter of excavation area be at least 2 ft wider and longer than the proposed absorption bed.
R
SPECIFICATIONS BY: TITLE:
APPROVED BY; vy, TI : Engineering Specialist II Dade CHD
N ie
DATE ISSUED: O16/25 5 EXPIRATION DATE: 06/14/2015
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated• 649-6.003, FAC The_. ', _ n�- _. ! Page 1 of 3
V 1. g o,i
if the. t __:c .,,,, 6
Permit NQ. P'L-3w1« { .
,ea�m s y Miami Shores Village ® Pennit Type. Plumbing Residiond�);i
10050 N.E.2nd Avenue NE
Fermi Work Classification, UP06" -
Miami Shores,FL 33138-0000 Permit Status:AP#"b'� -
`2 Phone: (305)795-2204
�CORiDA
Issue Date:3/2412015 Expiration: 09/20/2015
Project Address Parcel Number Applicant
10050 NE 12 Avenue 1132050190370
Miami Shores, FL Block: Lot: TIERES TAVARES ;
Owner Information Address Phone Cell
TIERES TAVARES 10050 NE 12 Avenue (305)244-2356
MIAMI SHORES FL 33138-
_ �, -_M M-
10050 NE 12 Avenue
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone ! $ 2,300.00
MR C'S PLUMBING&SEPTIC INC (305)651-7859 ! Valuation: _
Total Sci Feet: 300 I
�I
Type of Work:SEPTIC TANK AND DRAIN FIELD 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 Antt Paid Amt Due
Bond Type-Owners Bond $500.00 Invoice# PL-3-15-54845
CCF $1.80
DBPR Fee $4.50 03/24/2015 Check#:2699 e 272.80 $ 550.00
DCA Fee $4.50 03/24/2015 Check#:880 500.00 $ 50.00
Education Surcharge $0.60 03/18/2015 Check#:2688 S 50.00 $0.00
Permit Fee $300.00 Bond#:2647
Scanning Fee $9.00
Technology Fee $2.40 -
Total: $822.80
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance wit all ordinances and regulations pertaining
thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authoritie< of Miami Shores Village. In accepting this
permit Iassume responsibility forallworkdonebyeithermyself,mya3e-,t,s�: r.ts,3rc:,i::_,- d_ " ._: _ rr ate permits are required for ELECTRICAL,
PLUMBING,MECHANICAL,WINDOWS, DOORS,ROOFING and SWIMMING POOL work
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all vont will be done it com)liance with all applicable laws regulating
construction and zoning. Futhermore uthorize the above-named contractor to do the work stated.
- Mar;h 24, 2015
Authorized Signature:Owner / Applicant / Contractor / Agent -)ate
Building Department Copy
March 24,2015 - —-- ------------ ------ ------— 1