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PL-15-1471 4�jMiami Shores Village4m� 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 Phone: (305)795-2204 E •_ ^01 ^ A Expiration: 1 27/201 T •I` ` zE ,...1..."a Project Address Parcel Number Applicant 149 NE 105 Street 1121360050130 ZURDDO CORPORATION Miami Shores, FL 33138-2032 Block: Lot: Owner Information Address Phone Cell ZURDDO CORPORATION 12921 S CALUSA Drive (786)231-5339 MIAMI FL 33186- 12921 S CALUSA Drive MIAMI FL 33186- Contractor(s) Phone Cell Phone Valuation: $ 5,800.00 EMPIRE ENGINEERING SERIVICES C! (786)488-8657 Total Sq Feet: 00 Type of Work:SEPTIC SYSTEM INSTALLATION 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-Owners Bond $500.00 Invoice# PL-6-15-55983 CCF $3.60 06/15/2015 Credit Card $50.00 $782.60 DBPR Fee $4.50 DCA Fee $4.50 06/30/2015 Check#:1162 $500.00 $282.60 Education Surcharge $1.20 06/30/2015 Credit Card $282.60 $0.00 Notary Fee $5.00 Bond#:2773 Permit Fee $300.00 Scanning Fee $9.00 Technology Fee $4.80 Total: $832.60 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 p 1 assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for EL -TRI AL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AF DAVIT I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an zonin Futhermore,I authorize the above-named contractor to do the work stated. June 30, 2015 Authorize Si ature:Owner / Applicant / Contractor / Agent Date Building Department Copy June 30,2015 1 %�� ►.� DIVISION OF Environmental Health Florida Health Miami-Dade County QQOSTDS/WVell Division ��► 11805 SW 26th Street►Miami,FL 33175 O I�i�i��'/J Date ) 20 r - Address N Ci IDS 51 OSTDS#��0 Comments: Signature r ' Miami Shores Village CE�VFj� Building Department ED JW P015 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 BY: INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 16) BUILDING Master Permit No. �C 5_ T PERMIT APPLICATION Sub Permit No.}��1��r Z�w BUILDING ❑ ELECTRIC ROOFING REVISION EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP C c — 1_{_CONTRACTOR DRAWINGS JOB ADDRESS: l sk City: Miami Shores Countv: Miami Dade Zip: 33i,3R Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Typee:` Flood Zone: BFE: FFE: OWNER:_Name(Fee Simple Titleholder): Phone#: :a%')- -G I z Address:: ` C 0-5 CVQ�_ City: Z! S SK State: Zip: Tenant/Lessee Name: '—� Phone#: Email: �^ CONTRACTOR:Company Name: ii� '„ c�Q C �(�Phone#: �_ '� 7 2 Address: 4 ��(�- 2A(A City: State: q' L. Zip: Qualifier Name: ( csskE �� P�.J �I Phone#: / State Certification or Registration#: S -A-�Z 2- Certificate of Competency#: DESIGNER:Architect/Engineer: Q C- TWW_rV3EZ Phone#: SB2- 2 22 Address: --,)C-.o ©r4< t-0.3GG' y oc) City: Q State:*:!— Zip: Value of Work for this Permit: Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: C S�r S1M t PR �a� Specify color of color thru tile: Submittal Fee$ Permit Fee$ Xy CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ SM ` 03 TOTAL FEE NOW DUE$ ;-%9o'2• GO (Revised02/24/2014) � l 1 ON • 60 t 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 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 issu . n 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�)lJ42p— ,20 -,ZCJ by jl_day of 20 /�, by 10®1 Qs a)/p who is personally known to ��f e I Gfgd ,who is personally known to me or who has produced as me or who has produced /L'� —as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Si n: Print a A P f Florida Notary pclano Seal: �s►nr, Notary Public state of Florida Seal: ��� Joanna M #' �� Joanna M Feliciano c + Ery Ilo mi 1212018082753 My commission FF 082753 °� y1� Expires 01112/2018 ' ZO APPROVED BY _0= 6lsY5 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) E r R y € z= 5 "mow rov � i I i ACC>©® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) �....�'' 06/15/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in Ileu of such endorsement(s). PRODUCER CONTACT Alejandro NAME: J dro Moreno Best Rate-Insurance Exchange Of America PHONE , (866)616-0065 a No): (305)403-0801 8600 NW 17th Street ADDRESS: brian@instantquotesdirect.com INSURER(S)AFFORDING COVERAGE NAIC# Miami FL 33126 INSURER A: WESTERN WORLD INSURANCE CO INSURED INSURER B EMPIRE ENGINEERING SERVICES CORP INSURER C: 2423 SW 147 AVE INSURER D: #344 INSURER E: Miami FL 33185 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL UBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER M D MM D LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 300 000 DAMAGE CLAIMS-MADE a OCCUR PREMISESaEoccurrence) $ 100 000 MED EXP(Any one person) $ 5 000 A NPP1405422 02/17/2015 02/17/2016 PERSONAL 8 ADV INJURY $ 300 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 600000 X POLICY❑jRO F—] LOC PRODUCTS-COMP/OP AGG $ 300 000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per acciden ti UMBRELLA LUAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILI Y Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Septic Tank Installation SM0971292 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores Village ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 Ave AUTHORIZED REPRESENTATIVE Miami Shores,FI 33138 @ 1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Erx 13-SC-15928 STATE OF FLORIDA APPLiCATIOb _ AP 118x005 DEPARTMENT OF HMALTH DATE PAID ONSITE SEWAGE TREAMWT SAND DISPOSAL SYSTEM PAID: j CONSTRUCTION PERidT RECEIPT If � wcumm : PR969470 f CG�iSTRUCTlow PERMIT FOR: OSTDS New APPLICANT: (Zurddo Corp) PROPERTY ADDRESS: 148 NE 105 St Miami,FL 3313$ LOT: 13 BOK: 201 SIIBDIVIsION: Dunnings Miami Shores 11-213fi-Q05-0130 PROPERTY ID [SECTION, TOWNSHIP, RANGE, PARCEL NUMMI 1k: ------.— (OR TAX.ID NUMBER1 SYSTElf MOST BE CoNsTRIICTED '_ IN AcconuANCE 41IITH s$ECIFICATIoxB ANf! BTANQARDS OF SECT 381.0065, F.S. , AND CHAPTER " 64E-6, F.A.C. DEPARTMENT APPROVAL OF SY8TEM DOES NOT GVARANT SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF -TIME. ANY CHANGE IN MATERIAL. FACT a;- WHICH :,SERVED AS A BASIS FOR ISSUANCE :OF THIS PERMIT, REQUIRE THE APPLICANT TO M0410y PERMIT APPLICATION. SUCH MODIlrICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VO ISSUAXCE OF THIS PERMIT DOES NOT EXIT THE APPLICANT FROM COMPLIANCE WITH OTHER FED STATE, OR LOCAL PERMITTM REQUIRED FOR DEVELOPMENT OF THIS PROPERTY., j SYSTEM DESIGN AND SPECIFICATIONS T [ 900 ] GALLONS / Gamnew Septic tank CAPACITY A [ ] GAIJ NS / GED WA CAPACZTY N f ] G%t=NS GREASE XWTERCEPTOR CAPACITY; EMA)W= CAPACITY SINGLE TANK:12SO GALLONS] [ ] GALLONS DOSING TANK CAPACITY [` ]GALLONS 9[ ]DOSES PER 24 HRS #Pumps [ D f 6W ] SQUARE FEET new bad wnfip.drainfoid SYSTEM R [ ] SQUARE'FEET WA SYSTEM A'TYPE SYSTEM: (x) STANDARD f I FILLED [ ] MOUND ( ]' I CONFIGURATION: I ] TRENCH [x] R f ] N F;LomloN OF SENCaKhms FFE:IIM NGVD I ELEVATION OF PROPOSED SYSTEM SITE f 23.00] YNCHE:S FT ]f ABOVE/ BENCHMARiS/REFRPlEA10E E+OI1+1T E BOTTW OF DRAI'NFZELD TO BE 153.04 ] INCHES FT ]f ABOVE SELOW BENCHMARK /REFERENCE POINT L D FILL, REQUIRED: f 0;00] INCHES EXCAVATION REQUIRED: f 72.001 INCHES O F4.41'nstaI142" W gal min.septic tank with,an approved filter. 2.-Thesed contractor but fling the system is responsible for installing the minimum category.of tank in accordance T 6.013(3)(Q.FAC. a sf of drainfield in bed configuration- of Slightly limited soil at the bottom of the�drainfield. E 5.-Perimeter of excavation area shall be at least 2 ft wicker and longer than the proposed abso on bed in trench. (Comments Continued on Page 2.) J SPECIFICATIONS BY: Jorge Millan TITLE: a at IImeet#ng Bpgcial TITLE: i� Qi0 CND APSROVED BY: DATE ISSUED: , 03/31/2015 jf� ac0' ► o��3orz016 Previous editior:s which may Act be u�I DH 4016 '08/08 (Obao1®tee ail P= Pa ge 1 of 3