PL-16-281 Miami Shores Village
10050 N.E.2nd Avenue NEAw
) :3
•� Miami Shores,FL 33138-0000
F� Phone: (305)795-2204 : ,
k Expiration: 0 01!2016
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Project Address Parcel Number Applicant
1285 NE 95 Street 1132060144020
ROBERT AND NANCY FREHLINt ;
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
ROBERT AND NANCY FREHLING 421 E SAN MARINO Drive
MIAMI BEACH FL 33139-
421 E SAN MARINO Drive
MIAMI BEACH FL 33139-
Contractor(s) Phone Cell Phone Valuation: $ 12,000.00
MR C'S PLUMBING&SEPTIC INC (305)651-7859 Total Sq Feet: 767
Type of Work:INSTALL SEPTIC TANK&DRAIN FIELD. Available Inspections:
Type of Piping: Inspection Type:
Additional Info:
HRS Approval
Bond Return: I Final
Classification:Residential Scanning:3 Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $7.20 Invoice# PL-2-16-58529
DBPR Fee $4.50 02/02/2016 Credit Card $50.00 $287.20
DCA Fee $4.50
Education Surcharge $2.40 02/03/2016 Check#:3008 $287.20 $0.00
Permit Fee; $300.00
Scanning Fee $9.00
TechnologX Fee $9.60
Total:' $337.20
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 ftu�ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERSAFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constructibr and zoning. Futhermore,I authorize the above-named co r to do the work stated.
February 03,2016
Authorized Signature:Owner / Applicant Contractor / Agent Date
Buil ung Department Copy
February 03,2016 1
DIVISION OF
® Environmental Health
Florida Health
� Miami-Dade County gij0
40OSTDS!Well Division
11808g5--SWW2_26th Street•Miamy FL 33175 oG,c►
Inspector 1 �'Il ♦♦�
Date
AddressS
Comments: Ic
Signature_92
' a
:y
: Miami Shores Village i=_
Building Department i FE 2 20916
- .
10050 N.E.2nd Avenue,Miami Shores,Florida 333.38 -
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTON UNE PINE NUMBER:(305)762-4N9
FBC 2® � �
BUILDING Mamter Permit No.
PERMIT APPLICATIONsub Permit No.
❑BUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION aRENEWAL
®PLUMBING ❑MECHANICAL [PUBLIC WORKS CHANGE OF ®CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: a�ti NEg5 s+
Clw Miami Shores Countv' Miami Dade zip: �3f
Falco/Parcel#: 11 3a g —(21(4- �0� -ft the Building Historically Dated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
�.>! L
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OWNER:Name(Fee Simple Titleholder): L�l Phonei#: 30s s73 19636
i Address: /W r 02- y✓r',Sf
City: //NL J State:_ Zip: 73/.lfr
�
Tenant/Lessee Name:
Phone#:
Email:
� CONTRACTOR:Company Name:
Mr C's Plumbing and Septic Phone#: 305 6517859
Address: 19932 GVW 2 Ave
3 FL zip: 33169
Gly: Miami state:
Qualifier Name:
Kemble Ettrick Phone#: 305 6517859
! State Certification or Registration#: SR061536 Certificate of Competency##:
i
DESIGNER:Architect/Engineer: Phone#'
Address: City: State: Zip:
Value of Work for this Perm": GD•OD Square/Linear Footage of Work: 767
Type of Work: F71Addition� /erasion ❑ New ® Repair/Replace F1 Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee$ ' &7Z) Penult Fee$ ' '� CCF$ co/cc$
Scanning Fee$ Radon Fee$ DBPR$ Nary$
Technology Fee$ Training/Education Fee$ Double Fee$
Bond$ `--��—
Structural Reviews$
TOTAL FEE NOW DUE$
j (ReviseW2/24/2014)
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Bonding Company's Mame of applicable)
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Bonding Company's Address -----
Gly State Zip
Mortgage lender's Name(if applicable)
i Mortgage Lender's Address
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City State �
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° Application is hereby made to obtain a permit to coo the work and installations as indicated. l certify that no work or instaffathm has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
i construction in this jurisdiction. i understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
f FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC.._..
1111E
{ pWyER°r ppFtf3AVi7: 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 wrm 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$25W, the applicant most
promise in goad faith that a copy of the notice of commencement and construction Tien law brochure will be delivered to the person
whose property is bJect to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the Job site
permit is issued. in the absence of such pasted notice, the
for the first ins n which occurs seven {7j days after the building pe
inspection wiB n be approved and einspection fee will be charged.
Air
OWNER
Signature--4-t&�
OWNER or AGE CONTRACTOR
The foregoing instrument was acini More me this The foregoing instrument was acknowledged before me this
1 -7
i
oc� day of_ ��Ild�R`�- 20 6 by day of�f�t1f uA IC .20 I by
Kobe�'� �TGk�r�� ,who is personally known to is Ile(� ,who is personally known to
i as me or who has produced as
me or who has produced
identification and who did take an oath. identification and who did take an oath.
NOTARY MUMNOTARY PUBLIC:
Sign: Sign:
Print: TTRICK Print:
ary u is tate o Florida
c•; ;•=My Comm.Expires Sep 19,2017 Seal: s�� ° Notary F'uelk-State Of Florida
Seal: ••o My Comm.Expires Oct 23,2018
Commission#FF 055732 i". o;S Commission#FF 136597
'
OF„ Bonded Through National Notary Assn. °��;; ( ftd NoWy Assn.
APPROVED BY j Flans Examiner
Zoning
Structural Review Clerk
(Revmd02/24/2014)
PERMIT #:13-SC4546860
"STATE OF FLORIDA APPLICATION #:AP 1151974
DEPARTMENT OF EEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEB PAID:
CONSTRUCTION PERMIT RECEIPT #,
DOCUMENT #:PR944773
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Nancy Frehling
PROPERTY ADDRESS: 1265 NE 95 St Miami,FL 33138
LOT: 33 to 35 BLOCK: 84 SUBDIVISION: Miami Shores Sec 3
PROPERTY ID #: 11-3206-014-4020 [SECTION, TOWNSHIP, RANGE, PARCEL NrntiBERI
[OR TAX ID NUMBER]
SYSTEM MUST BB CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMBNT 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 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 I 1,200 I GALLONS / GPD Septic tank CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N ( I GALLONS GREASE INTERCEPTOR CAPACITY jh9JM+= CAPACITY SINGLE TANK:1250 GALLONS]
K I I GALLONS DOSING TANK CAPACITY I ]GALLONS @I IDOSES PER 24 HRS #Pumps I I
D I 767 I QUARE FEET bed configuration XTEM
R I I SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: Ix7 STANDARD [ I FILLED II MOUND I I
I CONFIGURATION: [ ] TRENCH Axl BED I I
N
F LOCATION OF BENCHMARK: CL NE 95 St.,5.71-NGVD
I ELEVATION OF PROPOSED SYSTEM SITE L 13.50]d-ni-cu-s-1 FT ][ BELOW IBENCHMAWREFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 8.50 ] ifigMST FT I[ABOVE/ BENCHMARK/REFERRNCE POINT
L
D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: [ 32.003 INCHES
One time 90 days permit extension was requested and granted by C.Icaza,permit will expire on 04111/16.
O 'Invert elevation of drainfield to be no less than 5.50'NGVD.
T 'Bottom of drainfield elevation to be no less than 5.00'NGVD.
H 'Install 10"of slightly limited soil under the bottom of drainfield.
-Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bad or drain trend.
B The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow
of 460 gpd.
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SPECIFICATIONS BY: Teresa q" old on TITLE: Master Septic Tank Contractor
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APPROVED BY: TLE: Dade CHD
rar168 N za
DATE ISSUED: 07/11 014 / EXPIRATION DATE: 01/11/2016
DH 4016, 08/09 (Ohsoletea previous editions which may not be used)
Incorporated: 64E-6.003, FAC -i-AC"
Hage 1 of 3
v ?:i 40., 3 'ti"r i+nl''11 '�4,M .;". SE933316
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