PL-16-3155 Permit NO. PL-11-16-3155
`geORES Miami Shores Village Permit Type' Plumbing..-Residential
10050 N.E.2nd Avenue NE
PerMiami Shores,FL 33138-0000 It Work Ciassification:Drainfield
Permit Status:APPROVED
2E 0 Phone: (305)795-2204
0Rit�
Issue Date: 12/2112016 Expiration: 06/19/2017
Project Address Parcel Number Applicant
9935 NE 13 Avenue 1132050090470
Miami Shores, FL 33138-2634 Block: Lot: FABIANO SILVEIRA AGUILAR M
Owner Information Address Phone Cell
FABIANO SILVEIRA AGUILAR MARIANA 9935 NE 13 Avenue
--- MIAMI SHORES FL 33138-2634
9935 NE 13 Avenue
MIAMI SHORES FL 33138-2634
Contractor(s) Phone Cell Phone Valuation: $ 10,000.00
MR C'S PLUMBING&SEPTIC INC (305)651-7859
,_.�. ...._.. _...-......._ _.._ _ Total Sq Feet: 432
Type of Work:DRAINFIELD REPAIR Available Inspections:
Type of Piping: Inspection Type:
Additional Info:DRAINFIELD REPAIR
HRS Approval
Bond Return: Final
Classification:Residential Scanning: 1 Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $6.00
DBPR Fee Invoice# PL-11-16-62106
$4.50 11/17/2016 Check* 1200 $50.00 $278.00
DCA Fee $4.50
Education Surcharge $2.00 12/21/2016 Credit Card $278.00 $0.00
Permit Fee $300.00
Scanning Fee $3.00
Technology Fee $8.00
Total: $328.00
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,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT—'1-certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constructiond zoning. uthermore, I authorize the above-named contractor to do the work stated.
December 21, 2016
`Authorized Signature:Owrier / Applicant / Contractor / Agent Date
Building Department Copy
December 21, 2016 1
Miami Shores Village RECEIV
NOV 17 2016
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: --
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 Sfi-
FBc 2014
BUILDING Master PermitNo.yt- 11—% -315,5
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9935 NE 13th Ave
City: Miami Shores County' Miami Dade Zip'
Folio/Parcel#: 11-3205-009-0470 Is the Building Historically Designated:Yes NO
Occupancy Type: R Load: Construction Type: Flood Zone: VE BFE: FFE:
OWNER: Name(Fee Simple Titleholder): Fablano S. Aguilar Phone#:571 236 8093
Address:9935 NE 13 Ave
City: Miami Shores State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email: fabianosilveiraaguilar@gmail.com
CONTRACTOR:Company Name: NV' (� T Phone#:
Address:
City: 2 Sta�te°:�, � Zip:
Qualifier Name: gzD�& G( / (C� Phone#:
State Certification or Registration#t: Certificate of Competency#:
DESIGNER:Architect/Engineer: zyz Phone#:
Address: City: State: ,? Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ��Repair/Replace
❑ Alteration ❑ New ❑ Demolition
Description of Work: 401.>Z-(/'J P(CL—b E-PAJ e—
��`
Specify color of color thru tile:
Submittal Fee$ 1E)-o 1 Permit Fee$ Son CCF$ CO/CC$
rr '' ( r O
Scanning Fee$ Radon Fee$ `tel .S DBPR$ `1 S Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
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 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 acknowledged before me this The foregoing instrument was acknowledged before me this
i b day of `A(N'eWi 1Q�Qt/ 20 J ( by 17 // day of /VD V e-M L2 2.. ,20 ��D by
�ck�lCtnC) 'ttyUl G r ,who is personally known to /�2✓>71� 6110C- XL who is personally known to
me or who has produced as me or who has produced F1,00C/Q dor,Ver C644 as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLI
Sign: _ g
Si n:
Print: caayye 1 ty?�{� S`il(�0 Print: /C-1PPE
Seal: Seal:
;'A1?Ae�;•:• �.�� %���
CARMEN ESTHER JUSINO PHILIPPE NEPTUNENotary Public-State of Florida
MY COMMISSION r FF046931 ' Commission N GG 013516
* * *** * ***********
(407)398.0153 FloricffiNotaryService.com
APPROVED BY P — Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
VZPARTMENT OF HEALTH APPLICATION #: AP1184690
ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID:
SYSTEM
' CONSTRUCTION PERMIT FEE PAID:
RECEIPT #•
WOO
DOCUMENT #: PR979504
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Fabiano Silveira
PROPERTY ADDRESS: 9935 NE 13 Ave Miami, FL 33138
LOT: 2 BLOCK: 4 SUBDIVISION:
PROPERTY ID #: 11-3205-009-0470 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX 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 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 [ 700 ] GALLONS / GPD Aerobic Unit CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N [ l GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ 375 ] GALLONS DOSING TANK CAPACITY [ 77.00 ]GALLONS Q[ 6 ]DOSES PER 24 HRS #Pumps [ 1 ]
D [ 432 ] SQUARE FEET _Trench configuration drain SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [x] HOUND [ ]
I CONFIGURATION: [X] TRENCH [ ] BED [
N
F LOCATION OF BENCHMARK: Crown of road NE 13 ave.,4.30'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 7.20 It INCHE3 FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 5.20 l [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [20.00] INCHES EXCAVATION REQUIRED: [ 72.00] INCHES
o *Invert elevation of drainfield to be no less than 5.50'NGVD.
*Bottom of drainfield elevation to be no less than 5.00'NGVD.
T *Install 42"of slightly limited soil under the bottom of drainfield.
H -Perimeter of excavation area shall be at least 2 ft.wider and longer than the proposed absorption bed or drain trench.
The system is sized for 4 bedrooms with a maximum occupancy of 8 persons(2 per bedroom),for a total estimated flow
E of 460 gpd.
R The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance
with s.64E-6.013(3)(f),FAC.Performing Lift Dosing.
SPECIFICATIONS BY: Charles J Chapman TITLE: Master Septic Tank Contractor
APPROVED BY: TITLE: Dade CHD
Carlos Gaza
DATE ISSUED: 06/29/2015 EXPIRATION DATE: 12/29/2016
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
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M � DIVISION OF
Environmental Health
Florida Heal
tij
Q�O Miami-Dade County
9i4
QQ� OSTDS
uaos sw Fell Division
-� 6th Street•Miami,FL 3317s O`"
--_� Inspector O
Date
� Address �?,f �L /L•L
Comments: OSTDS
Signature
i