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PL-17-555 Permit NO. PL-3-17-555 y4 Miami Shores Village Permit Type:Plumbing-Residential 10050 N.E.2nd Avenue NW � ' Work Classification:Drainfield Miami Shores,FL 33138-0000 Permit Status:APPROVED Phone: (305)795-2204 fLORtDP Issue Date:318/2017 Expiration: 09/04/2017 Project Address Parcel Number Applicant 469 NW 111 Terrace 1121360010470 Miami Shores, FL 33168- Block: Lot: EDWIN RIVERA Owner Information Address Phone Cell EDWIN RIVERA 469 NW 111 Terrace (305)298-3969 MIAMI SHORES FL 33168- Contractor(s) Phone Cell Phone Valuation: $ 3,150.00 STATEWIDE SEPTIC CONNECTIONS (954)963-0082 _.......n _.. �__._, ... ..__ q Total SFeet: 150 Type of Work:REPLACE DRAINFIELD Available Inspections: Type of Piping: Inspection Type: Additional Info:REPLACE DRAINFIELD HRS Approval Bond Return: 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-3-17-63145 CCF $2.40 DBPR Fee $2.25 03/03/2017 Check#:5257 $50.00 $619.90 DCA Fee $2.25 03/08/2017 Check*5267 $619.90 $0.00 Education Surcharge $0.80 Bond#:3333 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $3.20 Total: $669.90 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. OWNEAFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constr do and zoning. Futhermore, I uthorize the above-named contractor to do the work stated. March 08, 2017 orized Signature:Owner / Applicant / Contractor / Agent ate Builds g Department Copy March 08, 2017 1 Miami Shores Village D Building Department IG1Y2 '� 100SO N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305)795-2204 Fax:(30S) 756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 J FBC 201 BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ROOFING REVISION ❑ EXTENSION ❑RENEWAL [�PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: E�dy'j k() (Z!2,r'o` `'t—! NW R1 -Tey- City: Miami Shores County: Miami Dade Zip: 33166 Folio/Parcel#: :2[36- 00�.'OLC--I O Is the Building Historically Designated:Yes NO ✓ Occupancy Type: Load: _Construction Type: Flood Zone: BFE: FFE: QQ\ OWNER: Name(Fee Simple Titleholder): E dof(vn ``��era. Phone#: Address: 4-69. Nyco m -Tey- City: MA 0. rni State: �Z Zip: 33 1G ' Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name:_- -'� _ `GWI�e G l.� S ChC Phone#: 3 IGG (_66'63 Address: g W (9 Ave_ * k) City: OtC^ Lec_KO State: 1�L Zip: Qualifier Name: cS�6,,(,. o� Phone#: y State Certification or Registration#: r o 0?1(26 Z Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 3�SC7 A Square/Linear Footage of Work: f SO Tyne of Work: ❑ Addition ❑ Alteratio(nn��_M ff ❑ New [�R1 Repair/Replace ❑ Demolition Dr-scrirtinn of Work: f, 1qce- DYQ(n �-e Cj 40.x►-yL.___ .. v�.a1'�.eFkrrfSt ry' �,�� •5 ri.i:. Specify liorof colon �P f','r� `<<. `15'x, _ 31 Submittal Fee$• Permit'Fee$_ " d CCF$ A CO/CC$ Scarnirr Fns± $ Radon Fee$ DBPR$ _Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) � �� p _ _�• 6� l« Ce-y- 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 ORTAI.N- 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 inspFction will not be approved and a reinspection fee will be charged. Signatur Signature 6 OWNER or AGENT CONTRACTOR The for going instrument was acknowledged before me this The foregoing instrumtent was acknowledged before me this day of "'`yC�� 20 by 2g day of , rv,5� 20 k'?, by �iVy Qho is personally known to 1Q y ,D�� who is personally known to me or who has produced `li� ()L— as me or who has produced �r) as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign. Sign: Print: f�rrr5 Print: JERRIC •��" �'• Seal• '`PS�' No E A L.ARMSTRONG rl Seal: =s•� JERRICA L.ARMSTRONG Y Public-State Notary Public-State of Flortda CommlaSlon#FF of Florida *********MY COmssion#FF 197589 m.EXpi*e***b ?01 ********************* ', ?'o'un�**My CortlRli E* i '1*4t 20#S APPROVED BY 3-6- Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA PERMIT #: 13-SC-1742350 DEPARTMENT OF HEALTH APPLICATION #: AP1277534 m' ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID: SYSTEM CONSTRUCTION PERMIT FEE PAID: RECEIPT #: Wilk DOCUMENT #: PR1051188 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Edwin Riviera PROPERTY ADDRESS: 469 NW 111 Ter Miami, FL 33168 LOT: 31 BLOCK: 2 SUBDIVISION: PROPERTY ID #: 11-2136-001-0470 [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 [ 650 ] GALLONS / GPD Existing SeDtIC tank for remain. CAPACITY A [ 0 ] GALLONS / GPD CAPACITY N [ 0 j GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ 150 j SQUARE FEET Trench configuration drainfi SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [xj STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [XI TRENCH [ j BED [ ] N F LOCATION OF BENCHMARK: F.F.E., 12.60'NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 10.80 ] [ INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 58.80 ] [ INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: [ 48.00 ] INCHES 0 'Invert elevation of drainfield to be no less than 8.20' NGVD. `Bottom of drainfield elevation to be no less than 7.70' NGVD. T "THIS PERMIT IS NOT FOR"ADDITION(s)". H The system is sized for 2 bedrooms with a maximum occupancy of 4 persons(2 per bedroom),for a total estimated flow of r E 300 gpd. Required drainfield area based on rule 64E-6.015(6)(c)2. R Install a new drainfield to achieve Drainfield size requirement. SPECIFICATIONS BY: Teresa J Solomon TITLE: Master Septic Tank Contractor APPROVED BY: TITLE: Dade CHD Carlos M Icaza DATE ISSUED: 02/27/2017 EXPIRATION DATE: 05/28/2017 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 V 1.1.4 AP1277534 aE1024558 � 1F 0 DIVISI0N, 0 Environmental Health �o ,, Florida Health Q� M�iatrli-t?ade fount 'd �Qi� � nQSTDS/WeYI Division 11.805 SSV 36th Street•bliaml,FL 33175 f �► Opector + , ' . 1.. .k --.._._._...� Date... yy�'yr xw;: 1...O11III1BT1tS� Signatur i. 6�ia,AYf,t.