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PL-16-3164 6 Miami Shores VillagePel' 7 t 7" 0-(Utolno 0$100"t � N.E.2nd Avenue NE � pl- 10050 "• Miami Shores,FL 33138-0000 " `ti p Phone: (305)795-2204 APPROVED owl issue Oats:111111 Expiration: /20/2017 Project Address Parcel Number Applicant 934 NE 91 Terrace 1132060030140 Miami Shores, FL 33138- Block: Lot: JOHN STOKESBERRY Owner Information Address Phone Cell JOHN STOKESBERRY 934 NE 91 TERR (305)758-5849 MIAMI SHORES FL 33138-3220 Contractor(s) Phone Cell Phone $ 2,300.00 Valuation: A AARON SUPER ROOTER 305-944-8886 Total Sq Feet: 300 Type of Work:septic&drain field repair Available Inspections: Type of Piping: Inspection Type: Additional Info:septic&drain field repair HRS Approval Bond Return: Final Classification:Residential Scanning: 1 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Contractors Bond $500.00 Invoice# PL-11-16-62117 CCF $1.80 11/18/2016 Check#:5219 $50.00 $766.80 DBPR Fee $4.50 DCA Fee $4.50 11/21/2016 Check#:5222 $766.80 $0.00 Education Surcharge $0.60 Bond#:3258 Permit Fee $300.00 Scanning Fee $3.00 Technology Fee $2.40 Total: $816.80 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing informati n is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-na contractor to do th work stated. N ember 21, 2016 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy November 21,2016 1 Miami Shores Village � CF-,NKr) Nov 2016 Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY' Tel:(305)795-2204 Fax(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 BUILDING FBC 20 l 4 PERMIT APPLICATION Master Permit No. f Sub Permit No. ❑BUILDING ❑ELECTRIC ❑ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL CLIMBING ❑MECHANICAL ❑PUBLIC WORKS ❑CHANGE OF ❑CANCELLATION ❑SHOP JOB ADDRESS: l CONTRACTOR DRAWINGS City: Miami Shor Coun : Folio/Parcel#:_I—3?40 '�3'®(y Miami Dade —___Is the Building Historically Designated:Yes NO Occupancy Type: Load WA Construction Type:YP • '01A Flood Zone: Pj BFE: iy/A FFE: J!'a OWNER:Name(Fee Simple Titleholder): joktn stozes ? PF- 0(t � Phone# Address: 0, City. (h• to S State: �- Tenant/Lessee Name:_ q/A LP' 31 t 3 -4 Email: Phone#: CONTRACTOR:Company Name:- Address: 6 3S Phone#: City: rn Ck✓ _ State: Qualifier Name: �h� lU p:::!' : 23 State Certification or Registration#: Phone#• DESIGNER:Architect/Engineer: Certificate of Competency#: Address: Phone#: Value of Work for this Permit:$� �®©r Gty: State Zip: Square/Linear Footage of Work: 100 �— Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace 11 Demolition Description of Work: Dre,irn !d r Specft color of color thru NO.- Submittal lle:Submittal Fee$ Permit Fee$ ..5'0C> CCF$ Scanning Fee$ CO/CC$ Radon Fee$ DBPR$ �� Notary$ Technology Fee$ Training/Education Fee$ C® Double Fee$ ®®"" Structural Reviews Bond$ (Rev1sed02/24/2014) TOTAL FEE NOW DUE$ U47(0. .+ (® ( . ® BoodingCotpany's Name(if applicable) l Bonding Company's Address city State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address arty 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 I be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commenceme m st be posted at the Job site for the first inspection which occurs seven (7)days after the building permit is issued. In thea en of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The fore oing instrument was acknowledged before a this The foregoing instrument was acknowledged before me this day of Io 20 L�by f'7 dof r`�®� ay 20 1 ,by �5 Iia personally know— J6 h �J who is personally known to me or who has produced 1( I vag' LVeVr who has produced (rj identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC NOTARY PUBLIC: Sign: L--AA- � 0 Sign: -g Print G G? S�,pY PSB Print: Seal e°: ...,�% H.BARBARA ZEEMAN r vu MY COMMISSION#EE 860789 Seal: ,�A ••.�% TERESMY COMMISSlt*4 FF 928161 s EXPIRES:February 15,2017 BmMed Tlw Budget Notary Serkes EXPIRES:November8,2019 "ro Ffe-1 Bortwaru BudgeTNMrY S0116 OF APPROVED BY _ l� � �0 �/6- Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) APPLICATION #: I2 19'9 - STATE OF FLORIDA PERMIT #:13-SM-1718366 DEPARTMENT OF HEALTH DOCUMENT #:F11083328 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:11/10/2016 FEE PAID:55.00 RECEIPT #:13-PID-3140330 APPLICANT: JOHN STOKESBERRY AGENT: A AMERICAN SEPTIC PROPERTY ADDRESS: 934 NE 91 Ter Miami, FL 33138 LOT: 7.8 BLOCK: 2 SUBDIVISION: Biscayne Ridge ID#: 11-3206-003-0140 CHECKED [XI ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. TANK INSTALLATION SETBACKS [ 3 [011 TANK SIZE [11 1050.00 [21 [ 1 [271 SURFACE WATER FT [ 1 [021 TANK MATERIAL [ 1 [281 DITCHES FT [ 1 [031 OUTLET DEVICE [ 1 [291 PRIVATE WELLS FT [ 1 [043 MULTI-CHAMBERED [ Y LNJ [ 1 [301 PUBLIC WELLS FT [ 1 [051 OUTLET FILTER Polylok PL-68 [ 1 [311 IRRIGATION WELLS FT [ 1 [061 LEGEND 1. 70-143-10DC3 2. [ 1 [321 POTABLE WATER 20 FT [ 1 [071 WATERTIGHT [ 1 [331 BUILDING FOUNDATIONS 8 FT [ 1 [083 LEVEL [ 1 [341 PROPERTY LINES 5 FT [ 1 [091 DEPTH TO LID [ 1 [351 OTHER FT DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM [ 1 [101 AREA [11 300 [21 SQFT [ 1 [361 DRAINFIELD COVER [ 1 [111 DISTRIBUTION BOX HEADER X [ 1 [371 SHOULDERS [ 1 [121 NUMBER OF DRAINLINES 1. 3.00 2. [ 1 [381 SLOPES [ 1 [131 DRAINLINE SEPARATION [ 1 [391 STABILIZATION [ 1 [141 DRAINLINE SLOPE [ 1 [153 DEPTH OF COVER ADDITIONAL INFORMATION [ 1 [161 ELEVATION [ ABOVE / BELOW IBM 51.00 [ 1 [401 UNOBSTRUCTED AREA [ 1 [171 SYSTEM LOCATION [ 1 [413 STORMWATER RUNOFF [ 1 [183 DOSING PUMPS [ 1 [421 ALARMS [ 1 [191 AGGREGATE SIZE [ 1 [431 MAINTENANCE AGREEMENT [ 1 [201 AGGREGATE EXCESSIVE FINES [ 1 [441 BUILDING AREA [ 1 [211 AGGREGATE DEPTH [ 1 [453 LOCATION CONFORMS WITH SITE PLAN FILL / EXCAVATION MATERIAL [ 3 [461 FINAL SITE GRADING [ 1 [221 FILL AMOUNT [ 1 [471 CONTRACTOR [ 3 [231 FILL TEXTURE [ 1 [481 OTHER INFILTRATOR ARC 24 [ 1 [241 EXCAVATION DEPTH ABANDONMENT [ 1 [251 AREA REPLACED [ 1 [491 TANK PUMPED [ 3 [263 REPLACEMENT MATERIAL [ 1 [503 TANK CRUSHED & FILLED Comments: Comments are on page 2. CONSTRUCTION [ AppROVED / Dade CHD DATE: 11/17/2016 DISAPPROVED )' Environmental Specialist II Jermaine D CrittendenShaw(Florida Departmen FINAL SYSTEM [ APPROVED / DISAPPROVED 1: Dade CHD DATE: 11/17/2016 Environmental Specialist II Jermaine D CrittendenShaw(Florida epartmen (Explanation of Violations on following page) DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 2 of 3 Ell Databaaa v 1A AP1262199 EID1718366 APPLICATION #: P 1262199 STATE OF FLORIDA PERMIT #:13-SM-1718366 DEPARTMENT OF HEALTH DOCUMENT #:F11083328 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:11/10/2016 FEE PAID:55•00 RECEIPT #:13-PID-3140330 Violation Number Comment Comments The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow of 400 gpd.20 chambers and trench config. DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 2 of 3 EH Database v 1.0.1 AP1262199 6101718366 PERMIT #: 13-SM-1718366 STATE OF FLORIDA ql DEPARTMENT OF HEALTH APPLICATION I#:AP1262199 ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID: SYSTEM FEE PAID: CONSTRUCTION PERMIT DOCUMENT *: PR1037936 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: JOHN STOKESBERRY PRQPBMI R066; 934 NE 91 Ter Miami,Fl-33438 LOT: 7-8 BLOCK: 2 SUBDIVISION: Biscayne Ridge PROPERTY ID #: 11-3206-003-0140 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM MusT BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SEC'T'ION 381.0065, F.S., AND CHAPTER 64E-6, S.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 MDDIFY 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 [ 1,050 ] GALLONS / GPD NEW SEPTIC TANK CAPACI'T'Y A [ 0 ] GALLONS / GPD CAPACITY N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMM4 CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS 8[ ]DOSES PER 24 HRS #Pumps [ ] D [ 225 I SQUARE FEET trench confinuration drainf SYSTEM R [ 0 1 SQUARE FEET SYSTEM A TYPE SYSTEM: [X] STANDARD [ I FILLS [ ] MUND [ ] I CONFIGURATION: [X] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: FFE:11.9'NGVD I ELEVATION OF PROPOSED SYSTEM SITE 125.20][ INCHES FT ][ABOVE BELOW BENCHM3RK/RE8'BRENCE POINT E BOTTOMS OF DRAINFIELD TO BE [ 80.201E FT I[ABOVE' BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 67.001 INCHES o Installing a new 1050 gsl septic tank to the system-Amendment perform by Yvenel Clermont,11/15/2016. T 1:Install a 1050 gal.septic tank with an approved filter H 2:The licensed contractor Installing the system is responsible for Installing the minimum category of tank in accordance with s.64E-6.013(3)(0 FAC. E 3: Install 300 st of drainfield in TRENCH configuration. R 4:Install 12"of slightly limited soil at the bottom of the drainfield. 5:Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed or trench. SPECIFICATIONS BY: Yvenel Clermwmt TITLE: ENGINEERING SPECIALIST I APPROVED BY: TITLE: Dade CHD DATE ISSUED: 11/07/2016 EXPIRATION DATE: 02/05/2017 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 0£ 3 v 1.1.4 AP1262199 SE1012832 aocvMrT #: PR1037935 (Comments continued on Page 2) 6:Invert elevation of drainfield to be no less than 5.72'NGVD 7:Bottom of drainfield elevation to be no less than 5.22'NGVD 8:This permit includes the abandonment of the existing septic tank. THIS PERMIT IS NOT FOR ANY ADDITIONS. The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow of 400 gpd. The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E-6.013(3)(1),FAC.Required drainfield area based on rule 64E-6.015(6)(c)2. Install a new drainfield to achieve Drainfield size requirement. REGISTERED SEPTIC TANK CONTRACTOR JOHN J. TUFFY 6022 SW 35TH COURT MIRAMAR , FL 33023- A-AARON SUPER ROOTER, INC . Business Authorization: SA0920648 SR0921112 Registration Expires on September 30, 2017 002051 _ Local Business Tax Receipt Miami-Da Miami-Dade County, State of Florida �THIS IS NOT A BILL-DO NOT PAY FL El I 3494036 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES A AARON SUPER ROOTER INC RENEWALSEPTEMBER 30, 20 7 DOING BUS IN DADE CO 3649960 Must be displayed at place of business Pursuant to County Code Chapter 8A-Art 9&10 OWNER SEC. TYPE OF BUSINESS A AARON SUPER ROOTER INC 196 SPECIALTY PLUMBING CONTRACTOR PAYMENT RECEIVED SEP000648 BY TAX COLLECTOR Worker(s) 1 $75.00 08/15/2016 CREDITCARD--16-04 444 This local Business Tax Receipt only confirms payment of the local Business Tax. The Receipt is not a license, permit,or a eert Cad0n of the bottler"s qualiNeations,to do business. Holder n"Ist comply with any governmental or nongovemmental regulatory laws and requirements which apply to the buslaess. The RECEIPT NO.above must be displayed on all commercial vehicles-Ar"-Dade Code Sac Be-276, For more infarmation,visit www m na1dgdLg2j&xgeIIector 1217!2015 Report Viewar r FFF(c;,mcmceR STATE OFFLOMA DIEPARTMEN•i'OF FWANCIAL SKRVtc.E'S DIVISIONOFWORKERS'COMPEN'SAT10N CATE OF ELECTION TO BE EXEMPT FROM FIARI15A WORKERS'COMPENSATION LAW- CONSTRUCTION AW•CONSTRUCTION INDUSTRY EX.EMp-nON This mf ffies that tha individual listed below has eletted to be exempt from Floods Workers'C'ompens8tton law. EFFECTIVE DATE 1217)2016 EXPIRATION DATE: 1716/2017 PERSON: "iUFF•Y JOHN FON: 650501215 BUSINESS NAME AND ADDRESS: A AARON SUPER ROOTER IN.0 6022 SW 35 COURT MIRAMAR FL 33Q23 SCQPES OF BUSINESS Ott TRAD : IRRIGATION OR DRAINAGE SYSTEM crrc6adow", w4wffm ovpw �C pAm6am7nwp.g6�mpataoGefynleWmp�V.NerAsaeeca, . aumaata.•Aslnmae•epkYesbea a;atlEEeo} Oevpnp gr�Ye,agj�'eeratexwal��p�,N boaiamcdy.gd, Aa0�r�vnadmOfi.�a�rrber►�&�ro�m..�gR�er u�tl��ae�ep���n#xet�fa�tdenadca��e�anen�relpoa DF$W2-QWC-252 CERTIFICATE OF ELECT=TO RE OWMPT FWynsm 03.13 94ESUONS F f&s0yt73 iBQ9 6 i i'�:i/ephsB.R� �Q��arrepgy��,er/r�YfV��,��PX9 '7c9DA H8jIN FLORIDA DEPARTMENT OF HEAL'T'H CERTIFICATE OF AUTHORIZATION FOR SEPTIC TANK CONTRACTING HEALTH l:W F1o"idu ,)epurtment of l-1ealth hereby certifies the business ur enrity named below has sah.Vied the requirements uf f c -t 111. 46. Florida Statutes,frseptic tank contracting and hays been duly authorized by the Delmriment io prr,vic/r. septic lank conrractingy services under the mine of A-AARON SUPER ROOTER, INC. Qualirying Contractor: JOHN J TUFFY S k09.20.6418- April 6, 2015 March 31, 2017 Authorization Number Date Issued Expiration Date