PL-16-3270 �s -114 � Miami Shores Village ¢ ??/ t► l i ll RWentle,
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10050 N.E.2nd Avenue NW
74
CS�. lii# Cslii
...' Miami Shores,FL 33138 0000 E
Phone: (305)795 2204 fN
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2, JBI Expiration: 06106/2017
Project Address Parcel Number Applicant
25 NW 108 Street 1121360110300
Miami Shores, FL 33168-4310 Block: Lot: MARCO VELASQUEZ MAGNA VI
Owner Information Address Phone Cell
MARCO VELASQUEZ MAGNA VIERIA 25 NE 108 Street
MIAMI SHORES FL 33168-4310
25 NE 108 Street
MIAMI SHORES FL 33168-4310
Contractor(s) Phone Cell Phone Valuation: $ 2,400.00
MR C'S PLUMBING&SEPTIC INC (305)651-7859
Total Sq Feet: 300
Type of Work:DRAINFIELD REPAIR Available Inspections:
Type of Piping: Inspection Type:
Additional Info:
HRS Approval
Bond Retum: 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-12-16-62233
CCF $1.80 12/08/2016 Check#:598 $500.00 $168.30
DBPR Fee $2.25
DCA Fee $2,25 12/01/2016 Check#:1216 $50.00 $118.30
Education Surcharge $0.60 12/08/2016 Check*1218 $ 118.30 $0.00
Permit Fee $150.00 Bond#:3273
Scanning Fee $9.00
Technology Fee $2.40
Total: $668.30
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 assyne responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for EL /ICAL, LUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.a aOWNERS AF AVrtifyyjbat- foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction andermore,I authorize the above-named contractor to do the work stated.
December 08, 2016
Au orized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
December 08,2016 1
PL 1� -990#:,J!n € c o
STATE OF FLORIDA. PERMIT #:13-SC 1720633
DEPARTMENT OF HEALTH DANT #:FI1096103
ONSITE SEWAGE TREATMENT AND DISPOSAL. SYSTEM
�sy Y CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:11115/2016
FEE PAID:200.00
RECEIPT #:13-PID-3142185
APPLICANT: Marco Velasquez
AGENT: Mr C's
PROPERTY ADDRESS: 25 NW 108 St Miami, FL 33168
LOT: 14 BLOCK: 214
SUBDIVISION: ID#: 11-2136-011-0300
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION SETBACKS
[ ] [01l TANK SIZE [1] 900.00 [2] [ 1 [27] SURFACE WATER FT
[ ] [02] TANK MATERIAL Concrete [ ] (28] DITCHES FT
[ ] [03] OUTLET DEVICE [ ] [29] PRIVATE WELLS FT
[ ] [04] MULTI-CHAMBERED [ Y N ] [ 1 [30] PUBLIC WELLS FT
( 1 (05] OUTLET FILTER ( 1 [31] IRRIGATION WELLS FT
[ 1 (06] LEGEND 1. 01-011-04 2. [ l [32] POTABLE WATER 24 FT
( ] [07] WATERTIGHT [ 1 [33] BUILDING FOUNDATIONS 9 FT
[ 1 [081 LEVEL [ 1 (34] PROPERTY LINES 7 FT
[ 1 [09] DEPTH TO LID [ ] [35] OTHER FT
DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM
[ 1 [10] AREA (1] 300 (2] SQFT [ 1 [361 DRAINFIELD COVER
( ] [11] DISTRIBUTION Box HEADER X [ ] [37] SHOULDERS
( 1 [121 NUMBER OF DRAINLINES 1. 5.00 2. ( l [38] SLOPES
[ l [13] DRAINLINE SEPARATION [ ] [39] STABILIZATION
I l [14] DRAINLINE SLOPE
[ ] [15] DEPTH OF COVER ADDITIONAL INFORMATION
[ 1 [16] ELEVATION [ ABOVE ; BELOW ]BM 32.16 [ ] [40] UNOBSTRUCTED AREA
[ 1 [17] SYSTEM LOCATION [ 1 [41] STORNNATER RUNOFF
[ 1 [18] DOSING PUMPS ( ] [42] ALARMS
[ l [19] AGGREGATE SIZE [ ] [43] MAINTENANCE AGREEMENT
( ] [20] AGGREGATE EXCESSIVE FINES [ 1 [441 BUILDING AREA
[ ] (21] AGGREGATE DEPTH [ ] [451 LOCATION CONFORMS WITH SITE PLAN
FILL / EXCAVATION MATERIAL ( 1 [46] FINAL SITE GRADING
( 1 [221 FILL AMOUNT [ ] [471 CONTRACTOR KEMBLE ETfRICK(M C'S
[ 1 1231 FILL TEXTURE [ 1 [48] OTHER INFILTRATOR ARC 24
[ 1 [24] EXCAVATION DEPTH ABANDONMENT
[ 1 [25] AREA REPLACED [ 1 [49] TANK PUMPED
[ 1 [26] REPLACEMENT MATERIAL [ ] [501 TANK CRUSHED & FILLED
Comments: Comments are on page 2.
CONSTRUCTION [ APPRovi D / Dade CHD DATE: 02/03/2017
DISAPPROVED 1: Environmental Specialist 11 Jermalne D CrittendenShaw(Florida Depart
FINAL, SYSTEM [ AppROVND / DISAPPROVED ]: Dade CHD DATE: 02/03/2017
Environmental Specialist It Jermaine D CrittendenShaw(Florida Depar
(Explanation of Violations on following page)
DA 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 2 of 3
EH Database v ,,O.t API EafO9"i2f3 ;s
��\`�' Miami Shores Village
�° �
DEC 0 1 2016
Building Department
• 10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
L/ INSPECTION LINE PHONE NUMBER:(305)762-4949 14
FBC 20N
BUILDING Master Permit No.TL--1 3 2_-7
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION ❑RENEWAL
❑■ PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: S NVJ rt)
City: Miami Shores County: Miami Dade Zip: 331
Folio/Parcel#: 3o�— 611— 636-0 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): [Alk
" ilk rL 4vt�' Phone#:
Address: A5_ NIIJ 1W
C o�
City: a� S keya y State: r l s Zip: 3a 1 J ,R
Tenant/Lessee Name: `y/ Phone#:
Email:
CONTRACTOR:Company Name: Mr C's Plumbing and Septic Phone#: 305 651 7859
Address: 19932 NW 2 Ave
City: Miami State: FL Zip: 33169
Qualifier Name: Kemble Ettrick Phone#: 305 651 7859
State Certification or Registration#: SR061536 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ t4o Square/Linear Footage of Work: ��� .
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work: 'b P_At l4 P-P e6b ice—PRIP,
Specify color of color thru tile:
Submittal Fee$�®Q` Permit Fee$ d ® CCF$ I • $o CO/CC$
Scanning Fee$ -1 Radon Fee$ .Z� DBPrR$ 2•�S Notary$
Technology Fee$ _ 40 Training/Education Fee$ wZb Double Fee$
Structural Reviews$ Bond$ f:75 p• ��
TOTAL FEE NOW DUE$ -
(Revised02/24/2014) bT) 30
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.
/�VZIIIIAE��— &
Signature Signature
r.—��or�AGENT CONTRACTOR
The foregoing instrume,,ntr was acknowledged before me this The foregoing instrument was acknowledged before me this
n� 5,0 yda�y of OyIV e v ,20 f , by 3_day of f11b1�" ,20 It , by
y'vl Vi%�'Sf ��Z ,who is personally known to �[ /rte 7 �.who is personally known to
Me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
lot
Seal: "'"" KEMBLE ETTRICK Seal: """"" SHERYL A MENDES
r°4Fav°Ue''•• •,,ter P`'%
. .
Notary Public State of Florida ;r°, c;y Notary Public-State of Florida
My Comm.Expires Sep 19,2017 -
Commission#FF 055732 MY Comm.Expires Oct 23,2018
Nat ASsn. FF
Commission Commission#FF 136597
APPROVED BY � Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
PERMIT #:13-SC-1720633
STATE of FLORmA
APPLICATION #:AP 1263549
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID:
CONSTRUCTION PERMIT
RECEIPT B•
BENT II:PR1038919
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Marco Velasquez
PROPERTY ADDRESS: 25 NW 108 St Miami,FL 33168
LOT: 14 BLOCK: 214 SUBDIVISION:
PROPERTY ID 4: 11-2136-011-0300 [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., AMID CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE
SATISFACTORY PEREtiDRf2NCE 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 [ 900 I GALLONS / GPD Existing septic tank to remain CAPACITY
A [ 0 1 GALLONS / GPD CAPACITY
N I 0 I GALLONS GREASE INTERCEPTOR CAPACITYr 'i y� `C"
I CAPACITY SINGLE TANK. 5�: �
K [ ] GALLONS DOSING TANK CAPACITY
I I GALLONS
D I 300 I SQUARE FEET bed confiquradon drainfiel SYSTEM
R [ 0 I SQUARE FEET SYSTEM
r,t
c-
tl
A TYPE SYSTEM: (XI STANDARD I I FILLED I I MOUND C
I CONFIGURATION: [ ] TRENCH [xl BID I I gSu' ;n t
N
F LOCATION OF BENCHMARK: FIFE:12.8'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE 120.407 Ifx—u–cEM`s-T FT I[ABOVE BELOW BENCEMARK/REFERENCE POINT
E BOTTOM! OF DRAINFIELD TO BE 170.40 I[FnICHEST[FINCHESFT I[ABOVE/ BENK/RENMENCZ�POINT
L
D FILL REQUIRED: 10.001 INCHES EXCAVATION REQUIRED: [ 62.001 INCHES
1.-EXISTING 900 gal.septic tank with and approved filter TO REMAIN. -
O 2.- Install 300 sf.of drainfield in bed configuration.
T 3.-Install 12"of slightly limited soil at the bottom of the drainfield.
H 4.-Perimeter of excavation area shall be at least 2 It wider and longer than the proposed absorption bed or trench.
(Comments Continued on Page 2.)
E
R
SPECIFICATIONS BY: Lv! C ont TITLE: 9N--nazRING SPECIALIST I
APPROVED BY: ITLE: Engineer Supervisor III
Dade CED
V
Edemas
/16/2
DATE ISSUED: 1 016 EXPIRATION DATE: 02/14/2017
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 649-6.003, FAC Page 1 of 3
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