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PL-17-1119
P�rrnfta ISL- -' " - �e�'°.' ,� Miami Shores Village (77?�I 7 rt =F�4ettitid( 10050 N.E.2nd Avenue NE E... nb A i*Cfc2Sa7fication:Dlrainfield Miami Shores,FL 33138-0000 Per 1 Aarmlt Status.APPROVED Phone: (305)795-2204 �, 4127/2x17FExpiratlon: 10/2412017 Project Address Parcel Number Applicant 118 NE 102 Street 1132060131890 Miami Shores, FL Block: Lot: KARON COLEMAN Owner Information Address Phone Celt KARON COLEMAN 118 NE 102 Street (305)987-8422 MIAMI SHORES FL 33138- 118 NE 102 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: _�$ 2,400.00 SOUTHERN SEPTIC CONTRACTORS 1 (305)598-8266 Total Sq Feet: 300 Type of Work:REPLACE EXISTING SEPTIC TANK AND DR Available Inspections: Type of Piping: Inspection Type: Additional Info: HRS Approval Bond Return: Final Classification:Residential Scanning:3 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# PL-4-17-63783 DBPR Fee $4.50 04/27/2017 Credit Card $277.80 $50.00 DCA Fee $4.50 Education Surcharge $0.60 04/24/2017 Credit Card $50.00 $0.00 Notary Fee $5.00 Permit Fee $300.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $327.80 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 A IT: certi at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction�n� Futhermo ,I authorize the above-named contractor to do the work stated. April 27,2017 Authorid Sig er pplicant / Contractor / Agent Date Building a rtm C py April 27,2017 1 �O •i� EDIVISION OF 0� nvironmental Health Florida Health QQ� Miami_Dade Cou ODI STDS/we Inspector T ll my 11805 SW 26th Street. VISIpn Miami,FL 331750 OG Address Date f�.� azrl 7 Comments: - OSTDS# Signature I 9 Miami Shores Village Building Department i 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 _ Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20N BUILDING Master Permit No-y( cl f i�q PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL FE—]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 118 NE 102 ST City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11-3206-013-1890 Is the Building Historically Designated:Yes NO X OccupancyType?'^5Qe_ Load: Construction Type: SFR Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):KARON MARGARET COLEMAN phone#3aos- Address: 118 NE 102 ST City: MIAMI SHORES State: FLZip: 33138 Tenant/Lessee Name: N/A Phone#: Email: CONTRACTOR:Company Name: SOUTHERN SEPTIC Phone#: 305 598-8266 Address: 21051 SW 234 ST City: MIAMI State: FL Zip: 33031 Qualifier Name: ROBERTO RODRIGUEZ Phone#: 305 598-8266 State Certification or Registration#: SR 0021421 Certificate of Competency#: DESIGNER:Architect/Lngineer: N/A Phone#: Address: ® City: State: ©® '>t��a►��C� Value of Work for this Permit:$—'K Z ®®^ Square/Linear Footage of Work: Type of Work: ❑ Addition Q Alteration ❑ New ❑■ Repair/Replace ❑ Demolition Description of Work: REPLACE EXISTING SEPTIC TANK AND DRAIN FIELD DO TO FAILURE. Specify color of color thru tile: Submittal Fee$ Permit Fee$ ,f� ® CCF S- Scanning Fee$ Radon Fee$ y1 50 DBPR$ ( Notary$ {� � Technology Fee$ Training/Education Fee$ •�C V Double Fee$ Structural Reviews$ Bond$ a6 - TOTAL FEE NOW DUE$ (Revised02/24/2014) 1 Bonding Company's Name(if applicable) N/A Bonding Company's Address City State [� Zip W Mortgage Lender's Name(if applicable) e-\ T � Mortgage Lender's Address�,Q. ® C Ir,031ca City C)CAPS State —M Zips 5 a(©fix 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 r inspection fee will be charged. r (- AA Signature Signature OWNER or AGENT ONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument sac ed before me this g _day of �rz� f 20 by D2 day of p,� 20 ` by CuA fOi'1 µal{P�QK'� e'OIew+gn1 who ersonally know to 1�L3� 0 [�3`D21GVho is personally known two me or who has produced as me or who has produced'H--ZWk1;EQ as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOT PUBLIC: g Print: cn v r C a v Print: `� Seal: yi DHAELBMN Seal: W;'qp, Notary Public StateaiF!oride Com#FF 163805 �° t va Sindia Alvarez s; EON Sepwmber 28.2D18 � � 4 � - c a roly Connnss or F. >. gp�dTlwhgFdn { c®Foy Expires 09/03/2098 APPROVED BY ® ' Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) PERMIT #: 13-SM-1756444 STATE OF FLORIDA DEPARTMENT OF EMALTB APPLICATION #:AP1286717 01, ONSITE SEWAGE TREATV=T AND DISPOSAL DATE PAID: SYSTEM FEE Pte, CONSTRUCTION PERMIT RECEIPT #• DocmaNT #: PR1058736 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: MARGARET KARON PROPERTY ADDRESS: 118 NE 102 St Miami,FL 33138 LOT: 13 BLOCK: 14 SUBDIVISION: PROPERTY ID #: 11-3206-013-1890 [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 [ 900 ] GALLONS / GPD NEW SEPTIC TANK TO INSTALL CAPACITY A [ 0 ] GALLONS / GPD CAPACITY N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS Q[ ]DOSES PER 24 HRS #Pumps I ] D [ 300 ] SQUARE FEET NEW DF IN BED CONFIG SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [x] BED I ] N F LOCATION OF BENCHM10tK: CIL OF NE 102 ST.......11.49'NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 1.56 ] INCAS FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 43.56 ] [ INCHES FT ] [ABOVE) BELOW BENCM1ARX/REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 54.00] INCEEs 0 1:Install a 900 gal.septic tank with an approved filter 2:The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance T with s.64E-6.013(3)(0 FAC. H 3:Install 300 sf.of drainfield in ...BED....... configuration. E 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. R (Comments Continued on Page 2.) SPECIFICATIONS BY: Gerard L Philizaire TITLE: Engineering Specialist II APPROVED BY: TITLE: Professional Engineer I Dade CHD Jas DATE ISSUED: 04/21=17 EXPIRATION DATE: 07/20/2017 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 AP1286717 SE1031456 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR CONSTRUCTION PERMIT Permit Application Number --------------------------- PART II -SITEPLAN -- ------------------------- Scale: Each block re resents 10 feet and 1 inch =40 feet. WATER SERVICE I STI Gfl— 9 P IC TAK O E D 5' RO OS D S100 GALL01 SEPTIC 115' r RROJILIS or OP SE 300 Q T RAN IE D 5' 75' 13 .4S ' M Notes: THERE ARE NO PERTINENT FEATURES ON ADJACENT PROPERTIES AND OR ACROSS THE STREET THAT MAY AFFECT THE NEW SYSTEM INSTALLATION. Site Plan submitted by: SIt o 0'2���j Plan Approved of Approved Date By County Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015,08/09(Obsoletes previous editions which may not be used) Incorporated: 64E-6.001,FAC Page 2 of 4 (Stock Number. 5744-002-4015-6) DOC ENT #: PR1058736 (Comments continued on Page 2) 6.-Invert elevation of drainfield to be no less than 8.36'NGVD 7:Bottom of drainfield elevation to be no less than 7.86'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 300 gpd. Required drainfield area based on rule 64E-6.015(6)(c)2. Install a new drainfield to achieve Drainfield size requirement. 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. NOTICE OF RIGHTS A party whose substantial interest is affected by this order may petition for an administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for administrative hearing must be in writing and must be received by the Agency Clerk for the Department,within twenty-one (21) days from the receipt of this order. The address of the Agency Clerk is 4052 Bald Cypress Way, BIN A-02, Tallahassee, Florida 32399. The Agency Clerk's facsimile number is 850-413-8743. Mediation is not available as an alternative remedy. Your failure to submit a petition for hearing within 21 days from receipt of this order will constitute a waiver of your right to an administrative hearing, and this order shall become a 'final order'. Should this order become a final order, a party who is adversely affected by it is entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a second copy, accompanied by the filing fees required by law, with the Court of Appeal in the appropriate District Court. The notice must be filed within 30 days of rendition of the final order.