PL-17-1132 fuNd,PL-447-113
sK°.'TZ'—yMiami Shores Village ' Petit ry `lombino Resi en l
a�m 10050 N.E.2nd Avenue ) 1p�{� J,�,� affo Dro nfield
_.
Miami Shores,FL Per 33138-0000ewt'�tt15: RtiD
Phone: (305)795-2204
�t.OR'tPp'
Issue biiik�812017 Expiration: 10/25/2017
Project Address Parcel Number Applicant
9510 BISCAYNE Boulevard 1132060142880
Miami Shores, FL Block: Lot: SALVATORE AND LAURIE ANNE
Owner Information Address Phone Cell
SALVATORE ANNESE 9510 BISCAYNE BLVD
MIAMI SHORES FL 33138
Contractor(s) Phone Cell Phone $ 2,400.00
MR C'S PLUMBING&SEPTIC INC (305)651-7859 Valuation:
_.__. Total Sq Feet: 500
Type of Work:DRAINFIELD REPAIR Available Inspections:
Type of Piping: Inspection Type:
Additional Info:DRAINFIELD REPAIR
HRS Approval
Bond Return: 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-4-17-63799
CCF $1.80 04/28/2017 Check#:8524 $500.00 $322.80
DBPR Fee $4.50
DCA Fee $4.50 04/25/2017 Credit Card $50.00 $272.80
Education Surcharge $0.60 04/28/2017 Credit Card $272.80 $0.00
Permit Fee $300.00 Bond#:3386
Scanning Fee $9.00
Technology Fee $2.40
Total: $822.80
In consideratio issu ce to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining th eto d stri conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting th s pe it kresponsibilityty for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for EC HANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFID foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and o inorize the above-named contractor to do the work stated.
April 28, 2017
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
April 28,2017 1
���� �'I lY` �
Miami Shores Village
' DECEIVED
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 PR 2 17
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
BUILDING Master Permit No. f
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ROOFING ❑ REVISION EXTENSION RENEWAL
QPLUMBING ❑ MECHANICAL DPLIBLICWORKS CHANGE OF CANCELLATION ❑ SHOP
C R CONTR,ACCQTOR DRAWINGS
qJOB ADDRESS: �1 v� �OUI.�ud r
City: Miami Shores 1 , 0 tCounty: Miami Dade zip: 33138 Y
Folio/Parcel#: Jo286 +6 't'^ �"Oa " Is the Building Historically Designated:Yes NO /1
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simpletleholder
V��8 rre_ �riev Phone#:
Address: �Sl SCQQvQ
City: State: Zip: I.A 1
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Mr C's Plumbing and Septic Phone#: 305 651 7859
Address: 19932 NW 2 Ave
City: Miami State: FL Zip: 33169
Qualifier Name: Kemble Ettrick Phone#: 305 651 7859
State Certification or Registration#: SR061536 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: I vl(
City: State: Zip:
Value of Work for this Permit:$ '-z Square/Linear Footage of Work: g2jrz
Type of Work: ❑ Addition ❑ Alteration ❑ New Q Repair/Replace ❑ Demolition
Description of Work: r�
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ . �t�� s CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$�� a
(Revised02/24/2014)
ding 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 forgoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
/
day of �`F 41 L— 20 by day of AVr-/lam '20 17 .by
WGLKV'C2 Ah GS-e- who i_ s��ersonally knQ to VCN_rr�� � C'Tr< <-CAWho is personally known to
me or who has produced as me or who has produced c ` ,,�ZZ as
identification and who did t ke an oath. identification and who ke an oath.
NOTARY PUBLIC: NOTA UBLIC:
Sign: , Sign: (�
Print: Print: 1' B ✓e—�'
13'_EETTRICK
Seal: ia, ubhc -State of Florida Seal dNuvo�h.
o " °e,'s MARIE FIGUEROA
;'- My_ Comm. Expires Sep 19,2017 =r ° Notary Public-State o1 Florida
Commission#FF 055732 ,y Commission 4E GG 045807
Bonded Through National Notary Assn.
APPROVED BY RIP 1:2 Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
o STATE OF FLORIDA
PERMIT #: 13-SC-1756565
DEPARTMENT OF HEALTH APPLICATION #:AP 1286784
ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID:
SYSTEM FEE PAID:
CONSTRUCTION PERMIT
RECEIPT #:
DOCUMENT #: PR1058792
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Salvatorre Annese
PROPERTY ADDRESS: 9510 Biscayne Blvd Miami,FL 33138
LOT: 4 BLOCK: 75 SUBDIVISION:
PROPERTY ID #: 11-3206-014-2880 [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 ANTERIAL 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 [ 1,200 ] GALLONS / GPD NEW SEPTIC TANK TO INSTALL CAPACITY
A [ 0 ] GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY IMAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 500 ] SQUARE FEET NEW DF IN BED CONFIG SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: I ] TRENCH [x] BBD I ]
N
F LOCATION OF BENCHMARK: FFE........11.40'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE 110.80] [ INCHEs FT I ABOVE/�BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 60.80] INCHES FT ] [ABOVE/ BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 74.001 INCHES
0 1.-Install a 1200 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 500 sf.of drainfield in ...BED.......configuration.
E 4.-Install 24 a 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
Richard N Rojas
DATE ISSUED: 04/21/2017 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
Q 1.1.4 AP1286784 SE1031507
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