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PL-17-465 � . permit ruck PL. M 7- 4, 60 , Miami Shores Village k? Rift' pe:Pluilobin -Residential 10050 N.E.2nd Avenue Work 0 8f ca8 ali`:Septl Miami Shores,FL 33138-0000 # 5ta t1SJ'Al a11E0 Phone: (305)795-2204 [[ •' 212 Expiration: 27/2017 Project Address Parcel Number Applicant 465 GRAND CONCOURSE 1132060170320 JULIAN&DEBRA MONTERO Miami Shores, FL Block: Lot: Owner Information Address Phone Cell JULIAN&DEBRA MONTERO 465 GRAND CONCOURSE 305/685-0412 MIAMI SHORES FL 33138-2462 Contractor(s) Phone Cell Phone Valuation: $ 6,500.00 MIAMI DADE ENVIROMENTAL 786-251-4099 - Total Sq Feet: 500 Type of Work:INSTALL A NEW 1050 GALLON SEPTIC TA Available Inspections: Type of Piping: Inspection Type: Additional Info:INSTALL A NEW 1050 GALLON SEPTIC TA HRS Approval Bond Return: Final Classification:Residential Scanning:3 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $4.20 Invoice# PL-2-17-63038 DBPR Fee $4.50 02/22/2017 Credit Card $50.00 $284.20 DCA Fee $4.50 Education Surcharge $1.40 02/28/2017 Credit Card $284.20 $0.00 Notary Fee $5.00 Permit Fee $300.00 Scanning Fee $9.00 Technology Fee $5.60 Total: $334.20 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 information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Fu ore,I authorize the above-named contractor to do the work stated. February 28, 2017 riing�`Department ed Signa re:Owner / Applicant / Contractor / Agent Date BW" Copy February 28,2017 1 M.� w. MOO AMON a R � Mf g, AMF rs2 y sy: Q \\ LAU AM .. it E ... r .xr �. �:� ... ...� � •u� �.� , ,raYOM .. v ' r; .pOl . �€> fry;:' �;•' � °� ���� w FOR E r,. s E y � i A ti` oil s W �. n .�..o., -c .._ .. ..... ... �.�. �.,., ....,.,,. .« .��T, ..,__. o...... .... �. _, „ v,..., n• ,;,_.;-- cis....::.. ✓...,. ... /.is .,. ..,..._. �.: .''.- �...._� S 3 rz F r. r w, 84 Me Q>; 14 Id NO- PL 17-46 Miami Shores Village F Building Department F-,_F; Z �Se' • 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 4� L& BUILDING Master Permit No._, PERMIT APPLICATION Sub Permit No. BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS:�o 5 -a-,n-0, C® 1!C®US e- City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11- 3 200-0f 7 DA 20 Is the Building Historically Designated:Yes NO Occupancy Type: 8. Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):—\(B U A-lU ({` o kfTe--Il®. Phone#: Address: 46 S Co"QU llSv City: 14(A&I tI S00fig State: Fla Zip: II -32®Co.O(7O320 Tenant/Lessee Name: Phone#: Email: 6 CONTRACTOR:Company Name: Phone#:� � Address: "RZ90 lake 6h City: IM I b ILA i State: Zip: Qualifier Name: ©0 _. 0!6 i4- r Phone#: ZS&-2 5/^C/o 9 9 State Certification or Registration#:C_ _©Q 7 `2 7 (p Certificate of Competency#:S QQ9 f(o DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ (D.:a 00 Square/Linear Footage of Work: 00 Type of Work: ❑ Addition ❑ Alteration E.New ❑ Repair/Replace ❑ Demolition Description of Work: (flJ�,(rA (1 IA fVec9� 10 S !a A- S` P!(e TA U& A 'jy) -C,00Sat''r O F bAAI VI/6('t1'( Specify color of color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ PNr I A TOTAL FEE NOW DUE$ (Revised02/24/2014) Z_S ` . Z2 , 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. r SignatureSignature OWNER or AGENT ONTRACTOR The foregoing instrument was acknowledged before me this T e foregoing instrument was acknowledged before me this { _day of 20 �by 2 2 day of -Fe .20 % by 9tsr-Ju''J who is personally known to �'QS e 80QncS who is personally known to me or who has produced as me or who has produced�`J�Z 44 0-'53-21Q? -� identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: ,CA!ARAIKGONZgLEZ Print: Yl G- Print: O.-Olt. Banded Thm EXPIRES'Nwember2,2020 rs Seal: Seal: JOSE SCLANOS fQ MY COWISSION 4 FF 150202 ' EXP!RES:OCIaber 8,2018 u M' M1M1 #41g I SI iie `Nt APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) PERMIT #: 13-SC-1656378 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION #: AP 1221768 - ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID: SYSTEM FEE PAID: • CONSTRUCTION PERMIT RECEIPT #• •,� WE 2[;1.' DOCUMENT #: PR1007449 CONSTRUCTION PERMIT FOR: OSTDS New " APPLICANT: Julian Montero PROPERTY ADDRESS: 465 Grand Concorse Dr Miami, FL 33138 LOT: 23 BLOCK: 87 SUBDIVISION: PROPERTY ID #: 11-3206-017-0320 [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 [ 1,050 ] GALLONS / GPD Septic CAPACITY A [ ] GALLONS /.;PD N/A CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K`[ j GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ 500 ] SQUARE FEET Trench confi0uration drain SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [x] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: CL Grand Concourse 8.40'NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 1.20 ] [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 28.80 ] [ INCHEs FT ] [ABOVE JBELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 72.00 ] INCHES O *Invert elevation of drainfield to be no less than 6.50'NGVD. *Bottom of drainfield elevation to be no less than 6.00'NGVD. T *Install 42"of slightly limited soil under the bottom of drainfield. H -Perimeter of excavation area shall be at least 2 ft.wider and longer than the proposed absorption bed or drain trench. The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow E of 400 gpd. R 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. SPECIFICATIONS BY: Charles J Chapman TITLE: Master Septic Tank Contractor APPROVED BY: TITLE: Dade CHD Carlos X Xcaza DATE ISSUED: 03/02/2016 EXPIRATION DATE: 09/02/2017 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 1 of 3 1.1.4 AP1221768 SE987245 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.