PL-17-487 t n r n �
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►�r4N,fiPIG2,=17'7
Miami Shores Village Pet lft7 ill tl i e t al
10050 N.E.2nd Avenue NE
0:Drairt#ield'
Miami Shores,FL 33138-0000.;
Phone: (305)795-2204 "APPROVED
yP40RIRP
t Ia�t :X13# p17 Expiration: 09/30/2017
Project Address Parcel Number Applicant
730 NE 94 Street 1132060141690
Miami Shores, FL Block: Lot: ARTURO DOVALINA
Owner Information Address Phone Cell
ARTURO DOVALINA 730 NE 104 Street
MIAMI SHORES FL 33138-
730 NE 104 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 2,000.00
MR C'S PLUMBING&SEPTIC INC (305)651-7859
_.: .. __..,... Total Sq Feet: 240
Type of Work:NEW DRAINFIELD REPAIR Available Inspections:
Type of Piping: Inspection Type:
Additional Info:NEW 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
CCF Invoice# PL-2-17-63068
$1.20 03/03/2017 Credit Card $ 116.70 $550.00
DBPR Fee $2.25
DCA Fee $2.25 02/28/2017 Check#:225 $500.00 $50.00
Education Surcharge $0.40 02/24/2017 Credit Card $50.00 $0.00
Permit Fee $150.00 Bond#:3321
Scanning Fee $9.00
Technology Fee $1.60
Total: $666.70
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 ELECTRICA BING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT I ce ' t t II the f going information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zonin riz the above-named contractor to do the work stated.
March 03, 2017
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
March 03,2017 1
441�"
DIVISION OF
Environmental Health
``�Q Florida Health ,��
��1 Miami-Dade County ��
tiQ OSTDS/Well Division Q�
`�`� 11805 SW 26th Street•Miami,FL 33175
Inspector-,
_ Date
� f SSS
Address /f/r 1-4OSTDS# 19t'��7f''/3
Comments:
Signature
PL I
i
Miami Shores Village
BuildingDepartment �p
2\ 10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: 305 795-2204 Fax: 305)756-8972
( ) (
INSPECTION LINE PHONE NUMBER:(305)7624949 S
F BC 20
BUILDING Master Permit No. 191 Ig-us'-1-
PERMIT APPLICATION Sub Permit No.
r-JBUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
@PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
1, CONTRACTOR DRAWINGS
JOB ADDRESS: N L� l S�2: -
Ci • Miami ShoresCounty: Mia i Dae zip: 3
Folio/Parcel#: '��v _6
tq� Mb Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Constructioq T pe: Flood Zone: BFE: FFE:
t
&69 Cil -,9
OWNER:Name(Fee Simple Titleholder): AA Phone#:_A43�& ( ®�
Address: —) N 6-
City: M I D M I S EE S' State:1[r Zip: 'J fS
Tenant/Lessee Name: Phone#:
Email: i W� a
Uj
CONTRACTOR:Company Name: ( l a Lhone#:
Address: ��� C
City: ( 'L �
State: F-CZip
( ►R�l�
Qualifier Name: ___ Phone#: OSl
State Certification or Registration M S�� Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address City: State: Zip: PP��
Value of Work for this Permit:$ Square/Unear Footage of Work: a�klT
Type of Work: ❑ Addition ❑ Alteration ❑ New F Repair/Replace El Demolition
Description of Work: (�(� LnF �.�1 C�-1 1z�- Pqe
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$ O
TOTAL FEE NOW DUE$
(Revised02/24/2014) / 1
(. �O
Bonding Company's dame(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 wpkh 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 rei specti in fee w' a charged.
Signature Signature
OW ER o AGE CONTRACTOR
The foregoiIg instrument was acknowledged a this The foregoing instrument was acknowledged before me this
04j> day of '01 �� 20 1�" .by day of �� 20 k� by
7�1'I Cs 'rL�-who is Personal Iv known to U iC"ho is personally known to
1/ P
me or who has produced as me or who has produced���0 Z. -ax:> S q
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC NOTARY PUBLIC:
��)Te
Sign' Sign.
Print: P rEt=18LEETTRICK Print: '�N►' "" MAHARAIKGONZALEZ
A I!,
Nurai
u C- a e oJAssn.
q# :.km COMMISSION#GG 044602
Seal' _ `J+ 'cMy CommExires Se1Seal: o F EXPIRES:November 2,2020
La���
5 �gF ,• HondedThruNotaryPubltcUnderwriters
Not
*ss*s******s*s*s*******sass***********ss*s**********************s***ass********sss**************************
APPROVED BY -t Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
PERT #:13-SM-1738103
APPLICATION #:AP1274713
STATE OF FLORIDA
DEPARTMENT OF HEALTH DATE PAM:
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAM:
SYSTEM
e RECEIPT #:
DOCOMENT #TR1048909
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: arturo dovalina
PROPERTY ADDRESS: 730 NE 94 St Miami,FL 33138
LOT: 12-13 BLOCK: 65 SUSDIVIsION: Miami Shores Sec 3
PROPERTY ID #: 11-3206-014-1690 [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 Ewstino Seatic Tank to Remain CAPACITY
A [ 0 ] GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ I GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ 7
D [ 240 ] SQUARE FEET New Bed Conf.Drainfield SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ I MOUND [ I
I CONFIGURATION: [ ] TRENCH [X] BED 17
N
F LOCATION OF BENCHMARK: FFE:10.1'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 9.60 ][ INCHES FT ][ABOVE $Er BENCHMARK/REFERENCE P03VT
E BOTTOM OF DRAINFIELD TO BE [ 39.60]ff INCHES FT I[ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 42.001 INCHES
EXISTING SEPTIC TANK TO REMAIN,REPLACE DRAINFIELD ONLY
0
T 1.-EXISTING 900 gal.septic tank with and approved filter TO REMAIN.
H 2:Install 240 sf.of drainfield in bed configuration. i%
3:Install 12"of slightly limited soil at the bottom of the drainfield. O psc§otm a ftn$�
E {Comments Continued on Page 2.) c t gL�ulcr�t tim §
R 25 —611POe eatt°00
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SPECIFICATIONS BY: ick T> of � 0th � lme.
19 'Aa F� eggMe""Jttr
APPROVED BY: TIll
TLE: ENGINE*?R�T*? t�pxC0. {?, ,�:.�� � i� 5� Dade CHD
�5� 5
DATE ISSUED: 02/21/2017 ��2� @v°\�ta$t� �4IRATION DATE: 05/10/2017
P Y gtt�tp�e���tt� .
DH 4016, 08/09 [Obsoletes all previous editions which may not Q' used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1.4 AP1274713 SE1022471
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