PL-3-17-732Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Expiration: 09/25/2017
Parcel Number
Applicant
50 NE 96 Street
Miami Shores, FL 33138-
1132060130630
Block: Lot:
MIGUEL NAVARRO
Owner Information
Address
Phone
Cell
MIGUEL NAVARRO
50 NE 96 Street
MIAMI SHORES FL 33138-
50 NE 96 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone
MR C'S PLUMBING & SEPTIC INC (305)651-7859
Cell Phone
Valuation:
Total Sq Feet:
$ 2,000.00
0
Type of Work: INSTALL 300 DRAINFIELD
Type of Piping:
Additional Info: INSTALL 300 DRAINFIELD
Bond Return :
Classification: Residential
Scanning: 1
Fees Due
Bond Type - Owners Bond
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$500.00
$1.20
$2.25
$2.25
$0.40
$150.00
$3.00
$1.60
$660.70
Pay Date
Invoice #
03/16/2017
03/24/2017
03/29/2017
Bond #: 3352
Pay Type
PL -3-17-63355
Credit Card
Credit Card
Credit Card
Amt Paid Amt Due
$ 50.00 $ 610.70
$ 500.00 $ 110.70
$ 110.70 $ 0.00
Available Inspections:
Inspection Type:
HRS Approval
Final
Review Plumbing
,
In consideration of the
pertaining thereto and i
accepting this permit
required for ELEC
OWNERS AFFI
construction and
issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
ict c•. formity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
MBING ANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
horize the above-named contractor to do the work stated.
Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
March 29, 2017
Date
March 29, 2017 1
DIVISION OF
Environmental Health
Florida Health
Miami -Dade County
OSTDS/Well Division
Inspector ,,%frzat,Le_ j. W
Date
Address .J-0 ,d 141/2.
11805 SW 26th Street • Muni, FL 33175
OSTDS #
/1/7/27W7,
Comments:
Signature
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
EI BUILDING ❑ ELECTRIC ❑ ROOFING
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
JOB ADDRESS: c IV€ cltio �L
FBC 20
PL 4-1-13z
Master Permit No.
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County:
if X030
Folio/Parcel#:
Miami Dade
Zip:
31
Occupancy Type: Load:
Is the Building Historically Designated: Yes NO v
Construction Type: Flood Zone: BFE:
OWNER: Name (Fee Simple Titleholder):
Address: 50
Phone#:
City: ttic&C l`1 -
Tenant/Lessee Name:
Email:
14
State:
Zip:
Phone#:
FFE:
")-94-4(0-240
CONTRACTOR: Company Name: Hr- e1/4-4
yvt.ConcPhone#: 630SI 4'
Address: lIC7) 3y rt‘ -'6 2- v -e -
City: ° cc- dVl�d
Qualifier Name:
State: t'L_
'e(s3a,
Ai/ A--
1 �c
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Phone#:
Certificate of Competency #:
Phone#:
Address: City:
Zip: 3 6C\
SDS 5( -7g- 99
State: Zip:
Value of Work for this Permit: $ p.00. ~ 'fes Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New III
Description of Work:
Repair/Replace ❑ Demolition
nsEcc-1 1 300 `t -mac.,( N -q-
Specify color of color thru tile:
Submittal Fee $ ' JIJ - fl I Q Permit Fee $ f f� f CCF $ 1 • CO/CC $
Scanning Fee $ Radon Fee $ L • Z5 DBPR $ Z • ZS Notary $
Technology Fee $ I ' LP° Training/Education Fee $ ®c4C) Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ 0
(Revised02/24/2014)
(N I o e
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.
Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
n� day of /1�C ,20 /? ,by
/1 1 e4_ A1/ -V ep, who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC.
Sign:
Print:
Seal:
o`""""' KEMBLE ETTRICK
'utary •ublic - State of Florida
N y i��h My Comm. Expires Sep 19, 2017
%,QF-����;, Commission # FF 055732
Bonded Through National Notary Assn.
CONTRACTOR
The foregoing instrument was acknowledged before me this
/0 day of Ink t G44 , 20 17 , by
ISI.Ff E7e(x.GK , who is personally known to
mg or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: S
Seal:
****+Rig******************************************************
APPROVED BY
(Revised02/24/2014)
Plans Examiner
SAY Pie ,,, SHERYL A MENDES
4.gene �(% Notary Public - State of Florida
E.
; !� • E My Comm. Expires Oct 23, 2018
'VA c;; Commission # FF 136597
* *: *V3ftdtrilifedt8riffiteRaFWontasp
Structural Review
■** *SW *MI!
Zoning
Clerk
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: MIGUEL NAVARRO
PERMIT 41:13 -SM -1743766
APPLICATION 0: AP 1278479
DATE PAID:
FEE PAID:,
RECEIPT #:
DOCUMENT #: PR1052558
PROPERTY ADDRESS: 50 NE 96 St Miami, FL 33138
LOT: 5-6
BLOCK: 5
PROPERTY ID #: 11-3206-013-0630
SUBDIVISION: Miami Shores
[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 t 900 1 GALLONS / GPD Existing SeotigTank tto.Remain CAPACITY
A t 0 ] GALLONS / GPD CAPACITY
N [ 0 y GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS Q( ]DOSES PER 24 HRS #Pumps [ ]
D [ 300 1 SQUARE FEET New Bed Conf. Drainf. SYSTEM
R [ 0 ] SQUARE FEET
A TYPE SYSTEM: (x1 STANDARD [ l FILLED [] MOUND ( ]
SYSTEM
I CONFIGURATION: [ ] TRENCH [x] BED [ ]
N
F LOCATION OF BENCHMARK: FFE: 13.2' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL '011: RED: 0.00 INCHES
0
T
H
5
R
128.801E INCUBI/ FT ] [ABOVE BE • ; BENCHMARK/REFERENCE POINT
BENCHMARK/REFERENCE POINT
[ 78.80 ] [1 INCHES / FT ] I ABOVE
EXCAVATION 1 ±';UEDA 62.00 HES
EXISTING SEPTIC TANK TO REMAIN, REPLACE DRAINFIELD ONLY
1. -EXISTING 900 gal. septic tank with and approved filter TO REMAIN.
2.- Install 300 sf. of drainfield In bed configuration.
3.- Install 12" of slightly limited soil at the bottom of the drainfield.
4.- Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed
(Comments Continued on Page 2.)
SPECIFICATIONS BY:
APPROVED BY:
Ettriok
TITLE:
Clermont
DATE ISSUED: 03/08/2017
TITLE: ENGINEERING
DH 4016, 08/09 (Obaoletes all previous editions which may not be us
Incorporated: 64E-6.003, FAC
v 1.1.4
AP1279479
SIS1o2582o
Dade CBD
TION DATE 06/06/2017
Page 1. of 3
N. 96 STR
10.9MEDIAN
(80. TOTAL R/W. PER DNS PLAT)
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