PL-17-2150Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit NO. PL --8-17-2150
Permit Type: Plumbing - Residential
Work Classification: Drainfield
Permit Status: APPLIED
Issue Date: 9/19/2017 Expiration: 03/18/2018
Parcel Number
Applicant
29 NW 110 Street
Miami Shores, FL 33168-4318
1121360030620
Block: Lot:
Alexandra Besson-Manno
Owner Information
Address
Phone
Cell
Alexandra Besson-Manno
29 NW 110 Street
Miami FL 33168-
(786)223-5697
Contractor(s)
MR C'S PLUMBING & SEPTIC INC
Phone
(305)651-7859
Cell Phone
Valuation:
$ 2,450.00
Total Sq Feet: 400
Type of Work: DRAINFIELD REPAIR
Type of Piping:
Additional Info:
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
$1.80
$2.25
$2.25
$0.60
$150.00
$3.00
$2.40
$662.30
Pay Date
Invoice #
09/19/2017
08/24/2017
08/30/2017
Bond #: 3500
Pay Type
PL -8-17-64986
Check #: 331
Check #: 328
Check #: 246
Amt Paid Amt Due
$ 112.30 $ 550.00
$ 50.00 $ 500.00
$ 500.00 $ 0.00
Available Inspections:
Inspection Type:
HRS Approval
Final
Review Plumbing
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 perI ass, me responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELEL LUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AF
construction a
ify 4,141;1.
the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
rmore, I authorize the above-named contractor to do the work stated.
Auth d' ignature: Owner / Applicant / Contractor / Agent
Building Department Copy
September 19, 2017
Date
September 19, 2017 1
BUILDING
PERMIT APPLICATION
El BUILDING ❑ ELECTRIC
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
❑ ROOFING
4KLUMBING ❑ MECHANICAL ❑PUBLIC WORKS
ll1)-6" STREET
JOB ADDRESS:
RECEIVED
AUG 242011�
FBC 20.1501
Master Permit No.
Sub Permit No.
❑ REVISION ❑ EXTENSION
❑ CHANGE OF
CONTRACTOR
❑ CANCELLATION
❑ RENEWAL
❑ SHOP
DRAWINGS
City: Miami Shores County: Miami Dade Zip: .3314. 8
Folio/Parcel#: 11— o2% 3 — ( 3 - 6 Co., -.0 Is the Building Historically Designated: Yes NO K
Occupancy Type: Load: /�Co�nstruction Type:(e,, Flood Zone: BFE: I, FFE:
OWNER: Name (Fee Simple Titleholder): /'�►' " 1 ' ` t 4'd Phone#: 754- 55/ -G 1-2
7� OA, t — 'asTai-
City: t t,kIt4t SlAbt4S State: % Zip: 33/4 P
Address:
Tenant/Lessee Name: Phone#:
Email: OA_ 4Lt / Ca_ dot • Gor►�.
CONTRACTOR: Company Name: Alf Y' C S Pik -/'l .-p t C Phone#: &lc-6 s( - 7K-5
1113 2- N1A)
City: I`vl(,� � State�:,� t Zip:,, 3a-/
Qualifier Name: [1� h/l�?l!�- 1`l r 1 Phone#: du 1 - .6C7 7g -
Address:
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Address: City:
Value of Work for this Permit: $ (71-457)
N/A -
Certificate of Competency #:
Phone#:
State: Zip:
4 6-6
-
Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New FR—Repair/Replace
Description of Work:
►r'a t e. +-
1111
Demolition
Specify color of color thru tile: II
Submittal Fee $ Permit Fee $ i5 ' CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ C310 •00
TOTAL FEE NOW DUE$ (402-3o
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
(/V S f• •v •c.d B
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 th absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
0 NER or AGENT
The foregoing instrument was acknowledged before me this
day of
A ons lMa $
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Signature
CONTRACTOR
The forgoing instrum t was acknowledged before me this
, 20 ti , by D day of .f7.4 , 20 /� , by
, who is personally known to ) e/14/e- 66 / Gam, who is personally known to
as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: 1 // /
Print: OMaid nartA
Seal:
DONALD MARTIN
MY COMMISSION # GG102743
EXPIRES May 09, 2021
*********4(,. *'!'.******** **** **********
APPROVED BY
(Revised02/24/2014)
7if
Sign:
Print:
Seal:
YvtI a MArt, ^
•t*A*wt. DONALD MARTIN
•_c MY COMMISSION # GG102743
EXPIRES May 09, 2021
***************************************************************
Plans Examiner
Structural Review
Zoning
Clerk
STATE OF FLORIDA
• .; DEPARTMENT OF HEALTH APPLICATION #: API302984
It ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID:
104 _ SYSTEM
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1072566
PERMIT #: 13 -SC -1782699
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Anthony Manno
PROPERTY ADDRESS: 29 NW 110 St Miami, FL 33168
LOT: 30
BLOCK: 220 SUBDIVISION:
PROPERTY ID #: 11-2136-003-0620
[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 Seotic TAN TO REMAIN CAPACITY
A [ 0 ] GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS 8[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 400 ] SQUARE FEET DF IN BED CONFIGURATI SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: (X] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [x] BED ( 3
N
F LOCATION OF BENCHMARK: FFE13.0'
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED:
0
T
H
E
R
SPECIFICATIONS BY:
APPROVED BY:
[ 0.00 ] INCHES
[ 25.20 ] (J INCHES if FT ] [ ABOVE A BELOW U BENCHMARK/REFERENCE POINT
( 75.20 3 [l INCHES I FT ] [ ABOVE /) BELOW BENCHMARK/REFERENCE POINT
EXCAVATION REQUIRED: [ 62.00] INCHES
1. -EXISTING 1050 gal. septic tank with and approved filter TO REMAIN.
2.- Install 400sf. 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 absorption bed or trench.
(Comments Continued on Page 2.)
DATE ISSUED:
Mr C's Septic
Loania X Gonzalez
08/15/2017
TITLE:
TITLE: Engineering Specialist II
Dade CUD
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
A Pis029E4
EXPIRATION DATE: 11/13/2017
5';1"44252
Page 1 of 3
. STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR CONSTRUCTION PERMIT
Permit Application Number
PART II - SITEPLAN
Scale: Each block represents 10 feet and 1 inch = 40 feet.
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It
5-0
V`e
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5
brie
-41
4-15
Oe
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e
3
r' .1 3
PO w
ii
9; -
There are no pertinent features on adjacent properties and or across the street that
may affect the New Septic System Installation
Notes: 2e3 A)1.0 ) -
• batt 4 Ise t►e , s T • +0 Pei is i ri
Site Plan submitted by:
Plan Approved
By
Not Approved
County Health Department
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015, 08109 (Obsoletes previous editions which may not be used) Incorporate* 64E-6.001. FAC
(Stock Number: 5744-002-4015-6)
Page 2 of 4
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