PL-17-2373Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit NO. PL -10-17-2373
Permit Type: Plumbing - Residential
Work Classification: Drainfield
Permit Status: APPROVED
Issue Date: 10/13/2017
Expiration: 04/11/2018
Parcel Number
Applicant
262 NE 93 Street
Miami Shores, FL
1132060133500
Block: Lot:
ADOLFO GONZALEZ-GARCIA
Owner Information
Address
Phone
Cell
ADOLFO GONZALEZ-GARCIA
262 NE 93 Street
MIAMI SHORES FL 33138-2827
(305)206-0463
Contractor(s) Phone Cell Phone
MR C'S PLUMBING & SEPTIC INC (305)651-7859
Valuation:
Total Sq Feet:
$ 3,500.00
300
Type of Work: DRAINFIELD REPAIR AND SEPTIC TANK I
Type of Piping:
Additional Info: DRAINFIELD REPAIR AND SEPTIC TANK I
Bond Return :
Classification: Residential
Scanning: 3
Fees Due
Bond Type - Owners Bond
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$500.00
$2.40
$4.50
$3.00
$0.80
$300.00
$9.00
$3.20
$822.90
Pay Date Pay Type
Invoice # PL -10-17-65232
10/04/2017 Credit Card
10/13/2017 Credit Card
10/13/2017 Credit Card
Bond #: 3530
Amt Paid Amt Due
$ 50.00 $ 772.90
$ 500.00 $ 272.90
$ 272.90 $ 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 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 ce ify tha
construction aer
going information is accurate and that all work will be done in compliance with all applicable laws regulating
ze the above-named contractor to do the work stated.
Author' Applicant / Contractor / Agent
Buildin ment Copy
October 13, 2017
Date
October 13, 2017
1
Voi'0'Pg/e/-17/1c- P)(gi/S/�r°�`
UYZO‘v96 �
1 Miami Shores Village
BUILDING
PERMIT APPLICATION
❑ BUILDING ❑ ELECTRIC
• PLUMBING ❑ MECHANICAL
JOB ADDRESS: 262 NE 93 Street
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
❑PUBLIC WORKS
Master Permit No
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑ RENEWAL
RECEIVE1
OCT 13 2:)i
FBC 20ki
.D1 t=l-Z.3713
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parce1#:11-3206-013-3500
Occupancy Type:
Load: Construction Type:
OWNER: Name (Fee Simple Titleholder):AdolfO Gonzalez
Address:262 NE 93 Street
Is the Building Historically Designated: Yes NO X
Flood Zone:
BFE: FFE:
Phone#:
City: Miami Shores State: FL
Tenant/Lessee Name:
Email:
Zip: 33138
Phone#:
CONTRACTOR: Company Name: Mr. C's Plumbing & Septic
Address: 19932 NW 2 Avenue
Phone#: 305-651-7859
City: Miami State: FL Zip: 33169
Qualifier Name: Kemble EttrickPhone#: 305-651-7859
State Certification or Registration #: SR061536 Certificate of Competency #:
DESIGNER: Architect/Engineer: NA Phone#:
City: State: Zip:
Address:
Value of Work for this Permit: $ 3500
Type of Work: ❑ Addition ❑ Alteration
Square/Linear Footage of Work: 300
New
Description of Work: Drainfield repair and septic tank installation
Q Repair/Replace ❑ Demolition
Specify color of color thru tile:
Submittal Fee $ ..,Offpcil cf Permit Fee $ 30D CCF $ Z .4
0 CO/CC $
Scanning Fee $
Ra9don Fee $.3 d' DBPR $ 4 S 0 Notary $
Technology Fee $ J • 20 Training/Education Fee $ 0 . so
Bond $ 500
TOTAL FEE NOW DUE $ 2.3 Z , (I o
Structural Reviews $
(Revised02/24/2014)
Double Fee $
Bonding Company's Name (if applicable) NA
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 foJ/r�jegping instrume tt, ias acknowledged before me this The foregoi g instrumen wa acknowledged before
� me this
/) day 0UV6bar , 20 1/ , by �� day of i G -Pd 4er , 20 / 7 , by
/A / 0 6", Zito Z , who is personally known to \Q/Y'i 4/L (r/� �G'\ ,who is personal) kn wn to
Y
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
*************
�hald Mari' r
'::;;; DONALD MARTIN
MY COMMISSION # GG102743
-' EXPIRES May 09, 2021
* ********************
APPROVED BY
(Revised02/24/2014)
Sign:
Print:
Seal:
,e/1/4 -v
'j'' DONALD MARTIN
MY COMMISSION # 00102743
.e, :
EXPIRES May 09, 2021
******************! *aFn*********************** #**********
Plans Examiner
Zoning
Structural Review Clerk
3OUNDARY SURVEY
_-NE. 93rd STREET___
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PROPERTY ADDRESS: 262 NE. 93rd STREET. MIAMI SHORES . FLORIDA 33138
J
LEGAL DESCRIPTION��
, IN BLOCK 28
LOT 5
OF AN AMENDED PLAT OF MIAMI SHORES SECTION No. 1
ACCORDING TO 1HE PLAT THEREOF, AS RECORDED IN PLAT BOOK 10 , AT PAGE 70
OF THE PUBLIC RECORDS OF MIAMI•DADE COUNTY, FLORIDA
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SUBJECT TO CCMPUPN E WITH ALL FEDERAL
STATE ANIS CCUN ff LULLS AND REGULATIONS
LAND SURVEYORS LANG PLANNERS
921 S.W. 122nd Avenue, Miami. Florida 331 54— 2405
•• • • • AN. (305) 221—.3040
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STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT,AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Adolfo Gonzalez
PERMIT #: 13 -SC -1789766
APPLICATION 4: AP 1307342
DATE PAID:
FEE PAID•
RECEIPT #•
DOCUMENT #: PR1076053
PROPERTY ADDRESS: 262 NE 93 St Miami, FL 33138
LOT: 5
BLOCK: 26 SUBDIVISION: Miami Shores Section 1
PROPERTY ID #: 11-3206-013-3500
[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 : .:b[ODIFY THE
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEiNG.b ADE MULL AND 'WV
ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCt %LITH .VAR FEDERA7•,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. •
• •
1
•••• •••• • •
SYSTEM DESIGN AND SPECIFICATIONS • • • •
• •
••••
T [
A [
N [
K [
1,050 ] GALLONS / GPD New Septic Tank to Install CAPACITY • •
0 ] GALLONS / GPD CAPACITY •• ••
0 ] GALLONS GREASE INTERCEPTOR CAPACITY w•• ••
[MAXIMUM CAPACITY SINGLE TAN&: 1260. GALLON3f
] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ IDOSES PER 24•HRS i••#lamps [ ]
• • • • •
•
••••
•
•
•
D [ 300 ] SQUARE FEET New Drainfield Bed Conflau SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [x] BED [ ]
N
F LOCATION OF BENCHMARK: FFE 10.9'
• • •
•• • ••• • • •
••
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED:
0
T
H
E
R
[ 12.00 ] [I INCHES f FT ] [ ABOVE A BELOW h BENCiIMARK/REFERENCE POINT
[ 62.00 ] N INCHES I FT ] [ ABOVE A BELOW b BENCHMARK/REFERENCE POINT
10.00 ] INCHES EXCAVATION REQUIRED: [ 62.00 ] INCHES
1.- Install a 1050 gal. septic tank with an approved fitter
2.- The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance
with s. 64E -6.013(3)(f) FAC.
3.- Install 300 sf. of drainfield in ...BED... configuration.
4.- Install 12" of slightly limited soil at the bottom of the drainfield.
5.- Invert elevation and Bottom of drainfield to be no less than 6.23' & 5.73' NGVD respectively.
THIS PERMIT IS NOT FOR ANY ADDITIONS. (Comments Continued on Page 2.)
SPECIFICATIONS BY:
APPROVED BY:
Mr C j Pib Sept
DATE ISSUED: 09/21 .17
lizaire
TITLE:
TITLE: Engineering Specialist II
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
Dade CHD
EXPIRATION DATE:
v 1.1.4 AP1307342 SE1047586
12/20/2017
Page 1 of 3
10/2/2017
APPLICATION DOCS (2).jpg
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR CONSTRUCTION PERMIT
Permit Application Number
PART I! - SITEPLAN
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features
System
on
adjacent properties
Installation
and or across the street that
Notes:
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Site Plan submitted by: "lx 1/
Plan Approved Not Approved Date 11/0 f
6.y County Health Department
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ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
https://drive.google. com/drive/u/0/folders/OB3SYVJ uZWi RfZGdpYmY3S ENsSTQ
•
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e
1/1
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF
CONTRACTOR
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
Master Permit No.
JOB ADDRESS:
aha `we 93ri
C IVSD
6
FBC 20N
P1 -2343
Sub Permit No.
0 EXTENSION ❑RENEWAL
❑ CANCELLATION ❑ SHOP
DRAWINGS
City: Miami Shores County:
Miami Dade
Folio/Parcel#: II -3744 - o/3- 3 Coo Is the Building Historically
Occupancy Type: Load: Construction Type: Flood Zone:
4
OWNER: Name (Fee Simple Titleholder): Ad A( DflfieZ.
Address: c� �j oC _ E cy3r
City: \(`(\\QiAM sI VW r/ S State: _ F(
Tenant/Lessee Name: Al k
s+
Zip:
Phone#: '10c-1-106 "' vgd 3
Zip:
Phone#:
Email:
CONTRACTOR: Company Name:A /1, 9r•
Address: (1 Z I v )
City:
PGcPri6/i
S
Phone#: 35 S -b c/ _78Cc/
av>( i
Stat : PI r r
Qualifier Name: 1enn Ue__ e ` lv
State Certification or Registration #:
DESIGNER: Architect/Engineer: N' 4
Address: City:
Value of Work for this Permit: $ 3 co0 Square/Linear Footage .of.Work:
Zip: /
/ Phone#: 30 S ----1&-Cel
Ob 1 s 6 Certificate ?i 1 tency #:
Sta
Type of Work: 0 Addition 0 Alteration
Description of Work: D ram ,- dLt
as6a00 -1#
❑ New Repair/Replace
Q-M1C-
e. a Zip:
0 Demolition
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ 30 0
Scanning Fee $ Radon Fee $
CCF $ CO/CC $
DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee$
Structural Reviews $ Bond$
TOTAL FEE NOW DUE $
(Revised02/24/2014)
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. 1 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 commenceme must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the ab n�ch posted notice, the
inspection will not be approved and a reinspection fee will be charged. ''11
Signature
0 ER or AGENT
The foregoing instrume wa cknov%ledged before me this
�1 day of ` R4t1,20 /7 ,by
adC)) .0 (�� vi who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBU
Sign:
Print:
Seal:
• r
KEMBLE ETTAICK
Notary Public - State of Florida
rrn Commission # GG 141708
•
My Comm. Expires Sep 19, 2021
APPROVED BY
(Revised02/24/2014)
Signature
The fore
2- !i
CONTRACTOR
uwas acknowledged before me this
• %+ ��,�. 20 / , by
r - o , ho is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBUC:
Sign:
Print:
Seal:
AtA/#( /11A?*h
10-'f—/"Plans Examiner
Structural Review
Y:11:1' DONALD MARTIN
:. _ MY COMMISSION # GG102743
+
,L EXPIRES May 09, 2021
**1414'
Zoning
Clerk
DIVISION OF
Environmental Health
Florida Health
Miami -Dade County
OSTDS/Well Division
11805 SW 26th Street • Miami, FL 33175
Inspector ` ft.vti--
Address 'L�rl.
Comments:
Date kA:L(Q�Zp0(A
OSTDS # Oka \' ./3'-i2-12-.