PL-17-2423Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Parcel Number
Permit NO. PL -10-17-2423
Permit Type: Plumbing - Residential
Work Classification: Drainfield
Permit Status: APPROVED
Issue Date: 10/12/2017
Expiration: 04/10/2018
Applicant
801 NE 97 Street
Miami Shores, FL 33138-
1132060142580
Block: Lot:
MICHAEL & MARIELA MERRY
Owner Information
Address
801 NE 97 Street
MIAMI SHORES FL 33138-2527
Phone
Cell
Contractor(s) Phone
STATEWIDE SEPTIC CONNECTIONS (954)963-0082
Cell Phone
Valuation:
Total Sq Feet:
$ 2,600.00
150
Type of Work: REPLACE DRAINFIELD
Type of Piping:
Additional Info: REPLACE DRAINFIELD
Bond Return :
Classification: Residential
Scanning: 3
Fees Due
Bond Type - Contractors Bond
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$500.00
$1.80
$2.25
$2.00
$0.60
$150.00
$9.00
$2.40
$668.05
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL -10-17-65311
10/11/2017 Check #: 5438 $ 50.00 $ 618.05
10/12/2017 Credit Card $ 618.05 $ 0.00
Bond #: 3524
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 ELECTRICA L MBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT. 1.c ify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoni g. /{:J ermore, I authorize the above-named contractor to do the work stated.
Authorized ,l5ig)5 ture: Owner / Applicant / Contractor / Agent
October 12, 2017
Date
Building Department Copy
October 12, 2017 1
RECEIVED
OCT 1 rtti7
FL -n--21 23
Scanned by CamScanner
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC
IA PLUMBING ❑ MECHANICAL
JOB ADDRESS:
City:
Folio/Parcel#:
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
❑PUBLIC WORKS
801 t•le q-i5T
got
RECEIVED
oer �,� ion
BC20t
Master Permit No.? I '"'I -a `A Z 3
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
Miami Shores G County: Miami Dade Zip: 3 3 138
it - 3206 - 0 t4- 2-B 8 0 Is the Building Historically Designated: Yes NO
Occupancy Type:
Load:
Construction Type:
Flood Zone:
BFE: FFE:
I�,,
MA riP�Gi
OWNER: Name (Fee Simple Titleholder): M QX Yt1,S M l (�I' �QPj' Phone#:
Address: 891 Na/ Sfi v
City:
MI R m1 010 rCS State:
Zip: a3138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:
any Name: G
fa-fewide, S-ep-' G C•, 51 i
Address: l2680 tW (p
Ave, ( O
Phone# v3S—1 /00
City: 0 pckLoVOI
C State: I ti
Qualifier Name: C.f eU G SpM r
Oi
I o
Phone#:
State Certification or Registration #: S,/vl 0i711262 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address:
Zip:
5 30 5`f -
City: State: Zip:
Value of Work for this Permit: $ aCoo0 C19 Square/Linear Footage of Work: 1 So
Type of Work: ❑ Addition ❑ Alteration ❑ New
Description of Work:
Repair/Replace ❑ Demolition
Re -place J rgl r-aetd
Specify color of,color thru tile:
OW
1Tr tilA. a AJ 4a7i
Submittal Fee $ _ Permit Fee $
Scanning Fee $ I • " Radon Fee $'
Technology Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $
/CD CCF $ •
0 :Lyse '1 vi1Jic '/:'/ , '\
it .i-1 CO/CC$ „i i� "l
DBPR $ Notary $ '• ""
Training/Education Fee $ Double Fee $
(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 x
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 b: s 'pro ed and a reinspection fee will be charged.
Signatur
NER or AGENT
The foregoing instrument was acknowledged before me this
day of Q et , 20 1 , by
;-md,Gel rA , who is personally known to
me or who has produced ¶ L. IA
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
"L_
as
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
tOday of 6 e ,20 L7 ,by
` bet CIOmcv► , who is personally known to
l -A l._. as
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
f\r n'L *P..C.X.' Print:
,``,,►RY °4e%
****
APP vetrer—
(Revised02/24/2014)
4
JERRICA L. ARMSTRONG
Notary Public - State of Florida
**ri.ma #l>, i4E4M1a**
My Comm. Expires Feb 9, 2019
/0-11—
Seal:
Plans Examiner
Cvatiort
F00%'414'7%JERRICA L. ARMSTRONG 1
Si. Notary Public - State of Florida )
My Comm. Expires Feb 9, 2019
Zoning
Structural Review Clerk
1
Notes:
R
ECEIV ED
CT 017
STATE OF FLORIDA
DEPARTMENT OF HEALTH
PPLICATION FOR CONSTRUCTION PERMIT
Permit Application N
PART II - SITEPLAN
Each block re•resents 10 feet and 1 in h = 40 fe
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ALL CHANGES MUST BE APPROV
DH 4015, 08/09 (Obsoletes p
(Stock Number: 5744-002-4C
evious editions which may not be used) Inc
15-6)
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= riVeRMIT #:
Date
Miami Shcres Village County He
APPROVED
BY
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ZONING DEPT
JN I Y HbALU-I
LEPARTMEN-
,porated: 64E-6.00',
BLDG DEPT
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ALL CHANGES MUST BE APPROV
DH 4015, 08/09 (Obsoletes p
(Stock Number: 5744-002-4C
evious editions which may not be used) Inc
15-6)
(.1\-i�-
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= riVeRMIT #:
Date
Miami Shcres Village County He
APPROVED
BY
DATE
J BY THE CO
ZONING DEPT
JN I Y HbALU-I
LEPARTMEN-
,porated: 64E-6.00',
BLDG DEPT
FAC
EIP-I I
SUBJECT CO CrMPLIANCE TH ALL FEDERAL
STATE ANL) cr IjN'i V RULES AND REGULAT1DNS
Ith Department
Page 2 of 4
BOUNDARY SURVEY
SCALE: 1" = 20'
LOT 12, BLOCK 73
90'33'29''
10.0' LaLa
0
FIP. 1
No I.D.
LOT 14, BLOCK 73
0.5'
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PLANTER
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IP
R=25.
6=8976'
A=39.03'
No
1/2"
23.5' PARKWAY
.JJ
113 5"TiSFf t 4f VE ENT
•74tT7OD ; RIOT ,9F`AYAY'
"amu AOY/t=P30
LANG 9URVEYORB, INC.
PHONE: 305-822-6062 • FAX: 305-827-9669
6175 NW 153rd STREET SUITE 321
MIAMI LAKES FL. 33014
LEGEND
Overhead Woe Una
-- // Wood Fence
x — Cho'n Link Fence
—pIron Fence
- - — Monument Una
_ _.— Centerline
��� Properly Lite
Z C.R.S.
=Existing Elevations
=Catch Basic.
CAB =Water Meter
® =Electric Box
t1 =Sanitary Mathole
=Sprinkler Pump
'Lax =Wood Pole
=Conn. Pole
=Light Pale
ti =rue Hydrant
A =Water Valve
IE01 =Inlet
=Florida Pori
Light Trons,ormer
891 =Came Tv Box
Eg =Electric Meter Box
A/C=Air Conditioner
Conc. =Concrete
C.B.S. =Candela Black & Stucco
DI- =Drainage Easement
D.M.E.=Oroinogs Maintenance
Easement
F.F.E. =Fnish floor Devotion
F.I.P. -Found Iron Pipe/Pin
FIR. =Found Iran Rebor
P.N. =Found Nal
F.Ntdl =Found Nod & Disc
LME. =Lotto Maintenance
Easement
(M) =Measured
(P) =Platted
(R) =Record
Res. =Residence
SIP/R =Set Iran Pin/Rebar
U.E.-UltIity Easement
A=Arc
BRG=Bearing
CH=Chard
*-Dello
L=Length
R=Radius
T=Tongmt
Page 2 of 2
•
•
•
•
•
BOUNDARY SURVEY
Property Address:
801 NE 97 STREET, MIAMI SHORES, FLORIDA 33138
LEGAL DESCRIPTION:
Lot 13, in Block 73 of "MIAMI SHORES SECTION NO. 3", according to the plat thereof as
recorded in Plat Book 10, Page 37 of the Public Records of Miami -Dade County, Florida.
SURVEYOR'S NOTES:
1) The above captioned Property was surveyed and described based on the above Legal
Description: Provided by Client.
2) This Certification is only for the lands as described. it is not a certification of Title, Zoning,
Easements, or Freedom of Encumbrances. ABSTRACT NOT REVIEWED.
3) There may be additional Restrictions not shown on this survey that may be found in the Public
Records of this County, Examination of ABSTRACT OF TITLE will have to be made to determine
recorded instruments, if any affecting this property.
4) Accuracy:
The expected use of the land, as classified in the Standards of Practice (5J-17 FAC), is
"Residential High Risk". The minimum relative distance accuracy for this type of boundary survey
is 1 foot in 10,000 feet. The accuracy obtained by measurement and calculation of a closed
geometric figure was found to exceed this requirement.
5) Foundations and/or footings that may cross beyond the boundary lines of the parcel herein
described are not shown hereon. •
6) Not valid without the signature and the original raised seal of a Florida LicensId Surveyor arid' • •
Mapper. Additions or deletions to survey maps or reports by other than the signing partysw • •
•
parties are prohibited without written consent of the signing party or parties. • • •
7) Contact the appropriate authority prior to any design work on the herein-desehl4& parcel for • • •
Building and Zoning information. • • • • •
8) Underground utilities are not depicted hereon, contact the appropriate authority 'prior to any '• I '
design work or construction on the property herein described. Surveyor shall be petiifiad•as to my •I•'
•
deviation from utilities shown hereon. • • • • • •• •
9) The surveyor does not determine fence and/or wall ownership. • •'
10) Ownership subjects to OPINION OF TITLE. • •'
11) Type of Survey: BOUNDARY SURVEY. • • • '• .
12) North arrow direction and bearings are based on Recorded Plat Book 10 Page 31'of2he Public . • .
Records of Miami -Dade County, Florida. ' •
i
13) Elevations are based on the National Geodetic Vertical Datum (1929 Mean Sea Level)
14) Bench Mark Used: N/A
15) Flood Zone: "X" Base Flood Elev.: N/A as per Miami -Dade County, Florida. FEMA Panel
Number: 120652 -0306 -L -SEPTEMBER 11, 2009
16) This PLAN OF SURVEY has been prepared for the exclusive use of the entities named hereon.
The Certificate does not extend to any unnamed party:
A.) MICHAEL J. & MARIELA MERRY
SURVEYOR'S CERTIFICATE:
I Hereby Certify to the best of my knowledge and belief that this drawing is a true and
correct representation of the BOUNDARY SURVEY of the real property described hereon.
I further certify that this survey was prepared in accordance with the applicable provisions
of Chapter 5J-17, Florida Administrative Code.
Field Date: October 4, 2017
Job# RP17-0959
Pablo J. Alfonso P.S.M.
Professional Surveyor & Mapper
State of Florida Reg. No.5880
LAND SURVEYORS, I N C.
6175 NW 153id STREET. SUITE 321. MIAMI LAKES. FLORIDA 33014
Phone 305-822-6062 * Fax: 305-827-9669
Page 1 of 2
I` 1I1OIIN)ARY-SIIRVE.Y-NIYI I S1R01 NE 9i STR[ET-MIAMI SHOSES - NTS - 1S -O4 -Il Jac
S ATE OF FLORIDA
D PARTMENT OF HEALTH
O�IISITE SEWAGE TREATMENT AND DISPOSAL
SgSTEM
CONSTRUCTION PE
APPLICANT:. Merry
RMIT FOR:
s Michael
OSTDS Repair
PERMIT # :13 -SC -1788002
APPLICATI N # : AP 1306369
DATE AID:
FEE AID:
RECEI T #-
DOCUME T #: PR1075528
PROPERTY ADDRESS:
LOT: 13
PROPERTY ID #:
801 NE 97 St Miami, FL 33138
BLOCK: 73
11-3206-014-2580
SUBDIVISION:
[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 PE ORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS,
WHICH SERVED A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE
PERMIT APPLICATI N. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE �liMAA •AND VOID.
ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIA1CFE• ;PITH O•THER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. •••••• •
• •
•••• • • •
SYSTEM DESIGN AND SPECIFICATIONS
T [ 650 ] GALLONS / GPD Septic
A [ 0 ] GALLONS / GPD
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY
K [ ] GALLONS DOSING TANK CAPACITY
CAPACITY
CAPACITY
• •
0041•
• •
•• •1 •
•
[MAXIMUM CAPACITY SINGLE TAM :i;4Sp•GALLONS4
]GALLONS @[ ]DOSES PCR 24 :iRS • #sumps
D [ 150 ] SQUAREFEET SYSTEM
R [ 0 ] SQURE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD
I CONFIGURATION: [x] TRENCH
N
F LOCATION OF BENCHMARK: FFE 11.2'
[ ] FILLED [ ] MOUND [ ]
[ ] BED [ ]
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED: [ 0.00] INCHES
0
T
H
E
R
[ 22.80 ] 1.
[ 70.80 ] [1 INCHES
• • •
• • •
•• • 0014 •
• •
• •
4•••1•
•
•
•
INCHES
/ FT ] [ ABOVE /+BELOW
/ FT ] [ ABOVE/
BELOW
BENCHMARK/REFERENCE POINT
BENCHMARK/REFERENCE POINT
EXCAVATION REQUIRED: [ 48.00] INCHES
1.- EXISTING 65C gal tank with and approved filter TO REMAIN.
2.- Install 150 sf. of drainfield in TRENCH... configuration.
3.- Existing slightly limited soil at the bottom of the drainfield to remain. Any spoil material within 24" vertic lly that has
visible signs of effluent shall be removed as part of the repair.
4.- Invert elevation and Bottom of the drainfield to be less than 5.80' & 5.30' respectively.
5. -Using all available space.
THIS PERMIT IS NOT FOR ANY ADDITIONS.
SPECIFICATIONS BY:
APPROVED BY:
Teresa JI1~ olomon
DATE ISSUED: 09/15/2017
izaire
TITLE: Master Septic Tank
Contractor
TITLE: Engineering Specialist II
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
v 1.1.4
Dade
EXPIRATION DATE:
AP1306369 5E1047062
12/14/2017
CHD
Page 1 of 3
DOCUMENT # :
PR1075528
The system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow of 300
gpd.
Install a new drainfield o achieve Drainfield size requirement.
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