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PL-17-2148Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. PL -8-17-214$ Permit Type: Plumbing - Residential Work Classification: Drainfield Pennit Status: APPROVED Issue Date: 911912017 Expiration: 03/18/2018 Parcel Number Applicant 595 NE 96 Street Miami Shores, FL 33138- 1132060171600 Block: Lot: MARIA PULDON JANET CARBO Owner Information Address Phone Cell MARIA PULDON JANET CARBONELL 595 NE 96 Street MIAMI SHORES FL 33138-2735 Contractor(s) Phone MR C'S PLUMBING & SEPTIC INC (305)651-7859 Cell Phone Valuation: Total Sq Feet: $ 2,400.00 300 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 Pay Type Invoice # PL -8-17-64984 09/19/2017 Credit Card 08/30/2017 Credit Card 08/24/2017 Check #: 328 Bond #: 3501 Amt Paid Amt Due $ 112.30 $ 550.00 $ 500.00 $ 50.00 $ 50.00 $ 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 in stri ass pertaining thereto accepting this required for E OWNERS A construction an conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In e responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are UMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. ify tall the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating erfiiore, I authorize the above-named contractor to do the work stated. rized Signature: Owner / Applicant / Contractor / Agent Building Department Copy September 19, 2017 Date September 19, 2017 1 DIVISION OF Environmental Health Florida Health Miami -Dade County OSTDS/Well Division 11805 SW 26th Street • Miami, FL 33175 Inspector Address Comments: / Signature OSTDS # J PZ 8 BUILDING PERMIT APPLICATION ❑ 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 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: City: Miami Shores County: Miami Dade Zip: 33/ 38. Folio/Parcel#: 11— 3)-66-01'1-1600 Is the Building Historically Designated: Yes NO // Occupancy Type: Load: Construction Type: 6,42-11 Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Z/7Gf c Phone#: 7g4 gefir 935 C9S i)e 9Sr City: 4-4;44-1 C (PL"„e State: Tenant/Lessee ame: 59.5 ,vim RECEIVED AUG 2'4 1017 .ep ' FBC20N Master Permit No. P1-1-7 2_1 y Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ CHANGE OF CONTRACTOR ❑ CANCELLATION ❑ RENEWAL ❑ SHOP DRAWINGS Address: Email: Phone#: Zip: 3 3/ 3 CONTRACTOR: Company Name: A/. r � Address: 1•611 gql lQQJ NW i" `Atie.e itA- 1 {{{ City:��� ((�II __ State: Qualifier Name: ziv,v le7(L C'RY(ac- State Certification or Registration #: S OC`` 1 4 __ DESIGNER: Architect/Engineer: 1" Pr Address: 2 Phone#: 3S C Sl r 7° J Zip: I b/ Phone#: �6S'�sl—/M Certificate of Competency #: Phone#: City: State: Zip: Value of Work for this Permit: $ aq-6-1) Square/Linear Footage of Work: SO—to Type of Work: ❑ Addition ❑ Alteration ❑ New Description of Work: .1) rcu vk,-;t,t. a& J' ale_ Repair/Replace ❑ Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Technology Fee $ Structural Reviews $ (Revised02/24/2014) CCF $ CO/CC $ DBPR $ Notary $ Training/Education Fee $ Double Fee $ Bond $ 500 • ,r^^^^�� TOTAL FEE NOW DUE $ W ' �v 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 gip 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 instrum rt was acknowledged before me this �yhei day of 20 17 , by i'I r`jB�tG , who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: ************ ;pi`" '~Ftp: DONALD MARTIN ''x:. ' MY COMMISSION # GG102743 'x ;,.,rN EXPIRES May 09, 2021 41111111111 APPROVED BY (Revised02/24/2014) as Signature CONTRACTOR The foregoing instrum t was acknowledged before me this hd day of v -,c'6. , 20 % 7 , by i"\e f who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: Plans Examiner ✓Ia'iJ frJt,1 .4.:i '•':fit;: DONALD MARTIN '_ MY COMMISSION # GG102743 %,;a..,.: EXPIRES May 09, 2021 l T�. - _ . - . s • . k .. l.L.i.ir .a..S * Zoning Structural Review Clerk STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Janet Carbonell PERMIT #: 13 -SC -1782704 APPLICATION #: AP1302991 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1072573 PROPERTY ADDRESS: 595 NE 96 St LOT: 22 Miami, FL 33138 BLOCK: 99 SUBDIVISION: PROPERTY ID #: 11-3206-017-1600 [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 Septic TANK 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 @[ ]DOSES PER 24 HRS #Pumps [ ] D [ 300 ] SQUARE FEET NEW DF IN BED CONFIG SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [X] STANDARD [ I FILLED [ ] MOUND [ ] I CONFIGURATION: [ 1 TRENCH [x] BED [ ] N F LOCATION OF BENCHMARK: FFE 9.1' 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 { 7.20 ] IJ INCHES I FT ] [ ABOVE a BELOW h BENCHMARK/REFERENCE POINT [ 57.20 14 INCHES FT I [ ABOVE a BELOW h BENCHMARK/REFERENCE POINT EXCAVATION REQUIRED: [ 62.00] INCHES 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 absorption bed or trench. (Comments Continued on Page 2.) DATE ISSUED: Mr C"s Plb Loanis X Gonzalez 08/15/2017 TITLE: TITLE: Engineering Specialist II Dade CHD DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC 1.1.4 AP13O29.91 EXPIRATION DATE: 11/13/2017 SE1044262 Page 1 of 3 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR CONSTRUCTION PERMIT Scale: Each block re Permit Application Number PART II - SITEPLAN resents 10 feet and 1 inch = 40 feet. imunommusammin. 11111111111111111111111101111 immummiumnimmrimninmilim 111111111111111111111111111 ° ,111111 11111 1 111 5 There are no pertinent features on adjacent properties and or across the street that may affect the New Septic System Installation Notes: Sc' S ‘,. sr. ItA44. ✓+•v. J r );,‘ 4 -c-ed +2=- c,e . s . • 4t) r e c - Site Plan submitted by: Plan Approved Not Approved 7'4c r Date $)9 i,-7 By County Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DI -I 4015, 08/09 (Obsoietes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 2 of 4 (Stock Number: 5744-002-4015-6) LOT 2 BLK 99 BOUNDARY SURVEY LOT 1 BLK 99 J FW 1/2. 1P NO ID LOT 21 BLK 99 46 Vim. (V) Q) r .20 CL 4'CLF 1.65 C o_e. 3©o4 z)0ai ` 50.0' FND NCS b m N 1.70 CONC.CURB ASPHALT 15.0' ALLEY 50.0' ASPHALT DRIVE 16.65' u 4.5' :I AIC 23.35' 3 Al Sf� 1 STORY RES • 595 CEOS -'CBS WALL STONED PORCH 21.6' 6.65' 8.4' U 6.7' 10.0' FRO /2' IP 35.0' F z W a as ea tr• am sod tmo NE 96 STREET (20.0' PAvENENT)-----------------1---------