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DEMO-16-3019$ 800.00 0 ,..... j Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Pem»itNO. DEMO -11-16-3019 Permit Type: Demolition Work Classification: Plumbing Permit Status: APPROVED Issue Date: 12/1 2016 Expiration: 06/13/2017 Parcel Number Applicant 1276 NE 93 Street Miami Shores, FL 33138- 1132050270230 Block: Lot: SEYMOUR & JILL KANTOR Owner Information Address Phone Cell SEYMOUR & JILL KANTOR 1094 NE 91 Terrace MIAMI SHORES FL 33138- (305)336-7100 Contractor(s) APA PLUMBING CORP Phone (305) 992-4614 CeII Phone Valuation: Total Sq Feet: Type of Demo: Plumbing Additional Info: SEPTIC TANK PUMP AND ABANDONMENT FO Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 $108.60 Pay Date Pay Type Amt Paid Amt Due Invoice # DEMO -11-16-61917 12/15/2016 Check #: 14306 $ 58.60 $ 50.00 11/03/2016 Check#: 14224 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final 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 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. Futhermore, I authorize the above-named contractor to do the work stated. December 15, 2016 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date December 15, 2016 1 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: 1276 NE 93 Street RECEIVED N043� 2,,016 FBC 2131`1 Master Permit No. \ 6 t6 -' 3 A Sub Permit No.1):Q (G - 30( 9 ❑ REVISION ❑ EXTENSION ❑ RENEWAL s -14 ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 1 1 3205 027 0230 Occupancy Type: Load: Construction Type: Is the Building Historically Designated: Yes NO Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Seymour and Jill Kantor Address: 172 Golden Beach Drive Phone#:305 336-6691 City: Golden BeachState: FI Tenant/Lessee Name: N/A Email: Phone#: Zip: 33160 CONTRACTOR: Company Name: A.P.A Plumbing Address: 7075 SW 46 Street Phone#: lr2 — City: Miami Qualifier Name: Luis Garcia State: FI State Certification or Registration #: CFC1427783 DESIGNER: Architect/Engineer: N/A Address: Value of Work for this Permit: $ D a OD Type of Work: ❑ Addition ❑ Alteration Zip: 33155 Phone#: 305 992 - Certificate of Competency #: Phone#: City: State: Zip: Square/Linear Footage of Work: N/A ❑ New ❑ Repair/Replace ❑■ Demolition Description of Work: Septic Tank pump and abandonment for demolition of SFR Specify color of color thru tile: Submittal Fee $ • w Permit Fee $ /L'6 ✓ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ SY Cart (Revised02/24/2014) • Bonding Company' r Name (if applicable) / Bonding Company's Address City St;te. _ Zip Mortgage Lender's Name (if applicable) Q/ !� 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS. POOLS. FURNACES. BOILERS, HEATERS. TANKS and 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 regulatine 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 e.VCeeding $2500, the applicant Hurst promise in good felith that a copy of the notice of commencement and coustruclion 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 Hurst be posted at the job .site for the first inspectir 1 which occurs seven (7) days after the building permit is issued. In the absence of such posted notice. the inspection u:11 not b )proved a I a reinspec,n fee will be chargee). .*Signature The foregoing instrum was acknowledged before me this day of C.,(--( , 20 I(p. by vV\ov, r— wh pen poi ttl)wn to me or who has produced As identification and %vho did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: .F .P°646FRAMS MELGAARD MY COMMISSION II FF161297 EXPIRES: September 18, 2018 Signature 1' ontractor The foregoing instrument was acknowledged before me this day of OCT- , 20 t((, by i --UIS ss l s pen. c n. 4 -,known 10 me or who has produced as identification and who did take an oath. NOTARY PUBLIC: L1/4,,s Cal ri2 Sien: Print: eS My Commission Expire. pA� Pu e, FRANCE MELGAARD a;r MY COMMISSION 8 FF161297 EXPIRES: September 18, 2018 oP� *************************; *; ****************************+Rei******************************ski*+k****** APPROVED BY (Revised 117/ I0/(7)( Re% ised 1 N,/Ill/2_(8)9)(Revist d 3/15/09) ***i** Plans Examiner Zoning Structural Review Clerk STATE OF FLORIDA .::,,...., DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION - CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 GARCIA, LUIS ALBERTO A P A PLUMBING CORPORATION 8741 SW 49TH STREET MIAMI FL 33165-6701 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Departments initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! RICK SCOTT, GOVERNOR LICENSE NUMBER A ,, STATE OF FLORIDA i DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CFC1427783 ISSUED: 06/12/2016 CERTIFIED PLUMBING CONTRACTOR GARCIA, LUIS ALBERTO A PA PLUMBING CORPORATION IS CERTIFIED under the pr¢disions of Ch.489 FS. Expiration data : AUG 31, 2016 DETACH HERE L1606120601225 KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CFC1427783 The PLUMBING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2018 GARCIA, LUIS ALBERTO A P A PLUMBING CORPORATION 8741 SW 49TH STREET MIAMI FL 33165-6701 ISSUED: 06/12/2016 DISPLAY AS REQUIRED BY LAW SEC)* L1606120001225 010246 Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 6281687 BUSINESS NAME/LOCATION A P A PLUMBING CORP 7075SW46ST MIAMI FL 33155 OWNER A P A PLUMBING CORP Worker(s) RECEIPT NO. RENEWAL 8547389 LBT EXPIRES SEPTEMBER 30, 2017 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS 196 PLUMBING CONTRACTOR CFC1427783 PAYMENT RECEIVED BY TAX COLLECTOR S75.00 07/11/2016 CREDITCARD-16-037963 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a licence, permit or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws end requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sac 8a-276. For more information, visitwww.miamidadq,gav/raxcollsctor STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: OSTDS Abandonment APPLICANT: SEYMOUR KARTOR PERMIT #: 13 -SM -1717646 APPLICATION #:AP1261737 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1037310 PROPERTY ADDRESS: 1276 NE 93 St North Miami Beach, FL 33160 LOT: 11 BLOCK: 2 SUBDIVISION: Bay Lure PROPERTY ID #: 11-3205-027-0230 [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 [ ] GALLONS / GPD CAPACITY A [ ] GALLONS / GPD CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D R A I N F I E L D 0 T H E R SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: [ ] SQUARE FEET [ ] SQUARE FEET SYSTEM SYSTEM TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND [ ] CONFIGURATION: [ ] TRENCH [ ] BED [ ] LOCATION OF BENCHMARK: ELEVATION OF PROPOSED SYSTEM SITE BOTTOM OF DRAINFIELD TO BE FILL REQUIRED: [ 0.00 ] INCHES / ] [ ABOVE/ BELOW 1BENCHMARK/REFERENCE POINT / ][ ABOVE/ BELOW 1BENCHMARK/REFERENCE POINT EXCAVATION REQUIRED: [ ] INCHES Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The tank shall be filled with clean sand or other suitable material, and completely covered with soil.Have the system inspected by the health department after it has been pumped and ruptured but before it is filled with sand and covered. Betsy Lange-Olmino 11/01/2016 TITLE: TITLE: Engineering Specialist II Dade CHD EXPIRATION DATE: 01/30/2017 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC v 1.1.4 AP1261737 SE -1 a , Page 1 of 3 �` . NOTICE OF RIGHTS . A party whose substantial interest is affected by this order may petition for an administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for administrative hearing must be in writing and must be received by the Agency Clerk for the Department, within twenty-one (21) days from the receipt of this order. The address of the Agency Clerk is 4052 Bald Cypress Way, BIN A-02, Tallahassee, Florida 32399. The Agency Clerk's facsimile number is 850-413-8743. Mediation is not available as an alternative remedy. Your failure to submit a petition for hearing within 21 days from receipt of this order will constitute a waiver of your right to an administrative hearing, and this order shall become a 'final order'. Should this order become a final order, a party who is adversely affected by it is entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a second copy, accompanied by the filing fees required by law, with the Court of Appeal in the appropriate District Court. The notice must be filed within 30 days of rendition of the final order.