PL-17-2533Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
ermit
Permit NO. PL -10-17-2533
Permit Type: Plumbing - Residential
Work Classification: Drainfield
Permit Status: APPROVED
Issue Date: 11114120 i7
Expiration: 05/13/2018
Parcel Number
Applicant
320 NE 97 Street
Miami Shores, FL
1132060135860
Block: Lot:
JAMES LEVEROCK
Owner Information
Address
Phone
Cell
JAMES LEVEROCK
1201 NE 85 ST
MIAMI FL 33138-3429
Contractor(s)
MR C'S PLUMBING & SEPTIC INC
Phone Cell Phone
(305)651-7859
Valuation:
Total Sq Feet:
$ 2,000.00
200
Type of Work: 10/18/2017
Type of Piping:
Additional Info: 10/18/2017
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
$1.20
$2.25
$2.00
$0.40
$150.00
$9.00
$1.60
$666.45
Pay Date
Invoice #
10/25/2017
11/13/2017
11/14/2017
Bond #: 3556
Pay Type
PL -10-17-65448
Credit Card
Credit Card
Credit Card
Amt Paid Amt Due
$ 50.00
$ 500.00
$ 116.45
$ 616.45
$ 116.45
$ 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 ELECT; L, PL
MBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIrAVIT 1 t I the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and eu;: F �t = ore, I authorize the above-named contractor to do the work stated.
November 14, 2017
Authori..d Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
November 14, 2017 1
s
/ 1'
BUILDING
PERMIT APPLICATION
ElBUILDING ❑ ELECTRIC
[I PLUMBING ❑ MECHANICAL
JOBADDRESS: 320 NE 97 Street
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.
Sub Permit No.
❑ ROOFING ❑ REVISION
PUBLIC WORKS CHANGE OF
CONTRACTOR
KECEI
OCT 2_ 2017
BY: `,
FBC 20 14 -C-t"
PL n -zs33
❑ EXTENSION ❑ RENEWAL
❑ CANCELLATION
❑ SHOP
DRAWINGS
City: Miami Shores
County:
Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO X
Occupancy Type: Load:
Construction Type:
OWNER: Name (Fee Simple Titleholder): James Levelrock
Address: 320 NE 97 Street
Flood Zone: BFE:
FFE:
Phone#:
City: Miami Shores State: FL
Tenant/Lessee Name:
Email:
NA
Phone#:
Zip:
CONTRACTOR: Company Name: Mr. C's Plumbing & Septic
Phone#: 305-651-7859
Address: 19932W 2 Avenue
City: Miami State: FL Zip: 33169
Qualifier Name: Kemble Ettrick
Phone#: 305-651-7859
State Certification or Registration #: SR061536 Certificate of Competency #:
NA Phone#:
City: State: Zip:
Square/Linear Footage of Work: 200
DESIGNER: Architect/Engineer:
Address:
Value of Work for this Permit: $ 2000.00
Type of Work: Ell Addition I I Alteration ❑ New ❑� Repair/Replace I I Demolition
Description of Work: Drainfield repair
Specify color of color thru tile: ,
of
Submittal Fee $ �./b O (d, Permit Fee $ /6-0 --'---- CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $
(Revised02/24/2014)
Bond$ 30 j�
TOTAL FEE NOW DUE $ �1
,u" •;: DONALD MARTIN
MY COMMISSION # GG102743
e**•** ***************************
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 •sence of such posted notice, the
inspectio not be approved d a reinspection fee will be charged.
Sig
Signature
CONTRACTOR
The f, going instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
19thday of October , 20 17 by 19th day of October 20 17 by
James Levelrock , who is personally known to
Kemble Ettrick
, who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
************
APPROVED BY
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
I)MAtd Nave/44
**********************t
2 tofr
(Revised02/24/2014)
Plans Examiner
Structural Review
DONALD MARTIN
MY COMMISSION # GG102743
EXPIRES May 09, 2021
* * * * * * * *
Zoning
Clerk
DIVISION OF
Environmental Health
Florida Health
Miami -Dade County
OSTDS/Well Division
11805 SW 26th Street • Miami, FL 33175
Inspector
Address LLs ��. c:V- )S OSTDS # .4\"�—
Comments:
Vfr
•
Date \k(4)\‘-
Signature
?1G Im2.533
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: JAMES LEVELROCK
PERMIT #:13 -SM -1795046
APPLICATION #: AP1310537
DATE PAID:
FEE PAID:
RECEIPT #-
DOCUMENT #: PR1078657
PROPERTY ADDRESS: 320 NE 97 St
LOT: 9
Miami, FL 33138
BLOCK: 43 SUBDIVISION:
PROPERTY ID # : 11-3206-013-5860
[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
WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE AP.,LICAJT
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING• MADE'
•• •
ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
•
MATERIAL • FACTS,
•TO 411114#020/ THE
NULL AND VOID.
OTHER F$DERAL,
• ••
SYSTEM DESIGN AND SPECIFICATIONS
T [
A [
N [
K [
D [
R [
•••• 4.
••••
•
••
•
•
•• • • •
• • •
• 410
750 1 GALLONS / GPD EXISTING SEPTIC TANK TO REMAIN CAPACITY ••••
• • • • •
0 ] GALLONS / GPD CAPACITY •• •• •• •
0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:125C GALLONS] •
] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ IDOSES PER Q4 HRSS #pumps•
200 ] SQUARE FEET
0 ] SQUARE FEET
A TYPE SYSTEM:
I CONFIGURATION:
N
F LOCATION OF BENCHMARK:
NEW OF IN BED COMM SYSTEM
SYSTEM
[x] STANDARD
[ ] TRENCH
• • •
• • •
•• •
••• •
• •
••
• •
•
•
•
[ ] FILLED [ ] MOUND [
[x] BED [ ]
FFE 12.90'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED: [ 0.00 ] INCHES
0
T
H
E
R
[ 34.80 ] [I INCHES
[ 84.80 ] [I INCHES
/ FT 1 ( ABOVE A BELOW
FT ) [ ABOVE /I BELOW
]BENCHMARK/REFERENCE POINT
]BENCHMARK/REFERENCE POINT
EXCAVATION REQUIRED: [ 62.001 INCHES
1. -EXISTING 750 gal. septic tank with and approved filter TO REMAIN.
2.- Install 200 sf. of drainfield in... BED configuration.
3.- install 12 " of slightly limited soil at the bottom of the drainfield.
4.- Invert elevation and Bottom of drainfield to be no less than 6.33' & 5.83' NGVD respectively
5.- Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed or trench.
THIS PERMIT IS NOT FOR ANY ADDITIONS.
The system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow of
SPECIFICATIONS BY:
APPROVED BY:
A SupeIN ptic
•: S ore
DATE ISSUED: 10/13/2017
TITLE:
TITLE: Engineering Specialist II
Dade
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
v 1.1.4 AP1310537
1
EXPIRATION DATE: 01/11/2018
3E1050103
CHD
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Alp ACCURATE LAND SURVEYORS, INC.
L.B. 0635
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