PL-17-2186 Permit NO. PL-8'-17-21$6
ORES
`SH:a.�.,, y� Miami Shores Village Permit Type:Plumbing-Residential
10050 N.E.2nd Avenue NE
Penlimt Work Classification:Septic
Miami Shores,FL 33138-0000
y�— Phone: (305)795-2204 Pennit Status:APPROVED
F�'4 w
Issue Date:912572017 Expiration: 03/24/2018
Project Address Parcel Number Applicant
1075 NE 96 Street 1132060143690
Miami Shores, FL Block: Lot: NICOLAS TERZANI FRANZISKA
Owner Information Address Phone Cell
NICOLAS TERZANI FRANZISKA HINZE 1075 NE 96 Street (786)246-8759
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
ALLSTATE DIVERSIFIED ENGINEERI� 305 256-0306 Valuation: =2,500.00( ) (305)258-7797Total Sq Feet
Type of Work:SEPTIC TANK AND DRAINFIELD Available Inspections:
Type of Piping:
Additional Info: Inspection Type:
HRS Approval
Bond Return : Final
Classification:Residential Scanning: 1
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.80 G
DBPR Fee Invoice# PL-8-17-65022
$4.50 09/25/2017 Check*6976 $316.80 $0.00 1
DCA Fee $4.50
Education Surcharge $0.60
Permit Fee $300.00
Scanning Fee $3.00
Technology Fee $2.40
Total: $316.80
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 res onsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL BING, CHANICAL,WINDOWS,DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT I certify that all th foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and z g. thermore, I horize the above-named contractor to do the work stated.
I 1 1 Z�2September 25, 2017
uthoriz d Signature:Owner / Applicant Contractor' / ent Date
Building Department Co
September 25, 2017 1
_ olvlsON`of,ealth
o. Environmental H
(� Florida°Health
V
ade County E O
ell Division
�1 OSTDS Miami,FL 331'15
te'
O 11805 S26th Street• '
ate
Inspector OSTDs#
1 Address
,Comments:
N _
Signature
nature
1 �
Miami Shores VillageREC =WED
Building Department AUG 24 017
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305)795-2204 Fax: (305)756-8972 11
INSPECTION LINE PHONE NUMBER:(305)762-49491
FBC 201`t
BUILDING Master Permit No. PC11 —131 9
PERMIT APPLICATION V Sub Permit No.-Fu--) ^�1�
{❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL•
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
�
JOB ADDRESS: S WE `1 n
UQ
4
City: Miami Shores ^� County: Miami Dade Zip:
Folio/Parcel#: 115ao Ce o 0, 4 3(0 CI C J Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: r) �FFFE:
OWNER: Name(Fee Simple Titleholder): Gn Yl Phone#:
`Address: —(5- IS E
City: dam) State: Zip: /256
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company`.Naine:+ hone#:
Address: XS Q
City: oluj
State: Zip: �.3�
Qualifier Name: C ! �(Q,! �(' Phone#:�ls�J a803.
— :
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
�•
Address: City: State: Zip:
Value of Work for t is Permit:$ .�u�(m.1/� Square/Linear Footage of Work:
Type of Work: Addition
yp ❑ Alteration El New ❑ Repair/Replace El Demolition
Description of Work: S2 p�Cslc.To 1� (�-(QlrN Q-1`11)' — >'
d.1..nu..IL.+M NDN 4 aznlnMr+-
p ell�✓'. 1
i{ r ;-7:. TfSt/ • ... ' o -•� „ SJ1.•.1Jh)f M;tii:ilWeu,}'!y1� j }.. S f
Gr, ISP tt vr6S:��:C7 3 $tom;
Specify color.of color thru"tile: ,t
�� "'4�'* Ort +:a ,,rt`ctl oxK.,�'..w»s •' J _�.<,...„a%Sc,.��� a"��fS
'
Submittal Fee$""" � Permit Fee$ 360 CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$_
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ E30
(Revised02/24/2014)
Bonding Company's,Name(if applicable) L
Bonding Company's Address
City State Zip
MortgagelL nder's Name(if applicable)
1
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 ah 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..... h �
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. / C.
"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 issuarice of a building permit with an estimated value exceedin 2500;the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure ill be envered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commenct must posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. V;4�sencech posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature )c
OWNER or AGENT T
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of. ' -120 11 by �� day of s 20 Vby
"iYol�1�1In l-1 k.n�� who is personally known to who is p y cn o
me or who has produced 1 L. as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print: 0121
Seal: yam, NEW-
is�� Seal: T " '' SARIMABATISTA
�� " MY COMMISSION#GG 018885
9eulrrdS IisyH, spc EXPIRES:May 11,2021
pYieUnbrMi� ••,Wlr. .•..Bonded Thru Notary Public Underw11t m
APPROVED BY , 1/ Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
STATE OF FLORIDA PERMIT #: 13-SM-1772933
t DEPARTMENT OF HEALTH APPLICATION #: AP 1296727
ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID:
SYSTEM
' CONSTRUCTION PERMIT FEE PAID:
,y RECEIPT #:
DOCUMENT #: PR1070585
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: NICOLAS TERZANI
PROPERTY ADDRESS: 1075 NE 96 St Miami,FL 33138
LOT: 9-10 BLOCK: 82 SUBDIVISION:
PROPERTY ID #: 11-3206-014-3690 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
k
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 Seotictank CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY (MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 375 ] SQUARE FEET Trench confiauration SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [X] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: CL NE 96 st., 10.28'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 6.72 ] ( INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 36.72 ] [ INCHE3 FT ] (ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 72.00 ] INCHES
O Inspector to verify the existing septic tank is properly abandoned before final approval.
T "Invert elevation of drainfield to be no less than 7.72'NGVD.
"Bottom of drainfield elevation to be no less than 7.22'NGVD.
H "Install 42"of slightly limited soil under the bottom of drainfield.
E -Perimeter of excavation area shall be at least 2 ft.wider and longer than the proposed absorption bed or drain trench:
The system is sized for 2 bedrooms with a maximum occupancy of 4 persons(2 per bedroom),for a total estimated flow of
R 300 gpd.
The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with
SPECIFICATIONS BY: GUILLERMO SUAREZ TITLE:
APPROVED BY: TITLE: Dade CHD
Carlos N icaza
DATE ISSUED: 07/28/2017 EXPIRATION DATE: 01/28/2019
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1.4 AP1296727 SE1042382