PL-18-821Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permi
Parcel Number
Permit NO. PL-3-18-821
Permit Type: Plumbing - Residential
Work Classification: Drainfield
Permit+Status: APPROVED
Issue Date: 4/2/2018
Expiration: 09129/2018
Applicant
9505 NE 5 Avenue
Miami Shores, FL
1132060140710
Block: Lot:
DONALD STOBS
Owner Information
Address
Phone
Cell
DONALD STOBS
9505 NE 5 Avenue
MIAMI SHORES FL 33138-3161
(305)757-0950
9505 NE 5 Avenue
MIAMI SHORES FL 33138-3161
Contractor(s) Phone.
MR C'S PLUMBING & SEPTIC INC (305)651-7859
Cell Phone
Valuation:
Total Sq Feet:
$ 2,450.00
300
Type of Work: INSTALLATION OF DRAINFIELD
Type of Piping:
Additional Info: INSTALLATION OF DRAINFIELD
Bond Return :
Classification: Residential
Scanning: 1
Fees Due
Bond Type - Contractors Bond
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Amount
$500.00
$1.80
$2.25
$2.00
$0.60
$150.00
$3.00
$2.40
Total: $662.05
Pay Date
Invoice #
04/02/2018
03/29/2018
04/02/2018
Bond #: 3701
Pay Type
PL-3-18-66973
Check #: 1386
Credit Card
Credit Card
Amt Paid Amt Due
$ 500.00 $ 162.05
$ 50.00 $ 112.05
$ 112.05 $ 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 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 zonincy. quthernire, I authorize the above -named contractor to do the work stated.
April 02, 2018
Authorized Signature: Owner / Applicant / Contractor / Agent
Date
Building Department Copy
April 02, 2018 1
N1 Miami Shores Village
3\
�QBuilding ``% 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
BUILDING
PERMIT APPLICATION
ElBUILDING ❑ ELECTRIC
•PLUMBING ❑ MECHANICAL
JOB ADDRESS: 9505 NE 5 Avenue
Master Permit No.
Sub Permit No.
❑ ROOFING ❑ REVISION ❑ EXTENSION 0 RENEWAL
MAR 22018
FBC 20)� .6h'
eLi s --521
❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores County:
Miami Dade Zip:
Folio/Parcel#: 11-3206-014-0710 Is the Building Historically Designated: Yes
Occupancy Type: Load:
Construction Type: Flood Zone:
OWNER: Name (Fee Simple Titleholder): Donald Stobs
Address: 9505 NE 5 Avenue
NO X
BFE: FFE:
Phone#:
City: Miami Shores
State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Mr. C's Plumbing & Septic
Address: 19932 NW 2nd Avenue
Phone#: 305-651-7859
City: Miami
State: FL Zip: 33169
Qualifier Name: Kemble Ettrick Phone#: 305-651-7859
State Certification or Registration #: SR061536 Certificate of Competency #:
DESIGNER: Architect/Engineer: NA Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ 2450 Square/Linear Footage of Work: 300
Type of Work: ❑ Addition ❑ Alteration ❑ New M Repair/Replace [1 Demolition
Description of Work: Installation of drainfield
Specify color of color thru tile:
Submittal Fee $ `C° Ci1C1 Permit Fee $
Scanning Fee $ Radon Fee $ ' 0 DBPR $ 2 - 2 S
CCF $ CO/CC $
Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ SCOv ao
TOTAL FEE NOW DUE $ [ I Z . G L3
(Revised02/24/2014)
rot2.C55
Bonding Company's Name (if applicable) NA
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address NA
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 be approved and a reinspection fee will be charged.
Signature
2. 24 tA-D
OWNER or AGENT
The foregoing instrument was acknowledged before me this
20 day of M0Ye4 , 20 � , by
',nit Id c4&
, who is personally known to
me or who has produced ?7r, ✓C/f G;cenSe- as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
**********
()MAL
oit4I Ma►-44(:-
''""•`44"' MARTIN
`�; DONALD
1*E MY COMMISSION # GG102743
• ,o, EXPIRES May 09, 2021
APPROVED BY
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
f� day of� / 1,I "/h , 20 /0 , by
/te,n & GI &•;Cic , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
MA lid MAvt A
;;; Y^ : DONALD MARTIN
MY COMMISSION # GG102743
dr, EXPIRES May 09, 2021
******************************************************************
Plans Examiner
Zoning
(Revised02/24/2014)
Structural Review Clerk
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED:
0
T
E
[ 0.00 ] INCHES
U.
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: DONALD STOBS
PERMIT #: 13-SM-1834089
APPLICATION #: AP1335915
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1099951
PROPERTY ADDRESS: 9505 NE 5 Ave Miami, FL 33138
LOT: 13-14
BLOCK: 54 SUBDIVISION:
PROPERTY ID #: 11-3206-014-0710
[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 EXISTING 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 Drainfield Bed Conf. SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND
I CONFIGURATION: [ ] TRENCH [x] BED [
N
F LOCATION OF BENCHMARK: FFE 10.80'
I ELEVATION OF PROPOSED SYSTEM SITE [ 22.80 ] 4INCHES t FT ] [ABOVE ABELOW IBENCHMARK/REFERENCE POINT
[ 72.80 ] [ INCHES FT ] [ ABOVE 4BELOW f BENCHMARK/REFERENCE POINT
EXCAVATION REQUIRED: [ 62.00 ]' INCHES
1.-EXISTING 900 gal septic tank with and approved filter TO REMAIN.
2.- The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance
with s. 64E-6.013(3)(f) FAC.
3.- Install 300 sf. of drainfield in ...BED... configuration.
4.- Install 12 " of slightly limited soil at the bottom of the drainfield.
5.- Invert elevation and Bottom of drainfield to be no less than 5.23' & 4.73' NGVD respectively
THIS PERMIT IS NOT FOR ANY ADDITIONS.
(Comments Continued on Page 2.)
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED:
Mr C's Plb Sept
Gerard L Philizaire
03/28/2018
TITLE:
TITLE: Engineering Specialist II
Dade aiD
EXPIRATION DATE: 06/27/2018
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
v 1.1.4 AP1335915 5E1070491
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