PL-18-1587?l.,19. -Ise-)
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Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Permit NO. PL-6-18-1587
Permit Type: Plumbing - Residential
Work Classification: Drainfietd
Permit Status: APPROVED
Issue Date: 81112018
Expiration: 01/28/2019
Parcel Number
Applicant
9825 NE 4 Avenue Road
Miami Shores, FL 33138-2438
1132060170190
Block: Lot:
CHRISTOPHER KISH CHRISTINE
Owner Information
Address
Phone
CeII
CHRISTOPHER KISH CHRISTINE
9825 NE 4 Avenue Road
MIAMI SHORES FL 33138-2438
9825 NE 4 Avenue Road
MIAMI SHORES FL 33138-
Contractor(s) Phone CeII Phone
MR C'S PLUMBING & SEPTIC INC (305)651-7859
Valuation:
Total Sq Feet:
$ 3,000.00
300
Type of Work: INSTALL DRAIN FIELD & SEPTIC TANK
Type of Piping:
Additional Info: INSTALL DRAIN FIELD & SEPTIC TANK
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
$1.80
$4.50
$3.00
$0.60
$300.00
$9.00
$2.40
$821.30
Pay Date Pay Type
Invoice # PL-6-18-67875
08/01/2018 Check #: 1594
08/01/2018 Credit Card
06/08/2018 Check #: 1431
Bond #: 3844
Amt Paid Amt Due
$ 500.00 $ 321.30
$ 271.30 $ 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
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: cfrtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zonin F r i or- I «uthorize the above -named contractor to do the work stated.
Authorized Signature: OwnApplicant / Contractor / Agent
August 01, 2018
Date
Building Department Copy
August 01,' 2018 1
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
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
,QED
JUN 0 8 ' 018
FBC 2011 fith
Master Permit No. l� \ (6—\ S 61
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑■• PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9825 NE 4 Avenue Road
City:
Miami Shores County:
Folio/Parcel#:11-3206-017-0190
Occupancy Type:
Load: Construction Type:
OWNER: Name (Fee Simple Titleholder): Christine Kish
Address: 9825 NE 4 Avenue Road
City: Miami Shores State: FL
Tenant/Lessee Name: NA Phone#:
Email: I
Miami Dade Zip:
Is the Building Historically Designated: Yes NO X
Flood Zone: BFE: FFE:
Phone#:
CONTRACTOR: Company Name: Mr. C's Plumbing & Septic
Address: 19932 NW 2 Avenue
Zip: 33138
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 #:
Phone#:
Address: City: State: Zip:
DESIGNER: Architect/Engineer: NA
Value of Work for this Permit: $ $3000
Square/Linear Footage of Work: 300
Type of Work: ❑ Addition ❑ Alteration ❑ New
Description of Work: Install drainfield and septic tank
■❑ Repair/Replace
❑ Demolition
Specify color of color thruhtile:
Submittal Fee $ SO 1 U• Permit Fee $ 360- CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Training/Education Fee $ Double Fee $ Bond $ S COCJ SO
TOTAL FEE NOW DUE $ L 1 ,
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Bonding Company's Name (if applicable) NA
Bonding Company's Address
City
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
State Zip
NA
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 - absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
OWNER or AGENT
41111.
1�
Signature
CONTRACTOR
The foregoing instrument�{was acknowledged before
me this The foregoing instrument was acknowledged before me this
V day of VD-11/ .P , 20 O , by if day of 1 hG , 20 Al , by
Christine Kish
, who is personally known to
me or who has produced, ?rr✓ers GJ'Lur Sas
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
te/e/t.
Ova r14,-
:►il:' DONALD MARTIN
MY COMMISSION # GG102743
?, EXPIRES May 09, 2021
Kemble Ettrick
who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: al/(/V
Print:
Seal: •:► "•'• . DONALD MARTIN
•
MY COMMISSION # GG102743
*Fir -EXPIRES May 09, 2021
************************************************************************************************** *********
APPROVED BY /l 6-/ / 1/ Plans Examiner
Zoning
(Revised02/24/2014)
Structural Review Clerk
u s s.
SET NAIL. &
DISK 1.8/3870
PCP -
NE 4th AVENUE ROAD
There are no pertinent features on adjacent
properties and or across the street that may
affect the New Septic System Installation
75' RIGHT -OF --WAY
-ASPHALT PAVEMENT -VARIED 'WIDTH-
Got
'D 4 cis'&I
IRON
NO-ID
8
APPRO ✓'ED
Miami Shcres Village
ZONINC DEPT
BY
BLDG VRE.144 rcORNER
SUBJEC " i"O CCMIPLIANCE WI ri All FEDERAL
STATE A v 6'rW9 '( rit,LES AND REGULATIONS
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3.9'
6.0'
22.6'
40.1'
5' -CO11CRETE .SIDEWALK
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4LEVA110N=12.18`
FEN EN/c�EER1: 3
3p'` 6' METAL
FENCE
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FOUND 1/2
o LIGHT/
IRON PIPE POWER
NO � POLE
.2,NN//OD'E
LOT 21
ASPHALT--
. DRIVEWAY.
•
PLANTER
•
FLORIDA ROOM
QLANTER
-5'WALL
10.0'
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re iitAG-Pc"
EI EEVAT�d 8.90'
FOUND 1 2"
IRON PIPE
NO ID
• 110.00'
`BENCHMARK �•
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IRON PPIIPPE RADIUS=25'
NO ID
FOUND 1`2.
IRON PIPE
8.0',
11.3'
PLANTER
CORAL'PA110 ..
oho
ASPHALT PAVEMENT. 15' ALLEY
PLAT BOOK 15, PAGE 14
LOT 22
BLOCK 87
I
5' W
W FENCE
52.5 0.0'W
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10.0'
LOT 23
WATER'
METER }
OUND 1/2*
IRON PIPE NO ID
N3T38'17-W 0.25'
WA
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0.4'N/0.1'W
STATE OF FLORIDA
DEPARTMENT OF HEALTH
r`r7 =k''.... ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM •
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT:
Christine Kish
PERMIT #: 13-SC-1850632
APPLICATION #: API346856
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1119689
PROPERTY ADDRESS: 9825 NE 4 Ave Miami, FL 33138
LOT: 3 4
BLOCK: 87 SUBDIVISION: Miami Shores Sec 4
PROPERTY ID #: 11-3206-017-0190
[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 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
R
A
I
N
I
E
L
D
0
T
H
E
R
[ 300 ] SQUARE FEET New Drainfield Bed Conf. SYSTEM
[ 0 ] SQUARE FEET SYSTEM
TYPE, SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ 1
CONFIGURATION: [ ] TRENCH [X] BED [ ]
LOCATION OF BENCHMARK: FFE 12.3'
ELEVATION OF PROPOSED SYSTEM SITE [ 24.00 ] ['INCHES I FT ] [ ABOVE A BELOW P BENCHMARK/REFERENCE POINT
[ 74.00 ] [I INCHES FT ] [ ABOVE 4 BELOW (I BENCHMARK/REFERENCE POINT
BOTTOM OF DRAINFIELD TO BE
FILL REQUIRED:
[ 0.00 ] INCHES
EXCAVATION REQUIRED: [ 62.001 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 6.63 ' & 6.13 ' NGVD respectively
THIS PERMIT IS NOT FOR ANY ADDITIONS.
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED:
Mr C " s
Erick Perera
06/04/2018
TITLE:
TITLE: Environmental Specialist II
Dade CHD
EXPIRATION DATE: 09/02/2018•
DH-4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
,• i .l .. « AP? 346656 SE107384'2
Page 1 of 3
•
DIVISION OF
Environmental Health
Florida Health
Miami -Dade County
OSTDS/Well Division
11805 SW 26th Street • Miami, FL 33175
Inspector �� C` /' c •� �t o Date �(
Address g.2, f 112 ( d OSTDS # ,4 f /J 76 gJ.4 4
Comments•
Signature