PL-18-1074 (2)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
0PLUMBING ❑ MECHANICAL El PUBLIC WORKS
JOB ADDRESS: 10525 NE 2 Court
REC ED
APR I118
FBC 20n (°
Master Permit No. r L l B — 101 4
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
City: Miami Shores
Folio/Parcel#:11-2231-013-0610
Occupancy Type:
County:
Load: Construction Type:
OWNER: Name (Fee Simple Titleholder): Benny Newby
Address:10525 NE 2 Court
Miami Dade Zip:
Is the Building Historically Designated: Yes NO X
Flood Zone: BFE: FFE:
Phone#:
arty. Miami Shores
Tenant/Lessee Name: NA
State: FL zip: 33138
Phone#:
Email:
CONTRACTOR: Company Name: Mr. C's Plumbing & Septic
Address: 19932 NW 2 Avenue
City: Miami
State: FL
Phone#: 305-651-7859
Zip: 33169
Qualifier Name: Kemble Ettrick phone#: 305-651-7859
State Certification or Registration #: SR061536 Certificate of Competency It:
DESIGNER: Architect/Engineer: NA Phone#:
Address: City:
Value of Work for this Permit $ 3500.00
State: Zip:
Square/Linear Footage of Work: 300
Type of Work: ❑ Addition ❑ Alteration ❑ New
Description of work: Installation of drainfield and septic tank
■❑ Repair/Replace ❑ Demolition
4
Specify color of color thru tile:
Submittal Fee $ p:A4 Permit Fee $ 36 0 CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $ r^
Structural Reviews $ Bond $ S v
CD
TOTAL FEE NOW DUE $
(Revised02/24/2014)
- NA
Bonding Company's Name (if applicable)
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 absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
t. 4�
OW14141Mit
Signature
GENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
7n* day of1/✓iL , 20 /a , by f�, ������ 4�LLr;G
/Wm y A/e � , who is personally known to i'1'A14//, �-Gt"/cok
me or who has produced ,r;Very Lice/IQ- as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
(
Sign:
Print:
Seal:
l/ire
DONALD MARTIN
- ' MY COMMISSION # GG102743
a-;efi' EXPIRES May 09, 2021
APPROVED BY
day of
, 20 4 , by
, who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
to ., `� Sign: VAA-E
(1 /"( Print:
Seal:
,sitliY:;ik, DONALD MARTIN
MY COMMISSION # GG102743
.yam 105 EXPIRES May 09, 2021
led) 11' - (1' Plans Examiner Zoning
(Revised02/24/2014)
Structural Review Clerk
N - %i e-5rD jcE_
=rue #. 22_
Miami Shcres Village
APPROVED
ZONING DEPT
( 1 1 ✓ c:41'4:-1 ri P)1 44 I- S- 7 . 6e9LDG DEPT
BY
DATE
L( 2r
1Q-fY1 - 1) . ��.e Ii SJBJECT 10 CC MPLIFNCE wffrl Ali FEDEP
—I--1 1 CT�iTC AN I `( I rjV { �j�,r AND REGULATIONS
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STATE OF FLORIDA PERMIT #: 13-SM-1838951
DEPARTMENT OF HEALTH APPLICATION #: AP1339030
ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID:
SYSTEM
FEE PAID:
CONSTRUCTION PERMIT
RECEIPT #:
DOCUMENT #: PR1102922
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: BENNY NEWBY
PROPERTY ADDRESS: 10525 NE 2 Ct Miami, FL 33138
LOT: 15-16
BLOCK: 14 SUBDIVISION:
PROPERTY ID #: 11-2231-013-0610
[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 New 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
F
I
E
L
D
0
T
H
E
R
[ 300 ] SQUARE FEET New Dranfield Bed Conf. SYSTEM
[ 0 ] SQUARE FEET SYSTEM
TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND [ ]
CONFIGURATION: [ ] TRENCH [X] BED [ ]
LOCATION OF BENCHMARK: FFE 12.0'
ELEVATION OF PROPOSED SYSTEM SITE
BOTTOM OF DRAINFIELD TO BE
[ 12.00] INCHES
FILL REQUIRED:
[ 12.00 ] [I INCHES 1 FT ] [ ABOVE /) BELOW b LBENCHMARK/REFERENCE POINT
[ 62.00 ] [I INCHES r FT ] [ ABOVE A BELOW 6 BENCHMARK/REFERENCE POINT
EXCAVATION REQUIRED: ( 74.003 INCHES
1.- Install a 900 gal. septic tank with an approved filter
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 Tess than 7.33 ' & 6.83 ' NGVD respectively
THIS PERMIT IS NOT FOR ANY ADDITIONS. (Comments Continued on Page 2.)
SPECIFICATIONS BY: Erick Perera
APPROVED BY:
Astrid V Edwards
TITLE: Environmental Specialist II
TITLE: Engineer Supervisor III
Dade CHD
DATE ISSUED: 04/17/2018 EXPIRATION DATE: 07/16/2018
1
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
AP1339030
SE1073280