PL-17-2895Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit NO. PEL-12-17-28955
■ Permit Type: Plumbing - Residential
erlI I ' Work Classification: Drainfield
Permit Staters: APPROVED
Issue Date: 12/14/2017 1 Expiration: 06/12/2018
Project Address Parcel Number Applicant
129 NW 96 Street 1131010250100
ERIK SACCOMANI
Miami Shores, FL 33138- Block: Lot:
Owner Information
Address
ERIK SACCOMANI 129 NW 96 Street
MIAMI SHORES FL 33150-
129 NW 96 Street
MIAMI SHORES FL 33150-
Contractor(s) Phone Cell Phone
MR C'S PLUMBING & SEPTIC INC (305)651-7859
Type of Work: NEW DRAIN FIELD & TANK
Type of Piping:
Additional Info: NEW DRAIN FIELD & TANK
Bond Return :
Classification: Residential Scanning: 8
Fees Due
Amount
CCF
$1.80
DBPR Fee
$4.50
DCA Fee
$3.00
Education Surcharge
$0.60
Permit Fee
$300.00
Scanning Fee
$24.00
Technology Fee
$2.40
Total:
$336.30
Phone
Cell
Valuation: $ 2,400.00
Total Sq Feet: 375
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL-12-17-65854
12/14/2017 Credit Card $ 286.30 $ 50.00
12/08/2017 Credit Card $ 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 wo ne either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL IN O , DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing
construction and zoning. Futhermore, I authorize the a
Authorized Signature: Owner / Applicant /
Building Department Copy
December 14, 2017
accurate and that all work will be done in compliance with all applicable laws regulating
rrltraet& to do the work stated.
/ Agent
December 14, 2017
f �
or 1
�W� ik"
BUILDING
PERMIT APPLICATION
❑ BUILDING
(\
\XIPLUMBING
JOB ADDRESS:
Miami Shores Village
Building Department E 8 2017
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Lri`': CW
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20)f Soh
Master Permit No. t' L 11 ' C�
❑ ELECTRIC ❑ ROOFING
Sub Permit No._
❑ REVISION ❑ EXTENSION
[:]RENEWAL
❑ MECHANICAL ❑ PUBLIC WORKS 7 CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
Folio/Parcel#:��
Occupancy Type:
OWNER: Name (FeeS
Address: 1
City: 6(
Tenant/Lessee Name:
Email:
Load
Q/ ef-a Is the Building Historically Designated: Yes
Construction Type: Flood Zone: BFE: _
Phone#:
NO
FFE:
p: SSI_NU
ff
CONTRACTOR: Company Name: ` `� v /V ( u� t hone#: � —7 �-7
Address: l� �- NW a QA K--e— ??
City: `� Ak Statp:PC_ Zip: Jz 16 I
Qualifier Name: i 6L Phone#: �S-1 —
State Certification or Registration #: � 1 Certificate of Competency #:
DESIGNER: Architect/Engineer: ��' A— Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work: ��
Type of Work: ❑ Addition ElAlteration ❑ New Repair/Replace ❑Demolition
Specify color of color thru tile:
Submittal Fee $ 50 W A Permit Fee $ "'?&'o� CCF $_
Scanning Fee $ Radon Fee $ DBPR $
Technology Fee $ Training/Education Fee $
Structural Reviews $ —
CO/CC $
Notary $
Double Fee $ / /
Bond $ �� — .�-1
TOTAL FEE NOW DUE $ • 3 11
(Revised02/24/2014)
Bonding C epan* Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 s/may Signature -' �4
NER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this
day of /fft44 r 20 1- by
l 1 Cc6ee&7AA ►, who is Personally kn n to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
1
Cian
Print:
a 4, 4
The foregoing instrument was acknowledged before me this
'r dIV
of t/444VemLZ 20 14 by
cue lG who is personally known to
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Print:
Seal:=;?`'i : DONALD MARTIN
Seal:
MY COMMISSION # GG102743
EXPIRES May 09, 2021
Q vv ri
DONALD MARTIN
'? MY COMMISSION # GG102743
EXPIRES May 09, 2021
as
***********************************************************************************************************
APPROVED BY tl ' Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
tuTATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR: OSTDS Existing New
APPLICANT: Erik Saccomani
PROPERTY ADDRESS: 129 NW 96 St Miami, FL 33150
LOT: 10 BLOCK
3 SUBDIVISION:
PROPERTY ID #: 11-3101-025-0100
PERMIT #. 13-SC-1756874
APPLICATION # : AP 1286983
DATE PAID:
FEE PAID:
RECEIPT #'
DOCUMENT #: PR1077118
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MOST 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 Existino Sentic Tank to remain CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [M]LXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ j GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Ptm7ps [
D [ 375 ] SQUARE FEET Trench conflouration SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [X} MOUND
I CONFIGURATION: [X] TRENCH [ } BED [ ]
N
F LOCATION OF BENCHMARK: F.F.E., 12.45' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 22.201 INCHES FT ][ ABOVE JBELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 61.201 INCHES FT ][ABOVE iBELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 81.00] INCHES
O
T
H
E
R
*Invert elevation of drainfield to be no less than 7.85' NGVD.
'Bottom of drainfield elevation to be no less than 7.35' NGVD.
Install 42" of slightly limited soil under the bottom of drainfield.
-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 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of
300 gpd.
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.
SPECIFICATIONS BY: Kemble Ettrick
APPROVED BY: TITLE:
Carlos H IcaZa
DATE ISSUED: 10/02/2017
TITLE:
Dade - CHD
EXPIRATION DATE: 04/02/2019
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3