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PL-18-3725Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 01/03/2019 Location Address Parcel Number 990 NE 97TH ST, Miami Shores, FL 33138 1132060143150 Contacts Permit No.:'PL-12-18-3725 Permit Type: Plumbing - Residential Work Classification: Septic/Drainfield Permit Status: Approved Expiration: 06/17/2019 TRACY YOUNG LE Owner A AMERICAN SEPTIC & PLUMBING Contractor 990 NE 97 ST WILLIAM WOODARD 12555 BISCAYNE BLVD 970, NORTH MIAMI, FL 33181 Business: 3058665600 Other:7862365599 Description: INSTALL ONE NEW 1050 GEL SEPTIC AS PER DOH Valuation: $ 8,000.00 Inspection Requests: PERMIT. INSTALL ONE NEW 300 SQFT DRAINFIELD AS PER DOH 305-762-4949 Total 5q Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $4.80 DBPR Fee $4.20 DCA Fee $2.80 Education Surcharge $1.60 Permit Fee $230.00 Scanning Fee $9.00 Technology Fee $7.00 Total: $309.40 Payments Date Paid Amt Paid Total Fees $309.40 Check # 1493 12/19/2018 $50.00 Check# 1497 01/03/2019 $259.40 Amount Due: $0.00 Building Department Copy 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 cejyify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and z' ioy� ng. Futhermore,-.l_authorizQ_ft above named contractor to do the work stated. -`r � c._ Authorized SignatLy.Owner / Applicant / Contractor / Agent Date January 03, 2019 Page 2 of 2 BUILDING 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 FBC 20 + (D74� Master Permit No. PERMIT APPLICATION Sub Permit No. []BUILDING ❑ ELECTRIC ROOFING ❑ REVISION [] EXTENSION RENEWAL WMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION [:]SHOP CONTRACTOR DRAWINGS JOB ADDRESS: R9 0 NE q 1 4T City: Miami Shores County Miami Dade Zip: 3 t3 b YY Folio/Parcel#:_ i i'3 D' 0 lLt' 31SO Is the Building Historically DesIgnated: Yes NO /r Occupancy Type: Load: 1 r Construction Type: R Flood Zone: ti/h BFE: Pik- FFE: 1'a OWNER: Name (Fee Simple Titleholder): I ti end 0 d 4 _ Phone#: Address: Qq0 tac qi Sl City: VT) C-(Y i At" -CS State: V-L- Tp; 3313 9 Tenant/Lessee Name: t4/►c Phone#: Email: s ' CONTRACTOR: Company Name: MY��f CCU\L yi+'��Ii Phone#: �fl� Address: City: Miami State: �tl Zip:3-;1 Qualifier Name: 141 t, d(h N1 • Phone#: i; State Certification or Registration #: Stiff ©�Q` �� Certificate of Competency #: S&0000 a`i 1 DESIGNER: Architect/Engineer: Phone#: h/h Address: /� City: _State: Zip: Value of Work for this Permit: $ D ©� 04 Square/Unear Footage of Work: 300 S6t;, Type of Work: ❑ Addition El Alteration ❑ New Repair/Replace ❑Demolition Description of Work: ti&c�R QY- i-�Lw 3e0 s'a "- • d+-iC4r-% K-0- 0 0� pe.r �� '&MPm Specify color of color thru tile: Submittal Fee S i CSO Permit Fee $ CCF S CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews S_ Bond $ C3nd • [rs --V-ZA'' ��1V TOTAL FEE NOW DUE $ (ReWseW2/24/2014) 0 1Pr Bonding Company's Name (if applicable)1 Bonding Company's Address City State Mortgage Lender's Name (if applicable) Zip Mortgage Lender's Address City State Ztp 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 ,$Z500, 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. coSignatureo ~ rSignatu O E rAGENT 00 RACTOR. The foregoing instru�nt was ack,,onwiedged before me Is The foregoing instrument was acknowledged before me this day of /�'� egln'"" ` 20 by ( 9 day ofDE.M65;4,�- 1 20 _ (g by Yrx who is personally known to 1A I LL14M M ptQ-l< kwFs'ftermnaltv known to me or who has prod cell d '�+wcXs�r� ..r `�c �. mac- as me or who has produced T7"—b*4 LT-- CL V­ ue (� ' Identification and who did take an oath. Identification d who did take an oath. NOTARY P LIQ Sign: ' 1 l; '-TV.. Print: � f r-Jt7Jes F& W 410 Seal:,; SINDIA ALVAREZ MY COMMISSION # GG 238273 Po' EXPIRES: September 3, 2022 ss�ess�Rs���ssa�s�ss�asssjss*�sis�r�sssss�sss•sss Kris e,�sete�� y ,� _ Plans Examiner Zoning Structural Review Clerk laevusdo2/24/2014i 4 sEP000947 AMERICAN SEPTIC & PLUMBING INC 12555 BISCAYNE BOULEVARD #970 NORTH MIAMI, FL 33181 • NORTH DADE (305) 866-5600 BROWARD (954) 922-2119 SOUTH DA DE (305) 254-8600 FAX (305) 8916905 12/18/2018 State of Florida County of Dade Before me this daypersonally appeared �— C� P Y PPe who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: 990 NE 97th Street Miami Shores, FL 33138 Contractor !�"M Swornto (or affirmed) and subscribed before me this (9 day of DfZOEEMB'Lo— 18, By W I lA. A M M c }� �4R� Personally know OR Produced Identification Type of Iden#fication ProducedU: —Da� lk)ET= Print, T�e, oi�p Name of Notary MY COMM 8a Al . 6°"de�TbruN�,pp6 h~'Hfers SEP000947 AMERICAN SEPTIC & PLUMBING INC. 12555 BISCAYNE BOULEVARD 4970 NORTH MIAMI, FL 33181 NORTH DADE (305) 866-5600 BROWARD (9541922-2119 SOUTH DA DE (305) 254-8600 FAX (305) 8916901'' • • ...... . .. ...... 12/5/2018 .... . ..... ...... . .. ..... To whom it may concern, .. .. .... ...... • We would like to thank you for the opportunity to provide you with our quality sexvices: • • •' • , • • • • , Upon Approval of this proposal, please be sure to initial all areas and fax the completed and signed copy of the proposal. Our fleet includes service vans, pump trucks (grease traps, septic tanks & lift stations), (Parking Lot drains, catch basins, soakage pits), One (1) industrial size water jet truck, several sewer cameras and location equipment, Leak Detection equipment and confined space team & equipment. If you have any questions regarding this proposal or any matter please do not hesitate to contact our office at (305) 866-5600. Sincerely, Wm. Mark Woodard Construction Department Coordinator SEP000947 AMERICAN SEPTIC & PLUMBING INC. 12555 BISCAYNE BOULEVARD #970 NORTH MIAMI, FL 33181 NORTH DADE (305) 866-5600 SOUTH DA DE (305) 254-8600 12/5/2018 Tracy Young 990 NE 97 St Miami Shores, FL 33138 305-582-6599 BROWARD (954) 922-2119 FAX (305) 891-69W . ...... ...... . . . A American Septic & Plumbing Inc. would like to thank you for the opportunity to provtdyjTu 0 with our quality services, as per our conversation, here is the proposal for the services needed at the above -mentioned property. Scope of work: A American Septic and Plumbing Inc. proposes to: 1. Pump out to abandon existing septic tank as per code 2. Install one new 1050-gallon septic tank as per code 3. Install one new drain field to accommodate 3-bedroom residence Village of Miami Shores $500.00 refundable security bond not included. All labor material, debris, and permit fees associated with this scope will be the responsibility of A American Septic and Plumbing Inc. All work to be completed in a timely and professional manner. Total.Job Cost:_$8,000.00, Deposit: $4,000.00 Balance due upon completion: $4,000.00 Initial AMERICAN SEPTIC Sv PLUMBING INC. 12555 BISCAYNE BOULEVARD #970 NORTH MIAMI, FL 33181 NORTH DADE (305) 866-5600 SOUTH DA DE (305) 254-8600 BROWARD (954) 922-2119 FAX (305) 891-t � . 1-Exclusions and limitations: • ' • 1. A American Septic & Plumbing, Inc. reserves the right to refuse or to stop tJ,Job at anX time due to unsafe or due to unforeseen conditions that may change the scope of wg k, A Amerl Septic & Plumbing, Inc will evaluate the conditions and submit a proposal t;-" e the problem, work will continue after the customer's representatives and A American Septa &:Plunrbjv& zinc representatives have come to an agreement. If no agreement can be reach, A. Oierican Septic & Plumbing, Inc will collect payment for the portions of the work completed up to t ie tirrZg1 Cjob stops, and the customer agrees to hold A American Septic & Plumbing, Inc barOess, acid no penalties will apply to A American Septic & Plumbing, Inc . • . • 2. Customer will provide A American employees with access to the work area while construction is ongoing. 3. All deposits are non-refundable. 4. A American Septic & Plumbing, Inc will not be responsible for any broken, damaged or corroded sewer lines. 5. A American Septic & Plumbing, Inc will provide a separate proposal for any sewer lines that may need to be repair 6. A American Septic & Plumbing, Inc will try to minimize the damage of the work area, but will not be responsible for any concrete, asphalt, walls, cabinets, sod, landscaping, sprinkler, water or any other utility lines, walk ways, drive ways, asphalt, and any other structural damaged to the property. Initial: 2- COST This proposal will only be valid for 30 days after the date it was issued The cost for this service will be $8,000.00 Initial: 3-WARRANTY (5) year warranty provided with this service. Individual blockages or stoppages, caused by foreign material such as roots, rags, structural imperfections, etc. will not be covered and therefore charged a moderate fee. Initial: **<AMERICAN SEPTIC & PLUMBING INC. 12555 BISCAYNE BOULEVARD #970 NORTH MIAMI, FL 33181 NORTH DADE (305) 866-5600 BROWARD (954) 922-2119 SOUTH DA DE (305) 254-8600 FAX (305) 891-6905 - 4- GENERAL NOTICE ' F. ' ...... . .. ...... A American Septic & Plumbing Inc will not be responsible for the replamn;mt of any - concrete, asphalt, walls, cabinets, sod, landscaping, sprinkler, water or any 51her of 8W— ' lines, walk ways, drive ways, asphalt, and any other structural damaged to J;: ** pert; that .. ; .. • may be affected during this job unless otherwise stipulated in proposal. • • • • • • • • • • • • • • 5- NOTICE TO OWNER • Under Florida law, your failure to make sure that A American Septic & Plumbing lnc. is paid, may result in a lien against your property and your paying twice. To avoid alien and paying• - twice, you MUST obtain a written release from us every time you pay your contractor. RECOGNIZE that this Notice to Owner may result in a lien against your property. Initial: 6-EDIT NOTICE Any edits or changed to this proposal by the customer or his/ her representative must be reviewed and counter signed by A American Septic & Plumbing Inc, before final approval. Please sign, date, and return upon acceptance. If you have any questions regarding this proposal or any other quality work service A American Septic & Plumbing, Inc provides, please do not hesitate to contact our office at (305) 866-5600. ACCEPTED AND APPROVED BY: a axA l0Z/ q I Please pe grin or nmi Autho •ized A ure Date A American Septic and Plumbing, Inc Office Approval: za Date:12/5/18 Authorized Signature: fll.�. 12/5/18 Print name: William Mark Woodard/SEP000947 Date q,qa &� 07-7 57 Notice to Owner — Workers' C Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 766.8972 Insurance Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Star, § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if. 1. The officer owns at least 10 percent of the stock of the corporation,.or in the case of an LLC, a statement attesting to'the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions ar'e,valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: ner State of Florida County of Miami -Dade The foregoing was acknowledge before/me this __r day oli 2i 24ag . 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'.,Z �cst]' SKEET' f OFf LB 7M SfAL STATE OF FLORIDA PERMIT # :13-SC-1908418 DEPARTMENT OF HEALTHAPPLICATION #: AP1387383 ONSITE SEWAGE TREATINMNT AND DISPOSAL SYSTEM DATE PAID: CONSTRUCTION PERMIT FEE PAID: RECEIPT #• DOCUMENT # : PR1194425 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Tracy Young PROPERTY ADDRESS: 990 NE 97 St Miami, FL 33138 .. 0 6 % Gwaeee • • • • LOT: 12 BLOCK: 77 SUBDIVISION: •• • •• • • • • • • PROPERTY ID # : 11-3206-014-3150 [SECTION, TOWNSHIP, RAM&,• PARCEL NUMBER] � • • • • i [OR TAX ID NUMBER] •••• • • • • % • •••• • • • • • • • • • • • • SYSTEM MOST BE CONSTRUCTED •• ■• ��•• IN ACCORDANCE WITH SPECIFICATIONS AND • WARDS ••Q$•• SECTZiV••• 381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM SATISFACTORY NOT, GUARANTEE.' SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE *IN MA FAC WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT T1000601iFY ;RE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEIN6MME ••• NUL� l�rm VO'xD• • •• • ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTf�I!••FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T I 1,050 ] GALLONS / GPD NEW Seotic Tank CAPACITY A I 0 ] GALLONS / GPD CAPACITY N I 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K I ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ 300 ] SQUARE FEET NEW Drain Field in TRENC SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [XI STANDARD I ] FILLED II MOUND I ] I CONFIGURATION: [X] TRENCH [ ] BED I ] N F LOCATION OF BENCHMARK: FFE12.4 I ELEVATION OF PROPOSED SYSTEM SITE [ 27.60]I INCHES FT ][ABOVE / BENCMWK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 82.60][ INCHES FT ](ABOVE)BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: ( 0.001 INCHES EXCAVATION REQUIRED: [ 55.00] INCHES 0 1.- Install a NEW 1050 gal. septic tank with an approved filter T 2.- Install a NEW 300 sf. of drainfield in TRENCH... configuration. 3 - Install 12 " of slightly limited soil at the bottom of the drainfield. H 4.- Invert elevation and Bottom of drainfield to be no less than 6.02' & 5.52 ' NGVD respectively. E THIS PERMIT IS NOT FOR ANY ADDITIONS. R................................................................................................................................................................ ........................................................ SPECIFICATIONS BY: A American Sept TITLE: ---------------- APPROVED BY: TITLE: OPS ENVIRONMENTAL SPECIALIST III Dade ran z owaain CHD DATE ISSUED: 12/12/2018 EXPIRATION DATE: 03/12/2019 DR 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 AP1387383 SE1144245 OOCUMMqT # : PR1194425 ,Z)M Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption trench. The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow of 400 )pd. The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. ME-6.013(3)(0, FAC. Required drainfield area based on rule 64E-6.015(6)(c)2. nstall a new drainfield to achieve Drainfield size requirement. • • ...... . .. ...... .••••. •••• • ••••• • • • • • • • •• •• •••• •••••• • •••••• • • 0009 ••••!• •• • •• • • • • • `PL-12- 1�-3-� zS