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PL-19-233Miami Shores Village 10050 NE 2 Ave g Miami Shores FL 33138 305-795-2204 Issue Date: Location Address Parcel Number 26 NW 108TH ST, Miami Shores, FL 33168 1121360110110 Contacts Permit NO.: PL-02-19-233 Permit Type: Plumbing - Residential Work Classification: Drainfield Permit Status: Approved Expiration: 08/12/2019 Thomas Stocks Owner 26 108 MR C'S PLUMBING & SEPTIC INC Contractor KEMBLE ETTRICK Business: 3056517859 Description: INSTALL DRAINFIELD Valuation: $ 2,490.00 Inspection Requests_:__ 365-762-4949 Total Sq Feet: 0.00 Fees Amount Application Fee - Other $50.00 CCF $1.80 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.60 Permit Fee $50.00 Scanning Fee $9.00 Technology Fee $2.50 Total: $117.90 Building Department Copy Payments Date Paid Amt Paid Total Fees $117.90 Credit Card 02/13/2019 $67.90 Credit Card 02/01/2019 $50.00 Amount Due: $0.00 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/ioning. Futhermore, I authorize the above named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor ! Agent Date February 13, 2019 Page 2 of 2 6\� � r - , rb� tell. ''gECE `�IVED BY: BUILDING PERMIT APPLICATION 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 JZECEIVED FE 01 2019 BY: (� W , � FBC 2�0� Master Permit No. `i' Lj v'1J23'� Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION [PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CONTRACTOR JOB ADDRESS: �% A X) let 0 J(Y ❑ EXTENSION ❑ RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS City: Miami Shores County: Miami Dade Zip: 331(' / Folio/Parcel#: �` - ;[ 3L - Q//— 01/0 Is the Building Historically Designated: Yes NO. Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): R�IrnAS JTO 646S Phone#: Address: A /VA) /o �— J(r City: j-M.! State: Zip: Tenant/Lessee Name: &R' Phone#: Email: CONTRACTOR: Company Name: /�'(►� G �l l G Phone#: 36 5 — 6 :mil —?ff-S—/ Q Address: �- l "! 3 :)- Nw OZ � yLk— City: AV / / // State: PC zip: 33169 Qualifier Name: _(�e/11 hle_ C-9r, e /_ Phone#: State Certification or Registration #: S9 l_)G 6 ISS 6 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ l Square/Linear Footage of Work: OZ Type of Work: ❑ Addition ❑ Alteration VNew ❑ Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee $ �" ° oz� Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ DBPR $ Notary $ Double Fee $ Bond $ 6ck) , a TOTAL FEE NOW DUE $ (o--) ' ft 0 (Revised02/24/2014) / 0 + I , Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Will 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 OWNER or AGENT The foregoing instrument was acknowledged before me this 1 5 ( day of Ian vAry , 20 Iql by 771,wa! , who is personally known to me or who has produced )ri ve rs Z! %CCkSl as identification and who did take an oath. NOTARY PUBLIC: Signature CONTRACTOR The foregoing instrument was acknowledged before me this 41S day of !/ ,20 %9 by k��j�e,g, 6� who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: as Sign: Sign: -...' A A -� Print: I/�yla of I'i.(D�v-E,, Print:/Glta t`af Nra'`��^ Seal: Seal: i�"�° DONALD MARTIN DONALD MARTIN :. ' Nrl MY COMMISSION # GG102743 MY COMMISSION # GG102743 EXPIRES May 09, 2021 ''+ati EXPIRES May 09, 2021 ***s**s*s***sss *sss*ss**s***s**s*s*ssssss*ssssss*** ssss APPROVED BY / r Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT PERMIT # : 13-SC-1916892 APPLICATION # : AP 1393071 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1199083 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Thomas Stocks PROPERTY ADDRESS: 26 NW 108 St Miami, FL 33168 LOT: 3 BLOCK: 211 SUBDIVISION: PROPERTY ID #: 11-2136-011-0110 [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 [ 750 ] GALLONS / GPD Existino Seotic 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 [ 200 ] SQUARE FEET New Drainfield Bed Conf. SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [XI STANDARD [ ] FILLED [] MOUND [ ] I CONFIGURATION: [ ] TRENCH [X] BED [ ] N F LOCATION OF BENCHMARK: FFE12.9 I ELEVATION OF PROPOSED SYSTEM SITE [ 24.001 INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 74.001 INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: [ 62.001 INCHES O T H E R 1.-EXISTING 750 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 200 sf. of drainfield in ... BED .... TRENCH... 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 7.23 ' & 6.73' NGVD respectively THIS PERMIT IS NOT FOR ANY ADDITIONS. The system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow of _._...... ... ___ SPECIFICATIONS BY: Mr C ''s� s TITLE: APPROVED BY: `C Vc.: TITLE: Environmental Specialist II Dade CHD ric erere DATE ISSUED: 01/25/2019 EXPIRATION DATE: DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC 04/25/2019 Page 1 of 3 ✓ 1.1.4 AP1392591 SE1149807 ... . ..... . ca�uF.e • . ... . ... ... .. .. . . . •. •.. .. ........ :0 So r �r 110 f�N Z4A4 3/4ct f 4-� It. 3o.tor 0 h r C� r �,� I I icAq 114 V s ` 5 PLUMBING PLANS Approved _g �D e,2k'g DisapprW(Y _ ' Date PLUMBING PLANS Appr e arc 1 ` !d2 Disapproved •�. � � �e�:�--ram � �A o d'1✓D i 1'k- W 'cn r� JS a N C +v A: I a2r70 41; ;r ouc IROM J a � c r` egal`Desc i Qt' 3jr Blo I U flat Book FI County, Fl �_Date of fi i L, I GCompletion Ll WM ' ©� c:Flood zone Panel: 00 I= Survey nun `y Certified Thomas M. Floridai 7 Mortgage C 6-Ap- their inte