PL-19-1355Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
issue Dawe ti?/18/2019
Location Address Parcel Number
650 NE 97TH ST, Miami Shores, FL 33138 1132060171640
.ontacts
Permit No.: I'LL -O' -'i9-1355
Permit Type: Plumbing - Residential
Work Classification: Septic
Permit Status: Approved
Expiration: 01/14/2020
CHRISTOPHER HARAK Owner REGOSA ENGINEERING SERVICES INC Contractor
650 NE 97TH ST, Miami Shores, FL 33138 GUSTAVO VELEZ
Mobile: 7865662454 15700 NE 2nd AVE, MIAMI, FL 331624267
Business: 7862622964 CONTRACTORWORK@GMAIL.COM
Other: 7863448720
Inspection Requests:
Description: REPLACEMENT OF SEPTIC TANK Valuation: $ 8,000.00 Inspe tion Re
Total Sq 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
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$309.40
Check # 210
07/18/2019 $259.40
Cash
06/12/2019 $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 constryction yV zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorizedi t : Own—Applicant / Contractor / Agent
Date
July 18, 2019 Page 2 of 2
��
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o o\0 Miami Shores Village �C- . y.
Building Department JU 12 2019
' 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
in;L
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 201 _
BUILDING Master Permit No.—F-1— 06—lel 135S
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
FE—]PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 650 NE 97 STREET
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11 -3206-017-1640 Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): CHRISTOPHER HAREK Phone#: 76(�> S-64, !!!�y
Address: 650 NE 97 ST
City: MIAMI SHORES State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: REGOSA ENGINEERING SERVICES, INC Phone#: 786-262-2964
Address: 15700 NE 2 AVE
City: MIAMI State: FL Zip: 33162
Qualifier Name: GUSTAVO VELEZ Phone#: 786-262-2964
State Certification or Registration #: CFC -1427292 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address:,,QQ City: State: Zip:
Value of Work for this Permit: $ 6000 Square/Linear Footage of Work: C&O
Type of Work: ❑ Addition ❑ Alteration ❑ New ■❑ Repair/Replace F-1Demolition
Description of Work: Meekce iY1ed of -Fa A
Specify color of colorthru tile:
Submittal Fie'$'rr'l�'03 Permit'Fe6$ CCF $ 1 tCO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
DBPR $
Notary $
Double Fee $
Bond $L' q�
TOTAL FEE NOW DUE $ J
� rq ` q0
Bonding Company's 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 exceedin $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure 11 a delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement us be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absenc o such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature "-' - Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
day of_ � 20 �� by
j
` ,' Yzc.-�� who is personally known to
me or who has produced as
identification and who did take an oath.
The foregoing instrument was acknowledged before me this
21 day of MARCH 20 19 by
GUSTAVO VELEZ who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC' NOTARY PUBLIC:
Sign: Sign:
Print: — � 7 cJ�5 Print: "'—/
Seal 4J.Aftie Seal: ua 6+cI
Jones
�01111111{fleM�
COMMISSION # R20M
EXPIRES: March 14, 2019 Exp Mstrob !2, !�
APPROVED BY -/t3 A Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM ING PLANS
pL�B Date__ --
Approved
'DisapprOved
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Christopher Harek
PROPERTY ADDRESS: 650 NE 97 St Miami, FL 33138
LOT: BLOCK: 100 SUBDIVISION:
PROPERTY ID #: 11-3206-017-1640
PERMIT #:13 -SC -1940895
APPLICATION # : AP 1408703
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1228617
Miami Shores Sec 4 Amd Plat
[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 [ 1,050 ] GALLONS / GPD New 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 [ 400 ] SQUARE FEET
R [ 0 ] SQUARE FEET
A TYPE SYSTEM: [X]
I CONFIGURATION: [ ]
N
F LOCATION OF BENCHMARK:
Drainfield in Bed to Remain SYSTEM k- RPAIR PERMIT
SYSTEM FLORIDA HEALTH P 1AF'',A1J)AEJE CoUt4T-y
STANDARD [ ] FILLED [ l MOUND )] #
TRENCH [X] BED [ 1 . r ►l �� n!i1T1r1N.'-
.. _ e q•. 01l.%.J'
of Bottom Floor. 10.60' NGVD.
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D F
O
T
H
E
R
[ 19.80 ] [ INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT
[ 46.80][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
IL.L REQUIRED: [ 0.00 ] INCHES EXCAVATION REQUIRED: [ 39.UU JINCHES
1. -EXISTING 1050 GAL septic tank with and approved filter TO REMAIN.
2.- Install 400 sf. of drainfield in...... BED ....... configuration.
3- Existing SAND at the bottom of the drainfield to remain. Any spoil material UNDERNEATH THE DRAIN FIELD within 24"
vertically that has visible signs of effluent shall be removed as part of the repair.
4.- Invert elevation and Bottom of drainfield to be no less than 7.20' & 6.70 ' NGVD respectively
S PERMIT IS NOT FOR ANY ADDITIONS._ (Comments Continued on Page 2.)
SPECIFICATIONS BY: TITLE: Septic contractor
APPROVED BY: TITLE: Environmental Manager Dade CHD
and L - ilisaize
DATE ISSUED: 05/31/2019 EXPIRATION DATE: 08/29/2019
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 AP1409703 SE1177972
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PROPERTY ADDRESS: 650 NE 97 STREET, AIAW SHORES FL 33738 SCALE -1-10
LOCATION SKETCH
LEGAL DESCRIPTION:
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THE WEST j OF LOT 4 b ALL lOT 5. FLOCK 100, MUh9 SHORES SECTION 4 AMENDED, ACCORDING TO THEPLAT THEREOF AS
RECORDED IN PLAT BOOK 15, PAGE 14, OF THE PUBLIC RECORDS OF MIAMI DADE COUNTY, FLORIDA
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ELEV., .INFORMATION
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DEPARTMENT Of HEALTH
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STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Christopher Harek
PROPERTY ADDRESS: 650 NE 97 St Miami, FL 33138
PERMIT #:13 -SC -1940895
APPLICATION #:AP1408703
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PRI 228617
LOT: BLOCK: 100 SUBDIVISION: Miami Shores Sec 4 Amd Plat
PROPERTY ID #: 11-3206-017-1640
[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 [
1,050 ]
GALLONS / GPD New Seotic Tank
CAPACITY
A [
0 ]
GALLONS / GPD
CAPACITY
N [
0 ]
GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [
I
GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]]D�D,OSES PER 24 HRS #Pumps [ ]
D (
400 ]
SQUARE FEET Drainfield in Bed to Remain SYSTEM
R% C PAIR PERMIT
R [
0 I
SQUARE FEET SYSTEM
FLORIDA IDA HEALTF! {�y�{i,� ?�tj �'s�.�I�
A TYPE SYSTEM: [XI STANDARD [ ] FILLED [ ]
MOUND l! [•,al COUNTY
I CONFIGURATION: ( ] TRENCH [x] BED [ ]
tt �r
N
F LOCATION OF BENCHMARK: Top of Bottom Floor: 10.60' NGVD.
I ELEVATION OF PROPOSED SYSTEM SITE [ 19.80][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 46.80][ INCHE$ FT I[ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D E
O
T
H
E
R
'ILL REQUIRED: [ 0.00 ] INCHES EXCAVATION REQUIRED: [ Jtl.UU ] INCHES
1. -EXISTING 1050 GAL septic tank with and approved filter TO REMAIN.
2.- Install 400 st of drainfield in...... BED ....... configuration.
3: Existing SAND at the bottom of the drainfield to remain. Any spoil material UNDERNEATH THE DRAIN FIELD within 24"
vertically that has visible signs of effluent shall be removed as part of the repair.
4: Invert elevation and Bottom of drainfield to be no less than 7.20' & 6.70 ' NGVD respectively
PERMIT IS NOT FOR ANY ADDITIONS._ (Comments Continued on Page 2.)
SPECIFICATIONS BY: TITLE' Septic contractor
APPROVED BY: TITLE: Environmental Manager Dade CHD
lard -L Fpilizaire
DATE ISSUED: 05/31/2019 EXPIRATION DATE: 08/29/2019
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
.. 1.1.a AP1408703 SE1177972