PL-19-1503Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address Parcel Number
323 NE 91ST ST, Miami Shores, FL 33138 1132060136500
Contacts
Permit No.: PL -07-19-1503
Permit Type Plumbing - Residential
Work Classification: Septic
Permit Status: Approved
Expiration: 12/30/2019
JOSE ABRANTE Owner A SUPER SEPTIC & DRAIN FIELD INC Contractor
BRYAN K ZERO
Other: 3053231718 7701 W 18 LN, HIALEAH, FL 33014
asuperseptic@gmail.com
Description: DRAIN FIELD REPAIR Valuation: $ 5,200.00 Inspection Requests:
305-762-4949
Total Sq Feet: 0.00 11 1
Fees
Amount
Application Fee - Other
$50.00
CCF
$3.60
DBPR Fee
$2.73
DCA Fee
$2.00
Education Surcharge
$1.20
Permit Fee
$132.00
Scanning Fee
$9.00
Technology Fee
$4.55
Total:
$205.08
Payments
Date Paid Amt Paid
Total Fees
$205.08
Credit Card
07/10/2019 $155.08
Credit Card
07/01/2019 $50.00
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 A DAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating y�ryF�tru4��oning.,Kfhrmore, I authorize the above named contractor to do the work stated.
Owner
/ Contractor / Agent
Date
July 10, 2019 Page 2 of 2
Miami Shores Village
BUILDING
PERMIT APPLICATION
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
CEIED
JUL 01r2019)
FBC 201 �QTa
Master Permit No. 'PL -6-1-0 _ ISb S
Sub Permit No
F—JBUILDING ❑ ELECTRIC
❑ ROOFING
REVISION
EXTENSION
RENEWAL
PLUMBING ❑ MECHANICAL
PUBLIC WORKS
CHANGE OF
CANCELLATION
SHOP
CONTRACTOR
DRAWINGS
JOB ADDRESS: �j R1 �� G 1
ST-�---e e
City• Miami Shores
County:
Miami Dade
Zip:
Folio/Parcel#:6 - z9
o
Is the Building Historically
Designated: Yes
NOI
IV
Occupancy Type: f- Load:
Construction Type:
Flood Zone: BFE:
FFE:
OWNER: Name (Fee Simple Titleholder):
�GS c
j ig nT----
Phone#:
Address:
City: 11WVy\
State: )=1
Zip:
Tenant/Lessee Name:
Email
ne#:
CONTRACTOR: Company Name:)/11H y1c,T, t' w, (v t o (� �� r Phone#: 3o2- .3 0P 3
Address: /x%0) l,U IW? Au)—
)e-City: &/'6 4'0 / State: Zip:
Qualifier Na
Phone#:.90-'3 lob—o/i 3
State Certification or lagistration #: S 1 o 16 ( V 7- Certificate of Competency #: S,9 6
DESIGNER: Architect/Engineer: Phone#:
Address
State: Zip:
Value of Work for this Permit: $ 1,0 o0-
Square/Linear Footage of Work:
�.;�5 S4
A "-
Type of Work: ❑ Addition ❑ Alteration
�❑
New Q"Repair/Replace
❑
Demolition
Description of Work:
Specify color of color hru tile:
Submittal Fee $ SO Q) Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
CCF $ CO/CC $
DBPR $
Notary $
Double Fee $
Bond $ GV0 , W
TOTAL FEE NOW DUE $ 'S5 • 0�3
GGs . 6�3
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
Zi
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 Signature
_ &t-4�
OWNER or AGEN CO CTOR
The foregoing instrument as acknowledged before qme this The foregoing instrument was acknowledged before me this
n day ojf� Mk 20 1 1 by 2� day of � ()NF— 20 I �'IT, by
cam A-brci —�w�ho is p sonally known to �Q ` tJ �'�— who is personally known to
me o?ho has produced I�f',*Qv �('C�1�S`i as me or who has produced �i?�i � as
ide tificati n a d w
did take an oat�h,__������""""'F11IZ
,'/��
identification and who did take an oath.
'EFro
NO ARY PUB I
`••,''S(ONI�p
NOTARY PUBLIC:
'.
SI•0�
—
Sign
Print: h
f►' Cf •� o �' w
Print:
Seal:
��'••''•• • '••� ���
��/',aiii'`y�1��t�
Seal:
�P•; SINDIAALVAREZ
fit"
°+ MY COMMISSION # GG 238273
o EXPIRES: September 3, 2022
Bonded Thru Notary Public Underwriters
APPROVED BY 7//ef' Plans Examiner
Structural Review
(Revised02/24/2014)
Zoning
Clerk
A SUPER SEPTIC & DRAIN FIELD INC.
CC: SR0161772
PHONE: 305-364-0113
DATE: 6� 28 20 j
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
7701 WEST 18 LANE
HIALEAH, FLORIDA 33014
Licensed and Insured
E-FOAiL: ASUPERSEPTIC GF% IAIL.COM
WWW.ASUPERSEPTIC.COM
FAX: 305-364-0349
BEFORE ME THIS DAY PERSONALLY APPEARED, WHO
BEING DULY SWORN, DEPOSES AND SAYS: 657
THAT HE OR SHE WILL BE THE ONLY PERSO WORKING ON THE PROJECT AT:
Contractor Signature:
S ORN TO (OR AFFIRMED) AND SUBSCRIBED TO ME THIS 2e DAY OF
�V W',- 2019, BY: Q
PERSONALLY KNOWN
OR PRODUCED IDENTIFICATION
TYPE OF INFORMATION PRODUCED -p[�-PtT-v-ULC w( b
`=0t.91
-w`•C' SINDIA ALVAREZ
MY COMMISSION # GG 238273
EXPIRES: September 3, 2022
PRINT, TYPE, OR STAMP NAME OF NOTARY
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Notice to Owner — Workers' Compensation Insurance Exemption
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 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 are 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:
Owner
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this %fp' day of Un`e —,20(1
By 1
WJ I"�b rao `Q who is personally known to me or has produced�����``\
•.�;�: �oFto.:
as identification.
Notary. Z Z ' s #GG 2872K8
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NCE WI FH ALL FEDERAL
,ccepted By; 1 - HhLlS AND REGULATIONS
roperty Address: 323 N.E. 91 STREET NOtES:-NO"NOTE5'
MIAMI SHORES, FL 33138
MY OIRFCTION THIS OOMFI IFA UgTH THF MINIMUM ■ w .... n..e+..•-. ... •—
PERMIT #:13 -SC -1969228
APPLICATION II: AP1420379
STATE OF FLORIDA DATE PAID:
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID:
SYSTEM RECEIPT N:
DocuMENT I1: PRI 24193
SYSTEM DESIGN AND SPECIFICATIONS
T I 900) GALLONS / GPD Septic Tank to Remain CAPACITY
A [ 0) GALLONS / GPD CAPACITY
N I 0 l GALLONS GREASE INTERCEPTOR CAPACITY (MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS)
K [ l GALLONS DOSING TANK CAPACITY [ )GALI02i6 @[ IDOSES PER 24 HRSPumPs
D [ 225 ] SQUARE FEET New Drainfield Trench conf SYSTEM
R [ 0 l SQUARE FEET SYSTEM �c
X STANDARD [ 1 FILLED [ 1 MOUND [ f l^(^ ^i }�i I ty " 1}.ITY
A TYPE SYSTEM: I ) _.
I CONFIGURATION: [X) TRENCH [ ) BED [ 1 ►w1 L� li a
N
F LOCATION OF BENCHMARK: F.F.E: 11.30' NGVD.
I ELEVATION OF PROPOSED SYSTEM SITE ( 24.001[ INCHES FT ][ABOVE A BELOW t BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 54.001 INCHES FP I[ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: 130.001 INCHES
.-EXISTING 900 septic tank with and approved filter TO REMAIN.
O 2: Install 225 st of drainfield in TRENCH configuration.
T 3.- Existing SAND at the bottom of the drainfield to remain. Any spoil material UNDERNEATH THE DRAIN FIELD within 24'
H 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 7.30' & 6.80' NGVD respectively.
E 5.- Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption trench.
R THIS PERMIT IS NOT FOR ANY ADDITIONS.
fr. . ",
I!, . • , (
SPECIFICATIONSBeA Super Septic
TITLE:
.r Dade CHD
APPROVED BY. :--
- f,' t, _ irhrjTITLE: Environmental Manager
L Philizaire rrj
EXPIRATION DATE: 09/23/2019
DATE ISSUED. 06!25/2019
DH 4016, 08/09 (Obsoletes all prevaus editions which may not be used) Page 1 of 3
Incorporated: 64E-6.003, FAC SE1191265
.. 1.1.4 Ar1420379
TIG! c;. J"dCI-Ir (0 tt r;^
..'+r,4, jrr G*`1,.; , 2
CONSTRUCTION PERMIT FOR: OSTDS Repair
L. i ;i 1y .C' + t
t r € .tt Ir.:
APPLICANT: Jose Manuel Abrante
PROPERTY ADDRESS: 323 NE 91 St Miami. FL 33138
,.•
, ° , ], 67:....
f,
su>3DIVISIori:
.a....
Miami Shores
•
LOT • 1516 BLOCK: 48
(SECTION, TOWNSHIP, RANGF4`•>:ARCEL NUI+IDER] • •
PROPERTY ID Il : 11-3206-013-8500•
[OR TAX 3D NUMBER] ••••
• • • •'
• • • •
•"'i?P• • SECffo;' • •
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND ••31•@poE DS•
OES N GUARAt�'i�1�.'�•
381.0065, F.S., AND CHAPTER 64E-6, F.A.C.
DEPARTMENT APPROVAL OF SY
ANY CHANGE 2N MATER7J►L FACTS��
SATISFACTORY PERFORMANCE FOR ANY SPECIFIC
PERIOD OF TIME.
�*NT
THE APP,r.�..•-
W •'190DIFY • 9'U• •
WHICH SERVED AS A BASIS FOR *ISSUANCE O1
THIS PERMIT, REQUIRE
•
•
AND �•i
16
PERMIT APPLICATION. SUCH MODIFICATIONS MAY
RESULT I
COMPLEX STH
W LI• •
adW
ISSUANCE OF THIS PERMIT DOES NOT EXEMPT
CANT FROMERMIT
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T I 900) GALLONS / GPD Septic Tank to Remain CAPACITY
A [ 0) GALLONS / GPD CAPACITY
N I 0 l GALLONS GREASE INTERCEPTOR CAPACITY (MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS)
K [ l GALLONS DOSING TANK CAPACITY [ )GALI02i6 @[ IDOSES PER 24 HRSPumPs
D [ 225 ] SQUARE FEET New Drainfield Trench conf SYSTEM
R [ 0 l SQUARE FEET SYSTEM �c
X STANDARD [ 1 FILLED [ 1 MOUND [ f l^(^ ^i }�i I ty " 1}.ITY
A TYPE SYSTEM: I ) _.
I CONFIGURATION: [X) TRENCH [ ) BED [ 1 ►w1 L� li a
N
F LOCATION OF BENCHMARK: F.F.E: 11.30' NGVD.
I ELEVATION OF PROPOSED SYSTEM SITE ( 24.001[ INCHES FT ][ABOVE A BELOW t BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 54.001 INCHES FP I[ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: 130.001 INCHES
.-EXISTING 900 septic tank with and approved filter TO REMAIN.
O 2: Install 225 st of drainfield in TRENCH configuration.
T 3.- Existing SAND at the bottom of the drainfield to remain. Any spoil material UNDERNEATH THE DRAIN FIELD within 24'
H 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 7.30' & 6.80' NGVD respectively.
E 5.- Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption trench.
R THIS PERMIT IS NOT FOR ANY ADDITIONS.
fr. . ",
I!, . • , (
SPECIFICATIONSBeA Super Septic
TITLE:
.r Dade CHD
APPROVED BY. :--
- f,' t, _ irhrjTITLE: Environmental Manager
L Philizaire rrj
EXPIRATION DATE: 09/23/2019
DATE ISSUED. 06!25/2019
DH 4016, 08/09 (Obsoletes all prevaus editions which may not be used) Page 1 of 3
Incorporated: 64E-6.003, FAC SE1191265
.. 1.1.4 Ar1420379
DOCUMENT #: PR1241930
-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.
-Required drainfield area based on rule 64E -6.015(6)(c)2.
-Install a new drainfield to achieve Drainfield size requirement.
0000
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STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR CONSTRUCTION PERMIT
Permit Application Number
---------------------------PART II-SITEPLAN---------------------------
Notes: REPAIR, REPLACING EXISTING 300 S.F BED, WITH 225 SF IN TRENCH CONFIGURATION D.F
Site Plan submitted by:
Plan Approved
By
-Not Approved
CONTRACTOR
Date 6-24-19
_ County Health Department
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 2 of 4
(Stock Number: 5744-002-4015-6)
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Notes: REPAIR, REPLACING EXISTING 300 S.F BED, WITH 225 SF IN TRENCH CONFIGURATION D.F
Site Plan submitted by:
Plan Approved
By
-Not Approved
CONTRACTOR
Date 6-24-19
_ County Health Department
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC Page 2 of 4
(Stock Number: 5744-002-4015-6)