PL-20-111Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
F�tU1PJi ilJly
Issue Date: 01/28/2020'
Location Address Parcel Number
27 NE 94TH ST, Miami Shores, FL 33138 1132060130540
Contacts
Permit NO.: PL-01-20-111
Permit Type: Plumbing - Residential
Work Classification: Septic/Drainfield
Permit Status: Approved
Expiration: 07/27/2020
KRISTINE GEORGE Owner
27 NE 94 ST, MIAMI SHORES, FL 33010
Home: 3053425767
WESTLAND PLUMBING CORP Contractor
CARLOS COBOS
675 W 63 DR ****
Business:3058636223 westlandplumbingseptic@yahoo.co
Other:7862360198 m
Description: NEW SEPTIK TANK AND DRAINFIELD Valuation: $ 2,500.00 Inspection Requests:
305-62-4949
INSTALLATION
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
Payments
Date Paid Amt Paid
Total Fees
$117.90
Check# 4130
01/16/2020 $50.00
Credit Card
01/28/2020 $67.90
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 certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construction gnd zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner _ 7—Applicant / Contractor ! Agent Date
January 28, 2020 Page 2 of 2
RECEIVED
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
BUILDING
PERMIT APPLICATION
_ ❑BUILDING ❑ ELECTRIC ❑ ROOFING
J N 16 2020
BY•
FBC 20C�
Master Permit No7l, -0 I - W - I (
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 27 N E 94 St
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-3206-013-0540 Is the Building Historically Designated: Yes NO .X
Occupancy Type: SF Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Kristine A George TRS Phone#:
Address: 27 NE 94 St
City: Miami Shores
State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email
CONTRACTOR: Company Name: Westland Plumbing Corp Phone#: 305-342-5767
Address: 101 W 24 St
City: Hialeah State: FL Zip: 33010
Qualifier Name: Carlos M. Cobos Phone#: 786-236-0198
State Certification or Registration #: CFC037110 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#: _
Address: City: State:
u
Value of Work for this Permit: $ 6 p Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New A) Repair/Replace
Description of Work:
New Septic Tank and Drainfield Installation
Specify color of color thru tile:
Submittal Fee $ 9) ' 0 Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
Zip:
❑ Demolition
CCF $ CO/CC $
DBPR $
Notary $
Double Fee $
Bond $ %e — - (9
TOTAL FEE NOW DUE $ c0
(Revised02/24/2014)
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 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 46a�-Ie--A
OWNER or AGENT
The foregoing instrument was acknowledged before me this
J� day of laltl20 a V by
1�1(1 who i personally know o
me or who has produced as
()� day of , 20 -2 Q , by
r1oS VA, Q,JDb S , who i ersonally know o
me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:
Sign:
"10o,0.yP``••
ISPRA
Print:
MAI
Print:
Seal:
Commission # FF 981913
Seal:
PV6�•i
••,; oF��d%%
My Comm. Expires Jun 8, 2020
; O1�R
�:
KRISIA DEL PRAD]Florida
a=
..
Notary Public - State of
_
Commission # FF 98
�#########
APPROVED BY
3 tl.)Ic
Plans Examiner
Zoning
Structural Review
Clerk
(Revised02/24/2014)
L q
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT
SYSTEM
AND DISPOSAL
PERMIT #:13-SC-2028125
APPLICATION #:AP1460542
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1288171
CONSTRUCTION PERMIT FOR: OSTDS Repair
0000
APPLICANT: Kristine A Geroge
_ •
......
PROPERTY ADDRESS: 27 NE 94 St Miami, FL 33138
... _ _ _
__ _ _ __� • • • •.
15&16 SUBDIVISION:
LOT: BLOCK: 4 _
...•
......
•
�•••.• �_�
[SECTION, TOWNSHIP, RMt,
PARCEL NUMBER]•••••
PROPERTY ID #: 11-3206-013-0540 [OR TAX ID NUMBER]
• • •'•'••
• • •.•• •'••• • •
•
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS
A;D 16NDAMS •OF UN
381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF
%YS.TEV
DOES -N6T GtiARANTZE
SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY
CIMGe
IN••MMPERIAL • FAC7LS,
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 [ 1,060 1 GALLONS / GPD New SeDtic 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 [ 375 ] SQUARE FEET
R [ 0 ] SQUARE FEET
A TYPE SYSTEM: [X]
I CONFIGURATION: [X]
N
New Drainfield Trench conf SYSTEM
STANDARD
TRENCH
[ ] FILLED
] BED
SYSTEM
[ ] MOUND
F LOCATION OF BENCHMARK: 12.27' NGVD NE 94th St. Nail marked in front to the house left side.
I ELEVATION OF PROPOSED SYSTEM SITE [ 15.201E INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 39.201E INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D E
O
T
H
E
R
ILL REQUIRED: [ u.uu ] INCHES EXCAVATION REQUIRED: L 30.uu 1 1MMEZ
1: Invert elevation and Bottom of drainfield to be no less than 8.50' & 8.00, NGVD respectively.
2.- Install a 1,060 gal. septic tank with an approved filter.
3.- 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.
4: Install 375 sf. of drainfield in TRENCH configuration. R P—P.A, I R P E R M I _1
5 - Install 12" of slightly limited soil at the bottom of the drainfield. FLC)Id, 'A , ,FA, , F , N., , r 1, , , ,, , 4
THIS PERMIT IS NOT FOR ANY ADDITIONS. (Comments Continued on Page 2&01- VA I D f 0 r : /-%, E L- , - 1, N
SPECIFICATIONS l
CNTRACTO TITLE:
k I Yj'.jL. %M'
APPROVED BY:ITLE: Engineering Specialist II Dade CHD
Jesus D ernandezAcosta
DATE ISSUED: 01/13/2020 EXPIRATION Dom: 04/12/2020
DH 4016, 08/09 (Obsoletes all previous editions which may not be used) �` �I
Incorporated: 64E-6.003, FAC PLUMBING P DNS Page 1 of 3
v 1.1 4 AP1460542 SE1230
Approved i=? Dare
Disapproved
DOCUMNT #: PR1288171
-The system is sized for 2 bedrooms with a maximum occupancy of 4 persons (2 per bedroom), for a total estimated flow of 200
gpd.
-Required drainfield area based on rule 64E-6.015(6)(c)2.
-Install a new drainfield to achieve Drainfield size requirement.
...... .
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....
......
.. ..
.. .
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NOTICE OF RIGHTS
A party whose substantial interest is affected by this order may petition for an
administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such
proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for
administrative hearing must be in writing and must be received by the Agency Clerk for the
Department, within twenty-one (21) days from the receipt of this order. The address of the
Agency Clerk is 4052 Bald Cypress Way, BIN A-02, Tallahassee, Florida 32399. The Agency
Clerk's facsimile number is 850-413-8743.
. . . ....
Mediation is not available as an alternative remedy. ..
......
•
Your failure to submit a petition for hearing within 21 days from receipt of tkki erder will""'
. • �,;
constitute a waiver of your right to an administrative hearing, and this order shall bttltllht a'final -
......
order'. "' • • •
Should this order become a final order, a party who is adversely affected it.is.entitl;d •; •
• �; •
to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings arq • •
• •
......
governed by the Florida Rules of Appellate Procedure. Such proceedings may be'comenenced
•;
filing Notice of Appeal with the Agency Clerk of the Department Of Health arif e • •
"""
by one copy of a
second co panied b the filing fees required b law, with the Court of A al i� the
copy, accompanied y g q Y ply
• • • • •
•
�....•
appropriate District Court. The notice must be filed within 30 days of rendition of the final order! • •
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR CONSTRUCTION PERMIT
Permit Application Number
---------------------------PART II - SITEPLAN---------------------------
poil
ME
Site Plan submitted
Plan A d
By ,--
Not Approved
Date_____-- {)
County Health Department
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015, 08109 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC K
(Stock Number: 5744-002-4015-6)
PLUMBING PLANS
Approved _
Lsisapproved ---
Page 2 of 4
PLUM
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PREPARED 1, 16 2020
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NMI LAND SURVEYING - LAND PLANNING R/W RIGHT OF WAY
LEGEND:
RARIDA COWCAIE OF AUDMIZATION # Ul 4507 (Mess) MEASURED
ly
By.
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9350 S.W. 22nd TERRACE (R) RECORD
CENTER LINE MIAM �IDA 33165
310 5FL2O2F
_0073 RES. RESIDENCE '1A
AIR COND17MER
No.: NUMBER
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SPOT ELEVATION O.U.L OVERHEAD UTILITY LINE a
PL PLANTER
WATER METER •a*
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....................................................
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7
NOT VALID WITHOUT SHEET 1 OF 2
-DATE: 12-03 ?1PA-9, (SHEET I OF 2 CONTAINS LOCATION MAP AND SURVEYORS NOTES)
- i;� -
Kristine George JOB No.: ETCH No.: DATE: SCALE: SHEET:
27 N.E. 94th Street 19-31786 29437 09-13-2019 I"=20' 2 OF 2
1 E I I I I
Miami Shores, Florida '43138.T119
5r{M1I�OR OF Ste' r• RIVEY
PREPARED BY:
(15GUNTER GROUP, INC.
LAND SURVEYING - LAND PLANNING
FLORIDA CERTIFICATE OF AUTHUMTION 11B 4507
9350 S.W. 22nd TERRACE
MIAMI. FLORIDA 33165
(305) 220-0073
LOCATION MAP
NOT TO SCALE • • • i •
NE 95th STREET
10 • •"' •
15'ALLEY = ••••• �••
Q 11 ;••�•.� •••
= W 12 E32
13Z..NE 94th STREET
PROPERTY ADDRESS: 27 NE 94th Street Miami Shores, Florida 33138.
LEGAL DESCRIPTION:
Lots 15 and 16, in Block 2, of AN AMENDED PLAT OF MIAMI SHORES SECTION NO. 1; according to the Plat thereof as recorded in
Plat Book 10 at Page 70 of the Public Records of Miami -Dade County., Florida.
FOR: Kristine George.
SURVEYOR'S NOTES:
1) This survey was conducted for the purpose of a "Topographic Survey" only and is not intended to delineate the regulatory jurisdiction of
any federal, state, regional or local agency, board, commission or other entity.
2) The accuracy obtained by measurements and calculations on this survey, meets and exceeds the Standards of Practice requirements for a
Suburban area (1 foot in 7,500 feet) as specified in Chapter 5J-17, Florida Administrative Code.
3) The North arrow direction shown herein is based on an assumed Meridian.
4) In some cases graphic representation have been exaggerated to more clearly illustrate a particular area where dimensions shall have
preference over graphic location.
5) Legal description was provided by the client and is subject to any dedications, limitations, restrictions reservations or easements of record.
6) Examination of the Abstract of Title will have to be made to determine recorded instruments, if any, affecting the property; search of Public
Records not performed by this office.
7) No effort was made by this office to locate any underground utilities and/or structures within or abutting the subject property.
8) This survey has been prepared for the exclusive use of the entities named hereon only and the certifications hereon do not extend to any
unnamed patties.
9) Elevations shown referred to N.G.V.Datum (1929); Miami -Dade County benchmark No.: N-568, Elevation: 9.65 feet; located at N.E. 95th
Street (35 feet North of center line) and N. Miami Avenue (25 feet West of projected West edge of pavement); PK Nail and Brass washer in
concrete curb, S.W. of a handicap ramp.
10) According to the National Flood Insurance Program, the subject property falls in Community No.: 120652, Panel No.: 030Z Suffix: L,
Date of FIRM: 09-11-2009, Flood Zone: X.
11) Contact the appropriate authorities prior to any design work on the hereon -described parcel for Building and Zoning information.
12) Professional Land Surveyor and Mapper in responsible charge: Rolando Ortiz LS 4312, State of Florida.
13) This survey is not valid without the signature and the raised seal of a Florida Licensed Land Surveyor and Mapper.
I hereby certify to 1) Kristine George; 2) Fidelity National Title Insurance Company; 3) Best Value Title, LLC; that the Sketch of
Topographic Survey of the described property is we and correct to the best of my knowledge and belief, as recentlysurveyed and Platted
under my direction; also that meets the Minimum Technical Standards set in Chapter 5J-17, Florida Administrative Code, pursuant to Section
472.027 Florida Statutes.
By . olando Ortiz LS 4312
Professional Land Surveyor
& Mapper, State of Florida.
NOT VALID WITHOUT SHEET 2 OF 2
UP -DATE: 12-03-2019 (SHEET 2 OF 2 CONTAINS SKETCH OF SURVEY)
Kristine George JOB No.: SKETCH No.: DATE: SCALE: SHEET:
27 N.E. 94th Street 19-31786 29437 09-13-2019 1"=20' 1 OF 2
Miami Shores, Florida 33138.
9
S7
6
5
4
1