PL-19-836Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
490 NE 91 ST, Miami Shores, FL 33138
Contacts
Issue Date:05/01/2019
Parcel Number
1132060190010
Permit NO.: PL-04-19-836
Permit Type: Plumbing - Residential
Work Classification: Septic/DrainfieW
Permit Status: Approved
Expiration: 10/28/2019
SALVATORE CAVALLARO Owner SALVATORE CAVALLARO Applicant
21 E SUNRISE AVE, CORAL GABLES, FL 33133 21 E SUNRISE AVE, CORAL GABLES, FL 33133
Other:3055821985 Other:3055821985
WESTLAND PLUMBING CORP Contractor
CARLOSCOBOS
675 W 63 DR ****
Business: 3058636223
Other:7862360198
Description: SEPTIC AND DRAINFIELD Valuation: $ 7,500.00 Inspection Requests:
305-762-4949
TotalSq Feet: 626.00
Fees
Amount
Application Fee - Other
$50.00
CCF
$4.80
DBPR Fee
$3.94
DCA Fee
$2.63
Education Surcharge
$1.60
Permit Fee
$212.50
Scanning Fee
$3.00
Technology Fee
$6.56
Total:
$285.03
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$285.03
Credit Card
04/17/2019 $50.00
Check # 3964
05/01/2019 $235.03
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
regulat, on truction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner
/ Applicant / Contractor / Agent
Date
May 01, 2019 Page 2 of 2
Miami Shores Village
RECIV-D
E-
Building Department APR 17 2019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (30S) 79S-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 2 F:V
BUILDING Master Permit No. V) -0Y-19 -.9 CP
PERMIT APPLICATION Sub Permit No.T::9:—G- 18 193
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
Q CONTRACTOR DRAWINGS
JOB ADDRESS: q 1 D N �J q' 4-
City: Miami Shores County: Miami Dade Zip: 330o
Folio/Parcel#:1)' —yD(p` 019.
1 • b b) 0 Is the Building Historically Designated: Yes NO
Occupancy Typee�E Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee
Simple Titleholde1r.):' � --+ A0 +��i �`-' Phone#:
Address: 1-5 H e,�ir' � WQq '6f, ` -D
City: VOM) (Table-s ' State: FL- Zip:
Tenant/Lessee Name: Phone#:
Email: In �,t/ �/�
CONTRACTOR: Company Name: 1and )L tM Phone#: 5 �" .)-576 7
Address: � w a
City: 04k State: FL- Zip: 33010
Qualifier Name: LAA1 V.W V" l L)UUU--> Phone#:
State Certification or Registration #: CR 02011 o Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: j� City: State: Zip:
Value of Work for this Permit: $ i 5DD� Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
CCF $ CO/CC $
DBPR $
Notary $
Double Fee $
Bond $ O-Q- C r'
TOTAL FEE NOW DUE $ �5. J
(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
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 attachmen Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occur eve (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved an a 'ns ction fee will be charged.
Sign
OWNERr6r AGENT
The foregoing instrunt was acknowledged before me this
` day of� L 20 �C� ' by
who is personally known to
me or who has produced cy:AC � tl�'i �, as
identification and who did take an oath.
Si
Notary Public- 0'a-
Commission # GG 045883
My Comm. Exoires Nov 8, 2020
Signatur
CONTRACTO
The fore ing instrument was acknowledged before me this
day of 120 �, by
is'personally known to
me or who has proeuced r as
identification and who did take an oath.
NOTARY PUBLIC:, #
Sign:_
Print:
1 Dune - Mate of Florida
Seal: Commission # FF 981913
My Comm. Expires Jun 8, 2020
A^ �
APPROVED BY �(` �`i Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
`1
STATE OF FLORIDA PERMIT #: 13-SC-1927706
DEPARTMENT OF HEALTH APPLICATION #: AP1400134
ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID:
SYSTEM
CONSTRUCTION PERMIT FEE PAID:
RECEIPT #:
DOCUMENT #: PR1206883
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: (490 Investment LLC)
PROPERTY ADDRESS: 490 NE 91 St Miami, FL 33138
LOT: 12 BLOCK: 1 SUBDIVISION:
PROPERTY ID #: 11-3206-019-0010 [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 Septic CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE.TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ . ]DOSES PER 24 HRS #Pumps [
D [ 667 l SQUARE FEET
R [ ] SQUARE FEET
A TYPE SYSTEM: [x]
I CONFIGURATION: [ ]
N
Bed confiauration drainfield SYSTEM
N/A SYSTEM
STANDARD [ ] FILLED [ ] MOUND
TRENCH [X1 BED [ ]
F LOCATION OF BENCHMARK: F.F.E., 11.34' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 28.001[ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE 1 58.08][ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: [ 72.00] INCHES
O
T
H
E
R
Inspector to verify the existing septic tank is properly abandoned before final approval.
*Invert elevation of drainfield to be no less than 7.00' NGVD.
*Bottom of drainfield elevation to be no less than 6.50' NGVD.
*Install 42" of slightly limited soil under the bottom of drainfield.
-Perimeter of excavation area shall be at least 2 ft. wider and longer than the proposed absorption bed or drain trench.
The system is sized for 4 bedrooms with a ,maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of
400'gpd.
SPECIFICATIONS BY: GUILLERMO SUAREZ TITLE:-
FIU( lud : " ;';':1 i` l-c Wit' l.UuilLy
APPROVED BY:
DATE ISSUED:
0 Dade S Y D '�'o rn
Carlos
TITLE: CHD
caza
03/13/2019 - EXPIRATION DATE: 09/13/2020
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
Page 1 of 3
i 1.1 A AP1400134 SE1156638
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 this order will
constitute a waiver of your right to an administrative hearing, and this order shall become a 'final
order'.
Should this order become a final order, a parry who is adversely affected by it is entitled
to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are
governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced
by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a
second copy, accompanied by the filing fees required by law, with the Court of Appeal in the
appropriate District Court. The notice must be filed within 30 days of rendition of the final order.
STATE OF FLORIDA APPLICATION # AP1400134
DEPARTMENT OF HEALTH PERMIT # 13-SC-1927706
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATION DOCUMENT # SE1156638
APPLICANT: 490 Investment LLC
CONTRACTOR / AGENT: Westland Plumbing
LOT: 1 2 BLOCK: 1
SUBDIVISION: ID#: 11-3206-019-0010
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST PROVIDE
REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CONFORMS TO SITE PLAN: [X]YES [ ]NO NET USABLE AREA AVAILABLE: 0.31 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [ RESIDENCES -TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 775.02 GALLONS PER DAY [ 1500 GPD/ACRE OR 2500 GPD/ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 1001.00 SOFT UNOBSTRUCTED AREA REQUIRED: 1001.00 SQFT
BENCHMARK/REFERENCE POINT LOCATION: F.F.E., 11.34' NGVD
ELEVATION OF PROPOSED SYSTEM SITE 28.00 [ INCHES
/ FT I I ABOVE /IBELOW 1] BENCHMARK/REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: FT DITCHES/SWALES: FT NORMALLY WET: [ ]YES [ ]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: FT NON -POTABLE: FT
BUILDING FOUNDATIONS: 11 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 30 FT
SITE SUBJECT TO FREQUENT FLOODING?
10 YEAR FLOOD ELEVATION FOR SITE:
Rr)TT. DAAL•TTV c.
[ ]YES [X]NO 10 YEAR FLOODING? [
FT [ MSL /NGVD ] SITE ELEVATION: 9.00 FT
SOTT. PRAFTT.F. TWVn12MM PTnLi CTTO o
USDA SOIL SERIES. Urban land
Munsell #/Color Texture Depth
10YR 3/3 Fine Sand 0 To 8
REFUSAL Oolitic Limestone 8 TO 8
]YES [NGVDX]NO]
[ MSL /
USDA SOIL SERIES: Urban land
Munsell #/Color Texture Depth
10YR 3/3 Fine Sand 0 To 9
REFUSAL Oolitic Limestone 9 To 9
OBSERVED WATER TABLE: INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE: [ PERCHED / APPARENT ]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 60 INCHES [ ABOVE / BELOW ] EXISTING GRADE
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO DEPTH: INCHES
SOIL TEXTURE/LOADING RATE FOR SYSTEM SIZING: Replacement 4-FS/0.60 DEPTH OF EXCAVATION: 72 INCHES
DRAINFIELD CONFIGURATION: [ ] TRENCH [XI BED [ ] OTHER (SPECIFY)
REMARKS/ADDITIONAL CRITERIA
SITE EVALUATED BY:
SUAREZ, GUILLERMO (Title:) (G. SUAREZ SEPTIC TANK)
DH 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E-6.001, FAC
DATE: 02/26/2019
Page 3 of 4
A P1400134 EID1927706 v 1.0.2