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PL-19-2234Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: Location Address Parcel Number 20 NW 101ST ST, Miami Shores, FL 33150 1131010180230 Contacts Permit NO.: PL-09j Permit Type: Plumbing - R Work Classification: Permit Status: Expiration: 03/30 Philippe Logerais Owner 20 NW 101 ST MR C'S PLUMBING & SEPTIC INC Contractor KEMBLE ETTRICK Business: 3056517859 kemble@mreseptic.com Description: INSTALL DRAINFIELD Valuation: $ 2,490.00 Inspection Requests: 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 09/24/2019 $50.00 Credit Card 10/02/2019 $67.90 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, DOO S, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is ate aaorAo that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above n m nt do ork stated. Authorized Signature: Owner / Applicant / Contractor / Agent Date October 02, 2019 Page 2 of 2 Miami Shores Village Building Department 10959 N:F•2nd Avenue, Miami Shore§, Florida 33138 T@I; (393) 713S-ZZ@4 Fax; (395) 754-8972 INSPECTION 6iNF PHONE NUMBER; (305) 70-4949 FBC 2® iV a ter Aerml! Ng. ?L— 0i — 11 ZZ34 PERMIT APPLICATION Sub Permit E]OUIF®iNQ M ELECTRiC ROOFING R€VISION M €XT€N51ON ©RENEWAL U4€OMOING MMECHANICAL EJPIJBLICWQRKS M CHANGE OF —CANCELLATION El SHOP CO TRACTOR DRAWINGS dOR APPRESS; o N� I v G tv- Miami Shores County: Miami Dade Zip: 3 J 1 J V th@ Building Hi§t9ricolly P@§iSnat@d, Yes NO OEcupanq Type: _ Load! _ Con§tru@fl@n Type: _ Flood Zon@� OFF; FFF OWNER; Nam@ (F@@ Simpie Titieholder); �Yvf �i 1 b L. -&?je- 6L S Address: d- U City; al T?nant/1_essee Name: Email; CONTRACTOR, Company Nam@! — Addres§€ I 1\1� City: a _ Qwalifier Nam@; .G Sfat@ C@rfi#iEation or Registration # OOW `� Cerfifirate of Comp@t@nry # _ 11MIGNFRt Archit 0/FnRin@@r€ NI 1Fi Phone# Valu@ of Work for thi§ P@rmit; Typ@ of Work: M Addition Pwri@tion of Work; EJ Alt@rafion Specify color iof color thru 01g zip3� zip: 3�1 � g 3b -651- -7 k579 ntw Sfafe Zi : SRuar@/Lin@@rrFF990aR@ 9f Work; a� El N:@w I"i R@p@ir/R@pia€@ E] Qempiitipn Suhmittal F@@ S6 R@rmlt F@@ 6 (OO CCF . 80 w/CC Scanning F@@ $ �• i Radon F@@ $ 4. 0 0 OeRR $ o9. 00 N9tary Tochno19gy F@@ $ A.50 TraininS/Fdu@ation F@@ 0.00 Oouhi@ F@@ $ Strugurol R@vi@w§ 0 Pond 6 5DD TOTAL FEE NOW DUE $ � � .90 p�I0 PPPdint; i=Pmpany's Name (if applicable) _ RPndinR CPmpany's Address City —state - - _ Zip — Mortgage Lender's Name (if applicable) — ortRaRe Lender's Address - rity state _ 7ip Appkotion N hereby made to Pbtain a permit to do the work and installatigns as indicated, I certify that no work or installation has commenced prior to the issuance Pf a permit and that all work will be performed tP meet the standards of ail laws reRulatinb Eon4tructi9n in this Jurisdiction, i understand that a separate permit must be secured for ELECTRIC, PLLIMRINQ, s1ON5, POOLS, FLIRNAt €s, POIL€Rs, HEATERS, TANI(S, AiR CONPITIONFRs, ETC,—, OWNER'S AFFiAAVIT� i certify that all the foregoing information is accurate and that all work will be done in compliance with ail applicable iaws rgylating €onstrPctiPn and ; Pninp: "WARNING TO OWNER,, YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYiNIG 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," NPti€e to Applicgnt; A4 A €PndWpn to the 4suQn€e of a h0ding permit with an e0mAted vAlue e?eceeding $150R, the opplicent must premise in 9401oith that o copy Pf the nPti€o Pf cPmm€n€omgnt and EPns(rycVQn lien low brochure will be delivered tP the person who;@ RrPp€rty is sohiect to ottochment: A10, P c€rti 0 cPpy Pf the recorded nPOrg Pf commencement most he posted of the job situ for the first inspection which PccHrs seven (7) doys ofter the Wilding permit is issued: In the obsence Pf soch posted nAtic@, tho inspcctlPn will not be oppreved and o reinspectiPn fee will he chorpod- �I�natyre OWENER Pr AQFNT The ferwing instrum t was acknowledged before me this Ih 1A _ day of 20 b who is personally known to me or who has produced 1) ce-< < as identification and who did take an Path: NOTARY PUBLi€t Print: A J4crE�Y, siRnatyre CONTRACTOR The fore, 9�s instrumen was ackn9wledbed before me this day of 20 1 al b K�ok..�tC (, ✓i CA, wto me or who has produced as identification and who did take on Path NOTARY PUBLIC; Print: a 11041"1 seal''kr°w4; DONALD MARTIN seal° �►" •:'' DONALD MARTIN MY COMMISSION # GG102743 EXPIRES May 09, 2021 MY COMMISSION # GG102743 4S EXPIRES May 09. 2021 p'q' APPROVED BY Plans €xaminer Zoning Structural Review (R@vjse jQ?j9412914) STATE OF FLORIDA DEPARTMENT OF HEALTH 1 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM VMBING PLANS CONSTRUCTION P Approxied Pig: ��• CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Phillippe Logerais PROPERTY ADDRESS: 20 NW 101 St Miami, FL 33150 LOT: 12 BLOCK: 3 SUBDIVISION: PROPERTY ID #k: 11-3101-018-0230 PERMIT #: 13-SC-1989823 APPLICATION #: AP1433263 DATE PAID: FEE PAID: Date — RECEIPT N: } tr DOCUMENT # : PR1262863 [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 J GALLONS / GPD Septic Tank to Remain CAPACITY A [ 0 J GALLONS / GPD CAPACITY N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS Q[ ]DOSES PER 24 HRS #►Pumps [ D [ 200 J SQUARE FEET New Drainfield Bed conf. SYSTEM R [ 0 ] SQUARE FEET A TYPE SYSTEM: [X] STANDARD I CONFIGURATION: ( j TRENCH N [ ] FILLED [X] BED SYSTEM [ J MOUND [ ] F LOCATION OF BENCHMARK: F.F.E: 11.70' NGVD. I ELEVATION OF PROPOSED SYSTEM SITE [ 3.60 ][ INCHE3 FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE ( 53.601[ INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: [ 62.001 INCHES 0 T H E R 1.- Invert elevation and Bottom of drainfield to be no less than 7.74' & 7.24' NGVD respectively. 2.-EXISTING 750 gal. septic tank with an approved filter TO REMAIN. 3.- The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. 64E-6.013(3)(0 FAC. 4.- Install 200 sf, of drainfield in TRENCH configuration. 5.- Install 12" of slightly limited soil at the bottom of the drainfield. (Comments Continued on Page 2.) SPECIFICATIONS BY: KEMBLE ETTRICK TITLE: APPROVED BY; TITLE: Environmental Manager Dade CHD r z DATE ISSUED: 09/18/20 EXPIRATION DATE: 12/17/2019 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 AP1433263 SE1201927 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR CONSTRUCTION PERMI&G ,PLANS Permp�,cation Number Appr" C { C�,, �>a. _ Q • I =� 2 Z ( r 1 6L rl L C a 0 Ll W i- Notes: not. - �•�� ),,,,�el �tic lank andFor Seps ecticn dno fina► Inca ing ►s rdand ►andsp and • '�, i JF .�i,! 1;.r+.. ' I ! � '"r � • -'fir • • • • • • • • • i • ��f �rtJ, i� r rr �� ♦lf r�,r��. • • • �.. J�Jr •r'. f J � 1 .Jf•�•�1. •••• ( rJ..� L. %• frl tt J • • ••••� (t •••• • /JV, + ,•• N •• I • r•'r'r�' ..•i f • • • • �• I i • • • • • {l rX, 0 0 0 oil ,F,- W• S•f iMC,If) !� 1 J ' r; In n-CJA C �;> C- Iv L-Zv ( Q C -- . i,-ft -i relit 'FL - 1ti.T1 �-r t i�c� 3arc-L1 r--t %,tA Cf ''C"o L—C 70 te- yi/ a I K n /1 Site Plan submitted by: Plan Approved Not Approved By Y'Cc.Cl-b Y Date ! _ County Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015, 08f09 (Qbso,etes previous editions which may not be used) Incorporated: 64E•6.001, FAC (Stock Number. 5744-002-4015-6) Page 2 of 4