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PL-16-3402•� DIVISION OF °i Environmental Health ``�Q Florida Health �OR Miami -Dade County OSTDS/Well Division C11805 SW 26th Street • Miami, FL 33175 O + ,r Inspector 14-1 C 7 {�Ic Date G^/C Address /V C / S OSTDS #_ S C 3 S Comments: i r Signature hLtN�ICbt FLOR7DQ' Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit NO. PL-12-16-3402 Permit Type: Plumbing - Residential Work Classification: Drainfeld Permit Status: APPROVED Issue Date:12/23/2016 1 Expiration: 06/21/2017 r. vJa _.u. aaa Parcel Numper Applicant 94 NE 93 Street 1132060130150 Miami Shores, FL 33138- Block: Lot: CHARLES WALTER MARIA PAU Owner Information Address Phone Cell CHARLES WALTER MARIA PAULA 838 SALZEDO Street - - - CORAL GABLES FL 33134- 838 SALZEDO Street CORAL GABLES FL 33134- Contractor(s) Phone Cell Phone ALLSTATE DIVERSIFIED ENGINEERD (305)256-0306 (305)258-7797 Type of Work: SEPTIC TANK & DRAINFIELD Type of Piping: Additional Info: SEPTIC TANK & DRAINFIELD Bond Return : Classification: Residential Scanning: 1 Fees Due Amount CCF $1.80 DBPR Fee $4.50 DCA Fee $4.50 Education Surcharge $0.60 Permit Fee $300.00 Scanning Fee $3.00 Technology Fee $2.40 Total: $316.80 Valuation: $ 3,000.00 Total Sq Feet: 0 Pay Date Pay Type Amt Paid Amt Due Invoice # PL-12-16-62395 12/19/2016 Credit Card $ 50.00 $ 266.80 12/23/2016 Check #: 6262 $ 266.80 $ 0.00 Available Inspections: Inspection Type: HRS Approval Final Review Plumbing 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 hat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoiryf. Futherifiore, I authorize the above -named contractor to do the work stated. _afhoriked Signature: Owner / Applicant Building Department Copy December 23, 2016 / Contractor / Agent December 23, 2016 1 Miami Shores Village BUILDING PERMIT APPLICATION BUILDING PLUMBING 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 ❑ ELECTRIC ❑ ROOFING JCEIVED DELI 9 2016 FBC20(4 Master Permit No. ?4—'• & 1110• 102 S Sub Permit No. PL 12-- 16- 3402 ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 94 N E 93 Street City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:11-3206-013-0150 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Charles Walter Phone#:347-281-0407 Address:94 NE 93 Street City: Miami Shores State: FL Zip: 33138 Tenant/Lessee Name: Email Phone#: CONTRACTOR: Company Name: 1 CAAt()Otnj,(A Phone#: A3A SZZZ Address: City: State: r1 Zip: �3032 Qualifier Name: U C Phone#:a��c}�Q3 State Certification or Registration #: Certificate of Competency #:-. C.Pc •' 4-5 232 DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ &WO M Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration n New ❑ Repair/Replace El Demolition Description of Work: 0. 2 i Okin I ilnl 1- Specify colorFFof color thru td@. Submittal Fee $✓ I� Permit Fee $©� / CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ `-',.�•--- (Revised02/24/2014) r 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 b d at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence o such p sted notice, the inspection will not be approved and a reinspection fee will be charged. / SignatureSignatur OWNER or AGENT The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this I Z: day of GeMi7C f , 20 Ito by _L� day of 20 I 1p by �qr fj WA14—{,,r , who is personally known to / , wh is ersonall n to me or who has produced n) nin 'r),G as me or who has produced as identification and who did take an oath. NOTARY P identification and who did take an oath. NOTARY PUBLIC: Sign: ` Sign: G1 /Ary i Print: Print: Seal: ,� *a• till,PY6.,; STA Suyapa T. Vasquez '"" `r = SA COMMISIMA SION # EE Seal: ��� :+: +: MY COMMISSION i EE 873354 la Commission Commission # fF942611 a: EXPIRES: May 11, 2017 Expires: December 9, 2019'` Bonded Thru Notary Public Underwriters Bonded thru Aaron Notary APPROVED BY 12'�Plans Examiner Zoning Structural Review Clerk Sr (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: CHARLES WALTER PROPERTY ADDRESS: 94 NE 93 St Miami, FL 33138 LOT: 1.2 BLOCK: 2 SUBDIVISION: PROPERTY ID #: 11-2306-013-0150 PERMIT # = 13-SM-1698771 APPLICATION # : AP 1250385 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR1033653 Miami Shores Sec [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 PERFORb91NCE 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 [ 1,200 1 GALLONS / GPD SeDtIC CAPACITY A [ ] GALLONS / GPD WA CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS 9[ ]DOSES PER 24 HRS #Pumps [ D [ 625 ] SQUARE FEET TRENCH System Confiqu SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ J MOUND [ l I CONFIGURATION: [x] TRENCH [ l BED [ I N F LOCATION of BENCHMARK: 10.27' NGVD Intersection of NE 93rd ST. & 1st AVE. I ELEVATION OF PROPOSED SYSTEM SITE [ 3.96 ] INCHES FT ][ ASOV8 BELOW IBENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 26.0411 INCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT L D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: [ 72.001 INCHES O T H E R Install a 1200 gal. septic tank with an approved filter The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance Pith s. 64E-6.013(3)(f) FAC. - Install 575 sf. of drainfield in TRENCH configuration. - install 42" of slightly limited soil at the bottom of the drainfield. - Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed or trench. (Comments Continued on Page 2.) SPECIFICATIONS BY: Astrid V Edwards TITLE: Engineer Supervisor III APPROVED BY: TITLE: Engineer Supervisor III Dade CHD DATE ISSUED: 09/26/2016 EXPIRATION DATE: 03/26/2018 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Page 1 of 3 Incorporated: 64E-6.003, FAC v 1.1A AP1250385 SE1008818 PR1C33653 continued on Page 2 ) : Invert elevation of drainfield to be no less than 8.6' NGVD : Bottom of drainfield elevation to be no less than 8.1' NGVD system is sized for 5 bedrooms with a maximum occupancy of 10 persons (2 per bedroom), for a total estimated flow of gpd• licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s. -6.013(3)(0, FAC.