PL-19-1340Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 06/19/2019
Location Address Parcel Number
1499 NE 104TH ST, Miami Shores, FL 33138 1122320320110
r—t.r+c
Permit NO.: PL-06-19-1340
Permit Type. Plumbing - Residential
Work Classification: Drainfield
Permit Status: Approved
Expiration: 12/16/2019
PATRICK LONGMAN Owner MR C'S PLUMBING & SEPTIC INC Contractor
1499 NE 104 ST, MIAMI, FL 331382663 KEMBLE ETTRICK
Other:3056773046
Business: 3056517859
Description: INSTALL DRAINFIELD Valuation: $ 2,400.00 Inspection Requests:
305-762-4949
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
Credit Card
06/19/2019 $67.90
Credit Card
06/11/2019 $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.
I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
and zoning. Futhermore, I authorize the above named contractor to do the work stated.
ignature: Owner
/ Applicant / Contractor / Agent
Date
June 19, 2019 Page 2 of 2
Miami Shores Village
Building Department
10050 N,E,Znd Av@nu@, Miami Shoms, Florida SSLSS
Tali (505) 705=2204 Rees (505) 75"072
iNSPiCTION LiNi PHONI NUMBLRi (305) 7624949
BUILDING
PERMIT APPLICATION
MBUILDING [M ELECTRIC ® ROOFiNG
®PLUMBING ® MECHANICAL ®PUBLIC WORKS
JOB A9911535i
1499 NE 104 Street
R
UN 1120
FBC 20
Mostor Permit No, L- l � —13f 0
Sub Permit Na
C] REVISION 0 EXTENSION ® RENEWAL
® CHANGE OF ® CANCELLATION ® SHOP
CONTRACTOR DRAWINGS
ON., Miami SHoml ccwabrc Miami bade %:
Polio/Parmi#i 11-2232-032-0110 is the Building Historically Designatedi Y@s NO X
Occupancy Typ@, � Load, Construction T"w, —flood Zon@, RFi, FFE!
OWNIN; Nam@ (F@@ Simpl@ TIV@hold@r), Patrick Longman Ph®n@#
Addross,1499 NE 104 Street
City, Miami Shores MaW FL Zip. 33138
T@nant/L@ss@@ Namw NA Phon@#,
Email,
CONTRWORi Company Nam@, Mr. C's Plumbing & Septic Phon@#, 305-651-7859
Affiberm 19932 NW 2 Avenue
City, Miami etas@; FL 2 -. 33169
Quallfi@r Nam@, Kemble Ettrick phon@#, 30-651-7859
sw@ Cwti0cation or R%istration ih SR061536 C@rtificat@ of Comp@t@ncy #,
D€ IGNiRi Ar€hit@c1/l?ngin@@r, NA Phon*
Addr@ss, City: Mat@, Zip;
Value of Work for this Permit; 1 Square/Unear Pootega of Worki
Typo of Worki ® Addition ED Alt@ration
Description of Worki Install drainfield
® N@w xR@pair/i1@iliac@ ® D@molition
Spoor color of color thr tllo:
Sub�riRTel Poe �� ; cc Permit Pee 1 CCP 1 Cc/CC
1
Scenning Pee 1
Radon Pee 1
Technology Po@ Training/iducetlon Pao 1
Structural Reviews 1
ONION 1
Notary
Double Pee 1
Bond 1 b • W
TOTAL Pig NOW OUi 1
(90§00/24/2014)
bonding Company's Nam@ (if applicable) NA
bonding Company's Address --
city -
Mortgage Wnd@r's Nam@ (if oppli€abl@) NA --- --
Mortgage b@nd@r's Addr@ss
Pity _ _ Slat@ _ 210- ---
Application is hereby mad@ to obtain a permit to do the work and installations as indicated, I a@ftify that no work or installation has
comm@nc@d prior to th@ issuance of a permit and that all work will b@ p@rform@d to m@@t the standards of all laws mgulating
construction in this jurisdiction, i understand that a s@pafat@ permit must be s@cuf@d for ELECTRIC, PLUMbIN6, SIGNS, POOLS,
FURNACE$, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC -I,
OWNin ARRImIT" I c@ftify that all the for@going Information is accurate and that all work will be doff@ in compliant@ with all
applicabl@ laws regulating construction and sofling,
"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 ioouon€e of a building permit with an @stimat@d vela@ @xc@@ding $2590, the applicant mint
promio@ in good faith that a copy of the notice of commencement and construction lien law brochur@ will be d@liv@r@d to the person
whao@ property is ouNW to acts€hment, +Also, a c@rt W copy of the recorded no€ice of commencement must b@ poo€ed of the job si€@
for the Prot Inoptction whi€h accuro o@v@n (7) aft@r the building permit is inued. In the b3@n€@ of ouch pasted no€i€@, the
inopxtian will not be approved and a r@inop n e will be charged,
Signature
OWN€R or AN
The fof@going instrum flt was acknowledged before m@ this
!�? day of u 20 by
(GkiMCdlr Is p@rsoflally known to
m@ or who has produced
identification and who did tak@ an oath,
NOTARY PUdLICI
Sign;
CONTRACTOR
Theei foregoing Instfdm@ t was atknowl@dg@d b@forp M@ this
1 day of `1� ---==I 29 by
cvum u whq is p@mNally known to
m@ or who has produce Yid r I V0 n as
id@n 9 mom did take an oath, ���xMY @AFT /1,/i
NOT Y PUial
`\ y N zr;•, ',�'
s ;
im297268
Print" Print; v�1d DONAL
MAR
Mal.,"':
MY COMMISSION M GG102743@al" // UC, S7t,�
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• EXPIRES May 09, 2021
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#####################################################################################################
APPROVED by ��- �' !r l9 Plans Examiner — - —y Zoning
Structural R@vi@w Ci@fk
(Rm1§@dQW4/2014)
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT
SYSTEM
CONSTRUCTION PERMIT FOR:
APPLICANT: Patrick Longrr
PROPERTY ADDRESS: 1499 NE 104 St
OSTDS
LOT: 12 BLOCK: 3
PROPERTY ID #: 11-2232-032-0110
FL 33138
DISPOSAL
PERMIT # :13-SC-19451
APPLICATION # : AP 1411439
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT # : PR1224709
SION: River Bay Park
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCO ANCE WITH SPECIFICATIONS AND STANDARDS OF SEC ION
381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GU TEE
SATISFACTORY PERFORMANCE FOR ANY SPECIF C PERIOD OF TIME. ANY CHANGE IN MATERIAL F TS,
WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY I THE
PERMIT APPLICATION. SUCH MDDIFICATIONS RESULT IN THIS PERMIT BEING MADE NULL AND i ID.
ISSUANCE OF THIS PERMIT DOES NOT T THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVE PMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 750 ] GALLONS / GPD Seotic Tan to remain CAPACITY
A [ 0 ] GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ 225 ] GALLONS DOSING TANK CAPACITY I ]GALLONS @[ ]DOSES PER 24 HRS #Pumps I I1 ]
D [ 200 ] SQUARE FEET New Drainfield Bed C nf. SYSTEM
R[ 01 SQUARE FEET SYSTEM R E lP,A I R PERMIT
A TYPE SYSTEM: [X] STANDARD [ ] FI D I ] MOU PLOR' . :. t� C�+.�NT�1f
I CONFIGURATION: [ ] TRENCH [X] BED [ J
N R /'�i ✓ �.r � �a a V r1 i��
R WN OF ROAD 4 '
F LOCATION OF BENCHMARK: C O
I ELEVATION OF PROPOSED SYSTEM SITE [ 20 ][INCHES FT ][�'BELOW ]BENCHMARK/REFERENCE
E BOTTOM OF DRAINFIELD TO BE [ 9 .801[ INCHES Fr ][ABOVE BELOW BENCHMARK/REFERENCE
L
D FILL REQUIRED: [ 0.00] INCHES E CAVATION REQUIRED: [ 31.001 INCHES
I. -EXISTING 750 septic tank with and approved filter REMAIN.
O 3.- Insta11200 sf. of drainfield in BED configuration.
T 4: Install 12" of slightly limited soil at the bottom of the rainfield.
H 5.- Invert elevation and Bottom of drainfield to be no less than 4' & 3.5' NGVD respectively
THIS PERMIT IS NOT FOR ANY ADDITIONS.
E................................................................................................................................................................................
R.................................................................. (Comments
SPECIFICATIONS BY: Mr C
APPROVED BY:
DATE ISSUED: 05/02/2019
DR 4016, 08/09 (Obsoletes all previous edi
Incorporated: 64E-6.003, FAC
P440M0�lp
Environmental Manager
EXPIRATION DATE:
which may not be used)
AP1411439 SE1174246
Dade CHD
07131 /20 9
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