PL-02-20-335Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
150 NW 100TH TER, Miami Shores, FL 33150
contacts
Permit No.: PL-02-20-335
Permit Type: Plumbing - Residential
Work Classification: Septic/Drainfield
Permit Status: Approved
Issue Date:02/14/2020 Expiration: 08/12/2020
Parcel Number
1131010230290
Ismail Ozturan Owner STATEWIDE SEPTIC CONNECTIONS Contractor
150 NW 100 TER TERESA EDWARDS
13680 NW 19 AVE BAYil10, OPALOCKA, FL 33054
Business: 9549630082
L
cription: REPLACE TANK AND DRAINFIELDLValuation: $ 4,000.00 Inspection 49 nests:
305-762-4949
Feet: 0.00
_n�r�
Fees
Amount
Application Fee - Other
$50.00
CCF
$2.40
DBPR Fee
$2.10
DCA Fee
$2.00
Education Surcharge
$0.80
Permit Fee
$90.00
Sunning Fee
$9.00
Technology Fee
53.50
Total:
$159.80
Payments Date Paid Amt Paid
Total Fees $159.80
Cash 02/14/2020 $159.80
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 foregoi g information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. ohermore,AaLporize the above named contractor to do the work stated.
Authorized Signature: Owner ; I'//` Aiplic�/ Contractor I Agent Date
/
February 14, 2020
Page 2 of 2
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
ENTnRED
h FB 1 2 20
B3'Y
I=
FBC 201--t
BUILDING Master PermitNo.FL; QZ-40-335
PERMIT APPLICATION sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION []RENEWAL
UMBING ❑ MECHANICAL [—]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
Occupancy Type: Load:
OWNER: Name (Fee Simple Titlet
City: fl�cty�l y"
Tenant/Lessee Name: _
Email: t�nt601
CONTRACTOR: Company Name: jZ
Address: -ITS I �y��`C1 �
City: () tia Il l I t
Qualifier Name: it
State Certification or Registration #:
DESIGNER: Architect/Engineer: _
V Is the Building Historically Designated: Yes NO -
Construction Type: Flood Zone: BFE: FFE:
State: VL Zip:
ZZi-pq.
Phone#:
of Competency M
Value of Work for this Permit: 9 LA ,o) Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration
^ Y IDNew (1� � Repair/Replace
Description of Work: «Q�u 11 l t- - ffai all I 0 1 A
Zip:
❑ Demolition
Specify color of color thru file:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ S00 --j
TOTAL FEE NOW DUE $ 1 `� / . W
IRevised02/24/2014) G'Sq
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lenders Name (if applicable)
Mortgage Lenders 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 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 / /JJ Signatu7,I - ilt,)Q Edw(UL�
OWNER or AGENT
CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was
��acknowledged beforemethis
day Of P- 20 �bp Z-�.�;ayorf
S J 20 by
who is pers/onally known toEdIiJL di who is personally known to
me or who has produced V l d a 3 O ! 44 a�' me or who has produced 1� / CI L L as
identification and who did take an oath.
NOTARY PUBLIC:
T, Teyana Solomon
Seal: My Commission GG 20W41
�a ExPnn 10/17/2022
identification and who did take an oath.
NOTARY
Noury Puofic State or Fl no,
Seal: R Teyana Solomon
O My COMMISSiOn 22 2ee641
EapO„ 10i1712I2022
APPROVED BY �, I- At l,)G Plans Examiner
Zoning
Structural Review
(Revised02/24/2014)
Clerk
rRVranlL ffuVim�V . I JV ,.. • rvv
LOT: 1211 BLOCK: 4
SUBDIVISION:
PERMIT (1:13-SC-2030833
•SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
PROPERTY ID N: 11-3101-023-0290 [OR TAX ID `NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH -SPECIFICATIONS AND STANDARDS OF SECTION
381.0065, F.S., AMD CHAPTER 64E76, F.A.C. DEPARTMENT APPROVAL OF SYSTEM 'DOES NQ'i••6qARANTEE
SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OB TIME. ANY CHANGE .T,N• MATEfCW FACTS'••:•
WHICH SERVED AS , A - BASIS FOR ISSUANCE OF THIS PERMIT,: REQUIRE THE APPLICANL TO:�d`*7Y THE
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT,' IN THIS .PERMIT BEI
NG MFDE: NULL A9b V01D.....
ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM CQMPLIANCE WITA OTHER• FEDERA;y•••�
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. •••• %
SYSTEM DESIGN AND SPECIFICATIONS ••••• • •. ... .•
CAPACITY
_
•r [ 900 1 GALLONS / GPD New Seotic Tan]•: • • • • •
A I 0 1 CAPACITY
GALLONS / GPD •• •
N l 0 ] GALLONS GREASE INTERCEPTMAM
OR CAPACITY IM CAPACITY SINGLE TANK:1250 JAj.LONS? '� �•••��
K 1 ] GALLONS DOSING TANK CAPACITY I y GALLON9 @j 1DOSES PER 2a HRH @P 13t [ ]
D [ 225 1 SQUARE FEET New Drainfield Trench Con SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD ( ] FILLED (] MOUND ( 1
I CONFIGURATION: [X] TRENCH [ ] BED
N
F LOCATION of BENCHMARK: F.F.E: 13.2& NGVD AT FRONT +,OOP (RIGHT SIDE).
I ELEVATION OF PROPOSED SYSTEM SITE ( 29.1011.riNCHES FT ][ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE ( 77.10It INCHES FT ][ABOVE JHELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: 10.00] INCHES EXCAVATIGN REQUIRED: [ 48.003 INCHES
1: Invert elevation and Bottom of drainfield to be no less than 7.36 & 6.85 NGVD, respectively.
0 2 - Install a 900 gal. septic tank with an approved filter
T 3- Install 225 sf. of drainfield in TRENCH configuration.
H 4,- Existing SAND at the bottom of the drainfield to remain. Any spoil material U[ f VW! T(iHR II~N FIELD within a24'
vertically that has visible signs of effluent shall be removed a6 part of the repair. ,f�.Af 1 K : L _ " 1 V V
E THIS REPAIR PERMIT IS NOT FOR ANY ADDITIONS. + d,� ? /,�.1_i C C;I r 1,`r �, i iC ,•,i._,
R (Comments Continued on Page 2.)
SPECIFICATIONS BY: TerWO
` TITLE: Mastox
APPROVED BY:TITLE: Enq:.neering Specialis
rI
DATE ISSUED: 0112I' Ply
DH 4016, 00/09 (Obaolatea all previous editions which may no*hjypott>d
Ineorporated: 64E-6.003, FAC t-�.,`-,,�uC
V 1.1.4 A 14622%L j
'Tank
CHD
"EXP t-DAvi- (- 0412T12020
d i
Page 1 of 7
SE1239966
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR CONSTRUCTION PERMIT
Pmm.-AmIlcallon Number
-----• ----
PART II - SITEPI_AN...... -
By _...P,, Dale
Tom_
County Health Depanment
ALL CHANGES MUST BE APPROVED BY THE COUNTY {HEALTH DEPARTMENT
On 4015, 08109 (Obsotelss provloua edlUons which may not be ua�IrfU polBING PLANS
FAC
(SI0Ch NUmbeC 57aa-002.40166) Appl•o= _— _ -note PogC 2 of 9
%i :apj)mVGd _ _f). le_—=