PL-16-3398, 910 NE 99th Sti
Miami Shores Village C. p
Building Department FDEC 16 2016
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 —_
INSPECTION LINE PHONE NUMBER: (305) 762-4949e
FBC 20 tCj
BUILDING Master Permit No. l(/-.%-- sag
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION❑RENEWAL
dPLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
/ CONTRACTOR DRAWINGS
10B ADDRESS: 0(I U b E q "t /� "A" 5 �1' e,&
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11' 320t0 " 014 - 3Li I () Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: / 7
OWNER: Name (Fee Simple Titleholder): Ako'ns ) {G(A 50- Phone#: 3b , T" 0 tp . S L9
Address: Ll -+- 0 /U sa�j �O C,CK
City: M (-rn '�>QC'6A State: AIL-- Zip:
Tenant/Lessee Name: Phone#:
Email: (-
CONTRACTOR: Company Name: W� 1 a nJ V v>h p )'� 4 C'07— Phone#:
Address: 110 l uV a I-f i&+ {'
City: milA-1 — /� State: ' Zip: n / O
Qualifier Name: ka Q0 b. S Phone#:
State Certification or Registration #: Qx-y-• 0 3 7 ( O Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ �j QO Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration -j-� ❑ New
�,�^ Repair/Replace Demolition
Description of Work: CIO K(rn-t y\., "
Specify color of color thru tile:
Submittal Fee $ - - W Permit Fee ✓ CCF $ 0 Go CO/CC $
Scanning Fee $ Radon Fee $ DBPRR $ Notary $
Technology Fee k-/\-i Training/Education Fee $ 0-2-6 Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $
(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
Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection whic occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be appro Id and a reinspection fee will be charged.
ER or AGENT
The foregoing instrument was acknowledged before me this
�r�h day of 1e(�j la 20 by
S rLt J-S Q , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
S
Print:
Seal: Y
y0�
APPROVED BY, _
(Revisedo2/24/2014)
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of //yy . �. C. • 201 6 , by
.l> �vho is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
tin Illilllll
Sign:
Print:
KRISIA DEL PRADO
Seal:
z Notary Public -
••• CANot
� * s �� •; State of Florida
iFF!l2i+i2
Commission i FF 981913
: o�$ �'•Oo; ;° MY Comm.
Expires Jun
leans Examiner
Structural Review
Clerk
I
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR: OSTDS Abandonment
APPLICANT: Hans Krause
PROPERTY ADDRESS
LOT: 11
PROPERTY ID #
910 NE 99 St Miami, FL 33138
BLOCK: 12 SUBDIVISION:
PERMIT #: 1 3-SC-1 726434
APPLICATION #: AP1267192
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR1041901
11-3206-014-3410 [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 [
A [
N [
K [
] GALLONS / GPD
] GALLONS / GPD
] GALLONS GREASE INTERCEPTOR CAPACITY
] GALLONS DOSING TANK CAPACITY [
CAPACITY
CAPACITY
[MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
]GALLONS @[ ]DOSES PER 24 HRS #Pumps [
D [ ] SQUARE FEET SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [] MOUND [ ]
I CONFIGURATION: [ ] TRENCH
N
F LOCATION OF BENCHMARK:
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
DE
O
T
H
E
R
[ ] BED [ ]
][ABOVE/BELOW] BENCHMARK/REFERENCE POINT
][ABOVE/BELOW] BENCHMARK/REFERENCE POINT
ILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: t J 1NUMMb
Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom
of the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c)
The tank shall be filled with clean sand or other suitable material, and completely covered with soil. Have the system
inspected by the health department after it has been pumped and ruptured but before it is filled with sand and covered.
•• ••• • • • • • ••
SPECIFICATIONS BY: •• ••• •• TITLE• • ••
APPROVED BY: TITLE: so Engineering Specialist II Dade CHD
Erlande Omiaca • • • • • • • •
DATE ISSUED: 12/14/2016
• • • • • • • • • • • • • • • • • • EXPIRATION DATE: 03/14/2017
• • • • • • • • • •
DH 4016, 08/09 (Obsoletes all previous editions 4ahich•iffay riot be Esedr
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1. 4
kP12%19,
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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 party 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.
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Miami Shores Village
P`SHORES
10050 N.E. 2nd Avenue NE
�- "'
Miami Shores, FL 33138-0000
7
n f<OR 11D
Phone: (305)795-2204
Permit NO. PL-12-16-3398
Type: Permit Plumbing - Residential
erm Work Classification: Septic
Permit Status: APPROVED
Issue Date: 1/5/2017 1 Expiration: 07/04/2017
Project Address Parcel Number Applicant
910 NE 99 Street 1132060143410
Miami Shores, FL 33138- Block: Lot: HANS & URSULA KRAUSE
Owner Information Address Phone
HANS & URSULA KRAUSE 910 N 99 Street
MIAMI SHORES FL 33138-
910 N 99 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
WESTLAND PLUMBING CORP (305)863-6223 (786)236-0198
Type of Work: SEPTIC TANK ABANDONMENT
Type of Piping:
Additional Info: SEPTIC TANK ABANDONMENT
Bond Return :
Classification: Residential Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Jmn
Permit Fee
Scanning Fee
Technology Fee
Total:
Valuation:
Total Sq Feet
Pay Date
Pay Type Amt Paid Amt Due
Invoice #
PL-12-16-62390
01/05/2017
Credit Card $ 64.60 $ 50.00
12/16/2016
Credit Card $ 50.00 $ 0.00
Cell
(305)751-6529
$ 500.00
0
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 respo sibility for all work done by either myself, my agent, servants.. or employes. I understand that separate permits are
required for ELECTRICAL, PL Lea
CHANICAL, WINDOWS. DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certi tforegoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction anc�zonir1g. F�th m above -named contractor to do the work stated.
January 05, 2017
Authofized Stnature:�ewner / Applicant / Contractor / Agent
Building Department Copy
January 05, 2017 1
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Mia i Shotffvi age
APPROVED --BY
DATE
ZONING DEPT
BIJ6i DEPT -
------ — —
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SUBJECT TO L1A1�{ FEi
STATE D COUNTY RULES AND REGULAMONS
sv
EXIS1I11G ONE-STORY SINGLE-FAIIIEY
j kESIDENnAL STRUC1UfiC 10 DE REMOVE."
N ITS F.N TIRE TY, INCLUDING FLOOR ELADS —
AND FOUNOAn01r5
re,« oar
., .o .ao:.� s � r,
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I I I'�II S
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IfaCnit�
[ REAR ALLEY has
IN\\
�1 DEMOLITION SITE PLAN 9 FLOOR PLAN �_IJ
Ex SPNG CVE OAK (OACCUS VRG , ANA) MR P
TO CE RE:OVEED- TREE RENOV. HERMIT NO 7323
ISSUED DY NIAVI-CADE COUNTY ON 02 28 20 6
(F.F kE 0725-2017)'EE ATTACHED COPY 0.
THEE REMOVAL PERIIT
910 NE 99TH STREET
EXISTING FLOOR AREAS:
AREA BREAKDOWN:
MAIN HOUSE: 1,996 S.F.
GARAGE: 565 S.F
COVERED PORCH: 233 S.F.
Nl' IERIOR COURTYARD. 70. S, F]
TOTAL AREA: 2.864 S.F
KRAUSE
RESIDENCE
DEMOLITION
SITE PLAN 8
FLOOR PLAN
D-01
PIe
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