PL-05-1026Issue Date: 12/1/2005
Owner's Name: MARIAM KIRCHER
Permit Type: Plumbing - Residential
Work Classification: Drainfield
Job Address: 433 91 Street NE
Additional Information
Miami Shores Village, FL 33138-
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Expires: 12/28/2006
Contractor(s)
A ARON SUPER ROOTER
Phone
305 - 944 -8886
Primary Contractor
Yes
Type of Work: NEW DRAINFIELD
Additional Info:
Type of Piping:
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 foregoing information is accurate and that
all work will be done in compliance with all applicable laws regulating construction
and zoning. Futhermore, I authorize the above -named contractor to do the work
stated.
Fees Due Amount
Bond Type - Contractors Bond $300.00
CCF $1.44
Education Surcharge $0.48
Inspection Fee $75.00
Permit Fee - Additions /Alterations $100.00
Scanning Fee $3.00
Technology Fee $2.50
Total: $482.42
Building Department File Copy
Applicant Signature
Permit Status: APPROVED
Permit Number: PL -12 -05 -1026
Phone:
Parcel #: 1132060140120
Block: Lot:
Section: PB:
Total Square Feet: 150
Total Valuation: $ 2,400.00
Required Inspections
Rough
Landscaping
Final
DEC 0 5 PAID
Invoice Number
PL - 12 - 05 - 1120
Total:
Amt Due
$482.42
Amt Paid
7=-".4-14=2.
✓ f— � 493
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
°I\
1 jk
.
Passed
liper mments
\,
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Inspection Date: 09/28/2006
Inspector: Levrack; James
Owner: KIRCHER, MARIAM
Job Address: 433 91 Street
Miami Shores Village, FL
Project: <NONE>
Contractor: A ARON SUPER ROOTER
Building Department Comments
Wednesday, September 27, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
20 "1
C
Block:
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Drainfield
Phone Number
Parcel Number 1132060140120
Lot:
Phone: 305 - 944 -8886
Page 2 of 2
Issue Date: 12/1/2005
Owner's Name: MARIAM KIRCHER
Permit Type: Plumbing - Residential
Work Classification: Drainfield
Job Address: 433 91 Street NE
Contractor(s)
A ARON SUPER ROOTER
Phone
305 - 944 -8886
Primary Contractor
Yes
Additional Information
Miami Shores Village, FL 33138-
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Expires: 12/28/2006
Type of Work: NEW DRAINFIELD
Additional Info:
Type of Piping:
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 foregoing information is accurate and that
all work will be done in compliance with all applicable laws regulating construction
and zoning. Futhermore, I authorize the above -named contractor to do the work
stated.
Fees Due Amount
Bond Type - Contractors Bond $300.00
CCF $1.44
Education Surcharge $0.48
Inspection Fee $75.00
Permit Fee - Additions /Alterations $100.00
Scanning Fee $3.00
Technology Fee $2.50
Total: $482.42
County Copy
Parcel #:
Block:
Section:
Permit Status: APPROVED
Permit Number: PL -12 -05 -1026
Phone:
1132060140120
Lot:
PB:
Total Square Feet: 150
Total Valuation: $ 2,400.00
Required Inspections
Rough
Landscaping
Final
,DEC 0 5 PAID
Invoice Number
PL - 12 - 05 - 1120
Total:
Amt Due
$482.42
Amt Paid
Ti41 A
cx L9 3
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
i
BUILDING
PERMIT APPLICATI
FBC 2001
Permit Type (circle): Building
Owner's Name (Fee Simple Titleholder) M r, o, k NYC Inf Phone #
Owner's Address 143:73 N .
City S State ?t
Tenant/Lessee Name
Job Address (where the work is being done) "1' 3 '' N `j t 5
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO
Contractor's Company Name N 1 a r0 C1-0_4
Contractor's Address (0C'L Z 5 ? S C -t
City
Qualifier
MwC slY\
State Certificate or Registration No.
Architect/Engineer's Nanie (if applicable)
S ( t t
S Value of Work For this Permit 4 -v'
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
TIRE& r
NOV 2 8 2g0
Electrical
State . Zip - 5 - 3'= , e_ - 2)
Qcc>
Phone # 9`f4 -�8a'�
Type of Work: ❑Addition ❑Alteration ❑New [ rr Repair/Replace ❑ Demolition
Describe Work: tv� c, { l t'. 1),(Q rl'h - e 1 ol
Submittal Fee $
Notary $
Scanning S3 . 00
Code Enforcement $
Total Fee Now Due S
(Continued on opposite side)
* * * * * * * * * * * * ** * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Permit Fee $ 175 -°
Training/Education Fee $
Radon $
Structural Plan Review. $
05) 756.8972
r
Permit No. t O r oz,
Master Permit No.
Zip 33 "5,'
Phone #
Zip 33t3?
Certificate of Competency No.
Phone #
Square Footage Of Work:
Zoning
ck . 52 -G 3
1
Mechanical Roofing
CCF S - CO /CC
Technology Fee $ 4.37
Bond $ 30
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
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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
prcmise in good faith that a copy of the notice of commencement and construction lien law brochure ill be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencem t must be posted at the job site
• for the first inspection which occurs seven (7) days after the building permit is issued. In the . s.. ence of such posted notice, the jr ,
inspection will not be approved and a reinfection fee will be charged. /
NOTARY PUBLIC:
c
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of No , 20 055, by M►
who is personally known to me or who has produced - tv
As identification and who did take an oath.
Sign: g P'ti- 1
Print: ✓ r A
My Commission E cpire5°
Chc 05/13/03
APPLICATION APPROVED BY:
A
/
Signature
1 ,n2SO :,/ k
***************** SV************** * * * * * * * *c * * * * * * * * * * * * * * * * * * * * **
j. ; - . :rrvAl+.;cr. (41
Contractor
The foregoing instrument was acknowledged before me this EC.:
day of ki D v , 20 G S by J>. I;-un P
who is personally known to me or who has produced
U CSZ xe-
NOTARY PUBLIC:
Sign:
Print:
My Co
Zip
as identification and who did take an oath.
(i v212.0
;A" ' 4-v"-
'l t s,. •1.0MON
tS5 - . +.►NI■sr>s014 r: I :b2nj 47
V( of ; * *� * *�ir�* 9444 * *
RPh.': ,ri thl k.r4G. Sari.
* * * * * * * **
Plans Examiner
Engineer
Zoning
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR:
[ )New System [ ]Existing System [
[ X ]Repair [ ]Abandonment
APPLICANT: Kircher Tr, Miriam AGENT: SR091112, Tuffy John
PROPERTY STREET ADDRESS: 433 NE 91 St Miami FL 33138
LOT: 17 BLOCK: 49
PROPERTY ID #: 11- 3206 - 014 -0120
SYSTEM DESIGN AND SPECIFICATIONS
THIS PERMIT IS NOR FOR " ADDIT •N(s
SPECIFICATIONS BY: Andre, Paul
APPROVED BY: Andre, Paul
DATE ISSUED: 11/22/05
SUBDIVISION: Miami Shores Sec 2
[Section /Township /Range /Parcel No.]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC
DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME
PERIOD. 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 PROPERTY DEVELOPMENT.
T [ 900 ]Gallons SEPTIC TANK
A [ 0 ]Gallons
N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY
K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ [0
D [ 150 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R [ 0 ]SQUARE FEET SYSTEM
A TYPE SYSTEM: [ N ]STANDARD [ N ]FILLED
I CONFIGURATION: [ N ]TRENCH [ N ]BED
N
F LOCATION TO BENCHMARK: EFF El.:10.70'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 2.4 ] [ FEET
E BOTTOM OF DRAINFIELD TO BE [ 4.9 ] [ FEET
L
D FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 30.0 ] INCHES
OTHER REMARKS:
1.- Install 225 sf of drainfield in trench configuration.
2.- Install 12" of slightly limited soil @ the bottom of drainfield.
3.- Perimeter of excavation area shall be at least 2 ft. wider and longer than the proposed
a absorption trench.
4.- Existing 900 gal. septic tank , certified by " A Aaron Super Rooter on 11/21/2005" to
remain.
5.- Invert elevation of drainfield to be no less than 6.30' NGVD.
6.- Bottom of drainfield elevation to be no less than 5.80' NGVD.
4
DH 9016, 03/97 (Obsoletes previous editions which may not be used)
(Stock Number: 5799- 001 - 4016 -0) (ostds_cons_4016 -1)
CENTRAX #: 13 -SG -27126
DATE PAID:
FEE PAID : $
RECEIPT .
OSTDSNBR : 05 -3693- -R
]Holding Tank [ ] Innovative Other
]Temporary [ NA ]
MULTI - CHAMBERED /IN SERIES: [Y ]
MULTI - CHAMBERED /IN SERIES: [Y ]
]DOSES PER 24 HRS # PUMPS[ 0 ]
[ N ]MOUND [ N ]
[ N ]
] [ BELOW BENCHMARK /REFERENCE POINT
] [ BELOW BENCHMARK /REFERENCE POINT
TITLE:
TITLE: Professional Engin Dade CHD
EXPIRATION DATE: 2/20/06
Page 1 of 2
Scale: Each block represents 5 feet and 1 inch = 50 feet.
Notes:
, • '0
;;- •
• ,
DH 4015, 10/96 (Replaces HRS-H Form 4015 which may be used)
(Mod( Number: 5744-002-4015-6)
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT,—
Permit Application Number
PART II - SITE PLAN-
\\ / '‘ •
‘,\
Kr,
Isk
f"
R
Site Plan submitted by:
Signature
Plan Approved Not Approved
s
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
Title
Date
By County Health Department
Page 2 0'
CONSTRUCTION PERMIT FOR:
[ ]New System [ ]Existing System [ ]Holding Tank [ ] Innovative Other
[ X ]Repair [ ]Abandonment [ ]Temporary [ NA ]
APPLICANT: Kircher Tr, Miriam
PROPERTY STREET ADDRESS: 433 NE 91 St Miami FL 33138
LOT: 17 BLOCK: 49
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
PROPERTY ID #: 11- 3206 - 014 -0120
SYSTEM DESIGN AND SPECIFICATIONS
T [ 900 ]Gallons SEPTIC TANK
A [ 0 ]Gallons
N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY
K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0
I ELEVATION OF PROPOSED SYSTEM SITE [
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED: [ 0.0 ]INCHES
OTHER REMARKS:
THIS PERMIT IS NOR FOR " ADDIT
AGENT: SR091112, Tuffy John
SUBDIVISION: Miami Shores Sec 2
[Section /Township /Range /Parcel No.]
[OR TAX ID NUMBER]
D [ 150 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R [ 0 ]SQUARE FEET SYSTEM
A TYPE SYSTEM: [ N ]STANDARD [ N ]FILLED
I CONFIGURATION: [ N ]TRENCH [ N ]BED
N
F LOCATION TO BENCHMARK: EFF El.:10.70'NGVD
SPECIFICATIONS BY: Andre, Paul / TITLE:
EXCAVATION REQUIRED: [ 30.0 ] INCHES
CENTRAX #: 13 -SG -27126
DATE PAID:
FEE PAID : $
RECEIPT .
OSTDSNBR : 05 -3693- -R
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC
DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME
PERIOD. 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 PROPERTY DEVELOPMENT.
MULTI - CHAMBERED /IN SERIES: [Y ]
MULTI - CHAMBERED /IN SERIES: [Y ]
]GALLONS @ [0 ]DOSES PER 24 HRS # PUMPS[ 0 ]
[ N ]MOUND [ N ]
[ N ]
2.4 ] [ FEET ] [ BELOW] BENCHMARK /REFERENCE POINT
4.9 ] [ FEET ] [ BELOW] BENCHMARK /REFERENCE POINT
1.- Install 225 sf of drainfield in trench configuration.
2.- Install 12" of slightly limited soil @ the bottom of drainfield.
3.- Perimeter of excavation area shall be at least 2 ft. wider and longer than the proposed
a absorption trench.
4.- Existing 900 gal. septic tank , certified by " A Aaron Super Rooter on 11/21/2005" to
remain.
5.- Invert elevation of drainfield to be no less than 6.30' NGVD.
6.- Bottom of drainfield elevation to be no less than 5.80' NGVD.
APPROVED BY: Andre, Paul TITLE: Professional Engin Dade CHD
DATE ISSUED: 11/22/05 EXPIRATION DATE: 2/20/06
DH 4016, 03/97 (Obsoletes previous editions which may not be used)
(Stock Number: 5744- 001 - 4016 -0) (ostds_cons_4016 - 1)
Pars 1 of
Site Plan submitted by:
Scale: Each block represents 5 feet and 1 inch = 50 feet.
Notes:
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permit Application Number
DH 4015, 10/99 (Replaces HRS-H Form 4015 which may be used)
Stock Number: 5744- 002. 4015.67
PART II - SITE PLAN
Signature Title
Plan Approved Not Approved Date
By County Health Department
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
PAAP7n'