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1997 DRAINFIELD 770 NE 91 STBUILDING ELECTRICAL PLUMBING ❑ ROOFki tG , , ❑ 4 ° tea Owner of Buildi:ag Addres 3 of Buildincf In c ensideration pertaining .hgreto cepting 1 Pe i0 CONTRAC 4 xi MIAMI SHORES VILLAGE. FLORIDA 9 the s uance /to onform}'ty sponsijiiii BUILDER PERMIT N? 6200 Architect Contractor or Builder ' ,� ;;ee 4 ' f i Legal Lot / � Description � B e of = s permit I th the . ans, drawi for all w Work to be / tic 4 4 .E.4) Signed. _ performed under this Permit DATE Contractor's License No. 1957 Subdi- vision Value of Project $ Amount of Permit $ AUTH +RITY This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if NI work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder .... ed above assumes the responsibility f a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown o the 131ans or drawings or in the statemer sp= ; 'cations and that he assumes responsibility for work done by 1 is agents, servants or employees. strict ume INSPECT •• ti m th wor . cover =d hereunder in 40 nts or secifi .ti. s -' bmitted to the prib yself, ty agent, se ant or employee. 1,71 1� • t 1 It d l lr a u e wr BY ,O pliance! with all ordinances and r authorities of M • _• - ores egulations age. In ac- Owner/Lessee / Tenant /tf I i Owner's Address 7 7 0 Square Ft. FEES: PERMIT 3 S, RADON APPROVED: Zoning Mechanical PERMIT APPLICATION FOR MIAMI SHORES VILLAGE ' Date I r ) Job Addr ess 770 (---( l� ` �/ .� �•�$'ax Folio Legal Description Historically Designated: Yes Contracting Co. X , E Qutdifier /P c ,— ri • , C r&4 Scat! d'liOq/ S .Tt • Municipal # 3 ,86•S O S Arc] litect/Engineer Bon ling Company Mortgagor Pertnit Type (circle one): BUILDING ELECTRICAL WORK DESCRIPTION D i;., ii e1oI Pet)" 4' O o 0 12 Estimated Cost (value) 7 o o_ o a WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate perm is are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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 t egulating construction and z fning., Furthermore, I authorize the above -named contractor to do the work stated. Siena ure of o r and/or Condo President Date ro-op A Not`dr;' as to Owner and/or Condo President Commission mission Expires: ANNA QUINONES ; �• - MY COMMISSION / CC 502181 _ # { it f; ,. J • - EXPIRES: October 16,1999 I I "': ' Bonded lbw Notary Public Undenwlcere A 4C ,l fA car,- yr Master Permit # / cLV C.C.F. ( • NOTARY Building Plumbing 1 � t � i o o �P r Zi✓r . Address /3 6 9 /v . _ 7 S Address Address Address UMBING >IECHANICAL ROOFING PAVING FENCE SIGN Phone 7 S 7 / o / g Signa e of Con : ,.r or Owner- Builder Notary as to Contr ctor or Owner - Builder My Commission Expires: - Electrical BOND No '/ ss# / - Phone 3 os- 95 ¢,a o Competency # &' 00035 & Ins. Co. (a A 4 Date Date ANNA QUINONES I.F 'i a MY COMMISSION # CC 502181 s°;•: EXPIRES: October 16, 1999 ;1- Bonded Thou Notary Public lindens/tare i 30 0 TOTAL DUE 3 3 Engineering 9 A ICATION FOR: roll flew System [,t / Existing System [ Holding Tank [ Temporary /Experimental (/),] ]te air I/� 1 Abandonment ' ] Other(Specify) P Alp/ TELEPHONE: APPLICANT: A 414 1 p y are5 � o - OjU A ') - AGENT : 409 �`✓ MAILING ADDRESS: TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. ATTACH BUILDING PLAN AND TO -SCALE SITE PLAN SHOWING PERTINENT FEATURES REQUIRED BY CHAPTER 10D -6, FLORIDA ADMINISTRATIVE CODE. PROPERTY INFORMATION [IF LOT IS NOT IN A RECORDED SUBDIVISION, ATTACH LEGAL DESCRIPTION OR DEED],. LOT: BLOCK: SUBDIVISION: DATE OF %, see p. ; RATA •:.)( to ea' 19 s L147 P41 _ CONSTRUCTION: /Y' PROPERTY ID #: [Section /Township /Range /Parcel No.] ZONi.:u.: j/ 3ao b01 i 00,3 17, PROPERTY SIZE: ACRES [Sqft /43560] PROPERTY WATER SUPPLY: [ ] PRIVATE [ J] PUBLIC 0,3y, PROPERTY STREET ADDRESS: 77 Al- e. DIRECTIONS TO PROPERTY: g5 tscAy,de Io V' g 9n Z 7° 6)9, BUILDING INFORMATION Unit Type of No Establishment 2 3 4' 1 Apr- 00-op. AP ?LICANT'S SIGNATURE: STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC [NA Garbage Grinders /Disposals [Ad) Ultra -low Volume Flush Toilets 13b9 �.w. 7� ,u1;n 3J/l) �I✓� o rs�. [/] RESIDENTIAL // No. of Bedrooms 8- Building Area Sgft [ ] COMMERCIAL PERMIT # DATE PAID FEE PAID RECEIPT # //7 7/ 9'7 $ / SO /(( �9 757 # Persons Business Activity Served For Commercial Only Spas /Hot Tubs ] Floor /Equipment Drains ] Other (Specify) DATE: f /GI 9/9 7' HIM Form 4015, Mar 92 (Obsoletes previous editions which may not be used) Page 1 of 3 (S1:ock Number: 5744-001- 4015-1) bt ivin�o' co • In. ( *,... cc..i 1.: 'r:_r _ ': , 1 :f : u-f. r, coy U( ':.:iidiV ` . . t 4 c:Fiy , . c::;,::. � , .r _ ..!: o_ � .... r.., :o�:.:c ty vii:: ;..d7 :. c -ts r,: , . __ . n 'Ldiw ai t= iutc�. .-or ii riauct.: �'r�o,` r, ,'. �.. ;:,m.n..tn *.r.l.... ;f! ��.n::v -oi t . y r:�d C. rr_lu.: d in o. for property. '; ur lets witeic: r assigned str, ci cddres, iadicc'e s :o o. !vat c.fid i:: c ;i:n'y . i!istrdCiiuu:i to lo■ of i!tt7: ;:!1 F L,: F' trim .illowino. lot :n ct'on. ...x`I itl D.l of coj»i-:7;)rciti1. Li '7:: o. C' 1 [.- m.o.ml: i 'ii at - .. . . it ..:'AL'. Ext � . . -'1. 'JO,.L, 6,.si ;iidd primarily for i it:,' !':1.. '?US^ S1rdL', t: .nr:C •_Li to roil : V,OVicii cr 'om..l.1ta'. tlli7Riyia:..1 :11: a,: ,iJ j'„ c,xgJ ry. il(; 2F:7 , Cc: C.Y'rrlp' .. S' APPLICANT: /4 A SPEC]FICATIONS BY: APPROVED BY: HRS -H Form 4016, Mar 92 (Obsoletes (Stock Number: 5744 - 001 - 4016-0) STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC CONSTRUCTION PERMIT F R: M � [ a] New System [ ] xisting System [ ` "1 olding Tank ' Repair [Abandonment [ ArOther(Specify) SYSTEM DESIGN AND SPECI I(YATIONS f GALLONS _0 DATE ISSUED: / s'f 6L& CGk AGENT: A /9 PROPERTY STREET ADDRESS: IIss 7 7 LOT: BLOCK ,A : 47 E S U D V S N f •PROPERTY ID #: / O� / ® [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] ® ) [OR TAX ID NUMBER] SYS'.'EM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -6, FAC REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BAS] FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MOD] MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. T [ 0 G P _. ] EPTIC TANK /AEROBIC UNIT CAPACITY A [ ] [GALLONS / GPD] N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] K [ ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE.RATE [ ] PER 24 HRS NO. OF PUMPS: [ ] D [F0 c UARE FEET RIMARY DRAINFIELD SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND I CONFIGURATION: [._] TRENCH [ )4 BED [ ] N / / F LOCATION OF BENCHMARK: /O, �I C0--04o,/ U� _ RReif ( ��¢- r_ ^ f S D I ELEVATION OF PROPOSED SYSTEM SITE [ Bldg [INCHES /FT] [ABOVE /BELOM BENCHMARK /REFERENCEiP 'I E BOTTOM OF DRAINFIELD TO BE [ 7 c2. ] (INC • ELOW HES T [ABOVE BENCHMARK REFERENCE POINT L f �� D FELL REQUIRED: [ ] INCHES EXCAVATION REQUIRED: INSTALL ! CIF ,ZAM Y CW;,: 2 1 S/`= O ,r. _ r , i qq n -17.0 m i - O1, T ,7 II (777`17. �""''' F 1. Q..i'.a' AV,.. ,. :f3. �L. .-� ;_: LI, 1, is :y u..,,,, _, .. , �,r il . w,, H _ r __ . •- .m n 11,,,.71- vn ,nteP ene E i i 1 1 r ti i z i . Allve . � r 1 „ : . ' C % - . 1 A d n :N r � ` U . , ' r ' ° - vmv, R rem 77 V* 7 .' , \ 177 , APPdl©l1GJ U TITLE: previous editions which may not be. used) PERMIT # '7 7R O DATE PAID 9 ^ 2;1 cy' FEE PAID $ RECEIPT # 4j Temporary /Experimental [ 3 ] INCHES MULTI- CHAMBERED /IN SERIES:( ] CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] TITLE: � CPHU EXPIRATION DATE: �.... e, DTI 5s�171�C' e, r PJl1 h: [ :ikkcd • /J Page 1 of 2 !!"31.1 cl;• ••'7, p1 3 07 r;C'Zil0.1P-OrTanh;.::i!",7' A. !cm-v(31:7.3 ;..3C:vi(.13• ii :3y 3 Ctr (c:-:J) fo USWITI THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: SURFACE WATER: NO FT DITCHES /SWALES: /1/ FT NORMALLY WET? [ ] YES [Y] NO ' WELLS: PUBLIC: /(f' A FT LIMITED USE: A))1 FT PRIVATE: ,o) n , FT NON - POTABLE: /IJ1 01 . FT BUILDING FOUNDATIONS: ,2 FT PROPERTY LINES: ,S FT POTABLE WATER LINES: ' /O' FT s mot APPLICANT: ✓�l/ N4 t .SH C' pn , AGENT: /� te.' 2 ores a - /'7 �fi� �P 3( � ✓ e lQoo P LOT: BLOCK: SUBDIVISION: .fee Pobiic A974 ATTAc4eo �s 6u 2 ) PROPERTY ID #: TO PE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PROVIDE REGISTRATION NUMBER•AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: 0 YES ( ] NO NET USABLE AREA AVAILABLE: CO __ ACRES TOTAL ESTIMATED SEWAGE FLOW: *0 GALLONS PER DAY [RESIDENCES -TABLE 1 / OTHER -TABLE 2) AUTHORIZED SEWAGE FLOW: 860, 8 GALLONS PER DAY [1500 GPD /ACRE OR 2500 GPD /ACRE] UNOBSTRUCTED AREA AVAILABLE: goo SQFT UNOBSTRUCTED AREA REQU RED: - O 0 SQFT /V0%�' �POPet /y / ,-S . 7 /kJ ,c J4, So T'� 0/ 1.,zd i,J IPepAir/N �M J / j BENCHMARK /REFERENCE POINT LOCATION: /0, ? ed- r ,' ,g , ELEVATION OF PROPOSED SYSTEM SITE IS 1,0 [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT SITE SUBJECT TO FREQUENT FLOODING: [ ] YES C NO 10 YEAR FLOODING? [ ] YES [r] NO 10 YEAR FLOOD ELEVATION FOR SITE: 4,0 FT MSL /NGVD SITE ELEVATION: 6� FT MSL /NGVD SOIL PROFILE INFORMATION SITE 1 WI v V CA-,C) SOIL PROFILE INFORMATION SITE 2 Munssell # /Color Texture Depth Oar A. f)r9 AI N< <. V 4 to 1 ` / 1 1 . to / A-id / O'' to '1 to I i to p'' STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS 11- 3 01/ /0 SITE EVALUATED BY: LAN Q,ghlk !Pala?) � — to �; J i 1 to 11 o 7 USD1I6OIL SERIES: 7 h HRS -H Form 4015, Mar 92 (Obsoletes previous editions which may",not be used) (Stock Humber: 5744 - 003 - 4015 -1) ��l o PERMIT ,# (1 ��� D ✓� 5 --) [Section /Township /Range /Parcel No. or Tax ID Number] Munsell # /Color , /1.4 it k )1 Texture Depth /))- O i 'to ' .E::::to IA hi 9ANd . to 4, '( to o �1 �� t �� ,k o O'' 0 4444 - , Qw.d lPoJ a i p, r, o 'S to '' ' ' to \ 1, to 7. ,. USDA SOIL SERIES: ,Znq r,, v 6 OBSEEVED WATER TABLE: ' r 1-'INCHES [ABOVE / ELO EXISTING GRADE. TYPE: [PERCHED / ESTIMATED WET SEASON WATER TABLE ELEVATION: ;› INCHES [ ABOVE / BELOW ] EXISTING GRADE. HIGH WATER TABLE VEGETATION: [ ] YES [ ] NO MOTTLING: ( ] YES ( ] NO DEPTH: INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION: 3 6"INCHES DRAIMFIELD CONFIGURATION: [ ] TRENCH [ ( ] BED ( ] OTHER / (SPECIF D REMAFRS /ADDITIONAL CRITERIA: RepAlr Sw7 0 0 S) J,/e DATE: // J l Page 3 of 3 : :17 • c, . • ;.; zy.f , ; . . ' . ;:r; I • -;;.; : ;-„ • • 1 • • .;:3 a;:;?. • ' ■1: 2C3 :'; 70:7 !G yk;:.; fr.ofilcs ; cbr.aikr, tO dept;:l ...■;et 02 40!CM USF..)A 1;1,.;■/ :;1::-.;„5 if cvcil.zillo, 2cC n 7JNX" "i" the r::7'..:13 rd the c11; v..ztcr 7. tlic te...)11; • .. : . v` co • , f ;:f; .)„ .1.. STATE OF FLORIDA DEPARTMENT OF AND HA SERVICES �° APPLICATION FOR O NSITE SEWAGE HEALTH DISPOSAL RE SYST BI LITATI CONSTRUCTOON E PE RMIT Permit Application Number c1/ d 07 S Scale: Each block represents 5 feet and 1 inch = 50 feet. 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' A/O CP4,.Ier /9 tit 6 L Peel I r d,Je To 01'1 J 14)tfi1 1,).2).0)4 Site Plan submitted by: /T X) SIGNATURE Plan Approved e � Date By County Public Unit ALL CHAN M 6 UST BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT f HRS -H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) PART II - SITE PLAN (Stock Number. 5744 - 002- 4015 -6) Not Approved (Y' Page 2 of 3