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PL-05-1067Permit Type: Plumbing - Residential Work Classification: Drainfield Job Address: 1207 92 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 Issue Date: 12/2/2005 Expires: 11/21/2006 Owner's Name: MARK & JESSICA WOHL Contractor(s) Phone STATEWIDE SEPTIC CONNECTION 305 - 661 - 6633 Primary Contractor Yes Type of Work: INSTALL NEW DRAINFIELD Type of Piping: Additional Info: 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 Bond Type - Contractors Bond CCF Education Surcharge Inspection Fee Permit Fee - Additions /Alterations Scanning Fee Technology Fee Total: Amount $300.00 $1.44 $0.48 $75.00 $100.00 $3.00 $4.40 $484.32 Finance Copy Parcel #: Block: Section: Permit Status: APPROVED Permit Number: PL -12 -05 -1067 Phone: 786- 522 -2000 1132050270310 Lot: PB: Total Square Feet: 400 Total Valuation: $ 2,400.00 Required Inspections Rough Landscaping Final me 0 5 PAID Invoice Number PL - 12 - 05 - 22849 Total: Amt Due $484.32 Amt Paid 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. BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Owner's Name (Fee Simple Titleholder) Q T €SS V r' W O(4hone # Owner's Address (Sq WA) City State Zip Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Contractor's Address 3 0 r-.0 it State 1 , City Qualifier Te(e.SQ cs�l e� reN $ Value of Work For this Permit Q 4 Type of Describe Work: ['Addition ❑Alteration \+ ( I Submittal Fee $ Notary $ 2 Training/Education Fee $ Scanning $ 3. 0° Radon $ Total Fee Now Due $ 84 so. (Continued on opposite side) Miami Shores Village Building Department Mi 10050 N.E.2nd Avenue, ami Shores, Florida 33138 Tel: 56.8972 t201 N 92 k NO V Permit No. aster Permit No. Phone # County Miami -Dade Zip 3313/ �So I :ho C ne Contractor's Company Name 5 t ids , � # ( S) G C 1- 6 6 3 1 ® Sv Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: L� ❑New Repair/Replace ❑ Demolition 7 � w *******************4.* * * *,Fees ** * * ** *** * * * ** * * * * * ** * *** Permit Fee $ 1 7 3 -5.° CCF $ 1 • 0 CO /CC Zoning Bond $ 3CCD 00 Code Enforcement $ Structural Plan Review. $ 2 S LLB )Q.j7 Mechanical Roofing (3cs)c Z -)9S 2- Zip "33023 Technology Fee $ 4 — 40 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip 4 Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 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 a roved and a reinspection fee will be charged. j .. Signatur 4q �� ' Signature / ' Owner or Agent Contractor The foregoing ' ent was acknowledged before me this d i The foregoing instrument was acknowledged before me this day of Nov , 20D', by ASS1 c o Join day of 20 by —, Y who is personally known to me or who has produced VI ci< As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: (. Sign: Print: My Commission Expires: who is personally known to me or who has produced Do v ° Cho 12/15/03 MY COP/ X410 4 A 9D250437 1- 800.3- NOTARY F(rtosiriirleates* . Qo * * * * * * * * * ** * ** * * * * * * ** State Certificate or Registration No. Certificate of Competency No. APPLICATION APPROVED BY: * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * ***— * *' ********************************* ** * * * * *** * * * * * * * * ** * * * * *** * **** Print: My Commission Expires: petency Holder) Engineer Zoning Zip *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 11 `2-7 - e::? Plans Examiner LOT: 19 BLOCK: 2 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: [ ]New System [ ]Existing System [ ]Holding Tank [ X ]Repair [ ]Abandonment [ ]Temporary APPLICANT: Feinberg, Joseph & Meredith AGENT: SA0021074, Solomon Teresa PROPERTY STREET ADDRESS: 1207 NE 92 St Miami Shores FL 33138 PROPERTY ID #: 11- 3205 - 027 -0310 SUBDIVISION: Bay Lure [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. SYSTEM DESIGN AND SPECIFICATIONS T [ 1050 ]Gallons SEPTIC TANK A [ 0 ]Gallons N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K [ 300 ]GALLONS DOSING TANK CAPACITY [ 67 ]GALLONS D [ 400 ]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 I ELEVATION OF PROPOSED SYSTEM SITE [ E BOTTOM OF DRAINFIELD TO BE EL.:8.00'NGVD 2.7 ] [ FEET ] [ BELOW]BENCHMARK /REFERENCE POINT 4.0 ] [ FEET ] [ BELOW]BENCHMARK /REFERENCE POINT L D FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 30.0 ] INCHES OTHER 1.f'Install 1050 ga category -3 septic tank equipped with an approved filter. 2.- a licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with sec. 64E- 6.013(3)(f), FAC 3.- Install 400 sf of drainfield in bed configuration. 4.- Invert elevation of drainfield to be no less than 4.50' NGVD. 5.- Bottom of drainfield elevation to be no less than 4.00' NGVD. THIS PERMIT IS NOT FOR " ADDITION(s)." SPECIFICATIONS BY: Andre, Paul APPROVED BY: Andre, Paul TITLE: DH 4016, 03/97 (Obsoletes previous editions which ma not be used) (Stock Number: 5744 - 001 - 4016 -0) tostas cons 4016 -1j CENTRAX #: 13 - - 26900 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 05 [ ] Innovative Other [ NA MULTI - CHAMBERED /IN SERIES: [Y ] MULTI - CHAMBERED /IN SERIES: [Y ] @ [ 6 ]DOSES PER 24 HRS # PUMPS[ 1 ] [ N ]MOUND [ N ] [ N TITLE: Professional Engin Dade CHD L DATE ISSUED: 10/21/05 EXPIRATION DATE: 1/19/06 Page 1 of 2 Issue Date: 12/2/2005 Expires: 11/21/2006 Owner's Name: MARK & JESSICA WOHL Permit Type: Plumbing - Residential Work Classification: Drainfield Job Address: 1207 92 Street NE 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 Contractor(s) Phone Primary Contractor STATEWIDE SEPTIC CONNECTION 305 -661 -6633 Yes Additional Information Type of Work: INSTALL NEW DRAINFIELD Type of Piping: Additional Info: 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 Bond Type - Contractors Bond CCF Education Surcharge Inspection Fee Permit Fee - Additions /Alterations Scanning Fee Technology Fee Total: Amount $300.00 $1.44 $0.48 $75.00 $100.00 $3.00 $4.40 $484.32 Building Department File Copy Applicant Signature Parcel #: Block: Section: Permit Status: APPROVED Permit Number: PL -12 -05 -1067 Phone: 786- 522 -2000 1132050270310 Lot PB: Total Square Feet: 400 Total Valuation: $ 2,400.00 Reauired Inspections Rough Landscaping Final ,DEC 0 5 PAID Invoice Number PL -12 -05 -22849 Total: Amt Due $484.32 Amt Paid 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.