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425 NE 93 St (9)Permit No 3 Application is hereby made for the approval of the detailed statement of the lans and p specifications herewith submitted for the building or ether structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address 4 / 0 25 - . 1141,9 to Registered Architect and /or Eng r ___________________.__ Employing Plumber's Name __� Street and Number where work is to be performed —No New Building Remodeling_ Septic Tank_.- --_-- __ -. -- Feet of Drain 'ice____ -- Amount of Permit STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Location and Legal Description Lot Block State work to be performed and purpose of building (By Floors) _ Addition Nature of Water Supply: City— Well._ -- _ _ ...... _________.-- ..... -._____- -._Size of Soakage Pit No.___= L________ Street Street (Signed)_ • �r _ —_ - - -- Street: ___ � yp�� -- - -- - - - -- - -- - -•- -- -- - - -- Capacity Gals.... st. Seto ank or ain Field from Well M Commissio Expires Notary Public, State of Florida Repairs -- -- • -._ -' -. -- -- _ - -- No. of Stories... ____ _ Plumbing Ins The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and bus com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed b I ' n in t . Nork t performed under this permit; and will post or cause to be posted' for inspection on the site of the work such pu required by the Act. The undersigned agrees to employ only such sub - contractors, on work perfo licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall • appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. CLOSRe BATH TUBS SHOWER! LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBE U CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHICK —^ SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST — __ CHICK Permit No 3 Application is hereby made for the approval of the detailed statement of the lans and p specifications herewith submitted for the building or ether structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address 4 / 0 25 - . 1141,9 to Registered Architect and /or Eng r ___________________.__ Employing Plumber's Name __� Street and Number where work is to be performed —No New Building Remodeling_ Septic Tank_.- --_-- __ -. -- Feet of Drain 'ice____ -- Amount of Permit STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Location and Legal Description Lot Block State work to be performed and purpose of building (By Floors) _ Addition Nature of Water Supply: City— Well._ -- _ _ ...... _________.-- ..... -._____- -._Size of Soakage Pit No.___= L________ Street Street (Signed)_ • �r _ —_ - - -- Street: ___ � yp�� -- - -- - - - -- - -- - -•- -- -- - - -- Capacity Gals.... st. Seto ank or ain Field from Well M Commissio Expires Notary Public, State of Florida Repairs -- -- • -._ -' -. -- -- _ - -- No. of Stories... ____ _ Plumbing Ins The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and bus com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed b I ' n in t . Nork t performed under this permit; and will post or cause to be posted' for inspection on the site of the work such pu required by the Act. The undersigned agrees to employ only such sub - contractors, on work perfo licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall • appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. MIAMI SHORES VILLAGE, FLA. JOB 17409 7 #3 m r - ADDRESS ¢ 2,I N ` `-' INSPECTION S J TIME READY 7 r 6 REMARKS : INSPECTOR_ N° 6250 3 re: DATE Date / 29 / 94 Legal Description Square Ft. 300 SQ FT APPROVED: of owner Zoning PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address 425 NE 93 STREET Owner / Lessee / Tenant SHIFRIN Owner's Address 425 NE 93 STREET, MIAMI SHORES 33138 Phone 759 -5098 Contracting Co. NORTH DADE SEPTIC TANK Address 800 NW 111 STREET, 33168 Qualifier DENNIS NEVILLE SS# 267 - 94 - 6375 Phone 751 -7676 State # 025836 -8 Municipal # Competency #12842 Ins.Co. TRAVELERS & ESIF Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 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 permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and { nt all work will be done in compliance with all applicable laws regulating n and •ping. Fur, ermore�,'I authorize the above -named contractor.to do the work state d. Signature Date: Notary as to Own an /or Condo President My Con1ission Exbi es: — .tdb7ARY PUSL1C; SLATE :•f ILMIDA aT IXIC MY COMMISSIOra f. +:2E'..C!Nt 1 13:3 ** * * * E ONDEk THi.0 H:; :QED <: FEES: PERMIT and /or C do President INSTALL DRAINFIELD \ LL ( C' ,4 RADON C.C.F. Mechanical Fire Other Building Plumbing Tax Folio Estimated Cost(value) $1200.00 Master Permit # 37A-2() con io r`, Sig,. ' of Co tra or or Owner- Date. Lisa ;otar to 96 ly C �mmission( E 1.. ('.k :`er fractor or Owner- Builder pires: NOTARY PWLJC; STATE OF FLORIDA AT LARC MY COMMISSION EXPIRES JUNE*19, 1999 * ** * 111ONI0ED MAU NUCH*ESERRT R A330ClATE3 / l'iu NOTARY TOTAL DUE ' 1 . Electrical e ngineering Notes: Scale: Each block represents 5 feet and 1 inch = 50 feet II I �l 1 1 �— 1 I �� 1 1 11 , _ I I _ . _ _ I I . 1 t tt 11 11 � I I I1 1J 1 ' I I 11 1 I 1� 1 I I ., 1 I. 1- I - I - I 1 I _ 1 1 4 1 1 I 1 1 I ! Ii ! _ �1 L. I_ 1 1 J J I I I 1 I 1 1 I � - I I I _i 1_ 1 i . 1J . I I ! T I 1 1 1 1 !! �. 1_ 1 III I I _ 1 1 1 I I � _ 1 1 ;11I I I T _ -L' i 1 1 I 11 IL_ F ' lI . , i ' 1� 1 -17 I 1 . I _I I t 1 _ I_ I I L_ I I I 1 II i I I ■ I F I I' I I _ I I I ..�, 11' L 1'1 I t� t I I I I J I I ' '1 ' 1 -1_ . 1 I t 1 ` H H 1 . I � 1 1 1 t I i_ I I 1 1 j ) _I ' _ _ 1 1 1 1 1 .1 _L_ I.1 I i- I I _I. I__I_ 11 I_? 1 1 I -_ i 1 , I I .. I 9 Cif0�• ' ' 11 ! _1 11 I _ , 1 11 L . _ -- i I — 1,\ ' 1 ' 1 1H I I 1 . I , 1 _4 1_1 1 1 ' LI 1__, I_i1 1 I_i 1 1.1 I I H 1 '1 1 '_ 1 I JIM I I I , - 1 i - i ! -i - I I L l l 1 1_1.1 i l 111 III11 1 STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number '" "c D (4) Site Plan submitted by PART II - SITE PLAN 1 L i_ 1 i 1 1 1 1 1 1 - 1 1' 1 j_ I � 11 III I 1 I i Li �.1 1T_1: 1 1 1 1 1 1 � 1 i1 1 I ii 1 1 I I 11_' 11�II1.1_1 11 11 11 ;11i[`f 11 tilm-ififtii1tf,', 1 ;If� 1 11 1t41 ;tt'1II ` 'i AUDY SHIFRIN: 425 NE 93 STREET, 3313€ OLD SYSTET•I 3VER:FL©OINO. St-PTXv :TAW: WAS PIMPED OUT; 9/19/ !,- PdaL13CTIOii DEVIV, WAS IiigTALLD. S lefURE - TITLE f Plan Approved : I` Not Approved Date `e/ ° `? /; I By (� 1y' \i i ` , �°`°� (- = I v• .:.:3/) A I. '� j c °. County Public Unit U \ •_ ALL CHANGES MUST BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT HRS -H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744-002-4015-6) Page 2 of 3 APPLICANT: PROPERTY STREET ADDRESS: e ;r !; + (� j. LOT: BLOCK: ( d SUBDIVISION: Y C PROPERTY ID #: SYSTEM DESIGN AND SPECIFICATIONS SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC r • HRS-H Form 4016, Mar 92 (Obsoletes previous editions which may not be (Stock Number: 5744- 001-4016 - 0) s TITLE: 41 - 10ii APPLICANT d ai PERMIT # r' p'= - i ; DATE PAID c'; ...2 r FEE PAID $ RECEIPT # AGENT: ( i 1- [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] CONSTRUCTION PERMIT FOR: [ps ] New System CJ Existing System [ /.J Holding Tank [ ] Temporary/Experimenta)1- [g ] Repair [ y'J ] Abandonment [4/) Other(Specify) SYSTEM 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 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. T [' 1 rt;fl [GALLONS / GPD] SEPTIC TANK /AEROBIC UNIT CAPACITY MULTI— CHAMBERED /IN SERIES:( ] A [ ----• ] [GALLONS / GPD] CAPACITY MULTI— CHAMBERED /IN SERIES:[ ] N [ _as ] 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 [ Is ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ -• ] SQUARE FEET SYSTEM A TYPE SYSTEM: [° ] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [../ BED [ ] N F LOCATION OF BENCHMARK: (..)/A I ELEVATION OF PROPOSED SYSTEM SITE [lit ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 6 ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT L D FILL REQUIRED: 1,004/„.] INCHES EXCAVATION REQUIRED: [ ] INCHES TITLE: , a " CPHU EXPIRATION DATE: r Page 1 of 2 INSTRUCTIONS: PERMIT NUMBER: Permit tracking number assigned by CPHU. APPLICATION FOR: Check type of permit, if 'Other' specify type in blank. APPLICANT: Property owner's full name. TELEPHONE: Telephone number for applicant or agent. AGENT. Prciarty oe:ner'e legally authorized reprePntarive MAILING ADDRESS: P.O. box or street mailing address for applicant or agent. LOT, BLOCK, SUBDIVISION or PROPERTY ID#: 27 character id number for property. (CPHU may require property appraiser ID k or section/township /range /parcel number) SYSTEM DESIGN AND SPECIFICATIONS: TANK: Minimum specifications from Chapter 1OD-6, FAC. DRAINFIELD: Minimum specifications from Chapter IOD-6, FAC. OTHER: Other specifications, such as operating permit requirements, low - volume flush toilets, variance provisos. SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be sealed. APPROVED BY: County Public Health Unit (CPHU) personnel reviewing and approving permit. DATE ISSUED: Date permit is issued by CPHU. EXPIRATION DATE: One year from date issued if the system has not been installed. Permits for system repairs become void 90 days from the date issued. APPLICATION FOR: [N ] New System [ 4 Existing System [N ] Holding Tank [ Nj Temporary /Experimenta3' [1 ] ]Fepair [ 4 Abandonment [N ] Other(Specify) APPLICANT: SHRIFRIN AGENT: 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: PROPERTY ID #: PROPERTY SIZE: PROPERTY STREET ADDRESS: 425 NE 93 STREET, 33138 DIRECTIONS TO PROPERTY: BUILDING INFORMATION Unit Type of No. of No Establishment Bedrooms 1 2 3 4 SFR STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 1OD -6, FAC NORTH DADE SEPTIC TANK BLOCK: 800 NW 111 STREET [:y] Garbage Grinders /Dispos 4s N [ r ] Ultra -low Volume Plus Toilets � V APPLICANT'S SIGNATURE: SUBDIVISION: ACRES [Sqft /43560] PROPERTY WATER SUPPLY: [ ] PRIVATE [x] PUBLIC [XXJ RESIDENTIAL [ ] COMMERCIAL 3 BEDROOMS DATE OF SUBDIVISION. [Section /Township /Range /Parcel No.] ZONING: Building # Persons Area Saft Served ] Spas(Hot Tubs her (Spec HRS -H Form 4015, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 001 - 4015 -1) );°41 1/-6R3 6 Y0 PERMIT # DATE PAID /Z / FEE PAID $ RECEIPT # TELEPHONE: 759 -5098 754 -3375 Business Activity For Commercial Only • [ N] Floor /Equipment Drains DATE: 12/29/94 a Page 1 of 3 - . ....... ttc 7:11 cc • ". Ps r.'.1 r - :• t