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420 NE 92 St (6)
Applicant I . STATE OF FLORIDA ' DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT l eptic tank or r,> aerobic unit 1 w gallons Septic tank or aerobic unit gallons Graywater tank Laundry waste tank gallons Other Requirements: Ut Al e Permit Number ^ �-01> 2 Ae 5 RP- ` PART I - SYSTEM CONSTRUCTION SPECIFICATIONS AND CONSTRUCTION APPROVAL - -- gallons Treatment Tank Minimum Dralntrench OR Minimum Absorption Size Bed Size Grease interceptor gallons Square Feet 3 -7 8quere Feet Dosing tank gallons Square Feet Square Feet Square Feet Square Feet Square Feet Square Feet (a) Installation must be in accord with requirements of chapter 10D -6, FAC. (b) A system construction permit Is valid for a period of one calendar year from date of issue. (c) Final installation inspection and app v r uired before the system is covere p (d) Invert o 2) to be /� Invert of stub -out for benchmark. to be benchmark. Invert of stub-out for to be benchmark. Invert of stub -out for to be benchmark (e) Fill quality and quantity. System design and specifications Construction authorized by: Authority: Chapter 381, FS Chapter 10D-6, FAC County Public Health Unit 4ote: Completed copies of this form will be provided to the applicant, installer and the building department. AUDIT CONTROL NO 1085 f STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PER MIT Applicant Lo c S ZE z f" _ � Permit Number 3V Q - 2v / /7 PART 11 4 SYSTEM INSTALLATION INSPECTION AND FINAL INSTALLATION APPROVAL Installer ` - � .� A/6:a Tank Manufactured - o c ',, &LA Q.9/12, pp Propertank legend: Yes No Tank material Pl 6 €1k GL4S3Tank level: Yes No Tanks watertight: Yes No Proper tank outlet device: Yes p No Drainfleld Trench Length Wid th Length feet feet feet feet feet N feet feet feet feet Total = ft Total = Systems located as permitted: Yes No Inspected by: 6. A"` /i/ Date pproved by: Tank size HRS —H Form 4016, Jan 86 (Replaces Feb 85 edition which may be used) (Stock Number: 5744-002-4016-4) gallons gallons gallons Manhole or marker to grade: Yes ✓ No Absorption Bed Width feet Length feet x ..t= ft feet Proper No. drainlines: es _1/No .. 3C1. feet Proper pipe separation: Yes 1Vo ft Distribution box level: Yes No is Systems including plumbing stub -outs installed at proper elevation: Yes /No Average depth to drainpipe invert from finished grade: () M inches Maximum depth Inches 1 ij Average depth of drainfield gravel: I . z.._11 inches Minimum depth of gravel 1 inches Proper gravel size: Yes No / Grav I is suitable quality: Yes ✓ No required: Backfill or fill material as re Qualit Yes ( Y) Yes No (Quantity) es t No Other findings vim: _ _ � ; l -o : 1 L� C ___ Alb . L7 0 /7`roF" 61e45, Alg !, Al , J ' S 6t1/.5d6• / Pcc,' P T 101 a F0NAL 0 .!STALLATOOI I APPROVAL Length a feet x AV feet =43Z AN APPROVED INSTALLATION DOES N • "! 1_ NEE PERFORMANCE 7 t Date 7-^Z TY PUBLIC HEALTH UNIT Note: Completed copies of this form will be provided to the applica , installer and the building department. Page 2 of 2 - — - - GLOOQTO BATH TUDO SNOWQRO LAVA• YOR160 6"4" SLOP OINKO LAUPoDR Tug() URINALS CATCH ®Aa1 FLOOR DRAIN DRINKING FOUNT 'N/ TOTAL PIRTURCIO CONTR. LIOY CNQCK - - SCEPTIC TANK aQwaR Comm. DRAIN PI QLD 63OAKAG6 PIT GRQAOQ TRAP eoLAR HQATCER Dim %feu. SPRKLR. C3YOTQR7 aW)M'G POOL Cowrw. LIST Commix - V u Permit No ' cR 1A0G°Qk%0 SNJOO DES VOLLt' G PLUMBING INSPECTION DEPARTMENT aPPdOCATBOJ GOOD PLUMBING PERMIT State work to be performed and purpose of building (By F/ o) __._._ _•--- ___ -.- z 1�� Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other 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 °pacified or nag. A copy of approved plans and specifications must be kept at building during progress of work. Owne4 0 Name and Address Lett L4 i Registered Architect and /or Engineer Employing Flu ub r'o New t �Cel Location and Legal Description Lot. 9 Street and Number her work in to be performed -No 1/ 20 / 1 (-- {' No 220.-P-.6 New Building. _- ..._._._..- ..... ...... Remodeling___.._- ... —.__ Addition- .._.__-..__ Repairs No. of Stories Size Septic Tame -- _- ta..311 Type of Tank C. G ' - --- - - °- - • --- •--Capadty Fest of Drain Tile- _ Dent Feet of Tank at rain Field from Well .. ._._ Nature of Water Supply: City -WelL USG of Soakage Pit My Commission Amount of Permit 0 1 --1` ( S (Si Street._ - C/ 2 _6 Notary Public, State of Florida 9 Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat s as an employer of labor under the Florida Worlanen's Compensation Act, being Section 5986, Compiled General Laws of Florida Permanent Supplement, and her mm- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to 1s>: performed under this permit; and will poet or cause to be posted for inspection on the to of the work such public notice or notices an arc required by the Act. The undersigned agrees to employ only ouch sub-contra work to be performed undue jb1s_ermit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, Co. 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly antitteized to administer oaths and take acknowledgments, personally appeared to me well /mown, and who, being by me first duly sin, upon oath deposes and says that be is the .. .__._ .._ - - -•. -- _ _.... -. of the above described construction, that Its has carefully aged the god application, and that be did sign the same, and that all facto therein by him stated are true. NOTE: A re-inspection fee of OM will he scarla whce mak geemopearboa iii mede by hapropez satire for hupectios, or faulty moo onad /e?l Amount of Permit 6 M0 0 0 ©RES VDLLAGE APPLICATION MAR PLUMBING PERMIT Permit No.. • 1 -- ®ate.._.. — _- _ / C7 —. - - - - -.— PLUMBING INSPECTION DEPARTMENT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othee 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 ordlnanoeo of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, why haralu specified or rra't. A =spy of approved plans and speciflcxtlons must be kept at building during progress of work. Owner's Name and Address L©U Is L-e'- ZA 14 4 Registered Architect and /or Engineer ������ E�tployin6 Plurakes Ne o D(...) k c : 0 1��1- ) ra — l ®. ... � id�i : .. _... /Yt i c_. (_, -- Lacation and Legal Description Loo. 3 -i Subdivision , — Street and Number evhero work fa to be perform —No SC0 t )L a 1---- 61 - /titr ®et .._.. _ __ _ .._._. - -•.• - `k 2. t l d.a W State work to be performed and purpose of building (By Flaalro )__•---- •- �.--- �- P- 1 • - - -- — No ,t.,! 02 O A)-E- s treeL..�� • ?� S T. New Building- - - -..— — ... Remodeling__ —___ —__.__ Addition.. -- _ —.. -_ Repairs No. of Stories ........ Size Septic Tank Type of Tr nh Feat of Drain Tile. Diet. Feet of Torah Ca Dania Mead from Well .. ---__.------- • -.__ -- Nature of Water Supply: City —Well. Siva of Soakage Pit_ __--------- _ - - - - _ — .---- ... -.. 00Q. Zt ' S P e I iv_ (c -Ct,- _ ®o o ._.. ( - r/- �' Sissy. ��� _ Plumbing in nspector. Master Plumber. 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 5968, Compiled General Laws of Florida Permanent Supplement, and Ittiv com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the worir to be performed under this permit; and will post or cause to be posted' for inspection on the site . k such public notice or notices as are required by the Act. The undersigned age to employ only Gm& rub- ouatractore, k to • . perff under this permit, as are licensed by Miami Sharma Village. STATE OF FLORIDA. co. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly atalkaizetil to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly awn, upon oath deposes and says that he is the .- - _ .. .._ .._ ......_. -.. -.. _ _.... —._ of the above described construction, that hap corefr_i ssnd tlan foregoing application, and that be did sign the tame, and that all facto therein by hire stated are true. 4y Commission Espireo Notary Publo. State of Florida NOTE: A re-inspection fee C 01.00 will be whoa azb me.fiampeesdete seede'®s merry by Improper notice far inspection, es hart* naatCriala nand /ca woad CLODQ TD BATH Teo° SNOWQRO LAVA- Temao 01 SLOP Olago LAUNDR 'Noe URIPoALO CATCH SASIN FLOOR GRAIN D1IINKINO r OUNT'NS TOTAL PIATURao CoN . LIeT — CiHQCit GRAIN PIQLO 0 OAKA0Q PIT GRQADQ TRAP BOLAR NQATQR Oaten WaLL P;PRKLR. OYRTQM BV/IM'0 POOL SQPTIC TANK DaViaR COMM. Co 1TR. LIST CNacl Amount of Permit 6 M0 0 0 ©RES VDLLAGE APPLICATION MAR PLUMBING PERMIT Permit No.. • 1 -- ®ate.._.. — _- _ / C7 —. - - - - -.— PLUMBING INSPECTION DEPARTMENT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othee 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 ordlnanoeo of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, why haralu specified or rra't. A =spy of approved plans and speciflcxtlons must be kept at building during progress of work. Owner's Name and Address L©U Is L-e'- ZA 14 4 Registered Architect and /or Engineer ������ E�tployin6 Plurakes Ne o D(...) k c : 0 1��1- ) ra — l ®. ... � id�i : .. _... /Yt i c_. (_, -- Lacation and Legal Description Loo. 3 -i Subdivision , — Street and Number evhero work fa to be perform —No SC0 t )L a 1---- 61 - /titr ®et .._.. _ __ _ .._._. - -•.• - `k 2. t l d.a W State work to be performed and purpose of building (By Flaalro )__•---- •- �.--- �- P- 1 • - - -- — No ,t.,! 02 O A)-E- s treeL..�� • ?� S T. New Building- - - -..— — ... Remodeling__ —___ —__.__ Addition.. -- _ —.. -_ Repairs No. of Stories ........ Size Septic Tank Type of Tr nh Feat of Drain Tile. Diet. Feet of Torah Ca Dania Mead from Well .. ---__.------- • -.__ -- Nature of Water Supply: City —Well. Siva of Soakage Pit_ __--------- _ - - - - _ — .---- ... -.. 00Q. Zt ' S P e I iv_ (c -Ct,- _ ®o o ._.. ( - r/- �' Sissy. ��� _ Plumbing in nspector. Master Plumber. 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 5968, Compiled General Laws of Florida Permanent Supplement, and Ittiv com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the worir to be performed under this permit; and will post or cause to be posted' for inspection on the site . k such public notice or notices as are required by the Act. The undersigned age to employ only Gm& rub- ouatractore, k to • . perff under this permit, as are licensed by Miami Sharma Village. STATE OF FLORIDA. co. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly atalkaizetil to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly awn, upon oath deposes and says that he is the .- - _ .. .._ .._ ......_. -.. -.. _ _.... —._ of the above described construction, that hap corefr_i ssnd tlan foregoing application, and that be did sign the tame, and that all facto therein by hire stated are true. 4y Commission Espireo Notary Publo. State of Florida NOTE: A re-inspection fee C 01.00 will be whoa azb me.fiampeesdete seede'®s merry by Improper notice far inspection, es hart* naatCriala nand /ca woad I LSrERT 14 - OF ,--,:— N TO: 7 E ,r01 Tri-AN • - 5::::L,' ": IL ,i-t.11.0 r.;:) Uf 7•.--' 7 7:72'7: : I': DR ...: '...L i e21C-1114 5 • tl • Co!c„,