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423 NE 92 StlUILDING LECTRICAL 'LUMBING Lot CONTRACTOR 45R MIAMI SHORES VILLAGE, FLORIDA DATE y i 194 7 Contractor's a License No. Work to be performed under this Permi PERMIT N° 5208 )wner of a luilding �' � t i�„+r.t. ` architect .' ontractor d A ,r Builder .-` v , .egal )escription Iddress of ; uilding This permit is grante t. the contractor or builder named above to construct the building or to install the equipment or device described in the appli- ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any dans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked t any time if the work is not done in compliance with such ordinances or if the plans arcs chariggd without authorization. A further condition upon which this ,ermit is granted is the understanding that the contractor or builder named above asses the fesporitibility , , +thorough knowledge of the ordinances and egulations pertaining to the work covered hereby whether shown on the plan s o;Aiw ecifications and that he assumes respon- ibility for work done by his agents, servants or employees. Bl. Subdi- vision Value of Project Signed I i / j O NSPECTOR By 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 .ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. n acceptiug,this permit assume responsibility for all work done by either myself, my agent, servant or employee. BY Amt. of Permit ... AUTHORITY MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 B ding Inspection Request Date Type Insp' n I 0 \fl) S� c, L nC Strip. r� � IO — Permit No. f�,,� Phone # Inspection Date Approved Correction Re- Insp'n Fee Name UJc Pr 1 Address 4- Na q2 64- i1 t�l Compan 0 Pr a MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Btxi, ding Inspection Request TypeInsp'n�la )5P l- tC, 9 LO Permit No. P( Date Phone # Inspection Date 44 Approved Correction Re- Insp'n Fee Name UJC IPy onon Address NE_ 2 Company 0 s.-iv C f s BUILDING ELECTRICAL a PLUMBING i Owner of Building PERMIT N° 5208 Work to be performed under Architect f' Contractor �,�� -�,�,� r s � or Builder id:A ° Legal Lot Description Address of - , if 4 Building 0 / CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE Bl. this Permit Subdi- vision Value of Project This permit is granted : the contractor or builder named above to construct the building or to install the equipment or . evice described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 pro,ffper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans chap without authOtization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above a�es ` espo#iibilit for thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on theplans or, �:. in thg_stat ien r specifications and that he assumes respon- sibility for work done by his agents, servants or employees. /INSPECTOR • In consideration of the issuance to me of this permit I agree to perform the wo(rlc co hereunde ed' r in compliance with all ordi nances and igltl ttirs pertaining r y : d in/strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities'bf Miami ShoresVillage. In accept) 1 ',� rm assumeresponsibil trfor all work done by either myself, my agrSat, servant or employee. Contractor's //License No Amt. of Permit simsworow By AUTHORITY 194 CONSTRUCTION PERMIT FOR: [ ]New System [ ]Existing System [ [ X ]Repair [ ]Abandonment APPLICANT: Walterman, Stanley PROPERTY STREET ADDRESS: 423 NE 92 St Miami FL 33138 LOT: 15 [Section /Township /Range /Parcel No.] PROPERTY ID #: 11- 3206 - 014 -0240 [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 [ 900 ]Gallons SEPTIC TANK MULTI- CHAMBERED /IN SERIES: [Y ] A [ 0 ]Gallons MULTI- CHAMBERED /IN SERIES: [Y ] N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ [0 ]DOSES PER 24 HRS # PUMPS[ 0 ] D [ 300 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ 0 ]SQUARE FEET SYSTEM A,-..,)TYPE SYSTEM: [ J STANDARD [ N ]FILLED I CONFIGURATION: [ 14 ] TRENCH [ ]BED N F LOCATION TO BENCHMARK: Existing Finished Floor Elev.: 11.60 Ft NGVD I ,;ELEVATION OF PROPOSED SYSTEM SITE [ 2.8 ] [ FEET ] [ BELOW] BENCHMARK /REFERENCE POINT E ,BOTTOM OF DRAINFIELD TO BE [ 5.3 ] [ FEET ] [ BELOW] BENCHMARK /REFERENCE POINT L D FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 30.0 ] INCHES OTHER REMARKS: 1. Install 300 sf of drainfield in bed comfiguration. 2. Existing 900 gal. septic tank to be inspected for an appropriate pump -out and a solid vertical deflector installed on the outlet device. 3. Existing 900 gal. septic tank has to remain. 4. Invert elevation of drainfield to be no less than 6.80' NGVD. 5. Bottom of drainfield elevation to be no less than 6.30' NGVD. THIS PERMIT IS NOT FOR AN ADDITION. SPECIFICATIONS BY: Andre, Paul APPROVED BY: Andre, Paul DATE ISSUED: 1/3/05 STATE OF FLORIDA DEPARTMENT OF HEALTH •ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT BLOCK: 50 SUBDIVISION: Miami Shores TITLE: DH 4016, 03/97 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 001 - 4016 -0) [ostds_cons_4016 -1] ]Holding Tank ] Temporary NA ] AGENT: SR0931119, COCKING MSTEPHEN TITLE: Professional Engin CENTRAX #: 13 -SG -23306 DATE PAID: FEE PAID : $ RECEIPT . O S TD3SN 2: 04-4256- -R U - Innovative Other [ N ]MOUND [ N ] [ N ] Dade CHD EXPIRATION DATE: 4/3/05 Page 1 of 2 cale: Each block represents 5 feet and 1 inch = 50 feet. ' It By STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION P g [>AIT Permit Application Number - `` r < ° f= PART II - SITE PLAN Site Plan submitted by: �' `— = -_ `._` Signature Not Approved Plan Approved 4 DH 4015. 10/96 (Replaces HRS-H Forte 4015 which may be used) (Stock Number: 5744402- 4015.6) ALL CHANGES APPROVED BY THE COUNTY HEALTH DEPARTMENT Title Date County Health Department Page 2 of 3