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SEPTIC TANK APPLICATIONS
JAMES B. ROSE President January 27, 1986 Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, Fl 33138 Gentlemen Please cancel permit #26422, dated December 10, 1985. The contrac- tor's name is Rose Septic Tank Co., Inc. The owner's name is Larry Pendleton and the address is 972 NE 93 Street. The job was cancelled. We would appreciate it if you would refund us the $52.50 permit fee. Yours truly Larry Senna 8295 N.W. 93rd :street • Miami, Florida Mailing Address: • P. 0. Box 344, Hialeah, Florida 33011 blg.0 PHONE: Dade 887 -5594 Dade 885 -9405 Broward 524 -1270 144 To Whom it May Concern: This is to certify that I am the owner of the property located at 972 N.E. 93rd Street, Miami Shores, Florida. I do herby certify that the installation of the electrical service complies with all applicable codes. I further certify that I will assume all responsibility for any and all problems that may result from this installation and hold Miami Shores Village harmless from any legal action. • i Sworn to and subscribed before me 'this, 1st day, 'of rJanuary, 1986. `.Gail Macdonald, 'Notary Public M' CO /MISSION Xi :S !SLY 4 1537 . E ;'NDSD THRLI GENERAL INSURANCE ANCE UND My Commission Expires: 7 5--.-/-7 STATE OF FLORID DEPARTMENT OF HEALTH AND IiEHA =PILOT ONSITE SEWAGE DISPOSAL SYST M CONSTRUCTION AND INSTALLATION PERMIT Applicant ZJtfy I/L PART 11 - SYSTEM INSTALLATION INSPECTION A Installer 1 j /3e1 3/Y2 '44w. C Proper tank legend: Yes_.— No Proper tank outlet device: Yes Length Width fee feet feet feet feet feet Total = ft Systems located Other findings: Inspected by: Tanks watertight: Yes 1 .-1\ - lo Tank size:I P Manhole or marker to grade: Yes Drainfield Trench as permitted: Yes No Systems including plumbing stub -outs installed at proper (elevation: Yes No I Average depth to drainpipe invert from finished grade _flinches Maximum depth Inches Average depth of drainfield gravel: 12 ' inches Mininium depth of gravel 11 " inches Proper gravel size: Yes _J No Gravel is suitable quality: Yes � No Backfill or fill material as required: (Quality) Yes �\ o (Quantity) Yes No s, I/4 4 ° J ° , Ie / ! Length 1Vidth feet _— feet Length feet x k 7 'et'4 2' `;' 21 3 / G p sJ syp re44 r✓ / / L � � /� ww, G c� r r- � G rh,- PART I11 - FIN L 'INSTALLATION APPROVAL 1S—H Form 4016, Feb 85 (Obsoletes previous editions which may not be used) )ck Number. 5744- 002- 4016 -0) Tan feet __ feet feet _— feet Total = _ ft k Manufacturer TIDE SERVDCES Permit Number 4 IFINAL NS AL f WAPPROVAL Tank material /der Tank level: Yes No gallons gallons gallons No Absorption Bed Length 2S° 1 9 feet x a 2. feet = t feet= ft Proper No. drainlines: Yes No Proper pipe separation: Yes No Distribution box level: Yes N v No Date 1/ 1) Date fr A pproved by ` . _ J b.6 AN APPROVED INSTA - TION D ES NOT GUARANTEE PERFORMANCE Note: Completed copies of this form will b provided 'to_ the applicant, installer and the building department. COUNTY UBLIC HEALTH UNIT Page 2 of 2 Amount of Permit $ d 9 o My Commission Erwin's) MIAMO SHORES VDU. G PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PWWMBBNO PER IT Permit No "[- 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 wi whether herein speed ad as snot. A Dopy of approved plans and specifications must be kept at building during progress of work. E S / E R • No _ � 2 -- Street.. VF Owners Name and Address Registered Architect and /or Engineer — Employing Plumber's Mane Location and Legal Description Lot Street and Number where work is to be performed —No — Street iY ' - 4 / 7 .... _. State work to be performed and purpose of building (By Floors)________ �.lt_8- . _ _ ° - - -. S Cl .... "..... ... _ i-.41 l a New Building..__.._ ._-- •--- ........._.. Remodeling____._ ._. —__ Addition.. ___ _..__ Repairs 11-. No. of Stories.... (Signed Size Septic Tank__ _Type of Tank Feet of Drain Tile Dist. Feet of Tank cat Drain Field from Well Nature of Water Supply: City —Wells of age Pit. Subdivision Capacity Plumbing Inspector. 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 5988, Compiled General Laws of Florida Permanent Supplement, and hay com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em.loyed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection an the site of the work . ublic notice or notices as as required by the Act. The undersigned agrees to employ only such nib - contractors, • ; • k to � under this permit, as are licensed by Miami Shores Village. Notary Public, State of Florida Master Plumber. STATE OF FLORIDA, i COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authariaed to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath depose) and says that he is the . - -. •_ -•. of the above described construction, that he has carefaally read the kregairss application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of BL.®® will be mode when mice todiespeet1on k mraido by improper notice for inspection, et faulty materials and/or workmanship. CLOSET S BATH TUaE SNOWtRS LAVA. Toms Smote SLOP &LINKS LAUNDRY T JOS URINAL[ CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FtETVRES CONTR. LIST CHECK eOLAR HEATER Cair WELL sPRKLR. SYSTEM BY/IM' G POOL I SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP COMM LIST I ! I CHECK Amount of Permit $ d 9 o My Commission Erwin's) MIAMO SHORES VDU. G PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PWWMBBNO PER IT Permit No "[- 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 wi whether herein speed ad as snot. A Dopy of approved plans and specifications must be kept at building during progress of work. E S / E R • No _ � 2 -- Street.. VF Owners Name and Address Registered Architect and /or Engineer — Employing Plumber's Mane Location and Legal Description Lot Street and Number where work is to be performed —No — Street iY ' - 4 / 7 .... _. State work to be performed and purpose of building (By Floors)________ �.lt_8- . _ _ ° - - -. S Cl .... "..... ... _ i-.41 l a New Building..__.._ ._-- •--- ........._.. Remodeling____._ ._. —__ Addition.. ___ _..__ Repairs 11-. No. of Stories.... (Signed Size Septic Tank__ _Type of Tank Feet of Drain Tile Dist. Feet of Tank cat Drain Field from Well Nature of Water Supply: City —Wells of age Pit. Subdivision Capacity Plumbing Inspector. 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 5988, Compiled General Laws of Florida Permanent Supplement, and hay com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em.loyed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection an the site of the work . ublic notice or notices as as required by the Act. The undersigned agrees to employ only such nib - contractors, • ; • k to � under this permit, as are licensed by Miami Shores Village. Notary Public, State of Florida Master Plumber. STATE OF FLORIDA, i COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authariaed to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath depose) and says that he is the . - -. •_ -•. of the above described construction, that he has carefaally read the kregairss application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of BL.®® will be mode when mice todiespeet1on k mraido by improper notice for inspection, et faulty materials and/or workmanship. Permit No "ql Bldg o Permit #26392 ; HRS Permit# A5584 Application is hereby made for the approval of the detailed statement of p an 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 Shares Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein spedf;ed or not. A copy of approved plans and specifications must be kept at building during progress of work. Larry Pendelton Owners Name and Address Registered Architect and /or Engineer Emplcyln; Pltunbar.s mum Rose Septic Tank Co. MIA SHORES VOii GE PLUMBING INSPECTION DEPARTMENT APPLUCATF4N FOR PLUMIW9© PERMIT pobo . So•x 344 Hialeah 381511' M�inn and Legal escription Lot. Z . atark Street r and Number D where work is to be performed -No 979 N F , 9 State work to be performed and purpose of building (By Floors) . Size Septic Tank STATE sgnly.nnrie�.a STATE OF FLORIDA, COUNTY OF DADE. Subdivision.ed"-' Streat Stream - -- - -.-... New Building.___ _ __.._.._........_ -- Remodeling_- _ Addition ..• - -X ___ -• -. -- Repairs Feet of Drain Tile Dist. Feet of Tank cc Drib Field from Well .. .__.____ Nature of Water Supply: City -Well. Size of Soakage Pit. 1 =POR, nhandorn Amount of Permit $ 52,„50 (Signed)_‘ (51 R10 g_ Street_21 L < ) AAA Notary Public, State lodda No. of Stories ........ Plumbing Inspector. 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 5986, Compiled General Laws of Florida Permanent Supplement, and has corn - plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worie to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub -contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorl::ed to , stor oaths and take acknowledgments, personally appeared to me well known, and who, being by me first d sworn, upon oath deb ems and says that he is the _ - .• .... ..•------ - -.... _ _...._. of the above described construction, that he carefully read the icier:gag application, and that he did sign the same, and that all facts therein Whin, stated *re true. u,o aY3 Vent, Stlit: of :Y: w pi]tf Commission Fn r;�,..1_ . Bonded Thn:Myy �� nc, NOTE: A re- inspection fee of $1. 0 will bo scads wine aaseb ge-le speedos in mede•neostanry by Improper notice for inspection, or faulty materials and/es worlananship. CLO[IITS BATH TUBS 6""" LAVA. TORIES SIN" SLOP SINKS LAI NDRY TJSS URINAL[ CATCH BASIN FLOOR DRAIN DRINK NO FOUNT'N[ TOTAL FUTURES CONTR. LIST CHECK _ SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR CUP HEATER NA ELL SPRKLR. SYSTEM SWIM'O POOL I ' CONTR. I ! LIST _r9 _9 �P� CHICK Permit No "ql Bldg o Permit #26392 ; HRS Permit# A5584 Application is hereby made for the approval of the detailed statement of p an 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 Shares Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein spedf;ed or not. A copy of approved plans and specifications must be kept at building during progress of work. Larry Pendelton Owners Name and Address Registered Architect and /or Engineer Emplcyln; Pltunbar.s mum Rose Septic Tank Co. MIA SHORES VOii GE PLUMBING INSPECTION DEPARTMENT APPLUCATF4N FOR PLUMIW9© PERMIT pobo . So•x 344 Hialeah 381511' M�inn and Legal escription Lot. Z . atark Street r and Number D where work is to be performed -No 979 N F , 9 State work to be performed and purpose of building (By Floors) . Size Septic Tank STATE sgnly.nnrie�.a STATE OF FLORIDA, COUNTY OF DADE. Subdivision.ed"-' Streat Stream - -- - -.-... New Building.___ _ __.._.._........_ -- Remodeling_- _ Addition ..• - -X ___ -• -. -- Repairs Feet of Drain Tile Dist. Feet of Tank cc Drib Field from Well .. .__.____ Nature of Water Supply: City -Well. Size of Soakage Pit. 1 =POR, nhandorn Amount of Permit $ 52,„50 (Signed)_‘ (51 R10 g_ Street_21 L < ) AAA Notary Public, State lodda No. of Stories ........ Plumbing Inspector. 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 5986, Compiled General Laws of Florida Permanent Supplement, and has corn - plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worie to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub -contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorl::ed to , stor oaths and take acknowledgments, personally appeared to me well known, and who, being by me first d sworn, upon oath deb ems and says that he is the _ - .• .... ..•------ - -.... _ _...._. of the above described construction, that he carefully read the icier:gag application, and that he did sign the same, and that all facts therein Whin, stated *re true. u,o aY3 Vent, Stlit: of :Y: w pi]tf Commission Fn r;�,..1_ . Bonded Thn:Myy �� nc, NOTE: A re- inspection fee of $1. 0 will bo scads wine aaseb ge-le speedos in mede•neostanry by Improper notice for inspection, or faulty materials and/es worlananship.