PL-10-817 ., rt
Miami Shores Village M ' !I?I ItRP(11 IeS(C(et1
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 ���
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n Ex piration: 1108(2010
Ex p
Project Address Parcel Number Applicant
988 NE 93 Street 1132060350080
Miami Shores, FL Block: Lot: JOHN KREUZ
Owner Information Address Phone Cell
JOHN KREUZ 988 N. E. 93 ST.
Contractor(s) Phone Cell Phone Valuation: $ 3 ,200.00
MIA DADE E 786 - 251 -4099
Total Sq Feet: 200
Type of Work: DRAINFIELD Available Inspections:
Type of Piping: PLUMBING Inspection Type:
Additional Info: SEPTIC Final
Bond Return: Rough
Classification: Residential Landscaping
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type - Contractors Bond $300.00 Invoice # PL -5-10 -37852
CCF $2.40 05/12/2010 Check #: 2589 $ 459.40 $ 0.00
Education Surcharge $0.80
Permit Fee - Additions/Alterations $150.00 Bond #: 1967
Scanning Fee $3.00
Technology Fee $3.20
Total: $459.40
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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. Futhermors, I authorize the above -named contractor to do the work stated
May 12, 2010
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
May 12, 2010 1
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WSPZC �Jl'1 -PHONk NUIV,IBE 1 : (345 76 :4949
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FOL O PARCEL # -�
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Is B dmg Historically l�esi gn at g "
eld , I YES , , I NO Flood Zone
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State Certificate or Registration Noe Certifca of Competency No.
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Val of Worl��'� Fob this �! erxnitl $ � � � ' � � 1 5quar� 7 Ll earl? F o�alge 0
�T374 ri tural '�' f Work:
Add' Lion
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Str Review. T 'tal Fee Now Due $
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See Reverse side —�
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13onding Company's Name (if applicable)
II Bonding Company's Address
City State zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State zip
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.
I' "WARNING TO', YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
MPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND T BT
O 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 roved and a reinspection fee will be charged.
Signature Signa
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The fo going instnune t was acknowledged before me this
day of , 20 !D , by �5. Q c (Q/l( t'�., da of , 20 _, by 5��-
who is personally known tome or who has produced who is personally known to me or who has produced R—k o
As identification and who did take an oath. as identification and who did take an oath.
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NOTARY PUBLIC: NOTARY PUBLIC STATE OF FLORIDA NOTARY PUBLIC:
Jose Bolanos
Sig ,c Commission #DD603343 Sign:
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Print: �
P ND 1iRLJ �l'1� �9:�'BING Co., INC. Print: \ 1111 rrr �iii
My C sion Expires: 08 ( tO My Commission Expires: : '' . . '' q�/
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APPROVED BY �� ®� Plans Examiner Bonin
� � r J r r 111111111
Engineer Clerk checked
(Revised 07 /10 /07)(Revised 06/10/2009)
PERMIT # : 13 -SC- 1135417
STATE OF FLORIDA APPLICATION #: AP964596
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID:
SYSTEM
RECEIPT #:
DOCUMENT #: PR809705
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Desiree Ortiz
PROPERTY ADDRESS: 988 NE 93 St Miami, FL 33138
LOT: 8 BLOCK: Na SUBDIVISION: Magee & Hawkins
PROPERTY ID #: 11- 3206 -035 -0080 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.0065, F.S., AND CHAPTER 64E -6, F.A.C. DEPARTMENT 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.
ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 750 ] GALLONS / GPD Septic CAPACITY
A [ 0 ] GALLONS / GPD CAPACITY
N I 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS U ]DOSES PER 24 HRS #Pumps [ ]
D [ 200 J SQUARE FEET SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [x] TRENCH [ J BED [ ]
N
F LOCATION OF BENCHMARK: F ,F.E.: 12.0" NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 6.00 J[ INCHES FT ][ABOVE BELOW BENCHMARK /REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 34.00][ INCHES FT ] [ABOVE BELOW BENCHMARK /REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 28.00] INCHES
0 1- Existing 750 gal. septic tank certified by "Miami Dade Environmental' on 05/05/2010 to remain. 2- Install 200 sf of
drainfield in bed configuration. 3- Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed
T absorption bed. 4 -Invert elevation of drainfield to be no less than 9.66' NGVD 5. Bottom of drainfield elevation to be no less
H than 9.16' NGVD. -
E THIS PERMIT IS NOT FOR ADDITTION(s). P c
R UtAu
Vt7f't k;::,iTfl 11E�
SPECIF7DBY: TI BY: PEDRO N OSPINA TI
APPR TLE Dade CHD
ina
DATE ISSUED: 05/10/2010 EXPIRATION DATE: 08/08/2010
DH 4016, 10/97 (Previous Editions May Be Used) Page 1 of 3
v 1.1.4 AP964596 SE816626
T
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 142989 Permit Number: PL -5 -10 -817
Scheduled Inspection Date: May 14, 2010 Permit Type: Plumbing - Residential
Inspector: Hernandez, Rafael
Inspection Type: Final
Owner: KREUZ, JOHN Work Classification: Drainfield
Job Address: 988 NE 93 Street
Miami Shores, FL Phone Number
Parcel Number 1132060350080
Project: <NONE>
Contractor: MIAMI DADE ENVIROMENTAL Phone: 786- 251 -4099
Building Department Comments
Inspector Comments
Passed HRS APPROVAL IN FILE
Failed
Correction
q 1P
Needed 94
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
May 13, 2010 For Inspections please call: (305)762 -4949 Page 8 of 12
DIVISION OF
Environmental Health
• Florida Department of Health
Miami -Dade County Health Department
OSTDS /NN'ell Division
11805 SW 26 St. • Miami, FL 33175 J
( Date "2 <5 > z
Inspector
Address
G -3 OSTDS #
Comments:
Signature
�f`,.v-
O STATE OF FLORIDA
D PARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMI l & xli
Permit Application Number
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---------- - - - - -- — PART II -SITE PLAN---- - - -»=— - — ;=- -' - - --
Scale: Each block represents 5 feet and 1 inch = 0 feet. _
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Site Plan submitted by p - .., �c
ignature Title
Plan Approved ,, ° Not Approv d bate
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By ' / Z. ) County Health Department
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015,10/98 (Rep a= HWH Form 4015 rddch may be used)
(shat Number: 57"-002 401" Page 2 of 3
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