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1285 NE 95 St (7)
MIAMI' SHORES VILLAGE, FLA. JOB ADDRE INSPE6TION N9 5389 TIME READY REMARKS '')'(2-6 DATE Oillage of Miami Shores fOB ADDRESS I F INSPECTION TIME READY REMARKS L - ���� iz C ! INSPECTOR N? 4499 DATE - �� I , 1 1 1 . 1 1 1 1- ?LICANT: 3TRUCTION STATE OF PLORIDA DEPARTMENT OP HEALTH ONBITE BEWAGE AWDIPOBAL SYSTEM CONSTRUCTION INBPECTION AND FINAL APPROVAL S A O r7 C-� I n r', ?. . 1T: ..0 C" 054 4 -- AL, I, -)r ,' nn', )PERTY 'ADDRESS: 128°5 • N'tc t 95{'' St. M'6tt ' L'•. :3.313 5 • TANS INSTALLATION • ,] [01] TAN[ SIZE .[l 900 [2] )•. [02] TANK MATERIAL c.tr c 1 • [03] OUTLET DEVICE w/ 6 p., li/ 1 [04] MULTI CBAMSERBD [ / N ] [05) OUTLET FILTER 7,1-0 f [06] LEGEND. AST 1 3- 076 -ocl • [07) WATERTIGHT lb sa,c /s •( s Iv [08] LEVEL 2.35q .4. [09] DEPTH TO LID 4,20 " r fun ] • AREA (1) 25 5--' [ 2] [11]. DISTRIBUTION BOX [12] NUIBER OF DRAINLINES 6 Y 4 - -Fo o s ) [13] DRAINLINE SEPARATION 3X.1," [ ] [14] DRAINLINE SLOPE • . l [15] . DEPTH OF• COVER z1,.. "'6" b41 [ 16 ] .. 2:14 ATIQ,Iti IABOVEgaran 13/1_71_:02 .. [ 1 [17) . SYSTEM 'LOCATION [ ✓ 1 k DOSING PUMPS • 1 [19] • AGGREGATE SIZE , i/p $ DoT . ] [20] AGGREGATE EXCESSIVE FINES Oh' 1 [ 21 ] AGGREGATE DEPTH /2. ', FILL / EXCAVATION MATERIAL 1 [22] FILL' AMOUNT 1 [23] PILL .`t2 .9•: t , ,� f '?r t,: s: +,, z .: o �,. � . . �o�+n S• Sw +d 1 [24] EXCAVATION. 4ir /b. ] [25] AREA REPI:ACBD 7�� , 'sni7e��'oo¢ [A•' /] • 1 [ REPLBCEILJ1T L � A TSRI7IL 5? a" [ 4 ] • LANATION OF' VIOLATIONS ± j P RBMARR 1 45.2S tt /S'I /l CO 4 0 7 r /Nrn 14.fr•Ifttuti:•r.,.:77i 5, 40 b.og 1r c{m±V rrattih ap don ant nrr /sn„/,r /d. C: . 34 F ' 3S • BLpcK: 84 SUBDIVISIOIii: Kir T ' sA.0 -. Sec4i 3 .1/ 4;4 . s3 " :CSFD [X J ITE3LS ARE NOT IN COMPLIANCE WITS STATUTE OR RULE AND MUST BE CORRECTED. SETBACKS [ [ [29] [30] [ [32] [33 [34] [35] PROPERTY ID #: I I - 3u Ox. - 0121 • 4 12 ., SURFACE WATER DITCHES PRIVATE WELLS PUBLIC WELLS IRRIGATION WELLS • POTABLE WATER LINES z �„• .BUILDING. FOUNDATION •t'2o PROPERTY LINES j /7. s' OTHER FILLED / MOUND. SYSTEM [36] • DRAINFIELD COVER [37] • SHOULDERS [38] SLOPES [39] STABILIZATION PERMIT NO. • . 0 / - 0 4 / 6 , / DATE PAID: o? / ' ' J PEE PAID: ,G75. RECEIPT #: 5 rainy /Z ((2/ ADDITIONAL INFORMATION [49 . fl1O $TRu cutit [ 41 ]; BTORM WATER itbi OFl • [42) ALARMS o l( [43] MAINTENANCE 'AGREEMENT [44] BUILDING AREA [45] LOCATION' CONFORMS :FILTH °.SITE PLAN [ 48 ] OTHER 4 ,, /r [46] FINAL SITE GRADING (47] CONTRACTOR °' I -burs / ;,/ • FT FT FT FT FT ' FT FT FT FT ASANDONICENT . [49] 'TAN[ PUMPED [50] TANK CRUSHED & FILLED / / 2 'o valwitmifo4Ple re' r, .�'� >9.a M,D CND DATE: 0 /2 � BUILDING ELECTRICAL. PLUMBING HOOFING Owner of Building ".rchitect MIAMI SHORES VILLAGE, FLORIDA id/ p DATF 195 p PERMIT N® 3 916 Contractor's License No 0 ❑ Work to be performed under this Permit ontractor �r Builder egal Lot Description _ Bl a d dress of funding CONTACTOR OR BUILDER Subdi- vision Value of Project $ Amount of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application ierefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, uawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any ime if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is (ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations 'ertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work one by his agents, servants or employees. Signed. BY INSPECTOR 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. In ac- -opting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY 6.( BUILDING ELECTRICAL PLUMBING ROOFING DATE 195 ❑ PERMIT 11T° 4703 Contractor's License No. ❑ • . Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA B1 v Subdi- vision Value of Project $ Amount of Permit $ This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with 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 proper 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 are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed. BY INSPECTOR 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY Date Legal Description` 71(L, A I. Owner/Lessee / Tenant Owner's Address Contractin Co(� (� (.0 �S Qualifier CO( S ignature of owner and/or Condo President My Commission Expires: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE // Job Address / ,, /j Y < S 1 Tax Folio ((— .� . � ( �' d (� 7 a .�Q _ -Ii storically Designated: Yes No Master Permit # qg3 % /c f o K J Phone ° State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PL MB MEECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION � ""� rp___ fic2. - I s Date Phone // l �-- Address �� 6 7 , c,L o. 1)-? I eiL l 7� Square Ft. Estimated Cost (value) 9 'Y c7 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. 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. Furthermore, I authorize the above -named contractor to do the work stated. Signature of Contractor or Owner- Builder Date Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder Date My Commission Expires: FEES: PERMIT 6 ©� RADON C.C.F. / ° Si ) NOTARY °~ 0 BOND36 g ® APPROVED: TOTAL DUE Z/ °--* i Zoning Building Electrical Mechanical Plumbing Structural Engineer a Date V Job Address M s A./E- 9S STt . Tax Folio Legal Description e / ) 5/2 5e(/ `3 Historically Designated: Yes No Owner/Lessee / Tenant Owner's Address Phone g m ®t� � a b�a � 02 s' I . /0? 9k7 6 /3 t Conactin Co. �� Address Qualifier b',2/2 /5 j). &t/OC.•L ( -' Phone (365 State # eiCC C3 3 Municipal # Competency # Ins. Co. Architect/Engineer Bonding Company Address WORK DESCRIPTION ignature o wrier and/or Condo President No as to Owner y Commission E FEES: PERMIT APPROVED: Zoning Mechanical PERMIT APPLICATION FOR MIAMI SHORES VILLAGE RADON 112:7 Date N ■ °'r° , SUSAN.), NESENMAN AN COMMISSION # g603tA - tOF doe EXPIRES: Aug 3, 400 L 1- 8063NOTARY F14. wavy (Wm � ,.. ... _., .–. ...� -.... ..- �,....w��.... -.. _;zr� > %t: {sic;• C.C.F. Address Master Permit # Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL r' LUMBING F ECHANICAL ROOFING PAVING FENCE SIGN Square Ft. Estimated Cost (value) o 2S 1 60. ov ii- 3 6. -0 0 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 that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. \ as to Co y Commissio NOTARY Building Si ature . f Contractor or Owner- Builder — er §IJSAN J. NESENMAN MY WMMISSION # CC 860763 140 RXPIRES: Aug 4, 2003 105"9■0 f Way Service & Bonding Co Electrical BOND TOTAL DUE f 7 2 7/O/ Date Plumbing Structural Engineer Date PROPERTY ID #: /P DH 4016, STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATME CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: [M] New System ['-J ] Existing System ( .,1 Repair (A/ ] Abandonment APPLICANT: G C 4� iT , !I � ) osk PROPERTY ADDRESS: / c ii c 1 LOT: ,34 ) BLOCK: SUBDIVISION: 12/99 (Page 06 - 1 ®.z. O SYSTEM DESIGN AND SPECIFICATIONS tt - ).1.1 SYSTEM [ Holding Tank [AA Temporary 'S i r . R c T jL90 , [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 SAFTISFACTORY 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. 1 7E T (9Q' ] GALLONS / GPD SEPTIC TANI'AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN- SERIES [ 7] A [ ] GALLONS / GPD CAPACITY MULTI- CHAMBERED /IN- SERIES [ ] N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @ [ ] DOSES PER 24 HRS # PUMPS [ ] D (Z ® ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ STANARD (/.J1 FILLED [Al] MOUND [ xv _ I CONFIGURATION: [k] TRENCH [ r] BED [ N.Y N F LOCATION OF BENCHMARK: #1 AS r t J. t ( J a a �-� ? / U1 /-' ( I ELEVATION OF PROPOSED SYSTEM SITE [ .?. Z ] [INCHESL] [ABOVE /BtLa* BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ s¢.(t,,` 1 (jth /FT] (ABOVE/SEI ^ ] BENCHMARK /REFERENCE POINT L D FILL REQUIRED: 1 /) ft INCHES EXCAVATION REQUIRED: [ a © ] INCHES T 1° UBMIT BENCHMARK BEFORE B,NSPECTIM H THIS PERMlr is NOT FOR A0981104,1 E l Damn - EL VATt0 1 f I , R \ 1.8M2Vall tk DWASIMMLU (ALE SPECIFICATIONS BY: TITLE: APPROVED BY: _ p �^ -+� TITLE: �t e oc2 ��; • ► - DATE ISSUED: -Z1v,r(1) a o:J. • ..�� `eoS" 9 '• p 1: Health Department pt. 2: Applicant pt. 3: Installer /Contractor pt. 4: Building Department PERMIT NO. V / DATE PAID: .,5? _ 0 Z a 0 FEE PAID: RECEIPT #: j Ui n z: / - [ /]/ Innovative [•-4 EXPIRATION DATE: (� C1 Page 1 of 3 CHD INSTRUCTIONS: PERMIT NUMBER: Permit tracking number assigned by CPHU. CONSTRUCTION PERMIT 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: Property owner's legally authorized representative. 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. (CHD may require property appraiser ID # or section/township /range /parcel number) SYSTEM DESIGN AND SPECIFICATIONS: TANK: Minimum specifications from Chapter 64E-6, FAC. DRAINFIELD: Minimum specifications from Chapter 64E-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 Health Department (CHD) personnel reviewing and approving permit. DATE ISSUED: Date permit is issued by CHD 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. •'S r .. { • "!:413 •4• ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE (MOUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTCRS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS /ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS "HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER • SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELO, 4' TILE/RES. VIOLATION �P�� ABANDON SEPTIC �AAR - � REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE 'OOL PIPING _AWN SPRINKLER SYSTEM 3AS RANGE . AETER SET (GAS) 3AS PIPING (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL