DRAINFIELDMiami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: PL2005 -161
Printed: 5/24/2005
Applicant: SAMUEL TAMAYO
Owner: TAMAYO SAMUEL
JOB ADDRESS: 160 NE 95 ST
Contractor A AMERICAN SEPTIC & PLUMBING INC Contractor's Address: 17027 W. DIXIE HWY
Local Phone: (305) 866 -5600
Parcel # 1132060132830
Signed: (INSPECTOR)
Plumbing Permit
Permit Status: APPROVED Permit Expiration: 11/19/2005 Construction Value: $2,400.00
Work: INSTALL NEW DRAINFIELD
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 6 & 7 BLK 21 LOT SIZE 100.000
Fees: Description Amount
FEE2005 -6487 Building Fee $175.00
FEE2005 -6488 CCF $1.80
FEE2005 -6510 Training and Education Fee $0.60
FEE2005 -6511 Technology Fee $4.37
FEE2005 -6512 Scanning Fee $3.00
FEE2005 -6513 Builders Bond $300.00
Total Fees: $484.77
Total Fees: $484.77
Total Receipts: $0.00
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical
Owner's Name (Fee Simple Titleholder) 5crn J e L TariQr,
Owner's Address c,00 NQ q t5 ST
City i Skc tPe State PL.
Tenant /Lessee Name
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
Contractor's Company Name f P\ w 1 can
Contractor's Address 2 `.55S Bi SG ( k/N1 CSI
rwi State FL
L�II` �i Q wo fN O Qird
City
Qualifier
State Certificate or Registration No.
Architect /Engineer's Name (if applicable) Ni A
$ Value of Work For this Permit 4 2 Lico
Type of Work: ['Addition
Describe Work:
Submittal Fee $
Notary $
Scanning $ .5.00
Code Enforcement $
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
_ o 0 ct 4-1
❑Alteration ❑New
\'4 alp
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Permit Fee $ 1"7 5
. (*on
Training /Education Fee $
County Miami -Dade
NO V
Radon $ Zoning
Structural Plan Review. $
Master Permit No.
Phone #
Zip 3313J
Phone #
■(.o q s STE T
Zip 331
Phone # C5 oS)(0f u -S600
Zip 33iaf
Certificate of Competency No.
Phone #
MAY
Square Footage Of Work: ,2Cu \ 50
g Repair /Replace
�.S u2,w 0srq, r, -R-el d .
Total Fee Now Due $ u s q'f l 4 ,W = 464;71— 0
(Continued on opposite side)
Permit No. F► 65- i
11- 32oG -bo13 -2 $3,
Mechanical Roofing
L +G -1 2i
► ScAoi-e5 Sec. Arid
❑ Demolition
CCF $ . �� CO /CC
Technology Fee $ 4'83
Bond $ .00
Bonding Company's Name (if applicable)
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. 1 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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
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 be approved and a reinspection fee will be charged.
Signature X
Owner or Agent
The foregoing instrument was acknowledged before me this
TrTakiNC81105 01-1
MY COMMISSION #ntj 52(
n� • ots ' n,: • if c g a I U04JITB
6 i
. rtt ARY FL Notary Disco u ' 2
day of
who is pers
NOTARY
Sign:
Print:
My Commission Expires:
***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 05/13/03
*
17
take an oath.
t �d
'
Signature
day of 1: a 1 0 J 1 Y L
Contractor
The foregoing instrument was acknowledged before me this B
o ►Trfertfr,SAhb liiABaked
�, tF r'v ( n.nlVSSION # 00250437
Antifcation,and,:w,hg ¢ tak
OF �
.1 - 800.3- NOTAY FL. Notary Discount Assoc. Co.
who is personal(
NOTARY PUBLI
Sign: ' • • 4 0 1 �.
Print:
My Commission Expires:
an oath.
***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Plans Examiner
Engineer
Zoning
CONSTRUCTION PERMIT FOR:
[ ]New System [ ]Existing System [ ]Holding Tank [ ] Innovative Other
[ X ]Repair [ ]Abandonment [ ]Temporary [ NA ]
APPLICANT: Tamaya, Samuel & Teresa AGENT: SR0001342, Woodard William
PROPERTY STREET ADDRESS: 160 NE 95 St Miami Shores FL 33138
LOT: 6
[Section /Township /Range /Parcel No.]
PROPERTY ID #: 11- 3206 - 013 -2830 [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 [ 750 ]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 [ 150 ]SQUARE FEET PRIMARY DRAINFIELD
R [ 0 ] SQUARE FEET
A TYPE SYSTEM: [ ]STANDARD
I CONFIGURATION: [ . JTRENCH
N
F LOCATION TO BENCHMARK: FE: 12.1' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 1.5 ] [ FEET ] [ BELOW BENCHMARK /REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 4.0 ] [ FEET ] [ BELOW BENCHMARK /REFERENCE POINT
L
D FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 30.0 ] INCHES
OTHER REMARKS:
THIS PERMIT IS NOT FOR ADDITION(s).
SPECIFICATIONS BY: Andr -, Pau TITLE:
APPROVED BY: Andre, Paul TITLE: Professional Engin
DATE ISSUED: 5/20/05
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
BLOCK: 21 SUBDIVISION: Miami Shores Sec
DH 4016, 03/97 (Obsoletes previous editions wh' h may not be used)
(Stock Number: 5744- 001 - 4016 -0) [oatda cons 4016-
CENTRAX #: 13 -SG -25124
DATE PAID:
FEE PAID : $
RECEIPT .
OSTDSNBR : 05 -1711- -R
SYSTEM
SYSTEM
[ N ]FILLED [ N ]MOUND [ N ]
[ N ]BED [ N ]
1. Install 150 sf of drainfield in trench configuration.
2. Existing 750 gal. septic tank has to remain.
3. Existing 750 gal. septic tank to be inspected for an appropriate pump -out and a solid
vertical deflector installed on the outlet device.
4. Invert elevation of drainfield to be no less than 8.60' NGVD.
5. Bottom of drainfield elevation to be no less than 8.10' NGVD.
Dade CHD
EXPIRATION DATE: 8/18/05
Page 1 of 2
Scale: Each block represents 5 feet and 1 inch = 50 feet.
Notes: TO v-y)
• Site Plan submitt
Plan Approved
By
APPLICATION FOB ONSItE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT,-
Permit Application Number ' ' �•' "
6 Igo NAEr c5 o 33138
DH 4015. 10/96 (Replaces HRS-H Forth 4015 which may be used)
(Stock Number: 5744 - 002-4015 -6)
STATE OF FLORIDA
DEPARTMENT OF HEALTH
Signature
Not Approved
51111,E S
ALL CHAN S MUS ' BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
PART II - SITE PLAN 9
��� f r' `
i c ,b a� tra '°' µ s �c�+c�
d 0+ x.214
Title
Date
County Health Department
Page 2 of 3
, 2,41 CeAk
MIAMI SHORES VILLAGE 111/
InSt ING DEPARTMENT /OS
305- 795 -2204
Building Inspection Request
Date W 21
Type Insp' n ( I IcnciD rc
Permit No. P U 3 _I CO
Name I l,.k v t' c— l)
Address 1 () SSA—
Company fA J CFN
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
13.+ 2005 15:11 3055133472
•
PROPERTY ADDF.Es8 t /4 D A. C 4?C 5 7
LOT: .. ( ; . BLOCK: 2 i SUJDDIVISION: eh., A *
_1�'� � li.+: Cl � r�-c. PROM ID I�; � �- 7aC (y Q 7 ��3 e
=as:muawleaa=sa=aa>sesams • aa+.+e= .ssaas= LL. anemommam =myyulft... ..msewar..=
I! IN COMPLIANCE NITS 6TATthrx OR RULE AND MUST BE COlmCTED.
1 --- � J — (21 ( ] /27] smarm= ttAINR FT
1 ( ] DZTCloga PT
[ ] [14 ] PRIVATIt W LL rs
IND( /( 1 1 1
^ [ l
RA, r. ( 1
[ 1
=BONED [Y] ITF91S ARE No
-o -mt> =sue=
1
1
]
3
1
1
1
3
1
l
EXPLANATxolJ OF VIOLATIONS / REMARKS:
[ 1
CONSTRUCTION
STATE O:
DEPART1ta
MITE
CONSTRI
TANN INSTALLATION
(01] sec U Z . ( .
(02] TANK MATERS.
L0] CUTLET D$'VEt
[0R] 1RJLTI - c7LI GU
(05] OUTLET PILTT
[06) LEGEND
[07 ] WATERTXGBT
[08] LEVEL /;
(09] DEPTH TO LIX
FLORIDA
'IT OF REALT
SWAGE TREATMENT AND DIPOt1AL SYSTEM
Mu INSPECTION AND P][NAL APPROVAL
G
(APPROVED/Di APPROVED] 1 `-J
=AIRFIE[oD INSTALL :TICK
AREA [ 1 ] .,5 .
f ��2 ] ir $ BUT 15_(J [ Ai )
DISTRIBUTION 1:o2 " �R ✓ . [) ]
NUMBER of DM tlltLINSS I [ 1
mamma SE /RATION -3.,s4 ST
( eel
DRAINL ?AID! SL WE
DEP=OFCOVR rr
ZIZVATsox [A OVE t .}- 4f - 2 (
SYSTEM LOCAT ON
DOSING PUMPS o
AGGREGATE SI: E J")q
AGOENOATE Ex' E33IVE map
AGGREGATE DES TA
PILL / EXCAVATION 1 11TLRIA.'a
(21] PILL AMOUNT 11
[23] FILL TEXTURE
[24) EXCAVATION DI ?TV!
(2S) AREA REPLACE/ J
(263 REPLACE/OW 1 ATTBRIAL 1 j 141 � ?�.., �-�
OSTDS
1
3
1
1
- 3
1
1
FINAL 8Y3TEM [APPROVER D'I APPROOV3D) f •..
DE 4016, 10/97 (Previous : ditioa* May Be Used]
APPLICANT
PIA"
PERMIT NO.
RATS PAID;
FIE PA/Ds
RECEIPT #t
*am
[ PUULIC MELLO _ FT
[31] IRRIOATIos 1J L$ PT
(32] POTABLE MATER LIMES PT
(3]) BUILDING ?0 x01 5 ..� PT
[ (1 PROPERTY L1NE8 /, FT
(35] OMER Pr
FILLED / MOUND SYSTEM(
[34 ] GRAXD1PXALD COVER
[37] SHOULDERS
[38 ] SLOPES
[39] STABILISATION
ADDITIONAL INFORUMT=ORi
1 UNOBSTRUCTED AREA
/61) STORUWATE RUNOFF
[42) ALARMS
[ 43) *UNMAN= uc AGREEMENT
[44] Z8UILDIATr ARRA
'14S) LOCATION CONFORMS WITS SITE PLAN
[46] FINAL SITE GRADING
[47 ] CO1r1I R1ACTOR 4 A v ., A c' c
[ 44) OTEEbt.
ABANDONMENT
1 ( 491 TAUT Pt3WW _ J /.
(501 TAN CROWED 4 FILLED
ArNI7cd
V' 1: Appilcan;
rr ^: IrstAVIVlContrar..: r
PT :4: Budding r.)C6 :IrUlHr11
FAT 4: f k4 4t' <7"pa^rrar11
PAGE 08
4
CJ -.1?l/
.5 r
y,s �:5 l Stcv
DATE s S 5
}sago 2 of 3
MIAMI SHORES VILLAGE. FLORIDA
;UILDING ❑
:LECTRICAL ❑ DATE i : 195_4_
PERMIT N?
'LUMBING Q e 9510 Contractor's
License No
GOOFING ❑
❑ Work to be performed under this Permit
wwner of
3uilding
lrchitect
: ontractor
,r Builder
,egal
)escription
address of
wilding
Lot
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
erefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
rawings, 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.
r„ accepting this permit I assume responsib jity fo all work done by either, myself, my agent,,servant or employee.
i
CONTRACTOR OR BUILDER
Bl.
Subdi-
vision
Sq. Ft
Value of
Project $
Amt. of °r
Permit $ ,
BY AUTHORITY