560 NE 95 St (7)MIAMI SHORES VILLAGE
BUILDING PEP / ART
305- 795 -2204
Building I Request
Date QI
Type Insp'n n Pe '
Permit No. PL cOO`t
Name /ea.
Address SCO , V6 9 S7
Company( / / o r
Phone# oOSr63s r28a9
Inspection Date
Approved
Correction
Re- Insp'n Fee
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 8/4/2004
Applicant: PATRICK/LESLY
Owner: CASTELLANOS
JOB ADDRESS: 560 NE 95
Parcel # 1132060140800
Plumbing Permit
Permit Number: PL2004 -224
CASTELLANOS
PATRICK/LESLY
ST
Contractor ALL PRO SEPTIC & SEWER INC Contractor's Address: 1531 NW 26 AVE
Local Phone: (305)635 -3002
Page 1 of 1
Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOT 5 BLK 55 LOT SIZE 50.000 X 129
Fees: Description Amount
FEE2004 -7900 Building Fee $175.00
FEE2004 -7901 CCF $1.80
FEE2004 -7902 Training and Education Fee $0.60
FEE2004 -7903 Technology Fee $4.37
FEE2004 -7904 Scanning Fee $6.00
FEE2004 -7905 Builders Bond $300.00
Total Fees: $487.77
Total Fees: $487.77
Total Receipts: $487.77
Permit Status: APPROVED Permit Expiration: 1/26/2005 Construction Value: $2,350.00
Work: REPAIR DRAIN -FIELD (BACK -YARD)
Signed: (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 accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Owner's Address sc o N€ • ct S
S-•—
City Fk" . (-S State
Contractor's Company Name
Contractor's Address 9 ' 0 D
City frk TA Isdc-r" State
Qualifier BA-P-Pf -e- le-eg
lit el
$ Value of Work For this Permit
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No. pi__ aooy --
PERMIT APPLICATION i M Permit No.
FBC 2001 1..r.
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
�
� ��5 ' hon # 00 415- 931
Owner's Name (Fee Simple Titleholder) e
Tenant/Lessee Name Phone #
Q S �-
Job Address (where the work is being done) 5C C) L c 15
City Miami Shores Village County Miami -Dade Zip 3 3 1 3
Is Building Historically Designated YES NO
pito Sopt; +-
State Certificate or Registration N 51-- 33)- Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
35O
ca
Submittal Fee $ Permit Fee $ /7 0
Notary $ Training/Education Fee $
Scanning $ C „ 0 () Radon $ Zoning
Zip
3313
Phone # (305) to
3 5 - 3 Ot 2_
Zip 3 31 a
Square Footage Of Work:
Type of Work: ❑Additi ❑Alteration ❑New CA Repair/Replace ❑ Demolition
Describe Work: R .-€ t — Fes- tO ( - l
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CCF $ CO /CC
Te nology Fee $ , 37
Bond $ 3 D 0 1
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite side)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
. Alba
Owner tent
The foregoing instrument was acknowledge• ore me this
Signature
day of , 20 _ , by
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY P LIC:
Sign: Q
Print: \i
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 05/13/03
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
Zip
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 properly is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the joh 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 a proved • i d a reinspection fee will be charged.
Signature \—
Contractor
The foregoing instrument was acknowledged before me this 0 c
day of �,(,,,(JL
2 0.)` , by hi IV :E i ,
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLICi
Sign: tg
�,�►�" .`"�, VANFSSA B RIOS Print: U Cil.11C, i K I r ' t 4501; ::!fie, VANESSA B. RIOa
tAMMfS310N 1 DD 28
2008
MY COMMISSION II DD 281326 s MY i�`
°t! * My Commission Expires: * * E X PIRES : January 14
i EXPIRES: January 14, 2008
e, Bonded Thru Budget Services
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ************************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Plans Examiner
Engineer
Zoning
CONSTRUCTION PERMIT FOR:
( <j) New System [HJ Existing System
[ /1 Repair (t ] Abandonment
APPLICANT:
PROPERTY STREET ADDRESS:
LOT:
PROPERTY ID #:
SYSTEM MUST BE CONSTRUCTED 'IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 1OD -6,
FAC. REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER
PERMITS EXPIRE ONE YEAR FROM THE DDAT OF
NOT GUARANTEE SATISFACTORY PERFO
FACTS WHICH SERVED AS A BASIS FOR IS
PERMIT APPLICATION. SUCH MODIFICATIONS
SYSTEM DESIGN AND SPECIFICATIONS
T [ 9 ] .,[GALLONS / GPD
A [ ) ? .[ GALLONS / " GP1
GALLONS GREASE
D
R
I
F
I
E
D FILL REQUIRED: [i_200(41 INCHES
r
1
; PECIFICATIONS BY: /A
IPPROVED BY:
)ATE ISSUED:
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE DISPOSAL SYSTEM
CONSTRUCTION PERMIT
Authority: Chapter 381, FS &
BLOCK:
SUBDIVISION:
( Holding Tank [ ] Temporary /Experimental
[� Other(Specify)
•
AGENT: (1 (1 p r'
[SECTION /TOWNSHIP /RANGE /PARCEL NUMBER)
' `r :.) 0 (OR TAX /D NUMBER]
SEP,TI TANK /,AERD .. UN,.-T'TY'
CAPACITY
INTERCEPTOR CAPACITY
[ ?(1 J J SQUARE FEET PRIMARY DRAINFIELD SYSTEM
[ -- -- J SQUARE FEET SYSTEM
TYPE SYSTEM: (A STANDARD ( L FILLED
CONFIGURATION: ( ) TRENCH ( -I BED
)H 4016, 10186 (Replaces HRS -H Form 4016 (page 1) which may be used)
Stock Number. 5744 - 001 - 4016 -0) Annliran4
PERMIT 0 O'/t ?-. { - ;
DATE PAID . '. - ? •) l
FEE PAID $ 0, -;k.)
RECEIPT 0 ta_ r) iJ 7? ;Oa
Chapter 10D -6, FAC i =} (.1 - (f 7 O I
CO t 3
EXCAVATION REQUREQUIRED: [ T ? ) INCHES
E\IS1 ALI L ..OF ST IGHTHIX T .",^ s ''D `,tai i
UNDER BOTTOM OF
TME OF HEALTH APPROVAL OF SYSTEM -,DOES
PERIOD OF TIME. ANY CHANGE IN MATERIAL
RMIT REQUIRE THE APPLICANT TO MODIFY THE
Y RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
TI- CHAMBERED /IN SERIES:[ ]
MULTI- CHAMBERED /IN SERIES:[ ]
[MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS]
GALLONS PER DOSE DOSING TANK CAPACITY DOSE .RATE [ 1 PER 24 HRS NO. OF PUMPS: [ ]
) MOUND [ )
)
LOCATION OF BENCHMARK: / i ' / fi tt F t; ' r b. ',
ELEVATION OF PROPOSED SYSTEM SITE [2`T0f(] [INCHES /FT) [ABOVE /BELOH BENCHMARK /REFERENCE POINT
BOTTOM OF DRAINFIELD TO BE [ `, -� ) [INCHES FT) (ABOVE /BELOW) BENCHMARK /REFERENCE POINT
• •
TITLE: U v t 1 i j r j CHD
EXPIRATION DATE: / 1 f ,
Page 1 of 2
4
Votes:
3y
•
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permit Application Number J
Scale: Each block represents 5 feet and 1 inch = 50 feet.
Site Plan submitted by:
plan Approved
1111S 11141Q /QrJ.■• U00 U C... m. a a._ .._ _ w
PART II - SITE PLAN
• •
Signature
Not Approved
!r 1 /...i
ALL CHAtGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
S-
t• 13t3
Title
Date x 2 ,'
County Health Department
rILDING
ECTRICAL
•UMBING
DOFING
wner of
!tiding
chitect
mtractor
Builder
gal
ascription
'dress of
ilding
Lot
❑ PERMIT N9 3309
MIAMI SHORES VILLAGE. FLORIDA
Work to be performed under this Permit
Bl
DATE ?» 1,1
195 t
Contractor's
License No. 7 f ''
Subdi-
vision
Value of Amount of
Project $ 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
refor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
*wings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
e 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
;rated is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
taining to the work covered hereby whether shown on the plans or drawings cr in the statements or specifications and that he assumes responsibility for work
ie 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
xtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
Aing this permit I assume responsibility for all work done by either, myself, my agent, seri or employee.
CONTRACTOR OR BUILDER BY AUTHORITY '