705 NE 95 St (11)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Buil+ing Inspection Request \r
Date
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
Type Insp'n (, ` (�
Permit No. `P90 ✓- -15
Name hc—INL
Address - ?(Y5 ) ��
Company 12C/1' v '
APPLICANT: Arkin, Burt & Marilyn AGENT: SR091112,
PROPERTY STREET ADDRESS:705 NE 95 St Miami Shores FL 33138
LOT: 10
[14]
[15]
[16]
[17]
[18]
[19]
[20]
[21]
4.4 SY4:^TE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
BLOCK: 68
PROPERTY ID #: 11- 3206 - 014 -2120
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH CHAPTER 64E -6, FLORIDA ADMINISTRATIVE CODE.
TANK INSTALLATION
[01] TANK SIZE [1] 750 [2]
[02] TANK MATERIAL Concrete
[03] OUTLET DEVICE
[04] MULTI- CHAMBERS
[05] LEGEND N/A
[06] WATERTIGHT
[07] LEVEL
[08] DEPTH OF LID
DRAINFIELD INSTALLATION
[09] AREA [1] 172 [2] 0
[10] DISTRIBUTION BOX /HEADER
[11] NUMBER OF DRAINLINES 8
[12] DRAINLINE SEPARATION
[13] DRAINLINE SLOPE
DEPTH OF COVER
SYSTEM ELEVATION
SYSTEM LOCATION
DOSING PUMPS 0
AGGREGATE SIZE
AGGREGATE SOURCE
AGGREGATE WASHED
AGGREGATE DEPTH
FILL /EXCAVATION MATERIAL
[22] FILL AMOUNT
[23] FILL TEXTURE
[24] EXCAVATION DEPTH
[25] EXCAVATION AREA
[26] REPLACEMENT MATERIAL
CONSTRUCTION [ APPROVED
FINAL SYSTEM [ APPROVED
SUBDIVISION: Miami Shores Sec 3
[Section /Township /Range /Parcel No.]
[OR TAX ID NUMBER]
4.4
] Cave, Ronald
] Cave, Ronald
DH 4016, 03/97 (Obsoletes previous editions which may not be used)
(Stock Number: 5744- 002- 4016 -4) [ostds_cine_4o16 -2]
SETBACKS
[27] SURFACE WATER
[28] DITCHES
[29] PRIVATE WELLS
[30] PUBLIC WELLS
[31] IRRIGATION WELLS
[32] POTABLE WATER LINES
[33] BUILDING FOUNDATION
[34] PROPERTY LINES
[35] OTHER
W
FILLED /MOUND SYSTEM
[36] DRAINFIELD COVER
[37] SHOULDERS
[38] SLOPES
[39] STABILIZATION MATERIAL
ABANDONMENT
] [49] TANK PUMPED 3/22/05
] [50] TANK CRUSHED AND FILLED
Dade
CENTRAX #:13 -SG -24355
DATE PAID:
FEE PAID :
RECEIPT .
OSTDSNBR :05- 0942 -R
ADDITIONAL INFORMATION
[40] UNOBSTRUCTED AREA
[41] STORMWATER RUNOFF
[42] ALARMS
[43] MAINTENANCE AGREEMENT
[44] BUILDING AREA
[45] PLUMBING FIXTURES
[46] FINAL SITE GRADING
[47] CONTRACTOR A Aaron Super Rooter
[48] OTHER
EXPLANATION OF VIOLATIONS:
Trench Bio 3 Chamber
CHD Date: 3/22/05
Dade CHD Date: 3/22/05
Page 2 of 2
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: _ (305) 756.8972
E'c
Ww6E4
Permit No. pl.... 0J' C15
Master Permit No.
Mechanical Roofing
Owner's Name (Fee Simple Titleholder) Q t -r /UK / Phone #
Owner's Address Q � Q S ST
City ,n / ,q.. ' ( Testate Zip 7 (3V
Tenant/Lessee Name Phone # -36 S S7
Job Address (where the work is being done) ! 0 S NE E g ST
City Miami Shores Vi11ne County Miami -Dade Zip 51)1
Is Building Historically Designated YES NO
Contractor's Company Name /"`1 G ets YO f & Q T Phone # C : 1 4 `1 " U U G
Contractor's Address COO 22- &\ SS C
City M 10VM 6a- State Zi5a3C 2 3
Qualifier Jo-1W -'V F
State Certificate or Registration No. CSffiOO 004E' Certificate of Competency No.
Architect/Engineer's Name (if applicable) f Phone #
$ Value of Work For this Permit 2 4 0 9
Describe Work:
Total Fee Now Due $
(Continued on opposite side)
(s?
Square Footage Of Work: 300
Type of Work: EAddition ❑Alteration New Repair /Replace ❑ Demolition
�n 'Cf 1 I 3Jti or o In RICJ
* * * * * * * * * * * * * * * * * * * * * * * * * * ** ees * * * ** * * * * * * * * * * * * * * * * * * ** ** *** **
Submittal Fee Permit Fee $ CCF $
Notary $ Training/Education Fee $ i Technology Fee $
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Bonding Company's Name (if applicable)
Bonding Company's Address
City
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Owner or Agent
The foregoing instrument was acknowledged before me this 11
day of c(■. 81, 20 O by
who is personally known to me or who has produced
,VitntifgHigsti link,thoift tak
MY COMMISSION # DD250437
li !i O i (EXPI
IOTAItY
NOTARY PU
Sign:
Print:
My Commission Expires:
APPLICATION APPROVED BY:
chc 05/13/03
7 - ' 21 M3 01 o I..° „ r , .ccs-
** **** * * * * * * * * * * * * * * * * * * * * * * * * * * *>k **
State Zip
t 0
f
an oath.
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.
"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 m' St be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absenc of such posted notice, the
inspection will not b= approved a ' ' einss' - ion fee will be charged. j '
- Contractor
The foregoing. instrument as acknowledged before me t R 7
day of M r C. , 200 ? , by L��
Signature
who is personally k
NOTARY PUBLIC:
Sign:
Print:
ow ,t,14 me or who has produced
�<< B 6 6 TERESA J. SOLOMON
' t o nation nsi het tliat-ake a
9?i OF v%.e EXPIRES: September 16, 2007
1- 800-3- NOTARY F Notary Discount Assoc. Co.
My Commission Expires:
mo t'
€8 e`
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
* ** * ** ***************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
3 Plans Examiner
Engineer
Zoning
D-
oath.
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 3/24/2005
Applicant: BURT ARKIN
Owner: ARKIN BURT
JOB ADDRESS: 705 NE 95 ST
Parcel # 1132060142120
Signed:
(INSPECTOR)
Plumbing Permit
Permit Number: PL2005 -95
Contractor A AARON SUPER ROOTER INC Contractor's Address: 6022 S. W. 35 CT.
Local Phone: 954- 967 -9933
Page 1 of 1
Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOT 10 & LOT 11 BLK 68 LOT SIZE SITE
Fees: Description Amount
FEE2005 -3699 Building Fee $175.00
FEE2005 -3700 CCF $0.60
FEE2005 -3701 Training and Education Fee $0.20
FEE2005 -3702 Technology Fee $4.38
FEE2005 -3703 Builders Bond $300.00
Total Fees: $480.18
Total Fees: $480.18
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 9/14/2005 Construction Value: $2,450.00
Work: INSTALLING NEW DRAINFIELD
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: