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795 NE 95 St (2)MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ✓ , • Type Insp'n C;�-` Permit No. Name Address Company Phone # Inspection Date Approved Correction Re- Insp'n Fee '195 ,O& q5 (.5D5 7 -.5 7e5 0 -- MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Type Insp'n �i`-''�'C 7 1 e ,ozze Permit No. p — c 900 't" — Name Address /g , -'& -- 15 °j• Company Phone # 3t0s 6 T ' 5771g Inspection Date Approved Correction Re- Insp'n Fee k.40 \z„ BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical > Owner's Name (Fee Simple Titleholder) 1 9 6 - n l Z l A ) 1C FF Phone # (L 05) 7J Owner's Address -- 7q ,( - r J / e City AA ; - j c j State r� Tenant/Lessee Name >c- Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES NO Contractor's Company Name AI l OAS 0 Contractor's Address ( 3 q ( ) 3 City • o, Y ' State Qualifier q 1 () f l ' 14 U /� �! S Architect/Engineer's Name (if applicable) . Phone # Architect/Engineer's Address City $ Value of Work For this Permit Miami Shores Village Building Department Spa 5 vl4 � 4s Y1f3 0 ✓e_ State County Miami -Dade r Number of: Bays Stories Families Type of Work: ' dition ❑Alteration ❑New Des ri s e Work: & _ � S ; i vr K / D5 0 4 o : c Ur .UL n 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. L ' 100 1 - Master Permit No. B ©3 -70/ / Mechanical Roofmg Zip 33/3 / Phone # v1 K Phone # 305 0 - `I P 5 rki Zip Zip Square Footage Of Work: Zip 3 3 a / \ Bedrooms Baths ❑ Repair/Replace ❑ Demolition x. ( a Wei c(C4" S c County Escrow Fee $ Permit Fee $ i I,) • CC ' Notary $ 6.0 i Education/ Training Fee $ 00 Tech $ q. ?.) - Scanning $ 3 tvc) Radon $ Code Enforcement $ Bond $ 360 ,0 t , Struct. $ Minus Plans Check Fee $ Total Fee Now Due $ (Continued on opposite side) t t Ct Ctc C3.5. A 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 I nd installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand tha • separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, ATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I ce t all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating co ' ction and zoning. "WARNING TO 0 ER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWI 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 c. the permit is issued. In the absence of such posted notice, the inspection will no be approved and a reinspection fee will be charged. X Signature owledged before me this 1 L day of ^ _ , 20 0, by 0 ca CA Duhocc The foregoing instrument was ac who is personally known to me or who has produced NOTARY PUBLI Sign: Print: * * * * * * * * * * * * * *i * * * * * * * * ** APPLICATION APPROVE chcTnro3 Att /(,)/As-4 Owner or Agent State Certificate or Registration No.� As identification and 1Wit41514 VlitIrt9t Commission #DD23198 :'' E 411k es: Jul 13, 2007 -mX f nded Thru TiTiR7 o n. ing o., Signature ✓ V "' .r.��lvt�,, Contractor The foregoing ' strument was acknowledge before me this / 2 day of Ser , 20 by S +- J4 I ✓ki 4/ is 0 who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUB Sign: My Commission Expires: ****************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * *,► * * * * * * * ** Plans Examiner Engineer Zoning Print: My Commission Expires:" , "eV s ant ofk * a s &`I * ** (Certificate of Competency Holder) Certificate of Competency No. V ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** /- a CONSTRUCTION PERMIT FOR: STATE OF FLORIDA pE4ARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT ]New System [ }Existing System ]Repair ( ]Abandonment APPLICANT: Calandra, Patricia PROPERTY STREET ADDRESS: 795 NE 95 St Miami Shores FL 33138 LOT: 19 BLOCK: 68 SUBDIVISION: Miami Shores [Section /Township /Range /Parcel No.] PROPERTY ID #: 11- 3206 - 014 -2180 [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 [ A [ N [ K [ D R A I N F I E L D 400 ]Gallons SEPTIC TANK 286 ]Gallons 0 ]GALLONS GREASE INTERCEPTOR CAPACITY 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS [ 1050 ]SQUARE [ 0 ]SQUARE TYPE SYSTEM: CONFIGURATION: FEET PRIMARY DRAINFIELD SYSTEM FEET SYSTEM [ Y ]STANDARD [ N )FILLED [ N ] TRENCH [ Y ]BED LOCATION TO BENCHMARK: 10.42'NGVD FF $/R ELEVATION OF PROPOSED SYSTEM SITE [ 27.8 BOTTOM OF DRAINFIELD TO BE [ 57.8 FILL REQUIRED: [ 0.0 )INCHES EXCAVATION OTHER REMARKS: SPECIFICATIONS BY: RAM, --f -- - to/al / APPROVED BY: Arrieta, Rolando (2 21 o3 DATE ISSUED: DH 4016, 03/97 (Obsoletes previous editions hich may not (Stock Number: 5744 -001- 4016 -0) foatas cwns_ao16 ^1) ]Holding Tank [ ] Innovative Other ]Temporary [ NA AGENT: SR0890724, ALFONSO SATURNINO ] ] [ INCHES [ INCHES REQUIRED: [ 30.0 ] INCHES "SEE SPECIFICATIONS ON REVERSE SIDE" TITLE: be used) CENTRAX #: 13 -SG -17959 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 03 -2873- -M MULTI- CHAMBERED /IN SERIES: [Y ] MULTI- CHAMBERED /IN SERIES: [Y ] @ [0 ]DOSES PER 24 HRS # PUMPS[ 0 ] [ N ]MOUND [ N [ N ] BELOW 1 BENCHMARK/REFERENCE POINT ] ] [ BELOW] BENCHMARK /REFERENCE POINT TITLE: Engineier I Dade CHD EXPIRATION DATE: 'j .g[ OS 21 Page I of 3/ 2ONSTRUCTION PERMIT FOR: [ ]New System [ ]Existing System [ ]Repair [ ]Abandonment APPLICANT: Calandra, Patricia LOT: 19 3THER REMARKS: SPECIFICATIONS BY: RAM, DATE ISSUED: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT BLOCK: 68 SUBDIVISION: Miami Shores NPPROVED BY: Arrieta, Rolando [ ]Holding Tank [ ] Innovative Other [ ]Temporary [ NA ] AGENT: SR0890724, ALFONSO SATURNINO PROPERTY STREET ADDRESS: 795 NE 95 St Miami Shores FL 33138 [Section /Township /Range /Parcel No.] PROPERTY ID #: 11 - 3206- 014 -2180 [OR TAX ID NUMBER] SYSTEM DESIGN AND S EC% ICATIONS 0)50 �k ci��Q J ,i 0/ 5/03 P [ ] Gallons SEPTIC TANK A ( ]Gallons • [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K [ 0 ]GALLONS DOSING TANK..CAPACITY [ 0 ]GALLONS L00 ExtolN i D [ IO ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ 2 0b ]SQUARE FEET 1 N 3 SYSTEM A TYPE SYSTEM: [ Y ]STANDARD - [ N ]FILLED I CONFIGURATION: [ N ]TRENCH [ Y ]BED E LOCATION TO BENCHMARK: 10.42'NGVD FF E/R I ELEVATION OF PROPOSED SYSTEM SITE [ 27.8 ] [ INCHES BOTTOM OF DRAINFIELD TO BE [ 57.8 ] [ INCHES u FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: "SEE SPECIFICATIONS ON REVERSE SIDE" TITLE: TITLE: Engineer I [ 30.0 ] INCHES CENTRAX #: 13 -SG -17959 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 03 -2873- -M 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 2OMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. MULTI - CHAMBERED /IN SERIES: [Y MULTI - CHAMBERED /IN SERIES: [Y @ [0 ]DOSES PER 24 HRS # PUMPS[ 0 [ N ]MOUND [ N ] [ N ] ] [ BELOW BENCHMARK /REFERENCE POINT ] [ BELOW BENCHMARK /REFERENCE POINT EXPIRATION DATE: Dade CHD Miami Shores Village 10050 NE 2nd Avenue Plumbing Permit Phone: 305 - 795 -2204 Permit Number: PL2004 -7 Printed: 1 /20/2004 Applicant: PATRICIA CALANDRA Owner: CALANDRA PATRICIA JOB ADDRESS: 795 NE 95 ST Contractor ALFONSO SEPTIC TANK CONTRACTOR COBIBntractor's Address: 1391 W. 36TH ST. Local Phone: 305 - 889 -2959 Parcel # 1132060142180 Permit Status: APPROVED Permit Expiration: 7/5/2004 Construction Value: $2,500.00 Work: NEW SEPTIC TANK AND DRAINFIELD Signed: (INSPECTOR) Page 1 of 1 Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOT 20 & E1/2 LOT 19 BLK 68 LOT SIZE 75.000 Fees: Description Amount FEE2004 -553 Building Fee $175.00 FEE2004 -554 CCF $1.80 FEE2004 -555 Notary Fee $5.00 FEE2004 -556 Training and Education Fee $0.60 FEE2004 -557 Technology Fee $4.37 FEE2004 -558 Scanning Fee $3.00 FEE2004 -559 Builders Bond $300.00 Total Fees: $489.77 Total Fees: $489.77 Total Receipts: $489.77 pd c\c- 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: