PL-08-1190Owner Information
CARLOS ESPINOSA
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Project Address
1 1084 NE 97 Street
Miami Shores Village, FL 33138-
Address
Fees Due
Bond Type - Owners Bond
CCF
Education Surcharge
Notary Fee
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$300.00
$1.80
$0.60
$5.00
$175.00
$3.00
$4.38
$489.78
1084NE97ST
MIAMI FL 33138 -2556
Parcel Number
1132050170190
Block: Lot.
Contractor(s)
BOBS SEPTIC & DRAIN INC
Phone
305 -558 -5818
CeII Phone
Type of Work: PLUMBING
Type of Piping: DRAINFIELD
Additional Info:
Bond Retum :
Classification: Residential
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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL 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. Futhermore, I authorize the above -named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Phone
Valuation:
Total Sq Feet:
Applicant
CARLOS ESPINOSA
Available Inspections:
Inspection Type:
Rough
Final
Landscaping
1
June 30, 2008
Date
Expiration: 12 /27/2008
CeII
$ 2,500.00
0
Monday, June 30, 2008 1
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Carlos Espinosa
PROPERTY ADDRESS: 1084 NE 97 St MIAMI, FL 33138
LOT: 7
PROPERTY ID #: 11 - 3205 - 017 - 0190
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
SATISFACTORY 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.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 900 ] GALLONS / GPD Septic Tank CAPACITY
A [ 0 ] GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ 1
D
R
A
I
N
F
I
E
L
D
0
T
H
E
R
[ 300 ] SQUARE FEET Bed confiauration SYSTEM
[ 0 ] SQUARE FEET SYSTEM
TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND [ ]
CONFIGURATION: [ ] TRENCH [X] BED [ ]
LOCATION OF BENCHMARK: FFE eI.:11.90m' NGVD
ELEVATION OF PROPOSED SYSTEM SITE [ 21.60 ] [i INCHES I FT ] [ ABOVE /) BELOW II BENCBMARK /REFERENCE POINT
BOTTOM OF DRAINFIELD TO BE [ 39.60 ] INCHES 1 FT ] [ ABOVE it BELOW b BENCHMARK /REFERENCE POINT
FILL REQUIRED:
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED:
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
BLOCK: 181 SUBDIVISION: Miami Shores Sec. 8
[ 0.00 ] INCHES
rd L Philizaire
Astrid V Edwards
06/27/2008
EXCAVATION REQUIRED: [ 30.00] INCHES
TITLE:
TITLE: Engineer Specialist II
DH 4016, 10/97 (Previous Editions May Be Used)
v 1.1.9 AP886512 5E760426
PERMIT #: 13-SG- 944914
APPLICATION #: AP886512
DATE PAID: 06/26/2008
FEE PAID: $55.00
RECEIPT #: 13 -PID -10437
DOCUMENT #: PR743316
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
1.- Existing 900 gal. septic tank to remain.
2.- Install 300 sf of drainfield in bed configuration.
3. -Invert elevation of drainfield to be no Tess than 8.10 ft NGVD.
6. -Bottom of drainfield elevation to be no Tess than 7.60 ft NGVD.
THIS PERMIT IS NOT FOR " ADDITION(s) ".
Dade CHD
EXPIRATION DATE: 09/25/2008
Page 1 of 3
REPLACE DRAINFIELD ONLY
,FI
(, -
Ali%
P - 1:. li • ctor Comments
'
Passed
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspection Date: 07/03/2008
Inspector: Levrock, James
Owner: ESPINOSA, CARLOS
Job Address: 1084 97 Street NE
Project: <NONE>
Miami Shores Village, FL 33138-
Contractor: BOBS SEPTIC & DRAIN INC
Building Department Comments
Thursday, July 3, 2008
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
JUL 1QE
Block:
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Drainfield
Phone Number
Parcel Number 1132050170190
Lot:
Phone: 305- 558 -5818
Page 2 of 2
Inspector
Address
Comments:
Signature
Environme Health
Florida Department of Heath
Miami-Dade + ty Mahn Department
OSTDS/SepC'x Tank Division
?.p69NW 4a6 St. Suits 175
Mini. F 03166
Dote
OSTDS #
[
f
.APPLICANT
AGENT:
re
PROPERTY ADDRESS;
•BLOCK: 1 �! y , * .
SUBDIVISION:
CHECKED [X1 ITEMS ARE NOT IN COMPLIANCE • WITH STATUTE. OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
[ TANK SIZE [1 f21
(02] TANK MATERIAL .._
[03] OUTLET DEVICE).- *
[ MULTICHAMBERED - (Y
(05] OUTLET FILTER
091—, LEGEND
(07] WA R:19AL
08J LEV :L
9] DEP H TO LID
ST:ML
SI G P
G GA
GR GA
GR ' A
A' '• TION
OP
O 4p. •
AINFIELD 1 STALLATION
[1
[12] NqM
(131,%'x AINLINE S E
[ . * AINLINE
[1 ' D PTH O
0] AR
[1 E
[1 ] S
[1 1 D
[1 ] A
[ ) A
f2 ] A
F
[22]
[23]
[24]
[25)
[26]
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE AND DISPOSAL. SYSTEM
CONSTRUCTIONrINSPECTJON AND FINAL APPROVAL
1301- (2JdO
IBUTION BOX HEAD
• ATION 1 1111
MPS
E SIZE A/ Pljalla
EXCESSIV
DEPTH
/ 'EXCAVATI N TF•f�lAl,
FILL.AMOUNT]
FILL TEXTURE
EXCAVATION DEPTH
AREA REPLACED
REPLACEMENT MATERIAL
EXPLANATION OF VIOLATIONS / REMARKS:
[
[ )
[' 1
t ]
r•
CONSTRUCTIQN [APPROVE DISAPPROVED]
FINAL SYS M [APPROVI:I ISAPPROVEDj: A/>- 6o• i?9'
DH 4016 (Page 2), 10/97 (Previous Editions May Be 0404)
Stock Number; 5744 - 002 - 4015.4
•
SETBACKS
[
[
(29]
1
(31 ]
[
(
[34]
SURFACE WATER
DITCHES
PRIVATE WELLS
PUBLIC WELLS
IRRIGATION ,WELLS
POTABLE WATER LINES s` C") FT
' ' BUILDING FOUNDATION ' • FT
PROPERTY LINES /CJ
• OTHER' ' - ::"`w'•+ FT
�I•: FT
FILLED MOUND SYSTEM
[38) DRAINFIELP COVER
[37) SHOULbERS
[ : SLOPES..
[39] STABILIZATION
ADDITIONAL INFORMATION
[40] UNOBSTRUCTED AREA
[41] STORMWATER RUNOFF
[42] ALARMS
[43] MAINTENANCE AGREEMENT • [441 BUILDING AREA •
[45] . LOCATION CONFQRMS W1T1,$ITE
[461 FINAL SITE GRA
[47] CONTRACTOR
[48] OTHER
ABANDONMENT
] • • [49] : TANK PUMPED:/ •
] [50] TANK CRUSHED & FILLED / L
C CHD
PT 1: Applitanl
PT 2: Irralaller /CoMtctor
PT 3: Build Department
PT 4: Health Oopertmaru
•
PERMIT NO
DATE PAID:
.FEE PAID: • . , •% •
RECEIPT #:
:. ` •
CHD DATE: 7 (1"
DATE; /J- `
�'
Page 2 of 3
FT
FT
FT.
FT
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: Plumbing
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit No.
Master Permit No.
IMCFAMM
itil4 3o 247013
Owner's Name (Fee Simple Titleholder) „ -10,S G5pi � Phone #
Owner's Address G O ?j'S A16 9 7 S7
City )97,54,es
Tenant/Lessee Name /VP,
E -MAIL: A/1f9
Job Address (where the work is being done) /0 H-- Ale q 7
State
City Miami Shores Village County Miami-Dade
FOLIO /PARCEL //-' go c" - d /7 oi9
Is Buildin Historically Designated YES NO X
Contractor's Company Name b l 1c_
Contractor's Address logo 1) C % C
City 9 � t \ State
Qualifier Name 13v �) CP) l 1
State Certificate A-- Registration No. � R.0 11 �
E -MAIL:
Architect/Engineer's Name (if applicable)
Value of Work For this Permit S
Type of Work: ❑Addition DAlteration
Describe Work:
❑New
Zip
ebvio3/4 fC4c4 1A1 cek
Phone #
Zip 3313?
Phon(i ✓ VO
Zi p — %
Phone # J f /)
Certificate of Competency No. (DU
l
Phone #
Square / Linear Footage Of Wdrk: j✓ 7
)5k place ❑ Demolition
***************************************F s es *** ****'uaY*a:** ** *** *** ****1: es w***xxxxxx7kx**x
Submittal Fee $ Permit Fee $ 11 -a) CCF $ is X0 CO /CC
Notary $ Ste,{ 0 Training /Education Fee $ 0•® Technology Fee $ 4°3�
Scanning $ •00 Radon $ DPBR $ Zoning $
Bond $ 300 �4 !bode Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ 49 J
See Reverse side -*
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
Zip
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 h s
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 mu. t
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 e absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
on win tiecN be approved and a redispeelionlee Mitt de ctz Yrged I
inmission Expires
... ,rx,::, +k_83�•a..4.�+ x','eRx is k9Yk a:. 'xicz „dtiV sc , 7c
APPLICATION APPROVED BY:
(Revised 02/08/06)
Signature
The for oing instrument was ackno led ed f! e thi
day of , 2 by 4Y) k
who is
439 1
Ci11i ractor
ersonally known to me or who has producedr1Q4U
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
*** * * * * * * * * * * * * * * *** * * * * * * * * * * **
7 6P
z `' - I
* * * *,I ,,l * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
ale: Each block represents 50 feet.
Notes:
Site Plan submitted by:
Plan Approved
By
Date
County Health Department
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
STATE (
DEPARTMENT
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permit Application Number u
PART II - SITE PLAN
Not ° Approved
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ale: Each block represents 50 feet.
Notes:
Site Plan submitted by:
Plan Approved
By
Date
County Health Department
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
STATE (
DEPARTMENT
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permit Application Number u
PART II - SITE PLAN
Not ° Approved