1070 NE 96 St (2)Describe Work:
County Escrow Fee $
'
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical - w Plumbing
Owner's Name (Fee Simple Titleholder) r/ (• �,-,,,Q ' 61-A;'
Owner's Address d)-70 9.1 L
City hr,' . �4-- State
Tenant/Lessee Name Phone #
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name Phone #
Contractor's Address
City State
Qualifier
Architect/Engineer's Name (if applicable)
Architect/Engineer's Address
$ Value of Work For this Permit
Number of: Bays Stories Families Bedrooms
Type of Work: ❑Ad.'tion ❑ Alteration ❑New
Education/Training Fee $ •
Miami Shores Village
Building Department
AIL... rn .a ► .
6
(,
Permit Fee $
Tech $ Sa
Bond $
Permit No. 1t s
Master Permit No.
Mechanical Roofing
hone # 31 - 7 J 1 ) i3
Zip Tad
I 0 D
Scanning $
Struct. $
Code Enforcement $
$
Total Fee Now Due '0 D
Minus Plans Check Fee $ l '
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Zip
Phone #
Square Footage Of Work:
Baths
❑ Repair/Replace ❑ Demolition
* * * * * * * * * * * * * * * * * * * * * * **
Notary $
Radon $
(Continued on or
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. 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 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 Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20 _, by
who is personally known to me or who has produced
As identification and who did take an oath.
Contractor
The foregoin • strument was acknowledged before me thi(.5
day of 20 ___, by
who is personally known to me or who has produced
A as identificatiq who ;taltt : • S
NOTARY PUBLIC: NOTARY P =+� Commission • 0 0 8
1 •: :•_ E BJul ondedThr 2007
Sign: Si ��,. �1 1 2. ' ` � Bondin• Co., Inc.
_ . Print: �:��n ►:
My Commission Expires: I
' Commission Expires:
************************************************************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
te or Registration No.
(Certifi te of Competency Holder)
Certificate of Competency No.
* * * * * * * * * * * * * ** * ** * ** * ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WED BY: . //)I / ff.'
Plans Examiner
Engineer
Zoning
P1 . A
Miami Shores Village
Building Department
BUILDING Permit No. V(i9(1)(53
PERMIT APPLICATION Master Permit No.
FBC 2001
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) , M (Mat Phone # ' b r 7S I' ° q// 6. •
Owner's Address OW 1J E° qfz, S
City 4/14 ( State Pi(
Tenant/Lessee Name
Architect/Engineer's Name (if applicable) . Phone #
Architect/Engineer's Address
County Escrow Fee $ , rl'
Education/Training Fee $ ,( Tech
Code Enforcement $ Bond $ 3 0 C)
Minus Plans Check Fee $ Total Fee Now Duel
Permit Fee $
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Zip 1,/ '
Phone #
Job Address (where the work is being done) /67 /l • '96 S
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
q�/ 9
Contractor's Company Name "1. l . • Li !e.. J Phone # SC' C � l - 7®
Contractor's Address Mg / dd i- £ l /
City / 4t i State ' n " 1 Zip ,1j // e
Qualifier CP-a .d ' J- ` r
$Value of Work For this Permit 2it-o• ad Square Footage Of Work: 57/
Number of: Bays Stories Families Bedrooms Baths
Type of Work: ❑Addition DAlte tion ❑New ❑ Repair/Replace ❑ Demolition
Describe Work:A' . is 444/ '; CV 441 /I C J
S, IL Notary $
Scanning $ �. O
* * * * * * * * * * * * * * * * * * * * * * * * * * ** • , * * * * * * * * * * * * * * * * * * * * * * **
Struct.
t il?1 ,1 7
S-C'_ .
Radon i _ _
(Continued on opposite side)
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. 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 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 ill no be apprpv,g and a reinsp, tiogfee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day ofcft , 2001, by l('A�.�( S '? f
who is personally known to me or who has produced
n
NOTARYY PUBLIC:
Sign:
Print:
LAo
My Commission Expires:
APPLICATION APPROVED BY:
Chc 10/02/03
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of CC 7\ ,20Lby
who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUB
Sign:
Print:
My Commission Exp ,fig: 7: Bonded ,
1Thn' 2007
or n 0%
(Certificate of Co petency Holder)
i
State Certificate or Registration No. Certificate of Competency No.
** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * ** * * * * *. ************************ * * * * * * * * * * * * * * * * * * * * * * * *** * * * **
Plans Examiner
Engineer
Zoning
STATZ UY F LUKIUA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR:
[ X ]New System [ ]Existing System
[ ]Repair [ ]Abandonment
APPLICANT: Maxwell, Michael
PROPERTY STREET ADDRESS: 1070 NE 96 St Miami FL 33138
LOT: 9
BLOCK: 8 SUBDIVISION: Miami Shores
[ ]Holding Tank [ ] Innovative Other
[ ]Temporary [ NA ]
AGENT: SR0931119, COCKING MSTEPKEN
[Section /Township /Range /Parcel No.)
PROPERTY ID #: 11- 3206 - 014 -3510 [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
CO`HPLIANCE 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
1050 ]Gallons SEPTIC TANK
0 ]Gallons
0 ]GALLONS GREASE INTERCEPTOR CAPACITY
0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS Q
[ 571 ] SQUARE
[ 0 ] SQUARE
TYPE SYSTEM:
CONFIGURATION:
FEET PRIMARY
FEET
[ Y ]STANDARD
[ N ]TRENCH
DRAINFIELD SYSTEM
SYSTEM
[ N ]FILLED
[ Y' ]BED
LOCATION TO BENCHMARK: 11.94' Ngvd At F.F. of
ELEVATION OF PROPOSED SYSTEM SITE [ 2.1 ]
BOTTOM OF DRAINFIELD TO BE [ 54.7 ]
FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 72.0 ] INCHES
OTHER REMARKS:
[SE] House 3 bedrooms. 2,462.00 Building area.
Site elevation:9.88' ngvd.
HSWT contour map: 3.5 msl
Soil replacement required - See attached sheet.
Install 42° of slightly limited soilunder the botton
Invert elevation: 7.88' ngvd
Bottonof drainfield: 7.38' ngvd
Septic tank category: No. 1
The licensed contractor Installing
installing the minimum category of
Florida Administrative Code.
SPECIFICATIONS BY: Lopez,
APPROVED BY:
DATE ISSUED: 0 0P-
Hoist. Budq.
[ INCHES ] [ BELOW] BENCHMARK /REFERENCE POINT
[ INCHES ] [ BELOW] BENCHMARK /REFERENCE POINT
TITLE:
[0 ]DOSES PER 24 HRS # PUMPS( 0 ]
of drain field
the system is responsible for
tank inaccordance to 64E- 6.013(3)
Posted 10/01/2003
TITLE: 4 b�eT
MULTI- CHAMBERED /IN SERIES: (Y ]
MULTI- CHAMBERED /IN SERIES: [Y ]
CEN'rRAX 4: 13 - - 17537
DATE PAID:
FEE PAID : $
RECEIPT .
OSTDSNBR : 03 -2452- -N
[ N ]MOUND [ N ]
[ N
EXPIRATION DATE:
Dade i f CHD
UJ
STATE OF FLORIDA
DEPARTMENT OF HEALTH
" ONSITE SEWAGE DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEMS SPECIFICATIONS
APPLICANT: Maxwell, Michael
1. C.N 12CC1A tt.
OSTDSNBR : 03- 2452 -N
AGENT: MSTEPHEN COCKING, MR. C'S SEPTIC & DRAIN, INC. SR0931119
LOT: 9 BLOCK: 8 SUBDIVISION: Miami Shores ID #: 11- 3206 - 014 -3510
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S
MUST PROVTDE REGTSTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMTTTAL. COMPLETE ALL TTEMS.
PROPERTY SIZE CONFORMS TO SITE PLAN:[X)YES [ ]NO NET USABLE AREA AVAILABLE: 0.24 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [64E -6, TABLE 1]
AUTHORIZED SEWAGE FLOW: 600 GALLONS PER DAY [1500GPD /ACRE OR 2500GPD /ACRE]
UNOBSTRUCTED AREA AVAILABLE: 1605 SQFT UNOBSTRUCTED AREA REQUIRED: 1143 SQF]
BENCHMARK /REFERENCE POINT LOCATION: 11.94' Ngvd At F.F. of Esist. Budg.
ELEVATION OF PROPOSED SYSTEM SITE IS 2.06 [ INCHES ] [ BELOW ]BENCHMARK /REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES:
SURFACE WATER: N/A FT DITCHES /SWALES: N/A FT NORMALLY WET? [ ]YES [ X ]NO
WELLS: PUBLIC: N/A FT LIMITED USE: N/A FT PRIVATE: N/A FT NON - POTABLE: N/A FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 10 FT POTABLE WATER LINES: 100 FT
SITE SUBJECT TO FREQUENT FLOODING: [ ]YES [ X ]NO 10 YEAR FLOODING? [ ]YES [ X ]NO
10 YEAR FLOOD ELEVATION FOR SITE: 0 FT NGVD
SOIL PROFILE INFORMATION SITE 1
Munsell ## /Color Texture Depth
2 _ 5vm- 6/2 -P an Ssn,nAr Lewin n to 3 2
2 _ 5YP_1 /4 -n Rn Anl i hi r T.imAg 12 tO 72
to
to
to
to
to
to
USDA SOIL SERIES: 10 Udorthents,
SITE EVALUATED BY: Wilfredo Lopez
DH 4015, 03/97 (Obsoletes previous editions which may
(Stock Number: 5744- 003 - 4015 -1) (ostds_eval_4015 - 3]
SITE ELEVATION: 0 FT NGVD
SOIL PROFILE INFORMATION SITE 2
Munsell 0/Color Texture Depth
9 cvR- :; /2 -R Rn Rav►c r B.nam n to 15
7 _ 5YR -N /4 -n Rn Onl i ti r T.imaq 15 to
to
to
to
to
to
to
USDA SOIL SERIES: 10 Udorthents,
OBSERVED WATER TABLE76.00 INCHES [ BELOW ] EXISTING GRADE TYPE: [PERCHED
ESTIMATED WET SEASON WATER TABLE ELEVATION:76.00 INCHES [ BELOW ] EXISTING GRADE.
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO DEPTH: 0.0 INCHE:
SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING Replacemeat/0.70 DEPTH OF EXCAVATION:72.0 INCHE:
DRAINFIELD CONFIGURATION: [ ]TRENCH [ X ]BED [ ]OTHER (SPECIFY)
REMARKS /ADDITIONAL CRITERIA:
House 3 bedrooms. 2,462.00 Building area.
Site elevation:9.88' ngvd.
HSWT contour map: 3.5 msl
Soil replacement required - See attached sheet.
used)
DATE:
Page 3 of 3
APPFECATION FOR:
[ New. System
I . Repair
APPLICANT:
*47-
MAILING ADDRESS:
PROPERTY EMFORMTION
BUILDING INFORMATION
2
3
4
STATE OF FLORIIA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
APPLICATION FOR CONSTRU CTION PERMIT
1 A Masting System
It 1 Abandonment'.
======
po. isa6 ‘9,23,
LOT: BLOCK: SUBDIVISION:
AnA
( Floor/Equipm t Drains ( ] Other (Specify)
SIGNATURE: r;IF.,0Y
nu LAIC in/c.,
f( 1 Holding Tank
I 1 Temporary
Eto(RMSIDENTICAL 1 ] COMMERCIAL
y
PERMIT k
DATE PAID:
FEE PAID:
RECEIPT 0:
TELEPHONE:74- C51 lb,
TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEWS MUST BE CONSTRUCTED
. -
BY A PERSON LICENSED PURSUANT TO 489.105(3)W OR 489.552, FLORID STATUTES. IT IS THE
APPLICANT'S RESPONSIBIKTY TO PROVIDE DOCUMENTATMatt THE...pATM TEE LOT WAS CREATED OR
- PLATTED OW/D14111 IF REQUESTING CONSIDERATION OF sATetoxr GRANDFATHER PROVISIONS.
=
= ==
PROPERTY
ID 17: /1 0141- 5vo _ ZONING X/M OR EQUIVALENT: ( Y / N )
PROPERTY SIZE: A zvy RZ. WATER SUPPLY: ( 1 PRIVATE PUBLIC E 1<=2000GPD [ ]>2000GPD
IS SEWER AVAILABLE AS PMR 381.00cs FS? ([ Y 101
DISTANCE TO SEWER: FT
PROPERTY ADDRESS: /070 A ie. f 4 5 / 1/ ' ' 33/31
DIRECTIONS TO PROPERTY: r 9 X l' '9 6 7 rv‘ - A awl-
"Is. gt f
Unit Type of No. of Buildimg C ommercial/Institutional System Design
No Establishvent Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC
1 Innovative
E
PLATTED: /4'37,
Jeb Bush
Govemor
Maxwell, Michael
P.O. Box 693239
Miami, FL 33269
Program Supervisor
RE: 03- 2452 -N
Lot: 9 Block: 8 Miami Shores 11- 3206 - 014 -3510
October 1, 2003
We require two (2) sets of official plans to issue the permit.
Sincerely,
Sanrir F7mir, M.S.. P.E., Environmental Administrator
Miami -Dade County Health DepartmentlEnvironmental Health
1725 N.W. 167 Street, Miaml, Florida 33056
John 0. Agwunobi, PAD, MBA
Secretary
Dear Applicant:
This will acknowledge receipt of an application and plans for an onsite sewage
treatment and disposal system construction permit dated 08/07 /03 for a proposed
system to be constructed on the above referenced property.
On 10/01/03 this department performed a site evaluation of the above described
property. On the date of the evaluation, the site was suitable for an onsite sewage
treatment and disposal system under the laws and rules existing on that date, however
some fill may be required. Provided there are no changes to the lot site from our
inspection, this evaluation is valid for one year. The longer the time lapse from site
evaluation to a request for a construction permit, the more likely changes will have
occurred that may invalid this evaluation. The evaluation may be affected by: erosion,
man -made changes in the lot, changes in the water table, changes in drainage,
installation of wells on surrounding property, changes in the law, rules, or local
ordinances This permit will specify minimum conditions for your onsite sewage
treatment and disposal system.
If you have any questions on this matter, please call our office at (305) 513 -3466
.21
AIPPLICAN'1'a
AGENT
PROPERTY ADDRESS:
LOT: _j__ BLOCK: q SUBDIVISION: ___
miummummagmmisffsmairnam
C3ECKED..(X] ITEMS ARE NOT IN COMPLIANCE WITH OR RULE AND MUST BE CORRECTED
3
3
3
3
1
3
3
3
1
3
3
3
3
3
PILL / EXCAVATION MATERIAL
322] FILL AMOUNT y)
[23] FILL TEXTURE
[24] EXCAVATION DEPTH
[25] AREA REPLACED _ / 7-
11263 REPLACEMENT RIAL' r S
EXPLANATION OF VIOLATIONS / MARSH: j/
3 1
[
3 l
3
3
3
3
3
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DIPOSAL SYSTEM
CONSTRUCTION INBP CTIOU AND FINAL APPROVAL
621 C5 f, k
/07V c 9( 5'7
TANNK INSTALLATION
[011 TANK SIZE (1] /_
(023 TANK MATERIAL
(03] OUTLET DEVICE
(04] MULTI - CHAMBERED
[OS] OUTLET FILTER
(06] LEGEND a g-
[07] WATERTIGHT
[O8] LEVEL /0 SU
(09 ] DEPTH TO WO 0 .1 , '
Avo.r (a bit
DRAINFIELD INSTALLATION 57/
3103 AREA 111A1)62-103215-0 GQF
BI1] DISTRIBUTION BOX _
(12] NUMBER OF DRAINLINEB
[13] DRAINLINE SEPARATION
[14] DRAINLINE SLOPE
315] DEPTH OF COVER
[A] ELEVATION (ABOVE /BELOW] BM ®�
[17] SYSTEM LOCATION
[18] DOSING PUMPS N A
[19] AGGREGATE SIZE A16.3 D0;7;
(20] AGGREGATE EXCESSIVE FINES
(21] AGGREGATE DEPTH
f
r)
3 u
�
DI1 4016, 10/97 (Previous Editions May Be Used)
s \ 2L:r13';
S °e s
END 12
[ ] [
3 l 3
( 3 [
[ >a l 1
[ ] (32]
3 3 3
3 3 3
3 3 3
3 3
3 3
3.
3 3
[ 3
3
it 3
3 3
3 3
it 3
3
SETBACKS
SURFACE WATER
DITCHES
PRIVATE WELLS
PUBLIC WELLS
IRRIGATION 'WELLS
POTABLE WATER LI 0
BUILDING FOUNDATION
PROPERTY LINES S
OTHER
PERMIT N0,
DATE PAIDa
FEE PAID:
RECEIPT fa
0 3 -,g9L5
7 - G 3
7o
-
ERTY ID #: 1 /- 32 46- 014 3s
FT
FT
FT
EIT
FILLED / MOUND SYSTEM
3363 DRAINFIELD COVER
(373 SHOULDERS
3381 SLOPES
[39] STABILIZATION
ADDITIONAL INFORMATION '
3401 UNOBSTRUCTED AREA 01-
3413 STORMWATER RUNOFF Alps'
[42] ALARMS
1431 MAINTENANCE 'AG
(44] BUILDING AREA
(45] LOCATION CONFORMS WITH SITS PLC
[46] FINAL SITE GRADI ° . - /�
[47] CONTRACTOR Thf• OS 77C
3483 OTHER
ABANDONMENT
[ 49 ] TANK PUMPED / /
[50] TANK CRUSHED A YELLED _ /_ /_.
0- cam was a /d -31 -a
Page 2 og