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120 NE 97 St (7)STATE OF FLORIDA, t COUNTY OF DADE. Amount of Permit $ ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ( Signed) Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mialni Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address (� No. Street Registered Architect and /or Engineer / Employing Plumber's Name__ _2e No Street �� ��' �'�� y_ f =____ Location and Legal Description Lot 12,__v____ J Block `t% ,, Subdivision Street and Number where work is to be performed —No ' _�C_ r _ �?' . ` Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals , Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: CityrWell Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. / ( Signed )- -- Date u My Commission Expires Notary Public, State of Florida Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS ,.., %/; TOTAL FIXTURES CONTR. LIST __ // ( /� V CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK STATE OF FLORIDA, t COUNTY OF DADE. Amount of Permit $ ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ( Signed) Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mialni Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address (� No. Street Registered Architect and /or Engineer / Employing Plumber's Name__ _2e No Street �� ��' �'�� y_ f =____ Location and Legal Description Lot 12,__v____ J Block `t% ,, Subdivision Street and Number where work is to be performed —No ' _�C_ r _ �?' . ` Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals , Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: CityrWell Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. / ( Signed )- -- Date u My Commission Expires Notary Public, State of Florida Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. BUILDING'` ELECTRICAL PLUMBING Owner of Building Architect Contractor` or Builder Legal Lot Description Address of • Building o MIAMI SHORES VILLAGE, FLORID, DATE---->4 PERMIT /NT? 7594 Work to be performed under this Permi CONTRACTOR OR BUILDER Bl. Subdi- vision Value of Project This permit is grantEsd to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time 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 granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the state ents or specifications and th at he assumes respon- sibility for work done by his agents, servants or employees. Signed By ECTOR y In consideration of the issuance to me of this permit I agree to perfo • r work covered hereunder in compliance with all Q nags and regulations �rtaining thereto and in strict conformity with the ,plans, drawings, statement or specifications submitted to the proper authorities dt Miami Shores Village. - epting this permit I assume responsibility for all work dome by ither / self, m a +t servant or employee. `� r Contractor's License No. Amt. Permit G a AUTHORITY o 0 194E BUILDING ELECTRICAL PLUMBING ROOFING Owner of , - . Building Architect Contractor or Builder Legal Description Lot ❑ CONTRACTOR OR BUILDER : MIAMI SHORES VILLAGE, FLORIDA DATE " 19 Contractor's • License No. PERMIT Work to be performed under this Permit B1 Address of Building ? c N9 4941 Subdi- vision Value of Project $ BY AUTHORITY Amount of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time 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 granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. 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 ao cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. ADBOT "t+ BUILDING ELECTRICAL PLUMBING ROOFING Owner of a < Building Architect Contractor or Builder Legal Lot Description Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT Bl N9 4939 Value of Project $ DATE. Contractor's License No. Work to be performed under this Permit Subdi- vision BY AUTHORITY 19 Amount of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time 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 granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. 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 as cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. ABBOT Permit No Amount of Permit $ Application is hereby made for the approval of the detailed statement of the plans and specifications here fh submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address el- __ -- ___ -- _ &tr._ Registered Architect and /or Engi eer Employing Plumber's Name . Location and Legal Descrip Street and Number where work is to be performed— No._ — __ State work to be performed and purpose of building (By Floors)_ _____________ New Building Remodeling Addition Nature of Water Supply: City — Well.__ STATE OF FLORIDA, COUNTY OF DADE. My Commission Expires NO allo SNORES MOddQ©L PLUMBING INSPECTION DEPARTMENT QPpdDCz OOJ FOR PWMM e Of ©P[EQMIOi B1 C J Date Cti4. 42 ^ H 1 s treet/at e> --._ Street_ __- - Subdivision Street Repairs No. of Stories. Size Septic Tank Type of Tank Capacity Gals._. - Feet of Drain Tile Dist. Fee eof or Drai Field from Well ze of Soakage Pit (Signed) - Notary Public, State of Florida Ph bing Inspect The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, work to be performed under this 'emit, as are ,/ (Signed)._ eel/ 4. lioencsd b'y Miami Shores Village. ter Plumbe Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and/or workmanship. CLOOQTG BATH TUBS SNOWERO LAVA TORIES S INKS SLOP SINKS LAUNDRY TUBE URINALS U CATCH BASIN FLOOR DRAIN DRINKING FOUNT •NS TOTAL Fl XTURED CONE. LICIT CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM•G POOL CONTR. LIOT _ CHOCK Permit No Amount of Permit $ Application is hereby made for the approval of the detailed statement of the plans and specifications here fh submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address el- __ -- ___ -- _ &tr._ Registered Architect and /or Engi eer Employing Plumber's Name . Location and Legal Descrip Street and Number where work is to be performed— No._ — __ State work to be performed and purpose of building (By Floors)_ _____________ New Building Remodeling Addition Nature of Water Supply: City — Well.__ STATE OF FLORIDA, COUNTY OF DADE. My Commission Expires NO allo SNORES MOddQ©L PLUMBING INSPECTION DEPARTMENT QPpdDCz OOJ FOR PWMM e Of ©P[EQMIOi B1 C J Date Cti4. 42 ^ H 1 s treet/at e> --._ Street_ __- - Subdivision Street Repairs No. of Stories. Size Septic Tank Type of Tank Capacity Gals._. - Feet of Drain Tile Dist. Fee eof or Drai Field from Well ze of Soakage Pit (Signed) - Notary Public, State of Florida Ph bing Inspect The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, work to be performed under this 'emit, as are ,/ (Signed)._ eel/ 4. lioencsd b'y Miami Shores Village. ter Plumbe Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and/or workmanship. Permit No ' PLUMING INSPECTION DEPARTMENT avnoczaDom FOR PLURABONG PERM Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work / Owner's Name and Addres� _ G��� "aee f No,__ � Street_ Registered Architect and /or Engineer L�L�i� ? � c Employing Plumber's Name Location and Legal Description Lot_ Street and Number where work is to be performed— No._____-- -- Street State work to be performed and purpose of building (By Floors) N B Remodeling_____ Addition Repairs No. of Stories .... Nature of Water Supply: City —Well 614-g Amount of Permit $ Siva Septic Tank Type of Tank Capacity Cals. __._._ Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit No. - -- — (Signed)_ The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli ions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida vent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub -contrai:tors employed by him in t work to be performed under this permit; and will post or cause to be posted for inspection on the site of 'work su pu, ' ni : ce o notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, work to e per or ed I this nit, as are licenend by ?lI1cmi Shares Village. Date____ /— Street Subdivision Plumbing Inspector. (Signed ' - Master Plumber. STATE OF FLORIDA, I COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made . necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOIIETO BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT •NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. Liar _ ___ CHECK Permit No ' PLUMING INSPECTION DEPARTMENT avnoczaDom FOR PLURABONG PERM Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work / Owner's Name and Addres� _ G��� "aee f No,__ � Street_ Registered Architect and /or Engineer L�L�i� ? � c Employing Plumber's Name Location and Legal Description Lot_ Street and Number where work is to be performed— No._____-- -- Street State work to be performed and purpose of building (By Floors) N B Remodeling_____ Addition Repairs No. of Stories .... Nature of Water Supply: City —Well 614-g Amount of Permit $ Siva Septic Tank Type of Tank Capacity Cals. __._._ Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit No. - -- — (Signed)_ The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli ions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida vent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub -contrai:tors employed by him in t work to be performed under this permit; and will post or cause to be posted for inspection on the site of 'work su pu, ' ni : ce o notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, work to e per or ed I this nit, as are licenend by ?lI1cmi Shares Village. Date____ /— Street Subdivision Plumbing Inspector. (Signed ' - Master Plumber. STATE OF FLORIDA, I COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made . necessary by improper notice for inspection, or faulty materials and /or workmanship. - BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical p� Owner's Name (Fee Simple Titleholder) \)i +Irc' IN U IV Owner's Address zf,} e °1 & tr &- Cit Mkt .c State ,FR,, Tenant/Lessee Name (car -4- Job Address (where the work is being done) 020 NE fl St; City Miami Shores Village Is Building Historically Designated YES Contractor's Company Name P , r,zr Contractor's Address 12555 '6t Sc. PI v 4 City i' O. E State Ft Zip 331 G0 Qualifier ° Q O rrN, VQ. 0 d 4W State Certificate or Registration No. 00 O'��7ertificate of Competency No. Architect/Engineer's Name (if applicable) 1` A Phone # $ Value of Work For this Permit 4 2A-0®o 00 Type of Work: ❑Addition ❑Alteration ❑New Describe Work: Submittal Fee $ Notary $ Scanning $ 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 County NO * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit Fee $ 115 Training/Education Fee $ O ciQ( AlAAJ DV In -e Radon $ Zoning Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ " . 0SID - (Continued on opposite side) Miami • rV f Village •1 1 Building Department s 5 REV Miami -Dade Master Permit No. Zip 33113e5' Phone # Permit No. Pi 09-35/ Mechanical Roofing aC Phone # Zip 5v;? Phone # (c) fgL SG 0 0 Square Footage Of Work: ZZS Repair/Replace ❑ Demolition CCF $ 1 . CO /CC Technology Fee $ (4 -3 Bond $ Bonding Company's Name (if applicable) y� Bonding Company's Address ITT r .r City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address N City State Zip P Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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. 1 understand that a separate pennit 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 is. ue In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature K . . �! r?MO l,�Wft do and who dtd,.tike .dio IN; • tit Fl fury Discount Assoc Co . • / who is personally known to m NOTARY PUBLIC: Sign: T� Print: My Comn ***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * ** APPLICATION APPROVED BY: Chc 05/13/03 P e -5 ires: oath. Signature Owner or Agent The foregoing instrument was acknowledged before me this 1 . 3 The foregoing instrument was acknowledged before me this ) 3 day of DPC , 20 J!by Ni I -t GarC %° / s ffl*V - d =�1 -1Y C(MMl%Y f Y 0, r1XPIRCS. Septertlh•r ; c 1 ..' ,• • : V F yw Discount Assoc Co. • N t t\ low. WSD •Iced ALi 4 ' l� eX.AL� 1"W. day of k'C , 20 `J by who is per NOTARY P Sign Print: My Commiss xpires: Contractor take an oath. 44 * * * ************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning 12/15/2004 11:48 CONSTRUCTION PERMIT FOR [ ]New System f ]Existing System [ [ X )Repair ( ]Abandonment APPLICANT; Garcia, Vitra a Aubrey AGENT: 280001342, Woodard William PROPERTY STREET ADDRESS: 120 NE 97 St Miami Shores FL 33138 LOT: 11 BLOCK: 19 PROPERTY ID #: 11- 3206- 013 -25SO SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64-6,FAI DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TrK PERIOD. AMY 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 [ 900 ] Gallons SEPTIC TANK A ( 0 )Gallons M [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K • ( 0 ;GALLOWS DOSING TANK CAPACITY [ 0 )GALLONS 3055133472 OSTDS STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT )Holding Tank [ l Innovative Other Temporary ( WA ) SUBDIVISION: 1iaMi Sharma Sec N 1 [Section /Township /Range /Parcel No.] [OR TAX ID NUMBER] D ( 22S )SQUARE FEET PRIMARY DPAINFIELD SYSTEM R ( 0 3$QUARE FEET SYSTEM A TYPE SYSTEM: [ \P ]STANDARD [ N ]FILLED I CONPIGCTRATION': [ ]TRENCH [ N ]BED F N LOCATION TO BENCHMARK: Ex.ist,nm Finished Floor Elev. I ELEVATION OF PROPOSED SYSTEM SITE ( 2.1 1 [ FEET F. BOTTOM OF DRAINFIELD TO BE • ( 4.6 ] [ FRET L D FILL REQUIRED:[ 0.0 JINCHES EXCAVATION REQUIRED: [ 54.0 ] INCHES OTHER REMARKS: 1. Ine tall 225 sq. 2t. of ds'aingie1d in trench configuration. THIS PEI3KIT IS NOT FOR AN ADDITION. SPECIFICATIONS BY: Tessa, Carlos ! /�_. TITLE: nnma. ?s -rfRn: 12/16/04 APPROVED BY: 1Ca2a, Carlos ! TITLE: Engineer I CENTRAX #: 13 -SCE -23199 DATE PAID: FEE PAID : $ RECEIPT : OFTDSNBR : 04-4149-0R PAGE 01 MULTI - CHAMBERED /IN SERIES: [ Y l MULTI-CHAMBERED/IN SERIES: [ Y [ 0 J DOSES PER 24 HRS # PUMPS( " "0 ] ( M ]MOUND ( N ] C N l ® 13.20 It NGVp J f BELOW J BENCHMARK /REFERENC.E POIN' 1 [ BELOW]BENCHMARK /REFERENCE POIN' h. 4.. Exasting6 00 gal. septic tank to he inelpected for an appropriate pump-out and a, solid vertical dmsleetar installad on the outlet device. The pump-out receipt shall be provided prior to the granting of the final approval. 5. Invert elevation of draiafiald to be no less the4•9.10' NGVD. 6: Bottom of drainEiald elevation tc be no is than S. NGVD. - - - - -- rr� 001'¢,,61 D!n Dade EXPIRATION DATE: 3/14/05 C61D Scale: Each block represents 5 feet and 1 inch = 50 feet. - • I • .-; t ' r- . . , — . STATE OF FLORIDA t g•-• . / I .> DEPARTMENT OF HEALTH ; P"' 6::% ( APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION Perrnit Application *robe ' ....) PART II - SITE ' . • i• ! I Site Plan submitted by: N 0 i 20 NE C rl 51 S r'fr■. SV C 0' Ci0v ) Lt Signature Plan Approved • Not Approved Date By County Health Departmar ALL CHANGES MUST BE APPROVIE0 BY THE COUNTY HEALTH DEPARTRiiENT Di4 409 S, 10/08 (Ftc710sta HP0114 Fif 4018 safe may azol) Owi tsit,r4rtee • 1174.1_trO .B.111 115 +- 4 d rO Tate Paeo 2 0 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12/27/2004 Applicant: VITRA Owner: GARCIA JOB ADDRESS: 120 NE 97 Plumbing Permit Permit Number: PL2004 -354 GARCIA VITRA ST Contractor A AMERICAN SEPTIC & PLUMBING INC Contractor's Address: 17027 W. DIXIE HWY Local Phone: (305) 866 -5600 Parcel # 1132060132550 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 W1/2 LOT 11 & ALL LOT 12 BLK 19 LOT SIZE Fees: FEE2004 -13123 FEE2004 -13124 FEE2004 -13125 FEE2004 -13126 FEE2004 -13127 FEE2004 -13128 Description Building Fee CCF Training and Education Fee Technology Fee Scanning Fee Builders Bond Total Fees: Amount $175.00 $1.80 $0.60 $4.37 $3.00 $300.00 $484.77 Total Fees: $484.77 Total Receipts: $484.77 Permit Status: APPROVED Permit Expiration: 6/13/2005 Construction Value: $2,400.00 Work: UNSTALL NEW DRAINFIELD 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: Page 1 of 1 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12/27/2004 Applicant: VITRA Owner: GARCIA JOB , , *DRESS: 120 NE 97 Contractor A AMERICAN SEPTIC & PLUMBING INC Contractor's Address: 17027 W. DIXIE HWY Local Phone: (305) 866 -5600 Parcel # 1132060132550 Plumbing Permit Permit Number: PL2004®454 GARCIA VITRA ST Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 W1/2 LOT 11 & ALL LOT 12 BLK 19 LOT SIZE Fees: Description mount FEE2004 -13123 Building Fee $175.00 FEE2004 -13124 CCF $1.80 FEE2004 -13125 Training and Education Fee $0.60 FEE2004 -13126 Technology Fee $4.37 FEE2004 -13127 Scanning Fee $3.00 FEE2004 -13128 Builders Bond $300.00 Total Fees: $484.77 Total Fees: $484.77 Total Receipts: $484.77 Permit Status: APPROVED Permit Expiration: 6/13/2005 Construction Value: $2,400.00 Work: UNSTALL NEW DRAINFIELD Signed: (INSPECTOR) Page 1 of 1 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: