PL-08-1646Project Address
325 NE 97 Street 1132060135740
Miami Shores Village, FL 33138- Block: Lot:
Owner information Address Phone Cell
325 NE 97 ST
MIAMI SHORES FL 33138 -2405
PAUL STRAVINSKAS
Contractor(s) Phone
STATEWIDE SEPTIC CONNECTIONS 305 - 661 - 6633
Cell Phone
Type of Work: PLUMBING
Type of Piping: DRAINFIELD
Additional Info:
Bond Return :
Classification: Residential
Fees Due
Bond Type - Owners Bond
CCF
Education Surcharge
Notary Fee
Permit Fee - Additions/Alterations
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$300.00
$1.80
$0.60
$5.00
$175.00
$175.00
$3.00
$8.74
$669.14
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
Tuesday, September 9, 2008
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores , FL 33138 -0000
Phone: (305)795 -2204
e
Expiration: 03/08/2009
Parcel Number
Total
$ 0.00 $ 0.00
Payment Type :
Amt Paid 1 Amt Due
$ 0.00
1,
SEP 2t108 Cx�o �
MIAMI SHORES VILLAGE
Applicant
Valuation:
Total Sq Feet:
PAUL STRAVINSKAS
September 09, 2008
Date
$ 2,300.00
225
Available Inspections:
Inspection Type :
Rough
Landscaping
Final
1
1
REPLACE BROKEN TANK AND DRAINFIELD
Passed
pec
r Co
ments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Number: INSP -94312
Permit Number; PL -9-08 -1646
Inspection Date: 09/17/2008
Inspector: Levrock, James
Owner: STRAVINSKAS, PAUL
Job Address: 325 97 Street NE
Miami Shores Village, FL 33138-
Project:
<NONE>
Contractor: STATEWIDE SEPTIC CONNECTIONS
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Drainfield
Phone Number
Parcel Number 1132060135740
Lot:
Phone: 305 - 661 -6633
Tuesday, September 16, 2008
Page 2 of 2
REPLACE BROKEN TANK AND DRAINFIELD
Passed
or Comments
�l
w
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
pection Number: INSP 943'1'1
Permit Number: PL -9 -08- 1646
Inspection Date: 09/17/2008
Inspector. Levrock, James
Owner: STRAVINSKAS, PAUL
Job Address: 325 97 Street NE
Miami Shores Village, FL 33138-
Project:
<NONE>
Contractor: STATEWIDE SEPTIC CONNECTIONS
Building Deuartment Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
l/
Permit Type: Plumbing - Residential
Inspection Type: Landscaping
Work Classification: Drainfield
Phone Number
Parcel Number 1132060135740
Lot:
Phone: 305 - 661 -6633
Tuesday, September 16, 2008
Page 2 of 2
V kiiv-c
3 �FIS
in /
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: Plumbing
Owner's Name (Fee Simple Titleholder) L . j,� � 4 Phone #
Owner's Address 3,P-S"
City 11'1 SGl o r e5 State f `- Zip 27 ' J3 r
Tenant/Lessee Name Phone #
E- MAIL:
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL # 11 a )e "Of — 5740
Is Building Historically Designated YES NO
1)'.e `
Contractor's Company Name 5 �'` gt ��t C Chi -it,s Phone # 3 / 6 - 6633
Contractor's Address 3 S 50 S ' S°t RA '1- Z r;
City If•A\ r a on c. ' ' S tate - Zip 3 - 5o 2-�J
Qualifier Name T &z, 0 ' 50 I 0 v''l Phone #
State Certificate or Registration No. Certificate of Competency No.
E -MAIL:
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 2 • e7 0 Square / Linear Footage Of Work: 2 2 5
Type of Work: ['Addition
Describe Work:
Submittal Fee $
Notary $ S.
Scanning $ � OD
Bond $ "Jbb y ! 5
Structural Review.
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
DAlteration
325 NC 5t-
['New
Re l 4 ce.
/��0 99 2008 :L )
C IV
MIAMI SHORES VILLAGE
Permit No.
Master Permit No.
Repair /Replace
bra, ,1 -c1 J
* * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * **
Permit Fee $ 1 7. AGO �' t 7 3 IV CCF $ 1► V CO /CC
Training /Education Fee $ Technology Fee $ 1
Radon $ Zoning $
zip _3( �J'Cr
Total Fee Now Due $ 66 q. / I
See Reverse side
El Demolition
Bonding Company's Name (if applicable)
Bonding Company's Address •
City
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
•
State v
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
COMMENCEM ENT."
Notice to Applicant: As a conditi
promise in good faith t at a co oy
whose proper is s b ect o a ach
for the first i pect ' n w is occ
inspection wi l not • . app ov: d a d
•
Signatu
Owner or Agent
The foregoing instrument was acknowledged before me this 4-
day of T , 20 by Q 4v S1a` S ot
Sign:
Print:
. 'n ritiv • a : " Assn., Inc
su�m.on ane.snsen.nnnv.nnun
My Commission Exptres: nn
x$xxxxx,Yxlve se *****x
APPLICATION APPROVED B
(Revised 02/08/06)
...u.aa�aa�eua•
'TERES
„awrx,
State
Zip
to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
the notice of commencement and construction lien law brochure will be delivered to the person
ent. Also, a certified copy of the recorded notice of commencement must be posted at the job site
s seven (7) days after the building permit is issued. In the absence of such posted notice, the
a reinspection fee will be charged.
The for
day of
who is personally known to me or who has produced O1' � who i
IA As identification and who did take an oath.
NOTARY PUBLIC:
OM • a..a ai.,
i, Expires 11/8/2011
Contractor
nstrument was acknowledged befoite
, 2C0 d � , by
personally known to me or who has produced
1 JIntification and who did take an3ath.
OTAR , UBLIC: 4ti ® 1 �
►`s, � ti
( t j I'���4 n� .c
My Commission Expires:
•
xx' -0- xxxux *****, Y, Y, Y*u de******** e4*eYx'xs:x*,Y************' '********' oY******
q`
f- or"
Plans Examiner
Engineer
Zoning
LOT: 15-17
PROPERTY ID #: 11- 3206 - 013 -5740
0
T
H
E
R
DATE ISSUED: 09/0 /2008
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Paul Stravinskas & Ernesto Osuna
PROPERTY ADDRESS: 325 NE 97 St MIAMI, FL 33138
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
BLOCK: 42 SUBDIVISION: Miami Shores Sec 1 Amd
T [ 900 1 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 [ 225 ] SQUARE FEET Trench Confiauration SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [] MOUND [ ]
I CONFIGURATION: [x] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: FFE 11.40" "NGVD
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED: [ 0.00 ] INCHES
1.-Install 900 gal. category-3 septic tank equipped with an approved filter.
2. -The licenced contractor is responsible for installing the minimum category of tank sec. 64E- 6.013(3)(f).
3.- Install 225 sf of drainfield in TRENCH configuration.
4. -Invert elevation of drainfield to be no Tess than 7.99 ft NGVD. REPAIR
5. -Bottom of drainfield elevation to be no less than 7.49 ft NGVD.
THIS PERMIT IS NOT FOR " ADDITION(s) ". MIAMI -DADE COUNTY HEALTH DEPARTMENT
SPECIFICATIONS BY: card L lizaire TITLE:
APPROVED BY: J : teat TITLE: Engineer Specialist II
v 1.1.4
006
EXCAVATION REQUIRED: [ 30.00] INCHES
AP894375 8E766480
PERMIT #: 13-SG- 953205
APPLICATION #: AP894375
DATE PAID: 09/03/2008
FEE PAID: $55.00
RECEIPT #: 13 -PID -10605
DocuMENT #: PR749846
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
[ 18.00 ] [I INCHES f FT 1 [ ABOVE /) BELOW b BENCBMARK /REFERENCE POINT
[ 36.00 ] [I INCHES I FT ] [ ABOVE /) BELOW b BENCHMARK /REFERENCE POINT
Dade CHD
EXPIRATION DATE: 12/03/2008
DH 4016, 10 /9'l (Previous Editions May Be Used) Page 1 of 3
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Site. Plan submitted t
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR NSITE SEWAGE DISPOSAL SYSTEM
Permit Application Number
Y;
Plan Approved
By ` ° ?Apr
Scaki: Each block represents 5 feet and 1 inch = 50 feet.
OH 4015,10196 (Replaces HRS-H Form 4016 which may be used)
(Stock Number: 5744 - 002. 4015,6)
— PART II - SITE PLAN-
Signature
Not Approved
0g
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
Date -
County Health Department
TANK INSTALLATION
[01] TANK SIZE [1] [21
[02] TANK MATERIAL
[03] OUTLET
[04] MULTI-CHAMBERED [Y 1 N]
[05] OUTLET FILTER
[06] LEGEND
[07] WATERTIGHT
[08] LEVEL
[09] DEPTH TO LID
DRAINFIELD INSTALLATION
[10] AREA [1] [2] sorr
[11] DISTRIBUTION BOX __HEADER
[12] NUMBER OF DRAINLINES
[13] DRAINLINE SEPARATION
[141 DRAINLINE ORE
[15] DEPTH OF COVER
[16] ELEVATION [ABOVE/BELOW] BM
[17] SYSTEM LOCATION
[18] DOSING PUMPS
[19] AGGREGATE SIZE
[20] AGGREGATE EXCESSIVE FINES
[21] AGGREGATE DEPTH
FILL / EXCAVATION MATERIAL
[22] FILL AMOUNT
[23] FILL TEXTURE
[24] EXCAVA DEPTH
[25] AREA REPLACED
[26] REPLACEMENT MATERIAL
EXPLANATION OF VIOLATIONS / REMARKS:
DH 4010 x .
Stock Number 5744-us....-
" 4 1TSAPPROVED1:
-
„ z
•
SETBACKS
1 - SURFACE WATER
[36]
[37]
[38]
[39]
' •
PTI.: Applicant
PT -Inetatler/Contractor
PT 3: Building Department
PT 4: Health Depcutment
Fr
[28] DITCHES FT
[29] PRIVATE WELLS Fr
[30] PUBLIC WELLS '`.---„,, FT
[31] IRRIGATION WELLS-, FT
[32] POTABLE WATER LINES-- - FT
[33] BUILDING FOUNDATION FT
[34] PROPERTY LINES FT
[35] OTHER
Fr
FILLED / MOUND SYSTEM
DRAINF1ELD COVER
SHOULDERS
SLOPES
STABILIZATION
ADDITIONAL INFORMATION
[40] UNOBSTRUCTED AREA
[41] STORMWATER RUNOFF
[42] ALARMS
[43] MAINTENANCE AGREEMENT
[44] - AREA
[45] LOCATION CONFORMS WITH SITE PLAN
[46] - FINAL SITE..GRADWG
[471: . CONTRACTOR •- • -•Th -
[48] . OTHER
'--,ABANDONMENY ,
[49] .TANK. PUMPED • ,
• [50] TANK CRUSHED & FILLED
CHD DATE
• CHD DATE
Page 2 of 3
Recycld Pape.