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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: $55.00 RECEIPT #: 13 -PID -10605 DocuMENT #: PR749846 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] [ 18.00 ] [I INCHES f FT 1 [ ABOVE /) BELOW b BENCBMARK /REFERENCE POINT [ 36.00 ] [I INCHES I FT ] [ ABOVE /) BELOW b BENCHMARK /REFERENCE POINT Dade CHD EXPIRATION DATE: 12/03/2008 DH 4016, 10 /9'l (Previous Editions May Be Used) Page 1 of 3 I 1 # . .–= .. w } _�.,. I d � � L:: • ..� �,...�..... , ate. ,,.y i...,.. �... a._.. .a,... . ... 1 I i 1 # 'f 3 j I g- �•"`S." Y` t 'q^' y`" g �{� �_ .a'-Y" '� " � � 2:^`> - �. -.�.- w � ^- � "i `"a^ -� E ~ � L S S L.. - ��. i � i # k #..? � S I E I ,,.n�wwc��,�m:,�, 1 : � .��«., ?�-� f � Jy�;..:'�>* •..4.� -q _� �,.... � :�..•` £ -€ '".�.. �.�a- +- �xre- ...d... �..,, R.:..�b s� . z.. p , - �� . 3. w� .�i.�..,� '�'^. `$`11 -,�#- # - �5.. �..^.d „q k �'m 9 � _6 � € f ,..1 i y � 'I � ¢ �`�` .� P q "'� _ :.. � ¢. , _ £ & .�. t.. y,,.., •�...» � § E # i � # S # £� ... i F £ £ ^• s § � $. 'y' F 5 .fi �S fi -k. . - ,... �i d.. ...a...g:s. -S :� d-'^ 5'•• -° • -y . 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.