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PLC-08-1946602 NE 96 Street Miami Shores Village, FL 1132060141410 Block: Lot MIAMI SHORES Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 MIAMI SHORES PRESBYTERIAN Building Department Copy Address 602 NE 96 ST MIAMI FL 33138 -2742 Contractor(s) Phone CHAPMAN SEPTIC SERVICE, INC. (305)815 -9901 CeII Phone Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $19.20 $6.40 $960.00 $3.00 $24.00 $1,012.60 Authorized Signature: Owner / Applicant / Contractor / Agent tunbtng = .G PPROVE Expiration: 05/0912009 Phone (305)754 -9541 Payment Type: Total $ 0.0 $ 0.00 Amt Paid 1 Amt Due $ 0.00 1 120+1 5 0 Valuation: Total Sq Feet: Type of Work: PLUMBING Type of Piping: SEPTIC & DRAINFIELD Additional Info: Classification: Commercial Available Inspections : November 10, 2008 Date CeII Inspection Type: Abandonment HRS Approval Rough Landscaping Final 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. Monday, November 10, 2008 1 Inspection Date: December 11, 2008 Inspector: Levrock, James Owner: CHURCH, MIAMI SHORES BAPTIST 6711 Job Address: S treet NE Miami Shores Village, FL Project: <NONE> Contractor: CHAPMAN SEPTIC SERVICE, INC. Building Department Comments Wednesday, December 10, 2008 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 - Commercial Inspection Type: Final Work Classification: Septic Phone Number (305)754 -9541 Parcel Number 1132060141410 Lot: Phone: (305)815 -9901 Page 1 of 1 Passed Ins • - -tor H - • omments WORK IN FILE Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: December 11, 2008 Inspector: Levrock, James Owner: CHURCH, MIAMI SHORES BAPTIST 6711 Job Address: S treet NE Miami Shores Village, FL Project: <NONE> Contractor: CHAPMAN SEPTIC SERVICE, INC. Building Department Comments Wednesday, December 10, 2008 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 - Commercial Inspection Type: Final Work Classification: Septic Phone Number (305)754 -9541 Parcel Number 1132060141410 Lot: Phone: (305)815 -9901 Page 1 of 1 I \ 1 Passed s \ tor Comments ' S PAPER WORK IN FILE Ci Nsi Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: December 11, 2008 Inspector: Levrock, James Owner: CHURCH, MIAMI SHORES BAPTIST ru I Ioru Job Address: 60 96 Street NE Miami Shores Village, FL Project: <NONE> Contractor: CHAPMAN SEPTIC SERVICE, INC. Building Department Comments Wednesday, December 10, 2008 Block: Permit Type: Plumbing - Commercial Inspection Type: Final Work Classification: Septic Phone Number (305)754 -9541 Parcel Number 1132060141410 Lot: Phone: (305)815 -9901 Page 1 of 1 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Plumbing Owner's Name (Fee Simple Titleholder) WWra4::' i4tat4 /esilybrA" 641 rldi Phone # S — 213"5/ Owner's Address 6, p c/ ! 6 �F. City h7 .. ,,�, �� i State Zip ."..Fi 31 — ,Z) / y Tenant/Lessee Name Phone # E -MAIL: Job Address (where the work is being done) ®a _E clic, 6+ City Miami Shores Village County Miami -Dade FOLIO / PARCEL # 3 � "' 19 ID Is Building Historically Designated YES NO Contractor's Company Name 0114 1,1'4 Y 4,i(4 1,f). 5j S Ole" S Phone # 81.S.--95)8/ Contractor's Address f 7 0 `a g l 1 City . 1 r A vet State rl p Zip 3302'13 Qualifier Name C t $ C n,lhoe State Certificate or Registration No. Sli -410.(13(1 -1 [67 Certificate of Competency No. E -MAIL: 1 Architect/Engineer's Name (if applicable)° Value of Work For this Permit $ - 000 Type of Work: Describe Work: Bond $ Structural Review. $ ['Addition ['Alteration ['New Pt Repair /Replace ❑ Demolition ,s ?a l - D qa/ tn. son€s l f2l ,1,� Lila �' 2 // 6� Z t 4o vi4 s ) '7 36, 9 ****** * 'k'****weY9cdexnYdcaYir** **** xx'. - ****Fees ' ��de **** 9e*************�4aY************ ** ** 'r xfk r�l Submittal Fee $ Permit Fee $ Notary $ Scanning $ Radon $ Training /Education Fein $ DPBR $ Code Enforcement '$ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Double Fee $ Permit No.V1 Master Permit No. Zip 33158 8 Phone # c 1 8 tg - Phone # Square / Linear Footage Of Work: / / 7.2 Sy Ii NOV LE 0 5 2008 jg BY: .. e....... CCF $ CO /CC Technology Fee $ Zoning $ Total Fee Now Due $ See Reverse side -+ Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if applicable) Mortgage Lender's Address City 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 Owner or Agent The foregoing instrument was acknowledged before me this c( -' day of Ott. , t11/1a. 6. 0. in E2 , ho is pe know to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: -5//i// My Commission Expires: 7 ,/ **x*****************x x*** x**** xx****** x***xxxxr. APPLICATION APPROVED BY: (Revised 02/08/06) State State OTARY PUBLIC -STATE OF FLORIDA ' '" ' S lvia Halter_ ////di ' ' • ` ,, 'f ommission #DD665957 direr Expires: JUNE 0*, 2011 BONDED THEO ATLANTIC BONDING CO., INC. eked Contrator The foregoing instrument was acknowledged before me this 5 day of /i&1 , 20 a , by Nittig amfa4.4 who is„personalown to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Signature Sign: Print: My Commissio All VANESA CANTRELL Notary Public - State of Florida ommission Expires Jun 15.2009 ",, Bonded By National Notary Assn. YQ a`, tz 4e, Y+ tx, ex, 4x xaex& xxxx Yxxxx***w de c x Plans Examiner Engineer Zoning T A N K D A T N I E L D 08 -18- 08:15:22 :Glasshammer working. Found unsuitab soil undear the bottomof Invert elevation of Bottom of drainfiel SPECIFICATIONS B APPROVED BY: DATE ISSUED: 3052513103 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority Chapter 361, FS & cbapter 64E -6 FAC CONSTRUCTION PERMIT FOR: ( X (New System ( 1Existing System ( (Repair ( 1Abandonment APPLICANT: Miami acres Presbyterian Church PROPERTY STREET ADDRESS: 602 R.E. 66th 8t. Village of mead, gamma, 81. 33138 LOT: 1 to 10 BLOCKz 61 SUBDIVISION: WPM maw See iwn 0 2`, Pb. 10,3o. 37 0 tsection /Township /Range /Parcel No.] PROPERTY ID 4: 11 - 3206 - 014*- 1410 (OK TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,EAC DEPARTMENT APPROVAL OF SYSTEM !X)ES NOT GUARANTEE SATTSFACTORY 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 MODI3ICATIQNS 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 [ 1500 Capri Ri / GPO sti TTC TAN AEROBIC OMIT CAPACI TI [ 730 feiNASTO i / GPO d er in series CAPACITY 1#4 L• GREASE INTERCEPTOR CAPACITY ( 1200 (GALLONS DOSING TANK CAPACITY ( 250 (GALLON 6 *1472 (SQUARE t't.'ST PRIMARY DRAi.NFIELD SYSTEM (SQUARE FEET SYSTEM TYPE SYSTEM: i y (STANDARD t M ] FILLED 1 p ) MOUND ( ) System CONFIGURATION: ( N (TRENCH 1 y (BED (y ) Low Psseessure Dietribation Network LOGATTON OF BENCHMARK: EVE: First Floor of Buil No 2 is 8.58' NOVD ELEVATION OF PROPOSED INCHES 1 ( 1RENCCHMARK /ltEFER NCE POINT BOTTOM OF DRAINFIELD TO BE ( 30.96 1 ( Ike ) ( MON ]BENCHMARK /REFERENCE POINT FILL REQUIRED:( 0.00 ]INCHES EXCAVATION REQUIRED; ( 66.00J INCHES UTHER REMARKS: Install 1 00 & 5 gal. single -c = Sept c tanks equivalent in series, with an approval filter and 1200 gal. single - chambered dosing tank all category -3. The licensed contractor installing the system Ls responsible for installing Lhe minimum category of Lank in accordance with sec. 64E- 6.013(3)(f), FAC. // Install 2 x 736 = 1472 (2 x 750 = 1500 as per design) S. equivalent MPS - 9 dual - bed drainfield es low pressured dosing by submitted design (2 pump station required, certified as suitable for distributing sewage effluent to dose alternately its corresponding drainiield bed each time). Audio and visual alarms must be installed and s3. P.E. 1.3n. 45894 DS 4016, 03/97 tObsolotcs previous editions which may not (Stock Numbers 5744- 001 - 4016 -0) sm.,a4. .4s+a - 11 ]Holding (Temporary TITLE: be 'hood) Tank ( ) Innovative Other X 1 Low pressured ears. Caleb Arrieta s elassheumer, AGENT: faa. CENTRAX *: DATE PAID FEE PAID RECEIPT . OSTDSNBR : MULTI - CHAMBERED MULTI- CRAMBERED +2 X 736 8S Dseinfields TITLE: Florida State Licensed roamer. EXPIRATION DATE: Fit EPIP 4 4 # 3/ 3 ( 2 1DOSES /24 HRS /PUMP 4 PUMPS( 2 ) turbed native soil to be replaced with a2" slightly limited ld up to 12" around tho required drainfieid area. be no less than 6.35 NCVD. be no less than 6.00 NCVD. 4 [Q 1 4 z ] c eZ. C.. CRD Page 1 of 2 October 23, 2008 Miami Shores Village Department 10050 N.E. Second Avenue Miami Shores, Florida 33138 Dear Building Department Personnel: Sincerely yours, Wilda G. Womer, Business Manager MIflMI SNORES PPtSbYTtPIflI1 (BUPCB Please be advised that Chapman Septic Service, Inc. PO Box 431911 Miami, Florida 33243 is authorized to apply for permits for complete septic systems for the entire church campus. 602 N.E. 96 STREET • MIAMI SNORES, FEORIdA 33138 • TEIEphoNE: 3057549541 • FAX: 305 -758 -9597 E-Mail: MSpC @bEI15OUTIi.NET • WEb SITE: WWW.M5pC.NEr -it as- nio AGENT: PROPERTY ADDRESS'': LOT: STATE OF FLORIDA 1 -DEPARTMENT OF .HEALTH •1 i ONSIT5SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTIUCTION INSPECTION AND FINAL APPROyAL BLOCK: • k CHECKED [X] ITEMS AR NOT IN COMPLIANCE TANK INSTALLATION t TANK SIZEL [1] [2] P TANK MATERIAL OUTLET DVICE MULTI-CH 1 MBERED [Y./ N] OUTLET F TER --. [06] LEGEND [07] WATERTIGHT [08] LEVEL [09] DEPTH TO LID r' DRAINFIELD INSTALLATION [10] AREA [1] [2] SOFT 1 [11] DISTRIB ION E3OX _HEDER _ .A [12] NUMBER F DRAINUNES [13] DRAINLIN SEPARATION , [14] DRAINLIN SLOPE I . [15] DEPTH 0 , COVER [16] ELEVATI [ABOVE1BELOW] BM [17] SYSTEM I.pCATION -, [18] DOSING FUMPS [19] AGGREGITE SIZE [20] AGGREG TE EXCESSIVE FINES [21] •AGGREG TE DEPTH EXPLANATION OF VIOLATIONS / REMARKS: [ [01] [02] [ [04] [05] FILL / EXCAVATION MATERIAL [22] FILL AMO NT [23] FILL TEX1ttJRE [24] EXCAVAT DEPTH [25] AREA RE LACED [26] REPLACEAENT MATERIAL SUBDIVISION: PROPERTY ID #. nn „ CONSTRUCTIONPPROVE1D/DISAPPROVED]:J. .• • , FINAL SYSTEM4APPROVECpISAPPROVEDI: 4 ' _ _ _ „ „ ' t• DH 4016 (Page 2), 10/97 (Previods Editions May Be Used) Stock Number 5744-002-4016-4 PT 1: Applicant PT 2: Installer/Contractor PT 3: Building Department PT 4: Health Department PERMIT NO r: DATE PAID. FEE PAID RECEIPT #• WITH • STATUTE .OR RULE AND MUST BE CORRECTED. SETBACKS [ [27].. SURFACE WATER FT [ ] [28] DITCHES FT [ • ] [29] PRIVATE WELLS FT [ 1 [30] PUBLIC WELLS FT [ ] [31] IRRIGATION WELLS FT [ [32] POTABLE WATER LINES .FT [ ] [33] BUILDING FOUNDATION FT [ ; [34] PROPERTY LINES FT [ 1 [35] OTHER FT FILLED / MOUND SYSTEM [36] ' DRAINFIELD COVER [37] SHOULDERS [38). SLOPES [39] STABILIZATION ADDITIONAL INFORMATION [40] UNOBSTRUCTED AREA • [41] STORMWATER RUNOFF [42] ALARMS [43] MAINTENANCE AGREEMENT ,..[441 BUILDING AREA [45] . LOCATION CONFORMS WITH SITE PLAN [46] FINAL SITE GRADING [47] .. CONTRACTOR 4-- [48] - OTHER ABANDONMENT [49] TANK PUMPED / 7: - [50] TANK CRUSHED & FILLED. - CHD DATE CHD DATE-• - - • -* ' Page 2 of 3 R. la Paper ITEMS AR AI*. INSTALLATI f 6 14 TANKSIZ [1] / [2] TANK 4RIAL �fl�j ` Oti`fif D VIDE MULTt MBERE7 [Y-/ N ] O '£ET F TER R WATERTI STATE F FLORIDA DEPAR , MENT OF HEALTH ONSIT SEWAGE ThEATMENT AND DJSPOSAL. S CON!ST UCTION INSPECTION AND FINAL APPRO '. FILL TEXTl�RE (2 EXCAVATE 7N DEPTH j AREA REPLACED REPLACE1ENT MATERIAL - EXPL/iN41:10N OF VIOLATIO gS / REMARKS: D1- 40-16(P ge 2), t0 /9/ (Previous dhotis May Be Used) _. $0;3Ck NUit be X44 - GO2- 4016 -4 a ttD iNS A AT 1ON ,- -- SOFT 11� ' DISTRISUIION BOX ______i_. ADER 72]. - .MJMBER F DFIAINLINE t om-" DRAINLIN , SEPARATION ' ) , .)1 , .O RAINLINIa SLOPE . } 051 D PTI-I OF COVE , V 1': ' A8OVI/BEtO J]t EiM T - `1 w _, E -, . L , 6%14t6 A El SIZE ,Ai - n : L -{ 4 .m " -- -;k7 GA E EXCESSIVE FINES - { { .• `. AGG'REGA E DEPTH { - fla if £GCAVATION MATERIAL 225-: - FILL AMOUNT a" , CON&•Fi 1ON:{APPROVEC i'DISAPPROVED] : + �` STEM AL PROPERTY r s t ACE •WA?'E . ] , DITCHES. PRIVAi E:'WF# t :S; P1IBL W LL IRRIGAT1ON -W L1_S ri" POTABLE Lt1 ES' . a BUILDF3� FOUNDATION 'PtFbPEBTY lI ��EtL�.�D�iVlOUT�1D'SY�T�161'' =. [361: _D0. NI t= COVER [37] St 3EtL0 AS [38] SLOP {3] .,.. STABILIZkTION ADDt 1OWAL IN - ORMATION }} [#NOBST UCT Q AREA ' ] 1) r STORMVJI�TE1 RUMO . 1[42] ALARMS s r {43] MAI ENANC ARE III EVE [44] BUILDING AREA [45) LOCA - PEON CONP TAMS W-ITI-rSITE PLAN 1 {46) FINAL $tT1v fIEXCMNG [47] GQNTRAOTOR; T. = 7.C4' :' =; .�� .,. [48) OTHER I • ! 1! ABANDONMENT • 1[49] TANK PUMPED 1{50] TANK CRUSHED & 11t LE[J 4 PT t: Applicant PT 2' las al er /G�ntraCtot PI 3 .&hldrr4 Dtii i part i ..tnejA ,< i f PT 4: ! ,