750 NE 96 St (12)(OWNER TO RETAIN COPY)
Date y .Job Address 7 O NE $6 ,Fh s-- M,s� pm 3314fflax Folio/J-3,204, 0/41,g09,0 7
Legal Description to f v (. C/IL 1 .41/ 3 Master Permit #
Owner / Lessee / Tenant cfr r2 i FL RO,D 2/ CGthe
Owner's Address 751 /11If /U ? Phone C� .24
Contracting Co. 4x 4 P (lAn ihi; Address /70 / I 7 7E2/ Nt /V1 //j)v ; 7'L
Qualifier 4 714 Q�/ V E (J 1/Fz ss# Phone ' -.5 73 q_$E 4/36
State# Competency #_6 1 V(% Ins. Co.
Architect /Engineer
Bonding Company
Mortgagor 43,4ni/r,r073 S4kt.).17s ',AAA
Permit Type (circle one): BUILDING ELECTRICAL
WORK DESCRIPTION Drew; 'F �" " 375 SZ
Square Ft.
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO
DO SO 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).
Application is hereby made to obtain a permit to do work and installation as indicated above, and
on the attached addendum (if applicable). I certify that all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING, and MECHANICAL work.
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.
Furthermore, I authorize the above -named contractor to go the work stated.
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
PERMIT FEE: APPROVED:
Zoning
Mechanical
aPt> (0b
C4b T / n a al
Address
Address
Address
Sign ure
ARY PUBLIC; STATE OF FLORIDA AT LAA>ai
�Y COMMISSION EXPIRES APRIL 10, 1994
BONED THRU AGENT'S NOTARY BROKE048
Fire
Notary as to Owner and /or Condo President Notar
My Commission Expires:
* . * . * * * * * * * * *
Building
Plumbing
R3 a,5- sa ,,4I DI r / 1441/.
MECHANICAL PAVING FENCE SIGN
Estimated Cost r1A7U
Contractor or Owner- Builder
NOTARY PUBLIC; STATE OF FLORIDA AT LARGE
Y COMMISSION EXPIRES APx1L 10, 1994
DED THRU AGENT'S NOTARY BROKERA411
as to Contractor or Owner - Builder
My Commission Expires:
Other
*
*
*
�,'� ectrical
�( 16 ) EngJneering
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ON TE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT
Applicant G R r L '` O n R (G a 6 Z Permit Number /87/
8
7 50 �� c- 9 6
PART I - SYSTE CONSTRUCTION SPECIFICATIONS AND CONSTRUCTION APPROVAL ---- ---- --
Treatment Tank
Septic tank or Grease
aerobic unit gallons interceptor gallons
Septic tank or
aerobic unit gallons Dosing tank gallons
Graywater
tank
Laundry
waste tank
Other Requiremen
gallons
(e) Fill quality and quantity: o
/ Fomi 4018. Feb 85 (Obsoletes previous editions which may not be used)
k Number•.5744-001- 4018-0)
Authority: Chapter 381, FS
Chapter 100-6, FAC
(a) Installation must be in accord with requirements of chapter 10D -6, FAC.
(b) A system construction permit is valid for p riod of one calendar year from date of issue.
(c) Final installation inspe �Lion and approvsquired before the system is covered. r
(d) Invert of stub -e ut F ) / , c4.4 to . to be .ST J —
4/_S `- benchmark
Invert of stub -out for to be benchmark.
Invert of stub -out for to be benchmark.
Invert of stub -out for to be benchmark
c4 2
•
(f) Other:
Minimum Draintrench OR Minimum Absorption
Size Bed Size
p
Square Feet 7J Square Feet
Square Feet Square Feet
Square Feet Square Feet
Square Feet Square Feet
System design and specifications by Title
Construction authorized by l ,,... Date 3
County Public Health Unit
te: Completed copies of this form will be provided to the applicant, installer and the building department.
DITCONTROLNO. 64747
r
. y
Page 1 of 2
.7 ! Y6 T'^?.�'lc ;'7ti! •.... ' T.. + :"f Z�°ST � : �!L..y�'+. d ,; 4
STATE OF FLORIDA
cPEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
i
Date of Application 6 •
91
Authority: Chapter 381, FS
Chapter 10D -6, FAC
j;,"7-77.1)7777:77::-.7.777
.,.i.- -.-.�• --�-
Permit Application Number
9 7- 47/
PART 1- APPLICATION----« -------
«----«-«-«----------- « «««« «----- «- _._ --.__
Name of Owner C t * - r 3 R I E - ( R03 Q 4 C Telephone Number 63 5 24 -O4I-
Mailing Address of Owner 75 /l/E
Owner's Agent / /oPE Ow/ `J E Builder
Agent's Mailing Address n• 0 "617( E0 On /14 R-7141
s�
Property Street Address -7 N F 9 M' too
Lot No. 6 Block No Subdivision M/414; S t 11)176-- 3 " 3 Date Subdivided
NOTE: IF NOT IN A SUBDIVISION ATTACH A METES AND BOUNDS DESCRIPTION
This Application is for: New System >7 Repair Existing System
Type of
Establishment
u,; / &5 ;CCU -.Xe
'
TOTAL FLOW =
Telephone No 4 S 4 - J 3 (
Sewage Flow Sewage Flow
(Gallons per day) Based On
Type of No. Bedrooms Heated or Cooled Area No. Dwelling Sewage Flow
Residential. (each dwelling unit) (each dwelling unit) Units (Gallons per day) • 4
ice /14.41 I l.`J
DIT CONTROL NO. Applicant's Signatu
S
Form 4015, Feb 85 (Obsoletes previous editions wh1Eh may not be used)
Number. 5744-001- 4015 -1)
ft
Exact Directions to Property
G oo
Page 1 of 3
•
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S30IA233S 3AI!VI TOVH38 '8 HilV3H 30 1N314118Vd30
V0121O13 30 31d1S
a3AOIddd
BEARINGS
HEREON (IF
ANY) ARE REFERRED
SKETCH OF BOUNDARY SURVEY
SCALE 1" = 20 -
Al e. 6 "
/s/3 I
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c, 63. s.
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126.00•
/6.
a aNT.
� ?.�Il'Id Q3I3IZH
:d35 , T r rII '=$ ZZ�iH5 TId3ZSxS
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- - 9 • gi k • "a"e L
To AN ASSUMED V LUE OF
FoR
. SAID BEARING IS IDENTICAL WITH THE
ACCORDING To THE N.F.I.P. THE SUBJECT PROPERTY FALLS WITHIN FL000 ZONE:
/G .7
D..StJ
c % r
'1,NSIA?1,IKIOddd O3
KGS'OLt TWO 1AI. .SAS
'Its SOdSIQ SDVA13S :. IS
�- . C• \OLLOSdS` NV 2103
_mot T_O. - 'au Zsfl I j'1.aac
Ai :n00 a axt
PLAT OF RECORD
LEGAL DESCRIPTION
LOT 60 4e` ,E L L0' - 7 BLOCK G 5
SUBDIVISION: /q/aer . 1 2000 .567.47./41"e/if 3
ACCORDING To THE PLAT THEREOF AS RECORDED IN PLAT BOOK /cam AT PAGE 3 7
OF THE PUBLIC RECORDS OF I)D. .e� COUNTY. FLORIDA.
LOCATION SKETCH
SCALE 1" =
i
SURVEYOR'S NOTES.
Elevations are referred to N.G.V.DATUM.
Benchmark No B- 50,Elevation 10.02 feet
Locator- index.3250 S.
ABBREVIATIONS.
C.B.S....Concrete block structure.
C/L Center line.
SURVEY CERTIFY TO:
1 HEREBY CERTIFY THAT THE ATTACHED SKETCH OF BOUNDARY SURVEY OF THE ABOVE DESCRIBED PROPERTY IS A
TRUE AND CORRECT REPRESENTATION OF A FIELD SURVEY MADE UNDER MY DIRECTION AND MEETS THE MINIMUM
TECHNICAL STANDARDS As SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL LAND SURVEYORS IN CHAPTER
21HH -6 FLORIDA ADMINISTRATIVE CODE. PURSUANT To SECTION 472.027. FLORIDA STATUTES.
FOR: GABRIEL RODRIGUEZ.
Jos NUMBER: J5 s
F.B. No — /
MANUEL FELIPE
PROFESSIONAL LAND SURVEYOR
9525 S.W. 15th. ST., MIAMI, FL 33174
PHONE: (305) 554 -6592
DATE OF THE FIELO SURVEY:
REVISION DATE:
SURVEYOR'S NOTES:
LEGAL DESCRIPTION WAS FURNISHED BY CLIENT.
EXAMINATION OF THE ABSTRACT Or TITLE WILL HAVE To BE MADE To DETERMINE RECORDED INSTRUMENT, IF ANY
AFFECTING THIS PROPERTY.
THERE ARE No VISIBLE ENCROACHMENTS OTHER THAN THOSE SHOWN
LEGAL DESCRIPTION SUBJECT To ANY DEDICATION. LIMITATIONS. RESTRICTIONS. RESERVATIONS OR EASEMENTS
OF RECORDS.
.NO UNDERGROUND INSTALLATIONS OR IMPROVEMENTS HAVE BEEN LOCATED. EXCEPT As NOTED.
NOT VALID UNLESS SEALED WITH AN EMBOSSED SURVEYOR'S SEAL
MANUC ELIPE
PLS 4146
STATE OF FLORIDA
~^ `
ROCESS NO: X91101617
ABRIEL R0DRIGUEZ
50 NE 96 STREET
*lAMl SHORES,
REVIEW
TYPE
DERM D056
FEE
CODE
M E
__~~_~__~-~-___~_
�- 4-91
0010 SLOG/20SrrIG
BOi $35.0G
TOTAL $35.00
*CHEM $35.00
FEE
DESCRlPTION
TUTAL:
UNI T
UNITS DESC
0000001
06/24/91
FEE
AMOUNT
35.00
35.00
30 9968 001 062491 000003500
- '-. - - _ _-__ ' __--~_-.~_'--.�-' '___._ __-�~_'-'
/m`��'�,�vr�,*�:�� ~�� 5*:;,
~
010 04 O?9110161?0 000003500
JIF
MIAMI SHORES VILLAGE DRAINFIELD RELAY
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 the work.
December 15 9 59
Owner's Name and Address.. HOFFMAN No 75 Street N. E. 9 St.
State work to be done and purpose of building (by floo
Date
Registered Architect and /or Engineer
Sun Gold Septic Tank, Inc. b S W Avenue
j . 7
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 750 N • E. 96 Street
and for no other purpose.
New Building Remodeling. Addition._ Repairs No. of Stories
To be constructed of Kind of foundation R of Covering ...r --
Estimated Total cost of improvements $ Amount of Permit $
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
1
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 complied 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 subcontractors, n work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks ( Signed ) _ �Q
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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.
Permit No Date Read, Sworn to and Subscribed before me.
Disapproved Date
Notary Public, State of Florida
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 the work.
Date December 15 59
Owner's Name and Address HOFFMAN No 750 Street N. E. 9 St.
MIAMI SHORES VILLAGE
Subdivision._..._.
750 N. E. 96 Street
Notary Public, State of Florida
DBAINFIELD BELAY
Registered Architect and /or Engineer
Name and address of licensed contractor Sun Gold Septic *Tank , Inc. 4450 S. W. 74 Avenue
Location and legal description of lot to be built on:
Lot Block
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ Amount of Permit $
Zone cubage required plan Cubage
Distance to next nearest building- Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
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 complied 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 subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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.
Permit No Date Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.