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PL-09-1171 n y Miami Shores Village ' i 9 10050 N.E. 2nd Avenue ' ' 1 t° Miami Shores, FL 33138-0000 +u Phone: (305)795- 2204� " ,•,.. plan' 7 Expiration: 011101201 Project Address Parcel Number Applicant 102 97 Street 1131010250080 Miami Shores, FL 33150- stock: Lot: ONIEL LLOPIZ Owner Information Address Phone Cell 102 97 Street ONIEL LLOPIZ (305)756 -0120 MIAMI SHORES FL 33150 -1735 Contractor(s) Phone Cell Phone Valuation: $ 5,000.00 JOE LENS SPECIALTY SEPTIC (305)662- 7979 ;. Total Sq Feet: 0 Type of Work: SEPTIC 3 DRAINFIELD For Inspections please call: Type of Piping: (305)762 -4949 Additional Info: Available Inspections: Bond Return: Inspection Type: Classification: Residential HRS Approval Abandonment Final Rough Landscaping Fees Due Amount Invoice # Total Amt Paid Amt Due Bond Type - Contractors Bond $300.00 CCF $3 PL - 7 - 09 - 35368 $ 668.75 $ 668.75 $ 0.00 .00 Education Surcharge $1.00 Bond #: 1867 Permit Fee - Additions/Alterations $350.00 Scanning Fee $6.00 Technology Fee $8.75 Total: $668.75 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. July 14, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy July 14, 2009 1 "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 Applicaw: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also. a certified copy of the recorded notice of commencement trust be posted at the job site for the just inspection which occurs seven (7) days after the building permit is issued. In the absence o such posted notice, the inspection will not be approved and a reinspection fe ill be charged f Signature t� ---• Signature IV Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing sstrument was acknowledged before me this day of , 20 _, by day of , 20 _, by , who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: C.C17 Print TEOFFLORIDA an Bream Cc' If Q � a n � Ce (� cf ode My Commission Expires: "0ommi.4sion #DD63 ( Commission Expires: %..,.,..•` Expires: FEB. 18, fYdxta44k.TekYa?.+4s4& &�u.T teta u+4�at+k+4 #ir T+e YvaY it r. &ttt$� ���r�gfi+ rieiexir44atir�dea4a4 ,YuxstusYsY+4t at44zfee4r4w�$Yr���n*3ie }ita� APPLICATION APPROVED BY: Plans Examiner Engineer Zoning (Revised 07108106) �'� Ili 1 Sh6r 1n I JUL 1 2Q 9 10 qd Avenue Iir mi S a 3 138 'ore Fib "10 �'�9 .22U� ' s ir � V Y. -.0 esm�� -wa [ `0 ) 756 ,`,12 kk lw- B U I 1� l ,lr \T �I e� i,C�� r :v : g ,r ' it r..� �— N '', , ; 1I unit o. X A 1 'L III TOO hst�r er mit No. i Perms t Ty F4t1,,�' Owr�elr s Nacr��e (Fee Si pie Tjtt�h) t) I' �� " Pao #' n. OwnOl Addr ss �1 i.. I City /�11 q .S t �'I Zi Tenant essee� ame Job Address C'�' here th I ,�`,work is ooe I' ,I �. ;'� 2 r,/ f CO If I Id I I I I' 1, City, Ivtiami ores Villa c unty i -I"' a zip i< I. OL.I f i' Q A EL # I I I I I 1 Is Duiidin' F[ to l g rically Designal'ted Yd L NO - '� t Contrza�Ctor's ompany! Name � : ' ' ��' II 4 Phone #'� - 3 ®S -2— Con tor s i. � dress 30� II'' Ci I � 1 l �. - tY Z11) 33 0 2. 3 �,.— `* Is. t, � I f ualifi r N I am , Jo �,�� I r f '' t Q I Phone # r- 3 os 66 ?97 State C' rtifica l e or Regrstratron NoJ I S 1 F S Certifi !of Co et n e c No. !�P Y Archi etti peer's Name (if, , li I le)I , ° .Pon # Value f Wor Fir thi .Perm t s Square f 'nj r'Fopta je Of Work: r j 11 € I T e o Wor A drtion t „ e air /Re lace �� � � � ,1 I �� � �, �-? i'- P ' p El mo ikon Descr1be Wor� - „�. Ii o Al I' l lil r air u�a+tw ,�� �Ow1� ee$�`r �nit ' �:i l °`��$ I ' COtCC No �I to $ Tra 1 u ca ncil o gy Fee $ ,� cnnn g $ °�, I( I ��1' ' +DPI �[�; 1 I I$ Zoning $ - i3©nd tfOr�c D u B F663 I StrucrVra Re CeW. $ 1 'o i F Ito l Due $ 1 r (, See Reve*side �L�I��. �Iu,6,u:,�.�,�� Bonding Company's Name (if applicable) Ii Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zi P 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. 1 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 APFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in co applicable laws regulating construction and zoning. mpliance with all "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOURII: 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 q condition to the issuance o a building • .f . g 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 Signature Owner or Agent Contractor The of foregoing instrument was g acknowledged g Id ed be g fore me this The foregoing instrument was acknowledged before me this day of , 20 _, by day of 20 by who is personally known to me or who has produced who is personally known.to me or who has produced As identification and who did take an oath. as identification and who did take an oath. � NOTARY $UBLIC: NOTARY PUBLIC: I n III Sign: Sign: Print:, Print: My Commission Expires: M C I My Commission Expires: p I �r 9exdrdaxdrxacx4cxx9r Ytik ,������,��xx,� • • x�x • �xx�xxx x��xxxxx�xxx•�,��x��x��� #• ����, ����x• ��xxx��x�x�����x����x��x ,����.x�� I APPLICATION APPROVED' Y: lip Plans Examiner Engineer Zoning (Revised used 02!08/06). . I f I Ii I P ST # : 13 -SC- 995052 APPLICATION #: AP928888 STATE OF FLORIDA DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: SYSTEM RECEIPT #: DOCUMENT #: PR779074 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT Onier LLopiz PROPERTY ADDRESS 102 NW 97 St Miami, FL 33150 LOT: 8 BLOCK: 3 SUBDIVISION: PROPERTY ID #: 11- 3100- 025 -0800 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] 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 Fpm THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ 900 ] GALLONS / GPD SeDUc CAPACITY A [ 0 ] GALLONS / GPD CAPACITY N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIb1UM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ 200 ] SQUARE FEET SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [X] BED [ ] N F LOCATION OF BENCHMARK F.F.E.: 13.8' NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 28.80][ INCHES FT ][ BELOW] BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINEIELD TO BE [ 4.80 ] INCHES FT BE LOW] BENCHMARK /REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 24.00] INCHES 0 1— Install 900 gal. category-3 septic tank equipped with an approved filter. 2 -The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with sec. 64E- 6.013(3)(f). 3- Install 200 sf of T drainfield in bed configuration. 4- Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed H absorption bed. 5- Invert elevation of drainfield to be no less than 9.90' NGVD 7. Bottom of drainfield elevation to be no less E than 9.40' NGVD. REPAIR R THIS PERMIT IS NOT FOR ADDITION(s). ~ -" ' _ OO RMTH DEP SPECIFICATIOPI3 BY: PEDRO�N OSPINA -TI,TLE. - Legacy APPROVED BY: � .a,- ...__. .,,. Dade CHD Pedro N 08pina DATE ISSUED: 07/10/2009 EXPIRATION DATE: 10/08/2009 DH 4016, 10/97 (Previous Editions May Be Used) Page 1 of 3 v 1.1.4 AP928888 sE791979 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR'ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number 1V. 1 1, ' f 1a — — — -- — — PART 11- SITE PLAN - — -- Scale Each block represents 5 feet and 1 inch 50 feet ._ b j - fit, J r4 IJ j i .°„- `�}.,- .•..`-r • ' p � T S i r t J. 1 1 Lj w a t { I € ` _. p �. €,... ­ 1 7 # P «•q.�..1M:. Mn.y. .,.„ ,d„, ..� �. T 7 ­ �4- -j- -4- -4- H­­ 1 j 4 � ,. !...q 1 � � -, -_ ( ' — p _ .. I y ._ ... _ LJH - g _ j x ��6a a t �€ -4 P. Notes: r :",fi A` ` Site Plan submitted by:, . . 1 natu Title ; Plan Approved _ ;. Not v d Date: /` .: By - °� ' .Count Health .Deportment ALL.CHANGESMUST BE APPROVED BY THE COUNTY HEALTH DEPART1111ENT. DH 4016,.10W (Reptam HR8-H Forth 4015 WNch maybe used) _ (Stock Number. 6744 -oar- 4016.8) Rage 2 of 3 do'k= w.k .. ,�'skl af& ✓�31 9 % - 44 4 F 4 .. - _ _ s - - `.� _;. STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number PART II - SITE PLAN ------------- - - - - -® Sca le: Each block represents 5 feet and 1 inch = 50 feet. s a. , s g , 4 , y . .? r4z Y" q" e T s x 1 '. ..� F , 3• ; i i ,...,..:...t .. ... :. :.. :..:rte >. r .... t ... :... .,. . ,.� Notes: Site Plan submitted by: - _ - Signature Title Plan Approved Not Approved Date By County._Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015, 10M (Replaces HRS-H Forth 4015 which may be used) (Sloe Numbw: = -4M&6) Page 2 of 3 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 119372 Permit Number: PL -7 -09 -1171 Scheduled Inspection Date: July 20, 2009 Permit Type: Plumbing - Residential Inspector: Levrock, James Inspection Type: Final Owner: LLOPIZ, ONIEL Work Classification: Septic Job Address: 102 NW 97 Street Miami Shores, FL 33150- Phone Number (305)756 -0120 Parcel Number 113101025008 Project: <NONE> Contractor: JOE LEWIS SPECIALTY SEPTIC Phone: (305)662 -7979 Building Department Comments DRAINFIELD AND SEPTIC TANK REPAIR Inspect r mments Passed H P VAL IN FILE Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until p re- inspection fee is paid. July 17, 2009 For Inspections please call: (305)7624949 Page 24 of 32 Log- in I . � ��� r u�{� { `.* y + p P �, t � Y '��H��S ,� 9y eM 9 � �• �r $ �t ° .f' .a4 � t � r �� „ Ez��' � ry s m�” a � 4"`§� ✓ e, i� �r lz,� �'�, w 3, +pS -r �,�r ,a �,j�,. c, ti� �9 4`��.� � Y , 4 p�'� i, � , . a,:... ry aJ� �" s a �" �S. • 'f�+aS��� k.���4rr��yvtx 9Y�' ��k��� 4 k t �<._ .�;���„ � �1��5� 2 ' s �''' •c `��e ..X�¢ ��'��Cl � '`�4 e fa ^e r� <-e�-� � Zsa sa,+ r� „ +t �n5 s ifi i 4j4 ��i 'k`+F }�'(�,.. �+`^� �s �r.l �'�2 �r^ft<_ , �<�� t d. ;� r � ; � 1 s�� sz•k � q�. r x r ��� {` .v uA + '+E` "�' al;a �'S :�`, J �, - § �, ;� p t � �i h > 8 STATE OF FLORIDA PERMIT NO x ' DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID: CONSTRUCTION INSPECTION AND FINAL APPROVAL RECEIPT #: APPLICANT: - AGENT: PROPERTY ADDRESS LOT: BLOCK: SUBDIVISION: PROPERTY ID # CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. TANK INSTALLATION SETBACKS [ 1 [01] TANK SIZE [1] % ? [21 [ 1 [27] SURFACE WATER FT [ 1 [02] TANK MATERIAL: I l [28] DITCHES FT ( ] [031 OUTLET DEVICE ; ':; [ 1 [291 PRIVATE WELLS FT [ ] [04] MULTI - CHAMBERED [Y / N ] [ ] [301 PUBLIC WELLS FT [ 1 [05] OUTLET FILTER - [ 1 [311 IRRIGATION WELLS FT [ 1 [061 LEGEND -' [ 1 [32] POTABLE WATER LINES FT [ l [07] WATERTIGHT [ 1 [331 BUILDING FOUNDATION FT I 1 [08] LEVEL ' [ 1 [341 PROPERTY LINES FT [ 1 [091 DEPT -H TO LID _ I 1 [351 OTHER FT DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM I 1 [101 AREA [1] =" [2] -SQFT - [ 1 [36] DRAINFIELD COVER [ ] [11] DISTRIBUTION BOX HEADER - Q [ ] [ 37] SHOULDERS [ 1 [121 NUMBER OF DRAINLINES - ( 1 [38] SLOPES [ 1 [13] DRAINLINE SEPARATION ._ [ 1 [391 STABILIZATION [ 1 [141 > DRAINLINE SLOPE [ 1 [151 DEPTH OF COVER _. ADDITIONAL INFORMATION [ 1 [16] ELEVATION [ABOVFIBELOW]BM [ 1 [401 UNOBSTRUCTED AREA [ ] [17] SYSTEM LOCATION '` [ 1 [411 STORMWATER RUNOFF [ 1 [ DOSING PUMPS [ ] [ 421 ALARMS [ 1 [19] AGGREGATE SIZE [ l [43] MAINTENANCE AGREEMENT [ 1 [20] AGGREGATE EXCESSIVE FINES [ ] [441 BUILDING AREA [ 1 [21] AGGREGATE DEPTH _ [ 1 [45] LOCATION CONFORMS WITH SITE PLAN _ [ 1 [46] FINAL SITE GRADING FILL ! EXCAVATION MATERIAL [ 1 [47] CONTRACTOR [ ] [221 FILL AMOUNT :% - [ 1 [48] OTHER [ 1 [231 FILL TEXTURE [ 1 [241 EXCAVATION DEPTH ABANDONMENT [ 1 [25] AREA REPLACED [ 1 [49] TANK PUMPED [ ] [26] REPLACEMENT MATERIAL [ 1 [501 TANK CRUSHED & FILLED EXPLANATION OF VIOLATIONS / REMARKS: [ l [ l CONSTRUCTION - [APPROVED/DISAPPROVED] - CHD DATE: FINAL SYSTEM_[APPROVED/DISAPPROVED]: -` CHD DATE: DH 4016 (Page 2), 10/97 (Previous Editions May Be Used) Page 2 of 3 Stock Number. 5744002 - 4016 -4 PT 1: Applicant PT 9• lmt llwrlr`.rxrtrFa*w