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1167 NE 99 St (12)BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical t1G 1 NF 9q Week City kgAo eS State FL,, Owner's Address Tenant/Lessee Name $ Value of Work For this Permit Type of Work: ❑Addition Describe Work: r Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Owner's Name (Fee Simple Titleholder) 0oe1 ?exeZ Phone # C30 - 5) '758 — Nip} Job Address (where the work is being done) ` I �p� NIP &tr'ee r City Miami Shores Village County . Mi 1 -L ►de Zip 3313 Is Building Historically Designated YES NO ,, ��� 6 {�e Contractor's Company Name & u 1 rte, 1 1 � Ci CClnll[�. Oe # Co) 6 61 66 33 . Contractor's Address 3S9 o S • St 1 City i•MrQr r a r State ,-(-- Zip 3023 Qualifier 7RJ( e&II &■Ot mOx. State Certificate or Registration No. 5002101 I Certificate of Compecy No. Architect/Engineer's Name (if applicable) -�� Phone 4 !Dos° 23- ❑Alteration 1 • , -� . - no op . de * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * *x * * * * * * * * * * * * * * * * * * * * ** * * ** Submittal Fee $ Permit Fee $ 1 - 75. �..�J CCF $ I • 60 CO /CC Notary `�� Training/Education Fee $ • (00 Technology Pee $ 4-57 Scanning $ 3.00 Radon $ Zoning Bond $ CO Code Enforcement $ Stru ctural Plan Review. $ Total Fee Now Due $ _4 I (Continued on opposite side) ❑New Zip 331 38' Phone 0 Square Footage Of Work: 42-9 Master Pernik No. Permit No. Pion - Mechanical Roofing Repaiepiace i. 1 ❑ °WWI , r!�6?pr} $489,7 4_ .J'.. t 5 �l: • Bonding Company's Name (if applicable) Bonding Company's Address A City State Zip Mortgage Lender's Name (if applicable) iu Mortgage Lender's Address City State 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 COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant nzust 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 size 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 Own or Agent The foregoing instrument as acknowledged ore me this 20 day of tic r , 2005, by =Toe 1 Perez who is personally known to me or who has produced FLA D L k:engre As identification and who did take an oath. Signature day of who is NOTARY PUBLIC: NOTARY PUBL Ii Sign: Sign: Print: ` aA TERESA J. SOLOMON Print: My Commission Expires: �` �ii re EXPIRES: September 16.2001 My Com 1- 800- 3•NOTARY FL Notary Discount Assoo. Co. * * * * * * * * * * * * * * * * * * * * ** ***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 Sotcale\-- The foregoing instrument was acknowledged before me thi 200_5 2" by IJ' ` L t L O kQ C� rsonally kno . n to me or who has produced ii Contractor ission E entification ami wh9 did tak a 'ov,i `:or 23M4 2A7 „ K r' .i * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * ** ************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 7 5 Plans Examiner Engineer Zoning D A I F I E .L D 01/21/2005 CONSTRUC' fl:L I )New ,3 [ ' ] Re❑ai. APPLICADr:'. SYSTEM MUST DEPARTMENT PERIOD. NC REWIRE I:II:3 PERMIT BEEN{ COMPLIAN:.'Ii; SYSTEM 171:1( T `(' 90(r A .j; 0 N [ K ] ) ] 42S I 0 ] TYPE : W. CONF If I IE;,) LOCAT:: r :::Di ELEVAT, I:DF BOTTOM 01 FILL I'.li:l!t RED.: OTHER REM1!.RK [CP] Exic ti vertical de prior to th elevation • be no less SPECIFICA'.' I :UF 3055133472 16:20 3055133472 OSTDS I' ATE OF FLORIDA PARTMENT OF HEALTH OA SITE SEWAGE TREATMENT AND DISPOSAL SYSTEM C: ASTIZUCTIODT PERMXT T FOR: t,trr r ]Existing System [ ]Abandonment Irr Ds Joel AGENT: SA0021074, Solomon Teresa PROPERTY S7 air :'- DRESS: 1167 NE 99 St Miami PL 33138 LOT: 19 1.78 SUBDIVISION: Miami Shores [Section Towzlship/Range /Parcel No_) PROPERTY ID I:: ,1 „3205 -018 -0080 [OR TAX ID NUMBER] :E: C'.i:) 13TRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC :F03Y;r.., OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME C;iLklqIE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, IPl':L:I ANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS NUDE: DULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM TT: ;:(.'(ER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. SPECIFICATIONS I SEPTIC TANK MULTI - CHAMBERED /IN SERIES: [ Y ] 3 ' 1 1 `' r3 ' r MULTI SERIES: [ Y ] ,A:t L0 l i GREASE INTERCEPTOR CAPACITY .aa,LO(I I DOSING TANK CAPACITY [ 0 ] GALLONS @ [ 0 ]DOSES PER 24 HRS # PUMPS[ 0 ) q,ii :d:;.[ FEET PRIMARY DRAINFIELD SYSTEM TJ 1W FEET K: [ N ]STANDARD t':::'r7: ( N )TRENCH �) i3E1 I:ITMARK: 1Y)) );'f { HPOSED SYSTEM SITE I)fl i "s::[ h YIELD TO BE [ [ ]Holding Tank [ ] Innovative Other ]Temporary ( MO ] Modified SYSTEM [ N )FILLED [ N J BED [ N ]MOUND [ N ) ( N ) 0.0 ] [ FEET ] [ BELOW)BENCHMARK /REFERENCE POINT 0.0 ] [ FEET ) [ ]BENCHMARK /REFERENCE POINT 0.0 ]INCHES EXCAVATION REQUIRED: [ 0.0 ] INCHES i'Cf) gal. septic tank to be inspected for an appropriate pump-out and a solid le,:t,a;, installed on the outlet device. The pump-out receipt shall be provided g1a.ra; ing of the final approval. Instal]. 429 sq. ft. drainfield, Invert dl :;ai.ifield to be no lees than 5.50' NGVD. Bottom of drainfield elevation to :air. ;:I . DO' NGVD. :Y: I AM, Arrieta, Roland TITLE: DH 4016, 03/97 ( p ::;,n_ : previoU6 editions which may not be used) (Stock Number. '44 -CC 4016 -0) roabdo_cona_4ot6-ij CENTRAX #: 13 -SG -23322 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 04 -4272- -M APPROVED 117: ant : _, TITLE: EH Specialist I Dade CHD DATE ISSUED: L 21 , 14 EXPIRATION DATE: PAGE 01 Paqe 1 of 2 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 1 /25/2005 Applicant: JOEL Owner: PEREZ JOB ADDRESS: 1167 NE 99 Contractor STATEWIDE SEPTIC CONNECTIONS Local Phone: 305 - 661 -6633 Parcel # 1132050180080 Plumbing Permit Permit Number: PL2005 -31 PEREZ JOEL ST Contractor's Address: 3590 SOUTH STATE ROAD 7, SUITE 26 Legal Description: REV PL MIAMI SHORES SEC 8 Permit Status: APPROVED Permit Expiration: 7/20/2005 Construction Value: $2,350.00 Work: INSTALL NEW 429 SQFT DRAINFIELD Page 1 of 1 PB 43-69 LOT 19 Fees: FEE2005 -1087 FEE2005 -1088 FEE2005 -1089 FEE2005 -1090 FEE2005 -1091 FEE2005 -1092 FEE2005 -1093 Description Building Fee CCF Notary Fee Training and Education Fee Technology Fee Scanning Fee Builders Bond Total Fees: Amount $175.00 $1.80 $5.00 $0.60 $4.37 $3.00 $300.00 $489.77 Total Fees: $489.77 Total Receipts: $489.77 Signed: (INSPECTOR) 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 responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: BLK 178 LOT Permit No 0( Registered Architect and /or Engineer Employing Plumber's Name%- L/1111.1._ e ett Location and Legal Description Lot. Street and Number where work is to be performed —No STATE OF FLORIDA, } ss. COUNTY OF DADE. Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT uc .- a! State work to be performed and purpose of building (By Floors )-- _- _--- •.---------- a L-R ___ - -- - New Building Remodeling— —..__ Addition--- _ - -.-- Repairs Size Septic Tank_.— _._--____--___. _ -----Type of Tank__ Feet of Drain Tile._.— Y.— -- _Dist. Feet of Tank or Drain Field from Well. Nature of Water Supply: City — Well.— _.— __-- .. -. - - -- ---- -- ...Size of Soakage Pit (Signed)- Capacity Gals 7 7 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 work. Owner's Name and Address ____/ LTC k1 E LL. No.__.. //6 7 Street. ._1_ ` ?L f Block Subdivision wc Lpc ^ : ....___. No. of Stories Plumbing Inspector. The u ► undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor anent Supplement, and has com- under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida plied with the provisions thereof, and will require similar compliance from all contractor or sub -contr or mployed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on . e sit - of the ork ch public notke or notices as are required by the Act. The undersigned agrees to employ only such sub- contract rb on work o • . fo 1 ; d this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowl • gments, personally appeared 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 be has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Comnusslon Expo Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when suck re - inspection is made. necessary by improper notke for inspection, or faulty materials and /or workmanship. LAVA- Tom" SINKS SLOP SINKS LAUNDRY Tu•• URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS TOTAL FIXTURE[ CLOSETS BATH TUB[ SHOWERS CONTR. LIST CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR H Dip WELL SPRKLR. S SWIM'O POOL CONrw. LIST CHECK Permit No 0( Registered Architect and /or Engineer Employing Plumber's Name%- L/1111.1._ e ett Location and Legal Description Lot. Street and Number where work is to be performed —No STATE OF FLORIDA, } ss. COUNTY OF DADE. Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT uc .- a! State work to be performed and purpose of building (By Floors )-- _- _--- •.---------- a L-R ___ - -- - New Building Remodeling— —..__ Addition--- _ - -.-- Repairs Size Septic Tank_.— _._--____--___. _ -----Type of Tank__ Feet of Drain Tile._.— Y.— -- _Dist. Feet of Tank or Drain Field from Well. Nature of Water Supply: City — Well.— _.— __-- .. -. - - -- ---- -- ...Size of Soakage Pit (Signed)- Capacity Gals 7 7 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 work. Owner's Name and Address ____/ LTC k1 E LL. No.__.. //6 7 Street. ._1_ ` ?L f Block Subdivision wc Lpc ^ : ....___. No. of Stories Plumbing Inspector. The u ► undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor anent Supplement, and has com- under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida plied with the provisions thereof, and will require similar compliance from all contractor or sub -contr or mployed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on . e sit - of the ork ch public notke or notices as are required by the Act. The undersigned agrees to employ only such sub- contract rb on work o • . fo 1 ; d this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowl • gments, personally appeared 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 be has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Comnusslon Expo Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when suck re - inspection is made. necessary by improper notke for inspection, or faulty materials and /or workmanship. OwBofs Name :.e x 'A Registered tlrchhteot an Employg Pk+mb Lotatie•and L -_: Des ,t on Street aid Nz3..'.as a • ,1 . State work to bepea' rm New lila Size Septic T ai3 Ta Feet of Drain Th.— Nate The lmz j'; y aa(:d raider the Florida IVO pried wide the pr performed under required, 117 dm A licensed tor Miami Store Defoe me, the 33412 "'..,.