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DRAINFIELDMIAMI 'SHORES VILLA BUILDING DEPARTME 305- 795 -2204 Building nspection Request Date4"' C Type Insp'n P,nu' Permit No. 2- 00 Name Address ')� c I S e_ q� `S — Company o r '0' Phone # Inspection Date eP Approved Correction Re- Insp'n Fee BUILDING PERMIT APPLICA.TIO FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) Owner's Address /20 8 � e City 44,(14 a ( ■ State Tenant/Lessee Name City N, A1 Qualifier t z fN a�'V $ Value of Work For this Permit Type of Work: DAdditio�� QAlteration Describe Work: A CA_ 3 Total Fee Now Due S %k0 •1 1 0 4 4O 5 c%Q:, 't (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax (305) 756.8972 Permit No. Pi.- O° — " Master Permit No. State 14.r► O Ne Phone # Mechanical Job Address (where the work is being done) I■ J / • Iv 14 City Miami Shores Village County ade Zip Is Building Historically Designated YES NO Contractor's Company Name " t EA z.. b•Phone # 30 ,' — C S) 11 j • Contractor's Address / 9 / 5 2.- id 2 Zip Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: `:S dL! ************F Submittal Fee $1 Permit Fee $ 115 t . CO Notary $ rj .(X) Training/Education Fee $ , G t/ Scanning $ 5. ()() Radon $ Code Enforcement $ Structural Nan Review. $ ria Repair/Replace [ Demob tiot CCF $ ; I . GO Technology Fee $ 9.3 7 Bond $ .Co Ro Bonding Company's cable) Bonding Company's A City State Zip Mortgage Lender's Name (if applicable) 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 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 inspec which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be ap. _ed and a einspection fee will be charged. Signature Own r or Agent The foregoing instrument was acknowledged befor me this ( . day o C)(J((J , 20 9 3 by 14 ` r who is personally known to me or who has produced As identification and who did take an oath. NOTARY Sign: Print: :LIC: . _ Alai dirvi r oQ bel Vargas n # 1 D23 1 984 g nc. The foregoing instrument was acknowled day of , 2(D b who is personally known to me or who has produced as identification . • who did take NOTARY P Si P Contractor ed before me this {O M ommission Expires: * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ************** ** * ** ***** **** * * * * * * * * * * * * * * *a `a *'w *fit * *aft * * *dt ** *art * * * * * * * ** C rtificate of Competency No. My Commission Expires: State Certificate or Registration No. ********************* * * * * * * * * * * * * * * * * * * * * * * * * *•• * * ** ***;******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 10/14/03 (Certificate of Competency Holder) Plans Examiner Engineer Zoning (EM ATM TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE • IDET LIGHT OUTLETS CENTRAL HEATING ISHyASHER RECEPTACLES A/C (WINO) ISPOSAL SERVICE TEhPORARY A/C (CENTRAL) SINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK LOOK DRAIN SERVICE REPAIR/METER CHA} E REFRIGERATION REASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING NTERCEPTOR RANGE TOP UNDERGROUND TANKS AVATORY OVEN ABOVE GROUND TANKS AUNORY TRAY WATER HEATER U.F. PRESSURE VESSELS LOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS HOWER MOTORS OVER 1- 3 If HOT WATER BOILERS :INK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION INK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEM3LIES :INK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS EM'ORARY WATER CLOSET MOTORS OVER 10- 25 IP FIRE SPRINKLER SYSTEMS IRINAL MOTORS OVER 25-100 HP COOLING TOWERS iATER CLOSET MOTORS OVER 100 HP VIOLATION 'NOIRECTiWASTES A/C WIDOW RE INSPECTION 1ATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS 'HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COWERCIAL WATER SERVICE SIGN TUBES ;EWER CONNECTIONS SIGN TRANSFORMERS JTILITY -SEWER SIGN TIME CLOCK JT I L I TY -WATER F I XTLRES ;EPTIC TANK ANTENNA IELAY Jr TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES. VIOLATION 'UM' & ABANDON SEPTIC TANK REINSPECTION OAKAGE PIT CU. FT. ;ATCH BASIN DISCHARGE WELL )OMESTIC WELL 4REA DRAIN 100F INLET , • SOLAR WATER HEATER `, =IRE STANDPIPE 'OOL PIPING _AWN SPRINKLER SYSTEM 3AS RANGE . SET (GAS) 3AS PIPING AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL 01/02/20+4 12:54 2055133472 It ? LOCATION EJ CEMAR]L OSTDS REPAIR STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITI; SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT apiSTRUCTIO:x PERMIT FOR ! [2) Mew System [ 1 Bxieting S'yptem I Al Holding Tank [1J3 Innovative [A3 Repair ,� r) I a 3 Abandonment I r' J Temporary [ 1 APPLICANT, !" 1 Y Q 1 7 . . .?6L 2 0 !J. €, PROPERTY ADDRESS: •7 WTI C> �LOC7C: SiTEDI'VT P ROPIDRTY ILA 0: 11 3 2 J - Q4 �} - 0 2 Q SYSTEM NAST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SUCTION 361.0069, P.S., AND CHAPTER 64B -6, P.A.C. DEPARTMENT APPROVAL 07 SYSTEM DOES NOT GUARANTEE $ArTISFACTORY PERFPERFORMANCE !i'0R ANY SPECIFIC PERIOD 07 TIME. ANY MANGE IN MATERIAL FACTS, WITCH SERVED AS A BASIS FOR ISSUANCE Or TEIS PERMIT, REQUIRE THE APPLICANT TO MDDIFY TX! PERMIT APPLICATION. SUCH MODXP °CATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID'. ISSUANCE 07 TEIS PERMIT IOS9 NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITS OTHER FEDERAL, STATE, OR LOCAL PERMITTING FOR DEVELOPMENT OF THIS PROPERTY. EYSTEPI DJ! tGN AND SPECIFICATIONS T I J OT0 ) GALLONS / GPA SEPTIC TANK /AOROBIC UNIT CAPACITY M ULTI -C E ERBD /IN- SERIES 1 1 h [ --� ] GALLONS / GPD CAPACITY [MAXIMUM It I - 1 3 GALLONS GRIMM) INTERCEPTOR GALLONS DOSING TANK CAPACITY I ] GALLOES SINGLE TANK: 1 1 Dos =S PHR 24E RB 4 P tONE] >I: I [ 300 ] SQUARE FEET PRIMARY DRAINFIBLD SYSTEM [ -- ] SQUARE FE SYSTEM TYPE SYSTEM: I ) STANARD (A FILLED 1 3 MOUND ( 3 CONFIGURATION: I ] TRENCH I ] BED 1, l �- • r Ni ;1 D Pi.r yr \l 1N; . _.._. SPECI7ICA''IONS BY, APPROVED J3Y: DATE ISNOID: / 2 124,J`' 3 DB 4016. 12/98 (Page 1) (Previous Editions May Be Used) Ic`" , ,� 4 J• ~ 313 6 arl Pti fi/)'t PSRNIT NO. o3e- 3 ert4 DATE PAID: / 7.. 7t- Q FEE PAID: 7 C RBCNIPT it! S0Y/2,Z &I J -1&1.5"3 .ISECTIONL TOWNSHIP, RANGE, PA3tCXL NUMBER [OR TAX iD Ntn BER1 k PJs i E' Cl��llVh1 ITL=: b al. r lb, EXPIRATION DATE: Part 1 - Health Department Part 2 • Applicant Part 3 • Installer /Contractor Pert 4 - Building Department PAGE 02 d: 4t CHI r 3 /2 (°1 '1- Page 1 of 3 Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: PL2004 -2 Printed: 1 /6/2004 Applicant: KEITH POST Owner: POST KEITH JOB ADDRESS: 1208 NE 99 ST Contractor MR C'S SEPTIC TANK Local Phone: 305 - 651 -7859 Parcel # 1132050090200 Signed: (INSPECTOR) Plumbing Permit Contractor's Address: P 0 BOX 693239 Permit Status: APPROVED Permit Expiration: 7/3/2004 Construction Value: $2,500.00 Work: TO REPLACE 300 DRAINFIELD Page 1 of 1 Legal Description: 5 53 42 EARLETON SHORES PB 43 -80 LOT 8 BLK 2 LOT SIZE 75.000 Fees: Description Amount FEE2004 -81 Building Fee $175.00 FEE2004 -82 CCF $1.80 FEE2004 -83 Notary Fee $5.00 FEE2004 -84 Training and Education Fee $0.60 FEE2004 -85 Technology Fee $4.37 FEE2004 -86 Scanning Fee $3.00 FEE2004 -87 Builders Bond $300.00 Total Fees: $489.77 Total Fees: $489.77 Total Receipts: $486.77 0 1-s -o -44 if 103 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: Permit No _ -Q_ _ Application is hereby ade for the approval of the detailed statement of the plans and specifications herewith submitted for the bui ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores V lage, 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 No._ — Street Registered Architect and /or E : neer________ Employing Plumber's Name •Q — No. Street_ Location and Legal Description Lot.__..-_-.__- ---_________ _._ _Bllock_ Subdivision Street and Number where work is to be performed —No 1 c OF D y 1 9 % 9 Street State work to be performed and purpose of building (By Floors)_ New Building Remodeling Addition Size Septic Tank - -- Feet of Drain Tile_ _._____ Nature of Water Supply: City —Well. Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Type of Tank Capacity Gals. _Dist. Feet of Tank or Drain Field from Well . Size of Soakage Pit �-- -- 3 -75--- (Signed)_ Repairs No. of Stories .. ............... (Signed - - - - -- Date -_- •--- -�,,,7 umbing Inspector. 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 5968, Compiled General Laws of Florida Permanent Supplement, and has com- plied 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 sub- contractors, on work to be under this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, 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 he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWER• LAVA- TORIEe SINKS SLOP SINKS LAUNORY TUB. URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NB TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•G POOL CONTR. LIST `! CHECK Permit No _ -Q_ _ Application is hereby ade for the approval of the detailed statement of the plans and specifications herewith submitted for the bui ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores V lage, 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 No._ — Street Registered Architect and /or E : neer________ Employing Plumber's Name •Q — No. Street_ Location and Legal Description Lot.__..-_-.__- ---_________ _._ _Bllock_ Subdivision Street and Number where work is to be performed —No 1 c OF D y 1 9 % 9 Street State work to be performed and purpose of building (By Floors)_ New Building Remodeling Addition Size Septic Tank - -- Feet of Drain Tile_ _._____ Nature of Water Supply: City —Well. Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Type of Tank Capacity Gals. _Dist. Feet of Tank or Drain Field from Well . Size of Soakage Pit �-- -- 3 -75--- (Signed)_ Repairs No. of Stories .. ............... (Signed - - - - -- Date -_- •--- -�,,,7 umbing Inspector. 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 5968, Compiled General Laws of Florida Permanent Supplement, and has com- plied 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 sub- contractors, on work to be under this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, 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 he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship.