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.