PT-07-584 i
IRME
Miami Shores Village
a k w
10050 N.E. 2nd Avenue f `�
's f
•" Miami Shores, FL 33138 -0000
s a
Phone: (305)795-2204 v
Ent
p� Expira tion: l 11
Project Address Parcel Number Applicant
33 NW 98 Street 1131010330150
LYLLIAM LOUZADO
Miami Shores Village, FL 33138- Block: Lot
Owner Information Address Phone Cell
LYLLIAM LOUZADO 33 NW 98 ST
MIAMI SHORES FL 33150 -1736
Contractor(s) Phone Cell Phone Valuation* $ 1,0 00.00
HOME OWNER
::.::::::::::::::: :::..__:::::::::::::..::::::::: _:... __..:::::::::::__.-::::::..: N ._..::::.__:::::::::::::._..H__ .... ..................................................................... ................ ..:......:::::: _._.__- _:.T_ ......................_......._ . Total S Feet
q 0
Type of Work: Exterior Available Inspections:
Color. CANYON VIEW /SADDLERY Inspection Ty pe:
Additional Info: Final
Classification: Residential
Color: CANYON VIEW/SADDLERY-Approved Code Comments: WALL- BEHR CANYON VIEW
Color. CANYON VIEW /SADDLERY Approved Color: CANYON VIEW/SADDLERY-Denied
Fees Due Amount Total Amt Paid I Amt Due
CCF $0.60
Education Surcharge $0.20 $ 0.00 $ 0.00
Notary Fee $5.00
Permit Fee $60.00 Payment 1 2E )T W M t
Technology Fee $1.50
Total: $67.30 APR 2 0 2007
BY- ..--- .. ®. - - --
k rK 4 'W P
AM 2 ® PAID
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 1 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.
April 17, 2007
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
Tuesday, April 17, 2007 1
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
IC RM .
JAR Phone: (306)795 -2204 Fax: (305)756-8972
----------------------------------------------------
W ....... ........................................................... .......
..................................................................... .............. 7 ............. ...........
................. .................................. .............................
........................................................................... ...........
.......................... .................... ..... .......... .. .................. - .............
................. ........
.......................... . .. .................................. ....................................
........................................................................
......................................................................... .
..................................................................... ..
.................................................................... ............................ M
fN ..................................................................... ..
..................
Inspection Date: 05/22/2007 Permit Type: Paint
Inspector: Grande, Claudio Inspection Type: Final
Owner: LOUZADO, LYLLIAM Work Classification: New
Job Address: 33 98 Street NW
Miami Shores Village, FL 33138 -
Phone Number
Parcel Number 1131010330160
Project: <NONE>
Block: Lot:
Contractor: HOME OWNER
Buildina Deoartment Comments
PAINTING EXTERIOR OF THE HOUSE
MAY 2 2 2007
Inspector Comments
Passed Y 7
Failed E:I_
Correction
Needed
Re-inspection
Fee
($75)
No Additional Inspections can be scheduled until
re-inspection fee is paid .
Monday, May 21, 2007 Page 1 of 2
Receipt
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit Number: PT -3 -07 -584 Owner Address:
Invoice Number: PT -3 -07 -27963 33 NW 98 ST
Applicant: LYLLIAM LOUZADO MIAMI SHORES, FL 33150•
Company Name:
Job Address:
33 98 Street NW
Miami Shores Village, FL 33138 -
Date Payment Type Check Number Amount Change
Friday, April 20, 2007
04/20/2007 Check 4821 $67.30 $0.00
Total Payment: $67.30
Page 1 of 1
of . `1q
o M Shores Village. _
W( �Juc^ Buildin g D artment MAR 2 Q 2 007
04 �� i��ll' -- 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 B Y. - - - -- -
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
FBC 2004i�l
LtGtvt .
Permit Type (circle): Euildingg� Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) �,� p�. t .�'K -'2 0 oW Phone # > k2_3
Owner's Address -7� A) ,J
City State _ Zip
Tenant/Lessee Name fy / Phone #
Job Address (where the work is being done) C3
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO tl �
Contractor's Company Name Phone #
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) N Phone #
Value of Work For this Permit $ 1 D(D , " Square I Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition
Describe Work:
Submittal Fee $ Permit Fee $ CCF $ CO /CC
Notary $ 1 5co Training/Education Fee $ Techi►ology Fee $ .
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $� '
See Reverse side
APR 2 ® PAID
b
Bonding Company's Name (if applicable)
Bonding Companys Address
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 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 for om* g instrument was ackno hedged be 'ore pe this The foregoing instrument was acknowledged before me this
day IW ` 2 by �j y of , 20 , by
who is erso y known to me or who has produced 14 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 o ath.
NOTARY PUBLIC: NOTARY;PUBLIC:
A
Sign: ' ;. �y Sign:
Print: �IICrI �na�'%q tillss/ Print:
Z�� lobQ OO
My Commission Expires: yp �2p �63 My Commission Expires:
4bri�U�y`'�0 gs
�
APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
(Revised 02/08106)
Miami Shores Village
Paint Color Approval and Agreement
Date: 16 (
Owner's Name: y2,*J'D Phone #: -86 2? :7 -7
Job Address (where the work is being done): �7: of c ,13 7
City Miami Shores Villane County: Miami -Dade Zip:
Is Building Historically Designated ?: YES NO
Contractor's Company Name (if applicable): /-' / Phone #:
■■ rrrrrrrrrrr rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr�rrrrrrrrr�rirrrr
All elements on the site must be listed and indicate the color: to be printed -
Walls: y O>� �Ji tr
Fascia: se, c &I -- f Q Attach cc
Drip Cap /Drip Edge: (( with.
Soffit: q S ®. 4 t Q V
Roof: GU 1/0, zl
Flower Bins: P o
/
Shutters: �J (6 --
Awnings: b
Chimney: p
Doors and Door Jams: 6 j pp C 0- y
Garage Doors: s !q l k fZ-
Railings:
Fences: ( ;A 4 G It
Decorat Metal: �U f e.- All brick (simulated or regular): ,v l , I 3
Stucco Banding: 1 Body: Canyon view ECC -20 -1P
- 2Trim: Ranch Acres ECC -20 -2°
Any other Stucco Features 3 Accent: Hickory Grove ECC -20 -3°
Accessory Buildings: N e l 'o
Other:
■■ rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr a rrrrrrrrrrrr�
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.
Signature:
AL Date: l /,-o—
owirer or Agent .)
APPLICATION APPROVED BY: Date:
P & Z OFFICIAL
* *MUST BE ATTACHED WITH PURPLE BUILDING APPLICATION **
i
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: I'NSP - 71592 �ermit. Number: PL- 1 - M42
Scheduled Inspection Date: June 25, 2009 Permit Type: Plumbing - Residential
Inspector: Levrock, James
Inspection Type: Final
Owner: WILLET, RICHARD Work Classification: Septic
Job Address: 174 NW 93 Street
Miami Shores, FL Phone Number
Parcel Number 1131010330960
Project: <NONE>
Contractor: A AARON SUPER ROOTER Phone: 305 -944 -8886
Building Department Comments
Inspector Comme s
Passed HRS A I FILE
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
STATE OF FLORIDA PERMIT NO.
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID:
CONSTRUCTION INSPECTION AND FINAL APPROVAL RECEIPT #:
'6, :
APPLICANT: i �J
AGENT: 2 ,/ Y PROPERTY ADDRESS: Af • �� J V q 7T
LOT: 101 ` BLOCK:-ft4 SUBDIVISION: l''t y� "/ PROPERTY ID #:
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE . CORRECTE
TANK INSTALLATION a SETBACKS
[ ] 1011 TANK SIZE [1] _ " [2] [ ] 1271 SURFACE WATER FT
[ 1 [02] TANK MATERIAL [ ] [28] DITCHES FT
[ 1 [03] OUTLET DEVICE [ ] [29] PRIVATE WELLS FT
[ ] [04] MULTI - CHAMBERED
O N] ! / [ ] [30] PUBLIC WELLS FT
[ ] [05] OUTLET FIL R /J [ ] [31] IRRIGATION WELLS FT
[ 1 [06] LEGEND '^" _. .-� �j [ ] [321 POTABLE WATER LINES FT
[ ] [07] WATERTIGHT -' / [ ] [33] BUILDING FOUNDATION A FT
[ ] [08] LEVEL [ ] [341 PROPERTY LINES 16 FT
[ ] [09] DEPTH TO LID [ ] [35] OTHER FT
DRAINFIELD INSTALLATIOKL C FILLED / MOUND SYSTEM-
[ 1 [10] AREA [1] 4i; 21 SQFT� [ ] [36] DRAINFIELD COVER
[ ] [11] DISTRIBUTION BOX HEADER [ ] [37] SHOULDERS "
[ ] [12] NUMB4R OF D RAINLINES [ ] [38] SLOPES
[ ] [131. DRAINLINE SEPARATION [ ] 1 391 STABILIZATION
[ ] [14] DRAINLINE SLOPE
[ ] • {151 DEPTH OF COVER ADDITIONAL INFORMATION
[ ] [16] ELEVATION [ABOVEBEL OM BM [ ] [40] UNOBSTRUCTED AREA
[ ] [171 SYSTEM LOCATION �ltt��"" [ ] [41] STORMWATER RUNOFF
[ ] [18] DOSING PUMPS [ ] [42] ALARMS
[ ] [19] AGGREGATE SIZE [ ] [43] MAINTENANCE AGREEMENT
[ ] [20] AGGREGATE EXCESSIVE FINES [ ] [44] BUILDING AREA
[ ] [21] AGGREGATE DEPTH [ ] [45] LOCATION CONFORMS WITH SITE PLAN NG
[ ] [46] FINAL SITE GRA 1� r 1
FILL / EXCAVATION MATERIAL [ ] [47] CONTRACTOR r' 1
[ ] [22] FILL AMOUNT [ 1 [48] OTHER
[ ] [23] FILL TEXTURE
[ 1 [24] EXCAVATION DEPTH . ABANDONMENT
[ ] [251 AREA REPLACED ✓✓ [ ] [491 TANK PUMPED
[ ] [26] REPLACEMENT MATERIAL [ ] [50] TANK CRUSHED &'FILLED
EXPLANATION OF VIOLATIONS / REMARKS:
[ l
CONSTRUCTIO AP PR VED ISAPPROVED]: [ C. CHD. DATE: 0 O
FINAL SYSTEM PPROVED APPROVED]: t (l E 1 ° �l C i i 3 CHD DATE� tw
DH 4016 (Page 2), 10/97 (Previous Editions May Be Used) Page 2 of 3 j
Stook Number. 5744 -002- 4016 -4 PT 1: Applicant
PT 2: Installer /Contractor
PT 3: Building Department f
PT 4: Health Department
:: :: ::: ..
•:• i :•i:•i:::{:iiiiiiiiii ::•i: :i::: i:• i:Ci�i:•i:•i:•i:•: i:•::? i•:•:• i:•:• i:•:? i•: 6:• :•i:•:•i:•:•i:•:•ii:•ii ?:•::•:• :•iii: :::i:::
iiiiii: :i:•i:•i:•ii:-:- iiiii- i:- iiiiiisiiii: C:• i:• i:::::::• ii:: i:: i ::i::i::i::i::i::i::i::iii:::•: ii:: ::•:-:-::iiiiiiii
.� ^4 iiiii : : : :ii •••••
W . i.iii:: v : : : : : :ii.' : : :•i : : : :i : : : ?L'i :<C: •':.:: iiiiii: ":.:':: ••. •• ..
: isii:::• i% i' : :i����i : :i : :ii :•ii : : : :i����i :: iiiii ?iiii :' :• : :• : :•i :•i : :i :•: y:•:: : : {i'F,. : : : : : : : : :: iiiii::::: : : : : : :: iiiii:::::::::::: ii : :. : : :!.i :.i : :i : :j : :y!ii : : :ii ::
•'::: i::: iiii:: iiiii: :::: is : :• : :i : :i : :' : : : : :i : :i : : :i w::::. •.xw : : : : :. :� •: v : :.� :. : w: •: •.s:.:.
P:^ isv: A. . :i• :� : :viiiivii :•i :•i : ^:4:•i:•
eK. :M, . � Miami Shores Village iiiii :•< :. > :. .; > :;-=- •••� > :. > :. : : : : : :: --<; : : : :.- .. :.; :. :. : :.; : : :; : : : : : : :. : : : :i : :i : :i : :i : :i : :ik� : >.; • : :. :i :<l. : :. >; :- >. :..". :... : :?$>
1 •.
n
.� 10050 N.E. : : : :i : :i� : : :� :i
N. 2nd Ave
/ enue
t
:::i::::: . : •' '��� ;•;: �� :i:. • .i::: '?
L.
Miam aml Sh
ores FL
33138 -0000
w ;,;;;;:.;;:.::::: �:• i:• i:• i, i:• i; i;;:• i::• i:. i:• i:;;:.;>;:.>:-:;;;;;;;;::;::,::, :, :.; : :. : :.; :.i :. : :. : :.i : : >; :.; iiiii;:.:;:.;;;;;;;;;::. -- . I
•;• .. ;:; .:: -: . � .: "•�s : : :i:
t>
s
. / Pho
ne . 305 7 -
95 2204
::;:: i:: i::'::;::: iiiii iiiii iiiii iiiii: �:::::::: iiiii iiiii is3:::::: i:::: i�: �: �: i:; i:: i:: i:::::::: i����is : : :i : : : : : : : :; : : :i : : : :i : : : :i: • - "• . . .. . ..... .........................
'on•
Ex irate . 07/071
Project Address Parcel (dumber Applicant
174 NW 93 Street 1131010330960
ROBERT ST GELAIS
Miami Shores Village, FL Block: Lot:
................. •.•.•.•. .....{:.' L$ i •.❖.•.•.•. ' • ; i>........ e..?.:? v>.:• n�.>.................. .... >..:.. >.. » >.»K >. : :- :.•.. >.� .. i3.':> > : ° . :i'i : : ✓a�ri:L`. �+.•...❖:: L<•:{<•: KL•:•.•.•.•>.•.>.... .v >... :..x... >3.....✓.RL�v n J>...................... .................3. >..i
5?!! YlL&[. IIIf. Qrlpati4tl
........................................................... dtl m .................................................................................. Phone. .................................................. Cell ..............................
RICHARD WILLET 174 NW 93 ST
MIAMI FL 33150 -2235
. 4 b:•'•'•. w,.Y b 4wb:•bb:• bbN KKKK:•: KKKK•b. .KVC
••••. - - - .. - ..rrrrrr.. rw.wrr r.• - .....vrr �.. K pyr > �.wrr
:. ..........c.....nSb`,M� e ...>.:...> �i w"..}>>.• 9>' �F. ..:.:»�•�`.$ >>.ev...u..uY.b:4s> . x>.•> P»> ir. ii:....>..? i.:. v iu'..:.. vv. vviw.: aJ. pe? • n?.LtuK�:��.•8 }b :w.. {. »n::.i.• »:•»>.... •.'?...9...:.`2';L {'fLSii�ai .>.S.•Ye>.....>.... »>uC» >...... _.
........................................................ ...............................
Contractor(s) Phone Cell Phone Valuation: $ 5,000.
si
A AARON SUPER ROOTER 305- 944 -8886
.................. ......... ................ ........ Total Sq Feet: 150
Type of Work: SEPTIC & DRAINFIELD Available Inspections:
Type of Piping: Inspection Type:
Additional Info: Ab andonment
Bond Return: Final
Classification: Residential Rough
Landscaping
HRS Approval
Fees Due Amount Total Amt Paid Amt Due
Bond Type - Contractors Bond $300.00 ..............................
CCF $3.00 $ 668.74 $ 666.74 $ 0.00
Education Surcharge $1.00hr<
Permit Fee - Additions/Alterations $350.00 Payment Type: Check / Number: 8030
Scanning Fee $3,00
Technology Fee $8.74
Total: $665.74
JAN 0 9 2009 `
C K X030
M SHORES VILLAGE
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 .
January 09, 2008
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
Wednesday, January 9, 2008 1
Miami Shores Village REE
Building Department �a
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY,
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit N o. o
PERMIT APPLICATION Master Permit No.
FBC 2004
Permit Type: P lumbi ng 'W r+ S�
i�0 Ge�G QiC�
Owner's Name (Fee Simple Titleholder) Phone #
Owner's Address 1 1L+ W St
City M( �ko -e S State f7 Zip 3 3 1 �;
Tenant /Lessee Name Phone #
E -MAIL:
Job Address (where the work is being done) 1j \^j �i 3 S
City Miami Shores Village County / Miami -Dade Zip 3�5�
FOLIO / PARCEL # I I — 310 1— D 33- 0960
Is Building Historically Designated YES NO
Contractor's Company Name ` Phone # ( 5 4Lf— 8 ° "
Contractor's Address 6o2-2- Sul ?ys G-�'
City N�vG \a, State Zip 339 �3
Qualifier Name _ :ffi Phone #
State Certificate or Registration No. Certificate of Competency No.
E -MAIL:
Architect /Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ Square / Linear Footage Of Work:. 15D
Type of Work: ElAddition ❑Alteration ❑New Repair /Replace Demolition
Describe Work:
tid � -� .�,,�, Imo., Q►, ,/
Submittal Fee $ Permit Fee $ CCF $ � W CO /CC
Notary $ 0 Training /Education Fee $ 1 .0 0 Technology Fee $
Scanning $ . W Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due$
See Reverse side
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Z i p
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zi
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 bplchure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of co ncement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. n he absence of such posted notice, the
inspection will note approved and a reinspection fee will be charged.
r
Signature Signature
wner or Agen Contractor
The foregoing instrument was acknowledged before me this U" The foregoing instrument was acknowledged before me this
day of i%th , 20 01, by i6- wig r s day of �� , 20 �,> by t� �+. TI
who is personally known to me or who has produced who is personally known Jq • jUV.Ur who has produced
//n4 114.6.//. n 06404"M iY --
As id `j' .end.whpih .a oath. as ictnti ``f on a a an 0th.
E3A J. SOI "'�
NOTARY PUBLIC:
r
Comm# pD07 _ NOTARY PUBS _ 4118/2011
Expires 1118/'2011
Y AN.I..V
Sign: • .. YAso,kv
Sign:
Print: Z
�'�-o Print: (�� -f•- -�
My Commission Expires: My Commission Expires:
APPLICATION APPROVED BY:
Plans Examiner
Engineer
Zoning
(Revised 02 /08/06)
L o 94
. x JAN ®9 ENT'D PERMIT #: 13- SG- 831833
PLCCATION #: AP775198
STATE OF FLORIDA LBY
DEPARTMENT OF HEALTH DATE PAID: 01/04/2008
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: $200.00
SYSTEM RECEIPT #: 13- PID- 864497
DOCUMENT #: PR642053
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Robert Gallas
PROPERTY ADDRESS: 174 NW 93 St MIAMI, FL 33150
LOT: 10,11 BLOCK: 134 SUBDIVISION: Miami Shores Sec 6
PROPERTY ID #: 11 -3101- 033 -0960 [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 EXEMPT 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 Septic CAPACITY
A [ 0 ] GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [bDUMIUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ I
D [ 150 ] SQUARE FEET Trench Confiauration SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [X] STANDARD [ ] FILLED I I MOUND [ I
I CONFIGURATION: [X] TRENCH [ ] BED I I
N
F LOCATION OF BENCHMARK: FFE ......... 12.6" "NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 22.80][ INCHES FT ][ABOVE BELOW BENCHMARK /REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 40.80][ INCHES FT ][ABOVE BELOW BENCHMARK /REFERENCE POINT
L
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 30.00] INCHES
0 1.-Install 900 gal. category-3 septic tank equipped with an approved filter.
2.-The licenced contractor is responsible for installing the minimum category of tank sec. 64E-6.013(3)(f).
T 3- Install 150 sf of drainfield in trench configuration.
H 4.- Invert elevation of drainfield to be no less than 8.70 ft NGVD.
5 -Bottom of drainfield elevation to be no less than 8.20 ft NGVD.
E THIS PERMIT IS NOT FOR "ADDITION(s) ".
R
SPECIFICATIONS BY: P R izare TITLE:
APPROVED BY; Engineer Specialist II Dade CHD
DATE ISSUED: EXPIRATION DATE: 04 /06/2008
DH 4016, 10/97 41ious Editions May Be Used) Page 1 of 3
V 1.1.4 AP775198 SE656920
Yt
F
'. • • " f i • • •
R
tt
r■iri ■� ;. i �i
■ ■ ■� ��i ■i i ��! ■i. i ��■ifl�
■rii �iiia #■f iifiii �s � l�i �
Aii ■r Hi ��# ■iii i� ���
1�! #ir�iiiii ■■`� ri f _ tilt f � i
•■ ■r ■ ■■ NO ■i» ,, , ,�� ..fit ■r;
■ ■ifillrfii��riffi fi . , .., _, . , .Y . �I�` , �,: �►; . „,�� _
r�A ■iwriA'E'i Air ■•Ai 3 ,.� M.
■ri ir s irri i ■iii ri
■■■rr■riii#ia
f■rir■ ■rrf■■�I ii ! %'• ! i
iiiii iii
i ■ ■: ■ iiiriAi�rrsrisri� ri ■'■r sr ■
A
= ■ �i�iiiii
■re� ■�r�irt #■■��iir ■��#�r�r■ii
■il�i iiiif �r ■�iii
#r mass if Aar: ■A� it � � 1�L�. t
■i f■ ■iii .
■i�ii■i■i# ■i ■ ri■■i ■■ ■#i
■ri r�■riiiiiii■ �i%#�f� t i
■rr ■ ■i iii # ■ ■ii iRii■ri. �' E is !
INN ■v iii ■f ■ri! #ii # f■
� "'�■
irAAAAiAAAiAAAAAA #A ii!'.1A��'"" a�t�4#►G7c�41 #fit �! i� °s`�ir.
Samoa # ■ ■ii�iili ■ #iriri /AWM =rklww Nl �� Mfr; 11tl �AiiArA i# ■ fiAA r A rw
r� • � t +�ii r r ■tiA ■ #■rr�rr ■s��� �,,�i■i�r ■ �r���+�� � .: ■��� �i �r�. � ��r���i ■ f��� :
■ ■ ■ri ! # ■ ■fF!*- 1r�lr�fliiAri
■ri�ir ■ ■tA ■i.lYil"t #� "i�l:!'ii �� ■ i i� C" � �itr�..:. aa�i ■�' ���� is # ■iir_ i■
et
■ ■ir ■r�ii ■ #iiri ■W ��rtlim,'t,
n i yE _ t ■� 'i ��� ■ �
iiii ■ ■■ !k2su "!■.�i i ■s #
•#'iri� ■i li
iirl`iii#.�wL'iiii ,` fiil! ■ i ■rar r #
■rr ii ■ir■ ■i+MT.!►p:Y+i #iwi�i#E
f�fr ■irr ■Russ
A ■ :.r F _._ _•w.11�#liiii ■AAAwr#
it oans � manno� } ' llAl�ii� lea m •A �>I■ ■ ■i riii rAAAA ■!i
■ MUNSON ■ � ` � iriirf■i
■f■!■ri■i ■iArr ■ ■ ■irl. #■ iM�i I r r
i i ■ i E�!!�■f■i ■ ■■ir
f # ■i ■ ■ i
�■ ri■rf ■riii iii # ■ #fi 1 #slriMlilli i ji #iiiif■
1110 U ■iiw■ ■rir■■ifir ■ iii.9 ii#� [ tl■ Mi l■ ii■r fiii ■#
■fi ■ii ■ ■ ■■ #i ■iiiii ■ ■f ■1r!a� iri #i! t {!'� f , ifiriiiii■iiri■ if
it ■i.■ii ■ ■r / ■lii ■i # SON !'ai Mi
■ ■ril %f i II #iii i ii i#
i i
one ii #ll *'
■as■s' iiir■ ■iiir ■ii {!:' fi# ri I � � �t IR. i ■i
i#i� .. z1 isrir, ii�mii�ir
■fi ■ ■
i ■ ■1 1'� ■ ■i ■ii ■i1�i."1 i ii , 1 _ � iii #iiiiri�rirfff��
■rr■ >R ■Ni�AAAriA ■Ar■ ■.... i� # s��■i ■�rr ■ ■ ■ ■i
i sit%iiiiiam i��iri�i� � �'i� atr "� �RUNS�`�i�i ie�" ���i"�`t'i�i�"�ii�i i�a a s �
soon r�i �i■ r i �rw a NuMi■�eiirir �trso■■rArr� �rrr a 'Room
■ i■ ■■iirr i �■■ ■� •r ir�� . � .��■ so -
� .,al-_ �.. -� ii■■i■ ■i�ii"I�i"�am
M # was�a ME ! #tia `1 i lug �a ■ �a rno�w�iir wt sammis
iiiri ■:�t ■ii 0 iiiRii ■iiii #;riri■i ■1 #i;i ■ ■r ■rrtirr.
Runs a �� �� �E� i i iii Aim �A � ■iE � i #arAisuillersons
■
noun�r arPsti■�i rrr ti i�ri i
�AlAiEAAA A #>r1A ■AiAAii�AAA�A iiAririAAAAAi #AAIKiAAit ■'
el
s1 'i'" +A�+► �r
� � t
E
• i ! i