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1254 NE 100 St (5)1 " ?(10 DES � ,. BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Owner's Name (Fee Simple Titleholder) Owner's Address 1254- pl E 100 City M k v ."'; S h Oc . State Tenant/Lessee Name 'IQ A Contractor's Company Name '` ce G Contractor's Address Pc w x 38 City x,11 ,✓C cv cl State FL- Qualifier Ter @:3a J. Sao , ..e• Total Fee Now Due S L i . 0 1 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 ( ' +(o Phone # Permit No. Master Permit No. O'eSvS Do CC.,ss / 6 r ba fa Phone # Sire�� Mc FL Zip 33138 Phone # Mechanical Roofing Job Address (where the work is being done) 12 F f 14E 1 c'tI' 5{ -- City Miami Shores Village County Miami -Dade Zip 3313 b Is Building Historically Designated YES NO tr Zip 35013 3 Architect/Engineer's Name (if applicable) NIA Phone # $ Value of Work For this Permit � 2CC O" Square Footage Of Work: 3c o St e+ Type of Work: DAddition ❑Alteration ❑New Repair/Replace ❑ Demolition Describe Work: (n 5.1 - Pit 1•1e, Dro rl P td * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ 1 I S.00 " CCF $ i : LO ' t t -� Notary $ 5 . CO Training/Education Fee $ 140 Technology Fee e $ 4 J ! Scanning $ 3 . co Radon $ Bond $ ^->. - C�J Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable) N Pc Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) N 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." r F 1 , ', 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 er or Agent ntractor The foregoing instlment was acknowledged before me this Ei The foregoing instrument was acknowledged before me this day of , 20 by who is personally known to me or who has produced Vt. t P'' v , who is personally known to me or who has produced as identification and who did take an oath. day of Dec, , 2(P.3 , by , S v S iD v c sS Chc 10/14/03 Li c <nsfr NOTARY PUBLIC: Sign: Print: My Commission E As identification and who did take an oath. 1 � MON .. : _ }. NOTARY PUBLIC: Sign: Print: VT` J . h., II Of I� r �. co. * * * * * * * * * * * * * * ** *�pp�l6QI A,� Fl NdW ,. ******************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) My Commission Expires: State Certificate or Registration No. Certificate of Competency No. *** * * * * * * * * * * * * * * * * * * * * * * * * * **1* ** *************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: 44.--< J r " t j 1 ' t-1 J Plans Examiner Engineer Zoning 1030201 NOT A ORNFR LICENSE The Sunshine State IDENDRIZMICt4 NUMBER S455-810-67-712-0 TEFtES JOHNSON SOLOMON 4310 SW 26114 ST1REET HOLLYWOOD, R. 330234412 OATE SEK HGT. 06-1247 F 6-03 1.•:" ISSUED EXPIRES DUPIJCATE 11-0348 064243 maw RESIDENT: YES IMNTIRCATION IINIRPCXSFS OM V 1L/ lt7/ zon.1 tali: 4Y J11bb1.13472 STATE OF FLORIDA - DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT PPLICANT: Duaoesi, Jesus AGENT: 3A0021074, Solomon Teresa 'ROPERTY STREET ADDRESS: 1254 NE 100 Bt Miami shores FL 33138 SOT: 4 BLOCK: 1 SUBDIVISION: Earleton Shores [Section /Township Range /Parcel No.) ROPERTY ID #: 11- 3205 - 009-0040 [OR TAX ID NUMBER) YSTEM DESIGN AND SPECIFICATIONS . [ [ [ 150 ,] SQUARE FEET PRIMARY DRAINFIELD SYSTEM [ 0 ]SQUARE FEET SYSTEM TYPE SYSTEM: [ y )STANDARD [ N )FILLED CONFIGURATION: ( N )TRENCH ( Y ]BED FILL REQUIRED:[ 0.0 )INCHES EXCAVATION REQUIRED: [ 42.0 ] INCHES THER REMARKS: THIS PERMIT IS NOT FOR ADDITION PECIFICATIONS BY Andrd, P PPROVED BY: Andre, Paul ATE ISSUED: 12/9/03 OSTDS b.>l, EEFUMPED VICE INSTALLED TITLE; Profesaioxxal Enq�n PAGE 01 CENTRAX #: 13 -SG -10809 DATE PAID: FEE PAID : $ RECEIPT : OSTDSNBR : 03 -3722- ■R 'ONSTRUCTION PERMIT FOR: )New System ( )Existing System ( l Holdirng Tank ( ] Innovative Other X ]Repair" ( ]Abandonment ( )Temporary ( NA ) YSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIQNS AND STANDARDS OF CHAPTER 64E -6,FAC MPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME ERIOD. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, :EQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS 'hRMIT BEING MADE NULL AND VOID, ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM 'OMPLIANCE WITH OTHER PEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. MULTI - CHAMBERED /IN SERIES: [Y J MULTI- CHAMBERED /IN SERIES: [Y ] 900 ) Gallons SEPTIC TANK 0 ]Gallons 0 ]GALLONS GREASE INTERCEPTOR CAPACITY 0 ]GALLONS DOSING TANK CAPACITY [ 0 )GALLONS ® [0 ]DOSES PER 24 HRS # PUMPS[ 0 ] [ N ]MOUND [ N ] [ N J LOCATION TO BENCHMARK: Satiating Finished Flour Elej,, :9.60 Ft Navel, ELEVATION OF PROPOSED SYSTEM SITE ( 2.2 ) [ FEET 3 [ BELOW )BENCHMARK /REFERENCE POINT BOTTOM OF DRAINFIELD TO BE [ 4.7 ] [ FEET ] [ BELOWJBENCHMARK /REFERENCE POINT 1• Existing 900 gallons peptic tank to remain. 2.-Install 150 square feet drainfield in bed configuration. 3.- Invert elevation of the drainfield to be no less than 5.40' NGVD. 4.- Bottom elevation of the drain£ie14 to be no Lees than 4.90 NGVD. 5. Perimeter of excavation shall be 2 ft wider and longer than the proposed abaortion bed. Dade CHD EXPIRATION PATE: 3/8/04 12/10/2003 08:42 3055133472 PART II - SITE PLAN- - • Icale: Each block represents 5 feet and 1 inch 50 feet. . TT. --L. .1-4 •i- I .1 1 -1 • • • .1-.: I . . 4..- _ L L L . f11 ; . " • "I ) !. 1 • i i • 7 "1 ). • • 7 '; " • t1-11-11 ., . - •,. - • 171"- .. 1. - • • ; ••• •• ■• • r . • •!' • I •,1 .', 1. L Ii ..L.1 • ly totes: lite Plan submitted Plan Approved OSTDS STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PE Permit Applicatton Number IT I • " 40 AI 1.1 1_1 p:tilf 1 i- _ - ... : ... I" - -i--1.-- . -..,1...,...L. L., .1) 0 CO.S 5 4j ( N too * 3Y28 ii .p 0 vi,e 0 LAN d kon( Signature Not Approved .; .■ • • • • I , • ' I 1 (WAPJ( P ItR C amiarvuwn RV TI.1 nrst 1PJTV Mr A I 11.1 ricDACITUGMT PAGE 02 Tit Date 1 2- ,, ,. _ . ,, 1 .1.. .... .. _ ....! L I • I LI ,, i 1.: .,.,[...,.. *AO Lcir, 1 ,- 'i - • 1- •••, • ; - Sr 7 'i -.- i' 4 , '.. '''''" ' ':. 7 ' . • t • .!--,..! r - •: -1-J; .1- i r- ' • i , , ..,... 1 .: .:....1.. 1 •••■• -I • .. .; • ; • - /, • ' - i ... . ...1.•; 1 , ......• . J .1.....__ ............. ,....4.-J - •• • . • • - :•••• - • :---I '.--1 : 1 .• ! t ' '.' • •:'• • 1 .* ; • , ....• I • $ • • •1 , ---; 1 , - -: - • 1 - L ' . ' I : • ; • • • :- .. : .. 1 t i ; t 1 ..: . t._i_i .,...L..2_ ., .!, , , I I. t : t i. t__1_i_ . 4..,...L : .:......L.? . .;_ .....,_ i •,. . _ t.4 . _i_ LI .: ... : , • '.1 ., L '••• • I-. :- z 4--L-4.-1- i i i ■ : 1 1 t..L : J- 1 . ....4-1 • i'l ' • •"• ''' • -4 -i-- i--1.-',_ ; i._)_i - ,...,...„..,._...; i ! +-!..• ; -"*"• j• !.' f .1 -1-.i -.I .....- • ...4.44,i .1 4_1.4_1 _ . .__ ' 1 .. 4 ),:i . . . i . • „.,.. ; .....!.. I ..... ..,....., , . I■019.47% .A.............- ..1.-2 ..-......... -J-......-1-..: -4.. !... 4 L .1...L...1 ! . ...:- .i . . , . 2. ..i....4.... .1 ...;_;.. - - 7 i • ' 6,4(cc-hpe County Health Department Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: PL2003 -339 Printed: 12 /15/2003 Applicant: BARBARA Owner: MESSICK JOB ADDRESS: 1254 NE 100 Parcel # 1132050090040 Signed: (INSPECTOR) Plumbing Permit MESSICK BARBARA ST Contractor STATEWIDE SEPTIC CONNECTIONS Contractor's Address: 18800 N. W. 2nd Ave #223 Local Phone: 305 - 661 -6633 Permit Status: APPROVED Permit Expiration: 6/8/2004 Construction Value: $2,000.00 Work: INSTALL NEW DRAINFIELD Page 1 of 1 Legal Description: EARLETON SHORES PB 43 -80 LOT 4 BLK 1 LOT SIZE 75.000 X 109 Fees: Description Amount FEE2003 -8202 Builders Bond $300.00 FEE2003 -8203 Building Fee $175.00 FEE2003 -8204 CCF $1.20 FEE2003 -8205 Notary Fee $5.00 FEE2003 -8206 Training and Education Fee $0.40 FEE2003 -8207 Scanning Fee $3.00 FEE2003 -8208 Technology Fee $4.37 Total Fees: $488.97 Total Fees: $488.97 Total Receipts: $488.97 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: BUILDING ELECTRICAL PLUMBING ROOFING 4.j Owner of "-- Building / Architect Contractor or Builder 4 e: ❑ 0 Legal Lot Description — Address of Building ' ? MIAMI SHORES VILLAGE. FLORIDA DATP L i 195 _ PERMIT 11T° 3771 / Work to be performed under this Permit B1 i Si Subdi- vision Value of Project $ Contractor's License No / Amount of ,•/' ; Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or syeeifications and that he assumes responsibility for work done by his agents, servants or employees. J r Signed � `�BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work co d hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specification§§ submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all wofk done by either, myself, my agent, servant or employee. r _;r CONTRACTOR OR BUILDER c BY AUTHORITY e Permit No 3 2 7( MIAMI SHORES VIL:',AGk PLUMBING INSPECTION DEPARTME': APPLICATION FOR PLUMBING No Account of Permit $---- - - - - -- - ------ - - - - -- (Signed)---- -�--• Date Repairs ( Signed) -•- j- 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 conf:,u ,,ity 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 shell be complied with, whether herein specified OT rot. A copy of approved plans and specifications must be kept at building during progress of work. Street__ 1. —. ; ' a Subdivision- .--- :_..._.- ___. - - - -• StreeLW . - r Owner's Name and Address__. Registered Architect and /or Engineer _ . t� � � � 7 - 7 — t �' C c I �j � _ _ �_ -: o . ._____.__._.___._ _ S ? ��� / A Employing Plumber's Name Location and Legal Description Lot_ Block_ Street and Number where work is to be performed —No /' T State work to be performed and purpose of building (By Floors)_ P V.i? t New Building ____ -- _ -- Remodeling------------------- _ -.___ Addition <� -gi No. of Stories.._ Size Septic Tank. Type of Tank Capacity Gals. Feet of Drain Tile. Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well ..Size of Soakage Pit Plumbing nspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob 'gations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent 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 die Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this •ermit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Eefore 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 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 SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY rues U RINALS 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 3 2 7( MIAMI SHORES VIL:',AGk PLUMBING INSPECTION DEPARTME': APPLICATION FOR PLUMBING No Account of Permit $---- - - - - -- - ------ - - - - -- (Signed)---- -�--• Date Repairs ( Signed) -•- j- 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 conf:,u ,,ity 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 shell be complied with, whether herein specified OT rot. A copy of approved plans and specifications must be kept at building during progress of work. Street__ 1. —. ; ' a Subdivision- .--- :_..._.- ___. - - - -• StreeLW . - r Owner's Name and Address__. Registered Architect and /or Engineer _ . t� � � � 7 - 7 — t �' C c I �j � _ _ �_ -: o . ._____.__._.___._ _ S ? ��� / A Employing Plumber's Name Location and Legal Description Lot_ Block_ Street and Number where work is to be performed —No /' T State work to be performed and purpose of building (By Floors)_ P V.i? t New Building ____ -- _ -- Remodeling------------------- _ -.___ Addition <� -gi No. of Stories.._ Size Septic Tank. Type of Tank Capacity Gals. Feet of Drain Tile. Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well ..Size of Soakage Pit Plumbing nspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob 'gations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent 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 die Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this •ermit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Eefore 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 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.