Loading...
Drain fieldDate 11 No My Co FEES: PE PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address 1q-li 1q-1 Nis 1011 SI Tax Folio 11 3 2 0 5- 02- 02 0 Legal Description Lu T1 Z ('5,_01. 3 J 1 S1 -S & llist�lly Designated: Yes No Owner/Lessee / Tenant ftTEiZ- 1 1: U-g g Sew 5iFiA Owner's A d d r e s s 1A2- NE 101 ST l MS 3313E Contracting Co. S 1 Ci CON a1 frkk C.. Qualifier TER A S'0006■410cv State #PIteI)1s78 Municipal # Competency # Address Address a 11 2q)45 to Owner and/or Condo President late TEPIESA J, SOLOMON ® 1 MY COMMIP$I©N # CO 864806 EXPIRES: Jul 18, 2003 1.6o63NOTARY Fla. Notary Service & Bonding IA. RADON C.C.F. APPROVED: Zoning Building Mechanical Plumbing Address Master Permit # - 7 5 g 3 Phone C'3oS) 7S0 28$8 Fo f)( 3845 it rPtJit R 38o e3 ss# - Phone (305)C 61 -EC 33 Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL r2UMB1G MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION its STK-1. Ott BVNCtif) Square Ft. 5 3 q E stim ated Cost (value) cal WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work stated. ♦ S , It/ igq Signature of owner or Condo President Date Si : ture • Co : ctor or 1 er- Builder Date J )o01 J Notary as to ontractor or Owner-Builder My Commission Expires: NOTARY tom' BOND 3 O a Electrical Ins. Co. NLhtTt l.L to S Date Structural Engineer CONSTRUCTION PERMIT OR: lov ] Existing System fj] Abandonment 4 ] i l f APPLICANT: PROPERTY SYSTEM DESIGN AND SPECIFICATIONS T A N K [ [ [ New System Repair ] ] ] STATE OF FLORIDA ;�� Are 08- [GALLONS / GPD] D ®" ] SQUARE FEET DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC R [ ] SQUARE FEET A TYPE SYSTEM: I CONFIGURATION: N F LOCATION OF BENCHMARK: N TRENCH ELEVATION OF PROPOSED SYSTEM SITE g 4 ] E BOTTOM OF DRAINFIELD TO BE [ D FILL REQUIRED: r4 ] INCHES O ea—CAA C re F Lio H E R SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: ] REPAIR (4) Holding Tank AGENT: STREET ADDRESS: m / ®� 77 « 7 / 0 FAA • LOT: Q BLOCK: SUBDIVISION: - /' \I D /0A PROPERTY .ID #: PRIMARY DRAINFIELD SYSTEM S STEM [W] STANDARD [N]FILLED [, ] BED PERMIT # - 2.71® DATE PAID ,'/.- FEE PAID $ , `5 . 6) 0 RECEIPT # ,T 71° Temporary /Experimental Other(Specify) C 4 [ SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -6, FAC REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS 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. [GALLONS / GPD] SEPTIC TAN /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ] tj ] rj] S /FT] [ABOV / ES /FT] [ABOVE/4145p] EXCAVATION REQUIRED: [7 ] INCHES 1 ef L 4452 MA wear { KN KNOW :Re WOE TH'$ Knorr is NOT FOR ADOfTIN INVERT ELEVATION BOTTOM OF DRA L TITLE: TITLE f . ;a?..! own !I'r l , ftILEo) i Tn HRS-H Form 4016, Mar 92 (Obsoletes puvLous editions which may not be:used) (Stock Number: 5744 - 001-4016 -0) APPLICANT MOUND ] EXPIRATION DATE: tJ] 04 G39"L, BENCHMARK /REFERENCE POINT BENCHMARK /REFERENCE POINT r CPHU Page 1 of 2 APPLICANT: LOT: O 2 PROPERTY ID STATE OF FLORIDA DEPARTMENT OF HEALTH , ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS re-ER Et-Lef4 AGENT SEpT G I � i3 � f l�f t S [At= BLOCK: 3 SUBDIVISION: Pi I $ k 0 SPit Oft. 6= S ej A / } r [Section /Township /Range /Parcel.No. or Tax ID Number] 1: 11- 'bZo5no24- o24o 1 21 jt?E" 101 5T 33138 TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR OTHERsQUALIFIED PERSON. ENGINEER'S MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [ ] YES [Y(] NO NET USABLE AREA AVAILABLE: ACRES TOTAL ESTIMATED SEWAGE FLOW: ,O GALLONS PER DAY [RESIDENCES -TABLE 1 / OTHER - ABLE 2] 2 5 GALLONS PER DAY [1500 GPD /ACRE OR 2500 ,0PD /ACRE] ( SQFT UNOBSTRUCTED AREA REQUIRED: a O SQFT AUTHORIZED SEWAGE FLOW: UNOBSTRUCTED AREA AVAILABLE: BENCHMARK /REFERENCE POINT LOCATION: ELEVATION OF PROPOSED SYSTEM SITE IS 72.1 (INCHES /,p'P"1) /Bl BENCHMARK /REE POINT •9 THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SW EM TO HE FOLLOWING FEATURES: At SURFACE WATER: A4t FT DITCHES /SWALES: N FT 5NE WET? [ ] YES (l() NO WELLS: PUBLIC: 6,t A FT LIMITED USE: FI A FT PRIVATE: FT NON - POTABLE: V4,A, FT BUILDING FOUNDATIONS: FT PROPERTY LINES: "10 FT POTABLE WATER LINES: 10 FT SITE SUBJECT TO FREQUENT FLOODING: ( ] YES ['p] NO - 10 YEAR FLOODING? A ] YES ( NO 10 YEAR FLOOD ELEVATION.FOR SITE: FT MSL/NGVD, SITE ELEVATION: 64/12 FT/ NGVD SOIL PROFILE INFORMATION SITE 1 'T. 3° Munsell Color Texture Depth ®o1 to €0a Z' - /PIA , 040 to to to to to to to USDA SOIL SERIES: SITE EVALUATED BY: 0`%/ f � // �q fl n V I P OBSERVED WATER TABLE: N INCHES [ABOVE / BELOW] EXISTING /t{ ►DE: ( [PERCHED / APPARENT] ESTIMATED WET SEASON WATER TABLE ELEVATION: 50 INC ES [ ABOVE / '• ] EXISTING GRADE. HIGH WATER TABLE VEGETATION: ( ] YES [ NO MOTTLING: [ ] YES [ ) NO DEPTH: Kik INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: DRAINFIELD EON IGURATION: [ ] TRENCH ( ] REMARKS /ADDNONAL 1CRITERIA: DH 4015, 10/96 (Replaces HRS -H Form 4015 [Page 3] which m: .e used) (Stock Number: 5744- 003 - 4015 -1) 5.4` t-SB Munsell # /Color �t� pailD�1 USDA SOIL SERIES: [ ) OTHER (S ECIFY) �' � .14,,1 N' e ' s�4 .. PERMIT # SOIL PROFILE INFORMATION SITE 2 Texture Sa1 k •■■ DATE: Depth to [' �1( m to to to to to to to to .03 DEPTH OF EXCAVATION: 24o INCHES age 3 of 3 r _'n 11; L': .'.' •.;tr, ri'.I c 7 It[I :1 1 ' ;311^,:/ o1i c„1 dumber). 7. ReGorI', ...i U.` . 7 1 1 17 .:i - e!. <.:IiI ?IC - 01 _.rea 2xclusil.e. of a +i'1 L .1itl i,ts -of- sal cm:,!ia . r:d exclusite of strums. lakes. nr „iJi. r n . i;ar:1C Of Vit. r e iabl, ∎ •r .able. 2 (nun- residcntuii), t _ i .c >a' It `,+ r, Fur the lei nc :cu. +.n r., .. - ,side arcs and water supply I , ...v vraier ,uppi ;t.s acd 2500 i pc: a, b!ic +vatcr supplies;. t 1 or ezrnsd tht. ,.11:fatc s r� ;1,..: t' c , ;.,+lica::',n must he denied. .ire;, +;iilu';1 the an, u, ri. a i,not,'trc_,.;d area must be at )sorl+ti ul .:, a f :I, least ; ! r•, rl crlt 1'; i.!it, nnobstruc,tcd area most mcct - r +(' The 111 t _t: d area d h,: CON ! t,r,r1, to il'a drainfield. l.i r . 1 s ;,cnch v a tu: i elevat,on. 'Record the ••' iii lnw) t,t i,cnCf,tti.:rl +. CO 11 ,. _,1 itlacifes. ! l !t:c:" rr i'n,:n' mes+. be . cenrded or • n 1 sire i' • 1t +irt 7` f ti, ' lot Trust h,; incsur.d. 1i ..ith; 1 2.60 ! ti appi 1 1 kr 0 n unzl cr: , ;ct t0 i t t t r ieor.i 1 :(1 2rc:' .:1,'.I(11Uti .. n :,r r_ Fusel rii+: requii'e6. Sol , _.: or, . .1,1;.0 + (Mu Si::1 :,tail R; tll1. :s). 1 <.uf sals " i Tae :,: -it c be • 't oval a: r 1i., 01 "apparent" as riesaloe it - G tivelJai!un. IiSI),1 soil maps_ "title . ca' irati it mottling is poes :nt ' 7ucd elevr:uu t for tInc Scale: Each block represents 5 feet and f< r 1 I 1 t 1 . -.- 1 1 . 1 � _ _ I � I I , I � l I , i . - I _ _ 1 I ,_,I I l � I I I 11 1 , I i} 1 7 I r L _ h 1 t 1.7.i. r iJ }— b -_. t - -I ( j + i , I Ij f �� 1 ; Li_ I ,i._: t `;� ? 4'*-' ' -�n - a �4 , I � 1 J 4 _ 1 T � 1 J 1 A'ekri4 • } _, ��`' { j � 7 ' �-3 f ■ � [ [— _ T �. r_ i r 1� � 1 I_� ,... _ � l_ II _ .j f ( L . I j 1 t 1.-.r. �.� �x ... 1 I ; 1 I I I ''7 I I I , l d a (-1 i 1 � �i I `Y r i d a L ' I - _ ; .., J 4 i CI r 4 °,r l I U , I _ 1 f t ly i 1 (1 i i ■ 1: I ''' ..',.. t I. Notes: �( Site Plan submitted b Plan Approved 1 By (Stodc Number: 5744-002-4015-6) STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number77 7 4 PART II - SITE PLAN Signature Not Approved 331 a Title D .t- J# ALL CHANGE MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015. 10/96 (Replaces HRS-H Form 4015 which maybe used) ' Cd'urhty(Heaith Department Page 2 of 3 Permit No. 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 wor Owner's Name and Address Registered Architect and /or Efigin Employing Plumber's Name 2 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT = - -- Location and Legal Description Lot.------ __----- __ -_ -- /J lock _ -_ Subdivision ,--- _ -_..- Street and Number where work is to be performed —No J / '�;L /' J ✓ Street - State work to be performed and purpose of building (By Floors) ______ New Building —___ Remodeling_ __ ____._. — ___ Addition____ Repairs No. of Stories. Size Septic Tank Feet of Drain Tile L _Dist. Feet of Tank or Drain Field from Well Date. No._ Street-. - - -_ -. .... Street_ Tank__ Capacity Gab Nature of Water Supply: City — Well.___ — ____________ ..... of Soakage Pit Amount of Permit $ Plumbing 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 5966, Compiled General Laws of Florida Permanent Supplement, and Ilas 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 t}ie Act. The undersigned agrees to employ only such sub- contractors, on work to be performed unee, this emit, as e licensed by Miami Shores Village. �) i� ��� ���y� � A STATE OF FLORIDA, OIL COUNTY OF DADE. j (Signed)- Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well own, and who, being by me first duly sworn, upon oath deposes and says that he is the__ of the a ve described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein 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 and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK Permit No. 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 wor Owner's Name and Address Registered Architect and /or Efigin Employing Plumber's Name 2 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT = - -- Location and Legal Description Lot.------ __----- __ -_ -- /J lock _ -_ Subdivision ,--- _ -_..- Street and Number where work is to be performed —No J / '�;L /' J ✓ Street - State work to be performed and purpose of building (By Floors) ______ New Building —___ Remodeling_ __ ____._. — ___ Addition____ Repairs No. of Stories. Size Septic Tank Feet of Drain Tile L _Dist. Feet of Tank or Drain Field from Well Date. No._ Street-. - - -_ -. .... Street_ Tank__ Capacity Gab Nature of Water Supply: City — Well.___ — ____________ ..... of Soakage Pit Amount of Permit $ Plumbing 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 5966, Compiled General Laws of Florida Permanent Supplement, and Ilas 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 t}ie Act. The undersigned agrees to employ only such sub- contractors, on work to be performed unee, this emit, as e licensed by Miami Shores Village. �) i� ��� ���y� � A STATE OF FLORIDA, OIL COUNTY OF DADE. j (Signed)- Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well own, and who, being by me first duly sworn, upon oath deposes and says that he is the__ of the a ve described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein 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 and /or workmanship.