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320 NE 100 St (10)• BUILDING PERMIT APPLICATION FBC 2001 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Master Permit No .L. Q " Permit Type (circle): Building Electrica Mechanical Roofing Owner's Name (Fee Simple Titleholder) AL) 2)7z U t1 Ddk Phone # S � Owner's Address 3 ..Z v tit= /Off% 77--/ City /V „' Z'I / 6'' &/2E State FL- Gk /D74 Zip .5/ 3 Tenant/Lessee Name Phone # Job Address (where the work is being done) L /L� / 7 %H City Miami Shores Village County Miami -Dade Zip ; / 3eY Is Building Historically Designated YES NO Contractor's Company Name 4 L c y YC T/L Phone # -S — 7 S7- 7C 7 Contractor's Address /UJ iii) /C 7 %/ 5"72E City 4'1 / 144 / State FL / ?/ 2// Zip 5 5 /6 d " Qualifier 2- L) %L••%? 1 C'!?e)CY E T Architect/Engineer's Name (if applicable) - Phone # Architect/Engineer's Address City State Zip S Value of Work For this Permit l /LICZ' ' £'Z Square Footage Of Work: Number of: Bays Stories Families Bedrooms Type of Work: ['Addition ❑Alteration ['New []'Repair/Replace . ❑ Demolition Describe Work: C2)44 c 1: /G i - K / /AP / r i '4.'C - 74 Ai'Ae * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** County Escrow Fee $ 0 Education/Training Fee $ % L1 () Code Enforcement $ Bond $ Struct. $ Baths Permit Fee $ (.s. n Tech $ 31 Scanning $ Radon $ Minus Plans Check Fee $ Total Fee Now Due $ 1 S, 7 ~f7 Notary $ . 0 (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's 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 0, yl�C -,y Owner or Agent My Commission Expires: .' /r 1'i t e.2 State Certificate or Registration No. chc7t7/03 Signature J My Commission Le at: i 7. Contractor The foregoing instrument was acknowledged before me this / . The foregoing instrument was ac day of 4 , 9 , 20 cL1 , by ti• �c� /� �3� /� % Jc�? , day of_; 200 " b who is personally known to i br who has produced who is personally known to me or who has produced As identification and who did take an oath. NOT Y P IC: P _ e, ' Y P LESTER E. CROCKETT i Sign: 1:') I.( l C- +0 d +Ot fY �.� , • I , 4762 I Sign: Print: L L ' 4? L 0,7 II .! EXPIRES: May 20, 2005 ' Print: dged before me thi as identification and who did take an oath. .01Y Noqo l 1n kr -\ (Certificate of Competency Holder) Certificate of Competency No. APPLICATION APPROVED B 3 —D, , , . � %,`- C'� °L�'� Plans Examiner Engineer Zoning • Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 2/25/2004 Applicant: ANDRES OBRADOR Owner: OBRADOR ANDRES JOB ADDRESS: 320 NE 100 ST Contractor LLOYD NORTH DADE SEPTIC TANK SERVIORdNttactor's Address: 750 NW 107 ST Local Phone: 305 - 754 -3375 Parcel # 1132060135460 Plumbing Permit Permit Number: PL2004 -55 Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 9 & 10 BLK 40 LOT SIZE 100.000 Fees: Description Amount FEE2004 -1620 Building Fee $175.00 FEE2004 -1621 CCF $1.20 FEE2004 -1622 Notary Fee $5.00 FEE2004 -1623 Training and Education Fee $0.40 FEE2004 -1624 Technology Fee $4.37 Total Fees: $185.97 Total Fees: $185.97 Total Receipts: $185.97 Permit Status: APPROVED Permit Expiration: 8/16/2004 Construction Value: $1,400.00 Work: REPLACE SEPTIC TANK AND ABANDON EXISTING TANK Signed: (INSPECTOR) 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 PERMIT APPLICATION FBC 2001 County Escrow Fee $ Miami Shores Village Building Department Permit Fee $ l ZS 0 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. pL, `J V`S Master Permit No. Permit Type (circle): Building Electrical( Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) OBt-`l At. Ce 9 'R Phone # S S ,6 6 • 1 /z /t/ Owner's Address 3 :2 Le /1./L /G.-LT/-1 i 72 C=L 7 City jri'i?i77 / . / /C /2L -- 3 State A Zip 35/ 3 e Tenant/Lessee Name Phone # Job Address (where the work is being done) -) U / / - Z /H City Miami Shores Village County Miami -Dade Zip 33 / Is Building Historically Designated YES NO Contractor's Company Name L ° V / / 7/�Z." a-/ # � - '7S /- '7 Contractor's Address 7�C / • vL /07 City �7 /// /iT / State / "L t d /' ) / Zip 3 3/6 s` Qualifier - Architect/Engineer's Name (if applicable) - Phone # Architect/Engineer's Address City ` State Zip $ Value of Work For this Permit � Square Footage Of Work: 4 Number of: Bays Stories Families Bedrooms Baths Type of Work: DAddition DAlteration :New [alRepair/Replace 0 Demolition f Describe Work: R L P,1 / R /' k/l /fL F7CL2) * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Notary $ - v fJ / 1 Education/Training Fee $ . y 0 Tech $ t 3 '7 Scanning $ Radon $ Code Enforcement $ Bond $ 13 OD Struct. $ Minus Plans Check Fee $ Total Fee Now Due $CF-S (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's 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. l � L._ Signature Signature L Y lcLi 7, Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing ' strument was ackn ledged before me this day of J a .t i f, 20Cx/, by /an,'i7 k'L -S !� d�yDt 7 d o p - � ` 200 b� Q .(. l who is personally known to moor who has produced who is personally known to me or who has produced My Commission Expires: As identification and who did take an oath. My Coniimi Expires: ass identification and who did take an oath. (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. * * * * * * * * * * * * ** * * * * * * * * * * * * * ** ** * * *** ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED Y: ,C C, �1[ _ _ `Z -2 _ - Plans Examiner Engineer Zoning Chc7l7ro3 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: [ ]New System [ ]Existing System [ [ X ]Repair [ ]Abandonment APPLICANT: Obrador, Andres AGENT: SR0001343, Crockett Lester PROPERTY STREET ADDRESS: 320 NE 100 St Miami FL 33138 LOT: 9 BLOCK: 40 SUBDIVISION: Miami Shores [Section /Township /Range /Parcel No.] PROPERTY ID #: 33- 3206 - 013 -5460 [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME PERIOD. 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 PROPERTY DEVELOPMENT. SYSTEM DESIGN AND SPECIFICATIONS T [ 1050 ]Gallons SEPTIC TANK A [ 0 ]Gallons N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ [0 D [ 400 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ 0 ]SQUARE FEET SYSTEM A TYPE SYSTEM: [ N ]STANDARD [ N ]FILLED [ N ]MOUND [ N ] I CONFIGURATION: [ N ]TRENCH [ N ]BED [ N ] N F LOCATION TO BENCHMARK: Finished Floor Of Exist. Res. Elev. 11.20' NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 0.9 ] [ FEET ] [ BELOW]BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 3.4 ] [ FEET ] [ BELOW]BENCHMARK /REFERENCE POINT L D FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 30.0 ] INCHES OTHER REMARKS: 1- Install 1050 Gals Septic Tank Cat -3 W/ an approved outlet filter. 2- Install 400 Square feet drainfield In Bed Configuration.. 3- Invert elevation of the drainfield to be no less than 8..30' NGVD 4- Bottom elevation of the drainfield to be no less than 7:80'..NGVD. 5- Existing 500 Gallons Septic Tank to be Abandoned properly. 6 -The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with Chapter 64E- 6.013(3)(f) Florida Administrative Code. THIS PERMIT IS NOT FOR ADDITION. SPECIFICATIONS BY: Andre, Paul TITLE: P�,P PROVED BY: Andre, Paul 7113 „ „ (i FC?ros ?s c�}Yangin Dade CHD DATE ISSUED: 2/16/04 udduNyQJ dy 114iyY \Y ' '� „ ��Cf��i {1!}}}`yyyl {, 1(ry? ��.i+�(� �( DEFLECTION lhiffi. CE "`�f3Gwttwl Z Ea urY iiAbi U{% I$1 W�IH EXPIRATION DATE: 5/16/04 DH 4016, 03/97 (Obsoletes previous editions which may not be used) ic«,...i. .,...,L...... ❑7nn_nni_nn1c_nl CENTRAX #: 13 -SG -19628 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 04 -0598- -R ]Holding Tank [ ] Innovative Other ]Temporary [ NA ] MULTI - CHAMBERED /IN SERIES: [Y ] MULTI - CHAMBERED /IN SERIES: [Y ] ]DOSES PER 24 HRS # PUMPS[ 0 ] Dnno 1 r.f ') APPLICATION FOR: [ ,J] New System [ y] Repair APPLICANT: i•-7 A/ DkC` - O1 MAILING ADDRESS: BUILDING INFORMATION 1 2 3 4 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT [ Floor Equipm nt Dram i SIGNATURE: ••- %1! I ] Existing System [JI [AA Innovative I�l Abandonment Holding Tank [ [ Temporary [ ] AGENT: LLD/Z) /UO7/H azT' 47-j>T /C -7 TO /U • Liu • /07 71 Zs/6 / (v r TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST BE CONSTRUCTED BY A PERSON LICENSED PURSUANT TO 489.105(3)(m) OR 489.552, FLORIDA STATUTES. IT IS THE APPLICANT'S RESPONSIBILITY TO PROVIDE DOCUMENTATION OF THE DATE THE LOT WAS CREATED OR PLATTED (MM /DD /YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS. PROPERTY INFORMATION , Q (� LOT: % /0 BLOCK: ` / 0 SUBDIVISION: 1711/1t11/ .5 SL 9 I PLATTED: , 3 PROPERTY ID #: 1/ -206, - 0/3 O ZONING: I/M OR EQUIVALENT: [ Y / N ] PROPERTY SIZE: , ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC [' 2000GPD [ ] >2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ Yee] DISTANCE TO SEWER: ,, /FT PROPERTY ADDRESS: 310 AJ. L' /(� iH �c -T T / 1l �i�/d'� /L. 3 5 /3d' DIRECTIONS TO PROPERTY: - Q/ j A O 77-/ / A L /D /05g)Z J%,TZ r L-,Y/ %O AJ i ?2 / V VJF v iti TO /4 6'S [4 / RESIDENTIAL [ ] COMMERCIAL PERMIT QLj 1 '' " q 3 DATE PAID: FEE PAID: RE IPT #. TELEPHONE: Unit Type of No. of Building Commercial /Institutional System Design No Establishment Bedrooms Area Sqf t Table 1, Chapter 64E -6, FAC _Si /Jar: FAQ /L •/ 4 /-9..) A A . Other (Specify) DATE: - /v--oz-/ LC DH 4015, 10/97 (Previous Editions May Be Used) Page 1 or 4 APPLICANT: /LJ�j L"t5 O /9 J CONTRACTOR / AGENT: LOT: SUBMITTED BY: �C/J 1 L �L.57 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM EXISTING SYSTEM AND SYSTEM REPAIR EVALUATION L oYD /110? /D • BLOCK: ` 9 SUBDIV: m //3-m/ dND,CL �K? TO BE COMPLETED BY FLORIDA REGISTERED ENGINEER, DEPARTMENT EMPLOYEE, SEPTIC TANK CONTRACTOR OR OTHER CERTIFIED PERSON. SIGN AND SEAL ALL SUBMITTED DOCUMENTS. COMPLETE ALL APPLICABLE ITEMS. COMPLETE TANK CERTIFICATION BELOW OR ATTACH LETTER FROM A PERMITTED SEPTAGE DISPOSAL SERVICE. EXISTING TANK INFORMATION GALLONS SEPTIC TANK /GPD ATU GALLONS SEPTIC TANK /GPD ATU GALLONS GREASE INTERCEPTOR GALLONS DOSING TANK FY_THA : ABM. NOTED TANKS LY WE A [ SOLIDS DEFLECTION DEVIC: / OUTLET FILTER DEVICE ] INSTALLED. SIGNATURE OF BUSINESS NAME EXISTING DRAINFIELD INFORMATION [ .2Z] SQUARE FEET PRIMARY DRAINFIELD SYSTEM NO. OF TRENCHES [ ] DIMENSIONS: � X /0 [ ] SQUARE FEET SYSTEM NO. OF TRENCHES [ ] DIMENSIONS: X TYPE OF SYSTEM: [- STANDARD [ ]7FILLED [ ] MOUND [ ] CONFIGURATION: [ ] TRENCH [ ED [ ] DESIGN: [ ] HEADER [r/] D -BOX [t1 GRAVITY SYSTEM [ ] DOSED SYSTEM ELEVATION OF BOTTOM OF DRAINFIELD IN RELATION TO EXISTING GRADE INCHES [ ABOVE SYSTEM FAILURE AND REPAIR INFORMATION [/939] [ 407) ] GPD ESTIMATED SEWAGE FLOW BASED ON [ ] METERED WATER [v4 1, 64E -6, FAC SYSTEM INSTALLATION DATE TYPE OF WASTE [ ✓] DOMESTIC [ ] COMMERCIAL SITE [ ] DRAINAGE STRUCTURES [ ] POOL [ ] PATIO / DECK [ ] PARKING CONDITIONS: [ ] SLOPING PROPERTY [ ] NATURE OF [r/] HYDRAULIC OVERLOAD FAILURE: [ ] DRAINAGE / RUN OFF FAILURE [ ],,SEWAGE ON GROUND SYMPTOM: [&/1 PLUMBING BACKUP S /ADDITIONAL CR TERIA -% r OCKL / DH 4015, 10/96 (Previous Editions may be used) LEGEND: LEGEND: LEGEND: LEGEND: 4-/q ED ON ,2 / z /, PERMIT # [ ] SOILS [ ] MAINTENANCE [ ] ROOTS [ ] WATER TABLE [ ] O // - 0i3 "S'46.0 ID #: MATERIAL: (.o4.,tR[ - -%2 BAFFLED N] MATERIAL: BAFFLED:[Y / N] MATERIAL: MATERIAL: # PUMPS:[ ] HAVE THE VOLUMES SPECIFIED, ARE DATE [ ] SYSTEM DAMAGE [l/] TANK [ ] D BOX /HEADER (4 [ ] i 44 / i ___tornr AG, /Dso I - ',i Mrs.W.S TITLE /LICENSE , CP T / a/V772 T� DATE :�- /� Q(L Page 4 of 4 APPLICANT: LOT: ')O PROPERTY STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS BLOCK: 1. SUBDIVISION: ` /op`.5 j2:--c_ 4 ID #: II- 3'OG - o/3 -,"6p PROPERTY SIZE CONFORMS TO SITE PLAN: [•] YES [ ] TOTAL ESTIMATED SEWAGE FLOW: 42 00 GALLONS AUTHORIZED SEWAGE FLOW: 1.50 GALLONS UNOBSTRUCTED AREA AVAILABLE: ?IL/ SQFT BENCHMARK /REFERENCE POINT LOCATION: L //UlcS / i-Ll}j)7 I / . ELEVATION OF PROPOSED SYSTEM SITE IS /n, g" THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE SURFACE WATER: A•dq FT DITCHES /SWALES: WELLS: PUBLIC: A)41- FT LIMITED USE: A)-/ FT BUILDING FOUNDATIONS: S FT PROPERTY LINES: SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [ NO 10 YEAR FLOOD ELEVATION FOR SITE: 3, MSL SOIL PROFILE INFORMATION SITE 1 Munsell # /Color Texture to -/P / L o q,n'/ Q„ /0 `/7? /U / nrr / /1 // fr Depth to to to to to to to /2 " /f // to /( // to =J„-� /' USDA SOIL SERIES: UPaPlAJLIqA-0 SITE EVALUATED BY: � J9 ��/`t , fi /� ' 1 L7,57 C_ R �C.r�= T: DH 4015, 10196 (Replaces HRS -H Form 4015 [Page 3] which may be used) (Stock Number: 5744 - 003 - 4015 -1) 5 0 AGENT: PERMIT gc- ifi � 2A1 L- SL- %ice k'1o.1�RE. 03 Z'FI �v7 [Section /Township /Range /Parcel No. or Tax ID Number) TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. NO NET USABLE AREA AVAILABLE: • ::)() ACRES PER DAY CRESIDENCES -TABLE 1L OTHER -TABLE 2] PER DAY [1500 GPD /ACRE O Zi'00 GPD ACRE].' UNOBSTRUCTED AREA REQUIRED: rcE) SQFT FT] [ABOV % BELOW BENCHMARK /REFERENCE POINT PROPOSED SYSTEM TO THE FOLLOWING FEATURES: /VA FT NORMALLY WET? [ ] YES [ ] NO PRIVATE: ' Y7'FT NON - POTABLE: a FT iT FT POTABLE WATER LINES: /D FT 10 YEAR FLOODING? [ ] YES [�O GVD SITE ELEVATION: /p. ;' MS NGVD SOIL PROFILE INFORMATION SITE 2 Munsell # /Color Texture /0 v; Si/ LOAMY G _1y14).D /0 7/J c51 -'1A11) )! /1 /r It USDA SOIL SERIES: I( N ()P 317/OLAn1� Depth 0" to to /0" /0 " to to to to to to to OBSERVED WATER TABLE: AJ A. INCHES [ABOVE / BELOW EXISTING_GRADE. TYPE: PERCHED / APPARENT] ESTIMATED WET SEASON WATER TABLE ELEVATIO 74(y l `NCHES2)[ ABOVE -BELOW a EXISTING GRADE. HIGH WATER TABLE VEGETATION: [ ] YES [ ]] NO MOTTLING: [ ] YES [ -(NO DEPTH: N I' INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: j / '� DEPTH OF EXCAVATION: 3-22 INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH , [ ✓] BED [ ] OTHER (SPECIFY) REMARKS /ADDITIONAL CR, TERIA: 0/14.. / ' ) /i'z h d ca. -i rr ; a14, 21' affil' A/A4 i4 tir f /' !yi /DSz) 0 / i LPL / cam - Ae4 GD 7( DATE: -- / 3 -49c/ Page 3 of 3 ■�■■ • IS p.m ■ ■■ - �;. T L . 4 ■■ no ., IIIIIII. as t - +-; •• :ii - r■ ■ 1 t t \, Scale: Each block represents 5 feet and 1 inch = 50 feet Plan Approved By STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERM T 4 11 Permit Application Number -) DH 4015, 10198 (Replaces HRSH Fpm 4015 which may be used) (slack Number: 5744.002 -40154) PART II - SITE PLAN - ' 1 11 ■ ■ ititttt • O n ■ t ■■ s a.■ ■. ■I ■ ■■ ■ 11 MUM NO MO iu■=i. ii■ ® ` i■ ■ ■■ ■ /■ ■ ■ /■■■ - ill ■N ■N■■■■ N■MN ■ /■■•N. n■■ ■ •• i� ■ ■ / i � .■ mom Nor /i1f ■ ■■ ■■ om me ry C ni b Ind .■ ■.0 ■ ■�/� .. m• G MI N.. { ME N MUM ■■ mum= ~ =II. N.■■■N ._. ■■ ME ■ • •. N • ■N ■/� C:'■R:■C■''IIIMIN MRS O . ■. - N .■■.C■■.. =.r ■ ■N■M . ■N■■■ ■ ■ ■■/■N a ti, ••.. ■ ■/ ■ /tt� /■MO .�' MUM i� . ••iii■■■ ■M / • MU ■ ■ ■/■ ■■■■ 0 ■ 1 r-. • 4 or • f rr r E.. ■ ■ ■N r ►1� f-r Z - rt Not Approved - 1 j rt �-¢ t f- 1 Y� Y r t f i r� 2 e - 4-4 I • ■ MUM • II ih!E I mire ma n ni isiMmuninnionnammnomon unommmuminanne nommonnommnsiovi munneannonnueini mmmemminalligli nun miniummumm ■ ■// ■ ■■■ /Nu/■■ ■ ■■ ■ ■ r ` r _.>-. � ■■■■� ■■■■,■■■ N■■■■■ ■■■■■.■■■. ■ ••.a••• uR ■N ■ 1 I ■NN .................... in ■■■ C I : ■ i■■ '■■■ ■ ■N:■::. ■ . ■■ ill ... Mils IlltumaNCW MIINWMASE j oy 6, IA 110 _ ■■m u.■ ■■■ . SW. /■■■ m w■ r p r i ■� ■ ■■■ ■■■■N■■■ ■ ■■ ■ ■ ■ /�/ L Notes: �� 1 C;Lf/A.A,e_ 0%.!/it.P ter- Jt1/ Ce w2 7t"7 /._ Ct/t J7., 44W 4/1,1:6 .9i1A a-3 c�t1 /V--al Site Plan submitted by: f�hCT/ arZ.Z4 5Z 7?7C (261 `Z'A r r- r . doe 7T- Signature Title ALL CHANGeS MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT Date County Health Department Page 2 of 3 Owners Name: ANDRES C. OBRADOR Property Address: 320 NE 100 STREET MIAMI SHORES, FL. 33138 LEGAL DESCRIPTION: FOLIO #: 11- 3206 - 013 -5460 Lot 9 & 10, Block 40 of "MIAMI SHORES SEC 1 AMD" according to the plat thereof as recorded in Plat Book 10 at Page 70 of the Public Records of Dade County, Florida. SURVEYOR'S NOTES: 1) Not valid without the signature and the original raised seal of a Florida Licensed Surveyor and Mapper. 2) Additions or deletions to this certificate by other than the signing party or parties are prohibited without written consent of the signing party or parties. 3) This certificate elevation is for the purpose of septic and drains repair and /or construction. 4) This certificate elevation must not be use for the purpose of acquiring flood insurance 5) Elevations are based on the National Geodetic Vertical Datum of 1929. 6) Flood Zone: XXX Base Flood Elev.: XXX as per Dade County, Florida. FEMA Panel Number: 120652 - 0093 - J - MARCH 2, 1994 TOP OF BOTTOM FLOOR: TOP OF NEXT HIGHER FLOOR: ATTACHED GARAGE (at the door): GRADE @ DRAINFIELD AREA CROWN OF THE ROAD: Field Date: 2/11/04 ELEVATION CERTIFICATE ('A. 11.2' N/A 10.2' 10.3' 10.4' O v L cD1N1 Pablo J. Alfonso P.S.M. Professional Surveyor & Mapper State of Florida Reg. No.5880 LAND S U R V E Y O R S , I N C. 6175 NW 153 STREET, SUITE 103, MIAMI LAKES, FLORIDA 33014 Phone: 305 - 822 -6062 ** 305 - 698 -9468 ** Fax: 305 - 827 -9669 Miami Shores Village 10050 NE 2nd Avenue Plumbing Permit Phone: 305- 795 -2204 Permit Number: PL2004 -56 Printed: 2/18/2004 Applicant: ANDRES OBRADOR Owner: OBRADOR ANDRES JOB ADDRESS: 320 NE 100 ST Contractor LLOYD NORTH DADE SEPTIC TANK SERVIQdNttactor's Address: 750 NW 107 ST Local Phone: 305 - 754 - 3375 Parcel # 1132060135460 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 9 & 10 BLK 40 LOT SIZE 100.000 Fees: Description Amount FEE2004 -1625 Building Fee $175.00 FEE2004 -1626 CCF $1.20 FEE2004 -1627 Notary Fee $5.00 FEE2004 -1628 Training and Education Fee $0.40 FEE2004 -1629 Technology Fee $4.37 FEE2004 -1630 Builders Bond $300.00 Total Fees: $485.97 Total Fees: $485.97 Total Receipts: $485.97 Permit Status: APPROVED Permit Expiration: 8/16/2004 Construction Value: $2,000.00 Work: REPAIR DRAINFIELD Signed: (INSPECTOR) Page 1 of 1 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: APPLICANT: AGENT: l 1 1 1 1 1 1 1 1 1 1 1 1 l l 1 1 l 1 1 1 1 TANK [01] [01) [03] [04] [05] [06] [07] [08] [09] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19] [20] [21] STATE OF FLORIDA DEPARTMENT.OF HEALTH ONSITE SEWAGE TREATMENT AND CONSTRUCTION INSPECTION AND 1 ;'" ► ,J , „/62o '1;7, PROPERTY ADDRESS: LOT: BLOCK: ta, 0 SUBDIVISION: 1( 6 lr`. 511- " S saillassIIIIIM aasMMIIIMasaaaasaa a:: Cass ass s asaaaaaasaaaaa =saaa:SZUMasaasaasssacxa == CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. __==== ==== a= == === = =a= = ===== as ==aria as - z==== =s=ass== = == = = = = == INSTALLATION TANK SIZE [1]4 [4] , TANK MATERIAL a- ' C ,; 3 OUTLET DEVICE MULTI - CHAMBERED [,, Yr / ; N ] OUTLET FILTER :' LEGEND / % • WATERTIGHT LEVEL DEPTH TO LID DRAINFIELD INSTALLATION 1 , ,• 4 t. ' AREA [1] . ` - ' ° 7 [21' SQF [ rJ ] DISTRIBUTION BOX _ HEADER ' [ ) NUMBER OF DRAINLINES [j l DRAINLINE SEPARATION [('1 DRAINLINE SLOPE DEPTH OF COVER ELEVATION [ABOVE /BELOW] BM SYSTEM LOCATION DOSING PUMPS , AGGREGATE SIZE NJ ' (1 AGGREGATE EXCESSIVE FINES AGGREGATE DEPTH t FILL / EXCAVATION MATERIAL, [14] FILL AMOUNT [23] FILL TEXTURE [14] EXCAVATION DEPTH [25] AREA REPLACED' 1, 1 [26) REPLACEMENT MATERIAL( ' ' EXPLANATION OF VIOLATIONS / REMARKS: CONSTRUCTION ([APPROVED /LISAPPROVED]: ' ,1 °44A i. FINAL SYSTEM [APPROVED /DISAPPROVED]: .�r DH 4016, 10/97 (Previous Editions May Be Used) Installer / Contractor DIPOBAL SYSTEM FINAL APPROVAL 1 1 I 1 l 1 1 + �rr• � i SETBACKS [27] SURFACE [ [ [30] [31] [32] [33] [34] [35] FILLED / MOUND SYSTEM [36] [37] [38] [39] PERMIT NO. DATE PAID: PEE PAID :' RECEIPT #: PROPERTY ID f: � ✓.y -!t� L 1 � f `'u WATER DITCHES PRIVATE WELLS PUBLIC WELLS IRRIGATION WELLS POTABLE WATER LINES BUILDING FOUNDATION PROPERTY LINES OTHER DRAINFIELD COVER SHOULDERS SLOPES STABILIZATION ,) r ! 5 ABANDONMENT [49] TANK PUMPED _ / / [50] TANK CRUSHED i FILLED CHD DATE: FT FT FT FT FT FT FT FT FT ADDITIONAL INFORMATION [40] UNOBSTRUCTED AREA [41] STORMWATER RUNOFF [42] ALARMS [43] MAINTENANCE AGREEMENT [44] BUILDING AREA [45] LOCATION CONFORMS WITH SITE PLAN [46] FINAL SITE GRADING (47 ] CONTRACTOR L fi t,1. ft J [48] OTHER CHD DATE:'' Page 2 of 3 APPLICANT: AGENT: .. PROPERTY ADDRESS: �� j � ' LI SUBDIVISION: LOT: _ BLOCK: 1 1 1 l l 1 1 l l 1 1 1 1 DRAINFIELD [10] [11] [12] [13] [ [15] [16] [17] [18] [19] [20] [21] FILL [22] [23] [ [25] [26] STATE OF FLORIDA DEPARTMENT.OF HEALTH ONSITE SEWAGE TREATMENT AND DIPOBAL 8 =T CONBTRUCTION'INSPECTION AND FINAL f sz :szzass���casa = = =n zzsss sassssszszsssazsssss: :zz � RULE AND MUST BE CORRECTED. CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE - � M _ = an=- _= ��=�-- s�x_as= =azaazx -- SETBACKS TANK INSTALLATION ,� 5 G� 2 [ ] [ Z7 ] SURFACE WATER FT ] [01] TANK SIZE . [ 11 /4; [ l ' ] [02] TANK MATERIAL t' "'y,,. " FT , [ 1 [281 DITCHES FT ] [03] OUTLET DEVICE („4"11V(1 [ )] [29] PRIVATE WELLS FT ] [04] MULTI- CHAMBERED [; L /fill ] [ :1 [30] PUBLIC WELLS _ FT ] [05] OUTLET FILTER \''' `. I t ; ,; [ 1�. ] ( 31 ] IRRIGATION WELLS ] [06] LEGEND /3 �% [ ] [32] POTABLE WATER LINES / )' FT [ ] [33] BUILDING FOUNDATION n FT ] (088 ] [07] WATERTIGHT BU [ ] [34] PROPERTY LINES 5 FT ] LEVEL ] [09] DEPTH TO LID [ ] [35] OTHER FT INSTALLATION AREA [1] -1 [2] SQFT DISTRIBUTION BOX - HEADER NUMBER OF DRAINLINES DRAINLINE SEPARATION DRAINLINE SLOPE DEPTH OF COVER ELEVATION [ABOVE /BELOW] BM SYSTEM LOCATION DOSING PUMPS AGGREGATE SIZE AGGREGATE EXCESSIVE FINES AGGREGATE DEPTH k; i• / EXCAVATION MATERIAL,, FILL AMOUNT r -� FILL TEXTURE EXCAVATION DEPTH AREA REPLACED REPLACEMENT MATERIAL -� EXPLANATION OF VIOLATIONS / REMARKS: CONSTRUCTION ,APPROVED/DISAPPROVED] fi 1 1 1 1 1 1 [ 1 + ■ 1 , ( i't(J 1 , i FINAL SYSTEM [APPROVED/.DISAPPROVED] : -j" ,,.'• ` - '- ^'��!' DU 4016, 10/97 (Previous Editions May Be Used)" T..a *.11Pr 1 CnntractOr !) �- PERMIT NO. DATE PAID: FEE PAID: RECEIPT 1: ' r. ) PROPERTY ID #:7 h' ,,%o(a "L -)-, 4G FILLED / MOUND SYSTEM [36] DRAINFIELD COVER [37] SHOULDERS (38 ] SLOPES [39] STABILIZATION ADDITIONAL INFORMATION [40] UNOBSTRUCTED AREA [41] STORMWATER RUNOFF [42] ALARMS [43] MAINTENANCE AGREEMENT [44] BUILDING AREA [45] LOCATION CONFORMS WITH [46] FINAL SITE GRADING [47] CONTRACTOR L r vi ft p [48] OTHER ABANDONMENT [49] TANK PUMPED _ / / [50] TANK CRUSHED & FILLED / SITE PLAN AI CUD DATE: 2 CED DATE: L_ Page 2 of : 0) FLORIDA DEPA NT ALTH APPROVED Permi Ne.ke (-l . __ 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 work. Owner's Name and Address J2t-- Registered Architect and /or Employing Plumber's Name No._______ -___._ Street Location and Legal Description Lot dqq� oo Block Subdivision ....... ------..... _----_------___--- Street and Number where work is to be performed -No ' R -(d 1 COL � / Street State work to be performed and purpose of building (By Floors) _ New Building-- _---------------- •- __ -_ -- Remodeling 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 114.the Addition (Signed). Date -- ---- - /© /L_j No.___-_- _---- ___ - -_ _ Street. Repairs No. of Stories Capacity Gals ______Type of Tank eet of Tank or Drain Field from Well __Size of Pit (Signed)- L Numbing Inspector. The undersigned applicant for this building permit does hereby[ ify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5 Compiled General Laws of Florida Permanent Supplement, and has coin - 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 permit, as are licensed by Miami Shores Village. Master Plumber. 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 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 iaterials and /or workmanship. CLOSETS BATH TUBE 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 Cowrie. ` --- CHECK Permi Ne.ke (-l . __ 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 work. Owner's Name and Address J2t-- Registered Architect and /or Employing Plumber's Name No._______ -___._ Street Location and Legal Description Lot dqq� oo Block Subdivision ....... ------..... _----_------___--- Street and Number where work is to be performed -No ' R -(d 1 COL � / Street State work to be performed and purpose of building (By Floors) _ New Building-- _---------------- •- __ -_ -- Remodeling 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 114.the Addition (Signed). Date -- ---- - /© /L_j No.___-_- _---- ___ - -_ _ Street. Repairs No. of Stories Capacity Gals ______Type of Tank eet of Tank or Drain Field from Well __Size of Pit (Signed)- L Numbing Inspector. The undersigned applicant for this building permit does hereby[ ify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5 Compiled General Laws of Florida Permanent Supplement, and has coin - 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 permit, as are licensed by Miami Shores Village. Master Plumber. 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 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 iaterials and /or workmanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT / y Permit No /114-23- Date..._.. -�1 �lI_E..? z J . l.. 72 .— 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 work. Owner's Name and Address NI S I'd No 3 'r Street__ _1 00 " Registered Architect and /or Engineer Employing Plumber's Name L Wi P(2Ti 4 �d �( G., No, .....,.e...a..�..�.,.,... ttir ..�..._.:..... Location and Legal Description Lot. Block Street and Number where work is to be performed —No G it/C; Street . l loo S L State work to be performed and purpose of building (By Floors)--.--.. — New Building. . _ _—_ - _ Remodeling —__ _ ._.— __ Addition.. -_ - -. _.__... Repairs No. of Stories. Size Septic Tanlr Feet of Drain Tile Ter Nature of Water Supply: City —Well. Amount of Permit $ Plumbing Spec 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 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 rk to performed under this permit, as are lioensed by Miami Shores Village. My Commission Expires Type of Tank Feet of Tank or Drain Field from Well Size of Soakage Pit. (Si d (sip) Notary Public, State of Florida Muter P1 STATE OF FLORIDA, I u. COUNTY OF DADE. 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 be did sign the same, and that all facts therein by him stated are true. NOTE: A re inspection fee of $1.00 win be made whoa such rolaspeotlaa is madS•aaossaary by improper notice for inspection. or faulty materials and/or workmanship. CLOSETS BATH TUB[ SHOWER[ LAVA. TORIES SIN" SINKS LAUNDRY TUGS URINAL, CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURE[ CONTR. LIST CHECK � � SEPTIC TANK SEWER CONN. DRAIN SOAKAGE PIT GREASE TRAP SOLAR NEATER DEEP WILL SPRKLR. SYSTEM SWIM•O POOL CONTR. LIST CHECK A FIELD // ✓ O � '. 6�%�(/i c � / MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT / y Permit No /114-23- Date..._.. -�1 �lI_E..? z J . l.. 72 .— 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 work. Owner's Name and Address NI S I'd No 3 'r Street__ _1 00 " Registered Architect and /or Engineer Employing Plumber's Name L Wi P(2Ti 4 �d �( G., No, .....,.e...a..�..�.,.,... ttir ..�..._.:..... Location and Legal Description Lot. Block Street and Number where work is to be performed —No G it/C; Street . l loo S L State work to be performed and purpose of building (By Floors)--.--.. — New Building. . _ _—_ - _ Remodeling —__ _ ._.— __ Addition.. -_ - -. _.__... Repairs No. of Stories. Size Septic Tanlr Feet of Drain Tile Ter Nature of Water Supply: City —Well. Amount of Permit $ Plumbing Spec 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 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 rk to performed under this permit, as are lioensed by Miami Shores Village. My Commission Expires Type of Tank Feet of Tank or Drain Field from Well Size of Soakage Pit. (Si d (sip) Notary Public, State of Florida Muter P1 STATE OF FLORIDA, I u. COUNTY OF DADE. 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 be did sign the same, and that all facts therein by him stated are true. NOTE: A re inspection fee of $1.00 win be made whoa such rolaspeotlaa is madS•aaossaary by improper notice for inspection. or faulty materials and/or workmanship. Permit No . e7, Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submittefl 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 work. Owner's Name and Address Registered Architect and /or Engineer__ Employing Plumber's Name Location and Legal Description Lot__ Size Septic Tank Feet of Drain Tile_, Nature of Water Supply: City -Well STATE OF FLORIDA, 1 COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Amount of Permits vv -- (Signed) ( Signed )_______ Date_ No._ 7 0_— Street_ y l _�/ --_r e St �- ---_ No._ Street- Block - Subdivision Street and Number where work is to be performed -No 3 Pi. E- i -'- Street - - ‘Q 4 State work to be performed and purpose of building (By Floors)- Re-Col ----- ------ ° - --- -1_'�� New Building ________.____....._ -____ Remodeling____ ___ Addition Repairs o. of Stories. _ Type of Tank_ ak Dist. Feet of Tank or Drain Field from Well Capacity Gals _ Size of Soakage Pit bing 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 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 performed 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 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 Tues SH LAVA- TORIES INK6 SINKS SLOP SINKS LAUNDRY TUBS U RINALS 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 . e7, Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submittefl 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 work. Owner's Name and Address Registered Architect and /or Engineer__ Employing Plumber's Name Location and Legal Description Lot__ Size Septic Tank Feet of Drain Tile_, Nature of Water Supply: City -Well STATE OF FLORIDA, 1 COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Amount of Permits vv -- (Signed) ( Signed )_______ Date_ No._ 7 0_— Street_ y l _�/ --_r e St �- ---_ No._ Street- Block - Subdivision Street and Number where work is to be performed -No 3 Pi. E- i -'- Street - - ‘Q 4 State work to be performed and purpose of building (By Floors)- Re-Col ----- ------ ° - --- -1_'�� New Building ________.____....._ -____ Remodeling____ ___ Addition Repairs o. of Stories. _ Type of Tank_ ak Dist. Feet of Tank or Drain Field from Well Capacity Gals _ Size of Soakage Pit bing 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 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 performed 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 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. BUILDING ELECTRICAL PLUMBING ROOFING Lot In consideration of the issuance to me pertaining thereto and in strict conformity with ceptinq this permit I gssume responsibility for ir f . CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT Owner of Building Architect Contractor or Builder Legal Description t.. • Bl N° 4031 Signed. DATE Contractor's License No. c 19 Work to be performed under this Permit Subdi- vision Address of , . f , .- . ;~~ Value of 1 Amount of Building F .,x Project $— 1 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 applica- tion 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 specifications atul that he assumes respon- sibility for work done by his agents, servants or employees. �- o ,, r ,. { I • i• BY AUTHORITY INSPECTOR of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as all work done by either, myself, my agent, servant or employee. ••SOT BUILDING ❑ DATE '' 195 ELECTRICAL ❑ PERMIT R M I T PLUMBING ❑ N? 8829 Contractors License No ROOFING ❑ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA . Bl. Subdi- vision 1i < Sq. Ft Value of Project $ !,q 0, c� BY •r Amt. of Permit $ l 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 ip the statements or specifics ' ns and that he assumes responsibility for work done by his agents, servants or employees. Signed - • BY INSPECTOR 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, servant or employee. AUTHORITY STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 the work. AA ] Date el5//s P , 19 Owner's Name and Address. �0K4 9 No Street 1 Registered Architect and /or Engineer .__. /0J -1 Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ Amount of Permit $ g__ c _..,� Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to 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 has complied 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. � Remarks (Signed) 4 f w e-40 ` . _U "Al Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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 st d are true Permit No Date.___ y Disapproved (Signed) to me well known, Read, Sworn to and Subscribed before me. Date Building Inspec or "— My Commission Expires Notary Public, State of Florida PLANNING BOARD DATE Chairman Member Member Member Member ....... Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Permit No < ° I!__ _ New Building — Remodeling MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date 5- .. 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 work. Owner's Name and Address �._ ___ _ ----- Registered Architect and /or Engineer---_--- _____.____ Employing Plumber's Name Location and Legal Description Street and Number where work is to be performed— No. State work to be performed and purpose of building (By Floors) _________ 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 Amount of Permit $ _. ....... No.____ No.___. -_._ .._ ...... _____ Street Addition._______._..______._ Repairs No. of Stories. (Signed)_ (Signed) -Le_L__Ideitreet Street Subdivision Plumbing 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 5988, 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 the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. J 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 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 TUBE Toss SHOWERS LAVA. TORIES INK SINKS SLOP SINK! LAUNDRY Toes URINAL! CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N8 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 t el 3 A Permit No < ° I!__ _ New Building — Remodeling MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date 5- .. 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 work. Owner's Name and Address �._ ___ _ ----- Registered Architect and /or Engineer---_--- _____.____ Employing Plumber's Name Location and Legal Description Street and Number where work is to be performed— No. State work to be performed and purpose of building (By Floors) _________ 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 Amount of Permit $ _. ....... No.____ No.___. -_._ .._ ...... _____ Street Addition._______._..______._ Repairs No. of Stories. (Signed)_ (Signed) -Le_L__Ideitreet Street Subdivision Plumbing 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 5988, 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 the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. J 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 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. BUILDING ELECTRICAL PLUMBING Owner of Building Contractor or Builder CONTRACT it PERMIT N9 3330 Work to be performed under this Permit Architect i Legal Lot Bl. Description Address of e Building 7 MIAMI SHORES VILLAGE, FLORIDA '.. 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 of drawings or in the statements or spelcations and that he assumes responsibility for work done by his agents, servants or employees. - .. • By f In consideration of the issuance to me of this permit I agree to perform the workl�overed hereunder in compliance with all ordinances and regula- tions 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 (jy either myself, my agent, servant or employee. psi- A < (r' OR BUILDER Signed• Subdi- vision Value of Project . i . i 1J I .nit. NSPECTOR if B iu .�'�' `1C: This Construction `'inay be in violation of Board G�rier,l Limitations Geer e r,eturl: siarung the work authorized in DATE ;,` . - 194— Contractor's ° License No. i '' c. ;� s � i� / OILS/ Amt. of Permit AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Bulkier Legal Description Address of a t f % Lot Work to be performed under this Permit 2 MIAMI SHORES VILLAGE, FLORIDA // ' ERMIT N° 1593 Bl. Subdi- vision Value of Project BY DATE ., Amt. of Permit 19 4_ Contractor's License No Building � l ` �` r ; 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 oil in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed• �. . 7 is B INSPECTOR ' In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula- tions 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, servant or employee. AUTHORITY