PL-10-767BUILDING
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: PLUMBING
Owner's Name (FeSimple Titleholder) 6 41/Y1.Q� 1-/ / /') Phone # 2,61 52-5 0'5 --0 /
Owner's Address
ity/_ _! /A
Tenant/Lessee Name
Email
A.)e /e/
�S State I NI
/V/
Value of Work For this Permit $ 3 ��
Type of Work: • Addition ['Alter
/1rt
Describe Wor • •
Submittal Fee $
Notary $
Permit Fee $
Miami Shores Village
Building D epa; rtment
10050 N.End Avenue, Miami Shores, Florida 33138
Tel: (305) 795:2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Training/Education Fee $ Q
Job Address (where the work is being done) 3 j / X /'/
City Miami Shores Village � ; County Miami -Dade
FOLIO / PARCEL # //- J2& "0/3 .75320
Is Building Historically Designated YES l NO
II
J3
Phone #
Permit No. Y'" 6 1 0 er
Zip 57:34?
o
Contractor's Company Name t , 4 J ® 7 %.. /-'Phone # 92S 6,5(..5 3 2/
Contractor's Address coer fl ,
a II
City, ,--z.--- State Zip
Qualifier Name Phone # fi,c)(®3,5- ezi
State Certificate or Reg'stration NatIOW/312,, Certificate of Competency No.
Contact Phon .1 6 ""C(473 11
E -mail " �I� /_i l/5e ' /7 , /�
;
Architect/Engineer's Name (if applicable) /(4- Phone #
Square / Linear Footage Of Work:
@MOREV7 Ai MAY p 4 2p1
BY:..
Flood Zone
ion [New Wrtepair/Replace ❑ Demolition
•
* * * * * * * * * * * * * * * ** * * * * * * * * * * * *‘** * * * ** F le* * * ** * * *le * le* * le* * * * ** * * * * * * * * * * * * * * * * *
CCF $ a.4Q co/CCs
Technology Fee $ 3' R0
Scanning $3 'CO Radon $ DPBR $ Bond $
Double Fee $ Violation date: Q�
Structural Review. $ j Total Fee Now Due $ l� ` 0 •
See Reverse 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this 5
day of ,20 tin ,by /Y1€,Li1, ,,
who is person lly known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
My Commission Exp a _ _ _ _ - - - - - - - - " - - -
JEFFREY DOWS
MY E April 1 2014
Bonded Thru Notary Public Underwriters
* * * * ** * * * * * * * * * ** m ►x * * * ** * *** * * **************
APPROVED BY
(Revised 07 /10 /07)(Revised 06/10/2009)
ti sAtt
Plans Examiner
Engineer
Signature
Contractor
The foregoi g instrument was acknowledged before me this 5
day of ' , 20 t ®, by3 """ -C ,
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
/1
JEFFREY DOWSETT
��ION 11 2014
1189 Pubpo Underwrtere
Signr,�/
My Commission
Zoning
Clerk checked
05/05 /2010 13:56 FAX ALLPRO
0
T
CONSTRUCTION PERMIT rOA:
APPLICANT: Sean Cal • ini
PROPERTY ADDRESS z 312 NE 101 St Miami, FL 33139
LOT: 10-11
PROPERTY ID 4:
STATE O$' FLORIDA
DEPARTMENT OF HEALTH
()MITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
axiom; 39
11- 3206-013-5320
OSTDS Repair
SYSTEM MUST SE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.0065, F,S., AND CHAPTER 64E -6 P.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE
SATISFACTORY PERFORMANCE FOR ANY SPECIB'IC PERIOD OF TIME. ANY GRANGE IId MATERIAL PACTS,
WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIST THE
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
/ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT Or THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T
A (
N
R [
• [
R [
750 ] GALILoN9 / GPD
0 ] GALL0NB / GPD
0 ) GALLONS GREASE INTERCEPTOR CAPACITY
] GALLONS DOSING TANX CAPACITY
300 ] SQUARE FEET
0 ] SQUARE FEET
A TYPE SYSTEM: (X] STANDARD
I CONFIGURATION: [ ] TRENCH
N
✓ LOCATxo9 OF BENCHMARK:
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
D BILL REQUIRED: 0.003 INCHES
*Invert elevation of dralnfield to be no Tess than 7.90 ft. NGVD.
'Bottom of dralnfleld elevation to be no less than 7.40 ft NGVD.
'THIS PERMIT IS NOT FOR " ADDITION(s) ".
aP$cIFICATZONe z:
APPROVED BY:
Carlon M 1
Carlo
DATE ISSUED- 05/04/2
DU 4016, 10/97 (Previous Editions May Be Usad)
1.1.4
REPAIR
SUBDIVISION:
[SECTION, TOWNSETP, RANGE, PARCEL NUMBER]
(OR TAX ID NLTh 9ER]
Exlstino septic tank to remain CAPACITY
CAPACITY
INRXINDtd CAPACITY S19GI.E TANK :1250 GALLONS]
]GALLONS aI ]DOPES PER 24 HAS BPucps
bed canfQruration drainfllttid SYSTEM
SYSTEM
I ] WILLED (] MOUND I ]
[x] RED [ ]
F.F.E., 11.34' NGVD
1 23.20 ] E DiCHES k FT 3 [ ABOVE/ RLNCHE4<►RE /REPERENTCE PAINT
[ 47.20 ] I INCEST FT ] [ ABOVE / BENNCBMARK /REFERENCE POINT
EXCAVATION REQUIRED: [ 24.00] INCESS
TITLE:
AP96378A
TITLE:
p'ERNIT 4:1 -SC- 1134405
APPLICATION 0: AP963784
DATE PAID •
FEE PAID:
=CRYPT 8:.
DENT 8: PR809129
j THIS EEREE1113 NOT VA Aaornotim
fe VIE SEPTIC TANFN SHALL DE PUMPED AND A .SOLID
DEFLEcT10N DEVICE INSTALLED OD THE OUTLET TEE
Dade
EXPIRATION DATE: 08/02/2010
k1h616I6B
Pape 1 or 9
a 004 /005
CHO
05/05/2010 19:56 FAX ALLPRO
27I Each
7 ' . -
STATE OF FLORIDA
DEPARTMENT OF HEALTH .
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permit Application Number
•
I• s•i•+ •
Notes:
Site Plan submitte
Plan Approved
By
-PART hl - S,ITEPLA
VS27 z.‘-e rma#7, `
block re resents 10 feet and 1 inch
t
STATE OF FLORIDA
MASTER SEPTIC TANK CQ cTOR
BARRY G. TE06EIRA SM'0981332
ALL PRO SEPTIC & SEWER, INC
2700 NW 27 AVE SAM
MIAMI, FL 33142
Sos-(...
•
.f
OH 4015, 10/95 (Replaces HRS -H Form 4016 which may be used)
(Stock Number: 5744 - 002 -4016 -6)
Al ���� Signature
' Not Approved
HANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
el 005/005
Z (
•
Date 4:,15_,C
Caunty•Health Department
Page 2 or 4
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO.
Interest in property: 04
Name and address of fee simple titleholder.
4. Contractor's name and address:
5. Surety: (Payment bond
Name and address: _
Amount of bond $
6. Lender's name and address:
Notary Public
Print Not
TM FOLIO NO
524 (0 `0/. -1/45
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be ngde to certain real
property, and in accordance with Chapter 713, . Florida Statutes the following information
is provided in this Notice of Commencement.
1. Legal description of property and street/address: 4r i `e 39 e )o - 7
2. DescriAion of improvement:
re.5101,14
3. Owner(s) name and address: j346 L /,sS'e
ST/
different date is specified)
Signature of Owner
Print Owner's Name
Sworn to and subscribed before me this _ day of
7. Persons within the state of Florida designated by Owner upon whim notices
provided by Section 72.13(1 •)7., Florida. Statues,
Name and address
in Section 713.13(1)(b) Florida tatutes.
Name and address: s /- / ` �' / �
,g
My commission expires:
123.01 -52 PAGE 5/06
I 111111111:1111
CFN 2O1ORO295 17
OR Btu 27271 Ps 0639; (lps)
RECORDED 05/04 /2010 10:35 :12
HARVEY RUVIH CLERK. OF COURT
IIIAtII -DADE COUNTY, FLORIDA
LAgT PAF3E
other documents may be served as
8. In addition to himself, Owners designates the following person(s) to receive a copy of theLienor's Notice as provided
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
c
ALL PRO SEPTIC &'SEWER
2700 NW 27 AVE
MIAMI, FL 33142
Prepared by
Address: