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94 NE 100 St (2)4) Passed Ins a or Comme Is (/ Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until inspection Number . INSP -286 Inspection Date: 05/16/2006 Inspector: Levrack, James Project: <NONE> Building Department Comments Monday, May 15, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Owner: SALTZBURG, DONALD Job Address: 94 100 Street NE Miami Shores Village, FL 33138- Contractor: WP SEPTIC TANK CO INC 7 Block: Permit Number: PL -12 -05 -1050 Permit Type: Plumbing - Residential Inspection Type: Landscaping Work Classification: Drainfield Phone Number Parcel Number 1132060131190 Lot: Phone: 305 - 620 -6320 Page 1 of 2 IlAspection'Number: INSP -287 7 Permit Number: PL -12 -05 -1050 Inspection Date: 05/16/2006 Inspector: Levrack, James Owner: SALTZBURG, DONALD Job Address: 94 100 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: WP SEPTIC TANK CO INC Building Department Comments Monday, May 15, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Drainfield Phone Number Parcel Number 1132060131190 Lot: Phone: 305 -620 -6320 Page 2 of 2 f _ Passed I ns . • r Co ents 1� Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until IlAspection'Number: INSP -287 7 Permit Number: PL -12 -05 -1050 Inspection Date: 05/16/2006 Inspector: Levrack, James Owner: SALTZBURG, DONALD Job Address: 94 100 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: WP SEPTIC TANK CO INC Building Department Comments Monday, May 15, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Drainfield Phone Number Parcel Number 1132060131190 Lot: Phone: 305 -620 -6320 Page 2 of 2 Issue Date: 12/2/2005 Owner's Name: DONALD SALTZBURG Permit Type: Plumbing - Residential Work Classification: Drainfield Job Address: 94 100 Street NE Additional Information Miami Shores Village, FL 33138- Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 12/01/2006 Contractor(s) W P SEPTIC TANK CO INC Phone 305 - 620 - 6320 Primary Contractor Yes Type of Work: DRAINFIELD Additional Info: Type of Piping: In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due Bond Type - Contractors Bond CCF Education Surcharge Inspection Fee Permit Fee - Additions /Alterations Scanning Fee Technology Fee Total: Amount $300.00 $0.90 $0.30 $75.00 $100.00 $3.00 $4.40 $483.60 Building Department File Copy Applicant Signature Parcel #: Block: Section: Permit Status: APPROVED Permit Number: PL -12 -05 -1050 Phone: 305 - 754 -6576 1132060131190 Lot: PB: Total Square Feet: 300 Total Valuation: $ 1,500.00 Required Inspections Rough Landscaping Final Invoice Number PL - 12 - 05 - 22850 Total: : DEC 0 7 PAID LAS F-1- Amt Due $483.60 Amt Paid 483• foQ 0 NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. 4 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electric Owner's Name (Fee Simple Titleholder) PO/1C16 S'-v/ Z6eJ' hone # —' Owner's Address �� Pe //:)0 57 City ' 1 ,ate t State Tenant/Lessee Name .5 7^'1. Phone # Job Address (where the work is being done) 1 e City Miami Shores Village Is Building Historically Designated YES Contractor's Company Name `� 1 Y • � / � 7 t,f Phone # <9S-- t '2 _ ?ZD Contractor's Address City Qualifier Architect/Engineer's Name (if applicable) $ Value of Work For this Permit 1:1;/00 , 0,0 Type of Work: Describe Work: Submittal Fee $ Notary $ Scanning $ Code Enforcement $ Total Fee Now Due $ �/ /723 S A/ IA/ l/ /a / State G ✓4C' /`Q e (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 REtErtfiEn 2005 M Plumbin r l Zip 3 373? County Miami -Dide Zip 3 3/ S` NO Permit No. ster Permit No. Mechanical Zip 3 State Certificate or Registration No. Certificate of Competency No. Phone # Square Footage Of Work: 300 P ['Addition ['Alteration ['New [ Repair/Replace , ?fir) Jt Permit Fee $ /7.5 CCF $ Training/Education Fee $ Technology Fee $ Radon $ Zoning Structural Plan Review. $ Bond $ CO /CC. PLO5 - 1050 Roofing ❑ Demolition 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 curs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be app" oved . On a will be charged. Signature , Owner or Agent Contractor The foregoing instrument twwas acknowledged before me this / The foregoing instrument was acknowledged before me this day of�� / 2006, by day ofpetr'e`/L , 2005, by who is personally known to me or A s NOT R i` B, IC• 0 WA, . Sig i : 1 rill itaaFI I� (Ada Print: ; �. •_ Commissb iBpiresMz*1 My Comm APPLICATION APPROVED BY: chc 05/13/03 s produced d who did take an oath. NOTARY S Print: My C * * * * * * * ** ****, ti,.********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** who is personally k nown to me or w :..roduced as identific. '.� did take an oath. . ssion &piesMar16,2008 o m fn Ission # DD268491 * 0 *BetOdeAt3yrWeiliorelteletc bless * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * /2 02 vi * * * * * * ** Plans Examiner Engineer Zoning ADDENDUM TO BUILDING PERMIT APPLICATION AN ATPLI OAT ION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS E. OBTAINED, TIC, CAW= ' S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUZIT APPLICATIONS. u P. vivllt_ PLUMB -ING ELECTRICAL MECHANICAL TEM TUB UNIT FEE ITEM UNIT SWITCH OUTLETS FEE ITEM SPACE HEATERS UNIT FEE ATH IDET i LIGHT OUTLETS CENTRAL HEATING ISHWASHER RECEPTACLES A/C (WIND) ISPOSAL SERVICE TEMPORARY I A/C (CENTRAL) RINKING FOUNTAIN 1 SERVICE SIZE IN AMPS DLCT WORK LOS DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION TRAP APPLIANCE OUTLETS I PROCESS AND PRESS PIPING CREASE I RANGE TCP UNAERGROUIO TANKS NTERCEPTOR OVEN ABOVE GROUND TANKS .AVATCRY TRAY WATER HEATER U.F. PRESSURE VESSELS .AUNDRY MOTORS 0- 1 HP STEAM BOILERS ;LOTHES WASHER ;HOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS MOTORS OVER 3- 5 NP MECHANICAL VENTILATION ;INK, POT /3 CAMP. ;INK, RESIDENCE MOTORS OVER 5- 8 H° TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER B- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 FP FIRE SPRINKLER SYSTEMG URINAL MOTORS OVER 2E-100 HP COOLING TOWERS 'HATER CLOSET I I MOTCRS OVER 100 If VIOLATION I I INDIRECT WASTES 1 1 I A/C WINDOW I REI,NSP.ECTJON i I WATER SUPPLY TO: I I I AIR CONDITIONERS I A/C UNIT I STRIP HEATER FIRE SPRINKLER I 1 GENERATORS TRANSFORMERS I I I I HEATER -NEW INST. I I I GENERATORS TRANSFORMERS I I 1 HEATER - REPLACE 1 I I GENERATORS TRANSFORMERS I LAWN SPRINKLER -WELL I I I SPECIAL PURPOSE I I SWIM4ING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS 'SIGN TRANSFORMERS UTILITY-SEWER I SIGN TIME CLOCK UTILITY-WATER FIXTURES SEPTIC TANK I ANTENNA RELAY TELEVISION CUTLETS DRAINFIELD, 4 TILE/RES./03o VIOLATION . PUMP & ABANDON SEPTIC TAW, RE I N atSPECT I ON SOAKAGE PIT CU. FT CATCH BASIN DISCHARGE WELL DOMESTIC WELL I AREA DRAIN: ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE • I I I • POOL PIPING I i I 1 LAWN SPRINKLER SYSTEk GAS RANGE I METER SET (GAS) ( I I 1 ADDENDUM TO BUILDING PERMIT APPLICATION AN ATPLI OAT ION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS E. OBTAINED, TIC, CAW= ' S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUZIT APPLICATIONS. u P. vivllt_ PLUMB -ING ELECTRICAL MECHANICAL CONSTRUCTION PERMIT FOR: [ ]New System [ ]Existing System [ [ X ]Repair [ ]Abandonment APPLICANT: Saltzberg, Donald PROPERTY STREET ADDRESS: 94 NE 100 St Miami FL 33138 LOT: 1 [Section /Township /Range /Parcel No.] PROPERTY ID #: 11- 3206 - 013 -1190 [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 [ 900 ]Gallons SEPTIC TANK A [ 0 ]Gallons N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ [0 ]DOSES PER 24 HRS # PUMPS[ 0 ] D [ 300 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ 0 ]SQUARE FEET SYSTEM A TYPE SYSTEM: [ N ]STANDARD [ N ]FILLED I CONFIGURATION: [ N ]TRENCH [ N ]BED N F LOCATION TO BENCHMARK: Top of Bottom Floor EL: 12.6' NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 1.8 ] [ FEET ] E BOTTOM OF DRAINFIELD TO BE [ 4.5 ] [ FEET ] L DATE ISSUED: 10/13/05 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM . CONSTRUCTION PERMIT ]Holding Tank BLOCK: 9 SUBDIVISION: Miami Shores FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ OTHER REMARKS: 1 - Existing Septic Tank to remain. 2 - Install 300 sf of drainfield in bed configuration. 3 - Perimeter of excavation area shall be at least 2 ft. wider and longer than the proposed absortion bed. 4 - Invert elevation of drainfield to be no less than 8.63' NGVD. 5 - Bottom of drainfield elevation to be no less than 8.13' NGVD. This permit is NOT for ADDITION(S). SPECIFICATIONS BY: Heybeck, Nicholas TITLE: APPROVED BY: Heybeck, Nicholas &' /`L TITLE: DH 9016, 03/97 (Obsoletes previous editions which may not be used) (Stock Number: 5799- 001 - 9016 -0) [ostds_cons_4016 -1] ]Temporary [ NA ] AGENT: WALLACE P, Ponder Wallace CENTRAX #: 13 -SG -26783 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : ' 05 -3354- -R [ ] Innovative Other MULTI - CHAMBERED /IN SERIES: [Y ] MULTI - CHAMBERED /IN SERIES: [Y ] [ N ]MOUND [ N ] [ N ] [ BELOW BENCHMARK /REFERENCE POINT [ BELOW BENCHMARK /REFERENCE POINT 44.0 ] INCHES 4 i I i ! A ' - 7 ' - Dade EXPIRATION DATE: 1/11/06 CHD Page 1 of 2 • • STATE FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT., 2. Permit Application Number ( -1.)1 By Site Plan submitted by: Plan Approved , • r ; ; ' ' • ' " • ' • - : • ,-, , • - ' f " ; i • ' - I ' ' t ; - 4 - , it -=.. 4 ' t 'r ■ ' I 1 ' t ! I 1 .,r 1 i . . ■—: . , ■ , 1 , . ; ':'^',. • ., ,, . , ' • . 11;:r*I• '. ■.. ..i. H : le• , --, '.?' st . 1.1. . ; • . . ; : , . ., ' p.- -7.- , . , ...„. ..,„ .. ,, ',.. , , . . .., , . . „ . i . a . , i .,, f ,... i . j ., ... ' . . . .. . — 4,;::: .; . , ; ', ..: : ... ...; " . , . ', .. . . , .:,- t...44 . : . . • 7 ; ; .•. .. I , , • - ' . . ; - : , , - -:-": :-.. . : ; ' - - ' .I, ..: . ' ' ' ' ' : _1 : , . . _ ..,: ;: ; , . : ; . • .: ., . - : - -- ' - ,-.• : . : , : ; . : : , , 2 . : , e . ' ...". . r: ' 1 4''' '•" ''' ' ' • ' ' i ■ ' : . i ' e . f .. ' i : ' ' ■ ■ . I ' , . . ' .•' ' . . 1 ' ' + .., + i ' k , • ' . i • • ••••,.. I' 1 : ' ' 1 1 • • ' ' 1 ,r1 ' . ;1 tr,"::.1 .1-4..r.4...•;;;; , : ' : 1 1., : •: • ''''' '' " .11; , ----;- 1 ; . - i .T TT ' : T ; T. : T -, .. : - . . , I , , , , ,, ,,, . : , , , ,., .. „ 1 ..,,,, : : ■ ' . . 7 .: ; 1 r ''',. ,...+.'„.„ , 1 ' , ', . ' ' 4 '-- ' IX : ..; 7 ; ' I ,.' ': ' " ,„: i '.. : i .: ig : ' •• : :: : : . : : . ' l ' ■ , ■ 1 .. ■• . C ■ ' ' ■ 4. : . , . , :.- , : , : . . . . . r 1 -: , . - ; , „ . '.. , -:„ , , . : ' =. .., : , i ';--. ' ' - 1 - • , , . • t ' • • • • ' • ; . 1 kit 1 ' DH 4015, 10/96 (Replaces HRS-H Forth 4015 which may be used) (Stodc Number: 5744-002-4015-6) Ili .41vj2 J( Signature Not Approved , • • ; ! • ! , , 1 ; j 1 1. • ••• j J9 4 ; 4 " • ,• , • • , • "- 7 • ; • ; % ; ; • r t • . • 1. • - 1 • ft-- •• • : 4 - • • • • • 5 av • ' "i- ' ' ; . , , % , ; ' s -% i -%;..,,,,,,, '.,,,...;0 ; %. %.{..: ' % ' ' ' '. : i - -* "4.;;' , ZZ.,',),,,,,....,,,%.,...' 7 1 - ' -1 , - '''' '' - '' ' ' ...% : 1 1- 1 .%---,--, ' : ' -''' --'' : ' , • : : : ' : : • i ' ' : : ' ' ; : 1 .;. ' ! ; ' ; 1 : : ; 1 : - ; % ;-: -(--; - : - - - - 1- ' ; k. ..; .. , , • - . . : , : . . : . - - . I -, - • - . : : : r - • . . ,,, . : ' ; : : I, i • , „ ft .•;-;...............-.. - ,----- -„..--- --- '-- A ---. . , ! ---- q. , -,.....im. -, :14,1 ' ' '....-' ' ' .........: - - ---- , Notes: , /Vt.:ail." fiTitte Date At County Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT Page 2 of 3 BUILDING ELECTRICAL PL,UMBI KG 1,/ Owner of Building / TOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA . DATE )#' 194 PERMIT N9 4308 Work to be performed under this Permi Architect Contractor/ : t . or Builder P Legal Lot Bl. Description Address of Building 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 appli- cation 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 t r,esponsibilit for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether, shown on the plans or drawings r in the(st t hents or specifications a .that e assume respon- sibility for work done by his agents, servants or employees. 2 Signed: Cr INSPE' vba By In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with 411p •'nances and i (jlitans 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 assume responsibility for all work done by either myself, my agent, servant or employee. Subdi- vision 4 BY Contractor's License No AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building }c' PERMIT N° • 4308 - Contractor's License No 1 Work to be performed under this Permit /1�y' A Contractor ..+,.,, • ,r,: or Builder Legal Lot Description Address of { Building c - 1 �� / 4 . MIAMI SHORES VILLAGE, FLORIDA Bl. Subdi- vision Value of Project BY DATE r 194 Amt. 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 a..li- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance wits any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Pennit may be r: oked 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 wh' h this permit is granted is the understanding that the contractor or builder named above assumes the, responsibility for a thorough knowledge of the ordina ' es and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that h assum :. respon- sibility for work done by his agents, servants or employees. j•` Signed � = By INSPECT 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 P ass responsibility for all work done by either myself, my agent, servant or employee. ft O NTIid1�O t O BUILDER 7 at 16° AUTHORITY