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DS-08-1929Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 12/04/2008 Inspector: Bruhn, Norman Owner: BRANDT, DONNA & DANIEL Job Address: 350 102 Street NE Miami Shores, FL 33138- Project: <NONE> Contractor: PAVERS AND BRICKS SERVICES CORP Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: New Phone Number Block: Parcel Number 1132060135130 Lot: Phone: (305)986 -2544 Building Department Comments NEW BRICK PAVERS PATIO WITH OLD CHICAGO BRICK ON PATIO 20 X 12 ON A SAND BASE Passed , Inspector Comments CC Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Wednesday, December 3, 2008 Page 1 of 2 Miami Shores Village MEMME‘ItYL9 g p Buildin De artment P OV o 4 2 2308 fir' 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit No. 050 ff 9( ZC' Master Permit No. Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) % Z + , Phone # Owner's Address 3 SID /02. �� City,/ �� State 11 t Zip 331 3 Tenant/Lessee Name Phone # � �_ ��� —/G°A Job Address (where the work is being done) City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES 3 7 ,E (02 51 • County Miami -Dade Zip 3 )P2lue 1'iliA4Git1AS Contractor's Company Name ?w&5 + 0,n.iec5 Se VW i CS Contractor's Address 83 we' 1 Lt 1`e 1 chip 0 a4. "I 101 Phone # City ,&p droll vi t I f1A4 l State p Z. Zip 3 3/ 61 Qualifier Name `RALi F' btm/PEZ Phone # 916 0 .C/ q (5'6 State Certificate or Registration No. Certificate of Competency No. 0 ( a s 0 0 6 Architect/Engineer's Name (if applicable) Value of Work For this Permit ' ®ap Type of Work: ❑Addition Describe Work: A/ OE tv1-' DAlteration Phone # Square / Linear Footage Of Work: .2 2.0 . i ❑New ❑ Repair/Replace /❑ Demolition . {� Ja 0,1,7 ( o Q✓V li ff --;,0 �0� K l r o1`� sih /y / 7✓ s cr , -45 • • - Ascii 69 * ** * * **** , * * ** ** * *** * **** * * ** * * *** ** Fees * * * * **** * ** * ** * * *, * **** * ** *** * * * ** ** * * **** ** Submittal Fee $ Permit Fee $ je904=5' Notary $ Training/Education Fee $ Scanning $ Radon $ DPBR $ Bond $ Code Enforcement $ Structural Review. $ CCF $ elite€ Technology Fee $ Zoning Double Fee $ Total Fee Now Due $ See Reverse side —+ • Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) • Mortgage Lender's Address Zip 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 The foregoing instrument was acknowledged before me this 09 day of N®tlem , 200g by 3*Iu°. e ye C, , who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Afir My Commission Expires: Y NOTAR PUBLiC STATE OF FLORIDA Ruth Cordeiro Mau. 15) 20 -L APPLICATION APPROVED BY: (Revised 02/08/06) Signature Contractor The foregoing instrument was acknowledged before me this ©Y' day of lVaclesn , 200 Ti' byy &)L ,)' Un who is personally known to me or who has produced as identification and who did take an oath, NOTARY PUBLIC: Sign: Print: l Z c , OTARY PUBLIC .STATE OF FLORIDA , g :� Ruth Cordeiro �`+�_ ; � ommission #DD734765 J}. ,I I- :rap' :1': ::fs e,'•410 My Commission Expires: 1L% OU - . `�, aO..- U Plans Examiner Engineer Zoning PERMIT #; Miami Shores Village Building Department 10050. NE 2 Ave, Miami Shores, Fl 33138 Tel: (305)795 -2204 - Fax; (305)756 -8972 RECEIPT 1RAM,Q5. DATE: DV ;X712, ot( Contractor a Owner ❑ Architect I i-ei a up 2 sets of plans and Address: )40 In e02 S L g S From the building department on this date in order to have corrections done to plans And/or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged by: PERMIT CLEARK INITIAL: RESUBMITTED DATE: Ace PERMIT CLEARK INITIAL: h- ° • Miami Shores Village Building Department Permit No: 4ob'Name . 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel:'(305) 795.2204 Fax: (305) 756.8972 BUILDING CRITIQUE SHEET ti pti Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Permit NO. DS-11-08-1929 Issue Date : Not Issued Expires:Not issued Folio Number:1132060135130 Owner's Name: DONNA & DANIEL BRANDT Owners Phone: Job Address: 350 102 Street NE Total Square Feet: 220 Miami Shores, FL 33138- Total Job Valuation: $ 1,000.00 Contractor(s) Phone Primary Contractor PAVERS AND BRICKS SERVICES CORP (305)986-2544 Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 11/4/2008 : Yes Comments: Charlie Crist Governor Ana M. Viamonte Ros, M.D., M.P.H. State Surgeon General November 18, 2008 (Pavers Bricks Services) 350 NE 102 St Miami, FL 33138 RE: Contingency Letter Application Document No: AP902315 Centrax Permit Number: 13 -SG- 961523 OSTDS Number: 350 NE 102 St Miami, FL 33138 Lot: 5 -6 Block: 38 Subdivision: Miami Shores Section # 1 Dear Applicant: This will acknowledge receipt of an application dated 11/17/2008 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. 1. -There is no increase in sewage flow, change in characteristics compromising the integrity or function of the system installation. 2. -This project entails : " Installation of a Patio 20' x 12' " From a review of your completed application, it has been determined that your existing system is adequate for the proposed use : " APPROVED ". If you have any questions on this matter ,please call our office at ( 305) 513 -3459 Sincerely, f you ha questions on this matter, please call our office at (305) 513 -3459. Sincerely, Miami -Dade County Health Department 1725 NW 167th St, Opa Locka, FL 33056 Phone: (305) 513 -3459 Fax: (305) 513 -3472 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number PART - SITE PLAN- — — — — — — Scale: Each block represents 5 feet and 1 inch = 50 feet. = ' • t '• tit • 1.„.1,„,„ ,, A. ,.....,„. ,"",„," --::',„,,,,,,- .:" " A k---"--' - "-- "rr"---r- - ", " :., ', ' " ' 7,- TA„ " ,",-4-AT :' ": -. • , ' " "A-A,T, 4, „" : 1 , " '," '; " ' ' ' .',-, ,, ""-- I , 1 ' , , ,, I ", , ": i 1 , ': ,:i , , , ,.•:. TA,' J, AI. .,, .IL, ; ." ...„,1 ,,"-, , i.. 1,-" .40,,.. ,,„1„„" ;. •., „Aij11,,,,,I 1„,„!„,!":, ',A„,",.., ,".„At..,„„ .. 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A , .,'") / Notes: (!./ e 0 Site Plan submitted by — Signature Plan Approved Not Approved By :rf ///t gi(f ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015, 10/96 (Replaces HRS-H Form 4015 which May be used) (Stoc( Nutnber: 5744-002-4015-6) Title Date County Health Department Page,2 of 3 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number PART II = SITE PLAN Scale: Each block represents 5 feet and 1 inch = 50 feet. Site Plan submitted by: Signature Not Approved Plan Approved By Title Date County Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015, 10/96 (Replaces HRS-H Form 4015 which May be used) (Stock Number: 5744 - 0024015 -6) - I Page2 of 3 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT APPLICATION FOR: [ ] New System LA Existing System [ 1 Repair [ ] Abandonment ? " ' ':2 , APPLICANT: PERMIT NO. DATE PAID: 941,0/1„(CW FEE PAID: n cs ] Holding Tank [ ] Innovative ] Temporary I. 1 AGENT: e MAILING ADDRESS: p • --- TELEPHONE: 62' TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT., SYSTEMS MUST BE CONSTRUCTED BY A PERSON LICENSE-AZ PURSUANT To 489.105(3)(2) OR 489.552, FLORIDA STATUTES. PROPERTY INFORMATION LOT: -1 BLOCK: 3 '2C PROPERTY ID 1: 'II I) SUBDIVISION: PLATTED; ZONING: I/M OR EQUIVALENT: [ Y / N ] PROPERY SIZE: !<75:.:!!; 7ACRES WATER SUPPLY: [ 1 PRIVATE IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y /QH1 DISTANCE TO SEWER PUBLIC L',1<=20000PD [ ] >2000GPD PT PROPERTY ADDRESS: g I 0 2- vi 44/ DIRECTIONS TO PROPERTY: 0 AI1-7: 102 f r;kl 1' BUILDING INFORMATION Unit Type of No Establishment 1 2 3 4 1 1i RESIDENTIAL [ 1 COMMERCIAL No. of Building Commercial/Inititutional System Design Bedrooms Area Sqft Table 1, Chapter 64E-6, FAC ( ] Floor/Equipment Drains [ ] Other (Specify) SIGNATURE: --,--=-----5'-----2--- ----'7.'--„___--- ,7) . DH 4015, 10/07 7 Page 1 (Previous editions may be used) Stock Number: 5744-001-4015-1 , k 1 DATE: , Page 1 of 3 APPLICATION FOR: APPLICANT: AGENT: TELEPHONE: BUNG AOD ESS: LOT, BLOCK, SUBDIVISION: DATE OF SUBDIVISION: PROPERTY iD #: ZONING: P OPERT° SIZE: WATER SUPPLY: SEWER AVAILABILITY PROPERTY ADiRESS: DIRECTIONS: BUILDING INFORMATION: TYPE ESTABLISHMENT: NO. BEDROOMS: BUILDING AREA: BUSINESS ACTIVITY: FIXTURES: SIGNATURE / DATE: Cheek ty of permit, if "Other" specify type in blank LAP Property o errs full name. Property o er's legally authorezed representative. Telephne number for applicant or aertt. P.O. box or street, city, state and zi e rraaiUng address for apps or argent. Lo , bock, and :u ivision for lea (r unref , od sup 6 ivision). if Boa is not is a record subdivision, a copy of the lot legal de- scAption or deed must be attsched, I date of subdivision recorded in county plat books (month/day /year) ar dare lot originally recorded. Dividing an approved lot into two or more parcels for the purpose of conveying ownership shall be considered a subdivision of the id. 27 character number for property. CHD may require property anprai r lD �r section/township /range /parcel number. Specify zoning arad whether or not property is in I/M zoning or equivalent usage. Net usable area of property in acres (square footage divided by 43,560 square feet) exclusive of all paved areas and prepares road : s within public rights -of way or easements and exclusive of etre,r lakes, normally wet drainage ditches, marshes, or other such ,'ies rif water. Contiguous unpaved a m noes- compacted road rights-cif-way and easements with no subsurface obstructions may be included in calculating lot area. Check private or public <� 2000 gallons per day or public > 2000 gallons par day. is sewer available as per 381.0065, Florida Statutes, and distance to sewer in feet. Street address for property. For lots without an igned street address, Indicate street or road and locale In county. Provide detailed instructions to lot or attach @n area map erro ing lot !make. Check residential or eummerclal. List type of establishment fr Table ll, Chapter 10!' : , FAC. Ex pies: single family, single wide mobile h e, r aurant, <orzs office. Count all rooms designed primarily for sleeping and those areas expected to routinely provide sleeping eccomr s tons for ©pants. Total square footage of ends habitable aria of dwelling unit, exduding garage, carport, exterior storage shed, or open or fully s r - =ned patios or decks. Based on outside measurements for each story of structure. For emialfinstitutional applications only. List number of employees, shifts, and hours of operation, or other Information required by Table II, Chapter 10D-6, FAC° Mark Floor/Equipment Drains or Others and = ' item or "NA" if not applicable. Signature of applicant or agent. Date application submitted to the CHD with appropriate fees and- atta ents. ATTACHMENTS: A site plan drawn to e, showing bou ries with di nsions, locations of residen s or buildings, swimming pools, recorded easements, onsite sewage disposal system components and location, slope of property, any existing or proposed wells, drainage features, filled areas, o °acted areas, and surface water. Location o7 wells, onsite sewage disposal systems, surface waters, and other pertinent facilities or fe tures on adjacent property, if the features are with 75 feet of the applicant lot. Location of any public well ° tin 200 feet of lot. For residen , a floor plan (residences) showing number of rooms and building area of each unit.. For nonresidential establishments, a floor plan showing the square footage of the establishment, all plumbing drains and fixture types, and other features ne ry to determine composition and quantity of wastewater. N. 02""x• 0 2 O.0 PcA.,; 22,SC •agS P14-1-5 �j1G�M.G. WALK • . _ _ ... too.00 Rec.. Mea�s�•. • O lt1 fi Fo1. D. Fol. D. { . "!r y 4.25 cow,. .• SIQ�U • 44.1 t Eecr. • APr2Y RE MIAMI PERMIT tt DATE: cd .1 °pipe o.o4= 5. 2 02'W. cL. 6-- o.w.w. REF. F.5. Oro t - 5 seas, 10= to, 33 Rec :.34` Me :LS. Ed .1/2.'919e o.so' dee p INK. Cog' tt • 3d Z N. E. 102 N °' ST. X50 NI2 „ Il „ to . 9 8 ?� ••CJ �% ,. 4 „ 3 5o 2 57.3 1 35' N . E:. 10 t ST , LOC AT t ors Sx ETO A 111: 200' SKETCH OF SURVEY LEGAL DESCRIPTION: Lots 5 and 6, Block 38, "AMENDED PLAT OF MIAMI SHORES SECTION NO. 1" according to the Plat thereof as recorded in Plat Book 10, page 70, Public Records of Dade County, Florida. SURVEYOR'S NOTES: - Lands shown hereon were not abstracted for easements and /or rights -of- way of. records. - Lands shown hereon contain ling 11,503 square feet, more or less. SURVEYOR'S CERTIFICATION: We hereby certify that the attached "Sketch of Survey" of the above described parcel of land is true and correct to the best of our knowledge and belief as surveyed April 27, 1987 under our direction and complies with the minimum technical standards set forth by the State of Florida Board of Land Surveyors. FORTIN,, AVY, SKILES, INC. By: (~-0Vi/C Daniel C. Fortin, For The Firm Registered Land Surveyor No. 2853 State of Florida "NOT VALID UNLESS SEALED" Fortin, Leavy, Sidles, Inc. Consulting Engineers & Land Surveyors 855 South Federal Highway / Boca Raton, Florida 33432 Q 180 Northeast 188th Street / North Miami Beach, Florida 33162 Dade 653-4493 / Broward 463 -7180 / Boca Raton 395-7378 Dote /Scale 4 -1.1 -S 1 1 20` Job No. IDwg.Na 810494- I ter/ - 013 ••CJ NI S So 14 „ IS „ id, 0 17 . IS ,. t J ., 20 ,. 2.1 •. 22 w 23 5o 2¢N 525y 35' N . E:. 10 t ST , LOC AT t ors Sx ETO A 111: 200' SKETCH OF SURVEY LEGAL DESCRIPTION: Lots 5 and 6, Block 38, "AMENDED PLAT OF MIAMI SHORES SECTION NO. 1" according to the Plat thereof as recorded in Plat Book 10, page 70, Public Records of Dade County, Florida. SURVEYOR'S NOTES: - Lands shown hereon were not abstracted for easements and /or rights -of- way of. records. - Lands shown hereon contain ling 11,503 square feet, more or less. SURVEYOR'S CERTIFICATION: We hereby certify that the attached "Sketch of Survey" of the above described parcel of land is true and correct to the best of our knowledge and belief as surveyed April 27, 1987 under our direction and complies with the minimum technical standards set forth by the State of Florida Board of Land Surveyors. FORTIN,, AVY, SKILES, INC. By: (~-0Vi/C Daniel C. Fortin, For The Firm Registered Land Surveyor No. 2853 State of Florida "NOT VALID UNLESS SEALED" Fortin, Leavy, Sidles, Inc. Consulting Engineers & Land Surveyors 855 South Federal Highway / Boca Raton, Florida 33432 Q 180 Northeast 188th Street / North Miami Beach, Florida 33162 Dade 653-4493 / Broward 463 -7180 / Boca Raton 395-7378 Dote /Scale 4 -1.1 -S 1 1 20` Job No. IDwg.Na 810494- I ter/ - 013 • ;•• ■•••-•:• '20.0' Pco; 22.sd 6,ra-ss Vet. " pi pe 0.04: 5 • f, 12.64' 14C: 2.006 ?j: 7=8/1-""' 71.S1 tci 17.10 "e0 IS.2V 34 Res.* W) 1 (3.13cf; • • 23' 0 11.1 21.GE; Old 4-c.setce mercyrov", %•Sci " ern- -w• S'b.t et 25.45' t\ , .• • 8 LP . • -4.2.5' ce. • • • • :•••.:•••,.. stab 4Le Evicr. ", • wool" 100.02.1 MeaS :T PE. P ole. ‘1NA--1- 100. co' Rec • •2.0.9. 10‘ Pc act Ak CL. 611'4'' pi! 6,-- OM.%) _ • Woc,0 ° -11 U • Pole. v r .S0' S • FtoV11151v 0 4 2308 BY: PERMIT #: If Miami Shores Villa •e APPROVED ZONING DEPT BLDG DEPT ATE, tiall1170- 11EUM SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS