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PL-10-12311 1 1 Project Address Mlaml Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 153 NW 100 Terrace Miami Shores, FL 33150- 1131010230220 Block: Lot: EDUARD & PAULA GARVER Owner Information Address Phone Cell EDUARD & PAULA GARVER 153 NW 100 Terrace MIAMI SHORES FL 33150 305 -754 -6070 Contractor(s) Phone Cell Phone MR C'S PLUMBING SEPTIC INC (305)651 -7859 (305)651 -5652 Valuation: Total Sq Feet: $ 2,000.00 300 Type of Work: DRAINFIELD Type of Piping: PLUMBING Additional Info: SEPTIC Bond Return : Classification: Residential Scanning: 1 Fees Due Bond Type - Contractors Bond CCF Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $300.00 $1.20 $0.40 $150.00 $3.00 $1.60 $456.20 Pay Date Pay Type Invoice # PL -7 -10 -38368 07/07/2010 Check #: 5135 07/21/2010 Check #: 5176 Bond #: 1976 Amt Paid Amt Due $ 50.00 $ 406.20 $ 406.20 $ 0.00 Available Inspections: Inspection Type: Final Rough Landscaping HRS Approval 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. July 21, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date July 21, 2010 1 Miami Shores Village Building Department 10050 NE2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 g1103RVISitii jut 0 MP luj BY: ........ . .......... BUILDING Permit No. PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): PC1-4-ea- Gar\.)--er Phone#: 'a CS S ?" I — 9 22(- Address: / S 3 NI k..) City: rn 1. Ot. (fl ( 0 6"-e- Stale: FL . Zip: 5.sa 1 Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: G 3 NI/0 ocs) City: Miami Shores County: Miami Dade Folio/Parcel#: 11— (2)1 2_ Zip: 331 sc Is the Building Historically Designated: Yes NO e...""-- Flood Zone: CONTRACTOR: Company Name: Thrs C I.C1- PLIJI/14:::. ( Y'3.- 1 Phone#: ae:;:=S G / 72.5-4i Address: VI C)' 2- ii/ p A-ue City: 011-2J4( State:1-1-- Qualifier Name: C-1301/‘"l -fia n 1 Phone#: State Certification or Registration #: CFC- I 14-'9' a -7 I Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: Zip: &,s ;ZO(:)c) oz.> Value of Work for this Permit: $ ®® Square/Linear Footage of Work: Type of Work: ClAddress LIAlteration LINew Xliepair/Replace LIDemolition Description of Work: Ne pi cic 2o 4i aya ***************************************Fees******************************************** Permit Fee $ /rat CCF $ 1 .DSO CO/CC $ Scanning Fee $ Li* 1. Radon Fee $ DBPR $ Bond $ Training/Education g/Education Fee $ Technology Fee $ 14(00 Submittal Fee $ 5)*() Notary $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 40(0 • Se M� w rl1 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City r Zip State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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. 1 understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOIL .FRS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: 1 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 RECO ` _l ING 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 acIpitowledged before me this day of atAAAA. ,20 I , by Pt CTgr'4 Y"-- , who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission E APPROVED BY Contractor The foregoing instrument was acknowledged before me this 'ac") day of C lAj" , 201 Cb, by (-1OG` Vt• � h t.P t who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC• Structural Review (Revised 07 /1O/07)(Revised 06/10/2009)(Revisei 3115009) Sign: Print: My Comm " nm } (WIRES: September 14, 2013 %A{ , Bonded Thru Notary Public Underwriters Zoning Clerk 06/30/2010 14:17 3054858903 treegraLly and reaun o; Richard Waserstela President Closings.cam, Inc, 1124 Kane Concourse (96th Street) By Harbor Islands, FL 33154 305 - 9618809 File Number: 10 -00143 Will Call No.; TORRES VADILLO LAW PAGE 01102 [Space Above This Line For Sceurdmg Dotal_ Warranty Deed This Warranty Deed made this 7th day of June, 2010 between Jeffery S. Farmer and Ruchira Sethi*, husband and wife whose post ogee address is P.O. Buz 370701, Miami, FL 33137, grantor, and Eduard 3.. Garver, a married man and Paula V. Garver, a married woman whose post office address is 153 NW 100 Terrace, Miami Shores, FL 33150 , grantee: (Whenever and "grantor" and °grantee" include all the Hitler, to this instrument and the heirs. legal tepre cntetives, and assigns of assigns of cote rations. trusts and trustees) Witnesseth, that said gr, or, for and in consideration of the sum of TEN AND NCI /IOO DOLLARS (310.00) and other good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby acknowledged, has granted, bargained, and sold to the said grantee, and grantee's heirs and assigns forever, the following described land, situate. lying and being in Miami -Dade County, Florida to -wit: Lot 13 and the East 1/2 of Lot 14 in Block 3, of BONMAR PARK ADDITION, according to the Plat thereof, es recorded is Plat Book 24, Page 71, of the Public Records of Miaao -Dade County, Florida. Parcel Identification Number: 1131101- 023 -0220 Together with all the tenemcets, 1/credits:merits and appurtenances thereto belonging or in anywise appertaining To Have and to Hold, the same in fee simple forever. And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the grantor has good right and lawful authority to sell and convey said land; that the grantor hereby fully warrants the tide to said land and witl defend the same against the lawful claims of all persons whomsoever, and that said land is free of all encumbrances, except taxes accruing subsequent to December 31, 2009. in Witness Whereof, grantor has hereunto set grantor's hand and seal the day and year first above wt ttrvrr. botteleTlman 0613012010 14:17 3054858903 Signal, sealed and delivered in our essence: TORRES VADILLO LAW PAGE 02102 State of F erida County of Miami -Dade The foregoing instrument win acknowledged before me this 7tb day . Jun 2010 by eery S �. er and Rug who jJ are personally known or [X] have produced a driver's Tic y k ficati [Notary seal] aF;; •. S d • ►. w • k = s h z r. vitosve QC, gialt040 warranty my Deer- Page 2 Notary Public Printed Name: My Commission Expires: ri r r,CLItP, noubieTime a STATE OW 3 QRIDA DEPARTMENT OF HEALTH ONSITE SAGE TREATMENT AND DISPOSAL SYSTE4 OONSTRUCTE PERMIT a cONSTRtrcri0N VMSMIT FOR: QSTDS Repair APPLICANT: Paula Garver PROPERTY ADDRESS! LOT: 1 PERT TT 9: 13- SC- 1176477 APPLICATION : AP970283 DATE PAID: FEE PAID: RECEIPT #: DOCUMENT 0: PR814635 153 NW 100 Ter Miami. FL 33150 • 0P 1T ID 9: 11-3101-023-0220 SUBDIVISION • Bonmar Park [SECTION, TiARNSM.P, RANGE, PARCEL MUMMER] [OR MAX ID NUMBER] SYSTEM HOST ES CONSTRUCTED xw ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SP:ci rcN 381.0065, F.S., AND CHAPTER 64E -6, B.A.C. DEPART APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, REICH SERVED AS A HASIS FOR ISSUANCE or THIS PERMIT, REQUIRE THE APPLICANT TO MODITY THE PERMIT APPLICATION. 8VCA t+ODWICATXONS MAX RESULT IN THIS PERMIT BEING MADE N ML AND VOID. ISS[rANCE OF THIS PM= DOES NOT =SOT TEC APPLICANT most CsatIFLIANCC WIN mama FEDERAL, STATE, OR LOCAL PERMITTING SQUIRED FOR DEVELOPMENT OF TATS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ 900 ] GALLONS / GPD Sergio CAPACITY A [ 0 ] GALLONS / orb CAPACITY N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 Gnu:m ] A [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS BE MOSES i,+E$ 24 SAS #Pumps [ S [ 300 1 SQUARE FEET 0 1 SQUARE FEET [N] STANDARD [ 3 TRENCH A TYPE SYSTEM: 1 CONFIGURATION: m F LOCATION OF BENCHMARK: F.F.E.: 12.70' I ELEVATION OF PROPOSED SYSTEM SITS E NOT OF DRAIN FIELD TO BE L D FILL RrrQD'Iamo: [ [x] ligto SYSTEM SYSTEM ] FILLED [ ] WOUND D t] 0 T [ 0.00 3 =las [ 33.60 ] C 61.60 3 FT ] [ Assn FT ] [ ABOVE IMENCIDIARIVIZFERENCE POINT BENcA NAEK /REwRANCE POINT txrAVATxoN1 RED: [ 28.00 ] mama 1- Existing ±« " gal. septic tank certified by " Mr C's Plumbing & Septic " on 08/22/2010 to remain. 2. Install 300 sf of draii•ifield in bed czorfiguration.3- Perimeter of excavation area shalt be at least 2 ft wider and longer than the proposed absorption bed. 4- Invert elevation of drainfleld to be no Tess than 8.08' NCO©. 5. Bottom of drainfield elevation to be no less than 7.56' NGVD. THIS PERMIT IS NOT FOR ADDITION(s) SPECIFICATIONS BY: PEDRO N OSPINA APPRDVED BY: OATS ISSUED: 06128/2010 TITLE: DH 4016, 08/09 (0bso1®tee all previous d;tions which may not mead) Incorporated: 64E- 6.003, FAG v 1,1,4 Z00/i 00 j A139102B3 914920541. Page 1 of 3 xvJ o2.:b4 ol.0Z /8/80 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number PART II - SITEPLAN Scale: Each block represents 10 feet and 1 inch = 40 feet. Flcl S—t Y►o $6E7, 6Pe ?locece 1n *le l-te o.r$ea r r F0 N otes: J s� 1■.3 / 1 ao `r €A-cc,-,e t c Th ■ �-- - 64$1,$)-(1Ac. aero c t darair�g1 -€. 9cit p1 Site Plan submitted by: Plan Approved By County Health Department Not Approved Date C'IPM-11 c) ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015, 10/96 (Replaces HRS -H Form 4016 which may be used) (Stock Number: 5744 -002- 4015 -6) Page 2 of 4 Tasks about:blank 2 of 2 6/30/2010 8 :13 AM 9110 -12.51 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Paula Garver PERMIT 4:13 -SC- 1176477 APPLICATION #: AP970283 DATE PAID: FEE PAID: RECEIPT #- DOCUMENT #: PR814635 PROPERTY ADDRESS: 153 NW 100 Ter Miami, FL 33150 LOT: 13 PROPERTY ID #: BLOCK: 3 SUBDIVISION: Bonmar Park 11- 3101 - 023 -0220 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E -6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIFICATIONS T [ 900 ] GALLONS / GPD SBDtiC CAPACITY A [ 0 ] GALLONS / GPD CAPACITY N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ 300 ] SQUARE FEET SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [x] BED [ ] N F LOCATION OF BENCHMARK: F.F.E.: 12.70' NGVD I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D FILL REQUIRED: [ 0.00] INCHES 0 T [ 33.60 ] [I INCHES I FT ] [ ABOVE /) BELOW U BENCHMARK /REFERENCE POINT [ 61.60 ] [) INCHES I FT ] [ ABOVE A BELOW 11 BENCHMARK /REFERENCE POINT EXCAVATION REQUIRED: [ 28.00] INCHES 1— Existing 900 gal. septic tank certified by " Mr C's Plumbing & Septic " on 06/22/2010 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 absorption bed. 4 -Invert elevation of drainfield to be no less than 8.06' NGVD. 5. Bottom of drainfield elevation to be no Tess than 7.56' NGVD. THIS PERMIT IS NOT FOR ADDITION(s). SPECIFICATIONS PEDRO I' APPROVED By: ',o -rx! r ykt n4 rro P =� o N ()spina DATE IssUED: 06/28/2010 DH 4016, 08/09 (Obsoletes all previous editions which nay not be used) Incorporated: 64E- 6.003, FAC v 1.1.4 AP970283 Dade CHD EXPIRATION DATE: 09/26/2010 8E820541 Page 1 of 3 NOTICE OF RIGHTS A party whose substantial interest is affected by this order may petition for an administrative hearing pursuant to sections 120.569 and 120.57, Florida Statues. Such proceedings are governed by Rule 28 -106, Florida Administrative Code. A petition for administrative hearing must be in writing and must be received by the Agency Clerk for the Department, within twenty -one (21) days from the receipt of this order. The address of the Agency Clerk is 4052 Bald Cypress Way, BIN # A02, Tallahassee, Florida 32399 -1703. The Agency Clerk's facsimile number is 850 -410 -1448. Mediation is not available as an alternative remedy. Your failure to submit a petition for hearing within 21 days from receipt of this order will constitute a waiver of your right to an administrative hearing, and this order shall become a 'final order'. Should this order become a final order, a party who is adversely affected by it is entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a second copy, accompanied by the filing fees required by law, with the Court of Appeal in the appropriate District Court. The notice must be filed within 30 days of rendition of the final order. PAGE 62102 5 7 09 2 • • 10 '1123 t 155 t.1.1 100 PA{