RC-11-2162Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
ksml si n 'vaQ`3
�F�:ooaoa oma
OOOmm�oi:u ...'
FBC 20
Permit No. R6 I I — 21 Li 2
Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: (AG S ST c��
City: Miami Shores County: Miami Dade Zip: 3*-731 1
Folio/Parcelk
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): !40U-CL, Phone#: WS 7q q
Address: f j
City: ia zgf State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Phone #: i
Address: ��
City: l e State: Zip: l
Qualifier Name: \� -$ Phone#:
State Certification or Registration #: 14 b A F! Certificate of Competency #:
Contact Phone#: 40tm. _Email Address: AC Yea-1 fC0:i-kyVC 3
DESIGNER: Architec Phone#:
Value of Wor C, Square/Linear Footage of Work: dOO
Type of / OAlterationQ� ONew ORepair/Replace ODemolition
D
Color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ ;
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
-r
Signature Signature
CiWf1P.T AY Avrn ' Contractor
The foreg 'n instrument was a r wl ed before m
day of 2013, by
who i$�~ son y known to me r who has pro uced
n fication and who did takoath.
AV lA UDLII,: . j v S`a k4'O' oa
Sign: `► iP`` s Sept s`
=Ue, G� Ss�op `pal
Print:
My Commission Exp' � s,' _ ��0- eopdr
The fore o instrument w ssackno edged of m d ay of g , 20 ✓, b g who is�sonall known g me or who h s produce
I i . /1 --
VI f k' W -1WNwification and who did take an oath.
APPROVED BY /70'71 Plans Examiner Zoning
I Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 061102009)(Revised 3/15/09)
Water and Sewer
PO Box 330316 r 3575 S. Lejeune Road
M I�AM I -DADS ORDINANCE 89 -95 `,�A 4 ` L,_ i� Miami, Florida T 305-665-7471 0031
d ' � COMPLIANCE FORM
A ift& av D-7 INV#: P °11 M FORM #: 201232437 DATE o `m 3121/2012
This form acknowledges compliance on the part of the following with the requirements in
accordance with Miami -Dade County's Ordinance number 89 -95.
Name of Owner: VERONIQUE LESTRADE ADDTION & ALTER - M2012002156
Mailing:
Address: 11080 NE 105 ST
City, State, Zip: MIAMI SHORES FL 33138 -
Property Address 11080 NE 105 ST -MIAMI SHORES
Property Legal
Description:
Folio Number
Proposed usage /
No. of Units:
REPLACES:
Previous Usage /
MIAMI SHORES ESTATES PB 47 -58 LOT 9 BLK 1 LOT SIZE 75.000 X 150
COC 24270 -2538 05 2005
11- 2232 - 028 -0090
ADDIATION OF 1981 SF TO EXISTING 2862 SF SFR FOR TOTAL= 4850
SF
EXISTING SINGLE FAMILY RESIDENCE -COPY OF WATER BILL FROM
NORTH MIAMI ATTACHED
Gallons per Day 100
PREVIOUS FLOW: 220
PREVIOUS SQUARE FOOTAGE: 2,882 ❑ NEW CONSTRUCTION
PROPOSED FLOW: 320
PROPOSED SQUARE FOOTAG 4,850 7V INTERIOR RENOVATIO
Municipality:
Water Service Area
North Miami
Sewer Service Area
SEPTIC
Water Connection Charge
$61.00 Invoice No. �-
Sewer Connection Charge
$0.00
Total Connection Charge
$61.00
Comments:
SEPTIC APPROVAL= AP 1054866 OL =30.00 WSC =90.00
TOTAL = $181.00 -OL VALID ONLY W /PAID INVOICE
THIS FORM IS VALID ONLY WHEN ACCOMPANIED BY A STAMPED 'PAID' COPY OF INVOICE NO.
Approved By`�
Antonio Raide - New Business Representative
CONTACT NAME' DAVID Printed On: 3/2112012 NB Antonio Raide
CONTACT PHON 305 753 -179 2:50:15 PM PR
Approved By: 11w I
M I AM PDADE
miamidade.gov
Water Supply Certification Number: 5138 -OL- 201232437
Water Supply Certification Issued Date: 03/22/2012
Building Process Number: M2012002156
Applicant: Same
Re: Adequate Water Supply Certification
Water and Sewer
PO Box 330316 • 3575 S. Lejeune Road
Miami, Florida 33233 -0316
T 305 - 665 -7471
Owner /Agent: VERONIQUE LESTRADE SFARA
Organization:
325 S BISCAYNE BLVD #3221
MIAMI, FL 33131
The Miami -Dade Water and Sewer Department (Department) has received your request to receive water services
to serve the following project which is more specifically described in the attached Agreement, Verification Form, or
Ordinance Letter.
Project Name: VERONIQUE LESTRADE ADDTION & ALTER - M2012002156
Project Location: 1080 NE 105 ST Miami Shores
Previous Use:2862 SF SFR
Proposed Use:4850 SF SFR
Previous Flow: 220 (GPD)
Total Calculated Flow: 320 (GPD)
Reserved Flow: 100 (GPD)
The Department has evaluated your request pursuant to Policy CIE -513 and WS -2C in the County's
Comprehensive Development Master Plan and Limiting Condition No. 5. of the South Florida Water Management
District Water Use Permit Number 13- 00017 -W. Based on its review of all applicable information, the Department
hereby certifies that adequate water supply is available to serve the above described project.
This Adequate Water Supply Certification will expire if a building permit is not applied for within 365 days of the
date of issuance of said certification. If an Agreement is executed for the proposed project, the certification will
remain active with the terms of the Agreement until such time as the building permit is applied for. If a building
permit is applied for in accordance with the aforementioned conditions, this certification will remain active with the
building permit process.
Furthermore, be advised that this adequate water supply certification does not constitute Department approval for
the proposed project. Additional reviews and approval may be required from sections having jurisdiction over
specific aspects of this project. Also, be advised that the gallons per day (GPD) flow reserved herein is for water
certification purposes only and may not be representative of GPD flows used in calculating connection fees by the
utility providing the service.
Should you have any questions regarding this matter, please contact Maria A. Valdes, Chief, Comprehensive
Planning And Water Supply Certification Section, (786) 552 -8198 or via email at mavald @miamidade.gov.
Sincerely,
Comprehensive Planning And Water Supply Certification Section.
D6861140 -C8FE- 406E- A02F- 267904CBA1 EF
Id
I
STATE OF FLORIDA APPLICATION # AP1064866
DEPARTMENT OF HEALTH PERMIT # 13- SC- 1382044
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOCUMENT # SE865725
SITE EVALUATION AND SYSTEM SPECIFICATION
APPLICANT: Veronique Lestrade
CONTRACTOR / AGENT: C. David Morton, Architect
.LOT: 9 BLOCK: 1
SUBDIVISION: Miami Shores Estates ID #: 11- 2232 - 028 -0090
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTMENT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEERS MUST
PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CONFORMS TO SITE PLAN: [X ]YES [ ]NO NET USABLE AREA AVAILABLE: 0.25 ACRES
TOTAL ESTIMATED SEWAGE FLOW: 600 GALLONS PER DAY [ RESIDENCES - TABLET / OTHER -TABLE 2 ]
AUTHORIZED SEWAGE FLOW: 625.00 GALLONS PER DAY [ 1500 GPD /ACRE OR 2500 GPD /ACRE ]
UNOBSTRUCTED AREA AVAILABLE: 845.00 SOFT UNOBSTRUCTED AREA REQUIRED: 845.00 SOFT
BENCHMARK /REFERENCE POINT LOCATION: CL NE 105 St., 3.19' NGVD
ELEVATION OF PROPOSED SYSTEM SITE 24.70 I INCHES / FT ]
/ BELOW ] BENCHMARK /REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES
SURFACE WATER: 50 FT DITCHES /SWALES: FT NORMALLY WET: [ ]YES [ ]NO
WELLS: PUBLIC: FT LIMITED USE: FT PRIVATE: FT NON - POTABLE: FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 2 FT POTABLE WATER LINES: 2 FT
SITE SUBJECT TO FREQUENT FLOODING? [ ]YES [X]NO 10 YEAR FLOODING? [ ]YES [X]NO]
10 YEAR FLOOD ELEVATION FOR SITE: FT[ MSL /NGVD ] SITE ELEVATION: 5.25 FT [ MSL / NGVD
SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2
USDA SOIL SERIES: Urban land
Munsell #/Color Texture Depth
10G 611 Sand 0 To 10
1 OR 413 Oolitic Limestone 10 To 72
USDA SOIL SERIES: Urban land
Munsell # /Color Texture Depth
10YR 6/1 Sand 0 To 12
1OYR 4/3 Oolitic Limestone 12 To 72
OBSERVED WATER TABLE: INCHES [ ABOVE / BELOW ] EXISTING GRADE TYPE:
ESTIMATED WET SEASON WATER TABLE ELEVATION: 27 INCHES [ ABOVE / F13EZ0q3
HIGH WATER TABLE VEGETATION: [ ]YES [X]NO MOTTLING: [ ]YES [X]NO
[ PERCHED / APPARENT ]
EXISTING GRADE
DEPTH: INCHES
SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: Replacement 4-FS/0.80 DEPTH OF EXCAVATION:
DRAINFIELD CONFIGURATION: [X] TRENCH [ ] BED [ ] OTHER (SPECIFY)
I- REMARKS /ADDITIONAL CRITERIA
evaluated by: Jose Moraga P.E. Lic# 15115
SITE EVALUATED BY:
, (Title:) (None)
DO 4015, 08/09 (Obsoletes previous editions which may not be used) Incorporated: 64E- 6.001, PAC
AP1064866 EID1382044
45 INCHES
DATE: 03/07/2012
Page 3 of 4
v 1.0.2
F I
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR:
[ X ] New System [ ] 2sisting System
I ] Repair [ ] Abandonment
APPLICANT: LESTRADE RESIDENCE
PERMIT NO. At-
DATE �6
PAID:
FEE PAID:
RECEIPT #:
[ ] Holding Tank [ I innovative
L ] Temporary [ X ] ATU
PROPERTY ADDRESS: 1080 N.E. 105TR STREET. MTanrrr SHORES, FLORIDA.33138
LOT: 9 BLOCK: 1 SUBDIVISION: MIAMI SHORES ESTATES. PP.47 -58
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
PROPERTY ID #: _ 11 -2232- 028 -0090 [OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.0065, F.S., AND CHAPTER 642 -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 E] IPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
(800 GPD NEEDED AS PER TABLE IV)
T [ 900 ] GALLONS / GPD SEPTIC TANK /AEROBIC UNIT CAPACITY MULTI — CHAMBERED /IN— SERIES [ X
A [ 750 ] GALLONS / GPD PRE TREATMENT TANK CAPACITY MULTI— CHAMBERED /IN— SERIES [
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS
K [ 450 ] GALLONS DOSING TANK CAPACITY [100 ]GALLONS @ [ 6 ] DOSES PER 24 ERB # PUMPS [ 1
D [ 563 ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ X ] MOUND [ ]
I CONFIGURATION: [ X ] TRENCH [ ] BED L X ] DRIP IRRIGATION
N
F LOCATION OF BENCHMARK: CL / PL NE 105TR STREET (ROW) 3.19'
I ELEVATION OF PROPOSED SYSTEM SITE [24.72] [INCHES /FT] [ABOVE /BELOW] BENCHMARK / REFERENCE POTS
E BOTTOM OF DRAINFIELD TO BE [21.72] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POR
L
D FILL REQUIRED: [ 10.8 ] INCHES EXCAVATION REQUIRED: [ 45 ] INCHES
O ATU APPLY FOR
T
H
E
R
SPECIFICATIONS BY : `
APPROVED BY: JOSE MORAC4W Pj
TITLE:
TITLE:
Gwto cs
CMR 8agineering erviaes, Inc.
DATE ISSUED: EXPIRATION DATE:
�— The contractor ce designee) is required to perform
soil boring adJacent to the Prior Fenal Approval, the DOH
D8 4016, 10/97 (Previous Editioa6( spy shall witness)the soil boring and compare the
results to the original site evaluation submitted. A
re lilts t the fee will l assessed it the contractor is not
at tra ;Quite at ii1:, arrangev ti ne
Page 1 of 3