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PL-06-1860 N rami Shores Village D 1�'J1�In d 12 2DO� :. hIn 4 1 '�A�� Building DepartmentK11 JUL$ 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY;_ ------ Tel: (305)795.2204 Fax:(305)756.8972 BUILDING Permit No. �l2cI�� PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type(circle): Building Electrical CPlumbin Mechanical Roofing � . � Owner's Name(Fee Simple Titleholder) �� ,s ( ,p� Phone# /b Owner's Address "— CityState F-(-_ Zip Tenant/Lessee Name Phone# Job Address(where the work is being done) SoGS I SE U C t City Miami Shores Village County Miami-Dade Zip31 1 FOLIO/PARCEL# —'®Z Z® Is Building Historically Designated YES "N Contractor's Company Name IN A Tnen CA r, IC 'tP Phone#� Contractor's Address City M' CA m1 State Zip '351(0® Qualifier Name \00 1�C(m Vp4®Dd oLo-61 Phone# D State Certificate or Registration No. X 0 00 `[-'1 Certificate of Competency No. Ls Architect/Engineer's Name(if applicable) Phone# Value of Work For this Permit$ ® Square/Linear Footage Of Work: 1�® Type of Work: DAddition Alteration ONew 'K Repair/Replace ❑Demolition Describe Work: n 11 Submittal Fee$ Permit Fee$ 1-75• CD CCF$ CO/CC Notary$ Training/Education Fee$ . 6,30 Technology Fee$40a] Scanning$ ?J 'Q[� Radon$ DPBR$ Zoning$ Bond$ ?)CfJ Code Enforcement$ Double Fee$ _ Structural Review.$ Total Fee Now Due$ 4 See Reverse side c > 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 iss In the absence of such posted notice, the inspection will n e approved and a reinspection fee will be charged. Signature Signature O�orAgent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 1 day of Jas 2000. by N l ,nA 5%e-n 6aCt1 day of dj� 20 CG by wood 0( who is personally own to me or who has produced Dny- l i Q:,,SCwho is personallyown to me or who has produced ice,;,&e As identification and � s ide�p ratio A1%(M b&anath. NOTARY PUBLIC: .�*� TERI�SA J.SOLOMON NOTARY P 1 My CQMMISSION*OD;2.51437 MY COMMISSION*DD236137 �iF#i 1,,�? MIRES-September 16;2001 may+ «ac *iXplR Fs:SeN1'geni-16,20 7 141003-WOTMT Nit Diswu it Assoc.Co. Sign: yy�' S T FL DrcamoM Assoc..C*. Sign: g Print: eyk,41- Print: ` '�°CJ`�i J®I<�Y"*-, C-N_ My Commission Expires: My Commission Expires: APPLICATION APPROVED BY: 71 7 11olo �7 Plans Examiner Engineer Zoning (Revised 02/08/06) Invoice Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Bill To NINA BIRNBACH Invoice Number: PL-7-06-25544 10651 NE 11 CT Invoice Date: July 13, 2006 MIAMI SHORES, FL 33138-2122 Permit Number: PL-7-06-1860 Return to: Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Permit Type: Plumbing - Residential / Work Classification: Date Fee Name Fee Type Fee Amount 07/13/2006 Permit Fee-Additions/Alterations Percentage $175.00 07/13/2006 Scanning Fee Calculated $3.00 07/13/2006 CCF Calculated $1.80 07/13/2006 Bond Type-Contractors Bond Fixed $300.00 07/13/2006 Education Surcharge Calculated $0.60 07/13/2006 Technology Surcharge Calculated $4.17 Total Fees Due: $484.57 Payments Date Pay Type Check Number Amount Paid Change 07/13/2006 Check 5717 $484.57 $0.00 Total Paid: $484.57 Total Due: $0.00 Thursday,July 13, 2006 o� STATE OF FLORIDA CENTRAX #: 13-SG-29644 DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID $ CONSTRUCTION PERMIT RECEIPT Nal M 0 OSTDSNBR 06-2045- -R INSTRUCTION PERMIT FOR: ]New System [ ]Existing System [ ] Holding Tank [ ] Innovative Other X ] Repair [ ]Abandonment [ ] Temporary [ NA ] P ,T: Birnbach, Brett & Nina AGENT: SR0001342, Woodard William .OPERTY STREET ADDRESS: 10651 NE 11 Ct Miami Shores FL 33138 �T: 6 BLOCK: 2 SUBDIVISION: Miami Shores Estates [Section/Township/Range/Parcel No.] .OPERTY ID #: 11-2232-028-0220 [OR TAX ID NUMBER] STEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E-6,FAC APARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME ;RIOD. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, ;QUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION.] SUCH MODIFICATIONS MAY RESULT IN THIS ;RMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM )MPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. STEM DESIGN AND SPECIFICATIONS [ 750 ] Gallons SEPTIC TANK MULTI-CHAMBERED/IN SERIES: [Y ] [ 0 ] Gallons MULTI-CHAMBERED/IN SERIES: [ Y ] [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [ 0 ] GALLONS DOSING TANK CAPACITY [ 0 ] GALLONS @ [0 ] DOSES PER 24 HRS # PUMPS [ 0 ] [ 150 ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM [ 0 ] SQUARE FEET SYSTEM TYPE SYSTEM: [ % ] STANDARD [ N ] FILLED [ N ]MOUND [ N ] CONFIGURATION: [ ] TRENCH [ N ] BED [ N ] LOCATION TO BENCHMARK: F.F.E. : 5.8' NGVD ELEVATION OF PROPOSED SYSTEM SITE [ 2.2 ] [ FEET ] [ BELOW ] BENCHMARK/REFERENCE POINT BOTTOM OF DRAINFIELD TO BE [ 1.8 ] [ FEET ] [ BELOW ] BENCHMARK/REFERENCE POINT FILL REQUIRED: [ 22.8 ]INCHES EXCAVATION REQUIRED: [ 0.0 ] INCHES HER REMARKS: ..-Install 150 sf of drainfield in trench configuration. Existing 750 gal. septic tank, certified by "A American Septic & Plumbing On 07/03/2006" :o remain. Invert elevation of drainfield to be no less than 4.50' NGVD. Bottom of drainfield elevation to be no less than 4.00' NGVD. .-Install a lift/dosing tank and all requirements for an alarm system installation. 'HIS PERMIT IS NOT FOR "ADDITION(s)". r ECIFICA _;.0 : OSPINA, P RO TITLE: PROVED B i edro TITLE: Dade CHD TE ISSUED: 7/10/06 EXPIRATION DATE: 10/8/06 STATE OF FLORIDA a DEPARTMENT OF HEALTH � t APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT vwme Permit Application Number- ------------------- PART II -SITE PLAN------------- -,------ cale: Each block represents 5 feet and 1 inch=50 feet. _ v �k c+ -lois f. 0 E - - 4.. 41, J �^' -,�y•fly:�.. ...�� y� �� 4. e s_k'1% °,,F..P,� �`��]t-..rtb �'� �,< y k.•w�a�f x,�°.;V� a � ,�x;: l..x" e Plan submitted by: ., Signature r Tim to Approved Not Approved_ Date 1 County Health Department ALL CHANGES MUST EEA ROVED BY THE COUNTY HEALTH DEPARTMENT Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 = Phone: (305)795-2204 Fax: (305)756-8972 o�av� Permit Permit Status: APPROVED Issue Date: 7/13/2006 Expires: 01/09/2007 Permit Number: PL-7-06-1860 Owner's Name: NINA BIRNBACH one: Permit Type: Plumbing- Residential Parcel#: 1122320280220 Work Classification: Drainfield Block: Lot: Job Address: 10651 11 Court NE Section: PB: Miami Shores Village, FL 33138- Contractor(s) Phone Primary Contractor Total Square Feet: 0 A AMERICAN SEPTIC&PLUMBING Yes Total Valuation: $ 2,300.00 Comments: Re uired Inspections INSTALL NEW DRAINFIELD&DOSING TANK Rough Landscaping Final Additional Information Type of Work: Type of Piping: Additional Info: Bond Return: Classification:Residential 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 Amount Invoice Number Amt Due Amt Paid Bond Type-Contractors Bond $300.00 PL-7-06-25544 $484.57 $484.57 CCF $1.80 Total: $484.57 Education Surcharge $0.60 Permit Fee-Additions/Alterations $175.00 Scanning Fee $3.00 Technology Surcharge $4.17 Total: $484.57 Building Department File Copy 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. Applicant Signature