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PL-15-2524 E, S Miami Shores Village 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 , , y Phone: (305)795-2204 teni> ' E,>r i Expiration:04/0312016 Project Address Parcel Number Applicant 285 NE 95 Street 1132060133960 SANTIAGO MARTINEZ Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell SANTIAGO MARTINEZ 450 W 95 Place (773)793-0782 CHICAGO IL 60657- 450 W 95 Street CHICAGO IL 60657- Contractor(s) Phone Cell Phone Valuation: $ 7,000.00 STATEWIDE SEPTIC CONNECTIONS (954)963-0082 --�-�- - Total Sq Feet: 667 Type of Work:REPLACE SEPTIC TANK AND DRAINFIELD Available Inspections: Type of Piping: Inspection Type: Additional Info: HRS Approval Bond Retum: Final Classification:Residential Scanning:3 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Contractors Bond $500.00 Invoice# PL-10-15-57316 CCF $4'20 10/05/2015 Check#:4917 $50.00 $779.20 DBPR Fee $4.50 DCA Fee $4.50 10/06/2015 Check#:4922 $779.20 $0.00 Education Surcharge $1.40 Bond#:2864 Permit Fee $300.00 Scanning Fee $9.00 Technology Fee $5.60 Total: $829.20 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 i formation is accurate and that all work will be done in compliance with all applicable taws regulating construction and�pa�rig. Futhe re, orize the abo ntractor to do the work stated. 1 October 06, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy October 06,2015 1 Miami Shores Village _ pa - • Building Department OCT 05 2 15 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 W BUILDING Master Permit No. FL- 15°- 2.52 PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ISS Nz:7 C1 S S V City: Miami Shores / County: Miami Dade Zip: Folio/Parcel#: 4'-azoGo r b 6o Is the Building Historically Designated:Yes NO X/ _ Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder):sa rfiOC6 tAG 4IV1e ?, Phone#: Address:_ City: ko"e'S State: Zip: 33(54 Tenant/Lessee Name: Phone#: Email: R CONTRACTOR:Company Name: +cxA) d e- Ic �1 Phone#: r Y Address: 0564-p &jv`� �� *-IS City: am'LK-t'Lo State: ff Qualifier Name: ^�C'e \ u 4l to fy\p-, Phone#: State Certification or Registration#: 4VA ®�1 Z_C Z, Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: / City: State: Zip: Value of Work for this Permit:$ -7000 O -0© Square/Linear Footage of Work: 40 b7 Type of Work: TX Addition ❑ Alteration ❑ New ElRReeppair/Replace ElDemolition � Description of Work: (gr �`�/� 11(r l a`'1 Y2q `.j '�iC t i2e(U/ Specify color of co�ivr,fhru t,►led�y�r� `� °. •l%.,C' �F 7� r .., 'I:f7 • i ♦ � ... a. X11 ��1�, Submittal Fe .$ �7�.1�,�� QPer+nitFe# a �` CCF$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$$ Structural Reviews$ Bond$ �7 oo I TOTAL FEE NOW DUE$ ;L 7 � 2-0 (Revised02/24/2014) 9 + S7 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,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 L, Signature (rzwoa &Qt-� NER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 10 C- ,20 is ,by day of .20 cs ,by 1' C t`' -who is personally known to '4?,{' 4 t+r�l Aq r--v- ,who is personally known to me or who has produced FZA- [D as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: < Sign: Sign: ` Print: _ 'e S Print: l rf/�C1L`l o. L �se.Zr�? Seal: Seal: �ar�� Evvopo, wry Pum state a Floridp ;�V TeaaLa as My COMaa Leads k J My C"twasw FF 196307My COn1mi FF 198307 pt E■dres 02tOsr1019 E)WN"02/08/2018 R*3*kk*kNk I flMkkbsllkkbk*Nk+kik*kkk+k* w k&NlkIeAkffik APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) PERMIT #:13-SC-1631201 APPLICATION #:AP1205028 STATE OF FLORIDA DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID: CONSTRUCTION PERMIT RECEIPT #: DocumspT #:PR988968 CONSTRUCTION PERMIT FOR: OSTDS New APPLICANT: Santiago Martinez PROPERTY ADDRESS: 285 NE 95 St Miami,FL 33138 LOT: 22,21 BLOCK: 29 SUBDIVISION: Miami Shores Section#1 ` PROPERTY ID #: 11-3206-013-3960 [SECTxON, 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 V [ 1,05�0 GALLONS / GPD Septic CAPACITY A [ ✓ I GALLONS / GPD N/A CAPACITY N ] GALLONS GREASE INTERCEPTOR CAPACITY EbSU MM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps I I D [ 667 SQUARE FEET bed configuration drainfiel SYSTEM R [ ] SQUARE FEET N/A SYSTEM A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ I MOUND [ I I CONFIGURATION: [ I TRENCH [X] BED I I N F LOCATION OF BENCHMARK: CL NE 95 st.,9.89'NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 1.32 ] [ INCHES FT BELOW]BENCHMARK/REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 28.68 ] [FINCHES FT ] [ABOVE BELOW BENCFR�IRIC/REFERENCE POINT L D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 72.00] INCHES *Invert elevation of drainfield to be no less than 8.00'NGVD. o "Bottom of drainfield elevation to be no less than 7.50'NGVD. T *Install 42°of slightly limited soil under the bottom of drainfield. H -Perimeter of excavation area shall be at least 2 ft.wider and longer than the proposed absorption bed or drain trench. The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow E of 400 gpd. R The licensed contractor installing the system is responsible for installing the minimum category of tank In accordance with SPECIFICATIONS BY: Teresa lomon TITLE: Master Septic Tank Contractor APPROVED BY: TITLE: Dade CHD Carlo za DATE ISSUED: 09/28/2015 EXPIRATION DATE: 03/28/2017 DH 4016, 08/09 (Obsoletes al'li pr®vib.u$f4ft.-f:Lb$iat).Aiid may-not, fie:used) Incorporated: 64E-6.003, FAGF'`si u.� .,ci,1C�ti t,; 'ai �F ; .,�+5&�•.< .ilE�,., ..i';E Page 1 of 3 SE972535