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PL-16-1157 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 inspection Number: INSP-26$2$7 Permit Number: PL-4-16-1157 Inspection Date: October 03, 2016 Permit Type: Plumbing- Residential Inspector: Naranjo, Ismael Inspection Type: Miscellaneous Owner: MARTINEZ,SANTIAGO Work Classification: Septic Job Address:285 NE 95 Street Miami Shores, FL 33138- Phone Number (773)793-0782 Parcel Number 1132060133960 Project: <NONE> Contractor: STATEWIDE SEPTIC CONNECTIONS Phone: (954)963-0082 Building Department Comments REPLACE SEPTIC AND DRAINFIELD. Infractio Passed comments INSPECTOR COMMENTS False TO REPLACE PERMIT#PL15-2524 Inspector Comments Passed E] CANCELLATION OF PERMIT SANTIAGO 773-793-0782 285 NE 95 ST Failed El Correction ( 4,9 Needed I Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid For Inspections please call: (305)762-4949 October 03,2016 Page 1 of 1 To Whom It May Concern: I am cancelling the permit application for septic.tank move for 285 NE 95th Street Miami Shores FL. I am no longer proceeding with the previously planned addition. Thanks, Santiago Martinez , RwvsMs gas . . .De artment� ' � t. �3uiIdin P . . " 6 .. .`� .. ... . , .. . ...• �V.E.7�td A�t�;llldierrd'Shores;�la�ida 3R1�J$' • _. . Tela�}.'7!}5;'�?A41�.� 17�r�72 •• • ' -lNSl�t'IP1�i'UNE N=NIlIM91:R:(M)7524M FBC. /:,r ZO. .nn. PERMIT , PPUCATION subPooft Na suiL)D' '; : ..:C R i . O tt vs um.in" p MECHANICAL [jpU#LICWQRP c nlyr, .o�` Tlvti ; COM`!`RACMIR URAW,I�IGS . 1 •;:: . ,. Loa& .y . . i/i 1�. 4 ow zone Wr'"' ••ti ''mss" 4..i..t.�.r�" 'i • . ! ,ter:.is ;i �� "'.�:° a^^^"' .•.„' ^ r ..', An V.- CR s :t,• M••a•: ., c co nen • d�lE1tNACl� i at1�r N��. •:•.r•,:.• Addy PA r 1a. �W - _• + .. � � • � J. ; w wfW� ., t Y•w d MS.•,• ,, �R � �•�i i• ., y i f w• •4: , Of �liS $ ; � # _ of wi3rw •' Type sFWb&. 0 AdMIon 0 AtterOon :� New RepWrMoace D C►�poillion SOO color Mill: �7�IIRs10�lf�� � .: o �rt'-:•~�'; w �^n T.. ;1�Y/.W'�•-;_ - ' Coto fa low s •{�.{/_ X71■{ugh/�-�{ -ny]1Y+)'s1 N.pa�rJrl■�(it atlpumm) 1 f^�..y�_rlg GT r --I S1 ddram r..♦ , .. /y,,♦+�� M�YYY� rI•IYW 1 Stag Mortgage Lendet's Name(ifapploble) Mortgage taandees Aiddrew ' My �' • • .. Appii ftrk is t w*made to obtdn a permit to do the work and ftvftBadQMP meted. J :diet nQwgdr ,0r instaiiation as commenoad'oia•tv the ksuaiwe 4f la�pertrdt,'tritd*d alt work velli beI p�rforM d'to meet the staadatds `regula fth . t:ol wucnan in to phdimo n. I undogmtd that a mmp crate pmt roust.be'cured for M.i:C1 M PUJMSINC;, SIGNS, PO S, nAMACM solLpIN NIia4TIM u ,AIR CtiNDMCfliEEltS, .oWNEWS M6A1a1P I twt'iiy'that a the%mph*Mbimtwn is amVe and that aid wo&velli be'ddde in WnWbnm with Iii app>teahie laws>Nui�tting construcdon and zohittlg. "WARNING TO OWNER: 'YOUR.-FA#LUR�~6 RECORD A NOTICE OF COMMEAUMEW MAY RESULT.IN YOUR PAYS°T1 Ke FOR WIPIkOVEMENTS TO YOUR PROPERTY.' IF YOU ID TQ MAIN.F111MCL ;''C ONSULT`WW#TN..YQtiR'LENDER'Ol 'AN:ATTORNE`i ORE'RECORDINQ ,youn NQncE.0F CO1t MENCEMENT.'` • '. ' . Notke to app1 .as a.comdlrtotr to rhe rice of cr btdldlttg permit'v>�h as.�vaohte exraeedi�g$23oD,�ist'opp/�if m�`. Premiss In gwd ,VW a rapy of the noft r FtamnW=nefit idol M ' 00AM~- JOL&O*ftW- p=fl-. praperty s dtta�hrrterrt'Aiso;'a cared Copy aj�the ie riled.notice o aamme rt ffn&be pfd at the job•rne jbr ft fist'Dupe�on who QC=seam(i)dop.afty tits bats ng irenut k IsSM.•.m ft ab of-such paiWO r Eft, rhe' btapectuv i wX nor be appr+owd and a rt lhWKtbfifte wM be dtotged S' �� Sigrtal�fe•I • � Rori4GEN`f. .. .. CAWIRACTOR , w .. The f alitg tn*umeM was ackrtoMe before me titin Tl» lt>fg i�trutnettt was adcnowl b>sfore metier Yrir ;m.. .Ott „ _day o� :, - fir,• . . I who is p mono knstiKn to ^ Spmqv,ill+ ! tp. me or vrtto•has .ri c er- ( •t`S e:�as me or who t aismvduc�d, t'�.+�•-t�►,. as .. idewfii a&n and who diatda so o' `:. iaentHimtkm and who did take an 08W. ' • ilyr • , • I I • �• . • }. '1 .. .. ' BIEL Sip Print: ,Q�,•f+� Wit. t.rr y Saw, . . . . . , sal YMIADY PRIETO My OOMMMsION#FEM031. ": <= EXPIRES:March 25,2019 :. UW s�aN *tse**�**iwu's�is****�s I's.,rsswss* APpwm iy Ptam DoWnet' :�oniag Sbcucbnl Ru&w Clerk ,". i Miami Shores Village 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 Phone: (305)795-2204 ' ,,,r &µ•° _ ' Expiration: 11012016 Project Address Parcel Number Applicant 285 NE 95 Street 1132060133960 Miami Shores, FL 33138- Block: Lot: SANTIAGO MARTINEZ 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:TO REPLACE SEPTIC TANK AND DRAINFIE 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 CCF $4.20 Invoice# PL-4-16-59588 DBPR Fee $4.50 04/29/2016 Check#:6086 $50.00 $279.20 DCA Fee $4.50 Education Surcharge $1.40 05/05/2016 Check#:5064 $279.20 $0.00 Permit Fee $300.00 Scanning Fee $9.00 Technology Fee $5.60 Total: $329.20 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 information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I autho' e above-named c racto to do the work stated. May 05,2016 Authorized Signature:Owner / Appl' nt / Contractor / Agent Date Building Department Copy May 05,2016 1 \1P Miami Shores Village C����� Building Department AP 2 9 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201 BUILDING Master Permit NOT l-k�1 I 15� PERMIT APPLICATION Sub Permit No. BUILDING ELECTRIC ROOFING REVISION �h' tTRENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP C� C� CONTRACTOR DRAWINGS rJaSJOB ADDRESS: v Cec `�{- City: Miami Shores County: Miami Dade Zip: 33 136? Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: _ BFE: FFE: OWNER:Name(Fee Simple Titleholder): Phone#: Address: c2b S k/G l�; 911TQe r1,e� City: w a rr` N State: ��JV Tenant/Lessee Name: _ Phone#: Email CONTRACTOR:Company Name: 'AC Phone#3 633 p Y nn Address: k?) ao NW �� A e 0 trr 0 City: opa UX" State: Zip*33__'_ T Qualifier Name: l�G ��r�'� Phone#: State Certification or Registration#: �M 1 2 y2' Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: St fie_ � Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New �ff­Repair/Replace ❑ Demolition Description of Work: `t Q V�;— y. V-Y-0 v-) Specify colli of colas"thru idle: ,1k Submittal Fee$ • ` '' .,... Perfnit l�e�e"$ .,.�V is CCF$ 1•ca�© ` .. CO/CC$ . Scanning Fee$ Radon Fee$ Y' 50 DBPR$ y Notary$, Technology Fee$ G , 60 Training/Education Fee$ Y 0 Double Fee$ Structural Reviews$ Bond$T.�`L3' TOTAL FEE NOW DUE$ oQ • L-�d 'Revised02/24/2014) 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. IIII�e����� Qf V .t Signature—d" Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before/me this 2-'0 day of ( ,20 ,by day of tt�P rA - ,20 b ,by 94 °1'f' �� NIAr�'i�nr—rto is personally known to ��S 1 rn orwho is personally known to me or who has produced as me or who has produced ('7 as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: ® Sign ®Sign: Print: �A Vii^C f l LG L—-J —X Print: +� Seal: mer Notary PuWic State of FbrWa Seal: �Vv Tt a FiendsNOIRry Public Stow of :r Trern�a Lewis My C ay FF IMMMy Coon FF 10NW Exons 02W=19 E)Om 02N8d2018 ************ ******************************** * * * ************* APPROVED BY Plans Examiner 5: Zoning Structural Review r Clerk 17, (Revised02/24/2014)