PL-16-3132 ' rrnitp. PL-11:-16-3132
Iype
Miami Shores Village h .Plumbing-'I'dai ntiai
10050 N.E.2nd Avenue NW
WorkCla rfr tion. D ld_
:.
Miami Shores,FL 33138-0000 '
Phone: (305)795-2204 Peta?titteltr `APPROVED'
A -
11116/x016 ` Expiration: 05/17/2017
Project Address Parcel Number Applicant
460 NW 112 Terrace 1121360010180 LEO DE LA ROSA
Miami Shores, FL 33168- Block Lot
Owner Information Address Phone Cell
LEO DE LA ROSA 460 NW 112 TERR (305)751-7067
MIAMI SHORES FL 33168-3328
Contractor(s) Phone Cell Phone Valuation: $ 2,300.00
A AARON SUPER ROOTER 305-944-8886
__. _..•.. ... Total Sq Feet: 225
Type of Work: Available Inspections:
Type of Piping:
Inspection Type:
Additional Info:DRAIN FIELD HRS Approval
Bond Return: Final
Classification:Residential Scanning:3 Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.80
DBPR Fee InVOICe# PL-11-16-62080
$2.25 11/18/2016 Check#:5219 $ 118.30 $50.00
DCA Fee $2.25
Education Surcharge $0.60 11/16/2016 Check#:5203 $50.00 $0.00
Permit Fee $150.00
Scanning Fee $9.00
Technology Fee $2.40
Total: $168.30
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 n oning. Futherm r ,I auth rize the above-named contractor to do the work stated.
November 18,2016
Au o zed Signature:Owner / Applicant / Contractor / Agent 5 ate
Building Department Copy
November 18,2016 1
TA��
ob Miami Shores Village Nov
�•�' Building Department IBY:
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 201y s�
BUILDING Master Permit No. 1�u 23)3 2
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION (,RENEWAL
F-IPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: Ltw tyq i,9--T-e ' Ce'
City: Miami Shores County: Miami Dade Zip: t��
Folio/Parcel#: it ' �'�� -001-oleo Is the Building Historically Designated:Yes NO
Occupancy Type: Load: lo
Construction Type: Flood Zone: BFE: FFE:
Z-en'0b(-'>,0
OWNER:Name(Fee Simple Titleholder): I CCpSCZ Y�hone#: 78(.- 4/S)-c?/
Address:__ q('01n N`'-j jij.Z l tvfG G(i
City: XA� CArv1t "U-IP�',S State: F1, Zip:
Tenant/Lessee Name: Phone#:
Email: ( �g
CONTRACTOR:Company Name: r') rrD w'1 J �-0-r Phone#:
Address: SW a4 C+
City: 1 �Ci rt-v'k-r State: Zip: �330Z3
Qualifier Name: o V-\ Phone#: 30S—')LfLt"&S-,k6
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work: 2Z S
Type of Work: ❑ Addition ❑ Alteration ❑ New ] Repair/Replace �y ❑ Demolition
Description of Work: Ini 141
® �® Z� fi �l'L1�C lel 12.
Specify color of color thru tile:
Submittal Fee$ �`�` Permit Fee$ �� ' CCF$ I CO/CC$ (�
Scanning Fee$ Radon Fee$ DBPR$ 'Z 9 Notary$
Technology Fee$ Training/Education Fee$ Double Fee$ Rr
Structural Reviews$ Bond$ p
TOTAL FEE NOW DUE$
(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 (tl" 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 M 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 commenceynent must be posted at the job site
for the first inspection which occurs seven (7) days aftEr the building permit is issued. In t _ absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
ignatur Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of N 0%,f 20 �C , by day of ` 20 4 ( by
140 @�, ( �,who is personally known to 9 who is personally known to
me or who has produced �i 'd� as me or who has produced r--1 4q- (I as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
-
(- i'),
Sign: _ Sign: � s'- �' n
Print: T420
Print:
.- ��
Seal: * , MYCOMMISSION#FF 928161 Seal: * MYCOMMI66164#VF928161
c)(PIRf S:NovsTrtber 8,20i3 * t EXpIPMa.November 8,2019
r'IFOF�oA��' Bonded Thru Budget Notiry SeMm @�° tlItru @udg t Wry WAS
APPROVED BY � Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
_ 31
32
f �
L
AL
DIVISION of
Florldst Health- ,
+ Miami-Dade County
O TD / eR Divklen
11805 SW 260 Sitect o-1Miv6i, 33175
Inspector Date
Address OSTID �.
Comments: �.,,
v v ►. DIVISION OF 1""R
*`
Environment l kfi6i
ON
irawam
11805
Inspector -�'�"'" \ ate ILA
Address "t� »\ `\ STDS# LkS \
Comments: �� ..,
PERMIT #:
13-SC-1543009
APPLICATION #:AP 1149579
STATE OF FLORIDA DATE PAID:
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID:
CONSTRUCTION PERMIT RECEIPT #:
DOCUMENT #:PR942089
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Leopoldo Dela Rosa
PROPERTY ADDRESS: 4601#JV 112 Ter Miami,FL 33168
LOT: 2 BLOCK: 2 SUBDIVISION:
PROPERTY ID #: 11-2136-001-0180 [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 [ 750 ] GALLONS / GPD Septic 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 [ 225 ] SQUARE FEET SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [x] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: FFE 12.3'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 15.601 [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 53.60 ] [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED: [ 38.00 ] INCHES
**"THIS PERMIT IS NOT FOR ADDITIONS***
O 1.-Existing 750 gal.septic tank,certified by"A Aaron Super Rooter on 06/06/14"to remain.
T 2.-Install 225 sf of drainfield in trench configuration.
3.-Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed.
H 4.-Invert elevation of drainfield to be no less than 8.34'NGVD.
E 5.-Bottom of drainfield elevation to be no less than 7.84'NGVD.
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons(2 per bedroom),for a total estimated flow
R
SPECIFICATIONS BY: ,J n TITLE:
APPROVED BY: TITLE: Engineering Specialist II Dade CHD
icole P Gwnbs
DATE ISSUED: 06/11/2014 EXPIRATION DATE: 09/09/2014
DH 4016, 08/09 (Obsoletes all previous edit'ons i y sv@�)rcd to perform a soil
1�ne co rhracr deaf. nna, h_tlme ct
v 1.1.4 Page 1 of 3
Incorporated: 64E-6.003, FAC
;boring adjacent to the drain�ieid excavat��n a.t nI -_...
P.CfIOrAP�149V?,;r)3!
insp
Wit, ;h? SOi, C:. ^•�n:r_i .W�'T:-:!� �i i£ .. e t. 2 d
site evalu3t!cn s.�hrnit��c. reurspec;lon fee .v •be assessed
`thc contractor is rwt at t'ne jobsite at the arrrnged t!me.
F 1TATE Of ,
FLO �(UA A.
DE-PAPTN ENT OF HEALTH
APPLICATION FO i ONSITE SEWAGE DISPOSAL SYSTEM CO�ISTF 101-10N PEnirtl r
n � f
Permit Applicator,
— - ---- - ---- - - -- - — — PART II -SI-TE PLAN---- - - - -viC , ---- -
S c a e: Each block represents 5 feet arid 1 inch = 50 feet.
cc,-CS f`
►ee+
- - - - z- - -- --
11J. 7
S
Not;s:_--LeLo Pose - 4o NyJ f i 2 , Y ► .S�o f-r-.1 33 16,'
Sits Plan submitted by:
Signature -
Pim, Approved — -- Not Approved — Date
�- Cot_inty Health Departm
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTI-f DEP4.RTMEINT
!7E14()-5.!0/^F.>;rl,�tar��!•iRa-rt��<um 4�t5 ricicit:nay Fa ur;erl)
SR;ctc lurrfxx:574-1 002.4015.61 i� 7