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PL-15-3107BUILDING PERMIT APPLICATION ❑ BUILDING ❑ ELECTRIC ?PLUMBING ❑ MECHANICAL JOB ADDRESS: City: Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 REC 17 DE 16 2015 BY: FBC 20I-" N9CU $ Permit NoTPLU b"-31 0.4 Sub Permit No. ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS lay) N6 3 s+ Miami Shores County: Miami Dade Zip: 3313Y Folio/Parcel#: 11 - Vb1 0a?- 01Mo Occupancy Type: Load: Construction Type: Is the Building Historically Designated: Yes NO Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Lt/ti&.ZG Phone#: /S% ✓. 7f 07.0 Address: 10137 Are 43 St City: /44(444 / State: Zip: 3313E. Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: m/' c� s 40.4 /9f3,? ijw Address: Phone#: g,; Kg< ? 5 City: /14/4/k/ / State: TG Qualifier Name: Ket..,/( h'L State Certification or Registration #: .. SIQ.0(16-36 DESIGNER: Architect/Engineer: Phone#: Address: City: Value of Work for this Permit: $ 3000. 00 Square/Linear Footage of Work: Zip: 33'1�5 Phone#: 365 6 S/ 7Kc F Certificate of Competency #: State: Zip: Sao 544 Type of Work: ❑ Addition ❑ Alteration ❑ New � LL Description of Work: Repair/Replace ❑ Demolition 901+9M . if fn 9lF�d Specify color ofd Ior thru tile: 1 cri,J OM Submittal Fee $-ay•„ .:;:-.Permit Fee '$ Scanning Fee $ Technology Fee $ Training/Education Structural Reviews $ /SO, x� Radon Fee $ (Revised02/24/2014) CCF $ CO/CC $ DBPR $ Notary $ Fee $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ 11 e .30 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address ,i� !"ti Zip State fp 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. 4 "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOURPROPERTY..IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF.COMMENCEMENT." ti - 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 ab ce of such posted notice, the inspection will not be approved and a reinspection fee will be charged. s •. Signature OWNER or AGENT 3Ji33l73gnature•n . 40' '0 t The foregoing instrument was acknowledged before me this /‘' day of ,20 % ,by LI/Llu�t f/SCitPr , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: • Sign: Print: Seal: KEMBLE ETTRICK Notary Public - State of Horida My Comm. Expires Sep 19, 2017 Commission # FF 055732 oF ,, ,,' Bonded Through National Notary Assn. CONTRACTOR' 9"1 The foregoing instrument was acknowledged before me this /( day of �if:l�i�l�/1 , 20 /S , by K�21NbI� 6itt1►CJt , who is person iLanown to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: 4,5ki QUI... Al _— SHERYL A MENDES Seal: o'�"ay °°a'' °. �.`� : Notary Public - State of Florida 0 I My Comm. Expires Oct 23, 2018 ` ACommission # FF 136597 ".RSBonded Throw NtttleatlM Assn. * ********* **************************************************************Ye APPROVED BY (Revised02/24/2014) x' Plans Examiner Zoning Structural Review Clerk STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT PE1*IIT t:13 -SLC -1647264 APPLICATION fl: AP1215843 DATE PAID: FEE PAID: RECEIPT 1: Sa • r , ,'rl`'�j�f DOCUMENT 1:PR997483 CQUi tit `� CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Michael Fischer PROPERTY ADDRESS: 1237 NE 93 St Miami, FL 33138 LOT: 6 BLOCK: 1 SUBDIVISION: PROPERTY ID *: 11-3205-027-0060 [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 ( 900 ] GALLONS / GPD A [ 0 I GALLONS / GPD N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ 300 ] GALLONS DOSING TANK CAPACITY ( 1GALLONS 8( 6 IDOSES PER 24 HRS *Pumps [ 1 ] FEET Bed Drainfield SYSTE SQUARE M R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [x] STANDARD [ I FILLED '' [ I MOUND [ ] I CONFIGURATION: [ ] TRENCH (x] BED [ ] Septic (Existing) CAPACITY CAPACITY N F LOCATION OF BENCHMARK: FFE 7.6' NGVD I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D FILL REQUIRED: [ 0.00I INCHES 0 T H E R SPECIFICATIONS BY: APPROVED BY: [ 22.80 1 El INCHES J FT ] [ ABOVE A BELOW b BENCHMARK/REFERENCE POINT 148.80 1 (J INCHES 1 FT ] ( ABOVE d BELOW p BENCHMARK/REFERENCE POINT EXCAVATION REQUIRED: ( 38.00] INCHES "THIS PERMIT IS NOT FOR ADDITIONS" *Existing 300 gal dosing tank certified on 12/7/15 by Mr. C's Plumbing and Septic to remain. 'Install 12" of slightly limited soil at the bottom of the drainfield. `Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed. 'Invert elevation of drainfield to be no less than 4.03' NGVD. 'Bottom of drainfield elevation to be no less than 3.53' NGVD. *Water line within 10 ft of septic sy to be Sch 40 PVC or sleeved in accordance with FAC Ch 64E -6.005(2)(b). DATE ISSUED: DH 4016, 08/09 (Obaoletes all previous editions which lay not be used) TITLE: Incorporated: 64E-6.003, FAC v 1.1 .8 AP12158* I. . 8E979366 Page 1 of 3