PL-04-227Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 8/12/2004
Plumbing Permit
Permit Number: PL2004 -227
Applicant: LATIN AMERICAN INVESTMENTS
Owner: INVESTMENTS LATIN AMERICAN
JOB ADDRESS: 9495 BISCAYNE Blvd.
Contractor ALL PRO SEPTIC & SEWER INC Contractor's Address: 1531 NW 26 AVE
Local Phone: (305)635 -3002
Parcel # 1132050070010
Legal Description:
Permit Status: APPLIED Permit Expiration: 2/1 /2005 Construction Value: $7,200.00
Work: NEW SEPTIC AND DRAINFIELD FOR NEW HOUSE
Signed: (INSPECTOR)
Page 1 of 1
Fees: Description Amount
FEE2004 -8203 Building Fee $175.00
FEE2004 -8204 CCF $4.80
FEE2004 -8205 Training and Education Fee $1.60
FEE2004 -8206 Technology Fee $4.37
FEE2004 -8207 Scanning Fee $3.00
FEE2004 -8208 Builders Bond $300.00
Total Fees: $488.77
Total Fees: $488.77
Total Receipts: $488.77
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical (Plumbing)
Owner's Name (Fee Simple Titleholder) VV-Iriki, 02% \nck c \c \ Phone # � cLcz_ SSA
Owner's Address 20
City k_A\C rni State
Tenant/Lessee Name L®• Phone # C`J Z.(,3 \f3®R
Contractor's Company Name A
Contractor's Address d`Aro
aLS
Permit No. 9 104
Master Permit No.
Zip \
Job Address (where the work is being done) gaqq
City Miami Shores Village County Miami -Dade Zip 35\ �fl
Is Building Historically Designated YES NO X
City 1SZCArrl State V"\ Zip. 35■
Qualifier
State Certificate or Registration No. " \fib Z Certificate of Competency No.
Architect/Engineer's Name (if applicable) Q C.) Phone # (�
Zoning Bond $
Total Fee Now Due $ A • 33 i \d .1.0 —2 4
4
(Continued on opposite side)
RECEIVED
I3O 620!4
nfo 3"
Mechanical Roofing
$ Value of Work For this Permit 4 a Square Footage Of Work: 5 -\
Type of Work: ['Addition ['Alteration ELI New ❑ Repair/Replace ❑ Demolition
Describe Work: "C__, —' k... a °N — C \ � d,1CA o
****************************F
Submittal Fee $ Permit Fee $ 1 7S .66 CCF r40 36 CO /CC
Notary $ Training/Education Fee $ 1 - (U 0 Technology Fee $ 0 4 - s
Scanning $ 3.o O Radon $ .�
Code Enforcement $ Structural Plan Review. $
Bonding Company's Name (if applicable)
Bonding Company's Address
City
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attaciiment. Also, a certifted copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of ,20_,by
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Cho 05/13/03
Zip
Zip
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of 2, 0C.' by i'k l `k 9' �t v
who is personally known to me or who has produced
as identification who did take an oath.
NOTARY PUBLIC:
Sign: A /J
Print: Vail
My Commission Expires:
*>t *** *> *vr** *** *>t***** *** ** **** *t * * *> **** ** * * * *> >t ** * * * * ** *** *>t>t**** err ** *** * * *** ** *** * *>4"4
* MY COMMISSION # DD 281328
EXPIRES: January 14, 2008
*I fiuteuiptii vGnes
***** *** ******** **** ******** *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Plans Examiner
Engineer
Zoning
STATE O$'.. FLORIDA
,DEPARTMENT Of HEALTH
ONSITE SEWAGE. DISPOSAL
•`CONSTRUCTIO * ,lit rW H vino;) +itl
'Authority: Chapter 381, FS & Chapter 10D -6
C STRUCTION PERMIT OR:
[ ] New System (�J Exis System
;[ 1 Repair [ ] Abandpnment
,..j..14 4 t ‘ S4 1 s t . 4.4'jitt 9 FI T : Q
'
APPLICANT:
PROPERTY STREET ADDRES •
LOT: 1
PERMIT: 0
DATE PAID
. FEE :. , 1 :d 0-1) f;FipO t7 iECE PE R .,
FAC.. 'SC
ti,
•[ p Holding Tank [ hJ "Temporary /Experimental
up) .Ot1her ,Ir i , , .., ?, t141 'r's °+ 114 '.
11 riE'.�. , y 4,
21 t
aka ` IXi
2:1 e. :i 1
BLOCK: tJ I. 1 4 SUBDIVISION:
bah r' .r,atar,.ntittwgz•.ir�.i 3 tuSr t, Aft), a axlr:!tiv t ,w : s3, a =i4 t
PROPERTY ID 1:. Z QS -;Q. ? .- . a L .O [SECTI / TOWNSHIP /RANGE /PARCEL NUMBER " • [OR' TAX „ID "ER],:
= i .,
� i7R /,p t
3 is�R�lf ��dt� tii . 1 e: ,
_ r. t T� � N , ,, dy e T p �t . b`.A i; to S r. & .: 13
7il 9 �' ' i r. Iay 1 at aCI �t l xai, a�5 t t'ak d' r a rr �a'r, x+ , a7 }si' '.� ahus • a
. Y¢�i
SYSTEM MUST . BE CONSTRUCTE....IN..- ACCORD4NCE WITH. SPECIFICATIPN8110ANDstiBTRIDARDS .OF. CHAPTER, •lOp -6
FAC REPAIR PERMITS AND HOLDING TANR.PERNITS EXPIRE 90 DAYS FROM THE DATE OF : :ISSUE. ALL OTHER
• `PERMITS' EXPIRE ON E " YEAR FROM TNE` id s `DB"' ISSUE. :' DEPARTMENT OF HEAI;TH , AP RO1 L QF : , S X 4 5TEM I.QES
NOT GUARANTEE: SATISFACTORY PERFORMANCE FOR ANY SPECIF PERIOD % OF TIME. .ANY ci
FACTS WHICH SERVED. AS A BASIS FOR. ,ISSUANCE OF THIS PERMIT REQUIRE:, THE:'. APPLICANT TO MODIFY THE
'.PERMIT APPLICATION. .SUCH.MODIk'ICATIONS MAY RESULT IN THIS. PERMIT BEING MADENULL''AND`VOID
a xac===== asz= aaz aisaspsrsaa+. s- 3�' a >sl cariffialiaaairss=a��as =aa�aa
: TEM DESIGN AND, SPECIFICATIONS
[ ] SQUARE FEET PRIMARY 9. IN, m t l t ''F �1 fix. F4611/G4 t
[ J SQUARE FEET SYSTEM
[. v FILLED
CONFIGURATION: 44408E0
TYPE SYSTEM:
(` ] .STANDARD
[> ]TRENCH
N
..LOCATION} ►, r,).ii' ' � .. a , 'I i 7? , ^ �a Ai! 1:4,t7741 Iv
ELEVATION :OF PROPOSED: SYSTEM • SITE ( (INCHES FT] ABOVE / BELOWBEN
] CHMARK REFERENCE POINT
E BOT'J'OM OF DRAINFIELD TO .8 -z E [ Q 1 ( t, ]. [INCHES/FT] - ' [ABOVE BELOW] BENCHMARKKREFERENCE- .POINT
FILL REQUIRED: .: [ J J . IN
P k YP ( G!� c
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED:
DH 4016; 10198 (Replaces HRS -H Form 4016 (page 11 . which may be used)
(Stock Humbert 5744001. 4016-0)
aA b x�iJpiti tf - laarltieifM �t t_,yi. t
I I 0 S' 01 GALL S cPI} = SE 2 T AEROBIC UN T A4 T C IN SERI S is [ ]
.h l9ftrr •a pyt f4l!'G y 1 Y . � I� o b >> ^>• .119 , aqi R, ., r' •'I» � i }J.
CAPAC I . CHAMBERED/ IN SERIES: [ : ]
(
3
GALLONS GREASE INTE(CEPTGR . CAPACxTY (MA XIMUM CAPACI'i'7C SINGLE TANK:•1250 GALLONS]
[ ] OAL 3Q�NS PER `X00'8; � D�1S3'NG uTR NI�4 Q A P 4CITY/ g4) R k*OM, *t]r° ' +10 0 OF p S :-f'- [ ._ 3
MOUND
J INCHES
T � atilLen 2" rA
1.194 4Z
Pagel of 2
PROPERY SIZE: 37. ACRES. WATER SUPPLY: [,:.3 PRIVATE PUBLIC j 20000PD [`
IS SEWER AVAILABLE AS 'PER' 3 1.0063 r " FS? [ Y ./ > , y ' • r DI TANCB ' 0 SEWER:
PROPERTY ADDRESS, L. .
'DH 401
Stock N
SUBDIVISION't
Y STEMS MUST BS'CON
DA STATUTES.
11* OA ppremusin
[ 3. RES ( r 3 COMMERCIAL
No. of Building . Coamsrciai %Iastitutioaal Systole
Bedroow: Asa sq t o •Ta , ,:, Chaptsr
APPLICATION .FOR:
[NA New System
[ : Repair
, N‘
Ap1hICANT: / �.I
' AGiNT :
MAILING ADDRESS:
ar^ . STATE OF FLORIDA
: DEPARTMENT OF HEALTH
40=413 SEWAGE P DISPOSAT , : SYSTEN
APPLICATION FOR , CONSTRUCTION ` ; PER d-IT;
Xr�
TO BE CONPLE D. APPLIC OR.APPLICANT'S AUTEORIZED
BY A PERSON.LICENSED. PURSUANT' .T00 489.108(3)0) OR.489.SS31
fr i -.g/S 1
LL /1)oo I (,G'/
•
T rHONE: 2..39 Sz2L ` ..
1 'PLICANTs AGENTS
"% a, i US i;t ( I s Zi �
LOT: V
PROPERTY ID #:// OS ■
- 007- 0010 9S /3ise� ,,Jp /� / ✓D
3 r �� 3 _ _� 33 3.3 333 3333 33 = =3
TO BE COMPLETED BY ENGINEER,^' HEALTH UNIT EMPLOYEE, ORR PERSO . ENGINEER'S MUST
PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMP TE ALL ITEMS.
3
PROPERTY SIZE CONFORMS TO SITE PLAN:
TOTAL ESTIMATED SEWAGE FLOW:
AUTHORIZED SEWAGE FLOW:
UNOBSTRUCTED AREA AVAILABLE:
BENCHMARK /REFERENCE _ kOINT LOCATION:
ELEVATbN OF PROPOSED SYSTEM-SITE I
0.
THE 1NIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE
SURFACE WATER: /l1 ///Q FT DITCHES/SWALES:
WELLS: PUBLIC: /) FT LIMITED USE: A/ /� FT
BUILDING FOUNDATIONS: FT PROPERTY LINE$:
SITE SUBJECT TO FREQUENT FLOODING:
10 YEAR FLOOD ELEVATION FOR SITE:
SOIL PROFILE INFORMATION SITE
3S = o•32:xzr
OBSERVED WAT R TABLE: Aypt .INCHES [ABOVE '/ -`
ESTIMATED WET SE SdN WATER TABLE ELEVATION:
HIGHI?'ER TABLEVEGETATION: [ ] YES [•
SITE EVALUATED BY:
STATE OF FLORI
'DEPARTMENT OF TH
ON IT SEWAGE D SPOSAL SYSTEM
S' E UATION AND SYSTEM SPECIFICATIONS
BLOCK: .l SUBDIVISION:
3
1 5Nwra 3 -Cr
[Section /Township /Range /Parcel No. or Tax ID Number]
33333
[ YES [ 1
GALLONS
GALLONS
SQFT
SOIL -'TEXTURE /LOADING -RATE FOR SYSTEM S
DRAINFILD CONFIGURATION: [ ] TRENCH
S/ D ITIONAL CRITERIA:
pl c,:%✓,
6
- jr1frilh
7//) /(Pw,/ •
OH 4015, 10/96 (Replaces HRS -H Form 4015 (Pape 31 which may be used)
(Stock Number. 5744 - 003 - 4015 -1)
33333
NO. NET USABLE AREA AVAILABLE: er.„-p Z ACRES 4,
PER _,DAY , • (ES IDENCE S -TABLE 1 / OTHER-TABLE 2 ]
PER DAY [159,41 GPD /ACRE OR
UNOBSTRUCTED AREA REQUIRED:
fOrlr . SQFT
REFERENCE POINT
PROPOSED . SYSTEM TO THE FOLLOW ING FEATURES:
/0l FT N RMALLY WET? [ ] YES < ".° [ O NO
PR TE: /i//1 FT NON-POTABLE:-.009 FT
IV 1 FT POTABLE WATER LI Ss. 0 FT
[ ] YES i NO 10 YEAR' - FLOODING? [ 1 ES NO
/O /).¢ f'T MSL /NGVD SITE ELEVATION: p ili F' MSL /NGVD
•
SOIL PROFILE INFORMATION SITE 2 SN4 o
ERCHED
OW]. , EXISTING GRJWE. — ,TYPE:
INCHHES [ ABOVE / ELO EXISTING GRADE.
MOTTLING: [ ] YES: [k] N• ~ DEPTH: 47* INCHES
ArP / /4eeiJ� DEPTH OF4BCAVATION: 2 .`INCHES
[ 1 97E1 (SPECIFY)• r _f
TX
3
/`APPARENT]
'DATE: 0616 - o Y
Page 3 of 3
1
1 v' ,
fir
Passed . � LI
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
I
on Nu
Inspection Date: 01/10/2006
Inspector: Levrack, James
Owner: LOPEZ, JORGE
Job Address: 9495 BISCAYNE Blvd.
Miami Shores Village, FL 33181
Project: <NONE>
Contractor: ALL PRO SEPTIC & SEWER INC
Building Department Comments
Monday, January 9, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Imported Permit
Inspection Type: Septic Tank
Work Classification: Septic
Phone Number (305)608 -9180
Parcel Number 1132050070010
Lot: 4
Phone: (305)635 -3002
Page 2 of 2
AREA [11/0-4 (,ij1L SQFT
DISTRIBUTION BOX HEA DER
NUMBER OF DRAINLINES 6
DRAINLINE SEPARATION �. �'
DRAINLINE SLOPE V
DEPTH OF COVER
ELEVATION [ABOVE /BELOW] BM
SYSTEM LOCATION
DOSING PUMPS
AGGREGATE SIZE hi a t ;).
AGGREGATE EXCESSIVE FINES
AGGREGATE DEPTH
/ EXCAVATION MATERIAL,
FILL AMOUNT l•( p
FILL TEXTURE
EXCAVATION DEPTH
AREA REPLACED
REPLACEMENT MATERIA4.1/ 7(A,
EXPLANATION OF VIOLATIONS / REMARKS:
CONSTRUCTION APPROVED %DISAPPROVED]:
FINAL SYSTEM ;[APPROVED /DISAPPROVED]:
DH 4016, 10/97 (Previous Editions May
IDA
HEALTH
TREATMENT AND
NSPECTION AND
ISION:
OMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
[2]
• : :
Be Used)
SETBACKS
[} ] [271 SURFACE WATER FT
[ ? ] [ 28] DITCHES FT
[ # 1 [29] PRIVATE WELLS FT
[ ]
[30] PUBLIC WELLS FT
[,1 ] [ 31] IRRIGATION WELLS FT
[ ] [32] POTABLE WATER LINES FT
[ ] [33] BUILDING FOUNDATION FT
[ ] [34] PROPERTY LINES i' FT
[ ] [35] OTHER FT
PERMIT NO.
DATE PAID:
DISPOSAL SYSTEM FEE PAID:
FINAL APPROVAL RECEIPT #:
PROPERTY ID #:
FILLED / MOUND SYSTEM
[36] DRAINFIELD COVER
[37] SHOULDERS
[38] SLOPES
[39] STABILIZATION
ADDITIONAL INFORMATION
[40] UNOBSTRUCTED AREA
[41] 'STORMWATER RUNOFF
[42] ALARMS
[43] MAINTENANCE AGREEMENT
[44] BUILDING AREA
[45] LOCATION CONFORMS WITH SIZE PLAN
[46] FINAL SIZE GRAp;71NG:)
[47] CONTRACTOR //;. ;f
[48] OTHER
ABANDONMENT
E [ l
[49] TANK PUMPED _/ /
[ ] [50] TANK CRUSHED & FILLED
PT 1, f:;:p ic.,;a
PT
CHD DATE:
)' ^ P CHD DATE:
Page 2 of 3