PL-17-2961Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)7564972
Inspection Number: INSP-294068
Scheduled Inspection Date: January 22, 2018
Inspector Hernandez, Rafael
Owner: MOTIANI, SHARAD & PUJA
Job Address: 25 NE 108 Street
Miami Shores, FL 6 -
Project <NONE>
Contractor. MR C'S PLUMBING & SEPTIC
NC
Permit Number. PL -12-17-2961
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Septic
Phone Number (305)323-1964
Parcel Number 1121360110430
Phone: (305)651-7859
Building Department Comments
INSTALL SEPTIC TANK AND DRAINFIELD
Infrectio Passed Comments
INSPECTOR COMMENTS False
Passed
Falled
Correction
Needed
Re -Inspection
Fee
No Additional Mspections can
re -inspection fee is paid.
until
Inspector Comments
HRS APPROVAL ON FILE
January 19, 2018
For Inspections plea
call: (305)762-4949
Page 6 of 24
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Permit
Permit NO. PL -12-17-2966
Permit Type: Plumbing - Residential
Work Classification: Septic
Permit Status: APPROVED
Issue Date: 1/11/2018
Expiration: 07/10/2018
Parcel Number
Applicant
25 NE 108 Street
Miami Shores, FL 33161-
1121360110430
Block: Lot:
SHARAD & PUJA MOTIANI
Owner Information
Address
25 NE 108 Street
MIAMI SHORES FL 33161
Phone
Cell
Contractor(s)
MR C'S PLUMBING & SEPTIC INC
Phone
(305)651-7859
Cell Phone
Valuation:
Total Sq Feet:
$ 3,500.00
500
Type of Work: INSTALL SEPTIC TANK AND DRAINFIELD
Type of Piping:
Additional Info: INSTALL SEPTIC TANK AND DRAINFIELD
Bond Return :
Classification: Residential
Scanning: 3
Fees Due
Bond Type - Contractors Bond
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$500.00
$2.40
$4.50
$3.00
$0.80
$300.00
$9.00
$3.20
$822.90
Pay Date
Invoice #
01/11/2018
01/11/2018
12/18/2017
Bond #: 3606
Pay Type
PL -12-17-65931
Credit Card
Check #: 4063
Credit Card
Amt Paid Amt Due
$ 272.90 $ 550.00
$ 500.00 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
HRS Approval
Final
Review Plumbing
In consideration of the issuance to me of this permit, I agree
pertaining thereto and in strict conformity with the plans, drawi
accepting this permit I assume responsibility for all work d
required for ELECTRICAL, PLUMBING, MECHANICAL, WI
OWNERS AFFIDAVIT: I certify that all the foregoing infor
construction and zoning. Futhermore, I authorize the above -n
to perform the work covered hereunder in compliance with all ordinances and regulations
tate ents or specifications submitted to the proper authorities of Miami Shores Village. In
eith . r myself, my agent, servants, or employes. I understand that separate permits are
RS, ROOFI and SWIMMING POOL work.
to and that all work will be done in compliance with all applicable laws regulating
to do the work stated.
January 11, 2018
Authorized Signature: Owner / Applicant / Contractor
Building Department Copy
/ Agent
Date
January 11, 2018 1
Miami Shores Village
.C> 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
BUILDING
PERMIT APPLICATION
Master Permit No.
RECEIVED
D C 18 1017
FBC LUlLk
Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
[PLUMBING ❑ MECHANICAL DPUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
Citv: Miami Shores County: Miami Dade Zip: 33 i b ?
Folio/Parcel#: /1 - 021 X -al - OV'
Is the Building Historically Designated: Yes NO l ----
Occupancy
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
►�V 1
OWNER: Name (Fee Simple Titleholder):ar 1 A 0q-1 4fi_-f Phone#:
Address: (7.5--- Ike- 16 S
02-S NE /6g- PiCeet—
City: MA \a- l J I Y4 State:P-C Zip: ,3_s/ 4 1
Tenant/Lessee Name: - Phone#:
Email:
CONTRACTOR:Coomppany Name: !'�I r
Address: 1 g `' N
City: 1
Qualifier Name: �rivvt lD LQ.
C �s P/
State: Fc _
Phone#:
Zip: 3S1. i
/ I ��1 Phone#: �� c
State Certification or Registration #: cS /� Q b,1 /c/ 2s Certificate of Competency #:
DESIGNER: Architect/Engineer: ! V /
Address: l
Value of Work for this Permit: $ 3-C-zrz' Square/Linear Footage of Work: 5U�
Repair/Replace ❑ Demolition
Phone#:
City: State: Zip:
Type of Work: ❑ Addition ❑ Alteration
Description of perk:
(� 11.
❑ New
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ 300'
CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $ en3 - w
TOTAL FEE NOW DUE $ 2:42 . clo
(Revised02/24/2014)
Bonding Cc4-npany'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. 1 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
-----C-NER or GENT
The foregoing instrument was acknowledged before me this
4isi8 day of DeC'tw.iaa. r' , 20 17 . by
sKA,VA.b 11.toTli444/1 , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PJ.IBLIC:
Sign: J
Print: 144 rl
Seal: �DONAtO MARTIN
f•
`i MY COMMISSION # GG102743
?,y ♦��EXPIRES May 09, 2021
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
j, / 5 / b./
day offl De -4e htbe r , 20 % by
A2PO (t ''1"/C- , who is personalty known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
JA7-
nele A'1441'/1
ihv DONALD MARTIN
._ MY COMMISSION # GG102743
-'i
;rr,iii:
EXPIRES May 09, 2021
*********** ***********************************************************************************************
APPROVED BY l Plans Examiner Zoning
(Revised02/24/2014)
Structural Review Clerk
PERMIT #: 13 -SM -1793147
STATE OF FLORIDA
DEPARTMENT OF HEALTH APPLICATION #: AP1309409
ONSITE SEWAGE TREATMENT AND DISPOSAL DATE PAID:
SYSTEM
FEE PAID:
CONSTRUCTION PERMIT
RECEIPT #:
DOCUMENT #: PR1081194
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT:
SHARON MOTIANI
PROPERTY ADDRESS: 25 NE 108 St
LOT: 11
Miami, FL 33161
BLOCK: 215 SUBDIVISION:
PROPERTY ID #: 11-2136-011-0430
[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 [ 1,050 ] GALLONS / GPD Septic CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps ( 1
D [ 500 ] SQUARE FEET Trench confiauration SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [x] TRENCH [ ] BED [ ]
N
F LOCATION OF BENCHMARK: CL NE 108 st., 10.94' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED:
0
T
H
E
R
[ 0.00 ] INCHES
[ 3.96 ] [1 INCHES
[ 26.04 ] [I INCHES
FT ] [1 ABOVE jf BELOW ] BENCHMARK/REFERENCE POINT
FT ][ ABOVE /�BELOW I]BENCHMARK/REFERENCE POINT
EXCAVATION REQUIRED: [ 72.00] INCHES
*Invert elevation of drainfield to be no less than 9.27' NGVD.
*Bottom of drainfield elevation to be no less than 8.77' NGVD.
*Install 42" of slightly limited soil under the bottom of drainfield.
-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 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of
400 gpd.
The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with
s. 64E -6.013(3)(f), FAC.
SPECIFICATIONS BY: Teresa J Solomon
APPROVED BY:
TITLE:
Carlos M Icaza
DATE ISSUED: 11/03/2017
TITLE: Master Septic Tank Contractor
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
v 1.1..4
AP1309409
Dade CHD
EXPIRATION DATE: 05/03/2019
SE1052554
Page 1 of 3
12/18/2017 Miami -Dade Official Records - Print Document
V1LL CALL FOR TRI COUNTY
;/O TITLE GUARANTY OF S.
LORIDA, INC.
THIS INSTRUMENT PREPARED BY AND RETURN TO:
111111111111111111111111111111111111111111111
CFN 2OO9RO91388I
OR Bk 27125 Pss 1758 - 1760; (3oss)
RECORDED 12/22/2009 15:53:42
DEED DOC TAX 1,950.00
HARVEY RUVIN, CLERK. OF COURT
CIIAMI-DADE COUNTY, FLORIDA
Title Guaranty of Scarth Florida
4470 Weston Road
Davie, FL. 33331
Property Appraises Parcel identification (Folio) Nambeaa: I I a i3L 1 1
Space Above Tbis Line For Recording Data
THIS WARRANTY DEED, made the 2O'g day of NOVEMBER 2009 by TANLSHA GARY and SEKOU GARY ,
whose post office address is 25 NE 104 ST . ora to SHARAD MOTIANI and
PUJA MOMANI , whose post office address' berm eina9er called the Grantees:
(Wherever used basin the roma "grantor" mea yrwaee" aseiadr the parties to this hu5•aard and des heirs. legal r.premamArar
dad autms grOdividaaLs, and ire secosoort and mu[ycu
W 1 T N E S S E T H: That the grantors, for and in consideration of the SUM of TEN AND Od100'S ($10.00) Dollars and
other valuable considerations, receipt whereof is hereby arimowledged, hereby grants, hergains, sells, *lima, remise,
releases, conveys and confirms unto the grantee all that certain land situate in Miami Dade County, State of Florida, viz:
See Attached Exhibit A
Lot 11 Block 215 Dosings, Miami Wiens
Subject to easeseeMs, restrictions and reservations of record and taxes for the yeast 2009 and thereafter.
TOGETHER, with all the tenements, heeditaments and appurtenances thereto belonging et in anywise appertaining.
TO HAVE AND TO HOLD, the sane m fee simple forever.
AND, the grant= hereby covenant with said grantees that the grantors ere lawlWly seized of said land in fee simple; that
willthe grantors ego right sod lawful authority to sell and convey said land, and Beeby entrant the tide to said las and
same against the lawful claims of all persons whomsoever, and that said land is free of all encumbrances,
except axes accruing subsequent to December 31.2008.
IN WITNESS WHEREOF, the said granites have signed and sealed these presents the day and year first above written.
2's page of
File No: PS88
Book27125/Page1758 CFN#20090913880 Page 1 of 3
https://www2.m iam i-dadeclerk.com/Offi ci al Records/Pri ntDocum ent.aspx?QS=YaoUfOzxryl syiyl %2bbVsrGayCQ861 Tj N GU 3vgBxcN W tsyZBAbzO%2bH 6Yq... 1/3
12/18/2017
Miami -Dade Official Records - Print Document
`Tp S'.
Wimems A2 Printed Name
The foregoing instrument was acknowledged before me thisra0day of November, 2009 by T GARY
and SEKOU GARY who are personally known to me or have produced _ 11 as
identification.
SEAL
My Commies' Expires:
Pile No: PS88
T D SHAH
NOTARY PUBLIC
EXPIRES Al i(;!) 7, 2°12_,
Book27125/Page1759 CFN#20090913880 Page 2 of 3
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Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-296182 Permit Number: PL -12-17-2961
Scheduled Inspection Date: January 30, 2018
Inspector: Hernandez, Rafael
Owner: MOTIANI, SHARAD & PUJA
Job Address: 25 NE 108 Street
Miami Shores, FL 33161 -
Project: <NONE>
Contractor: MR C'S PLUMBING & SEPTIC INC
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Septic
Phone Number (305)323-1964
Parcel Number 1121360110430
Phone: (305)651-7859
Building Department Comments
INSTALL SEPTIC TANK AND DRAINFIELD
µtis„. jo (0S( 1'+,4-
Infractio Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP-294068. HRS APPROVAL ON
FILE
Pe- (10 t c)toc5(
4.-F=QA0
January 29, 2018
For Inspections please call: (305)762-4949
Page 42 of 59
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
APPLICANT: SHARON MOTIANI
APPLICATION # : AP 1309409
PERMIT # :13 -SM -1793147
DOCUMENT #: F11148350
DATE PAID :10/04/2017
FEE PAID:375.00
RECEIPT x:13 -PID -3406222
AGENT: MR. C
PROPERTY ADDRESS: 25 NE 108 St Miami, FL 33161
LOT: 11
SUBDIVISION:
BLOCK: 215
ID#: 11-2136-011-0430
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION
[01]
[02]
[03]
[04]
[05]
[06]
[07]
[08]
[09]
TANK SIZE [1] 1050.00 [2]
TANK MATERIAL
OUTLET DEVICE
Fiberglass
MULTI-CHAMBERED Er Y V N ]
OUTLET FILTER Tuf-Tite
LEGEND 1. 70-156-10DC3 2.
WATERTIGHT
LEVEL
DEPTH TO LID
DRAINFIELD INSTALLATION
[10]
[11]
[12]
[13]
[14]
[15]
[16]
[17]
[18]
[19]
[20]
[21]
FILL
[22]
[23]
[24]
[25]
[26]
AREA [1] 600
[2]
DISTRIBUTION BOX
NUMBER OF DRAINLINES
DRAINLINE SEPARATION
DRAINLINE SLOPE
DEPTH OF COVER
ELEVATION [ ABOVE /
SYSTEM LOCATION
DOSING PUMPS
SQPT
HEADER X
1. 5.00 2.
BELOW
l BM 30.36
AGGREGATE SIZE
AGGREGATE EXCESSIVE FINES
AGGREGATE DEPTH
/ EXCAVATION MATERIAL
FILL AMOUNT
FILL TEXTURE
EXCAVATION DEPTH
AREA REPLACED
REPLACEMENT MATERIAL
Comments: Comments are on page 2.
SETBACKS
SURFACE WATER
DITCHES
PRIVATE WELLS
PUBLIC WELLS
IRRIGATION WELLS
[27]
[28]
[291
[30]
[31]
[32]
[33]
[34]
[35]
POTABLE WATER
5
BUILDING FOUNDATIONS
PROPERTY LINES
OTHER
FILLED / MOUND SYSTEM
[36]
[37)
[38]
[39]
18
FT
FT
FT
FT
FT
FT
3 FT
FT
FT
DRAINFIELD COVER
SHOULDERS
SLOPES
STABILIZATION
ADDITIONAL INFORMATION
[40] UNOBSTRUCTED AREA
[41] STORMWATER RUNOFF
[42] ALARMS
[43] MAINTENANCE AGREEMENT
[44] BUILDING AREA
[45] LOCATION CONFORMS WITH SITE PLAN
[46] FINAL SITE GRADING
[47] CONTRACTOR Teresa J Solomon (Statewide
[48] OTHER ADS ARC 24
ABANDONMENT
[49] TANK PUMPED
[50] TANK CRUSHED & FILLED
CONSTRUCTION [
FINAL SYSTEM
APPROVED
APPROVED
DISAPPROVED ] : ENGIN
DISAPPROVED ]:
(Explanation of Violations on following page)
<I
Dade CHD DATE:
ECIALJST I Yvenel Clermont (Florida Department of Hea
12/21/2017
Dade CHD DATE : 12/21/2017
ENGINEERING SPECIAUST 1 Yvenel Clermont (Ronda Department of He
DE 4016, 08/09 (Obsoletes all previous editions which may
Incorporated: 64E-6.003, FAC
EH Database v1.0.1
AP1309409
not be used)
E!D1793147
Page 2 of 3
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
APPLICATION # : AP 1309409
PERMIT # :13-S M-1793147
DOCUMENT # : F11148350
DATE PAID :10/04/2017
FEE PAID :375.00
RECEIPT #: 13 -PI D-3406222
Violation Number
Comment
Comments
The system is sized for 4 bedrooms with a maximum occupancy of 8 persons (2 per bedroom), for a total estimated flow of 400
glad.
1050 GAL. SEPTIC TANK
600 SF TRENCH CONFIGURATION DF
5 LINES X 8 ADS ARC 24 CHAMBERS
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC
EH Database v 1.0.1
API309409
EID1793147
Page 2 of 3