PL-18-69 f
i
-inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-295119 Permit Number: PL-1-18-69
Scheduled Inspection Date: March 13, 2018 Permit Type: Plumbing - Residential
Inspector. Hernandez, Rafael
Inspection Type: Final-
Owner: MALAMED,ADAM Work Classification: Drainfield
Job Address:9215 N BAYSHORE Drive
Miami Shores, FL 33138-
Phone Number (917)685-2273
Parcel Number 1132050270590
Project: <NONE>
Contractor: MR C'S PLUMBING&SEPTIC INC Phone: (305)651-7859
Building Department Comments
DRAINFIELD REPAIR tnfractio 9 Passed Comments
INSPECTOR COMMENTS False
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Inspector Comments
Passed HRS APPROVAL ON FILE
Failed D
Correction
Needed ❑
Re-Inspection a
Fee
I No Additional Inspections can be scheduled until
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re-inspection fee is paid.
MaFch 12,2018 For Inspections please call: (305)7624949 Page 15 of 44
s � •, DIVISION OP
Environmental.Health':nc a .g
Florida,Healtli
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O .Miami-Dade County
oQ� r s: OSTDS/Well Division �-
`;` 11805 SW 26th Street•Miami,FL 33175
t rInspector 0��" '.�r���� Date
` . Address. 0STDStl# /7 /
Comments:
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s Signature
Permit NO. PL-1-18-59
�sµO1kEs y� Miami Shores Village Permit Type:Plumbing-Residential
5 �r 10050 N.E.2nd AN
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venue e, rt� lNorkClassification:Dra nfield
Miami Shores,FL 33138-0000 PPermit Status:APPROVED
Phone: (305)795-2204
�'CORtDP'
Issue Date:1/2312018 Expiration: 07122/2018
Project Address Parcel Number Applicant
9215 N BAYSHORE Drive 1132050270590
Miami Shores, FL 33138- Block:4 Lot:6 ADAM MALAMED
Owner Information Address Phone Cell
ADAM MALAMED 9215 N BAYSHORE Drive (917)685-2273 (305)572-4105
MIAMI SHORES FL 33138-
9215 N BAYSHORE Drive
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone
Valuation: $ 2,450.00
MR C'S PLUMBING&SEPTIC INC
(305)651-7859
Total Sq Feet: 400
Type of Work:DRAINFIELD REPAIR Available Inspections:
Type of Piping: Inspection Type:
Additional Info:
HRS Approval
Bond Return: Final
Classification:Residential Scanning:3 Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Owners Bond $500.00
CCF Invoice# PL-1-18-66087
$1.80 01/09/2018 Credit Card $50.00 $618.05
DBPR Fee $2.25
DCA Fee $2.00 01/23/2018 Credit Card $ 118.05 $500.00
Education Surcharge $0.60 01/12/2018 Check#:3172 $500.00 $0.00
Permit Fee
$150.00 Bond#:3609
Scanning Fee $9.00
Technology Fee $2.40
Total: $668.05
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 b er rxyself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDO O ROOFING and SWIMMING POOL work.
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OWNERS AFFIDAVIT: I certify that all the foregoing informati a c rat and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above-nam ntra�Ct o the work stated.
January 23, 2018
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
January 23, 2018 1
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romrty Addnos: 9215 NORTH BAYSHORE DRIVE NOTES:ALUMINIUM DOCK ENCROACHE OVER EAST
MIAMI SHORES,FL 33138 LOT UNE.
4'17 G ��G-�-dL S• '1 -�Zj
�S Miami Shores VillagetREC0VffDD% .
�k\ 2018
Building Department ,i y 10050 N.E.2nd Avenue, Miami Shores,Florida 33138LY. o
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20
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BUILDING Master Permit No.. I
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
QPLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
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JOB ADDRESS: 9215 N BAYSHORE DRIVE
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 1 1-3205-027-0590 Is the Building Historically Designated:Yes NO X`
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):ADAM MALAMED Phone#:
Address:9215 N BAYSHORE DRIVE
City: MIAMI SHORES State: FL Zip: 33138
Tenant/Lessee Name: NA Phone#:
Email:
CONTRACTOR:Company Name: MR. C'S PLUMBING & SEPTICphone#: 305-651-7859
J Address: 19932 NW 2ND AVENUE
City: MIAMI State: FL Zip: 33169
Qualifier Name: KEMBLE ETTRICK Phone#: 305-651-7859
State Certification or Registration#: SR061536 Certificate of Competency#:
DESIGNER:Architect/Engineer: NA Phone#:
Address: City: State: Zip:
Value"of Work for this Permit:$2450 Square/linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑■ Repair/Replace ❑ Demolition
Description of work: DRAINFIELD REPAIR
Specify color of color thru tile:
Submittal Fee$ � a) Permit Fee$ / CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
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Structural Reviews$ Bond$ T rW` )
TOTAL FEE NOW DUE$ I 1 uV
(Revised02/24/2014)
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Bonding company's Name(if applicable) NA
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable) NA
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 ence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
' The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
13th day Qf December 20 17 by 8th /daay of January
�J� --------J,20 18 by
Kam: a vl who is personally known t• el'�J(� [� ��\ ,who is personally known to
me or who has produced yV II e5 �l!��^SG as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
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'Sign: ' WJA141--
Sign: "P
Print: Print: 21k, I A ✓l
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Seal: ,'I`�P DONALD MARTIN Seal: 's"" DONALD MARTIN
MY COMMISSION#GG102743 MY COMMISSION#
6G102743
Ial�; EXPIRES May 09,2021b.''00 EXPIRES May 09,2021
APPROVED BYrat !/" Plans Examiner Zoning
Structural Review Clerk
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(Revised02/24/2014)
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PERMIT #: 13-SM-1810244
STATE OF FLORIDA APPLICATION #:AP1320242
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DEPARTMENT OF HEALTH DATE PAID:
* ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID:
SYSTEM
RECEIPT #:
DOCUMENT #: PR1087109
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Adam Malamed
PROPERTY ADDRESS: 9215 Bayshore Dr Miami, FL 33138
LOT: 6 BLOCK: 4 SUBDIVISION:
PROPERTY ID #: 11-3205-027-0590 [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 Existina Septic Tank to remain 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 [ 400 ] SQUARE FEET NEW DF IN BED CONFIG SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [X] BED [ ]
N
F LOCATION OF BENCHMARK: FIFE......10.80'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 32.40 ] [ INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 72.40 ] [ INCHES FT ] [ ABOVE BELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [ 0.00 ] INCHES EXCAVATION REQUIRED: [ 64.00 ] INCHES
1.-EXISTING 1050 GALLONS septic tank with and approved filter TO REMAIN.
0 2.-The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance G0
T with s.64E-6.013(3)(f) FAC. de
H 3.- Install 400 sf. of drainfield in ...BED....... configuration.
4.- Install 24"of slightly limited soil at the bottom of the drainfield.
E 5.-Invert elevation and Bottom of drainfield to be no less than 5.26'& 4.76' NGVD respectively
R THIS PERMIT IS NOT FOR ANY ADDITIONS.
SPECIFICATIONS BY: Kemble trick TITLE:
APPROVED BY: TITLE: Engineering Specialist II O Dade CHD
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DATE ISSUED: 12/2672MV EXPIRATION DATE: 03/26/2018
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1.4 AP1320242 SE1058246
•
DOCUMENT #: PR1087109
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-fhe licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with s.
64E-6.013(3)(f), FAC. Required drainfield area based on rule 64E-6.015(6)(c)2.
Install a new drainfield to achieve Drainfield size requirement.
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{
+(}it APPLICATION # AP1320242 Nr
STATE OF FLORIDA I It
PERMIT # 13-SM-1810244 cV
DEPARTMENT OF HEALTH C:)
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ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM DOC # RE407184 00
s � EXISTING SYSTEM AND SYSTEM REPAIR
EVALUATION U?
APPLICANT: Adam Malamed
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CONTRACTOR / AGENT: Adam Malamed
LOT:a 6 BLOCK: 4 SUBDIVISION: ID#: 11-3205-027-0590
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TO BE COMPLETED BY A FLORIDA REGISTERED ENGINEER, DEPARTMENT EMPLOYEE, SEPTIC TANK CONTRACTOR OR OTHEF
1
CERTIFIED PERSON. SIGN AND SEAL ALL SUBMITTED DOCUMENTS. COMPLETE ALL APPLICABLE ITEMS. COMPLETE TANF
CERTIFICATION BELOW OR NOTE IN REMARKS WHY THE TANKS CANNOT BE CERTIFIED.
EXISTING TANK INFORMATION
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[ 1050 ] GALLONS Septic Tank LEGEND: Unknown MATERIAL:Concrete BAFFLED: [I Y Y N ]
[ ] GALLONS LEGEND: MATERIAL: BAFFLED: [ Y / N ]
4 `
[ ] GALLONS GREASE INTERCEPTOR LEGEND: MATERIAL:
[ ] GALLONS DOSING TANK LEGEND: MATERIAL: # PUMPS: [ ]
I CERTIFY THAT THE ABOVE NOTED TANKS WERE PUMPED ON 12/04/2017 BY Mr C Plumbing & Septic HAVE
THE VOLUMES SPECIFIED AS DETERMINED BY 11DIMENSIONS FILLING / LEGEND ], ARE FREE OF OBSERVABLE
DEFECTS OR LEAKS AND HAVE A [ SOLIDS DEFLECTION DEVICE / OUTLET FILTER DEVICE ] INSTALLED.
E (Mr. C"s Plumbing&Septic) 12/26/2017
SIGNATURE OF LICENSED CONTRACTOR BUSINESS NAME DATE
EXISTING DRAINFIELD INFORMATION
[ '400 ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM NO. OF TRENCHES [ ] DIMENSIONS: 25.00 X 16.00
[ E ] SQUARE FEET SYSTEM NO. OF TRENCHES [ ] DIMENSIONS: X
TYPE OF SYSTEM: [X ] STANDARD [ ] FILLED [ J MOUND [ ]
CONFIGURATION: [ ] TRENCH [X ] BED [ j
DESIGN: [X ] HEADER [ ] D-BOX [X] GRAVITY SYSTEM [ J DOSED SYSTEM
ELEVATION OF BOTTOM OF DRAINFIELD IN RELATION TO EXISTING GRADE 40.00 INCHES [ ABOVE
SYSTEM FAILURE AND REPAIR INFORMATION
[ 01/01/1976 ]' SYSTEM INSTALLATION DATE TYPE OF WASTE [X] DOMESTIC ( ] COMMERCIAL
[ 400 ] GPD ESTIMATED SEWAGE FLOW BASED ON [ ] METERED WATER [ X] TABLE 1, 64E-6, FAC
SITE [ ] DRAINAGE STRUCTURES [ ] POOL [ ] PATIO / DECK [X] PARKING
CONDITIONS: [ ] SLOPING PROPERTY [ ]
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NATURE OF [ ] HYDRAULIC OVERLOAD [ ] SOILS [X] MAINTENANCE [ ] SYSTEM DAMAGE
FAILURE: [ ] DRAINAGE / RUN OFF [ ] ROOTS [ ] WATER TABLE [ ]
FAILURE [ ] SEWAGE ON GROUND (X ] TANK [ ] D-BOX / HEADER [X] DRAINFIELD
SYMPTOM: [X ] PLUMBING BACKUP [ ]
I
SUBMITTED BY: TITLE/LICENSE DATE: 12/18/2017
Kemble Ettrick(Mr C"s Plumbing)
DH 4015, 08/09 (Obsoletes previous editions which may not be used)
Incorporated 64E-6.001, FAC 1 Page 4 of 4
V 1.0.0 AP1320242 EID1810244
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1/9/2018 Property Search Application-Miami-Dade County
OFFICE OF DHE PROPERTY
Summary Report,
Generated On:1/9/2018
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Property Information
Folio: 11-3205-027-0590 -
W N�y
Property Address: 9215 N BAYSHORE DR
Miami Shores,FL 33138-2948
Owner ADAM MALAMED
9215 N BAYSHORE DR
Mailing Address MIAMI,FL 33138 USA
a
PA Primary Zone 1400 SGL FAMILY-3001-3250 SQ
Primary Land Use 0101 RESIDENTIAL-SINGLE
FAMILY:1 UNIT w
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Beds/Baths/Half 413/0
Floors 2
Living Units 1
Actual Area 4,480 Sq.Ft
Living Area 3,500 Sq.Ft
Adjusted Area 3,571 Sq.Ft
Lot Sae 13,861 Sq.Ft Taxable Value Information
Year Built 1976 2017 2016 2015
County
Assessment Information Exemption Value 1 $50,000 $50,000 $50,000
Year 2017 2016 2015 Taxable Value $2,246,205 $2;198,9771 $2,183,344
Land Value $1,766,183 $1,766,183 $1,635,355
School Board
Building Value $556,183 $562,432 $568.682 Exemption Value $25,000 $25,000 $25,000
XF Value $44,803 $45,290 $29,307 Taxable Value 1 $2,271,205 $2,223,977 $2,208,344
Market Value $2,367,169 $2,373,905 $2,233,344 City
Assessed Value $2,296,205 $2,248,977 $2,233,344 Exemption Value $50,000 $50,000 $50,000
Taxable Value 1 $2,246,2051. $2,198,977 $2,183,344
Benefits Information
Regional
Benefit Type 2017 2016 2015 Exemption Value 1 $50,000 1$50,000 $50,000
Save Our Homes Cap Assessment Reduction $70,964 $124,928 Taxable Value $2,246,2051 $2,198,9771 $2,183,344
Homestead Exemption $25,000 $25,000 $25,000
Second Homestead I Exemption 1$25,000 $25,0001$25,000 Sales Information
Note:Not all benefits are applicable to all Taxable Values(i.e.County,School Previous OR Book-
Board,City,Regional). Sale Price Page Qualification Description
03/31/2014 $2,700,000 29091-4126 Qual by exam of deed
Short Legal Description
08/02/2012 $100 28228-1097 Corrective,tax or QCD;min
5 53 42 consideration
BAY LURE PB 44-63 Financial inst or"In Lieu of
07/15/2011 $1,700,000 27779-0243
LOT 6 BLK 4 Forclosure"stated
LOT SIZE 83.000 X 167 05/16/2011 $100 27730-2347 Financial inst or"In Lieu of
Forclosure"stated
OR 19152-0772 06 2000 1
The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser
and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at http://www.miamidade.govrinfo/disclaimer.asp
Version: l
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