PL-17-2020Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number:INSP-287597 Permit Number: PL-8-17-2020
Scheduled Inspection Date: May 21, 2018
Inspector: Hernandez, Rafael
Owner: BARRANTES, JACQUELINE
Job Address: 9879 NE 13 Avenue
Miami Shores, FL
Project <NONE>
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Septic
Phone Number (917)698-2863
Parcel Number 1132050090490
Contractor: MR C'S PLUMBING & SEPTIC INC Phone: (305)651-7859
Building Department Comments
SEPTIC TANK AND DRAINFIELD
Infractio Passed Comments
INSPECTOR COMMENTS
False
Inspector Comments
Passed
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
r(te
May 18, 2018
For Inspections please call: (305)762-4949
Page 2 of 22
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Permit NO. PL-8-1 7-2020
Permit Type: Plumbing - Residential
Work Classification: Septic
Permit Status: APPROVED
Issue Date: 8/24/2017
Expiration: 02/20/2018
Parcel Number
Applicant
9879 NE 13 Avenue
Miami Shores, FL
1132050090490
Block: Lot:
JACQUELINE BARRANTES
Owner Information
Address
Phone
CeII
JACQUELINE BARRANTES
9879 NE 13 Avenue
MIAMI SHORES FL 33138-
(917)698-2863
i
9879 NE 13 Avenue
MIAMI SHORES FL 33138-
Contractor(s)
Phone
CeII Phone
MR C'S PLUMBING & SEPTIC INC (305)651-7859
Valuation:
$ 8,000.00
Total Sq Feet: 432
Type of Work: SEPTIC TANK AND DRAINFIELD
Type of Piping:
Additional Info:
Bond Return :
Classification: Residential
Scanning: 3
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$4.80
$4.50
$4.50
$1.60
$300.00
$9.00
$6.40
$330.80
Pay Date Pay Type
Invoice # PL-8-17-64827
08/09/2017 Credit Card
08/24/2017 Check #: 328
Amt Paid Amt Due
$ 50.00 $ 280.80
$ 280.80 $ 0.00
Available Inspections:
Inspection Type:
HRS Approval
Final
Review Plumbing
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 sume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for E C L, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFI
construction a
ceriifythat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
thermore, I authorize the above -named contractor to do the work stated.
August 24, 2017
Autlt6rized Signature: Owner / Applicant / Contractor / Agent
Date
Building Department Copy
August 24, 2017 1
BUILDING
PERMIT APPLICATION
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
RECEIVED
AUG 092017
FBC 2014 pp�
Master Permit No. G 15 — 15 4,•T
Sub Permit No. — 2. 0
El BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION
$PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION
G� (, CONTRACTOR
JOB ADDRESS: 9 O q of+E ! ✓ 'ce
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: l 1 — 3a 05 " otyi 04 (� Ms the Building Historically Designated: Yes
Occupancy Type: Load: Construction Type: Flood Zone:
OWNER: NameJ (Fee Simple Titleholder): a. (L1 tie tono ( VY ar A „.S
m
Address: '1 gq'a �CG [ 3 (Li
City: M ct JA, SV Avc.% State: t ,
Tenant/Lessee Name:
❑ RENEWAL
❑ SHOP
DRAWINGS
BFE: FFE:
Phone#: 6hl•t,�i� r7it
Zip: 3 3 1 U
Phone#:
Email:
.�,�,r c� PI�:.5 rsd,h�
CONTRACTOR: Company Name:
D 1 °tq3)- N&)
l"�ta f , State:
Name: � t L ��
Address:
City:
Qualifier
State Certification or Registration #:
DESIGNER: Architect/Engineer:
Address:
S12D6fS36.
Ni A -
Value of Work for this Permit: $ (3.-1) 0 • Qv
Type of Work: ❑ Addition ❑ Alteration
Phone#:
Phone#: 36S4S1-780 i
Zip: 31 �9
.3b %-6sl-Z
Certificate of Competency #:
Phone#:
City: State: Zip:
Square/Linear Footage of Work:
XNew
T3Z
Repair/Replace ❑ Demolition
Description of Work:
3 ern C- t A &&L tl- R-4-(
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Permit Fee $
CCF $ CO/CC $
Radon Fee $ DBPR $ Notary $
Training/Education Fee $ Double Fee $
Bond $�k-G����s- [
TOTAL FEE NOW DUE $ 1--50 • 60
` Bonding Company's Name (if applicable) Ni"
Bonding Company's Address r
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. 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. 1 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 commence t must be posted at the job site
for the first inspection h occurs seven (7) days after the building permit is issued. In the abse ce of such posted notice, the
inspection will not b
Signature
and a reins ' ct: • fee will be charged.
ignature
CONTRACTOR
Theeq g W
foregoing inst ment w ss�a/cknowl - • : • efore me this The fore oing instrument was acknowledged before me this
Of, day of �, 20 1' , by day of L , 20 i1 , by
/ Lj ��jj'' I J
,%,1K!/nc, 4rret4 5 , who is personally knnwrnto MDIrG , who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
,(+A DONALD MARTIN
MY COMMISSION * GG102743
EXPIRES May 09, 2021
**************..111t111
APPROVED BY
(Revised02/24/2014)
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal:
*******************
Plans Examiner
DONALD MARTIN
MY COMMISSION 0 00102743
frk` R EXPIRES May 00, 2021
11
Zoning
Structural Review Clerk
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Jacqueline Barrantes
PERMIT #: 13-SC-1628524
APPLICATION #: AP 1203268
DATE PAID:
FEE PAID:
RECEIPT #•
DOCUMENT #: PR998483
PROPERTY ADDRESS: 9879 NE 13 Ave Miami, FL 33138
LOT: 4
BLOCK: 4
PROPERTY ID # : 11-3205-009-0490
SUBDIVISION: Earleton Shores
[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 [
A [
N [
K [
D
R
A
I
N
F
I
E
L
D
0
T
H
E
R
700 ] GALLONS / GPD housing .90 Microfast unit CAPACITY
900 ] GALLONS / GPD Pretreatment tank CAPACITY
] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
375 l GALLONS DOSING TANK CAPACITY [77.00 ]GALLONS e[ 6 (DOSES PER 24 HRS #Pumps ( 1 ]
[ 432 ] SQUARE FEET Drip irrigation in trench con SYSTEM
[ ] SQUARE FEET
TYPE SYSTEM: [ ] STANDARD
CONFIGURATION: [x] TRENCH [ ] BED ( l
SYSTEM
[x] FILLED [ ] MOUND
LOCATION OF BENCHMARK: center line NE 13 Ave. 4.39' NGVD
ELEVATION OF PROPOSED SYSTEM SITE ( 8.52 1 [) INCHES I FT ] (I ABOVE ' BELOW ]BENCHMARK/REFERENCE
BOTTOM OF DRAINFIELD TO BE ( 7.52 l (I INCHES FT Hi ABOVE (r BELOW ] BENCHMARK/REFERENCE
FILL REQUIRED:
[ 17.00] INCHES
EXCAVATION REQUIRED: ( 43.20 INCHES
POINT
POINT
*" ATU Drip Irrigation system designed by Cesar Mera, PE.
*`Performing Lift Dosing. "Pumps must be certified as suitable for distributing sewage effluent.
**MOUND SYSTEM - This is a mound system and must comply with all the requirements of Chapter 64E-6.009(3).
** Maintenance entity agreement and DOH operating permit required prior to final approval.
1.-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.
(Comments Continued on Page 2.)
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED:
Erlande Otaiece
12/18/2015
DH 4016, 08/09 (Obsoletea
Incorporated: 64E-6.003,
TITLE:
TITLE: Engineering Specialist II
all previous editions which may not
FAC
v 1.1.4 AP1203268
Dade
EXPIRATION DATE:
06/18/2017
CHD
be used)
45T el
- sr & 3y�'c YFt ii(i
.>; r-rAa1.36-x]6nc^
i na ccn:ra::.. (r de ::;!e) s rz uirei to a soil boring
:e: e:1t tc �...{?l;, at:. fl atT the time of r'.:1a1
ir,apcc . P f'.r .� i ,r.al Approval, tip:. FL�OK inspector shall
witness t' .. s,, --ink ara co;npare rr ult3 to the original
site evatuatio:1 s!:b•ritted. A reinspect en Sea will be assessed
;f the r:ntractor is net at the jobsite at the arranged time..
1 111111 $1I11 ill
1111111111111111111111111
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO.
STATE OF FLORIDA:
COUNTY OF MIAMI-DADE:
iTATE OF FLORIDA, COU
THE UNDERSIGNED hereby gives notice that improvements will IMEAYa 4 : ea%ii•r'(r iS'
property, and in accordance with Chapter 713, Florida Statutes, th06lF8
is provided in this Notice of Commencement.
inTN
1AR
Ay
1. Legal des
tion of prqp�eaty d str et/address:
N(i 1.5 Aven uk2.
2. Description of improvement:
AILiv/ , A 0 20
if/;AW
nd On.al Seal.
F,.,'. �� aunty Courts
riff
II /,114_ D.C.
r-FN 20 ;:
DRBK. 31)647 P9
.lA!i-6,1t
ri T. f Si:(1
OF DADE
py of the
O
7 R04-Cc96'79'
2907 (:P95•)
y CLERK
RIR
Space above reserved for use of recording office
P6 LI-3 -860 4f BIk.
t ,c• a vsra►•'[�8 e• `19' 19 3 AY
N CAve-al'anu mer10 .
3. Owner(s) name and address: JQtuP� n
Interest in property: QtUnP.r'
Name and address of fee simple titleholder: ics at (ski e-
4. Contractor's name, address find phone number: C tS pil.L t 01 k S ► . t i Ae—.•
L t9b - Nu,) a- AveAvtZ l�l.�?xwu I Pc. at 9
5. Surety: (Payment bond required by owner from contractor, if any)
Name, address and phone number:
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)7., Florida Statutes,
Name, address and phone number:
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes.
Name, address and phone number:
9. Expiration date of this Notice of Commencement: Q' t o1.0
(the expiration d e is 1 year from the date of recording unless a different date Is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK
OR RECORDING YO OTCE OF C• ,MENCEMENT
Signature(s) of 0 or 0 , ner(s) Authori - • ' - Director/Partner/Manager
Prepared By Alli► Prepared By
Print Name 'ri%IMiI1 i '. Print Name
Title/Office Title/Office
STATE OF FLORI
COUNTY OF MIAMI-DADE
The foregoing instrument was a knowledged before me this day of
By jAi V�?J/Vg '6-74-44,9-Ar?%S
❑ Individually, or ❑ as for
personally known, or ❑ produced the following type of identification:
Signature of Notary Public:
Print Name:
(SEAL)
VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES
Under penalties of perjury, I declare that I have read the foregoing and KEMBLE ETiRICK
that the facts stated in it are true, to the best of my knowledge and belief.,1\aNotary Public -State of Florida
My Comm. Expires Sep 19, 2017
Signature of Ow er(s) ner(s)'s Authorized Officer/Director/Partner/Manager who sig'ed'at ve > Comm #
"r Bo1 nded Through Nationalission FF Notary055732ssn. A
By By
LnuS . ,Ro/ %
0/19 e
7
123 O1-52 PAGE3