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PL-10-234Inspection Number: INSP - 135678 Scheduled Inspection Date: June 04, 2010 Inspector: Hernandez, Rafael Owner: MITCHEL, KELLEY Job Address: 10320 NW 2 Avenue Miami Shores, FL 33150- Project: <NONE> Contractor: MR C'S PLUMBING SEPTIC INC Building Department Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments HRS APPROVAL IN FILE (c( June 03, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Number: PL -2 -10 -234 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Drainfield Phone Number (786)326 -6920 Parcel Number 1121360161100 Phone: (305)651 -7859 Page 2 of 4 10 - 3-1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 10320 2 Avenue Miami Shores, FL 33150- 1121360161100 Block: Lot: KELLEY MITCHEL Owner Information Contractor(s) MR C'S PLUMBING SEPTIC INC Phone Cell Phone (305)651 -7859 (305)651 -5652 Fees Due Bond Type - Owners Bond CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $300.00 31.20 $0.40 $150.00 33.00 $50.00 ($50.00) 31.60 $456.20 Building Department Copy March 01, 2010 Address Penz3it Tom. Plc tt Wor t �ssifrc r: Drain Parcel Number Phone eid Expiration: 08/18/2010 Applicant Cell KELLEY MITCHEL 10320 2 Avenue MIAMI SHORES FL 33150 -0000 (786)326 -6920 (305)893 -0954 • Valuation: Total Sq Feet: $ 2,000.00 Type of Work: REPLACE 300 DRAINFIELD Type of Piping: Additional Info: PLUMBING Bond Retum : Classification: Residential Invoice # PL -2 -10 -37056 Bond #: 1926 Invoice Total Amt Paid Amt Due $456.20 $456.20 $0.00 Check #: 6113 For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Final Rough Landscaping 1 2 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 200 Permit Type: Plumbing Owner's Name (Fee Simple Titleholder) K Ac `e l ( Phone # 1 f Owner's Atldress 1 0 b NUJ c & Fe SS City ���'"<t State '� Zip S✓/Jo Tenant/Lessee Name Phone # E -MAIL: Value of Work For this Permit $ Job Address (where the work is being dons) Permit No. Master Permit No. (0X2 -0 NW a -A-ve, City Miami Shores Village County Miami -Dade Zip S'' • FOLIO / PARCEL # ,t^ 'I 36 O) 0 Is Building Historically Designated YES NO l� Contractor's Company Name(h C Cis PU ... ail Ylg - 4 - St.0hhe # 'd' 6 51 7695 Contractor's Address \"t f fN GO D._ ev City I l.Ct.- 1'41 /,, State Zip at X 9'1 /� Qualifier Name V V �� la (�'�� Phone # ' Os �� State Certificate or Registration No:G`r ---4- l let A`e= 1 Certificate of Competency No. E- MAIL: Architect/Engineer's Name (if applicable)',' Phone # Square / Linear Footage Of Work: C5b Type of Work: ['Addition . ❑Alteration ['New epair/Replace [' Demolition Describe Work: FEB 1 1 2010 B• **x***** * *xx ** *** * *** *,4****** * * * * * *nX* F x**** * * * * *xx *xxx *Mx * * *KKx *x *x *x rp o) Submittal Fee $ 50. Permit Fee $ / CCF $ 1' CO /CC Notary $ Training /Education Fee $ © ,O Technology Fee $. 4(20 Scanning $ Radon $ DPBR $ Zoning $ PMD Bond $ 3 -t O Code Enforcement $ Double Fee $ gi � l° O� Structural Review. $ Total Fee Now Due $ 'a o .cco See Reverse side -- � Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a Isermit to do the work and installations as indicated. l 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 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. Sign: Signature(' (�,r o � j /4( "("-- Owne or Agent The foregoing instrument was acknowledged before me this day of {o , 20 it), by who is personally known to me or who has produced As idenf,'' . + n and who did take an oath. NOTARY PUBLIC: i 11 -I ig Print: e;,'•, KCMDI E EITRI - i My Commission EX )r s , *I4.1t EXPIRES' S p 13 **w w" xx x xfex wie xx R ty0 Publictlnd vriters _ z „ APPLICATION APPROVED BY: (Revised 02/08/06) 16 xxxx &dcxxxxx•xiexxeexd ****** Contractor The foregoing instrument was acknowledged before me this ( 6 day of T'Cle" , 20 (O, by JOIN r‘ who is personally known to me or who has produced as identificatio NOTARY PUBLIC: Sign: Print: My Commis ,p a � l KEMBLE ETTN CK 4■ • MY COMMISSION # DO 89134 • ' �� p1pE fyVti 2013 buter who did take an oath. Plans Examiner Engineer Zoning FEB.16.2010 5:11PM SOS FLORIDA DRPATOMMIT OF HEALTH AND DISPOSAL SYS cceamwestras e soa: OSTOS RepEdr 1179LZZ4NT * Kay pmeneg shoo / ■Db81ie9: 1032014012 Ave Miami, FL 33150 tar: 7 »s 10 pROatutrz ZD 0: 112130-0164100 SWAN WET H10 SZTS AND =WARM OP 381.0065, PAP., AND MASTER 64B -6, B.A.C. INNMENOINT APPROVAL OP RATIRRiternat =Women= NOR 173T Memo =moo OR T. Affix alum ?14 bnossouna mum, =Ca AS a BASIS Pait T9811 Ct3 OF Tsz8 Pte, Inignim RPIC ZCA R TO morn Tma MOUT APPLZCATI0. SUCH IIMI=MMIONS NAT Mow IN MIS Poem =Mg MN N0XL AIM Mx). MO= OF TOO > DOIS NOT =NWT THE A] ICANT imam CONPLIZNICB W2931 OMER INDERIAL, STARR, as LOCAL PEPATITTING RRIINTMED ECM DIMBIONINET OP TEES . ETETNN DREIER MD 88BCITNENETOffi8 A ffi a A x ffi x a L 0 R 1 t 900 ] Maims / eon O 1 GAUL= / tom O 1 omen man immeuxammou =sem 3 MILLM41 DOMO TAPE CAPACITT gXT.L : [ 0.00] MANS THIS PERMITIS NOT FOR ADDm0N(s). SPECIFICEXECENI PEDRO N O11PS1M APPROVED DERM 5,.._• 5(3 \J - NO. 165 P. 1 raynam #113-SC-1120853 aVIIracarD21 1 :A1 3 952247 DA NM: PPM MD: sa»ssrsaaN: D8 401.6, 10/97 Movie= Sc]Lticma Nay tad tread) v 1.1.0 sesS2247 EXCANITTON _ [ 20.001 PACERS RAT 6a Doc r 41:1 Pla�loa, aelaresze, », nem mama! tue SAN ID N0NSER1 caRnerer Etawcadom mew= maw TA36a12E0 GALLONS] MUMS 6[ 300369 PM 24 $$8 OBarnoe [ 3 [ 300 3 WET � t 0 1 3 le�b WIN SUM: [N] S [ 1 PILLED [ 1 N00.R t ] C '= : [ 1 MRCS £x1 ann [ 1 LOCATION or gam: .P.E.:12T NGVD 1TA'�'ZCOt OP »30$ED �! 1 13.70 3 1 t 7Z B00'2 [ OF DRS TO N [ 41.70 3 FT 1 [ A60VE PO 1-ExIsteg 800 Sal. septic tank certified by ` Mr Co Plumbing & Septic* on 02111/2010 to remain. 2-10sta® 300 sf of drelydleld in bbd COnilgtna6om of pecavatke area shaft be at feast 2 ft eider and to nger than the p.oposed absa►ption bed, 4- In1Vert elevation of dtotnfetd to be no less than 9-75' NGVD 8. Bog= of dtain6etd elevation to be no less Than 936 NGVD REPAIR 0lit1107a40 Dade incentAssos 1: 0511010 Page 2. of 3 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number Scale: Each block represents 10 feet and 1 inch = 40 feet 0 I X 1 57170 �ic)c� C1 3. PTL 7�N1 1 1 WA Notes: MS /LA 2 G re PART II - SITEPLAN Site Plan submitted by: (� �-- Plan Approved Not Approved T By County Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015, 10/96 (Replaces HRS-H Form 4016 which may be used) (Stock Number: 5744-002-4015-6) Date \ 0 Page 2 of 4