PL-09-1985 111 a r mmu
r Miami Shores Village
10050 N.E. 2nd Avenue r ��
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 rM
Expiration: 06131201
Project Address Parcel Number Applicant
9425 2 Place 1131010150180
Miami Shores, FL 33150- Block: Lot: CHRISTIAN PETIT
Owner Information Address Phone Cell
CHRISTIAN PETIT 9425 2 Place
MIAMI SHORES FL 33150 -2216
Contractor(s) Phone Cell Phone Valuation: $ 2,800.00
MIAMI DADE ENVIROMENTAL 786 - 251 -4099
Total Sq Feet: 300
Type of Work: For inspections please call:
Type of Piping: (305)7624949
Additional Info: Available Inspections:
Bond Retum : Inspection Type:
Classification: Residential Final
Rough
Landscaping
Fees Due Amount Invoice # Total Amt Paid Amt Due
Bond Type - Contractors Bond $300.00 PL -12-09 -36540 $ 482.80 $ 482.80
CCF $180 $ 0.00
Education Surcharge $0.60 Check #: 2376 Bond #: 1908
Permit Fee - Additions/Alterations $175.00
Scanning Fee $3.00
Technology Fee $2.40
Total: $482.80
In considera ion of the issuance to me of this permit, i agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining 9wreto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required f cff LECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS;4 FIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constructic'and zoning. Futhermore, I authorize the above -named contractor to do the work stated.
December 02, 2009
Aorized Signature: Owner / Applicant / Contractor / Agent Date
Builictng Department (Copy
December 02, 2009 1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
Permit No.
PERMIT APPLICATION Master Permit No.
FBC 200j I&-fjv
Permit Type Plumbing
Owner's Name (Fee Simple Titleholder) Rzrr - Phone ft
Owner's Address qq 25 L4J 01�0 t.
City 14 1,tot,t ! GOO State Rij- -- Zip 3 [ SCE
Tenant/Lessee Name Phone #
E -MAIL:
Job Address (where the work is being done) � `Z pu_" @_
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name H r`101W (a A b C'IJ(j( Ap"_(ft-Z5' Phone # 9(�,2 S ) —CLO g
Contractor's Address _ 8 7 2-10 L AA( _e O n S k H yi. pt,. r
City n
tl� -i-(t State �'�n— Zip ?J So
Qualifier Name Q �)iti, t 10- jrr4' Phone # -7 ?6- zs l _ Ito 0 9
State Certificate or Registration No. Certificate of Competency No.
E -MAIL:
Architect /Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ � $ 00 Square / Linear Footage Of Work: 30Q
Type of Work: ❑Addition ❑Alteration ❑New V Repair /Replace ❑ Demolition
Describe Work: I K'tCt.i `�Sw -Sa FE d F to
t iexxx >txxicxxxric>ci;r.r.xxxxxxY i:rrxic 9; x *rxxr.xx *r.�:i:r. *9;9; iczr.�aF rr;i; iexr. is c t i;xi; is r. is n'c is xi; r, 9: r. �i: i;xr.
Submittal Fee $ Permit Fee $ CCF $ CO /CC
Notary $ Training /Education Fee $ g �� Technology Fee $ 2
Scanning $ F O Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $
See Reverse side
Bonding Company'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. 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 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
CV Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this _ The foregoing instrument was acknowledged before me this
day of JJpU. _ 201M b day of , 20 _, by
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC -STATE OF FLORIDA
Jose Bolanos NOTARY PUBLIC:
Commission # DD603343
Sign: ������� Expires: OCT. 08, 2010
. Sign:
Prin • LN k—Rlr Print:
y Commission Expires: My Commission Expires:
OC!T • 0 t }
APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
(Revised 02/08/06)
PERMIT #: 13- SC -108
APPLICATION # :
STATE OF FLORIDA DATE PAID
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID:
SYSTEM RECEIPT #:
DOCUM #: PR791 882
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Christian Petit
PROPERTY ADDRESS: 9425 NW 2 PI Miami FL 33150
LOT: 10 BLOCK: 7 SUBDIVISION: Miami Shores
€SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
PROPERTY ID #: 11- 3101 - 015-0180 FOR 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 Mki 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 E 900 } GALLONS / GPD Qtic CAPACITY
A [ 0 1 GALLONS / GPD CAPACITY
x [ o } GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK.-1250 GALLONS}
K E } GALLONS DOSING TANK CAPACITY [ IGAS @[ ]DOSES PER 24 HRS #Pumps € 1
D E 225 l SQUARE FRET IMnneh g2nfioyEd2n SYSTEM
R E 0 1 SQUARE FEET SYSTEM
A TYPE SYSTEM: [ 1 STANDARD E%] FILLED [ I MOUND € 1
I CONFIGURATION: [XI TRENCH € I BED [ I
N
F LOCATION OF BENCHMARK: FF € ........... 13.80' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 25.20} INCHES FT ]E ABOVE BENCHMARK /REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE E 33.2011 INCHES FT I[ ABOVE) BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: [10.00] INCHES EXCAVATION REQUIRED: € 20.001 INCHES
O 1.- Existing gat. septic tank to remain.
2.-Install 225 sf of drainfield in TRENCH configuration.
T 3. Invert elevation of drainfield to be no less than 10.53 ft NGVD.
H 6.- Bottom of drainfietd elevation to be no less than 10.03 ft NGVD.
E
THIS PERMIT IS NOT FOR " ADDITION(s) ".
R
SPECIFICATIONS BY: Ger rd L Ph TITLE:
APPROVED BY: : Engineer specialist II Dade CHD
J eph R P verger
DATE ISSUED: 1 00 EXPIRATION DATE: 03/02/2010
DH 4016, 10/97 (Previous Editions May Be Used) Page 1 of 3
v 1.1.4 AP943684 BR8fl218?
_ STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMITr r
Permit Application Number ,
---- - - - - -- - -- —, PART II - SITE PLAN ---- r- =--. -=
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Notes: f-, Ivl9-) �� (ll to Ml Sfloo
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Site Plan submitted by: l )A - ;ItW I,OA-
Signature Title
Plan Approved _ Not Approved Date 11 -�
BY County Health Department
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015, 10!96 (Replaces HRS -H Form 4015 which may be used) Page 2 Of 3
(Stock Number: 5744.002- 4015 -6)
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 130555 Permit Number: PL -12 -09 -1985
Scheduled Inspection Date: February 19, 2010 Permit Type: Plumbing - Residential
Inspector: Hernandez, Rafael
Inspection Type: Final
Owner: PETIT, CHRISTIAN Work Classification: Drainfield
Job Address: 9425 NW 2 Place
Miami Shores, FL 33150- Phone Number
Parcel Number 1131010150180
Project: aNONE>
Contractor: MIAMI DADE ENVIROMENTAL Phone: 786- 251 -4099
Building Department Comments
New Drainfield
Inspector Comments
Passed HRS APPROVAL IN FILE
Failed
Correction ❑
Needed
Re- Inspection a
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
February 18, 2010 For Inspections please call: (305)7624949 Page 6 of 14
0 (ct 9 5
APPLICATION #: 943684
STATE =FLORIDA PERMIT #: -SC- 1080456
DEPARTMENT OF HEALTH DOCUMENT #: F1771410
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID : 11/25/2009
FEE PAID:
RECEIPT #: 13 -PID- 1206171
APPLICANT Christian Petit
AGENT: Miami Dade Enviromental
PROPERTY ADDRESS: 9425 NW 2 PI Miami, FL 33150
LOT: 10 BLOCK: 7
SUBDIVISI Miami Shores ID #: 11- 3101 -015 -0180
CHECKED [XI ITEM3 ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED.
TANK INSTALLATION SETBACKS
[ ] [01] TANK SIZE [1] 900.00 [2] [ ] [27] SURFACE WATER FT
[ ] [02] TANK MATERIAL Concrete [ ] [28] DITCHES FT
[ 1 [03] OUTLET DEVICE [ ] [291 PRIVATE WELLS FT
[ 1 [0 MULTI- CHAMBERED [LIJ N ] [ ] [301 PUBLIC WELLS FT
[ ] [05] OUTLET FILTER [ ] [31] IRRIGATION WELLS FT
I 1 [06] LEGEND 1. 2. [ ] [32] POTABLE WATER FT
[ ] [07] WATERTIGHT [ ] [33] BUILDING FOUNDATIONS FT
[ 1 [08] LEVEL [ ] [34 PROPERTY LINES FT
[ ] [09] DEPTH TO LID [ ] [35] OTHER FT
DRAINFIELD INSTALLATION FILLED'/ MOUND SYSTEM
[ ] [10] AREA [1] 225 [2] SQFT [ ] [36] DRAINFIELD COVER
[ ] [11] DISTRIBUTION BOX HEADER X [ 1 [37] SHOULDERS
[ ] [12] NUMBER OF DRAINLINES 1. 4.00 2. [ ] [38] SLOPES
[ ] [13] DRAINLINE SEPARATION [ 1 [391 STABILIZATION
[ 1 [14] DRAINLINE SLOPE
[ ] [15] DEPTH OF COVER ADDITIONAL INFORMATION
[ ] [16] ELEVATION [ ABOVE / SELOW ] BM 49.20 [ ] [40] UNOBSTRUCTED AREA
[ ] [171 SYSTEM LOCATION [ ] [41] STORMWATER RUNOFF
[ 1 [181 DOSING PUMPS [ ] [42] ALARMS
[ 1 [19] AGGREGATE SIZE [ ] [43] MAINTENANCE AGREEMENT
[ 1 [201 AGGREGATE EXCESSIVE FINES [ 1 [44] BUILDING AREA
[ ] [21] AGGREGATE DEPTH [ ] [45] LOCATION CONFORMS WITH SITE PLAN
FILL / EXCAVATION MATERIAL [ 1 [46] FINAL SITE GRADING
[ ] [22] FILL AMOUNT [ 1 [47] CONTRACTOR Jose Bolanos (Miami Dade E
[ ] [23] FILL TEXTURE [ 1 [481 OTHER ARDS ARC 24
[ 1 [241 EXCAVATION DEPTH ABANDONMENT
[ ] [25] AREA REPLACED [ 1 [49] TANK PUMPED
[ ] [26] REPLACEMENT MATERIAL [ ] [50] TANK CRUSHED & FILLED
Comments:
CONSTRUCTION [ p�ppgO�D / DISAPPROVED ] : Dade CHD DATE 12/07/2009
Ronald E Cave (Dade County Environmental Health)
FINAL SYSTEM [ p / DISAPPROVED 1: �� L Dade CHD DATE: 12/07/2009
Ronald E Cave (Dade County Environme ealth)
(Explanation of Violations on following page)
DH 4016, 10/97 (Previous Editions May Be Used) Page 2 of 3
EH Database v 1.0.1 AP943684 EID1080466
DIVISION 0�
Environmental Health
�O Florida Department of Health
Miami-Dade County Health Department
pQ� OSTDS /Well Division `�►�
11805 SW 26 St: - Miami, FL 33175
Inspector A_ Date j A " —
Address J 1 OSTDS # I f'� /
r
Comments: -
Signature
Lrl
i l� S�