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PL-10-2221Inspection Number: INSP - 154314 Scheduled Inspection Date: February 16, 2011 Inspector: Hernandez, Rafael Owner: LEVASSER, PHILIP&DARLENE Job Address: 9819 NE 4 Avenue Road Project: <NONE> February 15, 2011 Miami Shores, FL 33138- Contractor: MR C'S PLUMBING SEPTIC INC Building Department Comments 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 -12 -10 -2221 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Drainfield Phone Number (305)756 -6214 Parcel Number 1132060170210 Phone: (305)651 -7859 DRAINFIELD Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 7 of 21 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 / BUILDING Permit No. PL ( o -22j/ PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: PLUMBING / OWNER: Name (Fee Simple Titleholder): P►�II Ip LL Phone #: 3L7 -1g 6219 Address: 9 st Iq N E 4. e9rC City: rk14s..1 State: rt1� t . Zip: 331 3 t Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 9819 IJ 6 4 Age City: Miami Shores Village Building Department Miami Shores County: Miami Dade Zip: 33 Ise Folio/Parcel #: I I- SaO 6- 60- Daly Is the Building Historically Designated: Yes CONTRACTOR: Company Name: Pit 1 s f lo,,J i 4 Seqiit Phone#: 365 7f Address: I9 /5Z ma) 52. eux City: I'ti State: �Iort4a Zip: 33 14.4 Qualifier Name: Iokr■ Ha ley Phone #: 3. 30T 6 ft ?tn State Certification or Registration #: GfG • 14-2 t.7 r) Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 1 D . U0 Square/Linear Footage of Work: ° Type of Work: ❑Address ❑Alteration lew C7Repair/Replace Description of Work: ./1 'lit( kr0;44 NO f Flood Zone: ❑Demolition x * * *ew *x* * *** *ab * *x * * * * * *x * * * * * ** ** Fees *: * *x * * *a* ** ****xar.. * * *a * * * * ** ** *x *ra****o* Submittal Fee $ 0 Permit Fee $ / C '- CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1 (4.10 4 Bonding Company's Name (if applicable) Bonding Company's Address City Stye 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. 1 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: 1 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of coaunencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and reinspection fee will be charged Signature Sign: Print: My Comnussion Ex Owner or Agent The foregoing instrument was acknowledged before me this lb day of PQ C- , 20 Q, by Qi(ip G.e vti5$u- who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: (Revised 07/10107)( Revised 06r1(r2(019)(Revised 3/15/09) APPROVED BY Plans Examiner Structural Review Signature Sign: Print: My Co Contractor The foregoing instrument was acknowledged befo e this day of Ce ,20 112, by _ /°\ who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: ■ i Kew( MY COMMISSION tl U '• EXPIRES: September 'r•. '^^ ��►`' °' Public Urderwrser ThN Notary Zoning Clerk 12/15/2010 14:59 FAX STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PE LT FOR: OSTDS R @pair APPLICANT: Phd ? +: Levasser PROPERTY ADDRESS: LOT : 5 & 6 PROPERTY ID 8: 11- 32006- 017 -0210 9819 NE 4 Ave Miami, FL 3313$ BLOCK: 87 SYSTEM MST 88 CONSTRUCTED IN ACCORDANCE WITS SPECIFICATIONS AND STANDARDS QP SEQTI01 381.0065, F.S., AND CHAPTER 64E F.A.C. DEPARTMENT APPROVAL QF SYSTEM Does EDT GDARANTEE SATISFACTORY PERFORMANCE 1RQR ANY SPECIFIC PERIOD OP 't] ANY CHARM ra ratTRATAt. !AC's, WHICH MEWED AS A BASIS FOl( MOM= OF TILLS P>'0 =, RED THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODEPICATIONS MAI PENULT TN vas PEPltXT BEIM ISDE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT PR121 COMPLIANCE WITH OTHER PEDNBAL STATe / OR LOCAL PENL3ITrmS ItaguXaao FVR DBVMOSIMENT OP THUS paossarz. SYSTEM DEBIBN AN8 SPECIFICATIONS T 1 750 ] WAILLONS / G'o Sentic CAPACITY A [ 0 1 SONS / OPD _ CAPACITY N [ 0 ] NALL= GREASE INTERCEPTOR CAPACITY [MAXECEN CAPACITY BIAS TANK:1250 GALLONS] R [ ] GALLONS DOSING TANK CAPACITT [ ISEMONS 81 ]DOSES PEA 24 SRS t?U I 1 1 D [ 200 ] SWARE YEET SYSTEM R [ 0 ] SWAM FUT SYSTEM A 'rrPL+ SYSTEM: [S] STANDAE:D [ ] FEU= [ ] MOUND ] T CONFICt1RAT"ION: [ ] T [a] BM [ ] N P LOCATION OP RENCnMARx: F.F.E.: 12.70 NGVD I Er.EVEm10N OF PROPOSED SHSTEM SITE [ 31.20 E BOTTOM OF DEA.ZNE"IELD TO HE [ 59.20 0 T E THIS PERMIT I8 NOT FOR ADDITION(s). N D.pint DATE ISSUED: 12/15/2010 SUBDIVISION: Miami Shores x14470:,11 • ] [ ABOVE • ]1ABOVE DE 4016, 06/09 (Obsoieta, a11 pi*vicu4 rditiaNs which th may not bo used) Incaxp©rated: 64E- 6.003, PAC 4,. 1.4 pEpiarz I : 13SC- 1Z91311 APPLI # AP987O80 O FILT. REQU : [ 0.00 ] INCHBs xxclwATTON SW:7m: [ 40.00 ] TNCHEs 1— Ex14*Ing 760 gal. septic tank cartlflad by " Mr C's Plumbing $ Septic " on12/07/2010 to remain. 2- Install 200 sf of drainfleld in bed configuration. 3- Install 12" of slightly Ginned soil under the bottom of draintield. 4- Perimeter of excavation area shall be at least 2 It wider and longer than the proposed absorption bed. 5 elevation of dralnfleld to be no less than 6,26' NGVD. 8. Bottom of drainheld elevation to be no teas than 8.26' NGVD. EXPIRATION DATE . a 003 /004 DATE PAID: FMB PAID: !ECYIFr e; DOCtailerr * : PR829321 (SECTION, TOWNSHIP, RANCE, EAECEL mama] Ka TAX XD NuaasE1 DENCInaiWnENZFMICE MST Dade 03/15/2011 Page 1 of 3 Inspector Address Comments: Signature DIVISION OP Environmental Health Florida Department of Health M ami-Dade County Health Department OSTDSIWeII Division 11105 SW IS St: Moak FL 33175