PL-10-2057DRAINFIELD REPAIR
Passed
Inspector Comments
/ ,ZV✓
1�
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 153489
Permit Number: PL -11 -10 -2057 1
Inspection Date: November 22, 2010
Inspector: Hernandez, Rafael
Owner: LIVINGSTONE, KERI
Job Address: 10666 NE 11 Avenue
Miami Shores, FL
Project: <NONE>
Contractor: ROTO ROOTER SERVICES COMPANY
Building Department Comments
November 22, 2010
For Inspections please call: (305)762 -4949
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Drainfield
Phone Number (786)218 -0080
Parcel Number 1122320280690
Phone: (786)464 -1080
Page 1 of 1
Mail& IT 'RA aCAli[
Eavcsgsot
CONSTRUCTr
FINAL SYST
TANK INSTALLATION
[01] TANK SIZE [1]
[02] TANK MATERIAL
[03] OUTLET DEVICE
[04] MULTI - CHAMBERED [Y(
[05] OUTLET FILTER
[06] LEGEND
[07] WATERTIGHT
[08] LEVEL
[09] DEPTH TO LID
[2
DRAINFIELD INSTALLA . I �q �^y
[10] AREA [1] 1 [2] a RC OFT
[11] DISTRIBUTION BOX HEADER s.1°,-
[12] NUMBER OF DRAINLINES
[13] DRAINLINE SEPARATION
[14] DRAINLINE SLOPE
[15] DEPTH OF COVER
"[16] ELEVATION'[ABO ELO1Z1t] BM
[17] SYSTEM LOCATION
[18] DOSING PUMPS
[19] AGGREGATE SIZE 7
[20] AGGREGATE EXCESSIVE FINES
[21] AGGREGATE DEPTH
FILL / EXCAVATION MATERIAL
[22] FILL AMOUNT j
[23] FILL TEXTURE
[24] EXCAVATION DEPTH
[25] AREA REPLACED
[26] REPLACEMENT MATERIAL
EXPLANATION OF VIOLATIONS / REMARKS:
[
[
[
[ l
DH 4016 (Page 2), 10/97 (Previous Editions May Be Used)
Stock Number: 5744 -002- 4016 -4
[ 1
[ ]
_ = _ = a =
RECTED;
= ___ =_ =
SETBACKS e ,
[27] SURFACE WATER FT
[28] DITCHES • FT
[29] PRIVATE WELLS FT
[30] PUBLIC WELLS FT
[31] IRRIGATION WELLS FT
[32] POTABLE WATER LINES J FT
[33] BUILDING FOUNDATION S FT
[34] PROPERTY LINES / - FT
[35] OTHER FT
FILLED / MOUND SYSTEM
[36] DRAINFIELD COVER
[37] SHOULDERS
[38] SLOPES
[39] STABILIZATION
[40]
[41]
[42]
[43]
[
[45]
[46]
[47]
[48]
PT 1: Applicant
PT 2: Installer /Contractor
PT 3: Building Department
PT 4: Health Department
ADDITI ONAL`I NFORMATION
UNOBSTRUCTED AREA
STORMWATER RUNOFF
ALARMS
MAINTENANCE AGREEMENT
BUILDING AREA
LOCATION CONFORMS WITH SITE PLAN
FINAL SITE GRA G - y.
CONTRACTOR
OTHER
7
ABANDONMENT
[49] TANK PUMPED _I
[50] TANK CRUSHED & FILLED / L
CHD DATE ' '
N [APPROV /DISAPPROVED]: 4 � '
D/DISAPPROVED]: t �/� � ? c CHD DATE �! / c,)
Page 2 of 3
Recycled i c y Payer
BUILDING
PERMIT APPLICATION
FBC 2004
Owner's Address / C 06,69 } 1-6, t-- •
City )14444 t 6149245 State
Tenant/Lessee Name
E -MAIL:
Job Address (where the work is being done)
City Miami Shores Village
FOLIO / PARCEL # J! e><crclW -041 27
Value of Work For this Permit $
Type of Work: DAddition
Describe Work
Structural Review. $
Miami Shores Village
Building Department
/0050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 n
Permit No. PI )OO5i
❑Alteration
iOto(o E
Zip
County Miami -Dade
Is Building Historically Designated YES NO /"
Contractor's Company Name APT) - T &- 5e V/
Contractor's Address /.5 , yq (
City wt. A144 State
Qualifier Name�vt /�✓L - 44 (—
State Certificate or Registration No. C, 66
E- MAIL:
Architect/Engineer's Name (if applicable)
f5 o
Submittal Fee $ Permit Fee $
Notary $ Training/Education Fee $
Scanning $ Radon $ DPBR $
Bond $ Code Enforcement $
1 MOU
ov 1 7 2010 LIY
Master Permit No. 13 - S C.. / s Oq
Permit Type: Plumbing
Owner's Name (Fee Simple Titleholder) k0i2 - Li vi gC7$ 7 Z f1E Phone # .3O.s' 1 '- b8'7
3 ')l38'
Phone #
Zip
Phone # 78f4:9
Zip 93
Phone # 96
Certificate of Competency No.
Phone #
Square / Linear Footage Of Work:
Repair/Replace ❑ Demolition
eta**aa* a*aa *a* * * * ** * * *a * * ** * * *ee ****se***F * * * * * * *** *** ** *** tea * ** ** *ass* *******see *sews * *a
CCF $ CO /Cc
Technology Fee $
Zoning $
Double Fee $
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 fa c4spection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection r t be approved and a reinspection fee will be charged.
Signature
(Revised 02108/06)
Owner or Agent
The foregoing instrument was acknowledged before me this (
day of Y.td Z/ , 20 /0 by Pg : ( P' -
who is personally known to me or who has produced �L
1 (rz lte is 0 As
NOTARY PUBLIC.
Sign:
Print ' ah•AtA14
My Commission Expires: / 0 /, -/ o, —
„
Off Po Notary P /blic State of Florida
Magdiel Montanez
My Commission 00830567
°cop* Expires 10/1212012
APPLICATION APPROVED BY:
The foregoing instr ument was acknowledged before me this /
day of A/ ,20 10, by i'tg • l?/J OA k ?-
who isonally knoto me or who has produced
Signature
n i iert� gip � $ IC riodi, Y • ` e a an
vs Notary
. Maediei Montanez • M ommission DD830567
. •wee 10/12/2012
NOTARY
Sign:
Print:
My Commission Expires:
Contractor
/ O// Qg217/ • —
***************************************************************************** * * * * * * * * * * * * * * ** * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Keri Livingstone
PROPERTY ADDRESS: 10666 NE 11 Ave
LOT: 19
ap?
[SECTION, TOWNSHIP, RANGE, PARCEL NUMB]
PROPERTY ID #: 11 - 2232 - 028 - 0690 gp`�
[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 [ 900 ] GALLONS / GPD Septic 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 [ 200 ] SQUARE FEET SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [X] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [X] BED [ ]
N
F LOCATION OF BENCHMARK: NW Corner of NC Pad : 7.99' NGVD.
I ELEVATION OF PROPOSED SYSTEM SITE [ 3.32 ][I moms FT ] II ABOVE BELOW ] BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 21.32 ] [I INCHES I/ FT ] [I ABOVE I BELOW ] BENCHMARK /REFERENCE POINT
D FILL REQUIRED: [ 0.00] INCHES EXCAVATION REQUIRED: [ 36.00] INCHES
0
T
H
E
R
1- Existing 900 gal. septioc tank certified by " Roto Rootor Services Inc." on 11/03/2010 to remain. 2- Install 200 sf of
drainfield in bed configuration. 3- Install 12" of slightly limited soil under the bottom of drainfield. 4- Perimeter of excavation
area shall be at least 2 ft wider and longer than the proposed absorption bed. 5 -Invert elevation of drainfield to be no less
than 6.60' NGVD. 6. Bottom of drainfield elevation to be no less than 6.10' NGVD.
R EPAIR ,
THIS PERMIT IS NOT FOPR ADDITION(s).
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED:
Apok Roo-ler,
STATE OF FLORIDA
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID:
SYSTEM
• RECEIPT #:
DOCUMENT # : PR827019
BLOCK: 4 SUBDIVISION:
DH 4016, 08/09 (Obsoletes all previous
Incorporated: 64E- 6.003, FAC
v 1.1.4
Miami, FL 33138
editions which may not be used)
AP984756
SE829573
PERMIT #: 13-SC-1288041
APPLICATION #:AP984756
Page 1 of 3
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196PLUI1 PLUMBING CONTRACTOR
ROTO ROOTER CORPORATION
1550 NW 79 AVENUE
DORAL, FL 33126
2010-2011
LOCAL BUSINESS TAX RECEIPT
CITY OF DORAL„, FLORDA
Koo 5.2• Street 206
Dr.)rat Fkri& 33166
. .. ......... . .....
O ff163 J
2011002862
5
$30.00
8.300 5:.?;rd sae Fioricia ctt Pax: 305-5e<::.1-67613