PL-11-598Inspection Number: INSP - 157966 Permit Number: PL -4 -11 -598
Scheduled Inspection Date: April 13, 2011
Inspector: Hernandez, Rafael
Owner: PERATICOS, VICKY
Job Address: 672 NE 98 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: MARLIN PLUMBING OF MIAMI INC
Building Department Comments
REPLACE DRAINFIELD
Passed
Failed
Correction
Needed
Re- Inspection
Fee
April 12, 2011
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Drainfield
For Inspections please call: (305)762 -4949
Phone Number (305)439 -0062
Parcel Number 1132060171780
Phone: 305 -652 -6108
Inspector Comments
HRS APPROVAL POSTED ON T E JOB SITE AS PER YOUR REQUEST
Page 16 of 21
-- - R.€) 6-0 4.uL _
to•t3,1 104, f.,,
t-t(( - Iitt-rtsP
Miami Shores Village APR 0 5 2011
Building Department B Yo G ®a
BUILDING
PERMIT APPLICATION
FBC 20
JOB ADDRESS: 7.R NE !
City: /Vt ; a-,t'L i S h-oy'e s State: FL. Zip: "3'3 1 37'
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949 ��
Permit No. L- ( S9 (V
Master Permit No.
Permit Type: MECHANICAL '' I
OWNER: N ame (Fee Simple V C k Pe,irr e t CO S Phone #: 5 - (/37 Q
-
p
Address: (07 a 1 "4 5 S ee- 1
Tenant/Lessee Name: Phone#:
Email:
City: Miami Shores County: Miami Dade Zip: 3
Folio/Parcel #: i l ° 320 4 °-o 11- fl rc
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: M ( l % ve PI u /AL /'1 q IG rai ' Phone#: ,_3t1 / S — 6.52 ° .�i 3
Address: a0 0 14 $ WE / (o /4 Ny CP M
City: W M a. de-410.k% State: Zip: '3 3 f y
Qualifier Name: Cciu)4,rd y Ja.9 ke ✓ Phone #: :305 -- (S2
State Certification or Registration #: C° FCO / VA 9 a. Certificate of Competency #:
Contact Phone#: 30S-652- > 303 I Email Address: rrl a r k,, O 1 u tv! ,�, ra. 61.6 L d Cd y1
DESIGNER: Architect/Engineer: one #:
Value of Work for this Permit: $ 4 g 560 a do Square/Linear Foo • e of Work:
Type of Work: ❑Address ❑Alteration New epair/Replace ODemolition
Description of Work: Re—V o,�� l -geld
* * *************** *****+x****+x+x*** ******* Fees************ * ********************* * *** :*****
Submittal Fee $ Permit Fee $ /5V CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
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 be proved andanspection fee will be charged.
Signature
My Commission Ex
* * * * * * * * * * * * * * **
APPROVED BY
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Owner or Agent
The foregoing instrument was acknowledged before me this a 6'
day of r:kl:,er 120 L by L.ky PPfct 4-I @b £
who is personally ithown to me or who has produced Ft-
P - r7g - C3 ' As identification and who did take an oath.
NOTARY PUBLIC:
* * * * * * * * * * * **
Plans Examiner
Structural Review
Signature
Sign:
,cr,A9
Cbhtractor
The foregoing instrument was acknowledged before me this d q
day of Pio rau r , 20 IL, by Ec Ltuu ci �14 -11K C
who is personall own to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign: ^t_ M r L 'ti
Print:1 .att friaefeeir
INT
r ;, THERESA MCCREERY
;. . .g MY COMMISSION 4 DD 943806
f EXPIRES: December 6, 2013
1p
•
Wi bit
EXPIRES: December 6, 2013
BOtWed thru Notary Public Under/alters
* * **
* * * * * * * * * * * * **
Zoning
Clerk
STATE OF FLORIDA
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID
SYSTEM RECEIPT #.
DOCUMENT #: PR840495
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Vicky Peraticos
PROPERTY ADDRESS: 672 NE 98 St Miami, FL 33138
LOT: 1-4
BLOCK: 101
PROPERTY ID #: 11- 3206 - 017 -1780
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 [ 1,200 ] GALLONS / GPD Seam 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
R
A
I
N
F
I
E
L
D
0
T
H
E
R
[ 300 ] SQUARE FEET SYSTEM
[ 0 ] SQUARE FEET SYSTEM
TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
CONFIGURATION: [ ] TRENCH [X] BED [ ]
LOCATION OF BENCHMARK: F.F.E.: 9.60' NGVD
ELEVATION OF PROPOSED SYSTEM SITE
BOTTOM OF DRAINFIELD TO BE
FILL REQUIRED: [ 0.00 ] INCHES
SUBDIVISION: Miami Shores
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
[ 6.00 ] [) INCHES I r FT ] [ ABOVE /I W 6 BELO BENCHMARK /REFERENCE POINT
[ 42.00 ] [I INCHES f F T ] [ ABOVE 1 BELOW (I BENCHMARK /REFERENCE POINT
EXCAVATION REQUIRED: [ 48.00] INCHES
PERMIT # : 13 -SC- 1309574
APPLICATION #: AP999486
1— Existing 1200 gal. septioc tank certified by " Tropical Septic " on 03/22/2011 to remain. 2- Install 300 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 Tess than 6.60'
NGVD. 6. Bottom of drainfield elevation to be no less than 6.10' NGVD.
THIS PERMIT IS NOT FOR ADDITION(s). REPAIR OEPI"• -��tigT
COUNTY HEALTH
SPECIFICATIONS BY: dro N T u pMrpplOf (or d�kl"�) Is required to perform E a
TITLE:
Soil boring a(i M the dteld ��
DATE ISS 04/04 011 H
�apsna rrle , ia to e reln1
d iek I xcavau u a cFm
inspector shall ..:. °., .
,: soil boring and camps
results to the o � �{l�ubmitted. X7/03 /2011
APPROVED BY* DH 4016, 08/09 (Obsoletes all previous editions which may not f b tee Will be assessed if the contractor is not
Incorporated: 64E - 6.003, FAC at the iabslt8 at arranged time. Pa 1 o 3
v 1.1.4 AP999486 9E8�0 789 ��
NOTICE OF RIGHTS
A party whose substantial interest is affected by this order may petition for an
administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such
proceedings are govemed by Rule 28 -106, Florida Administrative Code. A petition for
administrative hearing must be in writing and must be received by the Agency Clerk for the
Department, within twenty-one (21) days from the receipt of this order. The address of the
Agency Clerk is 4052 Bald Cypress Way, BIN # A02, Tallahassee, Florida 32399 -1703. The
Agency Clerk's facsimile number is 850 -410 -1448.
Mediation is not available as an altemative remedy.
Your failure to submit a petition for hearing within 21 days from receipt of this order will
constitute a waiver of your right to an administrative hearing, and this order shall become a 'final
order'.
Should this order become a final order, a party who is adversely affected by it is entitled
to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are
governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced
by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a
second copy, accompanied by the filing fees required by law, with the Court of Appeal in the
appropriate District Court. The notice must be filed within 30 days of rendition of the final order.
No I s /CC
Scale: Each block represents 10 feet and 1 inch = 40 feet.
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STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERM)
Permit Application Number
4.) r) 1 co s
Site Plan submitted by: Pri rip j ; ,•`i _PL .1.4' 4/74./Y
Plan Appro ed_ Not Approved _ Date
By :.
% ,
z � Health Department
ALL MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015, 10/96 (Replaces HRS -H Form 4015 which may be used)
(Stock Number: 5744- 002 - 4015 -6)
- - - - - PART II SITEPLAN - - -
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STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERM)
Permit Application Number
4.) r) 1 co s
Site Plan submitted by: Pri rip j ; ,•`i _PL .1.4' 4/74./Y
Plan Appro ed_ Not Approved _ Date
By :.
% ,
z � Health Department
ALL MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015, 10/96 (Replaces HRS -H Form 4015 which may be used)
(Stock Number: 5744- 002 - 4015 -6)
- - - - - PART II SITEPLAN - - -
o zv o �z 1�
Page 2 of 4
Scale: Each block represents 10 feet and 1 inch 40 feet.
N
Site Plan submitted by: in f i
Plan Approved
By
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STATE OF FLORIDA
DcPARTMENT OF HEALTH
APPLICATIQIOR ONSITE SEWA3E DISPOSAL SYSTEM CONSTRUCTION PERM
P t f ()',
F L C ✓� ON 1
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DH 4015, 10/96 (Replaces HRS -H Form 4015 which may be used)
(Stock Number: 5744 - 002 - 4015 -6)
- - - - - - - - PART II - SITEPLAN -
Not Approved
Permit Application Number / f
t,c)J /1 /r
ALL.6HANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
Aire 4,c. ►
Date 3 -
/County Health Department
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Scale: Each block represents 10 feet and 1 inch 40 feet.
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Site Plan submitted by: in f i
Plan Approved
By
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STATE OF FLORIDA
DcPARTMENT OF HEALTH
APPLICATIQIOR ONSITE SEWA3E DISPOSAL SYSTEM CONSTRUCTION PERM
P t f ()',
F L C ✓� ON 1
�1
DH 4015, 10/96 (Replaces HRS -H Form 4015 which may be used)
(Stock Number: 5744 - 002 - 4015 -6)
- - - - - - - - PART II - SITEPLAN -
Not Approved
Permit Application Number / f
t,c)J /1 /r
ALL.6HANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
Aire 4,c. ►
Date 3 -
/County Health Department
Page 2 0
3
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO.
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
TAX FOLIO NO. A 32.06,-0t7 - !7 frd
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
2. Description of improvement: Dr& e vi -gefUl j
®G Space above reserved for use of recording office
1. Legal description of property and street/address: t 71 N6 / D S ee-f
Signature(s) of
Prepared By
Print Name
123.01 -52 PAGE 3 3/10
1 11111111111 111111111 11111111111 111111111 1111
CFN 2011IFS0118890
OR Bk 27594 F's 1633; (1s)
RECORDED 02/22/2011 12 :23:30
HARVEY RUVINT CLERK OF COURT
MIAMI-DADE COUNTY? FLORIDA
LAST PAGE
3. Owner(s) name and address:
Interest in property:
Name and address of fee simple titleholder:
4. Contr.ctor's name y address and phone number: Ma if 1. Tit) at, l6� rD-F M-44.0.4,/ nc 2.o/ 515 /46
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:
(the expiation date 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 YQUR N ICE OF COMMENCEMENT.
Authorized Officer/Director/Partner/Manager
Prepared By ° TheXP Ikee.i(eeiY
Print Name ° lbw�(P S2 M eG
Title /Office O— e.0 44271/
Title /Office
STATE OF FLORIDA
COUNTY OF MIAMI -DADE
The foregoing instrument was acknowledged before me this e ( day of a•brc�.la. r te! _ . 2o 11
By V i c .
E� Individua ly, or ❑ as for
❑ Personally known, or aproduced the following type of identific ti � on: L P& 32 - 7.? - 4 3 - c)
Signature of Notary Public:
Print Name: °yeas. 114. ee4e Tj0
(SEAL) dd
VERIFICATION PURSUANT TO SECTION 92,525, FLORIDA STATUTES
Under penalties of perjury, I declare that I have read the foregoing and
that the facts stated in it are true, to the best of my knowledge and belief.
Signature(s) of Owner(s) or Owner(s)'s Authorized Officer/Director /Partner/Manager
B y By