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PL-09-1250 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: INSP - 120277 Permit Number: PL -7 -09 -1250 Inspection Date: March 03, 2010 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: GEORGES, JOSUE Work Classification: Drainfield Job Address: 85 NW 99 Street Miami Shores, FL Phone Number Project: <NONE> Parcel Number 1131010180471 Contractor: MR C'S PLUMBING SEPTIC INC Phone: (305)651 -7859 Building Department Comments REPLACE 300 SQ DRAINFIELD Inspector Comments Passed HRS APPROVAL IN FILE Failed E:1 Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. For Inspections please call: (305)762 -4949 March 03, 2010 Page 1 of 1 �& M • Q 1' V'i:� R '� F K Y � x ASW x �d t a m w•WZ.SJ+ J,F (5145 f 9 3 r xq- t F ' Z/Z a6ed �oij;)3 ajgwa){ mgq (90£) 6b 11 6001 /9L /60 Q` F .s� Miami Shores Village Perri Tye )"� «tidentlal 10050 N.E. 2nd Avenue stficet F- D "0616 Miami Shores, FL 33138 - 0000•„ d r ,pomw ��V��, Phone: (305)795 -2204 �'CORLOP Expiration: 0120 /2010 Project Addres Parcel Number Applicant 85 99 Street 1131010180471 JOSUE GEORGES Miami Shores, FL Block: Lot: O wne r I Add Phone Cell JOSUE GEORGES 85 99 Street MIAMI SHORES FL Contractor(s) Phone Cell Phone MR C'S PLUMBING SEPTIC INC (305)651 -7859 (305)651 -5652 Valuation: $ 2, 000.00} Total Scl Feet: 300 Type of Work: PLUMBING For Inspections please call: Type of Piping: DRAINFIELD (305)762 -4949 Additional Info: Available Inspections: Bond Return : Inspection Type: Classification: Residential Final Rough Landscaping Fees Due Amount Invoice # Total Amt Paid Amt Due Bond Type - Contractors Bond $300.00 PL -7 -09 -35488 $ 664.98 $ 664.98 $ 0,00 CCF $1.20 Education Surcharge $0.40 Check #: 4132 Bond #: 1873 Permit Fee - Additions /Alterations $175.00 Scanning Fee $9.00 Technology Fee $4.38 Work without Permit Fee $175.00 Total: $664.98 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. July 24, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy July 24, 2009 - 1 Miami Shores Village k��� a P Building Department JUL 2 4 2009 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 ' Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit NoP �a PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type: Plumbing Owner's Name (Fee Simple Titlehdlder) �D4_0 Jac. G s Phone # — 7 gL, "{ l ^ - V 1 S Owner's Address N L&) 9 1 9+4^e.1e_r City " kcuk.41 State L� Zip Tenant/Lessee Name Phone # E -MAIL: Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # I 3 1 O d I " d 4 °1 0 Is Building Historically Designated YES NO Contractor's Company Nam C P l.t.cl'1, I -, DC ► Phone # Contractor's Address r— City V�`C04\ State Zip Qualifier Name I�VLY� (� I/l,�.( Phone # State Certificate or Registration NoI - ( L+ S1 Certificate of Competency No. E- MA I L: Architect /Engineer's Name (if applicable) Phone # Value of Work For this Permit C : r o Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New Repair/Replace ❑Demolition Describe o k: Submittal Fee $ Permit Fee $ V CCF $ •p� CO /CC Notary $ Training /Education Fee $ - 1 Technology Fee $. 4 Scanning $ Radon $ DPBR $ Zoning $ Bond $ M I U Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ n See Reverse side Bonding Company's Name (if applicable) Bonding Company's Address City State ip 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. 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. Signature � Si nature g Owner o�Agent Contractor The foregoing instrument was acknowledged before me this aO The foregoing instrument was acknowledged before me this � © day of ' 20 9�1 by day of J k , 2(> , by ZlO k V- � 1�.1 who is personally known to me or who has roduced p 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 PUB C: Sign- oftoft � 04 ON Sign: Print: KEhIBLECLRICK �r Print: F KEN413LE G ETTRICK t ,4'SSION # 1)1)471 4?� ",; i js`t N # DD471903 My Commission x wit.*-F 1 v a RES: Sept. 14, 2009 My Co m 'ssl8hr Tres: L ;. " ES: SePt. 14, 2009 398 -0163 F i - (407) 998-0153 F]Wda Np}� g ' x i i /j APPLICATION APPROVED B l/ Plans Examiner Engineer Zoning (Revised 02/08/06) 13-SC-994870 STATE APPLICATION # : AP928722 STATE OF FLORIDA DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL FEE PAID: SYSTEM RECEIPT #: DOCUMENT #: PR778866 CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Ifossa George PROPERTY ADDRESS 85 NW 99 St Miami, FL 33150 LOT: 15 BLOCK: 5 SUBDIVISION: Navarro ' PROPERTY ID #: 11 - 3101 018 - 0471 (SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 649 -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 IMA}Cikl[m CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY I ]GALLONS @[ ]DOSES PER 24 HRS #Pumps I ] D [ 300 ] SQUARE FEET SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [x] STANDARD [ ] FILLED I ] MOUND I ] I CONFIGURATION: [ ] TRENCH [x] BED [ ] N F LOCATION OF BENCHMARK F.F.E.: 12.7' NGVD I ELEVATION OF PROPOSED SYSTEM SITE I 13.20 ] [ INCHES FT ] [ ABOVE /BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE ( 41.20 q jMqKESj FT ][ABOVE �BENCHMARK /REFERENCE POINT L D FILL REQUIRED: 146.001 INCHES EXCAVATION REQUIRED: 1 28.00] INCHES 0 1— Existing 900 gal. septic tank certified by" McCs Plumbing 8 Septic on 06/28/2009 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 T area shall be at least 2 ft wider and longer than the proposed absorption bed. 5 -Invert elevation of drainfield to be no less H than 9.77' NGVD. 6. Bottom of drainfield elevation to be no less than 9.27' NGVD. E THIS PERMIT IS NOT FOR ADDITION(s) 11 1MAMI E CO Q l y Ii LTR E FF�4 Tf RIME NT R SPECIFICATIONS BY: PEDRO N OSP - Legacy APPROVED BY: TITLE: Dade CHD Pedro N Oapin DATE ISSUED: 07/09/2009 EXPIRATION DATE: 10/07/2009 DH 4016, 10/97 (Previous Editions May Be Used) Page 1 of 3 V 1.1A "928722 S8791796 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number --------------------- ------ PART It - SITEPLAN --------------------------- Scale: Each block represents 0 feet a I in &, M 40 fee'L 9 -A t t � t 1 � #�" .i l '� � { � 1 4 1 F t A.L -A (W C 'Iwe LA � ip U"C' aci 1)� it I I oh toa+ ke -- yrr - . V"4 t 1 -4 Notes: Sr t� C.,e lln ,- S�<vo -u-vq r) Site Plan submitted by*, i j -r-Q, r - - - - - - - - - - Plan Approved Not Approved By County Health Department ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015,10196 (Replaces HRS-H Form 4016 whi&,nsy be tised) Page 2 of 4 (Stock Number: 5744-002-4015-6) ELEVATION CERTIFICATE Owners Hama: JOSUE GEORGES& IFOSSA GEORGE Property Address: 55 NW 99 STREET, MIAMI SHORES, FLORIDA, 33150 LEGAL DESCRIPTION: FOLIO #. 11- 3°10'1.01 71 Lot 15, Block 5 of - NAVARRO SuEr according to the plat thereof as recorded in Plat Book 12 at Page 59 of the Public Records of Dade County, Florida. SURVEYOR'S NOTES: 1) Not valid without the signature and the original raised seat of a Florida Licensed Surveyor and Mapper. 2) Additions or deletions to this certificate by other than the signing Ply or party are proh'ibW without written consent of the signing party or parties. 3) This certificate elevation is for the purpose of septic and drains repair and/or construction. 4) This certlfmte elevation must not be use for the purpose of acquiring flood insurance 5) Elevations are based on the National Geodetic Vertical Datum of 1929. 6) Flood Zone: N/A Bass Flood Elev.: N/A as per Dade County, Florida. FEMA Panel Number: 120 652 - 0493 - J . MARCH 2,1994 TOP OF BOTTOM FLOOR: 12.7' TOP OF NEXT HIGHER FLOOR, NIA ATTADHED GARAGE (at the doer): NIA GRADE @ DRAINFIELD AREA 11.5' CROWN OF THE ROAD: 11.5' Field gate. 7/2M Pablo J. Alfonao P.S.M. Professional Surveyor & Mapper State of Florida Reg.. No.5880 LAND Su IRVEYo 109, INC- 6175 NW 153' STREET, 64117E 327, MIAMI LAKES, FLORIDA 83014 Phone: 305- 622 -6062 ** Fax: 3105- 827 -9668