PL-10-2168SEPTIC TANK AND DRAINFIELD
Passed
Inspector Comments
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Correction
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
I nspection Number: INSP - 154099
Permit Number: PL -12 -10 -2168 I
Inspection Date: December 20, 2010
Inspector: Hernandez, Rafael
Owner: TORRES, ONOFRE
Job Address: 117 NW 100 Street
Miami Shores, FL
Project: <NONE>
Contractor: STATEWIDE SEPTIC CONNECTIONS
Building Department Comments
December 20, 2010
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 Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Septic
Phone Number
Parcel Number 1131010220310
Phone: (954)963 -0082
Page 1 of 1
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: PLUMBING
Owner's Name (Fee Simple Titleholder) l r {e j a T r Phone #
Owner's Address t7 N \AJ i o Q Sfi
City (\/ki ar Sk0 reS State Zip SO
Tenant/Lessee Name
Email
Job Address (where the work is being done)
City Miami Shores Village
Contractor's Company Name
City Mf i^ra mn r
State FL
Qualifier Name T e rfS d'O f o r ,pn
S Z[7 Z
State Certificate or Registration No.
Contact Phone
Value of Work For this Permit $
Type of Work: ❑Addition
Describe Work:
Submittal Fee $
Notary $
Scanning $
Double Fee $
Structural Review. $
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Training /Education Fee $
Hi N w\J 1 O0 � r
County Miami -Dade
FOLIO /PARCEL# 0?,t0
Is Building Historically Designated YES NO
Contractor's Address 0 S , S-f S - - 7 2_6
J - �
❑Alteration
Re Ft a ce.
E -mail
fhc
G G't.+Y'SPhone #
it
❑New
G
Radon $ DPBR $
Permit No.
Master Permit No.
Phone #
Phone #
Certificate of Competency No.
Architect /Engineer's Name (if applicable) Phone #
LK)\ €D6S
31 sal- 2 Lt t-1-
Zip 33I S o
Zip 3302_3
Flood Zone
3/66 -66 33
Square / Linear Footage Of Work: 50
❑ Repair /Replace ❑ Demolition
01-0 e( d.
P 1C -1C l` ce ±CY �r-
���: ����: �• * * *�� * *� * *�� * *� *� * * * * * *� * * *� * ** F �******* �* * * * * * * *:� * * * * * * * * * * * * * * * * * * *•�*
.), Permit Fee $ 3 C`
(-{A -, CCF $
CO /CC $
Technology Fee $
Bond $
Violation date:
Total Fee Now Due $ // "
See Reverse side -+
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
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 approve and a reinspection fee will be charged.
Signature
Own or Agen
The foregoing instrument was acknowledged before me this 1
day of Dec , 20(® ,by Ov oere scilreS
who is personally known to me or who has produced Dr I v
LA t. en As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
'TERESA J �i SO SOLOMON
omm DD0733346
Expires 11/8/2011
fie
- „ „, o Florida Notary
rt noaues ' e � sseoucasgps�l • u ............. .. INS
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of 4 2— , 20 1, by
who is personally known to me or who has produced
as identification and who did takpmovil ,,, �/
era
NOTARY PUBLIC:
Sign:
Print:
Zip
My Commission Expires:
11/1 \�
* * * * * * * * * * * * * * * * * * * * ********** ************ ***tit ** ************ ************** *k***** *****k**** **** ** *k******
"2/ (2 //C0 Plans Examiner
APPROVED BY
(Revised 07 /10 /07)(Revised 06/10/2009)
Engineer
Zoning
Clerk checked
CONSTRUCTION PERMIT FOR: OSTDS New
APPLICANT: Onofre Torres
PROPERTY ADDRESS: 117 NW 100 St
LOT: 8+9 BLOCK: 4
PROPERTY ID #: 11 - 3101 - 022 - 0310
SYSTEM DESIGN AND SPECIFICATIONS
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED:
O
T
H
E
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM 4
CONSTRUCTION PERMIT ?I
[ 0.00] INCHES
R
SPECIFICATIONS BY: Carlos M Icaza
APPROVED BY:
Carlos M Icaza
DATE ISSUED: 12/06/2010
Miami, FL 33150
SUBDIVISION:
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.
T [ 900 ] GALLONS / GPD Seotic CAPACITY
A [ ] GALLONS / GPD N/A CAPACITY
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 500 ] SQUARE FEET bed confiauration drainfileld SYSTEM
R [ ] SQUARE FEET N/A SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [x] BED [ ]
N
F LOCATION OF BENCHMARK: F.F.E., 12.20' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 19.50 ] [1 INCHES I/ FT ][ ABOVE A BELOW bBENCHMARK /REFERENCE POINT
[ 49.50 ] [) INCHES I FT 1 [ ABOVE 4 BELOW b BENCHMARK /REFERENCE POINT
EXCAVATION REQUIRED: [ 30.00] INCHES
Inspector to verify the existing septic tank is properly abandon before final approval.
*invert elevation of drainfield to be no less than 8.57 ft. NGVD.
*Bottom of drainfield elevation to be no less than 8.07 ft. NGVD.
-The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with
sec. 64E- 6.013(3)(f). F.A.C.
TITLE:
TITLE:
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E- 6.003, FAC
;4:p9 t3 6210
PERMIT #: 13 -SC- 1290124
APPLICATION #: AP986210
DATE PAID:
FEE PAID:
0 RECEIPT #:
®S DOCUMENT #: PR828466
'4) '•40A k
[SECTION, TO .IP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
Dade CHD
EXPIRATION DATE: 06/06/2012
SES:3n772.
Page 1 of 3
DIVISION O!
Environmental Hash
Florida Department of Health
Miami -Dade County Health Departmegt
OSTDSIWen Division
lion $Wu51: * Mal, vs. 33175
f