PL-10-224Inspection Number: INSP - 135535 Permit Number: PL -2 -10 -224
Scheduled Inspection Date: February 26, 2010
Inspector: Hernandez, Rafael
Owner: MARDINI, MARUAN
Job Address: 26 NE 109 Street
Project: <NONE>
Contractor: MIAMI DADE ENVIROMENTAL
Building Department Comments
DRAINFIELD REPAIR
900 GALLON & 225 DRAINFIELD BED
Passed
Failed
Correction
Needed
Miami Shores, FL
Re- Inspection
Fee
February 25, 2010
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
Inspector Comments
HRS APPROVAL IN FILE
For Inspections please call: (305)762 -4949
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Drainfield
Phone Number
G�
Parcel Number 1121360110380
Phone: 786 -251 -4099
Page 4 of 11
d
APPLICANT-
AGENT:
PROPERTY ADDRESS:
LOT:
STATE OF FLORIDA PERMIT NO., -
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL, SYSTEM : FEE PAID:
CONSTRUCTION INSPECTION AND FINAL APPROVAL RECEIPT #:
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE
TANK INSTALLATION
[01] TANK SIZE [1]
[02] TANK MATERIAL F
[03] - OUTLET DEVICE
[04] MULTI- CHAMBERED [Y / N.].
[05] OUTLET FILTER
[06] LEGEND
[07] WATERTIGHT
[08] LEVEL
[09] DEPTH TO LID
BLOCK SUBDIVISION: " ' PROPERTY ID #
WITH STATUTE OR RULE AND MUST ' BE CORRECTED.
SETBACKS
[ } [27]- SURFACE WATER FT
[ ] ; [28] DITCHES FT
[ ] [291 PRIVATE WELLS FT
] [30] PUBLIC WELLS FT
[ ] [31] _ IRRIGATION WELLS FT
[ ] [32] POTABLE WATER LINES FT
[ ] [33] BUILDING FOUNDATION FT
[ 1 [34] PROPERTY LINES -' FT
[ ] _: [35] OTHER FT
ABANDONMENT
1491 TANK PUMPED _/
[50] TANK CRUSHED & FILLED
CHD DATE
CHD : _ DATE
PT 1: Applicant
PT 2: Installer/Contractor
PT 3: Buitdng Department
PT 4: Health Department
DRAINFIELD INSTALLATION
[10] AREA [1] ,7 [2] SOFT
] [11] DISTRIBUTION BOX HEADER -
] [12] NUMBER OF DRAINLINES
] [13] DRAINLINE SEPARATION
] [14] DRAINLINE SLOPE
] [15]' DEPTH OF COVER
1 [16] ELEVATION [ABOVE/13ELOWIBM
[17] SYSTEM LOCATION
[18] DOSING PUMPS
]' [19] AGGREGATE SIZE
] ' [20] AGGREGATE EXCESSIVE FINES
] [21]' AGGREGATE DEPTH
FILL / EXCAVATION MATERIAL
[22] FILL AMOUNT
[23] FILL TEXTURE
[24] EXCAVATION DEPTH
[25] AREA REPLACED
[26] REPLACEMENT MATERIAL'
FILLED / MOUND SYSTEM
[36] DRAINFIELD COVER
] [37] SHOULDERS
] [38] SLOPES
] [39] STABILIZATION
ADDITIONAL INFORMATION
[40] UNOBSTRUCTED AREA
[41] STORMWATER RUNOFF
[42] `- ALARMS
[43] MAINTENANCE AGREEMENT
[44] BUILDING AREA
LOCATION CONFORMS WITH SITE PLAN
FINAL SITE GRADING
CONTRACTOR "? ` -I
OTHER
EXPLANATION OF VIOLATIONS / REMARKS:
[ 1
[
[ 1
[
1
CONSTRUCTION [APPROVED /DISAPPROVED]:
FINAL SYSTEM [APPROVED /DISAPPROVED]
DH 4016 (Page 2), 10/97 (Previous Editions May Be Used)
Stock Number: 5744- 002 - 4016.4
Ro. Box or street mailing_ address for app ar agent
4
iL
r
•
0
T
CONSTRUCTION PERMIT FOR: OSTDS Rebell'
APPLICANT: David Hardy
PROPERTY ADDRESS: 26 NE 109 St Miami FL 33181
LOT: 6
PROPERTY ID #: 11 -2136- 011 -0380
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE HITS SPECIFICATIONS AND STANDARDS OF EJECTION
801.0065, 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 HAM FOR ISSUANCE OF THIS PERMIT, REQUIRE TEE APPLICANT TO MODIFY THE
PERMIT APPLICATION. SUCH MQAIFICATION9 MAY RESULT xN 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 REQtXRED FOR DEVELOPMENT 0$ TBIB PROPERTY.
SYSTEM DESION AND SPECIFICATIONS
T [
A [
N [
D [ 225 ] SQUARE FEET SYSTEM
R ( 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [X] STANDARD [ ] FILLED L 1 MOUND [ ]
I CONFIGURATION: [X] TRENCH [ ] RED [ ]
N
F LOCATION of BENCEmRE: F.F.E.: 12.9' NGVD
Y ELEVATION OF PROPOSED SYSTEM SITE [ 21.60 ] [I XNCIES p FT ] [ ABOVE A ENL0 BENCHM i E /REFERENCE POINT
8i BOTTOM O>3' DRAiNFIELD TO BE [ 41.60 ] [I iNCHE9 I FT ] [ ABOVE EEraov 1 BENoRNARR /RSBERENCE POINT
L
D FILL REQUIRED:
THIS PERMIT IS NOT FOR ADDITION(s).
SPECIFICATIONS BY: PEDRO N OSPINA
APPROVED EY:
Pocaa u evrna
DATE /SAWED: 02/12/2010
DR 4016, 1O/97 (Prerrioue Editsion° May Be treed)
v 1 1 4
100 /100 I1
1 os - - 1.%. _ 89 71,
STATE OF FLORIDA
DEPARTMENT OF REALM
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
=: 215 SUBDIVISioN: Dunning 'Vital Shores Ext 5
900 ] GALLONS /GPD
0 ] GALLONS / GPD
0 ] GALLONS GREASE INTERCEPTOR CAPACITY
] GALLONS DOSING TANX CAPACITY
Seotic
TITLE;
TITLE:
Ar9ti2750 ,F9o7649
piozaT # :13 -SC- 1120759
APPLICATION # : AP952158
DATE MAID: ,
WM PAID:
RECEIPT #:
DOCUMENT 0: PR798894
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR T*Z ID NUMBER]
CAPACITY
CAPACITY
[ Main [MAXMainX CAPACITY SINGLE TANx:1250 GALLONS]
1eAZLONS ®L 1DOSES PER 24 ERS #Pumps [ ]
G 0.00 ] INCHES EXCAVATION REQUIRED: [ 20.00 ] =CEEB
1- , Existing 900 gal. septic tank certified by " Miami Dade Environmental " on 02/11/2010 to remain 2- Install 225 sf of
drainfield in trench configuration. 3- Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed
absorption trench. 4-Invert elevation of dralnfleld to be no Tess than 9.94' NGVD 5. Bottom of dralnfleld elevation to be no
less than 9.44' NGVD.
Dade CND
EXPIEiATION DATE: 05/13/2010
Paga 1 of 3
XVJ LO :OL OLOZ /6l /ZO
Primary Zone:
1000 SINGLE FAMILY
RESIDENCE
CLUC:
0001 RESIDENTIAL -
SINGLE FAMILY
Beds/Baths:
3/1
Floors:
1
Living Units:
1
AO Sq Footage:
1,643
Lot Size:
9,225 SO FT
Year Built:
1953
$50,000/
$230,123
36 52 41 PB 52 -33
City:
DUNNINGS MIAMI
Legal
SHORES EXT NO 7 LOT
Description:
6 BLK 215 LOT SIZE
75.000 X 123 OR 15655-
3051 09921 COC
22289 -2785 04 20041
Year:
2009
2008
Land Value:
Applied
Applied
Taxing Authority:
Exemption/
Taxable
Exemption/
Taxable
23161 -7040
Value:
Value:
Regional:
$50,000/
$230,123
$50,000/
$231,517
County:
$50,000/
$230,123
$50,000/
$231,517
City:
$50,000/
$230,123
$50,000/
$231,517
School Board:
$25,000/
$255,123
$25,000/
$256,517
Folio No.:
, . r • .1..'
2008
Land Value:
Mailing
MARUAN MARDINI
dress:
DAVID HARDY
r6 NE 109 ST MIAMI FL
$145,572
23161 -7040
Year:
2009
2008
Land Value:
$142,387
$216,176
Building Value:
$137,736
$145,572
Market Value:
$280,123
$361,748
Assessed Value:
$280,123
$281,517
Miami -Dade My Home
My Home
.'.. : a o,
Show Me:
Property Information
Search By:
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Cgmt arison
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Summary Details:
Property Information:
Assessment Information:
Exemption Information:
Taxable Value Information:
Sale information:
k ale Date: /2004
ACTIVE TOOL i'SSELECT
Digital Orthophotography - 2007
http: / /gisims2.miamidade .gov/MyHome /propmap.asp
Web Site
Q 2002 Miami -Dade County.
All rights reserved.
0 112 ft
My Home I Progeny Information I Property Taxes
I gqy Nelahborhood I Property Apirlser
Home 1 Using Our Site I Al2281 I Phone Directory I Privacy I Disclaimer
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Legend
Property
unny
Selected
Property
Street
Highway
Miami -Dade
County
Water
4E
2/19/2010
2009
2008
+ n: • - .:
$25,000
$25,000
Mr* il MERMEN
MEE
Miami -Dade My Home
My Home
.'.. : a o,
Show Me:
Property Information
Search By:
Select Item
Text only
Property Appraiser Tax Estimator
Property Appraiser Tax
Cgmt arison
Portability S.O.H. Calculator
Summary Details:
Property Information:
Assessment Information:
Exemption Information:
Taxable Value Information:
Sale information:
k ale Date: /2004
ACTIVE TOOL i'SSELECT
Digital Orthophotography - 2007
http: / /gisims2.miamidade .gov/MyHome /propmap.asp
Web Site
Q 2002 Miami -Dade County.
All rights reserved.
0 112 ft
My Home I Progeny Information I Property Taxes
I gqy Nelahborhood I Property Apirlser
Home 1 Using Our Site I Al2281 I Phone Directory I Privacy I Disclaimer
If you experience technical difficulties with the Property Information application,
or wish to send us your comments, questions or suggestions
please email us at W, e
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Legend
Property
unny
Selected
Property
Street
Highway
Miami -Dade
County
Water
4E
2/19/2010
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: David Hardy
PROPERTY ADDRESS: 251IE 109 St Miami, FL 33161
LOT: 6 BLOCK: 215 SUBDIVISION: Dunning Miai Shores Ext 5
PROPERTY ID #: 11- 2136 -011 -0380
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 8[ ]DOSES PER 24 HRS #Pumps [ 1
D [
R [
A TYPE SYSTEM: [X] STANDARD [ ] FILLED
I CONFIGURATION: [X] TRENCH [ ] BED [ 3
N
F LOCATION OF BENCHMARK: F.F.E. : 12.9' NGVD
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED:
0
T
E
R
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
225 ] SQUARE FEET
0 ] SQUARE FEET
1— Existing 900 gal. septic tank certified by " Miami Dade Environmental " on 02/11/2010 to remain 2- Install 225 sf of
drainfield in trench configuration. 3- Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed
absorption trench. 4- Invert elevation of drainfield to be no less than 9.94' NGVD 5. Bottom of drainfield elevation to be no
less•than 9.44' NGVD.
THIS PERMIT IS NOT FOR
SPECIFICATIONS B
[ 0.00 ] INCHES
APPROVED BY:
P o N ()spina
DATE ISSUED: 02/12/2010
EXCAVATION REQUIRED: [ 20.001 INCHES
DH 4016, 10/97 (Previous Editions May Be Used)
v 1.1 4,
SYSTEM
SYSTEM
AP952158
[ ] MOUND
9E807649
PERMIT #:
13-SC- 1120759
APPLICATION #: AP952158
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT. #: PR798894
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID. NUMBER]
[ 21.60 ] [I INCHES r FT ] [ ABOVE / BELOW h BENCHMARK /REFERENCE POINT
[ 41.60 ] [� INCHES I FT 1 [ ABOVE A BELOW h BENCHMARK /REFERENCE POINT
EXPIRATION DATE: 05/13/2010
Page 1 of 3
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Parcel Number
26 109 Street
Miami Shores, FL
1121360110380
Block: Lot:
MARUAN MARDINI
Owner Information
Address
MARUAN MARDINI
Contractor(s)
MIAMI DADE ENVIROMENTAL
Phone
786 - 251 -4099
Cell Phone
Type of Work: PLUMBING
Type of Piping: DRAINFIELD INSTALLATION
Additional Info:
Bond Retum :
Classification: Residential
Fees Due
Bond Type - Contractors Bond
CCF
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$300.00
$1.80
$0.60
$150.00
$3.00
$2.40
$457.80
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Phone
Invoice # Total Amt Paid Amt Due
PL -2 -10 -37046 $ 457.80 $ 457.80 $ 0.00
Check #: 2456 Bond #: 1927
Date
Expiration: 08/17/2010
Applicant
Celi
For Inspections please call:
(305)762 -4949
Available Inspections:
Inspection Type:
Final
Rough
Landscaping
1
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.
February 18, 2010
February 18, 2010 1
Owner's Address 4 E> LC1 q s r
City N(1 iA i k% SE4Ol LQ
Tenant/Lessee Name
Email
Contractor's Address 8290 /Ake D
Architect/Engineer's Name (if applicable)
Value of Work For this Permit $ a-q
Type of Work: ❑Addition \ ❑
Describe Work: b R Al 1. J Et P tcA \Z e PA k
Submittal Fee $ Permit Fee $
Notary $
Scanning $
Double Fee $
Structural Review. $
Radon $
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
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: PLUMBING
Owner's Name (Fee Simple Titleholder) p V Y 111 1.110Ap Phone # — a — 1 �®
State t 1
Job Address (where the work is being done) C ki E _ [Da S T
City Miami Shores Village County
FOLIO / PARCEL # I l- 713 &. -0 f j _ 'tea
Is Building Historically Designated YES NO D
Contractor's Company Name MA 14 t AI e FN ui r oo to Air A
City it / A 1 State r l& Zip S' / 4c
Qualifier Name A 0.. c: `tatijor
State Certificate or Registration No.5 R O 7117 c Certificate of Competency No.
Contact Phone - 7 g'62 . `. S 1 -1 0 a il E -mail
VOL.
Miami -Dade
* * * ** * * *** * * * * * * * * * * * *, * * ** * * ** * * * * * ** F ees * * * * ** * * * * * * * * * * *, * * *** * * *** * * * ** * * * * * ** ***
/ro CCF $ CO /CC $
Training/Education Fee $
Violation date:
Square / Linear Footage Of Work: 2 7 S
❑New RI Repair/Replace El Demolition
DPBR $
Permit No
Master Permit No.
Zip 1St&.
Phone #
Phone# 78(gr S, -ieo 99.
Phone # 78-62 -25(-
Phone #
Total Fee Now Due $
Zip %3 1(01,
See Reverse side -+
IN :I =WEB
FEB 16 2010 EY
•••
10 - a91-
Flood Zone
Technology Fee $
Bond $ 303. O%ZD
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
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 approved and a reinspection fee will be charged.
Signature
0 or Agent
(Revised 07 /10 /07)(Revised 06/10/2009)
State
Sign:
Print:
My Commission Expires:
Engineer
Zip
7I
• ' in ent was ackno
0 0, by
Signature
The foregoing instrument was acknowledged before me this The for
day of , 20 _ , by , day o
who is personally known to me or who has p roduc dd w . is personally kno
NOTARY PUBLIC -STATE OF FLORIDA
0 -mitIke . ntifivoi s se .i�;l glid take an oath.
.
NOTARY PUBL 1 x�it :
Commission #DD603343
'e., / Expires: OCT. 08, 2010
BOls'BrD MN ATLANTIC BOND1N r E0 DiC.
NOT
Sign:
Print:
PUBLIC: .
Ai A
1!'111
-- rte
My Commission Expires:
edged before
to me or who has produced
as identification and who did take an oath.
1
titter y�C f• T
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101
************ * *ir &*** ***&irie*k*k*k******** 9r*9e4rk**9e*aY +F9r,r9e**** *9e9e4r9e9e*** *3e*9e9rir4r*dr9r** ***fr9e9 **49.* a *�Yaki�ic�k9r***
g 1 ��'
APPROVED BY '' �� 7 ` ' Plans Examiner Zoning
Clerk checked
Scale: Each block represents 5 feet and i = 50 feet.
Site Plan submitted by:
Plan Approved
By
(O ' K 4 4'0
ALL CHANGES 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- 40154)
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMI
Permit Application Number
PART II SITE PLAN
Not Approved )
x tz_ ao
S �ar(ok►P,A(1 4 .
Title
Date O -
County Health Department
Page.2 of 3
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Scale: Each block represents 5 feet and i = 50 feet.
Site Plan submitted by:
Plan Approved
By
(O ' K 4 4'0
ALL CHANGES 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- 40154)
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMI
Permit Application Number
PART II SITE PLAN
Not Approved )
x tz_ ao
S �ar(ok►P,A(1 4 .
Title
Date O -
County Health Department
Page.2 of 3