PL-05-3226
Inspection Date: 02/13/2007
Inspector: Levrack, James
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Owner: PAGADOR, RECCIE
Job Address: 749 95 Street NE
Miami Shores Village, FL
Project: <NONE>
Block:
Contractor: A AARON SUPER ROOTER
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Drainfield
Phone Number
Parcel Number 1132060142140
Lot:
Phone: 305 -944 -8886
Building Department Comments
INSTALL NEW DRAINFIELD
q i/
FER14
C1
Passed
-; - tor Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Monday, February 12, 2007
Page 1 of 1
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: PL2005 -322
Printed: 11/4/2005
Plumbing Permit
Page 1 of 1
Applicant: RECCIE PAGADOR
Owner: PAGADOR RECCIE
JOB ADDRESS: 749 NE 95 ST
Contractor A ARON SUPER ROOTER
Local Phone: 305 - 944 -8886
Parcel # 1132060142140
Contractor's Address: 6022 S.W. 35 CT.
Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOT 14 & E1/2 OF LOT 13
BLK 68
Fees: Description Amount
FEE2005 -14121 Building Fee $175.00
FEE2005 -14122 CCF $1.80
FEE2005 -14123 Training and Education Fee $0.60
FEE2005 -14124 Technology Fee $4.40
FEE2005 -14125 Scanning Fee $3.00
FEE2005 -14126 Builders Bond $300.00
Total Fees: $484.80
Total Fees: $484.80
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 5/2/2006 Construction Value: $2,400.00
Work: INSTALL NEW DRAINFIELD
Signed: (INSPECTOR)
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND D
CONSTRUCTION INSPECTION AND Fl
APPLICANT: /2
SAL SYSTEM
APPROVAL
PERMIT NO.
DATE PAID: fl^
FEE PAID /QL9 c-9 K>
RECEIPT #:
5,--
PROPERTY ADDRESS: �V% /1f • E
LOTy BLOCK:6 SUBDIVISION'
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST
BE CORRECTED.
TANK INSTALLATION cb
[01] TANK SIZE [1]/®C.)
[02] TANK MATERIAL
[03] OUTLET DEVICE
[04]
[05]
[06
[07]
[08]
[09]
MULTI - CHAMBERED N ]
OUTLET FILTER N/+
LEGENDN
WATERTIGHT
LEVEL
DEPTH TO UD /
DRAINFIELD INSTALLLA�TI N
[10] AREA [1� [2].•14 3,• QFT
[11] DISTRIBUTION BOX HEADER
[12] NUMBER OF DRAINUNES
[13] DRAINUNE SEPARATION
[14] DRAINUNE SLOPE
[15] DEPTH OF COVER `� ■
[16] ELEVATION M 4' s 3
[17] SYSTEM LOCATION
[18] DOSING PUMPS
[19] AGGREGATE SIZE JY/ -1,,
[20] AGGREGATE EXCESSIVE FINES
[21] AGGREGATE DEPTH N 1 4
FILL / EXCAVATION MATERIAL
[2J
[23]
[24]
[25]
[26]
FILL AMOUNT /2.
FILL TEXTURE
EXCAVATION DEPTH
AREA REPLACED
REPLACEMENT MATERIAL
EXPLANATION OF VIOLATIONS / REMARKS:
SETBACKS
[27] SURFACE WATER ' FT
[28] DITCHES FT
[29] PRIVATE WELLS FT
[30] PUBUC WELLS FT
[31] IRRIGATION WELLS i FT
[32] POTABLE WATER LINES FT
[33] BUILDING FOUNDATION S' FT
[34] PROPERTY UNES f FT
[35] OTHER FT
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
[45] LOCATION CONFORMS WITH SITE PLAN
[46] FINAL SITE GRADING
[47] CONTRACTOR
[48] OTHER -
322.
ABANDONMENT
] [49] TANK PUMPEDIL/ 1 /(i S
1 [50] TANK CRUSHED & FILLED / L
CONSTRUCTI [APPRO ED/DISAPPROVED]: /42 ' C
h'1 if
FINAL SY
D/DISAPPRQVED]:
D14 4016 (Page 2), 10/97 (Previous Editions May Be Used)
Stock Number. 5744-002-4016-4
CHD DATE /I '° Y -o
CHD DATE:// - V- a
Page 2 of 3
PT 1: Applicant
PT 2: Installer /Contractor
PT 3: Building Department
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APIIICATION
FBC 2001
Permit Type (circle): ! Building Elec
Owner's Name (Fee Simple Titleholder) go,( e,
Owner's Address
City State Zip
Tenant/Lessee Name
Permit No:4-0' -32
aster Permit No.
lumbin ? Mechanical Roofing
Phone#
Phone #
Job Address (where the work is being done) 1 i ► 1 E- I
City Miami Shores Villa e County Miami -Dade
Is Building Historically Designated YES NO
Contractor's Company Name P ka vo
Contractor's Address dO a Z S•4) 3 s C-1-
City AA 1.r a y• AV State
Qualifier ..lot f t/1 To
Zip y>
,,Stye ® fione # 4t-1 - 6
ZiZ a
State Certificate or Regis
tion No. SEPQ 00648' Certificate of Competency No.
Architect/Engineer's Name (if applicable)
$ Value of Work For this Permit
Type of Work: DAddttion
Describe Work:
�2tf-ou-
A Phone #
Square Footage Of Work: 2 ZS
['Alteration DNew Repair/Rep-lace D Demolition
•
Submittal Fee $
Notary $
Scanning $ 3. CO
Code Enforcement $
* ** * * * * * * ** * * * * * * * * * ** * * ** ** Fees * * ** * * * *** * * * * * * * * * * * * ** * * ** **
Permit Fee $ 1-7 S CCF $ 1 . SC) CO /CC.
raining/Education Fee $ d- icCD Technology Fee $ 4 .40
Radon $ Zoning Bond $ c30 • C D
Structural Plan Review. $
Total Fee Now Due $4 9-8 4 - 80
(Continued on opposite side)
NOV 0 3 PAID
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 com cement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. 1 e absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
Sign
Owner or Agent ,
The foregoing instrument was acknowledged before me this
day of Flt •, 20 cqs, by is c®
who is pers
NOTARY
Sign:
Print:
- I 1 •
ho.,has_pLoctuced
Asfden�ifcaii 4tpdnaVpho'/ id take an oath.
n °Rf
UZ e, al
--
`PBk�.�r ; 9,
A1)0.1 NOTAFtl° FL
Signature
The foreg
day of
who is p
Contractor
wleded before me this
w apt ? U�
,f T F�
j.9WMON .
o 'Oloww w,�ip,h pro , uced
9.816 iVOAAAY . FaN• 1;....
Pi
,•r
1 1
nvcifb
NOTARY PUBLJC.
Sign:
Print:
My Commission Expires:
'd take an oath.
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * ** ft * * * * * * * * * * * * * * * * * * * * * * * * ** *, *********************,>:*,* * * * * * * * * *** * * * * * * * * * * * * ** * * ** **
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED B
Chc 05/13/03
**************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
V \ / d Y 6 Plans Examiner
Engineer
Zoning
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR:
[ ]New System [ ]Existing System [
[ X ]Repair [ ]Abandonment
CENTRAX #: 13 -SG -26969
DATE PAID:
FEE PAID : $
RECEIPT .
OSTDSNBR : 05-3536--R
]Holding Tank [ ] Innovative Other
]Temporary [ NA ]
APPLICANT: Pagador, Reccie & Velasco, AAGENT: SR091112, Tuffy John
PROPERTY STREET ADDRESS: 749 NE 95 St Miami FL 33138
LOT: 13 BLOCK: 68
SUBDIVISION• Miami Shores Sec 3
[Section /Township /Range /Parcel No.]
[OR TAX ID NUMBER]
PROPERTY ID #: 11- 3206 - 014 -2140
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC
DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME
PERIOD. 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 PROPERTY DEVELOPMENT.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 900 ]Gallons SEPTIC TANK
A [ 0 ]Gallons
N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY
K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS
D [ 225 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R [ 0 ]SQUARE FEET SYSTEM
A TYPE SYSTEM: [ N ]STANDARD [ N ]FILLED
I CONFIGURATION: [ N ]TRENCH [ N ]BED
N
F LOCATION TO BENCHMARK: EFF E]..:10.60'NGVD
MULTI - CHAMBERED /IN SERIES: [Y ]
MULTI - CHAMBERED /IN SERIES: [Y ]
@ [0 ]DOSES PER 24 HRS # PUMPS[ 0 ]
[ N ]MOUND [ N ]
[ N ]
I ELEVATION OF PROPOSED SYSTEM SITE [ 1.5 ] [ FEET
E BOTTOM OF DRAINFIELD TO BE [ 4.0 ] [ FEET
L
D FILL REQUIRED: [ 0.0 ]INCHES
OTHER REMARKS:
] [ BELOW] BENCHMARK /REFERENCE POINT
] [ BELOW] BENCHMARK /REFERENCE POINT
EXCAVATION REQUIRED: [ 30.0 ] INCHES
1.- Install 225 sf of drainfield in trench configuration.
2.- Existing 900 gal. septic tank ,certified by "A Aaron super rooter on 10/25/2005 " to
remain.
3.- Invert elevation of drainfield to be no less than 7.10' NGVD.
4.- Bottom of drainfield elevation to be no less than 6.60' NGVD.
THIS PERMIT IS NOT FOR "ADDITION(s)."
SPECIFICATIONS BY: Andre, Paul �.;� TLE:
rte'_
APPROVED BY: Andre, P TITLE: Professional Engin Dade CHD
DATE ISSUED: 11/3/05 EXPIRATION DATE: 2/1/06
DH 4016, 03/97 (Obsoletes previous editions which may not be used)
(Stock Number: 5744- 001 - 4016 -0) (ostds_cons_4016 -11
Page 1 of 2
STATE OF FLORIDA
- k DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT 1 f"--
Permit Application Number
PART II - SITE PLAN-
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Site Plan submitte
Plan Approved
By
i
Signature
Not Approved
Title
Date
County Health Department
ALL CHAN S T BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015, 1W90 (Replaces HRS-H Form 4015 which may be
(SW& Number: 5744-002-4015-6)
Page 2 of 3