PL-08-556Inspection Date: 04/16/2008
Inspector: Levrock, James
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Owner: McCarthy, Thomas & Lisa
Job Address: 439 92 Street NE
Miami Shores, FL 33138-
Project: <NONE>
Contractor: BOBS SEPTIC & DRAIN INC
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Drainfield
CL-
Block:
Phone Number (305)754 -0119
Parcel Number 1132060140250
Lot:
Phone: 305 - 558 -5818
Building Dep
ment Comments
Replace nt of drainfield
1,
(1.04-
�a
`
�''.�R 1 7 :_:;
Passed
e tor
Com
ents
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Tuesday, April 15, 2008
Page 1 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATIO
FBC 2004
Permit Type: Plumbing
Permit No. �L og- rJJb
Master Permit No.
Owner's Name (Fee Si ple TitleholderT96/ 5' �� S� ifiaenk �
Owner's Address
City
>4°,3 iz s State .l .
Tenant/Lessee Name
E -MAIL: /"
Job Address (where the work is being done)
City Miami Shores Village
Zip 3-31V
5911,
Phone #
County Miami -Dade
FOLIO / PARCEL # G/ 52/,6 .J/042-- od
\t2
Is Building Historically Designated YES NO J
Contractor's Company Name
Contractor's A . dress
City L State--- , Zip l /
Qualifier Name / 4/2'111J Phone #
State Certifica . 49?-1/1 b Certificate of Competency No. ill/ }'J /
E -MAIL:
Zip ] 13
Architect /Engineer's Name (if applicable)
Value of Work For this Permit $
Type of Work:
Describe Work:
['Addition
['Alteration
Phone #
Square / Linear Footage Of Work:
['New
Repair /Replace
❑ Demolition
* x x x* x,wwwwwxxxx x* x w xxxxxr.xxr.xr.rx Fees W x x x'cxr, r. x>t r.rWW WW xxxkr.xxxxxxr.xW WWWWW .xxxr
Submittal Fee $ Permit Fee $ 1-7 5 W_
Notary $ •,OD Training /Education Fee $ 1) . 40
1 j. Scanning $ - .,00 Radon $ fWBR $
00
1til q Bond $ 3DD — Code Enforcement
Structural Review. $
CCF $ 110 CO /CC
Technology Fee $ 4. 37
Zoning $
Double Fee $
MAR 08 Total Fee Now Due $
S11»`'
''PQJ'r`ol
433 .y'7
See Reverse side —>
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 not be approved and a reinspection fee will b,e charged.
Signature Q/ /8,/, -
Owner or Agent
The foregoing instrument was acknowledged before me this 3f 3T
day of MMLM , 20 0 $, by Lei N01114 - &ccal y ,
who is personally known to me or who has produced n_
��- As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: KOAticc
ontractor
The foregoing instrument was acknowledge efore me this
day of /9,61 , 20 pi, by �4i/7 Th/tl /4
who is personally known to me or who has produced n. o0/3
L1G as identification and who did t e an oath.
�1
NOTARY PUBLIC:
My Commission Expires:
Sign:
Print:
\SSV0 bg��t+�`
Q�� pubCW�P�j,,.
My Commissi
xxxxxxx *x**xx * **
*X,:,: xx ,t *x x w,C x x x x Y. xx
*
,:wxx,,w * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
(Revised 02/08/06)
jvtt;(�r5 Examiner
Engineer
Zoning
t
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Thomas & Lisa H. McCarthy
PROPERTY ADDRESS: 439 NE 92 St MIAMI, FL 33138
LOT: 18
PERMIT #: 13-SG- 910062
APPLICATION #: AP852487
DATE PAID: 1/1/1899
FEE PAID: $55.00
RECEIPT #: 13 -PID- 1000797
DOCUMENT #: PR711716
BLOCK: 50 SUBDIVISION: Miami Shores Sec 2
PROPERTY ID #: 11-3206-014-0250
[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 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 [
A [
N [
K [
900 ] GALLONS / GPD
0 ] GALLONS / GPD
0 ] GALLONS GREASE INTERCEPTOR CAPACITY
] GALLONS DOSING TANK CAPACITY
Septic Tank
D [ 150 ] SQUARE FEET
R [ 0 ] SQUARE FEET
A
I
N
CAPACITY
CAPACITY
[MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
]GALLONS @[ ]DOSES PER 24 MRS #Pumps [ ]
Trench Configuration SYSTEM
SYSTEM
TYPE SYSTEM: [x] STANDARD [ ] FIT•T.FD [ l
CONFIGURATION: [X] TRENCH [ ] BED [ ]
F LOCATION OF BENCHMARK: FFE el .11.30" NGVD
MOUND [ ]
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED:
0
T
H
E
R
[ 28.80 ] [I INCHES 1 FT ] [ ABOVE /I BELOW BENCHMARK /REFERENCE
46.80 ] [I INCHES FT ][ ABOVE /)BELOW I] BENCHMARK/REFERENCE
[ 0.00] INCHES EXCAVATION REQUIRED: [ 30.00] INCHES
POINT
POINT
1.-Existing 900 gal. septic tank to remain.
2.-Install 150 sf of drainfield in trench configuration.
3.-Invert elevation of drainfield to be no Tess than 6.90 if NGVD.
6.-Bottom of drainfield elevation to be no less than 6.40 ft NGVD.
THIS PERMIT IS NOT FOR " ADDITION(s) ".
SPECIFICATIONS BY: Geri rd L P; filiz,. re
APPROVED BY:
DATE ISSUED:
TITLE:
TITLE: Engineer Specialist II
Dade CHD
EXPIRATION DATE: 06/26/2008
DH 4016, 10/97 (Previous Editions May Be Used) Page 1 of 3
v 1.1.8
A2852487 SE729098
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
,■=1 .M= ■=1 IM■ 1■It IIMMM
Permit Application Number
— PART II :SITE PLAN- — — —
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Site submitted by:"
Plan Approved V
By
TitI-
Date
County Health Department
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015. 1 (Replaces HRS-H Form 4015 whlek may be used
Page 2 of 3
pock No z5744-002,4015-6) -
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STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
•
. L..S4 4.1 j
' t �C
APPLICANT: 1". �! A ILA" lt„Z
AGENT:
PROPERTY ADDRESS'
•'7
LOT. 1 :^
BtOg
PERMIT NO
DATE PAID:
FEE PAID;
RECEIPT #•
AtitzaAS 7
Z--
CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE
TANK INSTALLATION
[011 TANK SIZE [1] , ? 0 2
(021 TANK MATERIAL
[03] OUTLET DEVICE
1041
(061 OUTLET FILTER
[06] LEGEND a �/ )G 7S'{° L
[07] WATERTIGHT
(08) LEVEL
[091 DEPTH TO LID
=
OR RULE
AND MUST BE CORRECTED,
MULTI - CHAMBERED [Y 1 N 1
DRAINFIELD INSTALLATION X L 0
[10) AREA [1. • I rO .(24. ,�_ �• SOFT ,lb...
(11) DISTRIBUTION BOX HEADER 1 [
[12] NUMBER OF DRAINLINES
(13) DRAINLINE SEPARATION 11
[14) MAINLINE SLOPE 0. 0 y
ON DEPTH OF COVER
(1 63 ELEVATION IABOV ELO BM
[17] SYSTEM LOCATION
[18] DOSING PUMPS
[191 AGGREGATE SIZE
[20)• AGGREGATE EXCESSIVE FINES
[21] AGGREGATE DEPTH
FILL / EXCAVATION MATERIAL
[22] FILL AMOUNT
[23] FILL TEXTURE
[241 EXCAVATION DEPTH
(25] AREA REPLACED
[28] REPLACEMENT•MATERIAL. ,... ,
30''
EXPLANATION OF VIOLATIONS / REMARKS:
I 1
I 1
[ 1
SETBACKS'
(27j SURFACE WATER
(28] DITCHES
129] PRIVATE WELLS.,
(30] PUBLIC WELLS
(311 . IRRIGATION WELLS 4 Q
(32] POTABLE WATER LINES, !.y'
(33] 'BUILDING FOUNDATION
(34] PROPERTY LINES - +3► FT
(35) '• OTHER' FT
ch
FILLED 7M UND SYSTEM
/t Cq. FT
viler FT
f•L FT
Pi(cl FT
FT
FT
FTrP
.ea►+�►�.aaiF.s fl; G�ibikd6�.i�,E► •siaau ,u.x� ...... r ,• u
(37) SHOULDERS
E381 SLQPE• •
(39] STABILIZATION
ADDITIONAL INFORMATION
[401 • UNOBSTRUCTED AREA ,: 7 • : • •
[41] STORMWATER RUNOFF
(42I' ALARMS"
(431 ; MAINTENANCE AGREEMENT
[44] BUILDING AREA
(451 . LOOCATIQN CONFORMS .WITH .SITE PLAN
[48] FINAL SITE GRADING
[471 CONTRACTOR 410t £ _
[48] OTHER
ABANDONMENT
1 1 ..:..149) TANK PUMPED •
1, • ] (50) • .TTNK CRUSHED CELLED — .,.�. __/ .
CONSTRUCTION [
PPROV
D/DISAPPROVED]:
FINAL SYSTEM [ 1C•1. /DISAPPROVED]:
CND DATE:
DH 4019 (Page 2), 10/97 (Previous Editions May Be Used)
Stock Number: 5744.002 -4018 -4
CHD DATE'
PT 1: Applicw1
PT 2: UretsuQr/Camsetor
P72: Building Onpai1ment
Pt 4: He**h DapMment
•
Pago 2 of 3
,ras++ P.P.