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PL-10-1391Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 163232 Scheduled Inspection Date: August 15, 2011 Inspector: Hernandez, Rafael Owner: WESENSTEN, JOHN Permit Number: PL -8 -10 -1391 Job Address: 1210 NE 100 Street Miami Shores, FL Project: <NONE> Contractor: MR C'S PLUMBING SEPTIC INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Drainfield Phone Number (305)757 -1457 Parcel Number 1132050090070 Phone: (305)651 -7859 Building Department Comments NEW DRAINFIELD INSTALLATION 400 SQ FT REMAINING TANK FOR 1050 SQ FT IN CAPACITY Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 149635. HRS IN FILE need to pick up permit August 12, 2011 For Inspections please call: (305)762 -4949 Page 36 of 36 DIVISION OF Enviromnental Health Lerida Department of Health M_ iami -i}ade County Health Department OSTDS/NIVell Division 11805 SW 26 St: • Dituld, FL 33175 Inspector •^•• --�( ,p Date Address /i /0 e .L:. . /dd c 11 sTDs# 1 f S7/? 3 S-17 Comments:. te/ -74% - 7n.4.„0, C S ter . Signature J�' `'°"- +,..4" --46/ DIVIS[Oit OF Envimnmentat M ii ,Florida Department of Health ami -Dade County Health Department OSTDS/Well Divhion 11895 SW 26 St: • Miami, FL 33175 *44 Inspector _.(�` Date P- 7' 2 0 f G Address /G L—. d � _' a TDs # .4 /' 2 %-Z 7 2 Comments: signature""''` ✓�Q -"� ti 0." 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 Permit No. V1 10—in Master Permit No. zawavisl ,i)G Ci 1 2011 /1)) BY : ....................... BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): Address: 1 0 Ni (© 0 S''' City: ,irGe- tvL.( irrOcqh Amy + V ��� 3 G� 7 3 3 g 762, a. Phone#. State: Zip: Tenant/Lessee Name: Phone#: Email: (Lwi W 10. r\'-\ C C 0 P'�N JOB ADDRESS: S C.-v r ,L- (t TUf l w s t) City: Miami Shores County: Miami Dade Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: (Y\ iL ° C S Phone#: Address: City: d 'tip, t State: Zip: ?3 c) Qualifier Name: gI �. q 4s 4 r y State Certification or Registration #: C ZZ. 1 teatin 1 Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: Zip: 75$ ,S ;z Phone#: Value of Work for this Permit: $ 24 a 00 Square/Linear Footage of Work: Type of Work: Address 4ati. ©Alteration UNew elRair/Replace Description of Work: Dry � ODemolition * * *** * *** ** ****** ** *** * *+ nee ***ua *********F * *** * ********** * * * * * ** *dew * * * ** * * *** **** * **** Submittal Fee $ Permit Fee $ f 0 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1 C r) - 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 F.IF,CTRICAL 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose properly is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Oar Agent Contractor The foregoing instrument was acknowledged before me this ( The foregoing instrument was acknowged befo this 1 day of )ui ,2011 , by , day of ,20 1 t , by UCkr ce to l'icj who is personally known to me or who has produced ® as identification and who did take an oath. NOTARY PUBLIC who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Exp' Mks%, MY COMMISSION # DD 591340 • s September 14, 2013 EXPIRES: Wu: Sep Punk Underwriters :a •�.. Bonded Wu Notary Sign: Print: My Commissio KEMBLE I ' ► F;, A. My COMMISSION # DD 891340 '<° EXPIRES: September 14, 2013 s` Bonded Thru Notary Public Underodters * * * ******** * **** **** ** ***** ** ,************************************************ ***** **** *****$H*$* *,s* * *** **** APPROVED BY —1 i Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06/10/2009XRevised 3/15/09) Zoning Clerk 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 No. 5MalEgWK111 at AUG 0 2 2,010 Ali BY: Master Permit No. Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): samki Pcamcc- OrcoN3L -753,2-70a Phone#: Address: /11C) IQE"` 015 St- City: Tenant/Lessee Name: Phone#: State: Zip: JOB ADDRESS: City: Folio/Parcel#: Is the Building Historically Designated: Yes r2-10 (o0 Miami Shores Comity: Miami Dade Zip: oStSg NO Flood Zone: CONTRACTOR: Company Name:01 r Ria-K1--61 v-+ ‘eP421C) Address: t 9 °I 5? Id° *QC City: ‘1"-fh State: • Qualifier Name: \.10k-l'A- "Fla )e State Certification or Registration #: Cr:s• 15 I Contact Phone #: Email Address: Phone#: 3os 6S I 1S-5/ Phone#: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ Atten, '90 Square/Linear Footage of Work: LlNew URepair/Replace CIDemolition Type of Work: LIAddress OAlteration Description of Work: 'CPC I y 1 leicr , ************************************Fees******************************************** Submittal Fee $ Permit Fee $ -74101°Y; c''.3 CCF $ g So . eac) Scanning Fee $ Radon Fee $ DBPR $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ CO/CC $ Bond $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Nanie (if applicable) i 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. 1 understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOII FRS, 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. "WA' '1 G 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 attaclunent. 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 l� Signature Owner or Agent Contractor The for oing instrument was acknowledged before me this The fore oing instrument was acknovwledg before the this 2 O 1(.h to day o - , 20 � 0, by day of �� , 20 �Q, by vQ � who is pe y known to me or who has produced who is personally known to me or who has produced p Pe As idea. .'on and who did take an oath. as identifica;,.n and ho did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Exp bt' A !rmo id ' CAMMISSI . EXPIRES: September 14. 20 1s .f BOflde d Thru Notary Public 01(1m/titers NOTARY PUBLIC. Sign: Print: My Con as LL 1" ¢OMMISSION # DD 891340 1 ° pIRES: September 14, 2013 Public Underwriters 7��+'`,•�' Bonded Thru Notary * * * * * **3.**** **** * * *** * * * **** * **** * * * *s **** ** `.** ******; eat **** * * * * ** ** * * * * *** tt * **** * * * * * *** * ** **** c* APPROVED BY I,IL ( 8- '1-/ "Plans Examiner Zoning Structural Review Clerk (Revised 07 /10/O7)(Revised 06/10/2009)(Revised 3/15/09) STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS Repair APPLICANT: Diane Wesensten PERMIT # :13 -SC- 1205908 APPLICATION #: AP972728 DATE PAID: FEE PAID: RECEIPT #• DOCUMENT @: PR816843 PROPERTY ADDRESS: 1210 NE 100 St LOT: 8 Miami, FL 33138 BLOCK: 1 SUBDIVISION: PROPERTY ID # : 11- 3205-009 -0070 [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 [ 1,050 ] GALLONS / GPD Septic CAPACITY A [ 0 ] GALLONS / GPD CAPACITY N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] A [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS @Pumps [ D [ 400 ] SQUARE FEET SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ 1 I CONFIGURATION: [ 1 TRENCH [x] BED [ 1 N F LOCATION OF BENCHMARK: F.F.E.: 12.5' NGVD I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D FILL REQUIRED: 0 T H E R [ 0.00 ] INCHES [ 30.00 3 [ 58.00 ] [ INCHES INCHES FT ][ ABOVEABELOW6BENCHMARK/REFERENCE POINT FT ][ABOVE `BE OWiBENCHMARK/REFERENCE POINT EXCAVATION REQUIRED: [ 40.001 INCHES 1— Install 1050 gal. category-3 septic tank equipped with an approved filter. 2 -The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with sec. 64E- 6.013(3)(f). 3- Install 400 sf of drainfield in bed configuration. 4- Install 12" of slightly limited soil under the bottom of drainfield. 5- Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed. 6 -Invert elevation of drainfield to be no Tess than 8.16' NGVD. 7. Bottom of drainfield e... an 7.66' NGVD.. THIS PERMIT IS NOT FO SPECIFICATION APPROVED i R TITLE: Pedro N Ospina DATE IS 07/20/2010 EXPIRATION DATE: 10/18/2010 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E- 6.003, FAC Dade CHD v 1.1.4 AP972728 9E822054 Page 1 of 3