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PL-07-2433F d� Scheduled Inspection Date: February 26, 2010 Inspector: Hernandez, Rafael Owner: SENA, DION Job Address: 1301 N 104 Street Project: <NONE> Contractor: A AARON SUPER ROOTER Building Department Comments February 25, 2010 Miami Shores, FL 33138- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Phone Number Inspection Number: INSP -69145 Permit Number: PL -12 -07 -2433 For Inspections please call: (305)762 -4949 UV Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Drainfield Parcel Number 1122320300040 Phone: 305 -944 -8886 DRAINFIELD REPLACEMENT Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments 1 Page 9 of 11 BUILDING PERMIT APPLICATIO FBC 2004 Permit Type: Plumbing FOLIO / PARCEL # Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel, (305) 795.2204 Fax: (305) 756.8972 Permit No. FL 1 Z4A aster Permit No. Owner's Name (Fee Simple Titleholder) D1 Yj . CO( $one # Owner's Address 1301 N E o4 S City M Sid %e5 State �L Tenant/Lessee Name E -MAIL: Zip 3 6 Phone # Job Address (where the work is being done) ) 5° ) NE 104- . e-d Miami Shores Village County Miami -Dade Zip 331 3? City f 1 � o 0640 Is Building Historically Designated YES NO t� A A � S .� 0 (33) - y ��T6 Contractor's Company Name � hone # Contractor's Address Go 22. ,SOI 3.5 fi i City qtr State Zip3 Z3 Qualifier Name 550' In TO Type of Work: ['Addition Describe Work: State Certificate or Registration No. JS C O dO 64 Certificate of Competency No. E -MAIL: Architect/Engineer's Name (if applicable) Value of Work For this Permit $. 2- }� ❑Alteration a ['New DEC 0 5 2007 eKS417 MIAMI SHORES VILLAGE Phone # Square / Linear Footage Of Work: - 3 Cs iQce, 7 •rgkn Phone # Repair /Replace ❑'Demolition , deg:********* * * * * * ** * ** *de' ** * * * *de * * * * * * * ** F de***** * * * * * * * * * * * * * * * *de * * * * * * * * *de ** Submittal Fee $ Permit Fee $' 17 5 - CCF $ /'S6 CO /CC 1 Notary $ Training /Education Fee $ a40 Technology Fef $ '01 Scanning $ �'bo DPBR $ Zoning $ ' Radon $ Bond $ 51 #1607 Cod etc ,.� Double Fee $ Structural Review. $ Total Fee Now Due $ 4 g4.7 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. 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. 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 promise in good faith that a copy of the notice of commencement and construction lien law br whose property is subject to attachment. Also, a certified copy of the recorded notice of comet for the first inspection which occurs seven (7) days after the building permit is issued. In inspection will not be approved and a reinspection fee will be charged. AZZO - - -Sig tore Owner or Agent The foregoing instrument was acknowledged before me this day of Dfc , , by D r See, A who is personally known to me or who has produced {v • �.a Leiw ,, Se As identification and who did take an oath. NOTARY PUBLIC: APPLICATION APPROVED BY: (Revised 02/08/06) 'TERESA J. SOLOMON 'ow"' Comm# DD0733348 11/8/2011 a Sign: Print: My Commission Expires: *ww wwwwwwwww,c*, ******** ** wwwww w* wwwwww** ding $2500, the applicant must will be delivered to the person ent must be posted at the job site bsence of such posted notice, the Contractor The foregoing instrument was acknowledged before me this L"' day of D-ec. , 20 431, by 43h who is personally known to me or who has produced D L. C.... as identification and who did take an oath. NOTARY P[JBLI RAJ• - 1..440 Comm# DDO7 181. Sign: n �u a unannu m 116 Print: -�'�6 ton My Commission Expires: ww.** t********.***# dr4exx***** ***w***.*****,ti...*wwwwwkwwwww* /�'60Pla s Examiner Engineer Zoning Project Address Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 Building Department Copy Address Contractor(s) A AARON SUPER ROOTER Phone 305 - 944 -8886 CeII Phone Fees Due Bond Type - Contractors Bond CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Vo0 Amount $300.00 $1.80 $0.60 $175.00 $3.00 $4.37 $484.77 Authorized Signature: Owner / Applicant / Contractor / Agent "ype: Plumbing - Reside Work Classification: gi airfield Permit Status: APPROVED Parcel Number 1301 N 104 Street Miami Shores Village, FL 33138- 1122320300040 Block: Lot: DION SENA 1 Phone CATHY SENA 1301 NE 104 ST MIAMI SHORES FL 33138 -2661 1 Type of Work: DRAINFIELD Type of Piping: Additional Info: Bond Retum : Classification: Residential II DEC 0 5 2007 CK bit( MIAMI SHORFS VII 1 Ar,F Expiration: 06/02/2008 Applicant Available Inspections : December 05, 2007 Date CeII Valuation: Total Sq Feet: $ 3,000.00 0 1 Inspection Type: Final Landscaping Rough 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. Wednesday, December 5, 2007 1 APPLICANT: Dion & Cathy Sena LOT: 6 T [ A [ N [ K [ 0 T E 1 PROPERTY ID #: 11- 2232 - 030 -0040 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS Repair PROPERTY ADDRESS: 1301 NE 104 St MIAMI, FL 33138 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 1,050 ] GALLONS / GPD BLOCK: 1 SUBDIVISION: River Bay Park 0 ] GALLONS / GPD 0 ] GALLONS GREASE INTERCEPTOR CAPACITY ] GALLONS DOSING TANK CAPACITY D [ 375 ] SQUARE FEET R [ 0 ] SQUARE FEET A TYPE SYSTEM: [x] STANDARD I CONFIGURATION: [x] TRENCH N F LOCATION OF BENCHMARK: FFE 8.7 "" NGVD I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D FILL REQUIRED: [ 0.00 ] INCHES Septic CAPACITY PERMIT #: 13-SG- 661464 APPLICATION #: AP611620 DATE PAID: 11/30/2007 FEE PAID: $200.00 RECEIPT #: 13- PID- 668419 DOCUMENT #: PR512671 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ Trench Conflauration SYSTEM SYSTEM [ ] FILLED [ ] MOUND [ ] [ ] BED [ ] [ 6.00 ] [1 INCHES 1 FT ] [ ABOVE /) BELOW I) BENCHMARK /REFERENCE POINT [ 36.00 ] [I INCHES I FT ] [ ABOVE 4 BELOW b BENCHMARK /REFERENCE POINT EXCAVATION REQUIRED: [ 42.00] INCHES 1.-Existing 1050 gal. septic tank to remain. 2.-Install 375 sf of drainfield in bed configuration. 3.- Install 12" of slightly limited soil at the bottom of the drainfield. 4. -Invert elevation of drainfield to be no Tess than 6.20 ft NGVD. 5. -Bottom of drainfield elevation to be no Tess than 5.70 ft NGVD. THIS PERMIT IS NOT FOR " ADDITION(s) ". R SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: DH 4016, 10/97 previous Editions May Be Used) v 1 .1.4 TITLE: :Engineer Specialist II AP611620 8E525345 Dade CHD EXPIRATION DATE: 03/02/2008 Page 1 of 3 APPLICANT: LOT: 6 T [ A [ N [ K [ STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT FOR: OSTDS Repair Dion & Cathy Sena PROPERTY ADDRESS: 1301 NE 104 St MIAMI, FL 33138 PROPERTY ID #: 11 -2232- 030 -0040 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 1,050 ] GALLONS / GPD Septic 0 ] GALLONS / GPD 0 ] GALLONS GREASE INTERCEPTOR CAPACITY ] GALLONS DOSING TANK CAPACITY [ D [ 375 ] SQUARE FEET Trench Configuration SYSTEM R [ 0 ] SQUARE FEET SYSTEM A TYPE SYSTEM: [X] STANDARD [ ] FILLED [] MOUND [ ] I CONFIGURATION: [X] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: FFE 8.7' "' NGVD I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D FILL REQUIRED: [ 0.00] INCHES T H E R 1.- Existing 1050 gal. septic tank to remain. 2.- Install 375 sf of drainfield in bed configuration. 3.- Install 12" of slightly limited soil at the bottom of the drainfield. 4.-Invert elevation of drainfield to be no Tess than 6.20 ft NGVD. 5.-Bottom of drainfield elevation to be no less than 5.70 ft NGVD. THIS PERMIT IS NOT FOR " ADDITION(s) ". SPECIFICATIONS BY: Gerala' L Philiz APPROVED BY: DATE ISSUED: / 12/ BLOCK: 1 SUBDIVISION: River Bay Park v 1.1.4 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID NUMBER] CAPACITY CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] ]GALLONS @[ ]DOSES PER 24 MRS #Pumps [ ] [ 6.00 ] ( INCBES I FT ] [ ABOVE A BELOW b BENCHMARK /REFERENCE POINT [ 36.00 ] [1 INCHES I FT 11 ABOVE / BELOW b BENCHMARK /REFERENCE POINT EXCAVATION REQUIRED: [ 42.00] INCHES TITLE: TITLE: Engineer Specialist II AP611620 8E525345 PERMIT #: 13-SG- 661464 APPLICATION #: AP611620 DATE PAID: 11/30/2007 FEE PAID: $200.00 RECEIPT #: 13- PID- 668419 DocumENT #: PR512671 Dade EXPIRATION DATE: 03/02/2008 DH 4016, 10/97 (Previous Editions May Be Used) Page 1 of 3 CHD male: tacnblocKrepresents5feetand 1 inch.50feet. ir m -4-- 111ME ,, en , .„,, am t.17 1 nil , IL IR. ,.. 4. L.4....,...i...4._±...4.4_4_- II m U 1 11 - H - : win ,. • ,.. , ,_ NM SR - _ 21 - m IAS MLR - ' ili --- a ' illta 241 • X= OMII 111. m RR , IIII . 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Notes: Site Plan submitted. by: Plan Approved By j'r r DH 401S. 10416 (Ftsplaoss HRS4IFiNM 4015 which May be used) Pock Number, 6744-002-40154) STATEOF DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number 4 PART II - SITE PLAN • !I , i 4— - 4., 6 'c'• Signature Not Approved • :Lf" r •-S• • • ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT Title County Health Departme Page 2 oi