PL-13-1110Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 194723 Permit Number: PL -5 -13 -1110
Scheduled Inspection Date: July 08, 2013
Inspector: Hernandez, Rafael
Owner: PERSUAD, MAHENDRA
Job Address: 8 NW 93 Street
Miami Shores, FL
Project: <NONE>
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1131010170080
Contractor: STATEWIDE SEPTIC CONNECTIONS Phone: (954)963 -0082
Building Department Comments
REPLACE DRAINFIELD
Infractlo
INSPECTOR COMMENTS
Passed Comments
False
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPE TIO FOR INSP- 191796.
July 05, 2013
For Inspections please call: (305)762 -4949
Page 33 of 33
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
FBC 20 t
Permit No.
Master Permit No. 1 3 °- 1 I 0
BUILDING
PERMIT APPLICATION
Permit Type: PLUMBING
JOB ADDRESS: r °A-9f 't 3 L' e t
City: Miami Shores County: Miami Dade Zip: 3 31 So
Folio/Parcel #: I ° K( 0 008,0
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple Titleholder):
(S6, t e)
Address:
NO Flood Zone:
M Ake d rc R &c,d
Phone #:
City: State: Zip:
Tenant/Lessee Name: Phone #:
Email:
CONTRACTOR: Company Name:L 3-cpt c''l Phone #: 6 C 1- 4 L3")
Address: ? Su 23 .S-firee.-E-
City: iY• re-NQ State: 7C Zip: 3 3c2-'3
Qualifier Name: Tee SC SO. 1 o -rn.rs Phone #:
State Certification or Registration #: S Cr 7 P 26 Z. Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ c Square/Linear Footage of Work:
Type of Work: ❑Address °Alteration °New jE(Repair/Replace
Rep I9ce .17(gi l
Description of Work:
°Demolition
* * * * * * * ** * * * ** u * *** * * * * * *** * ** Fees * * * * * * * * * * * * * * * * * * * * *** * *** * * ** * ** ** * * ** *
Submittal Fee Permit Fee $ /� Y CCF $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
CO /CC $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
g t
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 proved and a reinspection fee will be charged.
T
kSignature
Owner or Agent
The foregoing instrument was acknowledged before me this d 6
day of N\c ,20 ( 2),by Mclhe - Q.rcl Pe— qod
who is personally own to me or who has produced D r lJ
As identification and who did take an oath.
NOTARY PUBLIC:
The foregoing instrument was acknowledged before me this
day of N1 , 20 )9 , by ¶rS S
who is personally known to me or who has produced Pt--
as identification and who did take an oath.
Print:
My Commission Expires:
APPROVED BY
TERESA J SOLO ` r3�'
MY COMMISSION # EE1 •
EXPIRES November Oa, 20
Plans Examiner
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
C% • ty �� \4s�a�m m
Zoning
Structural Review Clerk
(Revised3 /12/2012XRevised 07 /10 /07XRevised 06 /10 /2009XRevised 3/15/09)
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
PERMIT # : 13-SC-1472504
APPLICATION #:AP1107E367
DATE PAID:
FEE PAID:
RECEIPT #•
DOCUMENT #: PR906544
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Mahendra & Minnachee Persuad
PROPERTY ADDRESS: 8 NW 93 St Miami, FL 33150
LOT: 8 BLOCK: SUBDIVISION: Canaday Extension
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
PROPERTY ID #: 11- 3101- 017.0080
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 BASI,3 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 [ 750 ] GALLONS / GFI) septic tank CAPACITY
A [ ] GALLONS / GF :3 CAPACITY
N [ ] GALLONS GREASI: INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY 1 ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [
D [ 150 ] SQUARE FEET trench configuration drainf SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [] MOUND [ ]
I CONFIGURATION: [x] TRENCH [ ] BED 1 ]
N
F LOCATION OF BENCHMARK: FFE 13.3' NGVD
1 ELEVATION OF PROPOSED SYi >TEM SITE 1 27.60 1 11 INCHES I FT 3 [ ABOVE /I BELOW li BENCHMARK /REFERENCE POINT
FT ] [ ABOVE 4 BELOW II BENCHMARK /REFERENCE POINT
E BOTTOM OF DRAINFIELD TO SE 1 57.60 ] 1
L
D FILL REQUIRED: [ 1 INCHES EXCAVATION REQUIRED: [ 30.00] INCHES
1.- Existing 750 gal. septic tank certified by Statewide Septic on 5/13/2013 to remain.
O 2.-Install 150 sf of drainfield in':rench configuration.
T 3.- Perimeter of excavation area shall be at least 2 ft wider and longer than the proposed absorption bed or drain trench.
4. -Invert elevation of drainfleld to be no less than 9.00' NGVD.
H 5. -Bottom of drainfield elevation to be no less than 8.50' NGVD.
E System sized for 2 bedrooms with a max occupancy of 4 persons (2 per bedroom), for a total est. sewage flow of
200GPD.
R
SPECIFICATIONS BY: Teresa J Solomon
TITLE: Master Septic Tank Contractor
Dade CHD
: �9ee"?1, TITLE: Engineering Specialist II
APPROVED BY:
Erlande pmieaa
DATE ISSUED: 05/16 /2013
DH 4016, 08/09 (Obsoletes all previous editions which may not be used),
Incorporated: 64E- 6.003, FAC
EXPIRATION DATE: 08/14/2013
v 1.1.4
AP11O7867 fff.:58
. VrAIT OF FLORIDiV: •
DEPARTMENT OF :KWH
APPL1C ATIOR FOR ONSITE SEWAGE DISPOSAL VS1`;',6:rt QONSTRUOTION PEAMIT
Permit Application
. • PART II $,ITE PLAN--
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Date 5h4,I20r:
County Health Departme
ALL CHANQES MUST BE APPROVED BY THE COUNTY.HEALTH DEPARTMENT
OH 4015, 10/06 (loptaces f435.1-1 Farm 4015 which 11 170 Used)
(SIO4 Number:5744-002-4015-5)
Page 2 of
10/15/2012 80:42 .9949899998
MAIZE AND TYSON
PAGE 89/09•
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10050 NE 2ND AVE
54M118 HORRSM FL 23138
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The Florida Department of Health hereby certifies the business or entity named below has satisfied the
requirements of Part ,III, Chapter 489, Florida Statutes, for septic tank contracting and has been duly authorized
by the Department to provide septic tank contracting services under the name of
March 19, 2013 March 31, 2015
Date Issued Expiration Date
Rick Scott Governor
DOEZ 4079, 1. 199?