PL-13-1117fr
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 191869 Permit Number: PL -5 -13 -1117
Scheduled Inspection Date: June 05, 2013
Inspector: Hernandez, Rafael
Owner: DENIS, JEAN -MARIE
Job Address: 310 NE 97 Street
Miami Shores, FL 33138-
Project <NONE>
Contractor: MC INVESTMENT GROUP INC
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Drainfield
Phone Number
Parcel Number 1132060135861
Phone: (786)294 -1987
Building Department Comments
INSTALLATION OF 300 SQ FT DRAINFIELD ON AN
EXISTING SYSTEM WITH A 900 GALLON SEPTIC TANK
CERTIFIED BY CONTRACTOR
Infractio Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
HRS IN FILE
June 05, 2013
For Inspections please call: (305)762 -4949
Page 16 of 47
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT
CONSTRUCTION INSPECTION
AND DIPOSAL SYSTEM
AND FINAL APPROVAL
APPLICANT:
AGENT:
. PROPERTY ADDRESS: $ Al. 7
LOT: ) BLOCK: V 3 SUBDIVISION:
z
P1130•Aivon
PERMIT NO. w /4427C7
DATE PAID:
FEE PAID:
RECEIPT #:
OPERTY ID
COMPLIANCE WITH STATUTE-OR RULE AND MUST.BE,CORRECTED..
2]
C SQFT
ER eV"
BM
.c
SETBACKS
[27] SURFACE WATER
(28] DITCHES. •
[29] PRIVATE WELLS
[30] PUBLIC WELLS
[31] IRRIGATION WELLS
[32] POTABLE WATER LINES
[33] BUILDING FOUNDATION
[34] PROPERTY LINES
[35] OTHER
FT
FT
.,. FT
FT
FT
(7 - FT
FT
•/ 7 FT
FT
FILLED / MOUND SYSTEM
[36] DRAINFIELD COVER ,
[37] SHOULDERS Ai (
[38] SLOPES _
[39] STABILIZATION
ADDITIONAL INFORMATION
.C401 UNOBSTRUCTED AREA
] [411 STORMWATER RUNOFF
] [42.] ALARMS.
] [43] MAINTENANCE AGREEMENT
] [44] BUILDING AREA '•
[451 LOCATION CONFORMS WITH SITE PLAN
[ 1 [46] FINAL SITE 0
] [47] CONTRACTOR
1. 1 [48] OTEitaz
• ABANDONMENT. .N/4 •
[49] • TANK PUMPED / /.
[501 TANK CRUSHED & FIILED / /
I
]
CONSTRUCTION PROVED ISAPPROVED] 4eeng, CHD. DATE: e, 3
/DISAPPROVED] :g..,,,,tAdat-v-q... CHD DATE: 6 — )-3
'INAL SYST
16, 08/09 (Obsoletes all previous editions which may not be used)
rated: 64E-6.003, FAC
Page 2 of 3
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
Permit Type: PLUMBING
JOB ADDRESS: 7j d - ct r 5
RECEIV
MAY 212013
BY: 1^"
FBC 20
Permit No. P) 13�' 11 n
Master Permit No.
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #: I( 1 ) - 0 (3
Is the Building Historically Designated: Yes NO Flood Zone:
33138
/176)
OWNER: Name (Fee Simple Titleholder): JCR, R, .'i/ S Phone #: �% e 5 a W
Address: 3 l 0 4) t�� - c
City: .4/i4 c `C rC S State: El �j' ' Zip: 3 / .3Y
( n `
Phone #: 4--
Tenant/Lessee Name: /'''1`
Email:
CONTRACTOR: Company Name: fh ( TAIL) Q 5 1C47 40(4 9 j urphone #: !1 T 4? " 4/
Address: [ S S `/ C W (6 7 57L- rr-�--�� / %
City: /14 r u "� 1 State: Eci 1 6 Zip: 2! 3 6
Qualifier Name: i4 r l� tie / C G 19 vi. e it R Phone #: l
State Certification or Registration #: C. & G Ica 7 be-f( Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ fo. Square/Linear Footage of Work: 3 C304
Type of Work: Address OAlteration , J� ONew
Description of Work: fkg ®', ®-C 2i C C
121‘pair/Replace Demolition
�rQ crdlCetc"'
* * * * * * *** ** * ***** * * *** * * * * * * * * * *** * * ** Fees *** * * * * *** * * ** * * ** r * * * ** * * **** * * * * * * * ****
Submittal Fee $ Permit Fee $ 1 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 115 •
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City a 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which oc rs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved 0 a reinspection fee will be charged.
Signature -r7,99'
.'
• 9 45 er or Agent
The foregoing instrument was acknowledged before me this /y
day of Ai'A , 20 (7., by ,,I.tr,oet.. C#43rzedrz ,
who is pers a ly known t e or who has produced
NOTARY P
Sign:
Print:
My Commission
/lion and who did take an oath.
co
6•
—
gesORIDAo ```�®`ve®
"lip11soittttt000`
* * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * ** * * **
APPROVED BY
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of
who is pe
A 201"7, by /1/6 1)•#"?.- G13aneru
me or who has produced
Plans Examiner
Structural Review
(Revised3 /12/20I2)(Revised 07 /10 /07XRevised 06 /10 /2009XRevised 3/15/09)
d who did take an oath.
na
rIl• °
Sign: m • r. °
Print: ,' � :' —
' ORIDA
My Commissio$
//11111►1100
Zoning
Clerk
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Jean -Marie Denis
PROPERTY ADDRESS: 310 NE 97 St Miami, FL 33138
LOT: 11
PERMIT #:13 -SC- 1472957
APPLICATION # : AP 1108169
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR906686
BLOCK: 43 SUBDIVISION: Miami Shores
PROPERTY ID #: 11- 3206 - 013 -5861
[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 [ 900 ] GALLONS / GPD Existing septic tank to remain. CAPACITY
A [ 0 ] GALLONS / GPD CAPACITY
N [ 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 300 ] SQUARE FEET bed configuration drainfiel SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND
I CONFIGURATION: [ ] TRENCH [x] BED [ 3
N
F LOCATION OF BENCHMARK: Crown of road, 9.85' NGVD
I
E
L
D
O
T
H
E
R
ELEVATION OF PROPOSED SYSTEM SITE
BOTTOM OF DRAINFIELD TO BE
FILL REQUIRED:
[ 0.00 ] INCHES
[ 0.24 ] ['INCHES f FT l 11 ABOVE' BELOW 3 BENCHMARK /REFERENCE POINT
[ 29.76 3 [I INCHES I FT 3 [ ABOVE 4 BELOW b BENCHMARK /REFERENCE POINT
EXCAVATION REQUIRED: [ 42.00] INCHES
Inspector to verify the existing septic tank is properly abandoned before final approval.
*Invert elevation of drainfield to be no less than 7.87' NGVD.
*Bottom of drainfield elevation to be no less than 7.37' NGVD.
"Install 12" of slightly limited soil under the bottom of drainfield.
- Perimeter of excavation area shall be at least 2 ft. wider and longer than the proposed absorption bed or drain trench.
'THIS PERMIT IS NOT FOR " ADDITION(s) ".
The system is sized for 3 bedrooms with a maximum occupancy of 6 persons (2 per bedroom), for a total estimated flow
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED: 05/17/2
TITLE:
TITLE:
Dade cHD
EXPIRATION DATE: 08/15/2013
4 . r ,4 �;N ;' d to perform a
DH 4016, 08/09 (Obsoletes all preys aceai.t.'ions which may d
Incorporated: 64E - 6.003, FAC SOO tiCrif i'�c vatit�i�i�� the
v $lme of final I'St+io is , "a i Approval, th' DOH
inspect Sic'i ano ;oinoaresll 8$03
reSL■t: the t,rit !ua; bit ! e‘n!uaticn subroitted. A
reinspw loh fer. , iil i::; Er`:S; :r:. ;i the contractor is not
at toe pbsiie al !i, u time.
Page 1 of 3
AC# 632.7063
STATE OF FLORIDA ' AC# 6327063
X1.,6 DEPARTMENT OF BUSINESS AND
PROFESSIONAL REGULATION
CFC1427648 08/31/12 127013904
CERTIFIED - PLING. CONTRACTOR
CABRERA, MIGIJ`EL
M C INVESTMENT GROUP, INC
IS CERTIF.IBD under the provisions s of Ch. 4.09 Fs
.'FhepiraEioa date,* AUG 31,' 2014 1i12083102955
THIS DOC,Uh9ENT HAS ACOLORED DACKCj30Up"; M4 "CROPRINTIY UNEM{1F3fC S P \TENTED PAPER
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
SEQ# L12083102955
LICENSE NBR
DATE
08/31/2012 ..127013904 CFC142764
Tfiist-41,1326iNGdONTRACT6PC.
Na
below TS CERTIFIED
nder the `provisions of Chapter
Expiration ::date: AUG .31, 2014 ,x
CABRNRA GUEL
'M C TNVSSTMENT GROUP, INC
15541 SW 163RD ST
MIAMI FL 33187-5219
.ICE . SCOTT'';
GOVERNOR
DISPLAY AS REQUIRED BY LAW
KEN LAWSON
SECRETARY