PL-12-2154Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 181539
Scheduled Inspection Date: April 01, 2013
Inspector: Hernandez, Rafael
Owner: CANNATA, SEBASTIAN
Job Address: 622 NE 98 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: STATEWIDE SEPTIC CONNECTIONS
Permit Number: PL -11 -12 -2154
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060171830
Phone: (954)963 -0082
Building Department Comments
REPLACE DRAIN FIELD ONLY
11/14/2012 - PENDING LIC AND INS. (UPDATE NOTE
WHEN RECEIVED)
Infractio
INSPECTOR COMMENTS
Passed Comments
False
Inspector Comments
Passed
EJ/
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspection can be scheduled until
re- inspection fee is paid.
EL0 -3 L000/E000d Z0E -Z
-WO€i3 LZ : 90 ET,-Z0-D,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
FBC 20 c3
BUILDING Permit No.
PERMIT APPLICATION Master Permit No. P�,� -z,�. Z (SI
NOV 14 2012
Permit Type: PLUMBING
G2Z N E 98 Street
JOB ADDRESS:
City: Miami Shores County: Miami Dade
Folio/Parcel #: 1 '3 ZOG —0f-1-18 30
Is the Building Historically Designated: Yes NO
Zip: 33/38
Flood Zone:
OWNER: Name (Fee Simple Titleholder): 5'e -b2.0 ► Qn CO nn crio. Phone #:
Address: CO22,_ 1.1E GO at
City: M'iQev 1 ShOreS State: Zip: 231 38
Tenant/Lessee Name: Phone #:
Email: r 1 il `� te. o C Z 6 l
`r9 £ I Phone#: --31G61,.. C G
CONTRACTOR: Company Name: Jte r c, C�
Address: s. 2- SL 2
City:
P"A tV� c" State: Zip:
Qualifier Name: Ter Sc C. 1 i Phone #:
State Certification or Registration #: `c FOR h L ,2, Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone t:
3 225
Value of Work for this Permit: $ 2 700 700-- Square/Linear Footage of Work:
Type of Work: Address °Alteration UNew =',` epair/Replace
Description of Work:
f Igce Dwrco 7 % -eta nlj
❑Demolition
************ ** **** * **** n**** ** **** **** Fees********************** ******a:***** * * *** *** **
Submittal Fee $ Permit Fee $ /5-0 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
• Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
Zip
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature. ; �.� --�.``
® Owner or Agent
The foregoing instrument was acknowledged before me this 4+"'
day of NOV , 2012-, by e. bc-S'tl tAn CA 6m-i-it-c
who is perso ally known to me or who has produced 011 V°
(� As identification and who did take an oath.
NOTARY PUBLIC:
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * **
APPROVED BY
Signature,
Contractor
e
The foregoing instrument was acknowledged before me this ' '1
day of N°4 20 IL,, by —f:%
who is personally known to me or who has produced �t
as identification and who did take an oath.
NOTARY PUBLIC:
OMON
QOMMIS$IQN # EE131931 p
EXPIRES November 08. 2015 v
398.0163 FlorltleNoraryServlce.00m
int:
y Commission Expires:
**************************************** * * * * * * * * * * * * * * * * * * * * * *x�x�*���`
��i
F \\ \`
Zoning
Plans Examiner
Structural Review
(Revised3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Clerk
1 2 - t,5(1
.
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT:
Sebastian Cannata
PERMIT #: 13-SC-1438657
APPLICATION #: AP 1087833
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #:PR889079
PROPERTY ADDRESS: 622 NE 98 St Miami, FL 33138
LOT: 9,10 BLOCK: 101 SUBDIVISION: Miami Shores Sec 4
PROPERTY ID #: 11- 3206 - 017 -1830
[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.
WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO TO FACTS,
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NIFY ID.
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 [
750 ] GALLONS / GPD Septic existing
0 ] GALLONS / GPD
0 ] GALLONS GREASE INTERCEPTOR CAPACITY
] GALLONS DOSING TANK CAPACITY
D [ 225 1 SQUARE FEET
R [ 0 ] SQUARE FEET
A TYPE SYSTEM: [x]
I CONFIGURATION: [x]
N
F LOCATION OF BENCHMARK:
CAPACITY
CAPACITY
[MAXIMUM CAPACITY SINGLE TANK :1250 GALLONS]
]GALLONS @[ ]DOSES PER 24 HRS #Pumps [
in trench configuration SYSTEM
SYSTEM
[ ] FIT.T,FD [ ] MOUND
[ ] BED [ ]
STANDARD
TRENCH
FFE: 11.44'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED:
0
E
R
[ 0.00 ] INCHES
[ 26.00 ] [I INCHES ( FT ] [ ABOVE 4 BELOW b BENCHMARK /REFERENCE POINT
[ 72.04 1 [I INCHES Y FT ] [ ABOVE 4 BELOW 1) BENCHMARK /REFERENCE POINT
- Install 225 sq ft drainfield in trench confi
- Elevation of bottom of drainfield to be no
- Existing 750 g septic tank, to remain.
- The system is sized for 3 bedrooms with
f t I
guration.
EXCAVATION REQUIRED:
less than 5.43' NGVD.
a maximum occupancy of 6 persons,
or a ota estimated sewage flow of 300 g /d.
- Not for additions
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED:
AL
DH 4016, 08/09 rsoletes all previous
Incorporated: 64E- 6.003, FAC
v 1.1.4
[ 46.00 ] INCHES
00
TITLE:
TITLE: Engineer Specialist II
editions which may
.P1087833
not be used)
EXPIRATION DATE:
5E882571
Dade CHD
02/04/2013
Page 1 of 3
ATE 'FLORIDA
DEPARTMENT OF HEALTH •
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION F)ERMfT'
Permit Application N iu;mbell*, • /
PART II SITE PLAN- •
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Site Plan submitted by:
Plan Approved
By
Signature
Not Approved
Title
Date
County Health Departme
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
014 4015. 10/96 (Replaces HRS-14 Form 4015 which may be used)
(Stock Number: 5744-002-4015-6}
Page 2 of