PL-13-269Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 185584
Permit Number: PL -2 -13 -269
Scheduled Inspection Date: June 10, 2013
Inspector: Hernandez, Rafael
Owner: HARRIS, SANDRA
Job Address: 945 NE 98 Street
Miami Shores, FL
Project: <NONE>
Contractor: SR0061536 MR C'S PLUMBING & SEPTIC INC
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060143450
Phone: (305)651 -7859
Building Department Comments
DRAINFIELD INSTALLATION
Infractlo 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
Nis gK
June 10, 2013
For Inspections please call: (305)762 -4949
Page 7 of 25
DIVISION OF
Environmental Health
Florida Department of Health
Miami -Dade County Health Department ��
OSTDS /Well Division O
11805 SW 26 St. • Miami, FL 33175
Inspector' P Date - / ` / 3
Address.v
USTDS #
Comments:
Signature -� ��
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
F '"",'
Li
BY: eevaoomoemomo�000mm
FBC 20 01 1
Permit No. ��~
Master Permit No.
Permit Type: PLUMBING
JOB ADDRESS: q 4C NE ` 8 s
City: Miami Shores County: Miami Dade Tip: 7 3 1 3i-
Folio/Parcel#: Il — 3z of C 1te — 34S-0
Is the Building Ilistorically Designated: Yes NO Flood Zone:
OWNER: Name J me (Fee Simple Titleholder): � nO41 1 5 Phone#: 1 b 2� 1
��
Address: " 1 y RE . St
City: M; ; SIN.te4 state: Zip: 33 i3(4
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: Mr C's Plumbing and Septic phone# 305-651 -7859
Address: 19932 NW 2 Ave
City: Miami State: FL hp: 33169
Qualifier Name: Kemble Ettrick p 305 - 651 -7859
State Certification or Registration #: SR- 061538 Certificate ofCompetency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer:
Value of Work for this Permit $ aT 6►v + Square/Linear Footage of Work: cro/
Type of Work: OAddress OAlteration UNew IadRepair/Replaee DDemolition
Description of Work: Plki+t (\t' ant �IG-�. t�•A
Submittal Fee $ Permit Fee $-1-45—° CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
S
TOTAL FEE NOW DUE $ I (p2.,
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 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment Also, a certified ied copy of the recorded no ' ' commencement must be posted at the job site
for the first ' • . «+ection which occurs seven (7) days after the building permit Ls In the absence of such !sled notice, the
inspection �t be approved and a reinspection fee will be charged.
Signature
;
(J\L, g. s
Owner or Agent
The foregoing instrument was ac At . wledged before this O
day of 20 th by v # }15 Z`t
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
My Commission Expires:
n>Y ervy�, KEpA° f1TRt^Irr --
. *: MY COMMISSION It DD 891340
EXPIRES: September 14, 2013
• ........ Bonded Thru Notary Public Underwriters
* * *** *** &*& *** * ** * ** *** ** * ***
APPROVED BY
Contractor
The foregoing instrument was acknowledged before me this
day of :Mv , 20 /3 , by Mk64 a 4._
who is personally known to me or who has produced
✓ as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
PriatY '
My Commission Expires:
DONALD MARTnN
Y COMMISSION # EE09t 50
201E
******#**R********* *** *Pr.*a'i ****h4k ***+k*ax*s *** * **** **** k** * ***** +$ * * ***** ***IQs *R
/—I3 Plans Examiner Zoning
Structural Review
(Revise43 /12/2012)(Revised 07 /10/07)(Revised 06/10 /2009XRevised 3/15/09)
Clerk
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Sandra Harris
PERMIT #: 13-SC-1452419
APPLICATION # : AP 1095572
DATE PAID:
FEE PAID:
RECEIPT #:
DocUMENT #: PR895796
PROPERTY ADDRESS : 945 NE 98 St Miami, FL 33138
LOT: 19,20
13LOCK: 80 SUBDIVISION: Miami Shores Sec 3
PROPERTY ID #: 11- 3206- 014-3450
[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[
A [
N [
K [
900 ] GALLONS / GPD Septic existing
0 1 GALLONS / GPD
0 3 GALLONS GREASE INTERCEPTOR CAPACITY
] GALLONS DOSING TANK CAPACITY
D [ 300 ] SQUARE FEET
R [ 0 ] SQUARE FEET
A TYPE SYSTEM: [x] STANDARD
I CONFIGURATION: [ ] TRENCH
N
F LOCATION OF BENCHMARK: FFE : 12.70'ngvd
CAPACITY
CAPACITY
[MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
in trench configuration SYSTEM
SYSTEM
[ ] FILLED [ ] MOUND
[x] BED [
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED: t 0.00] INCHES
0
T
C 30.00 1 [i INCHES ' FT ] t ABOVE / BELOW ] BENCHMARK /REFERENCE POINT
0.00 1 [I INCHES 1 FT HI ABOVE 11BELOw ] BENCHMARK /REFERENCE POINT
EXCAVATION REQUIRED: [ 42.001 INCHES
- Install 300 sq if drainfield.
- install 12" of slightly limited soil under bottom of drainfield.
- Elevation of bottom of drainfield to be no less than 7.70' NGVI7.
- Existing 900 g septic tank, to remain.
- The system is sized for 3 bedrooms with a maximum occupancy of 6 persons,
for a total estimated sewage flow of 300 g /d.
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED:
DH 4016, 08/09 (Obs
Incorporated: 64E-
Kemble Ettr'•
L ..i�
3
The Cnntractor (or design ) is reouiracl to perform a
soil borint, adjacent to the taitlfl :ti excavation at the
time of final impection. !'rittr to Final d:oprovai,. the DOH
inspector shall witness the soil boring and compare the
results to the original site evaluation submitted. A
reinspection leo will be assessed it the contractor is not
at the jabsite at the arranged time.
TITLE:
: Engineer Specialist II
tes all previous editions which may not be used)
003, FAC
v 1.1.4 A21095572
Dade CHD
EXPIRATION DATE: 04/30/2013
SE888734
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