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DEMO-13-2482 A Inspection Worksheet n Miami Shores Village 'J `V s 10050 N.E.2nd Avenue Miami Shores,FL S Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number. INSP-202350 Permit Number. DEMO-11-13-2482 Scheduled Inspection Date: November 12, 2013 Permit Type: Inspector. Diaz,Osvaldo ' Inspection Type: Final Owner: LLERENA, MARK Work Classification: Plumbing Job Address:1550 NE 103 Street Miami Shores,FL 33138- Phone Number (786)981-1301 Project: <NONE> Parcel Number 1132050310110 Contractor: YERBILLAS SERVICES INC Building Department Comments REMOVAL OF PLUMBING Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid November 08,2013 For Inspections please call: (305)762-4949 Page 21 of 37 } f3r � t86 w --- _� APPLICATION #:A112059 STATE OF FLORIDA �� PERMIT #:13-SC-1495459 DEPARTMENT OF HEAL TH DEC 0 20'�'� DOCUMENT #:F[934029 ONSITE SEWAGE TREATME AND DIS OSA� SYS CONSTRUCTION INSPECT APPROV. DATE PAID:09/17/2013 FEE PA.M:80.00 RECEIPT #:13-PID-2265484 APPLICANT: Richard J Caccamise AGENT: Thunder Demolition PROPERTY ADDRESS: 1490 NE 101 St Miami, FL 33138 LOT: 3 BLOCK: SUBDIVISION: Dunnings Waterway ID#: 11-3205-035-0030 CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. TANK INSTALLATION SETBACKS [ 1 [01] TANK SIZE [1] [2] [ l [27] SURFACE WATER FT [ 1 [02] TANK MATERIAL [ l [28] DITCHES FT [ 1 [03] OUTLET DEVICE [ l [29] PRIVATE WELLS FT [ 1 [04] MULTI—CHAMBERED [ Y / N ] [ l [30] PUBLIC WELLS FT [ l [05] OUTLET FILTER [ 1 [31] IRRIGATION WELLS FT [ l [06] LEGEND 1. 2. [ ] [32] POTABLE WATER FT [ ] [07] WATERTIGHT [ ] [33] BUILDING FOUNDATIONS FT [ ] [081 LEVEL [ l [34] PROPERTY LINES FT [ ] [09] DEPTH TO LID [ ] [35] OTHER FT DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM [ ] [10] AREA [1] [2] SQFT [ ] [36] DRAINFIELD COVER [ ] [11] DISTRIBUTION BOX HEADER [ ] [37] SHOULDERS I l [12] NUMBER OF DRAINLINES 1. 2. [ l [38] SLOPES [ ] [13] DRAINLINE SEPARATION [ ] [39] STABILIZATION [ 1 [14] DRAINLINE SLOPE [ 1 [15] DEPTH OF COVER ADDITIONAL INFORMATION [ ] [16] ELEVATION [ ABOVE / BELOW ]BM [ ] [40] UNOBSTRUCTED AREA [ ] [17] SYSTEM LOCATION [ 1 [411 STORMWATER RUNOFF [ 1 [18] DOSING PUMPS [ l [421 ALARMS [ l [19] AGGREGATE SIZE [ 1 [43] MAINTENANCE AGREEMENT [ 1 [201 AGGREGATE EXCESSIVE FINES [ 1 [44] BUILDING AREA [ ] [211 AGGREGATE DEPTH [ ] [45] LOCATION CONFORMS WITH SITE PLAN FILL / EXCAVATION MATERIAL [ 1 [461 FINAL SITE GRADING [ ] [22] FILL AMOUNT [ ] [471 CONTRACTOR Slava Rychkov(Bear Plum) [ 1 [231 FILL TEXTURE I 1 [48] OTHER [ 1 [241 EXCAVATION DEPTH ABANDONMENT [ ] [25] AREA REPLACED [ 1 [49] TANK PUMPED 12/03/2013 [ 1 [261 REPLACEMENT MATERIAL [ 1 [50] TANK CRUSHED S FILLED 12!03/2013 Comments: CONSTRUCTION [ APPROVED / Dade CHD DATE: 12/03/2013 DISAPPROVED ]: Engirt S I le Gumba(Dade CHD) PIS' SYSTEM [ APPRD / DISAPPROVED 1: . Dade CHD DATE: 12/03/2013 ng n Fmc a Nicole um s e (Explanation Of Violations on follorviag page) ear g DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 2 of 3 EH Database v 1.0.1 AP1120669 EID1495469 y APPLICATION #:AP1120569 STATE OF FLORIDA PERMIT #:13-SC-1495459 DEPARTMENT OF HEALTH DOCUMENT #:F1934029 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:09/17/2013 FEE PAID:80.00 RECEIPT #:13-PID-2265484 Violation Number Comment DH 4016, 08/09 (Obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 2 of 3 EH Database v 1.0.1 481120569 EID1496469 I f` "E V9 t � an„ 'w�, i:- yyy k. d a� '°fi 5f n rx 00� x } t , iz i'3 c4_,�e`*� ,,r'C'd�:5s 2•a�S �.iyb�'G..` s'y,nlR+- a r`s err M' �§S�'ti's -n,�'r�l�, �' � 1s`�(,,y14��.��r ��4h`,i+ S i9 4 F' ,1�s,�,,`. - � f `�« i,;¢a3F�yrs.;��' s; f""" •S"iyr si 3"S�2+1il d .� 2��. 5E"� S fti # 5 �# 8 i ° s� `��:- �,� i ,�. 3 �6 ?�"a....i N^t y ✓ y7� ., t - � ,...a� i � h y � �� 1� ,r lh w�,�4 �� q 'r�� s � �� y kF�n YYta.�� ti ;•.�� • Miami Shores Village Buildin g Department De artm t 10050 N.E.Znd Avenue,Miami Shores,Florida 33138 m OCT 3 1 2013` Tel:(305)7951204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 Y`°°°°° °°°°°°°°°°°✓ FBC 20 La BUILDING Permitxo.liLmd) .7- 24&'2 PERMIT APPLICATION MRster Permit No. Permit Type: PLUMBING JOB ADDRESS: .��S-� U _ J J City:-- Miami Shores County: Miami Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: ,II OWNER:Name(Fee Simple Titleholder):_ i,��1.'9 ' ),' Address: City: State: lip: Tenant/L Name: Phone#• Emafi: CONTRACTOR Company Name: Phone#: Address: .t} �Q City: State• Zip?a�t C� QualifierName: e Phone#: State Certification or Registration#•Sic 1 q 2 3 ?_0 C? Certificate of Competency#• r CoMAPhonet Email Address. 1 DESIGNER:ArchitecUEngineer: Phone#: Value of Work for this Permit:1; Square/Linear Footage of Work: "" e 9 Type of Work: OAddress rl Alteration ONew OR epairAteplace �em 'tion Description of Work: A%30 iid& } ki% Ok Submittal Fee$ Per Fee$��• CCF$ CO/CC$ Scanning Bee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Educatiou Fee$ Technology Fee$ 4t, Double Fee$ Structural Review$ TOTAL FEE NOW DUE$_ 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 COMIVIENCEMENT." 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 appr ed and a reinspection fee will be charged. Signature Signature Owner or Agent Comractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of_—__--,20_,by day of .20_,by who is personally known to me or who has produced who is personally known to me or who had produced _ 4 z As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: ,•'' "'ya•, DNAYI VEGA Print DAMAYI VEGA :' MY COMM My commission gyp' b4 EXPIRES:April 1,2018 My Co ¢� EXPIRES:April 1,2015 p er' Bonded Thru Notary Pubic Wadenxdters ......... Bonded ThN Notary Public Underwriters :o• ant�taa�,k,kut,��t�a,�r,�r�raaaranr�rw�a gat,k,rr,k*eklefratka�r,ririrrx+ti+irairaw�air�tiat,ka r*,r�a,rtx,txar�r��tat,�aNr*rc,�rdt,�,gave,�rw,ir�iFara k,�r+r,ear,�,rrat*,r,r��o-�a,xt� APPROVED BY /J-S-1n Plans Examiner Zoning Structural Review Clerk (Rmised3/122012)(Revised 07/10/07)(Revised 06/102009)Re0ed 3/15/09)