PL-12-1391 08-28-'13 06:39 FROM- T-701 P0013/0017 F-970
Inspeotion Workshoet
Miami 0.0rop Village
10aSQ'N1; :anti�xvenue.M 01 *Map.I
Pone;(3Q".�1785w274 Pxr
_402
Inspection Number:INSP-176348• Permit:N�tfber: PL� ''� 2-1:399
$oheduled Inspection[late:A410.ust 97,1613 Perr>�it`T s: P[unibin
Inspector:Diaz,Osvaldo YQ g . Re'stdentiai
inspection Typ¢a Final
Qwhot_ CARROLL,MMk ANv BARBARA WQrk'Clagslfication: septic
Job.Address:1461 NE 103,str,'eef
MAiamilhores,F1.13938206
Phone Number
Project: cNONE•,»
Parcel WOW 1132059310190
00 tiactor: M-2i_UMOING'4 SPRWKUR--*sERVIC'E Phone:(305)5125 79236
't3uildin,q Department Comments.
INSTALL NEW 300 DRAINFIELn.ON CERTIFIED SYSTEM
13Y CONTRACTOR 06b GALLON TANK
PEWIT'kLNEWED ON 8/21/9:3
I—VT 10 0*40 Or.Comments:Passed Has IN FILI=
Failed El
Correction
Needed
l te-Inspactfoh
Fee
NO Additional Inspect[ons Can be scheduled untq
#e fispedit fee 1s paid
Augutit Z%20,93 For Inspections please call:(306)782.4949
Page 2 of 30
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[ 7 1021 TANK MATERTAT.J _ ] 128} DITHE-S FT
I l [03] OUTLET DEVICE 1 [291 PRIVATE WELLS FT
C I [041 MULTI-CHAMBERED KDY / N l [ I [30] P19BY4IC WELLS FT
[ I 1051 OUTLET FILTER --.Al / [ ] [31] IRRIGATION.WELLS FT
I 1 [06] LEGEND W /.9 [ 1 [321 POTABLE WATER 14INES 6 U ' FT'
I ] [071 WATERTIGHT 2 [ ] .[331 BUILDING FOUNDATION '7 FT
[ 1 [08] LEVEL [ l [3 PROPERTY LINES s" FT
[ 1 [09] DEPTH TO LIT? �0 4][ 3 [35] OTHER FT
DRAINFIELD INSTAUaTIQN FILLED / MOQNA SYSTEM
[ ' I [10] AREA []I3®C7 [2] SQFT [.� [361 DRAINFIELD COVER
I l 1111 DISTRIBUTION BOX HEADER [.-1" [37] SHOULDERS
[ 7 [121 NUMBER OF DRAINLINES [-T [38] SLOPES
I l [13] DRAINLINE SEPARATION [ -1 1391 STABILIZATION
[' 1. [14] DRAINIINE SLOPE
C I [15] DEPTH OF COVER ADDITIONAL INFOMdLTION
[ I I163 ELEVATION [AB.OVE EI,O BM5-„.7. 8[ -T- [401 UNQBSTRUCTED AREA
[ ] [171 SYSTEM LOCATION-., [ j' [411 STORIMTER'RUli'OF'
[ ] [18] DOSING PUMPS / A 'm [ " [421 ALARMS O/C
C ] [19l AGGREGATE SIZE N j4 1 [43] MAINTENANCE AGREEMENT
VE
t l [20] AGGREGATE EXCESSI FINES 1 [44] BUILDING AREA
[ 7 [21] AGGREGATE DEPTH V Jyd [ -1- [45] LOCATION CONFORMS WITH SITE PLAN
[ --'Or [461 FINAL SITE GRADING A ,
FILL / EXCAVATION -MATERIAL [ -a- [47] CONTRACTOR �PAiH-aet.y.�V L
[ ] [22] FILL AMOUNT [ I [481 OTHER
I I [23] FILL TEXTURE "
I 7 [24] EXCAV'ATION•DEPTH ABANDONMENT
[ I [251 AREA REPLACED [ ] 1497 TANK PUMPED
[ 1 [26] REPLACEMENT MATERIAL .1 l 1 -I50.] TANK CRUSHED.& FILLED
EXPLANATION.OF VIOP TIONS / REMARKS: ,
t I •
CONSTRUCTION < PPROVE /DISAPPROVED] , , �,, h CM) DATE: '-2 - 3
FINAL SYSTEM IAPPRO /DISAPPROVED] CBD DAT$s -Z C)
DH .4016, 08109 (Obsoletes all previous editions which may not be used)
Incorporated, 64E-6.003, FAC Page 2 of 3
• s •�tF+
�f~
NEami. Shores Village JUL 2 4 2012 �
Building Department kl�---
10050 NX.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER;(305)762.4949
BUILDING Permit No. �l �i2 °
PERMIT APPLICATION Master Permit No.
FBC 20
OWNER:Name_(Fee Simple Tideholder): aAjaAjjA 14 Phonei_30 9,6-14,5
Address-_ l A14 �
City: ,Li �Vr� state: Zip; 0 3 1
Tenant) essee N Phone#:an
Email:
JOB ADDRESS: 3 ig
8
City: Miami Shores County: Miami Dade Zip:
Folio/Parcew 2.0
Is the Banding Historically Designated:Yes NO Flood Zone: a
CONTRACTOR:Company Name: �c�s�� ��JPi2y -c Phorie#c �f=�22 --�2
Address: ?- tJ •
City: & i.!E C'77 6F�J* State: lo – . Zip:s3 16
Qualifier Name:
Phone#:
State Certification or Registration Certificate of Competency'#:
Contact Phone#: Email Address:4,740 f��i►�� ��a, e„ �,.y
DESIGNER:Architect/Engineer: / T Phone#: r�° --
- .
Value of Work for this Permit.'s. qnuareAAnear Footage of Work:
Type of Work: OAddress OAlteration New, OR ai!R late
� a ODeraolition
�
Description of Work: '
�r� , t e:a a ,,► 'n s �.
r. M
kakkbk8a�ak8��Qa4�da4e kke kds��+kBidsBt$�$dwkk�Pd=��da � kdaR�Bs@Ead�sR�������8#i&Eck#'R���hd+�&���Yn$�dfi+�dsds8ds�
Submittal Fee$ Permit Fee$ '° CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
i
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 WORT,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 constriction 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$2500, the applicant,must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
Signature_,. Signature
Owner or Agent Contractor
The'foregoing instrument was ac wled ed before me s 3 The fore oing instrument was acknowledged before me this
day of ,20�,by _ day q
who is o y known to me or who has produced o is personally known to or who has produced
identification and who did take an oath. identification and who did take an oath.
NOTARY P C: NOTARY
Op
Sign: Sign: 3'
Print:
,.yy Cantu.Expires Aug J21015 e0ry'`� ��� OF?/0-4
My Commission Exp' I, o son Ex ` .�o octobe,.O'0830ISS
001yp
'NC a2
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
,.� D PERMIT #:13-SC-1408642
C APPLICATION #:AP1071334
STATE OF rLORSDA /,/
' Dl$PBRTMItiN'J' Or MMLTB DAM:
0 ffs
ITE SEW&= TROT AM DISPOSAL SYSTEM FEE PAID:
CONSTIWCTICN PERMIT RECEIPT #
• WWS Docor=T #:PR875124
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Mark Carroll
PROPERTY ADDRESS: 1461 NE 103 St Miami,FL 33175
LOT: 17 BLOCK: 6 SUBDIVISION:
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
PROPERTY ID #: 11-3205-031-0190 [OR TAX ID NUMBER)
SYSTEM MUST Re CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMEW APPROVAL OF SYSTEM DOES NOT GUARANTEE
SATISFACTORY pERrOgWWCE FOR ANY SPECIFIC PERIOD OF TIM$. ANY CHANGE IN MATERIAL STS,
WHICH SERVED -AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE XULL AMID VOID.
ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM CMELTANCB WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOniENT OF THIS PROPERTY.
n i r
SYSTEM DESIGN AND SPECIFICATIONS
T I 900 1 GALLONS / GPD SeptiC exiStinO CAPACITY
A L 0 I GALLONS / GPD CAPACITY
N [ 0 I GALLONS GREASE INTERCEPTOR CAPACITY DMXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GAL1"0 DOSING TANK CAPACITY I I GALLONS 6t IDOSKS PER 24 SRO #Pumps L ]
D [ 300 I SQUARE FEET all aya kdAe Space SYSTEM
R [ 0 3 SQUARE FEET SYSTEM
A TYPE SYSTEM: txI STRHDARD [ ] Fnim [ l MDUN D I ]
I CONFIGURATION: I I TRENCM L8I BED [ ] -
N
F LOCATION OF BEHCHMhRK: FFE*&4'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE 1 32.40 FT I[ABOVE BENCWWWgam POINT
E BOTTOM OF DRAINP"lELD TO BE t 58.80] IIJCHSS FT I I ABOVE J�BENCHS�RKI CE POINT
L
D FILL REQUIRED: t 0.00 I INCBES EXCUNATION REQUIRED: L 26.40] INCHES
-I rislall 300 sq ft cirainfield(a0 avaiaila*space).
O -Elevation of bottom of drainReld to be no Ids than 3.50'NGVD. The contractor for dftignee j Es required 20 perforn a
T -Exdsting 9W g septic tanK to remain. soil boring wiacRtnit w t)e dry infield excavation at the
-Not for additions time of final i,-ispeertim.°-for t.)rinai�ipproval,VIL i ic-
a inspector sl'3lt wi:nJss R a soil boring and compare[fie
results to the oriu1nal Site evaluation submitted.A
E reinspection fee Will be asse,see,if the i-,ontractor is nc
R at the jOWW at the arranged time..
SPECIFICATIONS BY: Hexuan Ed` •fig TITLE:
APPROVED BY :: Engineer Specialist II Dade CHD
DAIS ISSUED: 12 EXPIRATION DATE: 0$/07/2012
DR 4016, 08/09 (Obe tes all previous editions which may not be used)
1 of 3
Incorporated: 64E-6.003, PAC Page
v 1.1.4 A21071334 ss870096