PL-13-1458 08-09-'13 06:33 FROM- T-650 P0001I0013 F-849
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone:(305)795-2204 Fax, (305)756-8972
Inspection Number: INSP-194391 Permit Number: PL-6-13-1458
Scheduled Inspection Date:August 08,2013 Permit Type: Plumbing-Residential
Inspector: Diaz,Osvaldo • Inspection Types Final
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Owner:
ALCIME,MIMOSE&BENEGTE
Work Classification. Drainfield
Job Address:226 NW 111 Terrace
Miami Shores, FL 33168-3325 Phone Number
Project: <NONE>
Parcel Number 1121360010630
•
Contractor: STATEWIDE SEPTIC CONNECTIONS Phone:(954)963-0082
Building Department Comments
REPLACE DRAINFIELD Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed LZ
115
Failed � •
Correction
Needed
Re-Inspection
Fee
No Additional inspections can be scheduled until
re-inspection flee is paid,
August 07,2013 For Inspections please call:(305)762-4949 Page 1s of 35
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Comments: »
Siglrattre .,••—•�
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Miami Shores Village
Building De
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10050 N.E.2nd Avenue,Miami Shores,Florida 33138 JUN 2 7 2013
Tel:(305)795.2204 Fax: (305)756.8972 IL
INSPECTION'S PHONE NUMBER:(305)762.4949'
C 20
BUILDING ' � � �
Permit No. � Ll
PERMIT APPLICATION Master Permit No.
Permit Type: PLUMBING
JOB ADDRESS: I ra ill T�-+A
City: Miami Shores County: Miami Dade Zip: 6 8
Foho/Parcel#: [1` 2r?)G -- 00 1 -,o(; '60
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Si/m'pie Titleho`lder):�A t�®gS °t �� ,�'- Phone#:
Address: ` �C(�tA l
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: � �\ f Phone#: -60J- 66G6631
Address: e0 Ja Siz 7" Y-t
City y� State: ` L Zip:_-7 ®°-3
Qualifier Name: l '� �`� 0-r`'i'an Phone#•
State Certification or Registration#: S m aq-1 1 2(; z Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer. Phone#:
Value of Work for this Permit:$ 2-5'3 0 Square/Linear Footage of Work: �® �
Type of Work: L[Address UAlteration ONew ORepair/Replace ODemolition
Description of Work:
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$
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 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 6r--Agent Contractor
The foregoing instrument was acknowledged before me this 21 The fore omg instrument was acknowledged before me thiol
day of Jtj rl e ,20C by OQIC-Cte- t41 C.t c'-%Ne day of & '., 20 by� Stlli s tQp
who is personally known tome or who has produced - who is personally known to me or who has produced '
P r 1 V (1C41tk As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
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Sign: Sign:
Print ® '' Print =
My Commission Expires: My Commission Expires:
1(407) T ERESA J SOLOMON � OR I D PIKES November 08,2015
rysendce.APPROVED BY - er Zoning
Structural Review Clerk
(Revis /12/2012XRevised 07/10/07)(Revised 0611012009)(Revised 3/15/09)
PERMIT #: 13-SC-1480600
STATE OF FLORIDA APPLICATION #:AP 1111947
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID:
CONSTRUCTION PERMIT RECEIPT #:
•��°"�` DOCUMENT #: PR910162
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Benecte&MimoSe Alcime
PROPERTY ADDRESS: 226 NW 111 Ter Miami,FL 33168
LOT: 15 BLOCK: 3 SUBDIVISION: New Miami Shores Estates
PROPERTY ID #: 11-2136-001-0630 [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 1 GALLONS / GPD Septic CAPACITY
A [ 0 1 GALLONS / GPD CAPACITY
N [ 0 I GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ J GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 200 1 SQUARE FEET SYSTEM
R [ 0 1 SQUARE FEET SYSTEM
A TYPE SYSTEM: [xJ STANDARD [ 1 FILLED [ J MOUND [ J
I CONFIGURATION: [ ] TRENCH [xl BED [ 7
N
F LOCATION OF BENCHMARK: FFE: 11.74'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 12.101 [ INCHES FT ] [ABOVE BELOW BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 52.1011 INCHES FT ] [ ABOVE BE L NCHMARKP�NCE POINT
L , 100
D FILL REQUIRED: [ 0.001 INCHES EXCAVATION REQUIRED:
1.-Existing 900 gal.septic tank,certified by"Statewide Septic on 06/20/20 c0�
D 2.-Install 200 sf of drainfield in bed configuration
T 3.-Invert elevation of drainfield to be no less than 7.90'NGVD. VO
4.-Bottom of drainfield elevation to be no less than 7.40'NGVD.
H The system is sized for 2 bedrooms with a maximum occupancy of 4 persons(2 per bedroom),for a total estimated
E sewage flow of 300 GPD.
'""""'THIS PERMIT IS NOT FOR ADDITIONS)
R
SPECIFICATIONS BY: Joe Lewis TITLE:
APPROVED BY: TITLE: Engineer Supervisor III Dade CHD
Astrid V Edwards
DATE ISSUED: 06/25/2013 EXPIRATION DATE: 09/23/2013
DH 4016, 08/09 (Obsoletes all previous editions which may not be used)
Incorporated: 64E-6.003, FAC Page 1 of 3
v 1.1.4 AP1111947 SE902054
I
11-1.01"Il[DA
DEPARTfIvIEN F OF HEAL l.i i
SPOSAL SYSTEM CON
APPLICATION FOR ONsi rE SEWAGE 01,
PAil 1 11 - :-31 IL: ',)LAN-
Sca,o: Each block represents 5 teet and I inch = 50 tout.
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17 31 Z'
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Apprcv-,d N,-)f Approv:.-d
ALL CHANGES MUST BE APPROVED BY THE COUNTY H.E.-:ALT I DE':P-"\q TMIENT