PL-13-1481 08-14-'13 06:50 FROM- T-659 P0012/0013 F-877
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax:(305)756-8972
Inspection Number: I NSP-194543 • Permit Number: PL-7-13-1481
Scheduled Inspection Date:August 13,2013 Permit Type: Plumbing- Residential
Inspector, Diaz,Osvaldo
Inspection Type: Final
Owner. CHEE-AWAI,CAMILLE Work Classification: Drainfield
Job Address:1370 NE 103 Street
Miami Shores, FL Phone Number (305)710-3331
Project: <NONE> Parcel Number 1132050300080
Contractor; SR0061530 MR C'S PLUMBING&SEPTIC INC Phone:(305)651.7859
Building De adme -t Comme
INTA PE TIC TAN ND DRAINFIELD Infractlo Passed Comrrtents
INSPECTOR COMMENTS False
Inspector Comments
Passed HRS IN FILE
Failed
Correction
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
to-Inspection fee is paid
August 12,2013 For Inspections please call:(305)7624949
Page 13 of 51
Miami Shores Village
I
1 g JAIL 01 013
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
BUILDING Permit No._
PERMIT APPLICATION Master Permit NO.? *3 1
Permit Type:PLUMBING
JOB ADDRESS: " E�-�D 4 ;9-
City: Miami Shores County: Miami Dade Zip: 31 3
Folio/Parcel#: I1— 3d oS-° 630— 0080
—r
Is the Building Historically Designated:Yes NO Zoe — Flood Zone:
OWNER:Name(Fee Simple Titleholder): l� ;Cle 6�e6 6dk Phone#:
Address: 1-?2P9 ke Iva Sf
City: ` S State 5�_ Zip: momf Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: r C,f �`lo � Phone#: X0_1 1_1k5_fl
Address: IK.71Z .10J 1191&ja4/p
City: Azle— State: _Zip:
Qualifier Name: 61 � (. �//7ZL Phone#:
State Certification or Registration#: JAMM 0061 3f Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ c;2 t*/�V= � Square/Linear Footage of Work: !to—V
Type of Work: ❑Address ❑Alteration t ❑New 43Repair/Replace ❑Demolition
Description of Work: lit cv-h .411
������ xxxxxxxxx����xxxx�x�xxxxxxxxxxx�Feesx�xxx�xxxuxxxxxa�xx�xxxxxxx��x�x��xxxxxx+xxxx
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 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 fore mg instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ,20 j�,by CaAU—U1�• G h42`2 1-�, day of 20 L5,by }4 V 6C AL ,
who is person y known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: to Z Print s'
My Commissio g�ETTRIGK My Commission x
>k >keae< e<s< '*"�°;�'}!P Ty.Cr.t..r•„o @
' Wt ior"
#�- MY COMMSePtemer 4113
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BEE;,. lr= P Bded ThN an Y• ;a Oil
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APPROVED BY 7 (� Plans Examiner Zoning
Structural Review Clerk
(Revised3/1212012)(Revised(7/10/07)(Revised 06/10/2009)(Revised 3/15/09)
f
PERMIT #:13-SC-1480672
STATE OF FLORIDA APPLICATION #:AP1111989
DEPARTMENT OF HEALTH DATE PAID:
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID:
t CONSTRUCTION PERMIT RECEIPT #:
DOCUMENT #:PR910419
CONSTRUCTION PERMIT FOR: OSTDS Repair
APPLICANT: Camille Cheewai
PROPERTY ADDRESS: 1370 NE 103 St Miami, FL 33138
LOT: 8,7 BLOCK: 6 SUBDIVISION: Miami Shores Bay Park
PROPERTY ID #: 11-3205-030-0080 [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 I 1,350 ] GALLONS / GPD Septic CAPACITY
A I 0 ] GALLONS / GPD CAPACITY
N I 0 ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ]
D [ 400 ] SQUARE FEET SYSTEM
R [ 0 ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [x] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [x] BED I ]
N
F LOCATION OF BENCHMARK: FFE:5.9'NGVD
I ELEVATION OF PROPOSED SYSTEM SITE [ 16.80] [ INCHES FT ] [I BELOW]BENCHMARK/REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 22.20] [ INCHES FT ] [ABOVE JBELOW BENCHMARK/REFERENCE POINT
L
D FILL REQUIRED: 1 0.00] INCHES EXCAVATION REQUIRED: [ 51.00] INCHES
1.-Install a 1350 gal min,septic tank with an approved filter.
0 2.-The licensed contractor installing the system is responsible for installing the minimum cat f tank in ce
T with s.64E-6.013(3)(f),FAC. �@
H 3.-Install 300 sf of drainfield in bed configuration.
4.-Install 12"of slightly limited soil at the bottom of the drainfield. 00'j
E 5.-Perimeter of excavation area shall be at least 2 ft wider and longer th ted absorption bed.
R (Comments Continued on Page 2.) t�P
SPECIFICATIONS BY: TVs TITLE:
APPROVED BY: TITLE: Engineer Supervisor III Dade CHD
." Astrid V Edwards
DATE ISSUED: 06/27/2013 EXPIRATION DATE: 09/25/2013
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 AP1111989 SE902263
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• NOTICE OF RIGHTS
A party whose substantial interest is affected by this order may petition for an
administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such
proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for
administrative hearing must be in writing and must be received by the Agency Clerk for the
Department,within twenty-one(21) days from the receipt of this order. The address of the
Agency Clerk is 4052 Bald Cypress Way, BIN#A02, Tallahassee, Florida 32399-1703. The
Agency Clerk's facsimile number is 850-410-1448.
Mediation is not available as an alternative remedy.
Your failure to submit a petition for hearing within 21 days from receipt of this order
will constitute a waiver of your right to an administrative hearing, and this order shall become
a'final order.
Should this order become a final order, a party who is adversely affected by it is
entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings
are governed by the Florida Rules of Appellate Procedure. Such proceedings may be
commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the
Department of Health and a second copy, accompanied by the filing fees required by law,
with the Court of Appeal in the appropriate District Court. The notice must be filed within 30
days of rendition of the final order.